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Nunavut to train health workers, support students

"Care Closer to Home" already sees drop in Inuit transported to Winnipeg

JANE GEORGE

Nunavut's health department is backing more training programs for Inuit health workers and new incentives for Nunavummiut to become doctors and nurses because its "Care Closer to Home" policy needs a homegrown health workforce to succeed.

The priority, said the health department's deputy minister Bernie Blais, will be to train "middle-level" Inuit health workers who will become midwives, laboratory technicians and pharmacist assistants.

A "return-of-service" program is also in the works to encourage post-secondary students to study medicine in the South. This means Nunavut would pick up the tab for students' many years of study in medical school on the guarantee that they return to the territory to practice after graduation.

Six years down the road, this program would begin to change the face of Nunavut's health care system, Blais said, although medical specialists would continue to be provided by contracts with health care providers outside territory.

Blais said the Government of Nunavut plans to maintain its current service arrangements with university hospitals in Ottawa, Toronto, Churchill, Winnipeg and Edmonton for the foreseeable future.

The GN wants to expand the territory's relationship with these facilities so their medical schools can provide training opportunities to Nunavummiut and allow students from Nunavut to apply for admission as local students rather than out-of-province students, Blais said.

Meanwhile, the GN plans to continue recruiting medical staff for its new health centres in Cambridge Bay and Rankin Inlet.

In the Kivalliq region, the J.A. Hildes Northern Medical Unit, based at the University of Manitoba in Winnipeg, will continue to provide medical specialists and make sure there is a pool of doctors to share responsibility for hospital-based and outpatient care in Rankin Inlet as well as patient care in the region's seven communities.

Right now, there are four general practitioners serving the Kivalliq - two full-time doctors and two positions that are filled by doctors on rotation from Winnipeg.

The J.A. Hildes Northern Medical Unit has been supplying medical services in the Kivalliq for 35 years, since the late Dr. Jack Hildes founded the unit to meet the medical needs of Inuit living in the Kivalliq region.

In Oct. 1997, the unit's contract with the region lapsed, and a new contract wasn't signed until Apr. 1, 1999. It's up for renewal again this year, but the medical unit's director, Dr. Bruce Martin, expects the contract to be renewed - not least because there has been a noticeable drop in the number of Nunavummiut from the Kivalliq going to hospitals in Churchill and Winnipeg. He attributes this to improved care in the communities.

"There will always be patients in hospital from the Kivalliq region, but the numbers are much lower than they have ever been. It is absolutely amazing and it is one of those successes in terms of measurement of improved health care. The numbers have been significantly diminishing particularly during the past 12 years," Martin said. "It's a tribute to Nunavut's incredibly good immunization program, to water safety and water security, to sewage treatment and sewage handling and to better housing."

Martin said there have also been improvement in the outcomes for children with retro-syncytial virus, or RSV, which affects the respiratory system and can cause life-threatening breathing difficulties, particularly in young babies.

"I think it's much like the successes that were seen decades ago in the gradually diminishing numbers of people in tuberculosis sanitoria. That was a result of many things, not just better medical care, but improvement in health status."

Martin sees the future role of J.A. Hildes Northern Medical Health Unit as continuing to provide specialist care to the region and to fill gaps in the GN health care system.

"As the population grows, and as the pattern of illness changes, there is a need for a vast array of services. Some should be with the GN. Some, likely because of the specialized nature of care, need to be with other organizations," he said.

The Winnipeg medical unit is starting a new program with the Churchill Regional Hospital, historically the centre for low-risk births in the Kivalliq, which would offer a midwife service for low risk births from northern Manitoba and Nunavut.

"There will be times when care cannot be accessed in Rankin," Martin said. "This is to complement existing, longstanding midwife and nurse-based programs in the Arctic and is in no way a program to replace, supplant or alter the patterns of care within the Kivalliq."

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