Indigenous Success Stories: Inuit

Carpenter remembered for lifetime of hard work and determination, called ‘an inspiration to many northerners’

CBC News: Dr. Noah Carpenter often defied expectations.

In a 1983 CBC-TV profile, Carpenter — an Inuvialuk man originally from Sachs Harbour, N.W.T. — spoke about his arrival in Winnipeg years before, as a young student from the North enrolled at the University of Manitoba. “They had a welcoming party,” he recalled, with amusement, about what greeted him.

“They were expecting someone with dark hair and Oriental-looking features, wearing a big fur parka and carrying a big spear. And it must have been a great disappointment that they didn’t find this.”

Carpenter, who died this month, is being remembered for his lifetime of hard work and determination, his accomplishments as a skilled surgeon, and the inspiration he gave to many fellow Northerners.

“He was always on top of his game, in every way,” said his brother, Joey Carpenter, in Sachs Harbour. “He was always somebody to look up to.”

Noah Carpenter went to residential school in Aklavik in the 1960s before moving to Inuvik for high school, and then later the University of Manitoba to study chemistry. The 1983 TV profile said his original goal was to become a high school science teacher, but somewhere along the way he decided on med school. In 1971, he was said to be the first Inuk doctor in Canada.

His education and training didn’t stop there, though. He’d go on to study surgery, and go to school in Scotland to specialize in thoracic surgery. “You know, 50 years ago, you couldn’t imagine anyone of us becoming a doctor. You know, times were different and it was an aspiration that most of us couldn’t even dream of,” said his brother, Joey.

Noah would later describe how his father, Fred Carpenter — a successful trapper in the North— expected Noah to follow in his footsteps in what was then still a booming business in the North. Fred didn’t understand why his son would become a doctor instead, Noah recalled.

“As the years went by, I think he began to understand that perhaps I made the right move,” Noah said in 1983. “He’s quite proud, actually, that I am a doctor.”

In that profile, Noah would reflect more on his decision to carve a different path for himself, and the compromises it required. He spoke bluntly about “surrendering” to a system that’s often at odds with Northern culture and tradition. “You can’t expect to devote a lot of time to hunting and fishing and maintaining the old ways of life, and expect to become a first-class thoracic surgeon,” he said.

“There’s alway talk about breaking through and beating the system. Well, you know, the system isn’t out to beat you. I think you have to just accept it. Surrendering to it. And that way you’ll succeed. You have to work at it, you have to do your studies, you can’t do it half-heartedly.”

From 1983: Inuvialuit surgeon Noah Carpenter appears on Focus North – Part I

WATCH: CBC featured Noah Carpenter in a 2-part series in 1983: Duration 10:48

In 1983, Dr. Noah Carpenter, who became the first Inuvialuit doctor in 1971, appeared on Focus North, to talk about his career, and why he never worked in the North. Host Marie Wilson introduces the segment.

From 1983: Inuvialuit surgeon Noah Carpenter appears on Focus North – Part II: Duration 7:40

Dr. Noah Carpenter became the first Inuvialuit doctor in 1971. In Part II of this Focus North segment from 1983, he talks about how education changed his life, but led him south. ‘One of the tragedies about the North and I … is that after trying for so long, it hadn’t worked out.’

Click on the following link to view the videos:

https://www.cbc.ca/news/canada/north/noah-carpenter-nwt-inuit-surgeon-obituary-1.6980056?cmp=newsletter_Evening%20Headlines%20from%20CBC%20News_1617_1267326

‘An inspiration’

In 1995, Dr. Carpenter was recognized with an Indspire Award for his many ground-breaking accomplishments as “the only Inuvialuit specialist surgeon to emerge from the Northwest Territories.” “He has been an inspiration to many northerners and returns there to speak to the youth, motivating them to understand the importance of achieving higher education,” reads the Indspire website.

Noah Carpenter would enjoy a long career as a surgeon in Comox, B.C., and later Brandon, Man., but he always maintained his connection to the North. His last visit to Inuvik was in 2019, for a high school reunion. He would have liked to work in the North, he said in 1983, but described how he never had the opportunity. 

“I don’t know what it is about the North and I. It’s certainly something that I wanted to do,” he said. “The fact that I’m not working there will always remain a mystery.”

