Long Way from Home

Long Way from Home: The Tuberculosis Epidemic among the Inuit

PAT SANDIFORD GRYGIER
https://www.jstor.org/stable/j.ctt801wr
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  • Book Info
    Long Way from Home
    Book Description:

    Based on recollections of patients, interviews with participants in the government programs, available literature and statistics, and records of the Northern Affairs Program, Grygier examines the programs for the Inuit in all parts of Canada. She also explores the history of tuberculosis in Canada, conditions of life in the North for both Inuit and non-Natives, and the development and modification of government administration of the North.

    eISBN: 978-0-7735-6485-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Tables
    (pp. ix-x)
  4. Figures and Maps
    (pp. xi-xii)
  5. Place Names
    (pp. xiii-xiv)
  6. Abbreviations
    (pp. xv-xvi)
  7. Acknowledgments
    (pp. xvii-xx)
  8. Introduction
    (pp. xxi-xxiv)

    In the 1950s the Inuit in Canada numbered some 10,000 to 11,000 people, strung across the shores of the Arctic sea and Hudson Bay or scattered among the Arctic Islands, up to 4,000 kilometres north of the big southern cities. They were for the most part seminomadic hunting groups, living in skin tents in the summer and igloos in winter, speaking neither English nor French but Inuktitut, writing in syllables instead of our Roman alphabet, and having the most limited communication with the outside world – no telephones, no trains, roads, or regular air services, only limited radio, and a visiting...

  9. Illustrations
    (pp. xxv-xxxvi)
  10. PART ONE SETTING THE SCENE
    • CHAPTER ONE A Brief History of Tuberculosis in Canada
      (pp. 3-15)

      At the beginning of this century tuberculosis was the greatest killer of humans in the Western world.¹ In Canada it killed one out of every 1,000 people,² perhaps more, since not all cases were accurately diagnosed or reported. It was the disease for which there was no cure and was particularly prevalent in the slum areas and among the poor immigrant population of Canada’s too rapidly developing cities. The attitude of the general public to the consumptives was much like the attitude of people to lepers in the past or to AIDS patients when this disease was first recognized – social...

    • CHAPTER TWO The Inuit People and the Arctic
      (pp. 16-28)

      The conditions in the Arctic before the advent of the whites into the society played a part in promoting an epidemic of TB among the Inuit. The intrusion of the whites, when it was solely for their own purposes without regard to the original inhabitants or the ecological systems of the land (for example, in whaling, trapping, mining, and defence), often not only introduced the infection into the population but also tipped the delicate balance of ecosystem and society, and brought disaster. When eventually help came, the characteristics of Inuit social and spiritual culture, so in harmony with the Arctic...

    • CHAPTER THREE Other Players: The Hudson’s Bay Company and the Missionaries
      (pp. 29-39)

      The whalers arrived in the Far North in the nineteenth century and had a big impact on the Inuit. This was particularly the case with the American whalers, who stayed for two or three years at a time until their ships were full of oil and baleen. The Inuit crewed on their boats and learned a lot that was useful to them, but the whales and other animals on which the Inuit depended were overkilled and became very scarce. Moreover, the whalers brought tuberculosis and other diseases, against which the Inuit had developed no immunity, so the effect of their...

    • CHAPTER FOUR Other Players: The Government and the RCMP
      (pp. 40-52)

      The rights and wrongs of Canadian occupation of Inuit territory are not the subject of this book, nor is the government’s general administration of the territory since it assumed control. But some appreciation of the Canadian government’s policy and activities – or lack of them – in the Arctic is germane to its later handling of the TB epidemic.

      After Rupert’s Land and the North-Western Territory were acquired by Canada following Confederation, the Canadian government considered itself to be both the rightful and the de facto ruler of the northern lands. But apart from a few sporadic outbreaks of initiative, usually in...

    • PART TWO THE EVENTS
      • CHAPTER FIVE Emergence of the Problem
        (pp. 55-65)

        Isolation in their harsh climate preserved the Inuit from the ravages of southern diseases for thousands of years. But it also left them with no built up immunity, and when the Europeans began to arrive, inadvertently carrying the germs with them, epidemics of measles, influenza, poliomyelitis, and tuberculosis ravaged many of the communities. Usually, a disease hit one community or area, decimated the population, then retreated. But tuberculosis lingered, spread, and became endemic.

        Several factors contributed to this. First, the severe cold (which has no effect on the tuberculosis bacillus) made the Inuit vulnerable to respiratory troubles and forced them...

