In an article published in a recent issue of the Canadian Polar Commission’s Meridian newsletter, Dr. Anna Banerji, a well-known disease expert, unloads on the Government of , the and the pediatric for ignoring the appalling rates of respiratory infection among Inuit infants in Arctic communities, especially Nunavut.
A nasty little bug called RSV, or respiratory synctial virus is responsible for most of these serious infections: infections that require sick infants to be flown on highly expensive medevac flights to southern hospitals, where they receive equally expensive treatments to help their bodies recover. Much of what we now know about RSV, including its prevalence and its costs, is due to the work of Banerji and other researchers with whom she has worked.
RSV has blighted the lives of numerous Inuit children and their families. Inuit children suffer the highest rates of LRTI, or lower respiratory tract infection, in the world.
Banerji believes that health care providers can limit the damage by administering an agent called palivizumab. It’s manufactured by Abbot Laboratories and it costs a lot of money. Banerji, pointing to her research, asserts that palivizumab would help 80 per cent of infected children fight off the disease without their having to be hospitalized.
The Canadian Pediatric Society shares this view. But not the GN. The territorial government’s policy, even now, is to administer palivizumab only to premature infants or those who are at risk for other reasons.
The Canadian Press published a damn good story, by Bob Weber, about this dispute today. Your humble content provider is eager to see whether anyone in Nunavut pays attention to it.
Here are some salient quotes from Banerji’s Meridian article:
Working in the Arctic has been one of the most positive experiences in my life, but at times it has been very challenging. The biggest barriers I have encountered have been complacency and inertia. I have met many committed, dedicated people in the north. I have also met individuals so used to the high rates of LRTI, endemic diseases, poverty, overcrowding, and sub-standard housing that they have little motivation to lobby for change.
[Nunavut Tunngavik Inc.s] 2007–2008 Annual Report on the State of Inuit Culture and Society states that the Nunavut and federal governments “must communicate with and involve Inuit in the design and delivery of health care” as a legal requirement under the Nunavut Land Claims Agreement Article 32.
We have experienced situations when our research, though endorsed by the numerous Inuit organizations that we consulted for input and advice, and approved by the Nunavut Research Institute, has nonetheless encountered obstacles from the territorial government. We are still trying to to negotiate and overcome these difficulties.
And this is part of what she has to say about the complacency of the pediatric research community:
Although Canadian Inuit children have the highest rates of LRTI in the world, our study is the first (and only) case-controlled study of its kind published – and we submitted the papers five times before they were accepted for publication.
One reviewer from a major pediatric journal actually wrote that, “remote arctic communities are not of interest to the general reader.” To ameliorate the situation, Canadian journals should make it a part of their mission to include papers on aboriginal health and underrepresented populations, especially because very little data exists.
You can download Banerji’s entire article here: Meridian, Fall-Winter 2009, (PDF, 712 kb) The article runs from pages 1 to 3.