The Inuvialuit Regional Corporation (IRC) paid tribute this week to Carpenter, noting his “great success and strong determination,” and calling him an inspiration. “We are proud of Beneficaries who have since followed in pursuing areas of medicine and science, like Noah Carpenter, who dedicate themselves to complete advanced schooling and show Inuvialuit what we can achieve in our lives and careers,” said IRC chair and CEO Duane Ningaqsiq Smith, in a statement.

• Canada’s first Inuk heart surgeon returns from U.S. to take job in St. John’s
• Fabled 1930s Arctic fur-trading ship, built for Inuvialuit trappers, needs a new home

Speaking to CBC News this week, Joey Carpenter said he was still absorbing the news of his brother’s death. “He was always on the good side of everything … We looked up to him,” Joey said.

“It’s gonna take me a while to, you know, to think about it. It never really hit me yet.”

With files from Wanda McLeod

The “Our Health Counts” project will contribute to the priority area of Applying the “Two-Eyed Seeing” Model in Aboriginal Health, specifically utilizing “Two-Eyed Seeing” in assessing and improving the health of urban Aboriginal people. The study design provides an opportunity to address the broad gaps in urban Aboriginal health assessment across health domains and lifecycle stages with a focus on a key health care utilization indicator (ER use)

Our over-all goal is to improve urban Aboriginal health data by documenting many aspects of people’s health and well-being – as a baseline. At all stages of this project many and diverse partners work collaboratively to make health services effective, relevant and efficient for urban Aboriginal peoples. To date, the urban centres included in this project are Ottawa, Hamilton, Toronto, London, and Kenora. An urban Indigenous health information, knowledge, and evaluation (HIKE) network has formed. The HIKE network includes influential representatives from each urban community and members of the research team to share ideas, findings, tools, and resources.
http://ourhealthcounts.ca

Toronto Star – Anishnawbe Health Toronto’s Indigenous Health Centre broke ground on its new location in downtown Toronto. Its partners on the site include Miziwe Biik Training Institute for services around education and employment; a child-care and family centre operated by the city, a mixed-use condo building; a restored heritage building and a rental building.

The Indigenous community centre will be completed by 2022 and the remainder of the hub will be finished by 2024. The hub represents a place to celebrate with others, where Indigenous people can gather as a community…And there’s hope that the launch of the hub will inspire groups and businesses across Canada to partner with Indigenous communities to create spaces that will address the systemic discrimination Indigenous people face in Canada’s institutions.

News at Medicine: Memorial University – Dr. Jennifer Shea, Community Health and Humanities, Faculty of Medicine, along with a team of community partners, hopes to make cancer care delivery more culturally responsive and more respectful. Supported by the Canadian Partnership for Cancer at $866,000 for four years, the project is led by the Nunatsiavut Government, in partnership with Memorial University, the NunatuKavut Community Council, Sheshatshiu Innu First Nation and the Mushuau Innu First Nation.

Their project, “Courage, Compassion, and Connection, The Journey to Healing: Exploring Cancer Pre-diagnosis for Indigenous Peoples in Labrador” came from a stakeholder session held in Happy Valley-Goose Bay in 2018. Two main themes emerged: Challenges during both pre-diagnosis and transitions in care and Cultural Safety

Participants in the session expressed concerns about:

• the high costs of travel for tests;
• continuity in care due to a high turnover of health professionals
• communities without a physician;
• delays in getting test results.
• transitions in care around discharge planning, such as patients being released without awareness of the remoteness of their community and expectations on family/caregivers to provide palliative care once they return.

“For First Nations, Inuit and Métis, a cancer diagnosis has obvious health implications, but also social, financial and interpersonal challenges,” said Dr. Shea.

“Often people living in rural and remote communities have to leave their homes and familiar surroundings for health services in unfamiliar territory. Add to that language barriers and misunderstandings of cultural practices and beliefs, which can make communication difficult.

