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Back to March, 2002 Archive Index
Columns SEX ED: WHAT YOU NEED TO KNOW April 5, 2002 - HPV: Warts and why women need Paps Nunani April 12, 2002 - Now and then: Part four April 26, 2002 - The Last Great Polar Bear Hunt: Part one SEX ED: WHAT YOU NEED TO KNOW HPV: Warts and why women need Paps The human papillomavirus (HPV) is a virus that is not quite as scary as HIV, but nonetheless causes problems in sexual health. The virus is transmitted sexually by direct skin to skin contact. The spread of the infection can be reduced — you guessed it — by using condoms. HPV causes two main problems: warts and cervical cancer. Condyloma is the fancy medical word for genital warts. They are hard, usually painless bumps that can sprout on or near the vagina, penis and anus. Although the warts are caused by HPV, they are more of a nuisance and a cosmetic problem than anything else. Warts do not become cancers. These bumps are stubborn critters, but with various treatments 80 per cent of patients can get rid of them. However, the virus itself often remains, which means that it can still be transmitted even if no warts are visible. One study showed that a quarter of people who have warts have another STD as well — so be sure to be checked for other infections if you have genital warts. The place where HPV can cause real harm is a woman’s cervix (the opening into the uterus which is found a few centimetres up inside the vagina). HPV transmitted through intercourse can invade the cells of the cervix and this can lead to cancer. Smoking also increases the chances of developing cervical cancer — as if there weren’t enough reasons to quit already! The good news is that cancer in this area takes many years to develop, so it can be found before it causes a problem — that’s where the Pap smear comes in. So, what’s a Pap? Pap smears, named after Dr. Papinalacou, who invented them, are an excellent way to look at the cells at the cervix. Under a microscope, if the cells show early changes that can lead to cancer, then effective treatment can be started. It takes a few minutes with a nurse or doctor and involves having a small sample of cells taken from the cervix with a brush. It’s that easy! No woman should ever die from this disease. Sadly, Iqaluit is the only place where I have seen advanced cervical cancer, and the woman’s death was an avoidable tragedy. Some women and their partners worry that when a doctor suggests they get a Pap it means we suspect they have an STD. Not so. It’s just like being checked for diabetes or high blood pressure — we are trying to prevent disease before it happens. Having a Pap smear once a year is a very important way for women who have been sexually active to prevent cervical cancer. If you have one long-term partner and have had three normal Paps in a row, then every two years is OK. Just like using condoms and understanding birth control, knowledge is power and prevention is the key! Confidential questions or comments? Send an e-mail to nunatsiaqsexed@hotmail.com or drop a note by the news office. Next week: Herpes. Madeleine Cole is a physician at Baffin Regional Hospital. Genital herpes is no fun! Genital herpes is caused by the Herpes Simplex virus (HSV). Once you are infected, you have it for life. Herpes is transmitted sexually from direct skin to skin contact — usually when blisters are present. However, the virus can be passed along even between outbreaks when the skin looks normal. The first outbreak of genital herpes can hurt like hell. The earliest symptoms are usually itching and a feeling of burning when you pee. Blisters and ulcers usually develop on or near the penis or vagina two days to two weeks after being infected. With the first infection you can also have fever, joint-pain, swollen glands and a general feeling of lousiness. This initial attack is usually the worst and can last up to a month. Most people who have herpes will have occasional flares. Now for some good news: after the first one, they don’t last as long and are not nearly as painful. Don’t have intercourse when you’ve got the sores — as if you’d feel like it anyway. At the first signs of an outbreak, such as tingling or redness in the area where the blisters usually form, avoid genital contact. No oral sex either — and wait a couple of days after the blisters are fully healed and the skin looks normal again. So can it be treated? Alas, there ain’t no cure — but there are medications that can shorten the length of outbreaks and relieve the pain. If it hurts to pee, try pouring water over the rash while you do it. Wear cotton underwear and keep the area clean and dry. Add a tablespoon of baking soda to the bath and soak, or try a cold compresses on the blisters. Cold sores are caused by a similar virus — the HSV that causes herpes below the belt sometimes causes cold sores around the mouth too. It is possible to spread the virus from one part of your body to another, so hand-washing is very important. Herpes virus in the eye can be especially problematic. Unlike chlamydia, herpes doesn’t affect your ability to have babies. However, if a pregnant woman