Pauktuutit President Elisapee Sheutiapik expressed extreme concern and dismay over the recent decision by the First Nations and Inuit Health Branch (FNIHB) of Health Canada to no longer work with the organization on Inuit-specific health projects.
For nearly three decades, Pauktuutit has worked successfully with Health Canada, and extensively with FNIHB, on issues of mutual concern. “Many people will recall the HIV ‘Lifesavers’ project that featured country food-flavoured condom covers that helped raise awareness about this deadly disease in all of our communities,” Sheutiapik said. “This is only one example of our very successful health prevention and promotion initiatives that have been recognized all across Canada and internationally as well. This entire initiative was and is based on input and priorities from the communities. This resulted in popular and relevant resources in bilingual, plain-language formats. With our young and quickly growing population, raising awareness about issues such as preventing FASD, HIV and reducing the use of tobacco are not activities that can be done only once. They require ongoing delivery.”
In 2009/10, Pauktuutit received project funds from FNIHB to conduct activities that lead to the creation of Inuit-specific five-year strategic plans to address FASD, injury prevention and sexual health. These plans were developed with the participation of numerous partners including territorial and federal governments, regional health boards and other stakeholders. “Now there is no funding to move these plans forward. We have the highest sexually transmitted infection rates in the country, problems with addictions and alcohol abuse and a very young population. Violence against Inuit women and children, including the sexual abuse of children, are major physical and mental health issues and we don’t have access to many of the services and resources taken for granted by other Canadians. We all have a responsibility to address these issues, including the federal government. A strong North within Canada needs strong and healthy people. As Canadian citizens we have the right to the same health status and life expectancy as others, and the federal government has a responsibility to work with us to address the very serious health issues we are facing in our communities.” Sheutiapik concluded.
By taking a national approach and working closely with regions and communities, Pauktuutit produces culturally relevant information that can be used in all of the regions and adapted by communities to meet their own needs. All of its products are produced in as many regional dialects of Inuktitut as possible. “We have heard from many people such as community health representatives and other front-line workers, as well as regional health boards and territorial governments, about how important it is that these resources are available in their regional dialects. We have to reach people in a way that makes sense to them. We can’t forget that it has only been two generations since we were forced to settle in communities. There are words and concepts in English that don’t yet exist in Inuktitut. Pauktuutit is highly skilled at developing and translating health prevention and promotion information for Inuit to raise awareness and help us be more active partners in our own health. Health and wellness is more than operating nursing stations and health centres in our communities. The loss of these resources will severely limit our ability to work on these issues. There is a high cost associated with doing nothing” Sheutiapik said.
Pauktuutit has developed numerous workshop models on topics including FASD, injury prevention, developing community action plans and healing models which have contributed to individual and community capacity to work on these issues. In this way, a relatively modest financial investment by FNIHB and other federal departments is maximized by developing resources that are distributed for use in all 53 Inuit communities across the Canadian Arctic, and Pauktuutit’s work been recognized as a model in indigenous health prevention and promotion initiatives. “As recently as last month, as a member of the National Inuit Committee on Health, we were talking with senior officials of FNIHB about how they can better meet the unique health needs of Inuit women through a strategic plan they are developing. This input from Pauktuutit will no longer be possible even though they have acknowledged that they need our expertise.”
In March 2012, the Pauktuutit Board of Directors reviewed and approved a strategic plan to guide the organization’s activities over the next 10 years. Short term health priorities include maternal health, sexual health, food security, injury prevention, FASD, early childhood education, tobacco cessation, mental health, women’s health issues, family planning and youth. On April 14, the Pauktuutit Board of Directors met to discuss these cuts and have expressed deep concern about the impacts of the loss of these resources. The also questioned how the current government intends to move forward on several strategic plans that had been recently been developed in partnership with Health Canada and other partners to address FASD, HIV and sexual health and injury prevention, and their willingness to address other pressing Inuit health priorities.
External evaluations of many of Pauktuutit’s health projects note the products are appropriate and effective. A 2009 evaluation of Pauktuutit’s Journey to the Teachings injury prevention workshop found that more than 90 per cent of participants rated the workshop at four or higher on a scale of one to five. One participant in Nunavut said “I learned what I did not know and what I did not understand.”
Some of Pauktuutit’s current work with the Public Health Agency of Canada is assessing the knowledge, attitudes and behaviours of Inuit about hepatitis C, another life-threatening disease. According to Sheutiapik, “Our work over the last year indicates that many Inuit know very little about hepatitis C including risk factors, symptoms and treatment options. Last fall I participated in a Pauktuutit focus group in Inuvik that identified the need for more information and knowledge about potential transmission of this virus, including through traditional activities like harvesting and preparing and sharing food. We don’t know what the actual infection rates may be among Inuit as there is also little awareness about the need to be tested.”
“I have spoken with the Minister this morning and we will continue to talk about how Health Canada can continue to work with Pauktuutit. Our senior officials will meet at the first opportunity to discuss how we may be able to work more broadly with other sections of the department. We understand the need to continue direct service delivery in our communities, but we also have to have an adequate emphasis on prevention. This will help reduce the need for direct services and reduce health care expenditures. I do want to know if once the deficit has been eliminated will this funding be restored for Inuit health prevention and promotion work.”
Considering the ongoing health issues faced by Inuit women and their families and the demographic implications for effective public policy and health service delivery, these budget cuts will have a direct and negative impact on achieving progress towards equitable health and wellness status for Inuit comparable to other Canadians.