Shawana Pharmacy creates better pathways to care for Indigenous communities

Shawano Pharmacy is a place of trust, dignity and community-driven healing for Indigenous patients in northern Manitoba, underpinned by a unique ownership model. Since opening in 2018, Shawano Pharmacy in Winnipeg has been supporting the communities of the Southwest Resource Development Council (SERDC) with medications and medical supplies.

About 90% of patients live on reserve land across Manitoba, with a growing number living off-reserve in Winnipeg and surrounding areas. The pharmacy also provides supports to several health centres, including harm reduction programs and community-based homecare centres.

As up to 85% of patients are in remote communities, the pharmacy works with two local air carriers equipped with proper cold-chain provisions to ensure that the medications and supplies shipped weekly arrive safely. Th e pharmacy also provides pharmacist-led medication reviews and counselling virtually, and coordinates care with other providers as needed.

The eight First Nations that comprise SERDC are equal shareholders in the pharmacy and receive proportional profit-sharing based on the pharmacy’s transactions. The pharmacy invoices the Council for its services.

Every interaction with Indigenous patients starts by listening first, she explains. “You cannot know how to help until you understand what is really going on in someone’s life,” she says. Factors such as housing, food security, transportation, caregiving responsibilities, and ability to get to appointments significantly affect patients’ ability to take medications and maintain health. “These realities are at the heart of health and yet are often invisible in the healthcare system.”

For example, if a parent doesn’t have a fridge for storing insulin, this is not seen as non-compliance but as a barrier that needs solving through practical solutions (i.e., insulated coolers). Using Jordan’s Principle (established by the Canadian HumanRights Tribunal to ensure First Nations children do not face gaps, delays, or denials in accessing government services because of their identity), pharmacists help eligible patients connect with community nurses and others to get the support they need.

“These are not personal failures; they are systemic barriers, and our job is to help families navigate them,” says Nafez. Through regular pharmacy outreach days in the community and ongoing relationships with community leaders, nurses and home care programs, the pharmacy has earned members’ trust. “Families began reaching out to us earlier in their care journey, which to me is one of the clearest signs that we are moving in the right direction,” says Nafez.

While there is just one Indigenous employee (who is studying to be a pharmacy technician) among the 18 full- and part-time staff in the dispensary, there are 12 full- and part-time Indigenous community workers who live on reserve. These employees pick up medications, send them from the airport, and arrange for deliveries to the patient or trustee.

Two full-time and six part-time pharmacists proactively reach out during crises, such as the recent wildfire evacuations. “We went directly to the evacuation sites,” says Nafez. “We ensured people had their medications in hand, that children on weekly or monthly injections did not miss a single dose, and that anyone with questions about their treatmentcould speak to us face to face.”

Beyond medications, pharmacy staff poured their efforts into stabilizing families when every part of their lives was disrupted: housing, food, safety and access to care. “It was about calming fears, explaining options, and making sure no one slipped through the cracks while far from home. These moments reflect what social determinants of health really mean in practice. They remind us why we do this work: to stand in the gap when the rest of the system feels out of reach and ensure that families have continuity, dignity and trust in their care,” says Nafez.

The first Indigenous pharmacy-led clinic

Later this year, Nafez will open what is believed to be Canada’s first Indigenous pharmacy-led clinic, which will bring together a pharmacist, a nurse practitioner and a registered pharmacy technician working side by side, anchored within Shawano Pharmacy.

Families will be able to walk in for same-day prescribing services, lab work, chronic disease management and children’s immunizations. “We knew this kind of model could be life-changing for Indigenous families here, especially those falling through the gaps between provincial and federal services,” says Nafez. When needed, patients can receive care virtually from a physician.

Looking ahead, she hopes to add a registered social worker to address deeper challenges faced by First Nations families, offering services such as substance-use counselling and mental health support for youth and caregivers.

For Nafez, the concept of social prescribing is intrinsic to the work of Shawano Pharmacy. “It is not an add-on to pharmacy, it is the work,” she emphasizes. “You cannot separate someone’s health from their living conditions, food or finances.”

But there are caveats to ensure success. “Pharmacists cannot keep doing this quietly in the background,” she warns, noting that these services need to be supported within the system. “Right now, it often feels like this work is expected but not resourced.”

To remedy this, Nafez points to the need for proper supports. “With the right structures in place, pharmacies across the country could then connect patients to food programs, cultural supports, harm reduction and mental health services as naturally as we counsel on medications.”

This article is reprinted from CFP’s 2025 Changing Face of Pharmacy report, mailed to more than 14,000 community pharmacies in Canada in November 2025. A pdf version is also available.