Repairing the repair business

Excerpt from a speech by Aqqaluk Lynge, vice-president of the Inuit Circumpolar Conference, at the International Congress on Circumpolar Health in Nuuk

I want to talk to you today about the principles of community health. And the field of preventive medicine, or the practice of public health.

We need to focus on healthy lifestyles, rather than on curing the disease that follows unhealthy ones. We need to focus less on bringing expensive repairmen – or doctors – to Greenland, for example, and more on developing cost-effective local human resources that promote health and prevent illness.

Communicators, educators, and media people may be more instrumental in dealing with our health challenges in Greenland than doctors, expensive diagnostic equipment, and hospital beds.

The principles of community health and preventive medicine are not new. They go back a long way in most Arctic countries and, indeed, the world over.

Lip-service is often paid to prevention and public health, but it is just not as interesting as, say, studying an obscure chemotherapy for an equally obscure cancer. Or not as easy as simply putting more money into hiring more repairmen to fix what is wrong.

Community health principles are well known. It is time we turn back to these principles. They include things such as equitable distribution. In Greenland, and across the Arctic especially, this is a major challenge. For Greenland, our best health – or rather illness – facilities are here in Nuuk. The best diagnostic equipment is here. Some would argue, the best doctors. The principle of equitable distribution means that we must not neglect small communities and small municipalities.

Another principle stresses community involvement. This means that there needs to be active participation by members of the local community in their own health decisions. Again, using Greenland as an example, this means that within certain parameters, community members in Qaanaaq, say, should have a say on how the health-care kroners are spent on them. They should be given resources so that they can be decision-makers and take responsibility for their own health.

A further underlying principle is using appropriate technology. That is, the technology should be acceptable and relevant to society. This does not mean we need no new technology, or no new approaches to healing those who are sick.

But we need cost-effective technology that responds to local needs. I am not quite sure if we need bio-artificial livers, for example.

A final principle I want to raise is the necessity of a multi-sectoral approach to health care. This is perhaps one of the most important principles.

Treating the sick must be seen as only one segment of the big picture of health. We need to stress nutrition, education, clean drinking water, and appropriate and safe housing. These are all part of health and well-being.

If we move in this new direction, are we going to hear more about the woeful lack of doctors? This is a common complaint in many parts of Greenland society, and, I am sure, across the Arctic.

Doctors, I believe, are primarily acting as repairmen, and the new approach may actually call for fewer, not more, repairmen. Doctors cannot look after our preventive maintenance, in my opinion, because the structure of their practices is set up to encourage them seeing a patient in a few minutes, prescribing a medication, and shoving them out the door.

We cannot expect doctors to make our decisions for us, but we must find a better way, in my opinion, to use their time.

They cannot make decisions for us on how much to smoke. They are not the ones who decide whether we will consume alcohol and how much. They won’t knock on our door every night to get us out to exercise. They won’t stock our refrigerators with nutritious foods. They won’t stop environmental contaminants from entering our fragile Arctic environment. Doctors won’t make us healthy.

It is not time, in my opinion, to throw out all of our repairmen, but it is time to admit that the repair business is itself in need of repair. Perhaps we are asking too much of our doctors. And they cannot deliver.

Suicides, depression, alcohol-related diseases, cancer from smoking, and other ills are directly related to our society and individuals not focusing on life.

In order to build this new paradigm of cooperation, new research, and sustained political will, what do we have to do? Well, we have to first understand that life is essentially fragile and here in the Arctic it is especially so. Our individual life spans are short. And only a revolution of community life will help us turn it around.

What are we to teach our youth? Simple. Look at the data. We need to teach them not to smoke. We need to teach them to use alcohol wisely or not at all. We need to continually remind them of the nutritious and tasty foods we have in our seas and on our lands. We need to get them to reduce their junk food intake.

Children need to learn from their families to stay in the kitchen, that good food, taken from the large Arctic cupboard, is made there. Children need to be taught good eating habits.

We can, with a new focus on health, rather than on sickness, create an environment that is life-giving for all. Our communities and nations need strong leaders. When there is a leadership crisis, the whole nation feels it. Its members start to feel insecure, lethargic and, eventually sick.

Strong leaders in both the scientific and political spheres are needed to make the necessary changes. We need to work together with the researchers gathered here to forge a new path. Towards healthier individuals. Towards a healthier society.