BC Association of Aboriginal Friendship Centres – Indigenous patients can now report health system concerns anonymously using Safespace Networks on the B.C. Association of Aboriginal Friendship Centres’ (BCAAFC) website. Safespace Networks is a community-led, nationwide initiative to create change in the health care system by holding individuals, organizations and institutions accountable to addressing racism.
The app’s design follows the advice of Te′ta-in (Sound of Thunder) Shane Pointe, Knowledge Keeper within Mary Ellen Turpel Lafond’s “In Plain Sight” report to focus on change, rather than a “shame and name” approach.
Dr. Alika Lafontaine founded Safespace Networks in 2019 with the vision of a social enterprise and learning platform for patient advocacy. To learn more, please visit http://safespace.healthcare/

“COVID-19 and the Decolonization of Indigenous Public Health.” Canadian Association of Medicine Journal – First Nations, Inuit and Métis communities in Canada have had lower rates of COVID-19 overall and a lower case fatality rate than non- Indigenous Peoples despite structural inequities and social determinants that are generally related to poorer health outcomes. First Nations on-reserve have had a COVID-19 case rate:

• 4 times lower than that of the general Canadian population
• with 3 times fewer fatalities and
• a 30% higher recovery rate.

This is vastly different from outcomes during the H1N1 pandemic where rates of the infection were 1000 per 100 000 population among Inuit, and 24 per 100 000 population among non-Indigenous people in Canada Current strategies for Indigenous public health practice, grounded in self-determination, are an important reason for the relative resilience of Indigenous communities in Canada during COVID-19.

In Canada, almost all Indigenous communities have pre-existing emergency preparedness plans, and they have been updated and implemented to deal with the current pandemic. Furthermore, innovative educational materials and public health campaigns have been created by many different First Nations, Inuit and Métis communities. These materials build on prevention, isolation and containment measures put forward by public health institutions but are grounded in the local context of each community, including its language, culture, and physical and social environments.

Examples include the Qikiqtani Inuit Association’s educational materials, which illustrate hygiene practices, social distancing and isolation procedures in Inuktitut, using common examples from the daily lives of their local community members, as well as frameworks for wellness in the COVID era that draw on the knowledge of Elders and knowledge keepers from specific nations. The adaptation by the Centre for Wise Practices at Women’s College Hospital in Toronto of the Four Directions Medicine Wheel for a holistic approach to pre- venting and building physical, emotional, mental and spiritual resilience during COVID-19, is an example of the latter.

Anticipating further waves of COVID-19, it is important that the design, implementation and leadership of public health by First Nations, Inuit and Métis communities continue in Canada. At its foundation, Indigenous public health must be self-determined:

• adapted for the needs of specific nations and grounded in local Indigenous language, culture and ways of knowing;
• developed, implemented and led by Indigenous Peoples; and
• informed by ongoing monitoring of data as governed by appropriate data sovereignty agreements.

Moreover, all levels of government in Canada must address the social determinants of health both in the short term — to facilitate prevention, control and containment of COVID-19 — and in the long term through investments in infrastructure, food security and chronic disease prevention and management. This will require the decolonizing of health care at individual, organizational and policy levels. Governments, policy- makers and public health providers must embrace the know- ledge, expertise and strong leadership of Indigenous communities to face COVID-19.
https://www.cmaj.ca/content/cmaj/192/38/E1098.full.pdf

The article “Indigenous-led health care partnerships in Canada” raises four key points:

1. Indigenous Peoples in Canada benefit from regaining access to and strengthening traditional cultural ways of life, including health and healing practices.
2. Many Indigenous communities are working to strengthen cultural healing practices that were marred through colonization and oppressive government policies.
3. Indigenous-led health care partnerships provide innovative models of interprofessional collaboration, be it in community-based healing lodges, remote clinics or urban hospitals.
4. Emerging evidence suggests that Indigenous-led health service partnerships improve holistic (inclusive of mind, body, emotion and spirit) health outcomes for Indigenous Peoples, as well as access to care, prevention uptake and adherence to care plans.

The paper discusses specific Indigenous-led health practices in multiple jurisdictions. The paper concludes with specific suggestions for health care providers, managers and researchers across three dimensions:

• Personal practice
• In public forums and systems
• In research
• Indigenous healers and Elders are sometimes reluctant to build partnerships with physicians out of concern about:
  • the potential overharvesting of plant medicines,
  • disrespectful treatment,
  • cultural appropriation
  • commercialization,
  • unbalanced funding schemes,
  • tokenism and loss of autonomy.

