I have always been fascinated by the Canadian North. Born in Yellowknife but growing up elsewhere left me with a life-long curiosity about the Territories. So, when the opportunity arose to take a post as the Deputy Minister of Health in Nunavut, I didn’t hesitate to accept.

Few Canadians have had the opportunity to visit the North. Nunavut stretches over two million square kilometers, covers three time zones and is one-fifth the landmass of Canada. It is a place of strength, beauty and resilience. The Inuit who call this place home have a rich history, heritage, and worldview.

Colonialism, however, has had huge impacts on individuals and entire communities; its consequences are reflected in trauma and abuse, in poor health outcomes and in high rates of suicide. The Inuit way of life and fragile environment is also disproportionately impacted by global climate change.

I witnessed all of this in my brief time in Nunavut. I am now of the belief it is the duty of every health policy-maker, health leader and health professional to experience the North firsthand. If we define Canadians as a population filled with empathy and concerned with equity, then the opportunity to see, to witness and to learn from Inuit Peoples should be part of being Canadian.

This is a call for reciprocity, to give back.

Just reading about a place and a people falls far short of gaining a deep understanding of the richness of the culture and the land. Written records remain largely Eurocentric and colonial, framed as one of discovery and exploration. But this place had already been discovered and explored by the people who already lived there.

I watched, with great interest, in 1999 when the Territory of Nunavut was formed. It wasn’t until 2022 though, when serving as Deputy Minister of Health for the Government of Nunavut that I had my epiphany. My personal discovery of what was always there was incredibly humbling.

Within the first few days of arriving in Iqaluit, I discovered a set of Inuit principles, recorded and adopted by the Government of Nunavut at the inception of the territory. However, these principles predate the formation of the territory, the country and European contact; they perfectly capture the kind of health system and governance that we aspire to across Canada. They reflect a culture rooted in history and deeply connected to the land and are principles that all Canadians should aspire to emulate.

Take for instance, keys to the culture in some of the language:

• Inuuqatigiitsiarniq:Respecting others, relationships and caring for people
• Tunnganarniq:Fostering good spirits by being open, welcoming and inclusive
• Pijitsirniq:Serving and providing for family and/or community
• Aajiiqatigiinniq:Decision making through discussion and consensus
• Pilimmaksarniq/Pijariuqsarniq:Development of skills through observation, mentoring, practice, and effort
• Piliriqatigiinniq/Ikajuqtigiinniq:Working together for a common cause
• Qanuqtuurniq:Being innovative and resourceful
• AvatittinnikKamatsiarniq:Respect and care for the land, animals and the environment

Despite its size, there is not a single highway in Nunavut. Everything must be flown in or barged in. Barges are seasonal, during the brief period where ice conditions and ice breakers can assist in getting to the accessible communities. For all these isolating conditions, Nunavummiut are a well-travelled people, largely out of necessity. Travel south or accompanying a family member for specialized care to Edmonton, Churchill, Winnipeg or Ottawa is essential. On-site care is supported where possible, but the challenges of recruitment and retention are felt to an even greater extent than in other areas of Canada. The vision for Nunavut is to have an Inuit-led, Inuit-operated, and Inuit-staffed health system, but in the interim, the support of southern practitioners is needed to provide care and to keep health centres and the sole territorial hospital operational.

Many health professionals have answered the call to visit underserved populations in countries and continents across the globe. They have shared their healthcare knowledge and experience with many others. In fact, Canadians are defined by this sharing of ideas and knowledge – in areas such as the social determinants of health, population health, chronic disease management, primary and secondary prevention, harm reduction, specialized treatment and restorative medicine. In this same spirit, there are opportunities closer to home – in places such as the 25 communities in Nunavut.

The key to healthcare professional recruitment and retention in southern jurisdictions is providing good, high-quality and interesting job opportunities. If southern organizations would provide opportunities to their healthcare staff to circulate through the north for relief, these professionals could learn and gain new insights and experiences, which would act as an attractor. Meeting a special people in a special place is a way to give back while learning. It is about discovery, of not only what has always been there, but also what drives us to be truly Canadian.

I know the experience made me much better and as I returned home I felt I contributed to stabilizing care; the hope is the same experience would do the same for others, with the ultimate goal of Inuit self-governance and employment. 

Comments

Be the first to comment on this!