At several points when rates of TB diagnosis lessened, the efforts to prevent the disease were defunded, resulting in an increase in infection rates again.
(meta data) TITLE: University of Alberta Faculty of Law Blog: Tuberculosis in Inuit Nunangat # University of Alberta Faculty of Law Blog « In Light of the Hateful Letter to the Andersons | | Indigenous Homelessness » ## October 23, 2018 ### Tuberculosis in Inuit Nunangat Tansi Nîtôtemtik, An Inuit child being examined for tuberculosis. Photo Retrieved from: <www.rcinet.ca/en/2019/03/06/prime-minister-to-apologize-to-inuit-for-mistreatment-during-tb-programme/> Today's post looks at the disproportionate rates of tuberculosis among Inuit in Canada's North (Inuit Nunangat[1]). The alarming disparity is the result of the historical acculturation and displacement of Inuit peoples as well as the failure of settler governments to maintain sustainable, culturally appropriate, and accessible healthcare. Tuberculosis (TB) is an infectious disease that primarily targets the lungs and is caused by the inhalation of the bacteria Mycobacterium tuberculosis.[2] TB can affect bones, kidneys, and lymph nodes. Symptoms of active TB can include a bad cough, weakness, fever, and, if left untreated, death.[3] Currently, incidents of TB among Inuit peoples are 290 times higher than non-Indigenous Canadians.[4] The history of TB in North America stretches back to the earliest European contact. Settlers brought TB as early as the 1400s. The Indigenous populations had little resistance to the disease and were highly susceptible to infection.[5] Reports from the 1800s suggest that TB killed more Inuit than all other diseases combined.[6] During the 1950s and 60s, the Canadian government relocated Inuit peoples en masse from their traditional lands in order to control TB and "provide them with a better quality of life."[7] Many Inuit were taken to sanitaria in southern Canada for treatment but never made it back to their communities.[8] This resulted in the separation of Inuit families, the displacement of Inuit people thousands of kilometres from their communities, and the disruption of Inuit culture. The movement resulted in children being sent to Residential Schools. TB was a crisis in Residential Schools as well, accounting for nearly 50% of recorded student deaths.[9] The relocation caused radical changes in "gender roles, roles between generations, relationship with the land, coping mechanisms, and loss of language and cultural identity"[10] for the Inuit. Government efforts to house relocated Inuit "resulted in a dependence on social housing programs that continues today. Limited employment opportunities, coupled with lower levels of educational attainment, predispose Inuit to poverty which further entrenches this dependence."[11] Lastly, acculturation, the rapid transition from a traditional society to an industrialized one, has brought about food insecurity, malnutrition, inadequate housing, mental illness, and addiction among the Inuit.[12] As shown below, these factors increase the occurrence of TB. Sir William Osler, a Canadian physician, described TB as "a social disease with a medical aspect."[13] Indeed, evidence clearly shows that social determinants exacerbate and worsen the prevalence of TB.[14] Inuit face higher infant mortality rates, lower average life expectancies, lower median incomes, higher rates of food shortages, and higher rates of unemployment compared to non-Indigenous Canadians.[15] 52% of Inuit in Nunangat live in overcrowded housing.[16] Overcrowded homes, indoor air pollution, and household mould all contribute to higher rates of TB.[17] The shift from nutrient-dense country food to market food has caused poor diets and micronutrient deficiencies for Inuit peoples, which, in turn, increases the risk of TB.[18] It is recognized that utilizing traditional food systems results in "better cultural identity, health, and survival for Aboriginal peoples;"[19] however, there is a lack of access to culturally appropriate food. There exist serious geographic barriers, with Inuit patients having to travel thousands of kilometres for treatment. Furthermore, culture and language barriers between Inuit patients and non-Inuit healthcare workers can result in negative experiences, which can cause reluctance to seek further treatments.[20] Unemployment, mental illness, and addiction have been found to worsen rates of TB as well.