Thirty years strong: Sandy Lake First Nation and Sinai Health’s partnership is tackling diabetes and driving lasting change

Pictured above. An early consultation meeting with key community stakeholders that paved the way for the launch of the Centre for Diabetes Monitoring, Management and Education. Mary Mamakeesick is pictured at the front in a grey hooded sweatshirt, with Dr. Anthony Hanley second from the left.

Nestled in the remote northern reaches of Ontario, where the Severn River winds through vast stretches of boreal forest, lies Sandy Lake First Nation (Neh gaaw saga'igan). This fly-in Indigenous community, home to approximately 3,000 residents, is accessible only by plane or, for a few brief weeks each winter, by ice roads that span frozen lakes and rivers. 

For centuries, the people of Sandy Lake thrived as hunters and gatherers, living off the land with diets rich in wild game like moose and rabbit, along with roots, berries and herbs gathered from the marshlands. This way of life demanded physical strength, endurance and a deep connection to the land. 

However, in recent decades, rapid cultural and lifestyle changes have introduced new challenges for the community, including a devastating rise in Type 2 diabetes.
This issue extends far beyond Sandy Lake, mirroring a global crisis where Indigenous populations face disproportionately higher rates of diabetes. The root causes are complex, shaped by historical trauma, systemic inequities and significant barriers to accessing health care.

By 1991, the diabetes rate in Sandy Lake had skyrocketed to 25 per cent of the population. The community knew it was time to confront this crisis head-on— sparking the beginning of a transformative partnership with Sinai Health.

Listen first, act later: Dr. Anthony Hanley’s guiding philosophy

In response to the escalating health crisis, the Chief and Council of Sandy Lake reached out to experts at the University of Toronto, starting with Dr. Stewart Harris, who directed medical services in the region. They were quickly connected with Dr. Bernard Zinman, a trailblazer in diabetes research at Sinai Health and a leader at the renowned Leadership Sinai Centre for Diabetes. With its expertise in managing complex diabetes cases and serving over 20,000 patients annually, Sinai Health was uniquely positioned to help.

From the outset, the partnership prioritized culturally-informed care. Dr. Anthony Hanley, who took primary responsibility for the project, immersed himself in the community, living in Sandy Lake for two and a half years to build trust and gain a deep understanding of its unique needs. 

"It was life-changing for me. I still have many friends—lifelong connections, really,” says Dr. Hanley, reflecting on the experience. “It was remarkable on so many levels and eye-opening in ways I hadn’t imagined.”

His guiding principle became clear: listen first, act later.

Dr. Hanley's approach was grounded in recognizing the community's rich cultural heritage and the impact of colonization on Indigenous health outcomes. This understanding laid the foundation for designing diabetes prevention and management programs that were not only effective but also led by the community itself.

Launching the Centre for Diabetes Monitoring, Management and Education

A pivotal moment in the journey to combat diabetes in Sandy Lake came in 2018, when the decision was made to establish the Centre for Diabetes Monitoring, Management and Education. This decision followed extensive consultations with the community, who expressed a clear need for a dedicated space in Sandy Lake to address the growing health crisis.

The Centre, made possible through generous support from BMO, was set to open in February 2020. While the COVID-19 pandemic delayed its launch, the Centre ultimately opened its doors fully in 2022, becoming a vital resource for the community.

The Centre operates five days a week, offering a safe and supportive environment for community members to access essential services, such as point-of-care testing for blood sugar levels, kidney health and nerve damage (neuropathy) using non-invasive methods. 

Immediate test results enable Mary Mamakeesick, a Registered Practical Nurse at the Centre, to coordinate closely with the local nursing station, ensuring timely and effective follow-up care. This model offers personalized monitoring tailored to individual needs while also removing barriers to health care by providing consistent, community-based support. 

Additionally, the Centre offers regular screenings for community members, including children and adolescents, to help prevent the early onset of Type 2 diabetes. 

Mary’s lived experience, combined with her language skills and specialized diabetes training, makes her an invaluable resource. Her culturally sensitive approach to diabetes education—covering everything from management and nutrition to medication—is empowering residents to take charge of their health. 

"For many Indigenous communities, there is a deep hesitation toward the health-care system, rooted in historical experiences like colonialism and residential schools,” explains Dr. Hanley.  “The Centre bridges that gap by providing community-based care that builds trust. If someone has high blood sugar or concerning kidney readings, Mary can connect them directly with the nursing station—something that might not happen without that intermediary."

Community-led initiatives making a difference

The Sinai Health-Sandy Lake partnership has had a profound impact, significantly improving not only access to care but also diabetes knowledge and awareness within the community. 

The collaboration has spurred various initiatives, including:

• Walking Trails: A 6-kilometer trail encourages physical activity.
• Healthy Eating Education: Partnering with Sandy Lake’s sole grocery outlet, healthier food choices are promoted through more nutritional labelling and in-store events.
• School Programs: A culturally adapted curriculum for grades 3 and 4 teaches children about healthy living and diabetes prevention. This successful program is now being shared with other Indigenous communities. 

With impressive groundwork already laid in improving diabetes awareness and addressing its root causes, the focus now shifts to expanding and enhancing these efforts.

Plans include developing an educational greenhouse to provide fresh produce and hands-on learning opportunities in sustainable agriculture, expanding the school curriculum to reach both younger and older students, and conducting a door-to-door survey to assess diabetes and other chronic diseases in Sandy Lake. These initiatives will guide the next phase of health interventions, furthering the community’s progress toward long-term well-being. 

“I’m grateful to be part of this work.”

When partnerships are rooted in trust, cultural respect and community leadership, the results can be extraordinary. 

Dr. Hanley reflects, “First Nations are sovereign, and they determine what happens on their land. If they weren’t happy with us, we wouldn’t still be here. The fact that we’re listening to each other and co-creating solutions together has been critical to both the success and the longevity of this work.”

The unique collaboration between Sinai Health and Sandy Lake goes beyond simply implementing programs—it’s about cultivating deep, enduring relationships that drive meaningful, lasting change.

Dr. Hanley maintains regular visits with Sandy Lake, travelling from his home base in Toronto two to three times a year.

He continues to be deeply inspired by the community’s strength and leadership. “When I feel overwhelmed or defeated by the challenges we’re facing, returning to see the community’s energy, focus and dedication re-energizes me,” he says. “I’m grateful to be part of this work and the progress we’re making together.”

How you can help

To ensure initiatives like this continue to thrive, we rely on the generosity of donors. Philanthropy is a critical driver in transforming health outcomes and creating lasting change.

Donate today to support Sinai Health’s highest-priority initiatives. To contribute directly to the Sandy Lake-Sinai Diabetes Partnership, please select this option from the gift designation dropdown menu.