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Death in a bottle
Weekend Yellowknifer - Friday, April 9, 2010

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This warning is worth repeating for Health Minister Sandy Lee and all health officials:

"Prescriptions for venlafaxine XR (an antidepressant) should be written for the smallest quantity of drug consistent with good patient management, in order to reduce the risk of overdose, particularly in patients who have more severe illness or risk factors for suicidal behaviour."

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Startlingly, an NWT coroner's report into the fatal overdose of a 20-year-old man last year revealed that at the time of his death the man had 59 times the therapeutic dose of venlafaxine in his bloodstream.

The warning - dated Oct. 23, 2008, more than three months before the troubled young man died - is posted on the website of Wyeth Canada, which makes the antidepressant drug, also known as Effexor.

The warning also advises patients using the drug be monitored, that patients may persist in having suicidal thoughts after taking the drug, and that all antidepressants carry a potential risk for a fatal overdose.

According to the coroner's report, written by NWT deputy chief coroner Cathy Menard, the 20-year-old was given a three-month prescription of Effexor by a doctor at Stanton Territorial Hospital less than one month before his death. When he went to the hospital he had an empty Effexor bottle on him.

Menard made three recommendations, one of which was that NWT doctors be educated in the dangers of providing large prescription orders of Effexor to patients.

The department's response? Why everything is hunky-dory around here; write a policy on how much Effexor should be prescribed? Well, we don't do that, what doctors prescribe is entirely up to them.

"All medical professionals are on top of all medical warnings from Health Canada and practising due diligence when prescribing medication," says Lee, which is akin to saying all pilots don't crash planes.

Something went wrong prior to the man's death on Feb. 1, 2009, and it wasn't an act of God. This person, who had previously attempted to commit suicide three times, was allowed to wander off alone and unsupervised with a bottle of full of dangerous medicine that later killed him.

Chief coroner Garth Eggenberger is suspicious of two more deaths in recent years where patients had been prescribed Effexor before they died.

In a letter to the editor in last Friday's Yellowknifer, Dr. Thomas Ripley - a Stanton psychiatrist no less - warns that the drug can be dangerous, particularly when consumed with alcohol.

We don't know how many NWT residents have been prescribed Effexor, but we do know that mental health is a serious issue in the Northwest Territories.

Effexor, it should be mentioned, was the seventh most commonly prescribed drug in Canada in 2008, according to IMS Health, an international company that provides pharmaceutical companies with sales data.

Health officials and their minister have held a press conference, and it's clear they're not taking the coroner's recommendations seriously. We can only ask how many more people will have to die to change that.

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Toying with fire
Editorial Comment
Roxanna Thompson
Deh Cho Drum - Thursday, April 8, 2010

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Medical emergencies, house fires and serious vehicle accidents, are all scenarios that people seek to avoid.

All of these things, however, can and do happen. In larger centres there are paid professionals, namely firefighters and ambulance attendants, who respond to these situations.

In the Deh Cho people who need help in the face of an emergency are reliant on volunteers. It's regular community members who staff the volunteer fire departments in the various communities.

Volunteer firefighters play very important roles in all of the Deh Cho communities. Without them the communities wouldn't have any immediate line of defense in the case of a fire or serious vehicle accident.

These volunteers give up their free time to attend practices so they'll be prepared to save lives and buildings if the need arises. The volunteers are on call 24/7 to respond to emergencies.

Often the importance of their roles is forgotten. No one spends a lot of time thinking about volunteer firefighters until they need them. As long as the service is available, everything is OK.

If, however, there was an emergency in a community and the response was insufficient, alarm bells would be sounded. Of course by then it would be too late.

By virtue of their size some Deh Cho communities have stronger volunteer departments than others because there are more people to draw from. Fort Simpson and Fort Providence have solid teams but even those communities can face recruitment problems.

Currently the Fort Simpson Volunteer Fire Department is down to 10 people, half of the number Fire Chief Pat Rowe said is ideal. Six firefighters are needed to respond to a fire. All it would take is for three current members of the department to be away for a weekend and two to be sick and suddenly there wouldn't be enough.

While there's no cause for alarm yet the department is looking for new recruits. In fact every fire department in the Deh Cho would probably welcome new members.

Volunteer fire departments are of crucial importance in the Deh Cho but they don't happen by accident.

Communities have to continue to support and foster their fire departments if they want them to be prepared when that inevitable emergency call comes in.

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Wellness starts with the young
Editorial Comment
Andrew Rankin
Inuvik Drum - Thursday, April 8, 2010

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Having a nurse practitioner here in Inuvik seems to be a win-win situation for everyone working in the health care system and for those who need it most, the chronically ill.

That's who our newest nurse practitioner Valerie Jefferd (see story, page 12) will be working with at the Arctic Family Medical House.

The job of nurse practitioner involves a lot of upgrading where a nurse is trained to take on some of the duties of a doctor, such as ordering and interpreting X-rays and prescribing certain medication.

While working with her patients, Jefferd will also be consulting with a variety of other health care workers, such as a nutritionist and physiotherapist, to ensure patients are well looked after. That's great. No one needs reminding of just how prevalent chronic illnesses, especially type 2 diabetes, are in communities across the territories.

The GNWT say it's a priority to have a nurse practitioner in each community, especially given how hard it is to retain nurses and doctors here. That sounds like a great idea but it also seems a little easier said than done.

With all the talk about Northern communities being plagued by long-term illnesses, don't you wonder what's being done to solve the situation? Do people even really have an understanding of the root causes of why these illnesses are so prevalent here?

It's a complex issue to say the least, one I'm sure our politicians, especially the ones who represent us in Ottawa, have no idea how to approach.

