Nunavik Inuit take ownership of 2017 health survey
"Information is power"
Davidee Fleming, like most Nunavimmiut, has concerns about access to health care in his community, Kuujjuaraapik, the southernmost village in Nunavik.
He has friends and family members living with diabetes and high blood pressure and he’s seen poor mental health take a toll on loved ones.
So it’s perhaps no surprise that Fleming was the “first, first patient” of Qanuilirpitaa, the 2017 Nunavik Inuit health survey that’s touring the region by icebreaker this month.
The CCGS Amundsen research icebreaker started its region-wide tour in Kuujjuaraapik Aug. 19, when Fleming and a group of five other community members were the first selected to be surveyed.
“I was so proud of that,” said Fleming, a housekeeper at Kuujjuaraapik’s co-op hotel.
Fleming took part in Nunavik’s first health survey in 2004, called Qanuipitaa? which translates to How are we doing? This year’s survey, Qanuilirpitaa, asks How are we doing now?
“They wanted me to go back this time,” Fleming laughed. “They even interviewed me on television. I was nervous at first but it was okay.”
The survey is lead by a crew of 40 made up of medical specialists, interviewers, lab technicians and researchers.
On board the Amundsen, Fleming saw a number of health care professionals and researchers; gave blood and urine samples; had his weight and height measured and answered questions about his past and current state of health.
“They check everything,” he said. “We were on the ship for about six hours.”
He considers that a small sacrifice to make when you think of the wider impact the survey will have on the region, he said.
“It’s important to me that we know the condition of our health,” Fleming said. “We’ll know a lot when we get the results… about our medical problems. Inuit want to know how we’re doing.”
He said he believes the health survey will translate directly into better health services in the region and eventually, better health for Nunavimmiut.
Since the first health survey in 2004, the region’s population has grown from about 8,000 to more than 13,000, said Dr. Françoise Bouchard, director of public health at the Nunavik Regional Board of Health and Social Services.
“The most recent data goes back to 2004—that’s already 13 years ago,” she said. “Information is power. And we know the population is growing rapidly.”
While the previous survey relied heavily on the involvement of southern health care workers and researchers, Bouchard insists the 2017 survey has been developed, “by and for Inuit.”
Qanuilirpitaa is a collaboration between Nunavik organizations and Quebec’s Institut national de santé publique du Québec (institute of public health) and Université de Laval’s health research centre.
But the survey itself is directed by a regional steering committee—chaired by the Nunavik health department’s executive director, Minnie Grey, and filled with representatives from Nunavik organizations and communities.
That committee will have ownership of the data, once it’s processed, Bouchard said, and researchers will have to ask permission to access it.
“We focused on having the agreement of all the regional organizations,” said Bouchard, who is also a committee member. “They are all taking part and contributing financially to the survey.”
The steering committee decided that this year’s survey would focus on youth: 1,000 Nunavimmiut between the ages of 16 and 30 will be interviewed as part of Qanuilirpitaa, while another 300 adults aged 30 and up will be contacted to take part.
The committee asked health care workers and researchers to address mental health and substance abuse in their interviews with participants, Bouchard said.
The survey gathers individual data but will also capture and create a community profile, which Qanuilirpitaa will provide to each of Nunavik’s 14 villages.
“Because the objective is really to give back to the communities,” Bouchard said, “to give them the information they need to do their own decision making.”
Individual participants will also receive the results of their check-up and follow up care, if needed.
The timing is just right for Nunavik’s health department, Bouchard added, as the organization is in a planning phase. The results of the survey—expected to be released in the fall of 2018—will inform which new specialized health services not currently offered in Nunavik should be established.
Following the last survey, for example, Nunavik started to offer a mobile breast cancer screening clinic once a year in the communities.
Based on available data, the health board is now looking at the possibility of offering colon cancer screening in the region too, although the survey results will confirm that.
There’s a buzz around town in Inukjuak as the Amundsen arrives along the shores of the Hudson coast community of 1,800 on Aug. 24.
Asinnajaaq Ningiuk, one of dozens of youth selected and approached to take part in the survey, said she agrees with participating.
Ningiuk, 19, is a mother of two boys, the youngest of them just a month old. She brings her baby Peter with her as she boards the ship Aug. 29.
“I’m glad I went to the ship with my youngest baby,” she said. “And I’m glad they came here to check our health.”
Bouchard said she hopes more Nunavimmiut youth will feel as inclined to take part as Ningiuk did, as the ship makes its way up the Hudson coast, across the Hudson Strait and then down into Ungava Bay.
Qanuilirpitaa staff and community members have been using the FM radio to announce the survey and those selected to take part, but not everyone has responded..
“The youth population is probably more difficult to convince,” Bouchard said. “We’re making a special [effort] to reach out to them.”
If Nunavimmiut want to get in touch with the survey co-ordinators, the best way to do that is through the Qanuilirpitaa Facebook page.
The Amundsen completed interviews in Puvirnituq Sept. 4 before the tour was temporarily suspended when the vessel was called on to help with a search and rescue in Frobisher Bay.
The Amundsen is expected to return to Akulivik Sept. 6, where crews will resume the survey. From there, the tour continue north: Ivujivik on Sept. 8 and then Salluit from Sept. 9 to Sept.12.
Qanuilirpitaa will continue to make its way around the Nunavik coast until it reaches Kuujjuaq Sept. 26, where it will stay until Qanuilirpitaa wraps up its work Oct. 6.
Bad weather prevented the Qaniulirpitaa crew from hosting a community celebration at the start of the tour in Kuujjuaraapik; Bouchard said the Nunavik healed board hopes to organize another celebration in Kuujjuaq instead, in early October.
You can find the survey schedule on the NRBHSS website.