Nunatsiaq News
LETTERS: Around the Arctic May 02, 2018 - 1:15 pm

TB commentary harmed the morale of GN health workers

“I do not think Giles’ commentary was intended to harm the morale of those who are working towards the eradication of TB … but it did.”

This is a close-up of a Mycobacterium tuberculosis culture, showing the bacteria that lead to TB, which infected Nunavummiut in 2016 at a rate nearly 180 times greater than among non-Indigenous Canadian residents. (PHOTO COURTESY OF THE CENTRE FOR DISEASE CONTROL/DR. GEORGE KUBIC)
This is a close-up of a Mycobacterium tuberculosis culture, showing the bacteria that lead to TB, which infected Nunavummiut in 2016 at a rate nearly 180 times greater than among non-Indigenous Canadian residents. (PHOTO COURTESY OF THE CENTRE FOR DISEASE CONTROL/DR. GEORGE KUBIC)

Dr. Sarah Giles’ recent commentary contains much accurate, factual information and could have been a reasonably good basic introduction to the issues surrounding the tuberculosis crisis in Nunavut.

However, the overtly lecturing style and the context of the piece seem to imply that the people managing this tragedy aren’t aware of the severity of the epidemic and are not practising all of the complex TB protocols she mentions. Guess what? They are!

Just because screening, contact tracing and diagnosis is logistically complex and time-consuming and is not yet complete, doesn’t mean that it isn’t being done.

Unfortunately, there is no platoon of trained, Inuktitut speaking, culturally sensitive health workers that can be parachuted in at a moment’s notice. Despite that lack, the GN, together with its partners, managed to pull off, in very short order, the screening of almost every person in Qikiqtarjuaq—one of our hardest hit communities.

If Giles had talked to her medical colleagues here in Nunavut, she would have learned much, and could have relayed that information to your readers. So much for educating and advocating for the people of Nunavut.

Instead, she gave the impression to readers that we are bumbling idiots that need to be saved by some “experts” from away.

Secondly, Giles makes conclusions that are not warranted by the evidence she presents. Giles concludes that “the real crux of Nunavut’s TB problem is the ... incomplete database.”

Unquestionably, the database issue is important and is newsworthy along with the “embedded” access to information scoop.

Is it the “crux” of the problem? How can the reader know, if no other opinions were referenced in the article?

Is it not possible that completing that particular database with near perfect accuracy in the short term was nigh on impossible and that—ethically and practically—screening, diagnosis, and treatment can and must continue with the imperfect but still useful information that has been collected in other databases?

Giles spends considerable time attempting to persuade the reader of her expertise by listing her accomplishments, and with the concluding attestation of her non-affiliation with organizations that would seek to profit from our tragedy.

While she is undoubtedly accomplished, as far as I am aware, Giles has no specific expertise in managing a TB epidemic, nor has she described having experience working in Nunavut.

Rather than persuade us of her expertise and selfless advocacy, she could have used that time to seek and present good evidence-based arguments for the conclusions she both makes and implies. You don’t even need to be a doctor to do that kind of public advocacy reporting.

Finally, I simply do not accept that Sarah Giles couldn’t find a source to go on the record or, at least, to provide “background.” The northern medical community, in which she claims membership, is very small. It should have been dead simple for her to get an introduction to someone who had valuable knowledge and insight to add.

When notable advocate Stephen Lewis came here on a fact-finding exercise, he was able to gather a fully nuanced view of our crisis by talking with: people in communities, elders, healthcare workers, nurses, doctors, Canada’s most accomplished TB researchers, Natan Obed and NTI, our medical officer of health, GN managers, politicos and Government of Canada experts.

He didn’t, despite his considerable experience in TB treatment in Africa, lecture us. He listened. And when he spoke to the Globe and Mail, local and national news organizations, he was knowledgeable, eloquent and generous to the dedicated hardworking crew here in Nunavut, while still advocating strongly for a substantial response from our Government of Canada partners. Now, that was effective public advocacy!

Nunatsiaq News is the newspaper of record for Nunavut and TB is one of our most pressing public issues.

I do not think Giles’ commentary was intended to harm the morale of those who are working towards the eradication of TB, nor cause additional mistrust among those who require testing and treatment, but it did. You dropped the ball on this one. I hope that you will do better in the future.

Mike DeMaio
(a.k.a. Luuktaap Nulianga)

Editor’s note: Sarah Giles’s TB commentary was first published online in The Conversation on April 8. CBC North published a similar opinion piece by Sarah Giles on April 25.

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(14) Comments:

#1. Posted by Qujannamiik Dr. DeMaio on May 02, 2018

I appreciate all that you and your team are, Dr. DeMaio. Delivering healthcare services is the single most difficult job in Nunavut. We only want to salute and support you.