[21] Although past governments made concentrated efforts to combat TB during periods of outbreaks, there were never consistent treatment campaigns. Historically, when TB rates declined, healthcare intervention was abandoned.[22] Currently, the Tuberculosis Task Force, developed in partnership by Inuit Tapariit Kanatami (a leading organization representing Inuit peoples) and the federal government, aims to "[break] the cycle of transmission and [engage] Inuit as full partners in all aspects of TB prevention and control."[23] Furthermore, the Liberal federal government has pledged $13 million for TB prevention and control, with over $1 million of that amount specifically aimed at Inuit populations.[24] Settler governments have paternalistically approached TB treatment by ignoring the consequences of separating Inuit peoples from their families, communities, and traditional ways of living. The effects of this systemic ignorance have rippled through generations and plague thousands today. As future practitioners, it is important to remember that our legal systems are not separate from social realities. Moreover, settler and non-Inuit lawyers need to keep the above social and historical context in mind when working with Inuit clients and partners. Until next time, Team ReconciliAction YEG - - - - - - - - - - - - - - - - - - - - - - - [1] The traditional territories of the Inuit are collectively known as Inuit Nunangat, which includes four regions: Inuvialuit (Northern NWT), Nunavut, Nunavik (Northern Quebec), and Nunatsiavut (Northern Labrador). See: "About Inuit" (no date), online: Inuit Knowledge Centre <www.inuitknowledge.ca/inuit-research/about-inuit>. [2] "Tuberculosis: Frequently Asked Questions" (2016), online (pdf): Alberta Health Services <www.albertahealthservices.ca/assets/news/rls/ne-rls-2016-10-03-tb-faq.pdf>. [3] "Symptoms of Tuberculosis (TB)" (last modified 24 March 2016), online: Government of Canada <www.canada.ca/en/public-health/services/diseases/tuberculosis-tb/symptoms-tuberculosis-tb.html>. [4] M Patterson, S Finn & K Barker, "Addressing Tuberculosis Among Inuit in Canada" (2018) 44:3/4 Can Communicable Disease Report 82 at 82, online (pdf): Government of Canada <www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2018-44/issue-3-4-march-1-2018/ccdrv44i03a03-eng.pdf> [Addressing Tuberculosis]. [5] Report of the Royal Commission on Aboriginal Peoples: Looking Forward, Looking Back, vol 1 (Ottawa: Supply and Services Canada, 1996) at 21. [6] "Inuit-Specific Tuberculosis (TB) Strategy" (March 2013) at 12, online (pdf): Inuit Tapariit Kanatami <www.itk.ca/wp-content/uploads/2013/03/20130503-EN-FINAL-Inuit-TB-Strategy.pdf> [TB Strategy]. [7] Ibid at 14. [8] The Nanilavut Initiative seeks to right this wrong by locating the burial grounds and remains of ancestors and relatives, returning them to their original communities. See: Michele LeTourneau, "Federal Apology Expected to Accompany Nanilavut Launch", Nunavut News (10 March 2018), online: <nunavutnews.com/nunavut-news/federal-apology-expected-to-accompany-nanilavut-launch/> [9] Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada (Winnipeg: TRC, 2015) at 93. [10] TB Strategy, supra note 6 at 14. [11] Ibid at 16. [12] Ibid at 14. [13] Truth and Reconciliation Commission, Canada's Residential Schools: The History, Part 1: Origins to 1939, vol 1 (Montreal: McGill-Queen's University Press, 2015) at 379. [14] Addressing Tuberculosis, supra note 4 at 83-84. [15] "Social and Economic Inequality in Inuit Nunangat" (January 2018), online (pdf): Inuit Tapariit Kanatami <www.itk.ca/wp-content/uploads/2018/03/Social_Inequity_Infographic_English.pdf>. [16] Ibid. [17] TB Strategy, supra note 6 at 16-17. [18] Ibid at 17. [19] Ibid. [20] Ibid at 21-22. [21] Ibid at 20. [22] Addressing Tuberculosis, supra note 4 at 83. [23] "Tuberculosis Task Force" (last modified 7 November 2017), online: Government of Canada <www.canada.ca/en/indigenous-northern-affairs/news/2017/10/tuberculosis_taskforce.html>. [24] Ibid. - - - - - - - - - - - - - - - - - - - - - Join the conversation by following us on Twitter: @ReconciliYEG; Facebook: www.facebook.com/reconciliActionYEG/; and Instagram: @reconciliactionyeg. To receive daily alerts to our blog, email the words "add me" to reconciliactionyeg@gmail.com. ### Comments Tuberculosis in Inuit Nunangat Tansi Nîtôtemtik, An Inuit child being examined for tuberculosis. Photo Retrieved from: <www.rcinet.ca/en/2019/03/06/prime-minister-to-apologize-to-inuit-for-mistreatment-during-tb-programme/> Today's post looks at the disproportionate rates of tuberculosis among Inuit in Canada's North (Inuit Nunangat[1]). The alarming disparity is the result of the historical acculturation and displacement of Inuit peoples as well as the failure of settler governments to maintain sustainable, culturally appropriate, and accessible healthcare. Tuberculosis (TB) is an infectious disease that primarily targets the lungs and is caused by the inhalation of the bacteria Mycobacterium tuberculosis.