Nunavik medical crisis drives patients south

MONTREAL – A health crisis is brewing in the big city: more and more Nunavimmiut are in Montreal to receive health care, as services provided by Puvirnituq’s Inuulitsivik Hospital become stressed to the breaking point.

Inuulitsivik is responsible for providing all patient services in Montreal and oversees the Northern Module, the unit that looks after Nunavik patients and escorts.

This year’s tidal wave of arrivals to the city has been overwhelming: the numbers of Nunavimmiut coming to Montreal for health care has doubled since 1998 to more than 3,000 a year.

Last summer’s Qanuippitaa health survey in Nunavik led to many referrals for further medical examinations.

But those referrals aren’t the only cause of the huge increase for patient services. A growing shortage of medical health professionals in the North is also sending patients south.

Nearly a dozen pregnant women from the Hudson Bay coast recently arrived in Montreal because there weren’t enough laboratory technicians at Puvirnituq’s Inuulitsivik hospital to carry out required tests. Women from the Hudson Bay communities can usually deliver with midwives at the Inuulitsivik hospital or at the maternity unit in Inukjuak.

Inuulitsivik’s midwifery coordinator says the lab problem has now been resolved.

But there’s a continuing shortage of doctors who are trained in obstetrics at the Tulattavik Hospital in Kuujjuaq. This means that, for more than a year, all pregnant women from Nunavik’s Ungava coast communities have had to deliver in Montreal.

So, Montreal has been hosting the “party des bédaines”

– a continuing party of the big bellies, jokes a Northern Module employee.

But it’s no laughing matter for pregnant women who have to travel up to 1,500 kilometers away from home, because more of them will end up delivering their babies by cesarean section than in the North.

This means that during their fertile years these same women will be obliged to return to Montreal several times to give birth, and there will be more dependence in the future – not less – on medical services in the South.

Up to 180 Nunavimmiut are now in Montreal every week for hospitalization, outpatient treatment or consultations. The 50-person Nunavik House at 6177 St. Jacques St. has been bursting at the seams ever since it opened in 2000, and the new Hampton House located nearby for 28 residents and escorts, which opened in mid-May, will also be at capacity soon.

Even so, many Nunavimmiut will still be housed at great expense at the Travelodge hotel in Dorval, private boarding homes and downtown hotels, causing Northern Module drivers to wrestle with heavy traffic and patients to miss their appointments.

“It could be a lot better, but, of course, it could be a lot worse,” says an employee, who, like others workers who spoke to Nunatsiaq News about health services in Montreal, did not want to be named. “What it needs is a vision, a plan.”

But a consistent vision has been lacking. Leadership at the Northern Module has been in a state of flux, with several directors coming and going over the past four years.

Daniel Michaud, the module’s acting director, replaced Ginette Taillon earlier this year. Taillon left at about the same time as several other top managers, including long-time patient services coordinator, Serge Auclair, left Inuulitsivik.

Michaud has been scrambling to make sure the new Hampton House operates smoothly. The residence needs 24-hour staff as well as improvements and finishing touches to the buildings that restaurauteur Nick Patulli, who holds the operating contract for the two patient residences, must provide.

But staff are concerned about the safety of the two residences. They wonder whether there are enough employees on hand during the night and worry what they would do if there was an actual emergency evacuation.

The new Hampton House is nevertheless an inviting and spacious place. Its refrigerator is stocked with country food provided by the Fédération des coopératives du Nouveau-Quebec, but the Hampton House, like Nunavik House, is no resort: there’s a baggage search on arrival, a zero tolerance drug and alcohol policy, and a strict evening curfew.

Patients and escorts won’t be housed under one roof for at least a few years as a plan to put everyone in Dorval stalled due to staff upheavals, employees say.

Meanwhile, other Inuulitsivik employees in Montreal face change. Financial services for Inuulitsivik were transferred from Puvirnituq to the northern Montreal suburb of Anjou after massive payroll and accounting errors surfaced a few years ago. Now, the division is to be relocated North over the next two years, for political rather than practical reasons, some say.

Uncertainty over the future is causing a staff exodus from Anjou office and openings can’t be filled.

“When you tell them they’ll work in Montreal, it’s easy to hire personnel. When you say they’ll be transferred to the North, they won’t accept the job,” one employee says.

Overcrowding in Montreal and understaffing at Inuulitsivik are among the issues, which Nunavik health board directors were to discuss this week at a board meeting.

More money from Quebec that could be used to bring Nunavik’s health care services into line with the region’s growing needs would help, says Jeannie May, executive director of Nunavik’s regional health and social services board. That’s a message May planned to take directly to Quebec City this week during a meeting with provincial health minister Philippe Couillard.

May says she’s determined to keep more Nunavimmiut from heading south for health care.

“It’s a big goal for me to reduce the numbers of people and the trauma that sends them there,” she says. “If we could cut those expenses in half, we would save a lot of money.”

May says she’s optimistic things will turn around – and points to a new training program in obstetrics for doctors in Kuujjuaq. This will allow women from the Ungava coast communities to start delivering once again at the Tulattavik Hospital later this year.