As promised, a few more observations about health care in the Canadian arctic.
Last week I had the privilege to work with a nurse who has for the past 30 years been working in what is now Nunavut.
During one of our rare breaks from the steady flow of patients, she told me that in the early ’80s she did not see any Inuit with diabetes or high blood pressure.
Nor did she see the currently not uncommon pre-eclampsia of pregnant women, a condition that puts health and life of both mother and baby that risk.
Knowing how smart this nurse is, I am sure that it was not because she missed recognizing these conditions.
During the past eight years that I have been looking after the Inuit, I am getting a very different picture.
One out of every nine Inuit has adult onset diabetes and many have high blood pressure, necessitating the taking of medications to prevent strokes and heart attacks.
Why this enormous change in such a relatively short time span?
The short answer lies in the lifestyle revolution these people have experienced.
The longer answer is that a little more than a half century ago, the Inuit used snow for shelter and survived by hunting, trapping and fishing.
Their diet consisted mainly of fat, protein and very little carbohydrate.
Translated into what they actually consumed, it was mainly caribou meat and fish and walrus, whale or seal blubber, supplemented with berries they gathered in the fall on the tundra.
Their metabolism had adapted very well to what strikes us as a rather unusual menu. All essentials including vitamins and minerals were included in this diet
The caribou hunt was the mainstay and provided the Inuit with virtually everything they needed to survive: first of all, the meat, but also the hides used for clothing, tents, bedding and the construction of kayaks. The caribou bones were turned into tools and virtually nothing was wasted.
In order to survive the winter, an Inuit hunter needed to kill 35 caribou and cache the meat near his igloo.
By the 1950s, something happened to the migration of the caribou herds and mass starvation ensued.
The federal government gathered up the scattered population into settlements suitable for social assistance, health care and basic government, and organized a massive food airlift.
The Inuit were housed in shoddy government homes, their children in abusive residential schools and a new culture of dependence on social assistance cheques was established.
The government provided every settlement with a health centre, a cooperative general store or northern store, where the local population could buy food clothing and other essentials.
If you would visit any of the stores, you will see aisle upon aisle stocked with processed food, pop and an incredible assortment of what is best described as junk food. I am told that one of the store managers ordered three cans of pop per day per person over the age of 10 for the whole year to arrive by sea lift. The store ran out of pop months before the next delivery.
More pop had to be flown in with the cargo planes to meet the demand. Many of the high consumers panicked if the next delivery was delayed on account of a blizzard and no aircraft could land.
It is this drastic change in diet that has caused these previously healthy people to develop diabetes and high blood pressure and all the dire consequences of these diseases.
It will probably take a generation or two of education to enable them to make better choices and develop food preparation skills that will prevent these costly health problems.
Poor planning on the part of the government has created a demand for health care that can only be partially met and so far very little effort has been apparent to reverse the situation. More about this next time
Dr. Marco Terwiel is a retired family physician who lives in Maple Ridge.