[2] TB can affect bones, kidneys, and lymph nodes. Symptoms of active TB can include a bad cough, weakness, fever, and, if left untreated, death.[3] Currently, incidents of TB among Inuit peoples are 290 times higher than non-Indigenous Canadians.[4] The history of TB in North America stretches back to the earliest European contact. Settlers brought TB as early as the 1400s. The Indigenous populations had little resistance to the disease and were highly susceptible to infection.[5] Reports from the 1800s suggest that TB killed more Inuit than all other diseases combined.[6] During the 1950s and 60s, the Canadian government relocated Inuit peoples en masse from their traditional lands in order to control TB and "provide them with a better quality of life."[7] Many Inuit were taken to sanitaria in southern Canada for treatment but never made it back to their communities.[8] This resulted in the separation of Inuit families, the displacement of Inuit people thousands of kilometres from their communities, and the disruption of Inuit culture. The movement resulted in children being sent to Residential Schools. TB was a crisis in Residential Schools as well, accounting for nearly 50% of recorded student deaths.[9] The relocation caused radical changes in "gender roles, roles between generations, relationship with the land, coping mechanisms, and loss of language and cultural identity"[10] for the Inuit. Government efforts to house relocated Inuit "resulted in a dependence on social housing programs that continues today. Limited employment opportunities, coupled with lower levels of educational attainment, predispose Inuit to poverty which further entrenches this dependence."[11] Lastly, acculturation, the rapid transition from a traditional society to an industrialized one, has brought about food insecurity, malnutrition, inadequate housing, mental illness, and addiction among the Inuit.[12] As shown below, these factors increase the occurrence of TB. Sir William Osler, a Canadian physician, described TB as "a social disease with a medical aspect."[13] Indeed, evidence clearly shows that social determinants exacerbate and worsen the prevalence of TB.[14] Inuit face higher infant mortality rates, lower average life expectancies, lower median incomes, higher rates of food shortages, and higher rates of unemployment compared to non-Indigenous Canadians.[15] 52% of Inuit in Nunangat live in overcrowded housing.[16] Overcrowded homes, indoor air pollution, and household mould all contribute to higher rates of TB.[17] The shift from nutrient-dense country food to market food has caused poor diets and micronutrient deficiencies for Inuit peoples, which, in turn, increases the risk of TB.[18] It is recognized that utilizing traditional food systems results in "better cultural identity, health, and survival for Aboriginal peoples;"[19] however, there is a lack of access to culturally appropriate food. There exist serious geographic barriers, with Inuit patients having to travel thousands of kilometres for treatment. Furthermore, culture and language barriers between Inuit patients and non-Inuit healthcare workers can result in negative experiences, which can cause reluctance to seek further treatments.[20] Unemployment, mental illness, and addiction have been found to worsen rates of TB as well.[21] Although past governments made concentrated efforts to combat TB during periods of outbreaks, there were never consistent treatment campaigns. Historically, when TB rates declined, healthcare intervention was abandoned.[22] Currently, the Tuberculosis Task Force, developed in partnership by Inuit Tapariit Kanatami (a leading organization representing Inuit peoples) and the federal government, aims to "[break] the cycle of transmission and [engage] Inuit as full partners in all aspects of TB prevention and control."[23] Furthermore, the Liberal federal government has pledged $13 million for TB prevention and control, with over $1 million of that amount specifically aimed at Inuit populations.