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Nunavut had a choice

When called upon to provide health care to Palluq Manning of Cape Dorset, the Government of Nunavut had a choice.

They could have chosen to treat him, for instance, like a human being.

But common sense and compassion, as it so often does, eluded the Government of Nunavut. Instead, they chose to treat him as a cost-centre, an inconvenient financial burden fit only to be transported to another place, dumped onto another government, then forgotten.

In a June 27 letter that GN officials are either too gutless or too stupid to own up to, a health bureaucrat by the name of Wayne Govereau told Manning that his current predicament "requires you to become an Ontario resident and therefore qualifies you to be financially supported under the Ontario system."

Is that so?

Manning was last medevaced to Ottawa less than a year before the letter was written, in mid-July, 2004. At that time, he appeared to have already been under Nunavut's care for a substantial period of time, even though he spent most of his time in Ottawa. Between 2002 and 2003, he was able to stay at Larga Baffin, a privatized patient home in Ottawa paid for by the Nunavut government. There, he recieved outpatient treatment for his failing kidneys, and occasionally returned home to Nunavut. For a period of time in 2005, he again stayed at Larga Baffin.

For at least two years, Manning resided mostly in Ottawa and Nunavut took responsibility for all or most of his care. But all that changed last July, when Manning collapsed into a coma while visiting Iqaluit and was medevaced to Ottawa, where he remained unconscious for about seven months.

After emerging from his ordeal, during which his bowels burst and he suffered three heart attacks, Manning discovered that his ailing body had become too inconveniently expensive for Nunavut to maintain any more. He needs access to an expensive dialysis machine to do the work that his kidneys cannot do for themselves. He needs a regular supply of colostomy bags. He also needs a secure place to live, and transportation several times a week to get to and from his medical appointments.

He also discovered that his home territory wants nothing to do with him anymore.

On the surface, Nunavut's decision to dump Manning onto the Ontario health care system appears to be legally correct, and, conincidentally, points up yet another serious weakness in the land claim agreement. "All of the benefits you would receive through your Nunavut Land Claims Agreement status would only cover you if you lived in Nunavut," Wayne Govereau said in his letter.

But that doesn't explain how or why Nunavut was able to pay for Manning's care during much of the two-year period prior to his last collapse. It was only when he was unconscious, and unable to comprehend what was being done to him, that Nunavut officials decided to wash their hands of him.

It doesn't explain why he had to pay $2,400 for medically necessary colostomy bags - on a disability income of $700 a month. On the face of it, that particular blunder looks like a violation of the Canada Health Act.

And it doesn't explain why numerous other Nunavut residents are able to stay in the South for many years as long-term care patients - at Nunavut's expense.

The evidence suggests, therefore, that Nunavut assumed a duty of care, and then reneged on it. To us, that sounds like a dereliction of duty that's worthy of a lawsuit.

To be fair, health care is the most difficult service that the Nunavut government is required to provide. Nunavut's population is one of the unhealthiest in Canada, and costs, especially for patient travel, are enormous.

At the same time, Nunavut health officials are under constant pressure to control those costs. The health and social services department now eats up more than one-quarter of the GN's annual budget. For the 2005-06 fiscal year, the department expects to spend $240.6 million. You can count on that figure ballooning to at least $260 million, or more, by next April. It always does. And there's never quite enough money.

And there are no clear answers to the constitutional question of who should assume the fiduciary duty to pay for Inuit health care. The federal government's Non-Insured Health Benefits program, or NIHB, is supposed to take care of people like Manning - but in his case it didn't.

But those realities don't excuse the callous manner in which GN health officials treated Palluq Manning.

As a diabetic, and with a pair of kidneys that are nearly dead, Manning needs a proper diet to survive. Right now, staff at Nunavut's Baffin Larga are forced to break their own rules just to feed him. And all sick people need rest and a secure place to live. Manning, however, is homeless - and no one from either Nunavut or Ontario seems able to find him a place to live.