Furthermore, from the patient’s perspective, a survey conducted in eastern Canada reported that 92% of the Indigenous respondents who use tradi¬tional medicine feared disclosing this information to health pro¬fessionals. Better understanding is needed on how to protect Indigenous medicines, healing practices and knowledge in their full integrity while developing and promoting self¬-determination in Indigenous-led health care services and systems that foster cultur¬ally safe spaces for patients, Elders and healers.
https://www.cmaj.ca/content/cmaj/192/9/E208.full.pdf

Inuit Tapariit Kanatami – The name of the project, Qanuippitaa?, echoes the names of the Inuit Health Survey that operated in Nunavik in 2004 and 2017 and in the Inuvialuit Settlement Region, Nunavut and Nunatsiavut in 2007-2008. It is a permanent health survey, funded by a 2018 federal budget allocation of $82 million over 10 years with $6 million a year ongoing. Data collection is expected to begin in 2021 and take place every five years. All of the data will be owned by Inuit and survey questions will reflect Inuit health priorities.

“Through the work of this survey, we will overcome longstanding challenges regarding the availability and accessibility of data related to Inuit health and wellbeing. Reliable data that is owned and directed by Inuit is an essential component of good policy making to produce transformational change in the wellbeing of Inuit,” said Natan Obed, President, Inuit Tapiriit Kanatami.

“The Inuit Health Survey has contributed greatly to our understanding of Inuit health in Inuit Nunangat. Inuit-supported research is critical to informing the design of policies that influence our quality of life,” said Natan Obed, President of Inuit Tapiriit Kanatami. The continued storage of the data and samples provides insight into changes in Inuit health over time. The regional Inuit organizations including Nunatsiavut Government, Nunavut Tunngavik Incorporated, and the Inuvialuit Regional Corporation in partnership with McGill University are conducting the re-consent. This is being done in support from the Government of Nunavut, the Government of the Northwest Territories and Inuit Tapiriit Kanatami.
https://www.itk.ca/inuit-launch-qanuippitaa-national-inuit-health-survey/

CBC – “M-174 National Suicide Prevention Action Plan” passed unanimously in House of Commons. M-174 establishes a “national suicide prevention action plan, including among its provisions (i) commitment to the actions and resources required to establish culturally appropriate community-based suicide prevention programs as articulated by representative organizations of the Inuit, First Nations, and Métis peoples. Timmins-James Bay MP Charlie Angus says crises in northern Ontario First Nations prompted motion.

On May 8, 2019, parliamentarians voted unanimously in favour of a national suicide prevention action plan. The Motion M-174 calls on the Government of Canada to establish a national suicide prevention action plan, including among its provisions:

• commitment to the actions and resources required to establish culturally appropriate community-based suicide prevention programs as articulated by representative organizations of the Inuit, First Nations, and Métis peoples;
• establishment of national guidelines for best practices in suicide prevention based on evidence of effectiveness in a Canadian context;
• the creation of a national public health monitoring program for the prevention of suicide and identification of groups at elevated risk;
• creation of programs to identify, and to attempt to fill, gaps in knowledge relating to suicide and its prevention, including timely and accurate statistical data;
• development of tools to promote responsible and safe reporting of suicide and its prevention by media;
  establishment of national standards for the training of persons engaged in suicide prevention, whose contact with potentially vulnerable populations provides an opportunity to identify at-risk individuals and direct them to appropriate assessment and treatment;
• creation of a national online hub providing essential information and guides to accessing services, in English, French, selected Indigenous languages, and other languages spoken widely in Canada for suicidal individuals, their families and friends, people bereaved by a loved one’s suicide, workplaces and other stakeholders concerned with suicide prevention;
• conducting within 18 months comprehensive analyses of high-risk groups of people, and the risk factors specific to each such group:
  • the degree to which child sexual abuse and other forms of childhood abuse and neglect have an impact on suicidal behaviour,
  • the barriers to Canadians accessing appropriate and adequate health, wellness and recovery services, including substance use, addiction and bereavement services,
  • the funding arrangements required to provide the treatment, education, professional training and other supports required to prevent suicide and assist those bereaved by a loved one’s suicide,
  • the use of culturally appropriate suicide prevention activities and best practices,
  • the role that social media plays with respect to suicide and suicide prevention,
  • means to reduce stigma associated with being a consumer of mental health, bereavement and other associated services, and ways in which society can reduce access to means and methods for people to harm themselves; and,
• report to Parliament annually on preparations for and implementation of the national action plan for suicide prevention, including data on progress over the previous year, and a comprehensive statistical overview of suicide in Canada for the same year.