[24] Settler governments have paternalistically approached TB treatment by ignoring the consequences of separating Inuit peoples from their families, communities, and traditional ways of living. The effects of this systemic ignorance have rippled through generations and plague thousands today. As future practitioners, it is important to remember that our legal systems are not separate from social realities. Moreover, settler and non-Inuit lawyers need to keep the above social and historical context in mind when working with Inuit clients and partners. Until next time, Team ReconciliAction YEG - - - - - - - - - - - - - - - - - - - - - - - [1] The traditional territories of the Inuit are collectively known as Inuit Nunangat, which includes four regions: Inuvialuit (Northern NWT), Nunavut, Nunavik (Northern Quebec), and Nunatsiavut (Northern Labrador). See: "About Inuit" (no date), online: Inuit Knowledge Centre <www.inuitknowledge.ca/inuit-research/about-inuit>. [2] "Tuberculosis: Frequently Asked Questions" (2016), online (pdf): Alberta Health Services <www.albertahealthservices.ca/assets/news/rls/ne-rls-2016-10-03-tb-faq.pdf>. [3] "Symptoms of Tuberculosis (TB)" (last modified 24 March 2016), online: Government of Canada <www.canada.ca/en/public-health/services/diseases/tuberculosis-tb/symptoms-tuberculosis-tb.html>. [4] M Patterson, S Finn & K Barker, "Addressing Tuberculosis Among Inuit in Canada" (2018) 44:3/4 Can Communicable Disease Report 82 at 82, online (pdf): Government of Canada <www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2018-44/issue-3-4-march-1-2018/ccdrv44i03a03-eng.pdf> [Addressing Tuberculosis]. [5] Report of the Royal Commission on Aboriginal Peoples: Looking Forward, Looking Back, vol 1 (Ottawa: Supply and Services Canada, 1996) at 21. [6] "Inuit-Specific Tuberculosis (TB) Strategy" (March 2013) at 12, online (pdf): Inuit Tapariit Kanatami <www.itk.ca/wp-content/uploads/2013/03/20130503-EN-FINAL-Inuit-TB-Strategy.pdf> [TB Strategy]. [7] Ibid at 14. [8] The Nanilavut Initiative seeks to right this wrong by locating the burial grounds and remains of ancestors and relatives, returning them to their original communities. See: Michele LeTourneau, "Federal Apology Expected to Accompany Nanilavut Launch", Nunavut News (10 March 2018), online: <nunavutnews.com/nunavut-news/federal-apology-expected-to-accompany-nanilavut-launch/> [9] Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada (Winnipeg: TRC, 2015) at 93. [10] TB Strategy, supra note 6 at 14. [11] Ibid at 16. [12] Ibid at 14. [13] Truth and Reconciliation Commission, Canada's Residential Schools: The History, Part 1: Origins to 1939, vol 1 (Montreal: McGill-Queen's University Press, 2015) at 379. [14] Addressing Tuberculosis, supra note 4 at 83-84. [15] "Social and Economic Inequality in Inuit Nunangat" (January 2018), online (pdf): Inuit Tapariit Kanatami <www.itk.ca/wp-content/uploads/2018/03/Social_Inequity_Infographic_English.pdf>. [16] Ibid. [17] TB Strategy, supra note 6 at 16-17. [18] Ibid at 17. [19] Ibid. [20] Ibid at 21-22. [21] Ibid at 20. [22] Addressing Tuberculosis, supra note 4 at 83. [23] "Tuberculosis Task Force" (last modified 7 November 2017), online: Government of Canada <www.canada.ca/en/indigenous-northern-affairs/news/2017/10/tuberculosis_taskforce.html>. [24] Ibid. - - - - - - - - - - - - - - - - - - - - - Join the conversation by following us on Twitter: @ReconciliYEG; Facebook: www.facebook.com/reconciliActionYEG/; and Instagram: @reconciliactionyeg. To receive daily alerts to our blog, email the words "add me" to reconciliactionyeg@gmail.com. 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train27584
Indian hospital
History.:National initiative.
In 1953 it was also made a crime for an Indigenous person to refuse treatment or to leave a hospital before being discharged. Patients who wished to return home to their communities were arrested and taken to jail or brought back to the hospitals. 
 
 
Studies show that In the 1950s tuberculosis became a grave problem with the mortality rate approaching 1% per annum and the incident rate almost 3%. The annual risk of infection has been estimated at 25% per annum. These are probably the highest rates recorded anywhere in the world in the 20th century. Medical professionals continue to congratulate themselves on successfully stemming the tide of the disease through such interventions of forcible removal of infected individuals from their homes.