Tuberculosis rates for Inuit living in Nunavik, the Inuit territories in northern Quebec, are 1,000 times higher than among non-foreign-born Quebecers, and a lack of local health care resources adds to the difficulty of the disease, according to new research published in CMAJ (Canadian Medicine Journal Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251824.
The study, conducted in collaboration with Nunavik Inuit and led by a predominantly Indigenous research team, aimed to assess current Inuit experiences with TB care and elicit recommendations from Inuit for effective disease eradication tactics. First Nations and Inuit researchers interviewed 156 Nunavimmiut—Inuit people from Nunavik—of whom 61% were women and 37% were under the age of 35, as well as 21 non-Inuit health workers. Importantly, a significant number of interviews were in Inuktitut.
Inuit expressed strong desires for healthy communities and healthy residents, with particular emphasis on Inuit control of TB eradication strategies.
“Inuit are deeply committed to ending TB and are calling for specific changes in policies and services, which currently create significant difficulties. Study findings were shared with communities, local political leaders and health organizations. What emerges is a clarion call: an urgent response—respecting community autonomy and reality—is needed to end the epidemicsaid Native American Ben Geboe, a member of the Yankton Sioux Dakota Nation, first author of the study and a postdoctoral researcher with co-senior author Dr. Faiz Ahmad Khan of the McGill University Health Center Research Institute.
Inadequate health care resources have led to the current program-centered approach causing difficulties for Nunavimmiut who have had to leave their communities for diagnosis, for example. Additional burdens include a lack of language-specific care, a lack of support for long periods of treatment in isolation, the potential for police or judicial intervention, and insufficient sharing of information and data on TB rates. Nunavik health authorities are already implementing changes and policies that better align with Inuit preferences.
The research describes the Inuit recommendations, called 7 Calls to Action on Tuberculosis:
- Increase Inuit control over services and data
- Provide person-centered care
- Increase local services to minimize displacement
- Use community-wide screening tailored to local needs
- Train and recruit more Inuit health care workers
- Reduce stigma
- Implementing Inuit-led cultural safety training for health workers
“In the face of a rapidly worsening TB epidemic, the governments of Quebec and Canada must respond urgently by addressing the chronic lack of health care resources to enable a robust and supportive approach to end this epidemic, as requested by Nunavimmiut“, the authors conclude.
In a related comment https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260331Dr. Pamela Orr, University of Manitoba, Winnipeg, Manitoba, writes “When working with Indigenous partners, non-Indigenous researchers have a specific duty to do the work of reconciliation. [The authors] they do this through engaging in a reciprocal relationship with the community, raising awareness of past and present harms in the context of the TB epidemic in Nunavik, and describing the steps they have taken to try to achieve policy change through their research findings. They move from recognition to action in the work of reconciliation.”
Source:
Journal Reference:
