ITK calls for pan-Inuit swine flu strategy

Gail Turner
Chair of ITK National Inuit Committee on Health

The following is excerpted from a recent ITK presentation to the House of Commons standing committee on health.)

I am honored to speak on behalf of Inuit Tapiriit Kanatami (ITK), representing Canadian Inuit on the issue of H1N1 and its impact on us. I am an Inuk public health nurse working for my homeland of Nunatsiavut, northern Labrador, and the chair of the National Inuit Committee on Health…

Inuit fear H1N1, a fear not generated by media attention but rather by the very real history of the impacts of previous pandemics. In Okak, Labrador, the Spanish flu wiped out nearly the whole community in a matter of days.

The Canadian Pandemic Plan does not address the unique issues pertinent to pandemic planning in Inuit regions — remote and isolated communities where the guidelines do not fit, and use language full of false assumptions and hints of colonial bureaucracy.

In June, the board of directors of ITK met in Nain, Labrador, and passed a resolution calling for an Inuit-specific appendix to the Canadian Pandemic Plan.

They consider that, given our high risks for contracting H1N1 and other viruses, a pan-Inuit strategy is an important step in the prevention and management of current and future pandemics.

The challenges of planning for Inuit is further complicated by jurisdictional issues, with land claims in two territories and two provinces and the lack of clarity around the role of Health Canada and the Public Health Agency of Canada.

The relationships between federal, territorial and provincial governments reflect the changing nature of politics and require a more concentrated focus on the people they serve.

It is essential that this appendix is written with us and not for us. Inuit must be engaged so that what is written is culturally relevant…

In some communities, there is only one nurse, whose priority is the provision of primary care. We have no capacity for alternate care sites and will have to use home isolation and fly out the seriously ill.

The support required for families living in crowded homes will challenge us and we have to be realistic, yet creative, in how we guide care practices. We will have to rely heavily on the natural caring of Inuit and their wonderful resilience.

Supplies will be an issue, masks, gloves, needles, hand sanitizers, syringes (and where to store these safely given the increase in IV drug use in our communities.)

The logistics are daunting with both staff and supplies having to be flown in and the vaccine protected against the extreme temperatures that we will face in the Arctic by the time it is ready.

We cannot be efficient. Immunizing a community of 250, given our resources, may take several days once you factor in the flight schedule and the weather. Remote communities must be a priority, especially as winter draws near…

Challenges such as these are foreign to health-care providers south of 60. Five years ago at a national meeting, I heard a representative from PHAC say that antivirals could be sent to any community in Canada within 12 hours.

I challenged that statement and used Grise Fiord in the High Arctic of Nunavut as an example. I am appalled on a daily basis at the lack of knowledge by bureaucracy at all levels on who Inuit are and where and how we live.

We have become the subject of much media attention lately as we shore up our defenses North to protect our Arctic sovereignty. I would suggest that we invest in the health of Inuit…

ITK and Inuit of Canada call upon the standing committee on health to:

• support the creation of an Inuit-specific annex to the Canadian Pandemic

Plan;

• make mass immunization in remote communities a high priority once the H1N1 vaccine is available;
• and begin the very serious work of addressing the social determinants of health that keep Inuit in Canada on the bottom of the health-status scale.

Housing, food security and access to health care must be improved. There are significant issues of social injustice that must be addressed.

Canada must set target dates with incremental reductions in the average number of Inuit living in a household until it resembles that of the average Canadian. The life expectancy of Inuit should be rising, not continuing to fall.

At the end of the day, Canada will be judged on its efforts to improve health of all Canadians.