has an outbreak, it can cause serious problems in the baby — so be sure to let your doctor or nurse know if you’ve had herpes There is evidence that you can reduce the number of herpes outbreaks by living the good life: avoid stress, sleep well, eat a healthy diet and exercise regularly. Some people get herpes flares when exposed to very hot, cold or sunny conditions. In folks who get many outbreaks each year, taking a regular medication may decrease the number of attacks too. Wearing condoms every time you are naked with someone decreases the chances of spreading (or picking up) the Herpes virus. And as with all the STDs, let your partner know you’ve got it. That’s one of the rules of fair play. Confidential questions or comments? Send an e-mail to nunatsiaqsexed@hotmail.com or drop a note by the news office. Next week: HIV. Madeleine Cole is a physician at Baffin Regional Hospital. HIV: More than a Harmful Icky Virus The human immuno-deficiency virus (HIV) is an infection that attacks and damages the body’s immune system. The immune system fights off infection. But over years, HIV breaks down our ability to get over even minor infections. When a person has had a number of infections, illnesses or cancers as a result of the virus, the condition is labeled as AIDS (Acquired Immuno-deficiency Syndrome). HIV is the most devastating STD of all — but understanding how it works is all it takes to move from fear to understanding. With knowledge, you can protect yourself and care for people living with the disease. Viruses aren’t picky. HIV will infect women and men, Inuit and Qallunaat, straight, gay, bi, or lesbian, young or old. There are only a few ways to get HIV. Zillions of little virus particles are found in blood, semen (cum), pre-ejaculate (that wet stuff before a guy comes), vaginal fluids and breast milk. HIV can be spread from one person to another through unprotected sexual intercourse (vaginal, anal, or oral sex), sharing needles (for intravenous drugs, body piercing or tattooing), or from an infected mum to her baby during pregnancy or through breastfeeding. So if you have it does it mean you can never have sex again? Of course not. But there’s stuff to remember and choices to make. You need to tell all your past, current and future partners that you are HIV positive. Remember that sex is more than intercourse and different activities carry different amounts of risk of transmission. There is no risk with touching, kissing, hugging or massage. There is a low risk with oral sex (with ejaculation) and with vaginal or anal intercourse with a latex condom. There is a high risk of transmitting the virus with intercourse without a condom. All pregnant women in Canada should be tested for HIV with their consent. Treatments are available that reduce the risk of passing the infection on to the baby. You should also know that it takes up to three months from the time of infection before a blood test will show the virus. Over the past decade there has been a large increase in the number of aboriginal people living with HIV in Canada. Although aboriginal people (Inuit, Metis and First Nations) make up 2.8 per cent of Canada’s overall population they accounted for 5.5 per cent of all HIV infections in 1999. Aboriginal Canadians made up 8.8 per cent of all new diagnoses in that same year. The proportion of aboriginal AIDS cases has increased eight-fold in the last decade. Enough stats — you get the picture! HIV is on the rise and there is potential for disaster in the North. Inuit initiatives such as Pauktuutit’s colourful, flavourful condom campaign are essential if we are to avert a crisis. I cannot write about HIV and AIDS without remembering and sending hope to the people of Africa who are already being devastated by the disease. Rates of infection there are sky-high, medications to control the virus are not affordable, and millions of children have been orphaned as their parents die of AIDS. In North America, there are some incredible medications to control the progress of HIV. But make no mistake — there is no cure for HIV. Even people who look well and feel great can be infected with HIV and with every sexual encounter the virus can be passed along. Universal precautions — condoms for everyone! Avoid casual, anonymous, unprotected sexual experiences. And intravenous drugs are deadly too. It isn’t worth it. One little mistake could cost you your life. Be a latex lover. Wear that condom. Free condoms are available at public health offices, health centres and hospitals everywhere. For more information see a nurse or doctor or check out these organizations: • Canadian Aboriginal
AIDS Network • Canadian Inuit HIV/AIDS
network (Pauktuutit) • HIV treatment/information
services • Voices of Positive
Women Confidential questions or comments? Send an email to nunatsiaqsexed@hotmail.com or drop a note by the news office. Want to read past Sex Ed columns? Go to www.nunatsiaq.com and click on columns. Next week: Syphilis Madeleine Cole is a physician at the Baffin Regional Hospital. Syphilis: Making a comeback Syphilis has also been called "bad blood" or the "pox" and is caused by bacteria called treponema pallidum. Like most STDs, it can be spread from one partner to another through vaginal, oral or rectal sex. It can also be passed from a pregnant woman to her fetus and cause some major problems in the developing baby. Overall, 90 per cent of syphilis is transmitted sexually and the remainder is spread through blood. Syphilis has three main stages and it can take anywhere from 10 days to three months until symptoms start. First you get a painless open sore around the genitals (or sometimes around the mouth.) After two to six weeks the ulcer heals up on its own. One to two months later the second stage can lead to flu-like symptoms and a spotty rash to the palms and soles or even the whole body. From the first painless ulcer through the second stage, it is very infectious. Without treatment, the symptoms usually go away and the infection becomes dormant. That is the fancy medical term for lying low and waiting to cause problems later on. In the third phase, or tertiary syphilis, it makes a come-back slowly. It can damage the heart, joints, liver, brain, and eyes. In fact, there’s not much of the body that the virus can’t affect. The way to find out if you have syphilis is a blood test. Anyone with a painless genital ulcer sore should be tested. Folks that have had unprotected sex and have any unusual rashes should also be checked for syphilis. All pregnant women are tested as well. Good news: syphilis can be cured. Syphilis is treated with injections of penicillin or sometimes with pills by mouth. Once treated, the blood test still stays positive but other tests can show that the bug has been killed. Syphilis has been found in men at twice the rate it infects women. The incidence peaks in people between ages of 15 and the mid-30s. Since about 1997, when there was an outbreak in sex trade workers in Vancouver, syphilis has been on the rise in Canada. It’s affecting and infecting the North too. The Yukon had their number of cases go from none, to 11 in 2000, and it doubled again the next year. It may not sound like many infections but with a couple of cases of syphilis in a community, like HIV, it can spread like wildfire. So, time to hammer home that same old message one more time! If you want to stay healthy and protect yourself from STDs there are two choices. Don’t have sex. Or if you do, be sure you know who you are getting involved with, limit the number of partners you are with, and wear those condoms every time. Confidential questions or comments? Send an email to nunatsiaqsexed@hotmail.com or drop a note by the news office. Want to read past Sex Ed columns? Go to www.nunatsiaq.com and click on columns. I’m going skiing on the icefields between Clyde and Pond Inlet for the next two weeks — then back to write about hepatitis, trich, critters and more. Madeleine Cole is a physician at the Baffin Regional Hospital. Nunani Now and then: Part four RACHEL ATTITUQ QITSUALIK We’re a naive generation. In our hubris, we assume that we have achieved a level of political savvy that puts us beyond the need to study history. We have come to believe that we, unlike any generation before us, are tolerant and wise. We tend to call our new gospel, "political correctness." We have become pretty smug, proving our goodness by openly decrying injustices of the past, the totalitarianism, the sexism, the racism. And in doing so, we have become comfortable with the idea that we are better than generations before us, that we have politically "arrived," and that history has no lessons to offer. Why study the deplorable deeds of those before us? We know that everything leading up to now has been nothing but an extended tale of horror and exploitation, so why not focus on tomorrow? And then there is that excuse of the laziest mind: "History is written by the conquerors, so there’s no point in studying it, because it’s all biased anyway." Yet I say that history, any history, is useful for one great reason: if you can teach yourself to recognize what is broken, you can then fix it. Aboriginal peoples, as exploited peoples, particularly need to adopt this approach. Inuit are no exception. How many aboriginal people, Inuit included, know about the events of the Lakota War? All should know, because the Lakota War is a model for most aboriginal-federal relations. In America, the tensions that mounted between settlers and Native Americans throughout the 1800s, are no mystery. As settlers pushed west, they increasingly intruded upon the traditional lands of numerous Indian tribes, which resulted in skirmishing back and forth. But such damaging colonization of the American West was greatly accelerated by the American Civil War, which divided the whites between North (the United States of America) and South (the Confederate States of America). Think of how the Indians must have felt. It would be like having two strangers trying to kill each other in your living room. The United States won the war, of course, but was nevertheless left with a severely divided nation. So, in order to get back on its feet, economically and politically, the government began to redouble its efforts to colonize the west — to assert its "sovereignty." The