Perspectives / Optique

Health care in North must acknowledge Inuit values, traditional medicine

Gail Gray, MSc, MD, CCFP

Canadian Medical Association Journal 1996; 155: 1613-1614

[en bref]

Gail Gray, a family physician in Mississauga, Ont., has spent several terms as a locum tenens in Northern Canada.

© 1996 Canadian Medical Association (text and abstract/résumé)

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In brief

Dr. Gail Gray spent a week on Baffin Island in a retreat devoted to discussions about health care delivery in the North. She says it is obvious that traditional medical practices and Inuit cultural values must be part of any new health care initiatives if the initiatives are to be successful.

En bref

Le Dr Gail Gray a passé une semaine sur l'île de Baffin, dans le cadre d'une retraite portant sur la discussion de la prestation des soins de santé dans le Nord. Il est évident que les nouvelles initiatives de soins de santé devront intégrer les pratiques médicales classiques et les valeurs culturelles des Inuit si l'on veut qu'elles réussissent, affirme-t-elle.
As we stood quietly around our circle of stones listening and watching as an Inuit elder performed a drum dance, an excited whisper raced among the conference participants: "Tuktu, Tuktu!"

Over the ridge we could just see the top of a proud rack of caribou antlers moving steadily toward our camp. As the caribou came closer even the drummer fell silent. Head held high, the stag ran by gracefully until the silence was pierced by a shot that rang out sharply from behind our tents. As we watched in disbelief, the caribou staggered with uneven steps in ever-smaller circles before falling. For a few moments no one spoke. Then one of the elders said happily: "Caribou for dinner!"

We had gathered on the shore of Peterhead Inlet on Baffin Island for 5 days to discuss medical and traditional knowledge of the Inuit. This was to provide the basis for a review of the current status of medical care in the Northwest Territories (NWT), with a further focus on innovative ways of delivering health care in the future. The paramount goal that underlined all discussions was the preservation of traditional Inuit values.

The conference was held "on the land" to reinforce the very strong link between the Inuit and their environment. The beautiful grey waters of the sound, the clear blue of the sky and the rugged rock of the mountains combined to provide an awesome setting for our retreat.

Participants came from all parts of the NWT and represented all aspects of the health care system. Most important were the Inuit elders, who spoke to us of their personal knowledge about traditional medicine and educated us in traditional Inuit customs.

I had come to the retreat as a qallunaaq (white person) to learn more about Inuit culture. In order to work effectively in their communities, I would need a greater understanding of their values. The opportunity to immerse myself in Inuit life for a week seemed a marvellous chance for both education and adventure.

Each participant was given an amauti or silapaaq, a traditional outer garment for women or men to wear during the day's activities. We lived in canvas tents that were supported by wooden frames and held down at the edges by rocks; two larger tents served as the kitchen and conference room. A large circle of rocks was our ceremonial meeting place for prayers, drum dancing and singing at the beginning and end of each day.

During the week, we discussed preselected health care topics. As Inuit values and customs traditionally have been passed from one generation to another by word of mouth, each elder had stories to tell of community and personal healing practices.

One told of a treatment for boils. Lemming skins cut into pieces are applied wet to draw the infection to the surface. When the area is ready to lance, it will feel cold and tense to the tip of the tongue. After piercing the area with a bone fragment, caribou sinew is used to pull out the core of pus or sebaceous material.

Traditional cures for sore joints include the topical application of green algae from river rocks, or warming the affected area with small rocks heated in fires. Bleeding is controlled by cleansing the injured area with urine and then applying spores from certain mushrooms.

Both men and women in the community gather the plants and mosses used to heal various ailments. Labrador tea leaves are boiled and the liquid mixed with seal fat to make an ointment. Leaves from the bearberry plant can be boiled and drunk to ease a stomachache. Purple saxifrage flowers and leaves can be eaten or made into a tea. Mosses are used as wicks for the traditional oil lamp (qulliq), or for diapers or sanitary napkins.

The community also deals regularly with mental-health problems and social issues. Individual interventions, often provided with the help of a shaman or respected elder, are done discretely to avoid hurtful gossip and to preserve the stability of the community. Emotional and spiritual wellness is promoted by a strict set of rules that governs the behaviour of each person and establishes each individual's relationship with the community. The importance of family, both for personal and community integrity, was emphasized.

Each day of the retreat involved hours of discussion about health care issues, but there was also time for cultural activities such as seal hunting, clam digging, drum dancing and hide cleaning. Meals always included "country" foods such as fresh caribou, raw Arctic char, muqtuq (whale blubber) and clams. Every effort was made to adhere to a traditional lifestyle, and we were all encouraged to participate as much as possible.

The nature of health care in the North is obviously still evolving, but from this conference it was evident that the Inuit want to preserve their customs and values and make them the underpinnings of any future programs. Love of the land, the importance of relationships, respect for elders -- such values must underlie any health care initiatives and be intrinsic in any new programs.

The path toward healing must start in the past if it is to lead to wellness for the Inuit in the future.

| CMAJ December 1, 1996 (vol 155, no 11)  /  JAMC le 1er décembre 1996 (vol 155, no 11) |