#2. Posted by Priorities on May 02, 2018

So Nunavut children are dying, hundreds of people are coughing their frickin’ lungs out from TB, babies are catching TB, nobody keeps track and it is all out of control.

The important issue though is staff morale. I mean, we wouldn’t want all those overpaid southern imports to have a bad day, would we?

Thanks for telling us about our Nunavut government’s true priorities.

#3. Posted by #2 This is why many don't want to work here on May 02, 2018

Ever noticed how hard it is to get Medical Staff to stay long term and develop relationships and knowledge of the communities? It because of comments and people like you #2 that do this. “Southern Imports” especially Medical professionals do not need to come to Nunavut for the money or for the work. They make just as much, with lower cost of living, more training, more staff support, and less mandatory overtime. So when people like you make comments like this, or we have articles being very critical of them, it sure makes it hard to recruit people to come. Hows the Nunavut Nursing program going btw? Not to many Inuk medical professionals yet. I hope one day we do. But with comments like this why would anyone Inuk or Southern want to be degraded, called names, and yelled at after working a 80hour week, when you can aspire for a cushy GN job 9-5 with 30min coffee breaks, and can call in sick to work every day….....

#4. Posted by The Truth be Told on May 02, 2018

#3. You’re on to something there, bud. Thank you medical staff. You are the best! You are appreciated! You are welcome in my community!

#5. Posted by Bravo! on May 02, 2018

#3 Great comment, thank you!

#2 - Yes, staff morale is important. But that’s not entirely the issue either. Read the letter again, this time drop the self-righteousness and the reactive dislike of these “southerners” who are working so hard to protect your well being.

#6. Posted by SM on May 02, 2018

I’m a GN worker who often misses a break and often works thru lunch hour. I haven’t taken a single sick day this fiscal year, thanks to general good health. I work 8:30 to 5:00 and don’t know anyone who works 9:00 to 5:00 but one that has flex hours from 9:00 to 6:00 to accommodate service needs from Western Nunavut. I think it’s ignorant and slanderous to make blanket statements like that in #3. And doctors are GN employees and paid for the time they work. Just like me.

#7. Posted by Zoom Zoom on May 02, 2018

#6 If you are a GN worker then you know more than enough people who fit the description above. I know I do.

#8. Posted by Concerned Inuk on May 03, 2018

This is really lame!  The Inuit TB rate is 270 times higher than the non-indigenous population in Canada, and the healthcare workers are taking criticism personally and their feelings are hurt?


#9. Posted by Yes Hurt on May 03, 2018

#8 Are you suggesting that the blame for the TB rate falls on healthcare workers? Now who’s lame! The TB rate is where it is because of lousy living conditions. That’s it that’s all.

#10. Posted by Lame Indeed on May 03, 2018

#8’s comment encapsulates a couple ongoing problems we see consistently in the comment section: an inability to comprehend what has been written, and a rush to excoricate the other.

#11. Posted by Ex nunavut on May 03, 2018

Unfortunately, Nunavut is a Kakistocracy.

Dr Dimaio is upset, maybe rightly so but going after the messengers is not helping. This letter is cloaked in buzz words labeling Dr. Gilles as an imperialist. The issues in Nunavut are serious, hurting a few peoples ego may be the beginning of a solution.

I lived in Nunavut for almost 15 years and I saw no improvement in the local lives during that time. There are many people like dr Demario who cares but not enough. That is the issue.

#12. Posted by cough a what? on May 04, 2018

Too many people mistake coughs that lasts more than a month to allergies, smoker’s cough. Especially if you coughing up stuff and having other symptoms with it. oh it’s just a cough, i’m just tired, I don’t have time to go the clinic, and if you have a cold more half a year! go get checked!

I was lucky I went to the Public Health when I did, I had originally went there for STI testing; so I decided to get tested for TB, If I had not checked that box off, I would be much worst off today!

Who cares if you will miss your alcohol intake if you have TB, Alcoholics are the hardest to get thru.

#13. Posted by Bone Head on May 04, 2018

The health of Nunavummiut is not contingent on how much Dr. Demario “cares”, granted I have no doubt that he does care.

What a weird statement.

#14. Posted by Suspected Kakistocrat on May 04, 2018

@#11 thanks for making me learn a new word:

Kakistocrat: a system of government which is run by the worst, least qualified, or most unscrupulous citizens.

There is some truth to that but it’s also flawed - the worst in Canada run Nunavut, but they are still the best in Nunavut.

Problem is, the best Nunavut-born people shouldn’t be in government, they should be teachers, nurses, entrepreneurs etc. instead of bureaucrats.

So, we take the best people, send them to NS to learn entitlement then give them GN bureaucrat jobs in which they put the entitlement they learned to good use by featherbedding and dragging their feet and learning from the worst of Canada who find their way into the GN.

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