The Nunavut government has a rare talent for inflicting painful embarrassments upon itself. In this case, its blundering has brought an ailing man to the brink of suicide, and his friends to say things like "They don't want to help Inuit."

It's sad indeed to see that the territorial government that Inuit surrendered their aboriginal title for in 1992 is now so eager to abandon its own people. JB

Polar bear quotas: Did the GN screw up?

About five years ago, the Nunavut Wildlife Management Board published a widely-admired report called the Inuit Bowhead Knowledge Study.

This document collected the observations of Inuit hunters and elders living in many Nunavut communities, and helped to confirm that bowhead populations in the eastern Arctic are increasing. This, in turn, gave the people of Nunavut a solid base of written knowledge that they can point to whenever skeptical outsiders attempt to criticize Nunavut’s limited, but culturally important, harvest of bowhead whales.

Its greatest benefit, perhaps, is that it recognized the validity of Inuit traditional knowledge, or Inuit Qaujimajatuqangit, and presents it in a way that allows the NWMB to honestly says that its bowhead management decisions are supported by a combination of IQ and Western science.

An earlier study on Inuit knowledge of the southeast Baffin beluga, which involved three communities, achieves a similar goal.

And even before that, in the early 1990s, the Environmental Committee of Sanikiluaq and the Canadian Arctic Resources Committee co-operated in the production of a report called Voices from the Bay, which collected Inuit and Cree observations of evironmental changes related to the James Bay hydroelectric project. Its purpose was different than the other two reports, but its greatest benefit was the same: it recognized the validity of traditional aboriginal knowledge, allowing it to be used in combination with Western science as a basis for policy decisions.

There is, therefore, a well-established way of gathering and presenting traditional aboriginal knowledge so that it can be used to make vital decisions. When it’s collected and organized well, traditional aboriginal knowledge can be decisive.

Unfortunately, there are many signs that the Government of Nunavut did not do this when, last December, they approved a substantial increase in polar bear quotas. The numbers vary from region to region, of course, and some regions saw no increases at all. But the total allowable Nunavut-wide harvest rose from 403 to 518 a year.

The NWMB recommended the numbers, which were worked out in a series of regional sub-agreements called “MOUs, based on information supplied by the GN.” The GN then “approved” the numbers that they had first recommended to the board.

In the Jan. 7 press release announcing their decision, the GN said they “agree to include Inuit Qaujimajaqutangit in decision-making,” but the ambiguous grammar of the sentence doesn’t make it clear whether they plan to do that in the future, or whether they’ve already done it.

That question is probably irrelevant now, and in a way, it’s already been answered.

That’s because the U.S. Fish and Wildlife Service is now asking Nunavut for more information about its polar bear management practices, and for the “traditional knowledge study” that was used to justify the quota increases. So far, Nunavut hasn’t given them anything, even though their GN’s decision was announced more than six months ago, and the MOU negotiation process spanned many years. The evidence so far suggests that no such study exists, that Inuit traditional knowledge about polar bears was never gathered in an organized manner.

If they get no credible information to evaluate, then it’s likely that U.S. officials will conclude that the Inuit traditional knowledge that was purportedly used to justify Nunavut’s quota increase is not valid. And they will likely impose a ban on the importation of trophies from Nunavut polar bear sports hunt into their country.

This won’t prevent Inuit from exercising their legal right to hunt polar bears within the total allowable harvest. But it will destroy an important source of income for those communities where people set aside some of their tags for southern sports hunters. On a Nunavut-wide basis, it’s estimated that these sports hunts are worth about $1 million a year.

When asked about this last January, Nunavut’s environment minister said he wasn’t concerned about U.S. reaction to Nunavut’s decision. “We have other people in the world besides Americans who would do the hunt,” he said at the time. The way things are going, Nunavut communities may get a chance to test that proposition quicker than they think.

The most serious issue, however, is that the credibility of Inuit traditional knowledge will suffer unneccessarily. We know that it’s a valid form of knowledge — but GN blundering may end up creating the opposite impression.

