Homegrown TB crisis: Why a preventable disease persists among Canada's Inuit

Stephen Lewis is an international health care advocate best known for his efforts regarding AIDS/HIV in the developing in the developing world. But this week Lewis was calling for help in his own country.

In a statement, Lewis appeals to the Canadian government to do more to help with what he calls a tuberculosis "crisis" in Nunavut.

Lewis was in the territory last week, speaking with elders and frontline healthcare workers.

"It was a riveting, memorable experience, not just because it was our first visit to the High Arctic, not just because of the astonishing beauty of the unfolding landscape, not just because the entire Inuit community was uniformly generous and welcoming, but because we were exposed to issues for which we were entirely unprepared," says Lewis in his statement.

The issues to which Lewis is referring are those related to the prevalence of TB in Nunavut, particularly within the Inuit community.

As Natan Obed tells Day 6 host Brent Bambury, the rate of TB among Inuit is 277 times higher than that of non-Indigenous people born in Canada.

"One of the great challenges with Canada and with its relationship with Indigenous people, is that many of our social conditions, many of our specific health status indicators, are in line with developing countries and are not in line with the greater Canadian population," says Obed.

Obed is the President of the Inuit Tapiriit Kanatami, a non-profit organization that represents and advocates for more than 60,000 Inuit.

"[TB among Inuit has been at] an elevated rate since the 1950s," says Obed.

TB persists

"For whatever reason, there has been a lack of interest by the Canadian government to eradicate tuberculosis in Inuit Nunangat, our homeland," says Obed.

He can't understand why the prevalence of the disease among Inuit is not seen as a crisis by government officials.

"I'm not sure how much larger the number has to be before it's actually a public health crisis for Canada, not just a specific health concern that is managed as if it's just acceptable by those responsible for health care systems in this country," says Obed.

TB in the North also made headlines in January of 2017, when 15-year-old Ileen Kooneeliusie died from the disease.

So how does a teenager die of a preventable disease in Canada in 2017?

Obed says there are several factors involved in the persistence of TB in the North, including social conditions.

Overcrowded housing is one factor.

There is a 40 per cent overcrowding rate in Inuit Nunangat compared to a four per cent rate for the rest of Canada.

"So if you have the conditions that we live in in the Arctic in the winter — poor ventilation, many people living in the same place, not a lot of food security — we have the recipe for health concerns, and especially tuberculosis," explains Obed.

TB is spread through the air when a person infected in the lungs or throat coughs, sneezes or talks.

Food and nutrition

Food security is a significant factor, with Obed noting that the average household income among Inuit is $60,000 less than their non-Inuit community members.

"Our median income is about $18,000. And in a setting where food prices are exorbitantly high and there are huge challenges to get our traditional food," explains Obed, "we have a scenario where a lot of our people don't have enough to eat." 

The lack of proper nutrition, says Obed, exacerbates the situation.

Steps toward TB elimination

Obed says one step toward eradicating TB in the North would be with an education campaign.

"At the same time, if we want Canada to be able to live up to its moral high ground and standards about how it treats all of its citizens, and this expectation that all Canadians have social equity to some degree," says Obed, "then we need to start working on the social determinates."

That means improving housing conditions, health care service delivery and reducing poverty, according to Obed.

He says he is talking with Jane Philpott, the federal Minister of Health, as well as other ministers involved in social issues.

"If we start with this idea that we can eliminate TB in Inuit Nunangat, then I hope that other things will follow, because you can't look at the issue and say 'we can eliminate this' without thinking that we need to do something about overcrowding or other social conditions."

For the full interview with Natan Obed, download our podcast or click the 'Listen' button at the top of this page.