Bureaucratic rules leaves burned woman with no care

PUVIRNITUQ — A 70-year old Kangiqsujuaq woman suffering severe burns over most of her body waited nine hours for medical treatment because no nurse from the nearby community was willing to go out on the land and help her.

Two nurses in Kangiqsujuaq said that they weren’t allowed to travel out of the community to help Sarah Ningiuruvik at her camp because of “internal regulations.”

“It’s inacceptable,” said Jean Dupuis, the head of Nunavik’s Regional Board of Health and Social Services. “It doesn’t make sense that people who are paid big bucks don’t respond to people who are suffering.”

Ningiuruvik couldn’t be immediately medevaced out to Kuujjuaq, either, because pilots at every northern airline said they’d already flown their allotted hours for the day. According to the federal Civil Air Services Navigation Commercialization Act, pilots can only fly eight hours in a 14-hour shift.

The community’s mayor, Charlie Arngak, tried to convince the nurses to go to help the woman, but to no avail. He made call after call, without any luck, to help organize a medevac.

Increasingly more desperate, he finally appealed to local leaders in Puvirnituq attending a meeting of the Kativik Regional Government.

Dupuis and KRG chairman Johnny Adams stayed up all night on the telephone, trying to convince medical authorities and airlines to get some urgent assistance to Ningiuruvik.

Hours of wrangling

This wrangling went on for hours. Finally, accompanied by a nurse, a group of local Canadian Rangers, and the police constable, arrived at the scene seven hours later.

They didn’t arrive back in Kangiqsujuaq until 3 am. At daybreak, a helicopter finally able to leave Kuujjuaq to bring the burned woman to Kuujjuaq, and then on to Montreal.

Ningiuruvik’s feet are the only parts of her body that were not burned in the explosion that rocked her cabin around 6 pm on Tuesday evening. Ningiuruvik, who has poor vision, was attempting to light a camp stove, but had apparently filled the stove’s reservoir with gasoline instead of naptha.

Her son, Pitsiulak, who was outside chopping wood when the blast occurred, looked up through the window to see his mother’s face on fire. Pitsiulak, whose hands were also burned when he rescued his mother, then travelled by skidoo back into Kangiqsujuaq, some ten kilometers away.

Nurse not allowed to leave

Nurse Philippe Poirier had wanted to answer the call for help, but Poirier was reminded by his co-worker, Diane Trudelle, that nurses are not permitted to leave the village, even to respond to medical emergencies.

“It’s a good policy,” she said. “We’re only two and if we go to the site, there’s a loss of time and resources. Even with two people, it took us one and a half hours to prepare the equipment.”

Trudelle said that she’d been up for more than 26 hours by Wednesday morning.

She said that outpost nurses would require more back-up and better facilities if they’re expected to offer pre-hospital care, too. Police and Canadian Rangers, she maintained, have enough First Aid training to bring in patients.

“We’re not responsible for the transport of the injured,” said Trudelle’s boss, Minnie Grey, executive director of Kuujjuaq’s Tulattavik Health Centre. “It was a total example of panic, not knowing what to do and depending on the nurses.”

Grey said existing rules protect the nurses and do not jeopardize patients. By badgering the nurses to go to the woman, she feels rescuers lost valuable time in getting Ningiuruvik to the nursing station.

Grey said Nunavik’s municipalities need to better organize their response to emergencies, a point that was also brought up during the recent coroner’s inquest into the disastrous New Year’s Eve avalanche in Kangiqsualujjuaq. The KRG recently received nearly $3 million from Quebec’s department of public security, money that is supposed to pay for emergency equipment and planning.

Grey stands by her decision not to let one of the nurses go to answer the call, saying she’s not afraid of being branded “the Wicked Witch of the North”, especially when the airlines also stood by their policies.

“I have my rules and protocols, too, and I have my limits,” Grey said.

Rescue team has no skills

But the rescue team felt that they lacked the necessary skills and confidence to apply the moist bandages and painkillers that Ningiuruvik needed.

And members of the community were baffled by the nurses’ reluctance to attend to the woman. Many people are out on the land, and there’s concern that none of them have access to emergency medical services.

“It’s not like in the South,” said municipal councillor Ulayu Argnak. “It isn’t fair. We have to do something.”

The morning following the incident, local leaders were already planning a political response. Dupuis, Adams and Pita Aatami, the president of the Makivik Corporation, plan to go to Ottawa next week to lobby federal ministers.

They’re hoping to meet with Transport Minister David Collenette and Defense Minister Art Eggleton. They want to see Nav Can regulations changed to get rid of the duty-time restrictions in the case of medevacs, and they want the Canadian Armed Forces to be able to step in immediately in case of an emergency.

Nunavik’s member of parliament, Guy St-Julien, was appalled by the reports of Ningiuruvik’s long wait for help. His standing committee on Aboriginal Affairs recently called for changes to Nav Canada’s regulations.

“I’m angry because there are rules that we can’t break to save a life,” St-Julien said. “We are ready to save people in a foreign country with evacuations, but here we can’t even provide any help to someone who was suffering so much.”

But it’s not a political issue, Nunavik’s leaders insist. They say they’re not persuaded by the regional health officials’ arguments, either.

“They can explain it all the want,” said Johnny Adams. “But there was no attention given to the person in the field.”