There were 139 cases of tuberculosis identified in Pangnirtung between January 2021 and May this year, the largest outbreak to be revealed in the territory since 2017. Pat Kane / The Globe and Mail
The president of a major Inuit organization has reiterated her call for transparency after The Globe and Mail published an investigation into a major TB outbreak in Pangnirtung, a village of about 1,500 people on Baffin Island.
In an interview, Aluki Kotierk, president of Nunavut Tunngavik Inc., said the country’s economy is growing rapidly. (NTI), stressed the need for the Nunavut government to release tuberculosis data for individual communities.
In the letter of February 24, Mrs. Kotierk urged John Main to hear a decision by the Territory Privacy Commissioner calling for tuberculosis case counts to be released for all 25 Nunavut communities of entry. He wrote that the government’s refusal has “endangered the health” of residents and has acted as an impediment to signing a crucial action plan against tuberculosis.
The non-binding decision of the Privacy Commissioner of February 7 arose from an appeal for access to information filed by The Globe.
In Nunavut, medical staff saw signs of a devastating outbreak of tuberculosis. The government did not
Nunavut admits a large outbreak of tuberculosis in Pangnirtung months later
A la carte, Mrs. Kotierk said the information requested by The Globe (including TB case counts and rates, broken down by community, age, and gender) was essentially the same information that NTI wanted to make public before signing a joint action plan. TB with the territorial government.
Nunavut’s “continued refusal … to provide this and other relevant information in a timely and complete manner has endangered Nunavummiut’s health by hindering the implementation of the Tuberculosis Action Plan,” Ms. Kotierk a la carte, a copy of which NTI provided to The Globe.
Until there is a plan, NTI will not give the territorial government more than the $ 13 million in federal money it received to begin work toward the Trudeau government’s goal of eliminating tuberculosis in Inuit communities by 2030.
In 2018, when Ottawa cast its vote, it allocated $ 27.5 million over five years to Inuit Tapiriit Kanatami, a national organization representing 65,000 Inuit. ITK divided the money among four Inuit regional organizations, the largest of which is NTI.
It was assumed that each Inuit group, working with local health officials, had to develop an action plan tailored to their specific needs. Nunavut is the only Inuit region where no agreement has yet been reached.
NTI plays an important official role in Nunavut. It is responsible for ensuring that territorial and federal governments fulfill the promises made to Inuit in the Nunavut Agreement, the founding document of the territory.
Globe’s investigation, based on more than 200 pages of internal documents obtained through a request for access to information, revealed that front-line nurses were asking for help in managing tuberculosis in Pangnirtung last summer, months before an outbreak was declared on November 25th. , 2021.
The government did not disclose the extent of the spread until six months after declaring the outbreak. This comes after The Globe sent a list of questions for its investigation and the mayor of Pangnirtung called for more transparency.
There were 139 cases of tuberculosis identified in Pangnirtung between January 2021 and May of this year, the largest outbreak to be revealed in the territory since 2017. Thirty-one were active tuberculosis; the rest were latent infections that are not contagious and do not get sick, but that can eventually turn into active tuberculosis.
Considering its population of about 1,500 people, the incidence rate of Pangnirtung tuberculosis in 2021 is among the highest in the world, surpassing the rates regularly seen in the less developed countries of Africa.
The Nunavut Department of Health declined to publish the numbers of tuberculosis cases for any other community, saying doing so would run the risk of identifying patients in small villages, stigmatizing entire communities and having no practical purpose outside of ‘an outbreak.
Mr. Main explained these concerns in his reply letter to Ms. Kotierk, which The Globe obtained through a request for access to independent information.
“In the past, villages have expressed concern about publishing data publicly because of the stigma,” Mr. Main. “Even in cases where it would not be possible to identify individuals, there has been increased attention and stigma towards specific communities where there were cases.”
He offered to discuss the provision of tuberculosis data at the community level in a confidential manner to NTI and village officials without making it public.
But Ms Kotierk said in the interview that such an approach would perpetuate the “colonial” idea that “we cannot make decisions for ourselves about our own health, that we are not intelligent and self-determined people.”
Joe Savikataaq, Jr., the mayor of Arviat, also wants the territorial government to make public the tuberculosis case counts for communities. His village of nearly 3,000 people in the central Kivalliq region has been battling tuberculosis for the past few years, but he doesn’t know the real extent of the problem.
Arviat was the site of the first major outbreak of COVID in Nunavut in November 2020. The territorial government provided periodic public updates on COVID case counting, a transparent approach that Mr. Savikataaq Jr. he said it helped alleviate the stigma associated with the new virus.
“Donations came from all over the country to Arviat,” he added, “so there was nothing wrong with publishing numbers. Names were never published, only numbers, and that should be the case. for TB “.
In 2020, the most recent year for which national data are available, there were 72.2 active cases of TB per 100,000 diagnosed in Inuit patients, compared with a national case rate of 4.7 per 100,000. Despite being 15 times higher than the national average, the rate of tuberculosis among Inuit in 2020 dropped significantly from a 10-year annual average of 184.14 per 100,000 between 2010 and 2019, a decrease that some experts attribute to which cases of tuberculosis were not diagnosed in the first year. of the pandemic.
High rates of tuberculosis among Inuit are a reflection of the poverty that affects their isolated Arctic villages and other Indigenous communities across Canada, said Elizabeth Rea, co-chair of Stop TB Canada and an associate physician in Toronto.
Tuberculosis bacteria are more likely to spread to overcrowded and poorly ventilated homes, and people are more likely to become seriously ill if they are malnourished, smoke cigarettes, and suffer from chronic illnesses.
“It’s horrible that Canadians who were born and lived their whole lives in a country as rich as Canada … suffer from tuberculosis and tuberculosis outbreaks,” Dr. Rea said.
Mrs. Kotierk added that it is important to share detailed information about the burden of tuberculosis in Inuit communities. In this way, “the rest of Canada cannot forget” the ongoing health crisis.
“Why keep it a secret so everyone feels comfortable and forgets that we live in circumstances that don’t even cover basic housing and food needs, which contributes to high rates of tuberculosis in our communities?” she said.
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