    • CHAPTER SIX The Assault
      (pp. 66-85)

      Having wrested control of Inuit health care from the Department of Mines and Resources, Dr Moore and his colleagues in the Indian Health Service (IHS) launched their attack on tuberculosis. The Inuit and tuberculosis were not, of course, their only concerns. Health services for Indians were also their responsibility, and this represented an enormous challenge because the Indians also had a very high incidence of tuberculosis and had suffered from the same chronic underfunding of medical services as the Inuit. But the timely combination of the end of the war and the consequent freeing-up of money and medical personnel from...

    • CHAPTER SEVEN The Eastern Arctic Patrol
      (pp. 86-103)

      “The ship was deep in misery. It was terrible because it was the ship which carried the Inuit away from their homes to the sanatoria in the south. And they were herded together in the foc’sle, in the hold of the ship in three-tiered bunks, mass-fed, mass-accommodated. In the stormy seas they were sick, they were terrified, they were demoralized. They were frightened of what was happening to them, of what was likely to happen to them.”¹ This was Robert Williamson’s recollection of the Eastern Arctic Patrol (EAP) ship, the C.D.Howe, on which he was a passenger in 1953...

    • CHAPTER EIGHT Life in the San.
      (pp. 104-116)

      There were many routes to the sanatoria, most requiring a stopover, sometimes for a week or more, before transport was available or the weather was right or the group big enough to move south conveniently. The Inuit left the Arctic by ship or plane and usually transferred to another plane or to a train for their journey farther south. Some arrived in small groups or singly, but most arrived in large groups following the spring or summer x-ray surveys. Post-survey arrivals at the two principal centres where Inuit were treated, the Charles Camsell Indian Hospital in Edmonton and the Mountain...

    • CHAPTER NINE After the Hospital: Going Home, or a Southern Grave
      (pp. 117-132)

      Patients could rarely go home as soon as they were well, particularly in the early years. They had to wait until the conditions were right for planes or ships to get into their district. Sometimes they stayed at the sanatoria, sometimes local accommodation was arranged by the hospital or, as at Caughnawaga and Shubenacadie, by the local Indian agent. Usually, they were sent by air or rail to an intermediate point, such as Churchill or Moose Factory, where they were put up in the military or Indian hospital until further transport was available. Patients returning to the Eastern Arctic might...

    • CHAPTER TEN The 1960s: New Measures in the Northwest Territories
      (pp. 133-151)

      In 1961 the Indian and Northern Health Service was renamed Medical Services branch, but its Arctic component continued to be known as the Northern Health Service (NHS), and through the 1960s the program of surveys, immunization, and evacuation to southern hospitals continued to be the mainstay of its fight against TB. More nursing stations and health centres were opened, and links were developed between the small northern hospitals and the medical schools in the South which supplied visiting specialists.

      The Department of National Health and Welfare was legally responsible for health services to the Inuit in the Northwest Territories and...

    • CHAPTER ELEVEN Distinct but Similar: The Epidemic in Quebec and Newfoundland
      (pp. 152-172)

      In the 1950s some 2,000 Inuit were living along the coast of the Ungava Peninsula in northern Quebec, as they had for thousands of years. The Hudson’s Bay Company (HBC) had set up trading posts in Rupert’s Land around James Bay in the seventeenth century and had expanded into Inuit territory by opening a post at what is now Umiujaq in 1749. Other posts followed during the nineteenth and early twentieth centuries, until by 1930 there were trading posts dotted around the coast at most of what are now the Inuit villages of northern Quebec. After the traders came the...

  11. PART THREE CONCLUSIONS
    • CHAPTER TWELVE The Balance Sheet: One Person’s Point of View
      (pp. 175-186)

      So the epidemic ended, and the Inuit now make up a very small portion of tuberculous patients in Canada - 1.1 per cent in 1987–89. Their rate of infection, though still high, is lower than that of either the native Indians or Canadians born in Asia.¹ That the rates in the Inuit population have dropped so markedly compared with the appalling rates at the mid-century, when they were considered to have the highest incidence of TB in the world, is undoubtedly duet the massive effort put out by Health and Welfare in the thirty years or so following 1945....

  12. APPENDICES
    • APPENDIX ONE Arctic Administration and Principal Events, 1870–1970
      (pp. 189-192)
    • APPENDIX TWO Interviews
      (pp. 193-194)
    • APPENDIX THREE Hospitals to which Inuit Were Sent, 1940s to 1960s
      (pp. 195-197)
    • APPENDIX FOUR NANR “Standard Eskimo Discharge Kit”
      (pp. 198-200)
  13. Notes
    (pp. 201-220)
  14. A Note on Sources
    (pp. 221-222)
  15. Credits
    (pp. 223-224)
  16. Index
    (pp. 225-233)