As British Columbians experienced the first real heat wave of 2024 over the past week, residents in some rural communities were faced with the reality that immediate emergency care may not be available to them if they needed it. 

Throughout the Interior Health region, a shortage of doctors and nurses temporarily shuttered emergency rooms at five hospitals at least once between July 5 to 10. Each closure lasted between 10 and 48 hours and forced anyone who needed urgent medical attention during that period to travel outside of their community, up to several hours away. 

Health Minister Adrian Dix attributed the temporary shutdowns to an unusual surge in health-care workers calling in sick, saying about 20,000 were off over the past week. But the issue of unreliable emergency room access is one rural B.C. communities have been dealing with for far longer. 

鈥淭his isn鈥檛 a new situation, it鈥檚 one that鈥檚 been decades in the making," said Paul Adams, the executive director of the B.C. Rural Health Network. 

Health-care resources have gradually been falling behind health-care demand for years, slowly creating critical shortages provincially, nationally and beyond. The impact of that is felt everywhere, but Adams said rural areas always bear the brunt of it. 

Attracting doctors and nurses to small or far-flung communities is difficult. Not many people want to uproot their lives from the urban centres where they studied and rural hospitals often don't offer the equipment or capabilities for fresh graduates to practise the skills they have just specialized in, Adams explained.

Those that do choose a rural community can end up overworked and burned out because resources are stretched so thin. And, if working conditions are bad, Adams said people aren't likely to stick around for long. 

Two communities that have felt the impacts of this acutely are Port Hardy and Alert Bay on the northern tip of Vancouver Island. Both communities' emergency departments have been closed overnight since January 2023 due to a lack of staff. Anyone needing immediate care overnight there has had to travel to Port McNeill 鈥� a 30-minute drive largely without cell service from Port Hardy and an hour boat ride from Alert Bay. 

Port Hardy Mayor Pat Corbett-Labatt said people were horrified when the decision came down a year and a half ago. It's not just that they have to go further for help, Corbett-Labatt said, but that the care offered elsewhere is now more strained and takes longer too. She had to go with a family member to the Port McNeill Hospital a couple of weeks ago and said the emergency room there "was slammed."

鈥淭hey were run off their feet.鈥�

The emergency room in Central Saanich, in the south of the Island, is also closed overnight indefinitely, there since July 2023. 

Elsewhere in the province, the closures are more erratic, making it even more difficult for residents to know where they may be able to get help if an emergency occurs. 

In the Northern Health region, emergency rooms have had to suddenly close for brief stretches over the last month in Chetwynd, Dawson Creek and Fort Nelson. Prince Rupert's emergency room has been steady recently but closed at least eight times in March. 

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The city's mayor, Herb Pond, said the ever-changing situation has residents on edge. 

鈥淭here鈥檚 a certain nervousness that I鈥檝e heard people express."

Pond said they're losing physicians faster than they can replace them. And it's not just emergency room doctors he's concerned about. Prince Rupert doesn't have a walk-in clinic, so when there's a shortage of family doctors, many people are relying on the hospital for everyday issues. 

"It鈥檚 being used in a way it was never really designed to be used.鈥�

Perhaps the most outspoken mayor on the issue has been Merritt's Michael Goetz. He's been tracking the closures for his community of 7,000 people and says their Nicola Valley Hospital and Health Centre has temporarily closed its emergency room 23 times since the start of 2023. 

When the hospital isn't an option, Goetz said, the burden is transferred onto paramedics. And when they're busy transporting patients to emergency rooms an hour or an hour-and-a-half away, the community can suddenly be left with no nearby ambulances.

In those situations, Goetz said it's then firefighters who have been stepping in to provide residents with emergency first aid. 

It's because of this drain on city resources that Goetz said he is preparing to bill the province. By his calculation, B.C. owes Merritt about $84,000 for the 19 emergency room closures in 2023. At the end of 2024, Goetz said he'll send the province another bill for this year's closures. 

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Beyond that, Goetz said he would like to see the province drop its COVID-19 vaccine mandate for health-care workers, which, according to a , resulted in the firing of 2,496 people.

The Merritt mayor said he also thinks it may be a good idea to contract doctors and nurses who are trained in B.C. to stay in the province for at least two to three years after graduation, so they aren't immediately head-hunted elsewhere. Or, like the RCMP does, Goetz said perhaps new graduates should automatically be placed in communities in need. 

Adams, the executive director of the B.C. Rural Health Network, said he would like to see the province further remove barriers for foreign-trained doctors and speed up the process on allowing physician assistants into emergency rooms.

He said he sees the province taking action 鈥� increasing medical school residency spots, offering rural relocation incentives, building a new school at Simon Fraser University and slowly better resourcing the B.C. Ambulance Service 鈥� but that they simply need more. 

And, importantly, Adams said steps forward need to be considered with a rural lens. He's pushing for the Ministry of Health to create a division devoted to rural health-care access. 

"We need equity," he said. 

Asked about the ongoing closures, a spokesperson for the Ministry of Health cited its Health Human Resources Strategy, which devotes close to $1 billion over the next three years to strengthening the health-care system. They also noted that the government has added 40,000 net new health-care workers since 2017.

In speaking with reporters on the issue on Tuesday (July 9), Premier David Eby said "every single British Columbia deserves high-quality care, regardless of where they are."

But, he admitted, delivering that care is far more challenging in rural and remote places. 

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