Nursing shortage, overcrowded homes in Pimicikamak Cree Nation make tuberculosis cases difficult to monitor

The chief of a northern Manitoba First Nation says overcrowding and poor access to health-care services in his community can make tuberculosis cases harder to monitor and contain.

Pimicikamak Cree Nation, also known as Cross Lake, currently has three active cases of tuberculosis — a contagious and potentially fatal lung disease, but one which is also treatable and preventable.

That's a relatively normal number of cases for the community, said Chief David Monias, but he believes more needs to be done to tackle the disease, and issues in his community that put residents at risk of getting it.

"If you put [it] in the context of the lack of housing and the lack of resources, nurses and doctors in the community, and then being able to access medical services … you do run into risk of getting really sick and dying," Monias told CBC News on Saturday.

Pimicikamak, which has more than 6,500 people living on reserve, struggles with a nursing shortage, making it difficult for people to get regular checkups or get medical help there once they have contracted the illness.

"It's hard to monitor people when you're short-staffed," said Monias.

Homes in the community also tend to be overcrowded, he said.

There are "multiple families living in one dwelling, and most of them only have one washroom," he said. 

"When somebody gets sick, it's really hard to contain any illnesses or diseases or viruses from spreading from one person to the next. And that potentially could be very dangerous to our health."

Though the number of tuberculosis cases has dropped dramatically since the mid-20th century, "that's not seen equally across the globe," said Heejune Chang, a public health and preventative medicine physician at the Winnipeg Regional Health Authority.

"Canada sees somewhere in the ballpark of 1,500 to 2,000 [new] cases per year … and then Manitoba sees in the ballpark of, like, 150 to 200 cases per year," Chang said.

First Nations and Inuit populations tend to see higher rates of the disease, she noted. Factors like overcrowding, poor ventilation in homes and poorer health are all associated with greater transmission of tuberculosis.

For those communities, "it's sort of like tuberculosis never really went away," said Chang.

Monias said the people with active cases are in their homes being monitored by physicians.

National strategy

Chang said she hopes Canada will adopt a national strategy to address the disease, and that the public becomes more aware of it, especially with World Tuberculosis Day being marked on March 24.

"Many people live their lives without really thinking about tuberculosis disease anymore," said Chang.

"There's a lot of work that could still be done."

That includes making medications and treatment for the disease more obtainable and accessible, and having better support for patients during the treatment process.

Monias also hopes for a national strategy, and says funding from governments for housing and clean drinking water is also needed. 

People also need to know just how harmful the disease is, added Monias, who said his dad survived tuberculosis, but later struggled with lung problems.

"It's a silent killer … and attacks people without [them] knowing what the symptoms are," he said.

Hopefully, "they catch it before it spreads or gets worse."