first thing it realized was that there were too many Indians, so it had to find a way to reduce their numbers. In 1866, General Philip H. Sheridan proposed a systematic program to wipe out the buffalo, upon which the Indians depended, summing it up with the statement, "Kill the buffalo and you kill the Indians." I get a chill when I think of this and remember the old Canadian documents I’ve read, full of statements like, "Without the dogs, the Eskimo will adapt to settlement life." Or, "Since the family is the basic unit of Eskimo culture, separation of parent and child is the key to assimilation." And, as with the U.S., the federal government’s overarching excuse for its forced relocations and its dismantling of culture was always, "protecting Canadian sovereignty." In the American West, the rush of settlers carried there by new railroads, and impelled by government financial incentives, only accelerated tensions with the Indian tribes. The tribes of the plains were large at the time, and were skilled fighters. Years of lucrative trade with whites had armed nearly all of them with horses and rifles. When they fought, they packed enough of a sting that the government was forced to sign treaties with them — land claim agreements, if you prefer. The U.S. and the Lakota, one of the largest of the plains tribes, signed the Fort Laramie Treaty in 1868. This treaty set aside traditional lands for the Lakota, and the federal government was obligated by treaty to protect those lands from white settlers. The land claim included some of the areas the Lakota considered most sacred to them, and the area was thought by the U.S. government to be pretty useless for farming or development. It seemed like a pretty good deal for both sides. It was not to last. In 1874, George Armstrong Custer, having no regard for treaties with Indians, announced the presence of gold in the Black Hills area — the most sacred part of Lakota territory. It started a gold rush. (Continued next week.) Now and then: Part five RACHEL ATTITUQ QITSUALIK Custer’s announcement of gold in the Black Hills set off a stampede of fortune-hunters, having no regard for the fact that prospecting in this area meant desecrating one of the most sacred sites of the Lakota people — not to mention outright violation of the 1868 Fort Laramie Treaty. The Lakota were outraged, of course, but spent the next few years appealing to the U.S. government. What they didn’t realize, unfortunately, is that the federal government possessed considerably less enforcement power than it pretended, and this was only aggravated by genuine greed for the gold. Economic development is, after all, what puts the glow in any government’s cheeks. Then, as now, money talks. In 1875, a Senate commission met with several Lakota chiefs to negotiate access for gold miners, even offering to purchase the sacred area for $6 million (not a large sum, even for that era). The Lakota, to their credit, had by then learned to be distrustful of new deals, and the site was just too important to them. They weren’t interested. Having been refused, the government promptly dropped its peaceable facade, commanding the chiefs to report to their designated reservations by Jan. 31. But the Indians had had enough, and the government’s position set off a firestorm of armed resistance by chiefs such as the great Sitting Bull, Crazy Horse, Red Cloud, and many others determined to police their lands. The federal response was to use the army to "herd" Indians encampments away from the Black Hills, systematically butchering any bands — to a child — that stood in their way. This common threat forged a powerful alliance between the tribes, who fought effectively (Little Big Horn, or "Custer’s Last Stand", being an example) until they were finally routed in 1877. Sitting Bull eluded capture by bringing his band safely to Canada. The U.S. Congress voted, in the end, to repeal the Fort Laramie Treaty, seizing 40 million acres of Lakota land — as well as the Black Hills, which were soon dotted with mining camps. Now, having had all of that out, I hope the reader can intuit the point of these past few articles. I’m desperately afraid there are some out there, saying, "What the hell has all of this got to do with Arctic Canada?" I’m even more afraid that there are readers saying, "I see — she’s saying that white people aren’t trustworthy." No, no, and no. The point I’m making is that the Lakota War is an example of a situation wherein everything goes wrong — in the worst possible way — between aboriginal peoples and a federal government, accelerating to a disaster point within the space of only a few years. The events leading up to the Lakota War illustrate tensions that have existed time and again — and still today — between aboriginal peoples and respective federal governments. A federal government is not necessarily an evil entity, but it is an institution with its own unique interests. Those interests can often conflict with smaller, regional interests, and all-too-easily conflict with the interests of aboriginal peoples. Aboriginal peoples — Inuit being no exception — are constantly in a surreal position, that