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CMA, QMA wrap up "amazing visit" to James Bay, Nunavik

Presidents of the CMA have made many trips on behalf of the association since it was formed in 1867, but few of them can match Dr. Anna Reid's journey into northern Quebec in June.

"This trip was the highlight of my year, no doubt about it," Reid says of the visit, designed to allow her to witness the health and social issues facing the Cree who live along James Bay and the Inuit who live further north, in Nunavik.

The visit, organized by Quebec Medical Association President Laurent Marcoux, took Reid almost as far north as Baffin Island and into areas where things that are taken for granted in the south - cellular service, for instance, or connection to other communities by road - are often non-existent.

Marcoux, the director of professional services for the Cree Health Board, is intimately familiar with the health care issues facing the region. He described the visit as an opportunity to witness some of the "excellent work" being done by physicians, nurses, pharmacists and dentists in remote parts of northern Quebec.

"There is no issue with collaboration among health care workers here," he said. "It is a way of life - it has to be."

Marcoux said the visit also tied in perfectly with the CMA's drive to make Canadians - and politicians - more aware of the impact issues such as poverty and poor housing have on health. "If you want to witness the social determinants of health in action, you can do it here," he said.

Reid and Marcoux made their first stop at Chisasibi, a community of about 4,500 mostly Cree residents on the eastern shore of James Bay. It is the most northerly Cree community accessible by road.

Reid says the briefings she received from Chisasibi's physicians, nurses and health administrators were both informative and moving. "It was sobering to realize that in a G-8 nation such as Canada there are people living without access to clean drinking water and proper sanitation, to say nothing of adequate housing."

One band administrator in Chisasibi told Reid that the community has a backlog requirement of 400 new homes. "As a nation we like to brag about our standing as one of the best countries in the world," said Reid, "but when you witness the living conditions here you realize that perhaps we brag a little too much."

Further north, Reid came face to face with more of the same problems. In Puvirnituq, for instance, water has to be delivered to the 1,700 residents every day, and it must be boiled before drinking.

The region produces many health care challenges, ranging from cases of tuberculosis to a heavy suicide rate. Reid also discovered that one of the biggest problems affecting the recruitment of health personnel in Nunavik is not recruitment per se but inadequate housing and a shortage of office space. The shortages have made it impossible to hire some potential recruits.

However, there is some good news too, particularly in relation to education initiatives surrounding fetal alcohol spectrum disorder and attempts to encourage the young to speak more freely and openly about issues such as addiction and suicide.

Reid described the visit as an educational trip that brought the social determinants of health - such as poverty and housing - into clear focus. "An amazing trip," she said, "where I met some amazing people."

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