Nunatsiaq News – In a move partly influenced by work done by Inuit Tapiriit Kanatami and the governments of Nunavut and Quebec, members of all parties in the House of Commons said yes to the idea of a national suicide prevention action plan. “Our government is working closely with Indigenous leadership to encourage and promote Indigenous-led strategies to address suicide prevention in their own communities,” Dan Vandal, parliamentary secretary to Indigenous Services Minister Seamus O’Regan said. Vandal also gave a detailed description of ITK’s National Inuit Suicide Prevention Strategy, listing its six priorities.

But at the same time, Vandal said ITK’s strategy may not be a good fit for other Indigenous peoples. To that end, he said the federal government is working with the Métis Nation to develop “a Métis Nation specific approach” to suicide prevention. And the federal government is also working with First Nations on a First Nations mental wellness continuum framework directed at First Nations communities, Vandal said.

The motion calls for the following:

• The establishment of national guidelines for best practices in suicide prevention.
• A national public health monitoring program to identify groups at elevated risk of suicide.
• Culturally appropriate, community-based suicide prevention programs for Inuit, First Nations and Métis.
• Creation of programs aimed at filling in gaps in knowledge related to suicide and its prevention.
• National standards for training people in suicide prevention.
• Development of tools to promote safe and responsible reporting of suicide by media.

The motion also calls for a comprehensive analysis on how child sexual abuse and other forms of childhood abuse and neglect contribute to suicidal behaviour. And it calls for an analysis of the barriers that Canadians face in gaining access to health, wellness and recovery services, including substance use, addiction and bereavement services.

The Indigenous Peoples’ Health Research Centre (IPHRC) and the Saskatchewan Centre for Patient-Oriented Research (SCPOR) – have developed an in-person training module for Health researchers. ”Building Research Relationships with Indigenous Communities” (BRRIC), is the first of its kind in Canada. It seeks to provide researchers with the basic tools and knowledge to build meaningful research relationships in a good way with Indigenous peoples and their communities.

BRRIC also incorporates traditional Indigenous knowledge and the Truth and Reconciliation Commission’s Calls to Action. It is designed to provide researchers with the necessary policies, frameworks, and Indigenous ethical standards needed to respectfully engage with Indigenous communities and patients including:

• the history of Indigenous health and research in Saskatchewan;
  existing policies and frameworks guiding research with Indigenous communities such as OCAP™,
• Truth and Reconciliation Commission Calls to Action,
• Tri-Council Policy Statement Chapter 9 and;
• protocol on how to respectfully and meaningfully engage communities in research projects.

https://www.schoolofpublicpolicy.sk.ca/news-events/news-articles/2019/iphrc-and-scpor-launch-first-of-its-kind-training-for-health-researchers-engaging-with-indigenous-communities.php

Ten years after the Inuit Health Survey was completed in 2007-08, researchers are reaching out to 2,500 participants in Nunavut, Nunatsiavut and the Inuvialuit Settlement Region (ISR) of the Northwest Territories to seek consent to maintain data for continued study and comparison to results of future Inuit Health Surveys. The 2007-08 International Polar Year Inuit Health Survey, known as Qanuippitali: How about us, how are we? was the first comprehensive research project to look at the health of Inuit in these three Inuit regions. A separate Inuit Health Survey project operated independently in Nunavik in 2004 with a second survey in the region being conducted this year.

Assembly of Manitoba Chiefs – Today’s resurgence of the Bear Clan Patrol is in response to the need in Winnipeg to protect the women, children, elderly and vulnerable community members. Originally started in 1992, a reconstituted Bear Clan Patrol hit the streets after the murder of Tina Fontaine in 2014 with 12 members that now boasts 980 people in Winnipeg alone. It has also spread outside Winnipeg, spanning across 24 different communities in 12 cities in five provinces all the way from Ottawa to East Hastings in Vancouver.
So far in 2018 35 tonnes of food has been donated. They clocked 21,000 volunteer hours in 2017 and forecast 33,000 volunteer hours this year. They have collected almost 30,000 needles so far in 2018. They have seven paid full-time and part-time staff workers. In June, they had $50,000 in temporary work placements. They are janitors, first responders, neighbours, ambassadors but most importantly they do this because they care about the people who call the North End home. (Assembly of Manitoba Chiefs)