Room for a view
Metamorphoses
Brian Postl, MD; Anne Marie Todkill
CMAJ 1999;160:1037
Dr. Postl is Vice-President, Clinical Services, Winnipeg Hospital Authority; Anne Marie Todkill is Editor of The Left Atrium.
© 1999 Canadian Medical Association
April 1 marked the birth of Nunavut in Canada's Eastern Arctic — a territory of close to two million square kilometres, almost all of it above the treeline, severed by plebiscite and act of Parliament from the Northwest Territories. Nunavut — the name means "our land" in Inuktitut — is home to 25000 people, of whom 85% are Inuit and 56% are under 25 years of age. The Nunavut Land Claims Agreement, the largest aboriginal land claim settlement in Canadian history, gives the Inuit ownership of 350 000 square kilometres and 80% of the territory's known mineral reserves. They will also receive roughly $1.2 billion in compensation, and, given the demographics, de facto self-government.
 MacKenzie Art Gallery |
Shaman Woman, George Auksaq (b. 1963), 1986. Stone; 22.0 cm × 24.6 cm × 9.0 cm. Collection of Jacqui and Morris Shumiatcher. |
This depiction of an angakoq, or shaman, by George Auksaq from the island of Igloolik, off the coast of Nunavut's Melville Peninsula, is part of an exhibition of Inuit sculpture from the Shumiatcher collection at the MacKenzie Art Gallery in Regina. In the shamanic belief system, the angakoq functioned as a healer of the sick and helped to ensure the community's good fortune. The angakoq performed these duties by achieving an ecstatic state in which the soul journeyed to the spirit world — often with the assistance of a benevolent spirit in animal form. Shamans are frequently portrayed in Inuit art as taking on the shape of their spirit helpers. In this sculpture, the angakoq is portrayed as an elderly woman; her spirit helper, a bird, may represent her power of flight, and its positioning "probably point[s] to the belief that the human soul resided in the top of the head" (Gibson J. Creation & Continuity: Inuit Art from the Shumiatcher Collection. Regina: MacKenzie Art Gallery; 1988. p. 36-8).
Health status is one of the many areas in which self-determination is bound to have a positive impact. The shaman depicted here represents an ancient culture of healing that prevailed in the North until the arrival of southern populations and cultures. The incursions of modernity had a devastating impact: infant mortality climbed as high as 240 per 1000 live births in the 1950s and early 1960s as new illnesses entered communities that had no immunologic protection or experience in infection control. Although improvements to infrastructure have become an important feature in Inuit communities over the last few decades, paving the way to better health, the burden of illness is still disproportionately high. The infant mortality rate is twice the national average, and rates of teenage suicide are still eight or ten times higher. Epidemics of respiratory syncytial virus continue to sweep through Northern communities, the prevalence of injury places an enormous burden of mortality and morbidity on nearly all age groups, and the incidence of diabetes, heart disease, otitis media, dental caries and certain cancers are all significantly in excess of the national average. Rickets and tuberculosis continue to be seen more frequently than in the general population.
These inequities in health status reflect inequities in opportunity. The dev-olution of political power and responsibility will help to redress that imbalance. Health needs can now be tackled within a framework of assets rather than from the discouraging perspective of a catalogue of illness. These assets include culture, tradition and a land base five times the size of Alberta. The harnessing of these collective assets will do more to improve health than health services alone can achieve. The establishment of Nunavut is a landmark in our history that all of us should celebrate.
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