We already know that the GN’s wildlife division has been badly damaged by an ill-considered decision to move it to Igloolik, where two or three employees sit surrounded by empty desks. Did did this lack of capacity help produce a GN screw-up of the polar bear quota process? Stay tuned. We’ll soon find out. JB

Was Nunavut worth it?

As many Nunavut residents get ready to celebrate Nunavut Day tomorrow, and then to "celebrate" it again on Monday if they happen to work for a government or quasi-government employer, now may be as good a time as any to think about whether the Nunavut project was worth doing.

It's a complicated question, because Nunavut is, and was, a complicated project: an agreement to compensate Inuit for lands that came under the control of the Canadian state, and a related agreement to divide the Northwest Territories and create a new territorial government.

It's never a welcome question, either. Most Nunavut leaders, like political leaders everywhere, are excessively fond of feel-good political displays full of fluffy words and little substance.

A good example of that is tomorrow's proclamation of the Wildlife Act into law - minus the regulations that will actually tell people what they may or may not do. It's like being armed with a rifle, but no bullets.

And there are many members of territory's small political and bureaucratic elite who get prestige, social status, and above all, easy money, from Nunavut's multi-layered networks of administrative institutions. It's simply not in their interest to ask many deep questions whose answers could weaken the legitimacy of the system.

So was the creation of Nunavut worth it?

There are some beneficial things that governments, and others, have done that could not have happened without the creation of Nunavut. They include a nursing program at Arctic College that has already begun to graduate Inuit nurses; more aggressive efforts by the RCMP to recruit and train Inuit police officers; and the highly-publicized program to train Inuit law graduates.

And when Nunavut left the Northwest Territories in 1999, it was possible, at long last, to get a clear picture of what the people of Nunavut really need to better their lives: especially in health care, housing, municipal infrastructure, correctional services, education, and economic development. It isn't often a pretty picture. But now, policy makers enjoy access to indisputable sets of facts that they can use to lobby for better housing, health care and many other essential services.

The creation of the Nunavut government and other institutions has also given the region a stronger voice. In the national health care funding debate, Nunavut is now recognized as a special region with special needs, even if those needs are still not met. Though a child born in Nunavut today can expect to live, on average, 10 to 15 fewer years than a child born in Toronto or Vancouver, at least that is now known.

And in the allocation of fish harvesting rights within Nunavut's adjacent offshore, Nunavut's share is rising slowly. Even though Nunavut still doesn't have the infrastructure needed to take advantage of its new quotas, it makes future planning easier.

On the other hand, many Nunavut residents are not happy with the Nunavut project, especially those who live far from the capital. Many Kitikmeot residents are so dissatisfied, they've been musing aloud about threatening to separate from Nunavut. That's not surprising, given that for many years Nunavut's western region received better services from Yellowknife than they now get from Iqaluit.

The Nunavut government has now had enough time to recover from the wounds inflicted upon it by blunders committed within the Office of the Interim Commissioner during the 1997-99 planning period. But when Nunavut residents try to get services from their government, they're too often confronted with incompetence and confusion. Just ask a student who's tried to get a FANS cheque on time, an entrepreneur who's applied for an economic development grant, or a medical patient stranded in Ottawa.

The Government of Nunavut may be better staffed than in the desperate days of 1999 and 2000, but it's clear that many employees still don't know what they're doing, and that some departments are still suffering from the effects of decentralization.

And some communities are, in different ways, signaling that the Nunavut project's official institutions are inadequate. The hunters of Qikiqtarjuaq, for example, have turned their backs on the officially-endorsed Baffin Fisheries Coalition, and have made great strides towards the creation of their own community-based fishery. In Baker Lake, hamlet councillors have said they want to make their own deals with a company that plans to build a gold mine near their community - because they believe the Inuit Impact and Benefits Agreement process doesn't offer them enough.

But these are hopeful signs, because it shows that the spirit of independence still lives in the hearts of Nunavummiut. If that spirit isn't crushed by Nunavut's often robotic bureaucracy, then perhaps a decade or so from now we may be able to say with certainty that the Nunavut project was worth it. JB

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