A new tuberculosis (TB) epidemic has reached the community of Pond Inlet in Nunavut, Canada. This disease, contained in our latitudes, remains nevertheless a very present reality within this vast Canadian territory communities.
World Tuberculosis Day took place on 24 March, an opportunity for the Government of Nunavut to reaffirm its joint commitment with Nunavut Tunngavik Incorporated (NTI), the legal representative of the Inuit in Nunavut, in the fight against tuberculosis in this Canadian territory.
A week earlier, the Departement of Health declared a tuberculosis outbreak in Pond Inlet due to a recent increase in the number of active TB cases, according to the statement posted on the Government of Nunavut official website. With five cases and twenty-two cases of latente disease (inactive form of TB), Pond Inlet is not really an exception. Regularly, epidemics break out affecting more than half of the 24 communities spread across Nunavut.
«To reduce and eventually eliminate TB in Nunavut, attention must be given to both the clinical care for active and sleeping TB, and the socio-economic conditions that allow TB to persist in our communities.», mentions the press release published on the Government of Nunavut website. « The GN will continue to deliver TB care programs and services, and NTI will continue implementing Inuit-centered and Inuit-led initiatives to support the health and wellness of individuals, families and communities, and especially those affected by TB today and in the past. There is much work to be done, and by working together, we will achieve our goal of eliminating TB in Nunavut.»
A disease rooted in poverty
And indeed, there is a lot to do. Overcrowding and malnutrition are the factors of contagion and propagations of tuberculosis, as well as poverty. This disease primarily affects populations living in difficult socioeconomic conditions. Restricted access to healthcare infrastructures is yet another factor even more aggravating in that it does not allow rapid prevention, diagnosis or patient treatment.
The Inuit communities of Nunavut and their 39,000 inhabitants are thus particularly exposed to the disease. The housing crisis in many communities, resulting in overcrowded homes, creates an ideal breeding ground for TB. If we add to this the great precariousness that affects the communities, malnutrition, as well as geographical isolation, remoteness of healthcare structures and the lack of medical staff, it is hardly surprising that the number of tuberculosis cases among Inuit in Canada is nearly 300 times higher than among non-Indigenous people.
A heavy past
Nunavut ist he most affected by the disease in the country, government policies being thwarted, for lack of resources and manpower, but also becaue of Inuit mistrust. The latter is rooted in the national strategy in progress between the 1940-1960, which consisted in sending people who tested positive for the disease to the south, by force and without letting them say goodbye to their loved ones. Isolated in care facilities where staff didn’t speak their language, many of them did not survive. On 8 March 2019, with tears in his eyes, Canadian Prime Minister Justin Trudeau apologized to the Inuit for this disastrous management of tuberculosis.
Brought by explorers, hunters and fishermen, tuberculosis reached the Inuit as early as the 19th century. Nicknamed the white plague, tuberculosis is an infectious disease caused by a bacterium, Mycobacterium tuberculosis. Airborne transmitted, it mainly affects the lungs and causes symptoms such as cough, weight loss, great fatigue, fever and night sweats. Treated with antibiotics, systematic vaccination has made it possible to tackle it in rich countries. However, it continues to rage in poor countries, being the leading cause of death from infectious origin before AIDS, according to the World Health Organization (WHO).
Featured image : Wikicommons / Tuberculosis-x-ray-1
Mirjana Binggeli, PolarJournal
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