of feeling as if a very large, very powerful stranger has come to occupy their home. It is a bit like having a bear living in your house: You are safe as long as the bear is minding its own business, but you know it means trouble if it suddenly turns its attention to you. One way or another, you can never really relax, because even if it isn’t interested in you today, you know it would roll you if it got hungry tomorrow. It’s just the bear’s nature. So the point I’m trying to make is that aboriginal peoples, including Inuit, who have a notably non-violent history with the Canadian government, can still never afford to take their eyes off the bear. Due to their cunning and perseverance in negotiation, Inuit have generally come to earn an unprecedented grip on the north, their home — a grip perhaps unrivalled by any other aboriginal people. But we must understand the history of this continent, so that we are not caught off-guard if that bear comes sniffing around, smelling new resources, asking for the re-negotiation of old agreements. For negotiation is difficult, if not impossible, with one who already holds all the cards. Pijariiqpunga. The Last Great Polar Bear Hunt: Part one There I was, sitting on the kamotik, praying that we wouldn’t catch up to the owner of the massive footprints in that snow. Please, please, I silently begged to no one in particular — let the tracks be a few days old. Please, please let the creature be long gone from the scene. And please, even if we did catch up with it, let it get away. I’ve always had a morbid fear of polar bears. They’re bigger than any animal on land, and they can eat your dogs and kill your family. So there I was, pre-adolescent, out on the Land, and rigidly locked into my imagination of all the horrible things that would happen to us if we ever caught up with that thing. That thing had left its tracks, huge imprints the size of pie plates. I watched in mingled horror and fascination as the deep impressions filled with errant, wind-borne snow. I knew enough to realize that the bear had at least been here this day, since these impressions were concave. Older prints would have been heavily raised. The weight of the creature compacts the snow underneath it, making it more dense than the untouched snow. As the uncompacted snow is blown away, the dense stuff is left in view, looking like a sort of inverse footprint — a cast of the bear’s foot. It was a good thing the dogteam couldn’t "read" the prints, or they would already have freaked out, as I was, sitting behind my father on the kamotik. Then again, they hadn’t caught scent of it yet, either, although that didn’t make me feel much better. The bears, like many Arctic animals, had evolved to carry very little scent, so the dogs had to be fairly close or downwind before they could detect it. I was making plans concerning what I might do if things went wrong, slipping my mitted hand under a piece of lashing to hang on in case the dogs bolted. That was so I wouldn’t be dumped and left behind, weaponless before one of the world’s most capable hunters. In the Arctic, throughout the ages, human beings have only held second place in the rating for top predator. Hunting the beast entailed skills even the greatest hunters took years to perfect. It had never become a sport, and no one but no one ever took it lightly. Once, as an adult, I ran into a pleasant old hunter in Rankin Inlet. He was positively ancient, a real Inummarik ("true" Inuk). He sat me down and, in his archaic style of Inuktitut, told me of the bear encounter that had nearly killed him. His head was a strange shape, especially around the top, where his silvery hair was little more than wisps, like curling smoke. I tended not to stare — until he tilted his head to show me. There were scars — no, a single, great scar — that took up his entire crown. His head was nothing but, and his skull, at the apex, was hideously indented, like a broken soup bowl. He explained to me that a bear had done this to him, a great bear that appeared out of nowhere one day, while he was hunting. To his chagrin, he admitted to using a skidoo, instead of dogs which can guard against approaching bears. It had been a long hunt, and he was out of ammunition. He claimed to simply turn, and there the creature was, a great male, standing over him. He danced backward, staying to its right, since bears are left-handed, strike first with that paw. But he could not evade it forever. The bear, he explained, cannot kill a standing man. He knew he had to remain standing at all costs, since the bear’s tactic is to push a man down, so that it can incapacitate its victim by ripping off the face, as it does with a seal. Again and again, the bear reared, smashing its weight down upon him. But every time, he resisted falling, willing himself to remain on his feet. He paid a great price, with several of the attacks lacerating his head, peeling his scalp away. One or more blows — he couldn’t rightly remember — crushed his skull like an eggshell. He never did fall, and the bear eventually grew bored, and left him. (Continued next week.)
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