|
April 12, 2002
Nunavut demands equal treatment
Nunavummiut want access
to health-care services that other Canadians take for granted
JIM
BELL
We want equal treatment.
Thats the message
the Nunavut government and three Inuit organizations brought this week to Roy
Romanow, the head of the federal governments one-person commission on
the future of health care in Canada.
"Simply stated, there
is an absence in the basic range of health services in Nunavut that are taken
for granted in the rest of Canada," Ed Picco, Nunavuts minister of
health, told Romanow at a public hearing in Iqaluit April 8.
In April 2001, Prime Minister
Jean Chrétien appointed Roy Romanow, a former NDP premier of Saskatchewan,
to head a commission aimed at finding ways of fixing Canadas dilapidated
health-care system.
Romanow will likely issue
a final report sometime next year.
Its too early to
say what Romanow will recommend, or whether Chrétien and his government
will heed his recommendations.
But its clear that
the Nunavut government and Inuit organizations, who dont always see eye-to-eye,
agree on at least one thing: Ottawas health policies are failing in Nunavut.
"Inuit leaders are
concerned that the [health] problems have already reached crisis proportions,"
said John Lamb, Nunavut Tunngaviks director of implementation.
Lamb said the federal government
may not be living up to commitments made in Article 2 of the Nunavut land claim
agreement, which state that Inuit are entitled to all the rights and benefits
available to other Canadian citizens, and to participate in government programs
aimed at aboriginal people.
"Whats really
needed is some nation-building," Lamb said. "Canada must live up to
its commitments to bring Nunavut into Confederation."
Mental health an Inuit
priority
The Qikiqtani Inuit Association,
represented by John MacDougall, a QIA policy analyst, told Romanow that Ottawa
should develop a separate "Inuit health policy."
"There is a need for
an Inuit-specific health policy made by Inuit themselves," QIA says in
its submission, called "The Seven Qulliqs of Inuit Health Renewal."
Another QIA submission,
prepared by Amanda Ford, QIAs health liaison officer, says mental health
is the highest priority health issue for Nunavummiut.
Nunavummiut feel they are
left alone to deal with the grief of suicide, domestic violence, sexual abuse,
alcohol and drug addiction, and most importantly, the development and decision-making
in the Health Policy Act," her submission said.
In his presentation, Ed
Picco cited a long list of shocking statistics that show the health status of
Nunavummiut is worse than it is for people in some Third World countries.
"The deplorable health
realities speak for themselves," Picco said.
For example, he said 80
cases of respiratory synctial virus, or RSV, have been reported in Nunavut since
January. There is no vaccine or treatment for RSV, which causes severe breathing
problems for infants and spreads rapidly among people living in overcrowded
housing.
Picco cited what he called
a "shocking study" by Dr. Anna Banarji of the B.C. Childrens
Hospital, who found that Inuit children are admitted to hospital for lung infections
during their first year of life at a staggering rate 484 admissions for
every 1,000 children.
"This rate is higher
than many developing and Third World countries and 50 times higher than the
Canadian national average of 10 admissions per 1,000 children," Picco said.
Tuberculosis rates in Nunavut
are 13 times the national average, and there have been community outbreaks of
TB in Arviat and Iqaluit, with sporadic cases in eight other communities.
"This is not acceptable"
And the deadly TB bacillus
still lurks within the bodies of the young. Picco said data collected in 2000
show that in the Baffin region alone, seven per cent of children in kindergarten
to Grade 5 have tested positive for TB.
"This is not acceptable
in a G8 country like Canada," Picco said.
Nunavuts infant mortality
rate is three times the national average, and the suicide rate is eight times
higher than any other Canadian jurisdiction. Alcohol and substance abuse are
also major problems in Nunavut, and reflect the territorys poor social
conditions, Picco said.
Saying that there are 50
per cent more residents per dwelling in Nunavut than in the rest of Canada,
Picco told Romanow that Nunavuts housing crisis only worsens Nunavuts
numerous public health problems.
"The cycle of illness
in such overcrowded conditions makes it even more difficult for our health-care
system to have a lasting impact on the health status of Nunavummiut," he
said.
To deal with these health
issues, Nunavut is making do with inadequate infrastructure.
"As you saw for yourself,
Nunavut has only one regional hospital. It is almost 40 years old and requires
immediate replacement," Picco said.
There are only 10 doctors
residing in all of Nunavut, Picco said, and all but one of them lives in Iqaluit.
That means 90 per cent
of primary health-care services in Nunavut are delivered by nurses.
"They operate on a
24-7, 365-day basis. The per-visit cost to see a community health nurse in Nunavut
is much higher than to see a physician in the South.
Picco told Romanow about
the delibilitating costs of sending patients to the South to see doctors and
receive specialized treatment not available in Nunavut $18.2 million
a year in payments to out-of-territory hospitals and physicians.
On top of that, Nunavut
must also pay $28.5 million a year for medical travel to southern centres. Picco
said one medevac can cost anywhere from $12,000 to $15,000 and that it can take
up to five hours to get a critically ill patient to an acute care centre in
the South.
Federal policies "asinine"
In 1999, Nunavut spent
$6,869 per resident on health care, compared with the national average of $1,904.
But Picco said Nunavut needs more.
"Those who suggest
that we are already doing a lot and spending too much should be reminded that
whatever the federal government and Nunavut is spending now and whatever we
are doing is not enough," he said.
And he criticized Ottawa
for introducing federal aboriginal health programs that ignore Nunavut and Inuit.
For example, he said that
its "asinine" for Ottawa to exclude Inuit from a recently announced
$125-million initiative to help aboriginal children with FAS and special needs.
That program is aimed only at on-reserve First Nations people.
He also said a federal-provincial-territorial
agreement in the fall of 2000 that increased Ottawas annual health and
social transfers to the provinces and territories by more than $3 billion a
year brought only a pittance to Nunavut about $3.2 million a year.
Thats because CHST
transfers are calculated on a per-capita basis, so that Nunavut always loses
out because of its small population.
And when Nunavut attempts
to get more program money, Ottawa threatens to reduce the money it provides
the Nunavut government under the formula financing agreement, Picco said, so
that Nunavut would get a net gain of zero.
Romanow, who toured Baffin
Regional Hospital and the Pangnirtung health centre with Picco the day before,
told Picco that he sees the Nunavut health-care system as a "remarkable
product of commitment, dedication and will-power."
"You must have one
of the most difficult jobs in the country," Romanow told Picco.
|