This infographic shows the rates of tuberculosis by Inuit region. The rate of TB among Inuit living in Inuit Nunangat is more than 300 times greater than that among non-Indigenous Canadians. (Graphic courtesy of ITK)
Historic trauma aside, TB remains a reality in Inuit communities
“The rate of tuberculosis is outrageous, but it’s eminently solvable”
While Prime Minister Justin Trudeau has apologized today for the treatment of Inuit who suffered from tuberculosis between the 1940s and 1960s, the respiratory infection continues to take a toll on northern communities.
In the Baffin community of Cape Dorset, health officials are a few weeks into a community-wide screening clinic, which will see most of the hamlet’s 1,500 residents tested for TB this winter.
Funded largely through Health Canada, the 12-week-long clinic has brought in X-ray technicians, respiratory therapists, TB specialists and top-line equipment, which has been set up in Cape Dorset’s community hall.
It’s the third clinic of its kind held over the last year in Nunavut, to respond to the North’s high rates of TB, which are some 300 times higher than among the country’s southern, non-Indigenous population.
Nunavut’s first TB screening clinic was hosted in early 2018 in Qikiqtarjuaq, where approximately 10 per cent of the local population was infected with TB.
That clinic came roughly a year after a 15-year-old girl from Qikiqtarjuaq, Ileen Kooneeliusie, died of the infectious disease in January 2017.
Since her death, two other young people from Nunavik and the Nunatsiavut region have also died of TB.
Those factors led to the creation of the federal government’s TB Task Force, which, in collaboration with Inuit groups, aims to see tuberculosis eliminated from the four regions of the Inuit Nunangat by 2030.
The government has also committed to reduce the number of active TB cases across the North by at least 50 per cent by 2025.
“The rate of tuberculosis is outrageous, but it’s eminently solvable,” said then-Indigenous Services Minister Jane Philpott, when that task force was launched in March 2018.
Last year’s federal budget included $27.5 million allocated to TB treatment and prevention in Inuit Nunangat, which has been invested in TB awareness campaigns, screening and specialized TB care.
But leaders across Inuit Nunangat have also called on the federal government to address the root causes of tuberculosis.
“Given that TB is largely a disease of poverty, our government also has to work to address root issues such as housing, unemployment, education and economic development,” said John Main, the member of Nunavut’s legislative assembly for Arviat North–Whale Cove.
Health Canada has also added rifapentine to its list of drugs that can be used to meet urgent public health needs, with its first major rollout being in communities in Nunavut.
The drug is taken weekly over 12 weeks, whereas other TB medications are taken daily over a nine-month period.
TB continues to spread because the sick are not isolated, even if they refuse to take or don’t comply with the medications. Considering how much people are complaining about inuit getting the very same treatment as any other Canadian with TB did back in the 40’s and 50’s, I can see why TB might remain a problem forever in Nunavut. Many inuit refuse to take the meds, and refuse to comply with isolation while they are infectious, which is an important way of containing an outbreak, no matter the race of the sick person in question. Isolation isn’t forced upon infectious people either, when it should be (it would be legal to do so), because of all the complaints about when it was done long ago. It’s kind ironic that Trudeau’s apology will just reinforce the thinking that it’s racist to enforce conventional TB treatment when the sick person is aboriginal.
Prime Minister Justin Trudeau’s apology for the inhuman treatment of Inuit with tuberculosis decades ago does nothing to address its continuing prevalence today.
Nunavut’s MLA John Main is quoted as saying, “Given that TB is largely a disease of poverty, our government also has to work to address root issues such as housing, unemployment, education and economic development.”
The immediate need for housing in Nunavut is for 3,000 units. But Mr. Trudeau’s government has committed only to building 200 units annually. That’s not enough even to replace inevitable losses and to provide for population increase. Many Inuit are homeless and some households have ten or more people living in a 3-bedroom accommodation of 1200 square feet.
By contrast, when Singapore became independent in 1965, Premier Lee began a ten-year program to re-house and intensively educate 60,000 Malays living in a terrible Asian slum. By the 1990s children of relocatees were doing master’s degrees at Berkeley and Cambridge, in physics and architecture. In 1965 Canada had five times the per capita GDP of Singapore. Today Singapore’s significantly exceeds Canada’s.
We could look at what those people in Singapore did for themselves instead of what the government did for them and then think about what would happen in Nunavut if families worked hard to raise their kids in homes that valued learning, education and school attendance. It would be great if students and parents realized that education and learning starts from birth, with parents as the teachers, and not just in grade 10 when the credit system kicks in and neuroscience shows it’s too late to form those neural pathways.
Asian culture strongly supports education, and with attendance rates like the ones shown in the article it seems that modern Inuit culture does not support education, at least not wholeheartedly as is the case in Asia.
Colin, do you recognize that the expectation that government can and will provide public housing ad infinitum is not practical or sustainable? You need a new paradigm to deal with this issue.