The health care system in the Canadian region of Nunavut is an ongoing issue. The approximately 37,000 inhabitants, spread over an area 50 times larger than Switzerland, often have limited access to medical care. As a result, disease outbreaks and illnesses such as latent tuberculosis can be more severe than in other places in Canada. Now, a region-specific new health care law has gone into effect that should improve the situation.
The old law, dating from the 1950s, had included the entire northwest region of Canada and took little account of the new conditions. The government in Ottawa had also recognized this some time ago and had passed the new Public Health Care Act in 2016. But implementing the law took another nearly four years, according to the Department of Health. Various aspects required by the new law had to be included for Nunavut’s circumstances. Among them regulations on food and drinking water safety. Dr. Jasmine Pawa, the deputy medical officer for the Nunavut administration, explains that currently there are still some regulations and ordinances that need to be reviewed before they can be implemented. “We are still working on food and drinking water regulations, or their inspection areas. There are still many discussions about inspections and reports.” The regulatory changes that have come into effect are intended to reflect the social values of the Inuit population, the ministry said earlier. Dr. Pawa also feels that aspects such as the environment and climate change need to be brought into the discussion, and how these affect the health of people in Nunavut, especially in the areas of nutrition and drinking water.
In addition to protection from environmental toxins in food and water, the new law is expected to bring better control over disease outbreaks and latent pathogens. Improved and faster reporting and control of outbreaks should better protect the population. “We get more information and the authority to take action on disease outbreaks to contain them,” Dr. Pawa tells CBC News. Special attention is paid to dormant pathogens such as latent tuberculosis (TB). In this context, patients are not infectious or sick themselves, but they are a potential source of disease. “We were already very good at detecting active TB. Now we have even better ways to monitor the latent form as well,” Dr. Pawa continued. “We know that the disease is a big issue throughout the region. We want to make sure we’re going to get all the information we can about it now, too.” That means health workers will be allowed to keep files on patients who test positive for latent TB, as well as histories of how and where infection occurred. This is especially important for TB, because the infection rate for tuberculosis in the Canadian Arctic is 290 times higher than in the rest of the country, according to a 2017 study. The World Health Organization (WHO) calculated that the infection rate in poor countries is between 150 and 400 per 100,000 people. In Nunavut, the 2017 projected rate was 265.8/100,000 population actual number: 101/37,082 population). The numbers are also higher than the national average in other Arctic regions.
The new law also brings changes to Nunavut’s medical staff. In addition to having more rights and authority (including over the central government in Ottawa), the position of medical officer of health must submit a comprehensive report on the health situation in Nunavut to the region’s administration every two years. This is intended to help accelerate health care development in Canada’s far north and provide Inuit with better care that meets the national average.
Dr Michael Wenger, PolarJournal
