Tuberculosis, Inuit and Getting it Right This Time

In the last couple of days, CBC has run a few stories about tuberculosis, Indigenous people and how the Canadian government has responded to the ongoing problem. And it has been an ongoing medical problem. In 1989, a CBC program reported that it was estimated that in the 1950s at least one third of the Inuit were infected with TB. The same program also suggested that one seventh of all Inuit (1600) were in a sanatorium in southern Canada. More recently, in at least one community on Baffin Island, it has been reported that 10% of residents are infected with TB.

The only cure for TB before the discovery of antibiotics was isolation from the community to prevent the disease from spreading, good food and lots of rest. For the Inuit, this meant being taken from their families and shipped to segregated sanatoriums in southern Canada. In these sanatoriums individuals would have been completed separated from their communities, their families - left with no way of contacting their families for at least two years.  The professional staff would not have spoken their language, no one could explain what was happening to them, no one could understand their questions. To make things worse, at least some (most?) of the staff were abusive either in terms of punishing the residents for speaking their own language to each other. Other staff physically or sexually assaulted them.

I have no doubt that even the most benign of the nursing staff were, in their Christian based righteousness absolutely sure that what they were doing was the right thing, that the Inuit people, perhaps especially the children, were fortunate to be able to live and to hopefully get better in the wonderful sanatorium  - supported by a benevolent government. Even the most kind of the individual working there would have been judgemental about the language and the lifestyles of the people under their care. Even the best of them would have been by today's standards, a racist.

The Inuit were taken from their homes, with very little if any explanation, families were left not knowing what was happening to their family member and in some cases never knew that they had died. The fact that it was "for their own good" is exactly the type of colonialist attitude that has tainted our relationship with First Nations people.

 But in spite of acknowledging that the TB epidemic was poorly handled - I am left unclear as to what should have happened. T.B was a major health crisis, one that a century earlier had been leading cause of death in Canada. In 1953 there were 18,977 sanatorium beds in Canada.  On the surface, the pictures of segregated sanatoriums do not look all that different from the ones other Canadians went to. Separating individuals from their families and communities was the "cure" for everyone. A far better alternative would have been to invest the time and energy into either training doctors and nurses from Inuit communities and then building sanatoriums in the north so that people would not geographically have been so far away. Or failing to at least insure that insuring that all of the staff some of the language of the people that they were taking care of.  

But in 1950, Canada had a population of approximately 14 million people (stats). Just under 50% lived in rural areas. The cost to create special facilities in the far north, given the lack of transportation, the lack of materials and the lack of trained staff would have made the cost prohibitive. Waiting six or seven years (at a minimum) to have any trained Inuit staff might have meant the destruction of whole communities. Given  the information available  and the amount of ignorance - it seems to me that the method of treatment was probably the best that could have been done at that time. It is troubling that such facilities continued to exist while other alternatives were not pursued.

Should the government have done far more to insure that there were competent translators available - yes. Should they have done a better job of screening prospective staff - yes. Should the government have insisted that families receive regular updates -yes. Should patients have been returned home as soon as possible - yes. There is a long list of what, we looking back over the last 60 years, should have done better.  We need to acknowledge our collective failures.

On the other hand.....

Next week in Qikiqtarjuag, Nunavut, there will be a mobile clinic to screen and treat the residents for TB. The operative word will be treatment - people will get the medication they need while living in their community. The clinic will remain in place to ensure that the treatment (7- 10 weeks) is effective. The cost for the mobile equipment is $1 million, but the clinic is mobile and can be moved to another community to repeat the process.

Hopefully this time we have got it right.