But who's looking out for the youth, especially young children, to ensure they don't fall between the cracks? I figure if you want to curb chronic illnesses you start with the young.

You get a child in the habit of eating well and the trend usually carries on throughout their lives. But where's the support systems for them? Nothing is being done to help poor families here buy expensive fruits and vegetables. There are no incentives.

Here and there you see signs of hope and improvement. The school offers a light breakfast program and the volunteers who are involved deserve credit.

What happens if children miss that meal? They go to class hungry. Perhaps there could be a healthy snack program built into the curriculum or even a healthy lunch program. Where's the community dialogue on this issue?

Governments and health care institutions are crying over the obesity and diabetes levels among people in the North.

You can throw all kinds of money in the health care system but it's a lot more difficult to work together to find creative solutions to these very serious problems. I wonder if the will is out there.

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Save the healing foundation
Yellowknifer - Wednesday, April 7, 2010

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The Aboriginal Healing Foundation's mandate came to an end on March 31, cutting off funding to more than a hundred community-run healing programs nationwide.

The foundation had contributed $321,000 to programs in Ndilo and Dettah, and $2.9 million to the Healing Drum Society in Yellowknife, which will stay open for another year.

In 1998, the foundation was given $350 million by the federal government and tasked with helping Canada's aboriginal peoples find ways to heal from the wounds of mental, physical, and sexual abuse suffered in Indian Residential Schools, as well as the deep-seated repercussions - depression, alcoholism, violence, poverty, suicide, weakening of cultural skills and parenting skills. The goal was to help those suffering and stop the destructive cycle from being passed on to future generations.

But it was optimistic in the first place to think 11 years of programming would be sufficient to heal the multi-generational pain created by residential schools.

As Dene National Chief Bill Erasmus pointed out, for years survivors kept silent and governments refused to acknowledge the damage done by the schools. Only in recent years has there been open discussion. "We're only now starting to deal with the impact," he told Yellowknifer.

Groups across Canada are protesting the exclusion of funding for the foundation from the Conservative government's 2010-11 budget announced in early March. A rally will be held in Yellowknife this Friday.

The House of Commons held an emergency debate on the topic on March 31. We hope the government is convinced of the value of these programs and will see fit to save them.

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Expand on drug abuse lessons
Yellowknifer - Wednesday, April 7, 2010

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Recent surveys show the use of illegal drugs among teens is high enough to be cause for concern. For example, four per cent of teens in city high schools admit to having tried crack.

Full results from Yellowknife's drug survey will be released soon, but the preliminary information confirms there's a need for more education. The lessons, of course, should be taught not only at school but at home.

We cannot trust that the RCMP's Drug Abuse Resistance Education (DARE) program for elementary school students - comprising 17 lessons - will, alone, be enough to serve them for the rest of their lives.

There are many examples of the terrible consequences of drug and alcohol addiction, as this newspaper documents throughout the year, particularly from the courts. Schools should not limit their deterrence to textbook lessons on the physiological effects of drug and alcohol abuse when the disturbing impacts of addictions in everyday life are all around us.

Health officials, teachers and those who have dealt with the perils of drug and alcohol addiction firsthand must take their valuable lessons to youths in elementary and high schools, and, sometimes, take senior students to places like the courts, where the consequences of wrong choices will be driven home.

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Time to shine like gold
Editorial Comment
Darrell Greer
Kivalliq News - Wednesday, April 7, 2010

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I closed out 2009 by predicting it wouldn't be long after the Meadowbank gold project went into production in Baker Lake that AgnicoEagle would announce it had taken over the Meliadine gold project in Rankin Inlet (Golden future for Rankin, Kivalliq News, Dec. 2, 2009).

And, with a threeday blizzard bringing back the winter blues this past week, coupled with the sudden death of the community's senior administrative officer, the community of Rankin Inlet was in dire need of some good news.

That good news was delivered in spades when AgnicoEagle announced it had reached an agreement with Comaplex Minerals Corp. to acquire all the shares from Comaplex it did not already own, resulting in AgnicoEagle owning a 100 per cent interest in the advanced stage Meliadine gold project.

In making the announcement, the company stated Meliadine is a perfect fit with its Arctic skill set, and the transaction solidifies its commitment to Nunavut.

AgnicoEagle's plans for Meliadine include accelerating an underground exploration program focused on expanding the resource, and converting the large resource into reserves during the next two years.

The company hopes to initiate a feasibility study prior to the end of 2011.

Make no mistake about it, this is wonderful news for Rankin Inlet and the Kivalliq in general.

A feasibility study being initiated about 18 to 20 months from now may seem like a long way in the future.

But those months will roll by very quickly.

And, enthusiasm is curbed somewhat by our inability to look into the future and see what awaits us years down the road, especially in regards to the price of gold.

But this should be a time for optimism and preparation.

Should things play out the way we hope, the Kivalliq will soon be ready to take a another big step forward towards self-sufficiency, at least for as long as these mining projects last.

It is now more important than ever to increase our efforts to ensure as much of the rewards as possible stay in the Kivalliq long after the mines have closed.

And that means training and more training.

Should Meliadine one day become a working mine, Agnico-Eagle will have no trouble reaching an impressive percentage of regional employees early on.

And, the company is showing in Baker Lake that it's willing to do what it can on the fly to increase local worker skills so they can obtain jobs requiring higher skill sets.

But, we can't simply take care of the basics and then sit back and wait for the company to do the rest.

We have to do our share to ensure we have skilled workers ready to hold jobs when the project passes the construction stage.

In all probability, the mineral-exploration activity we're seeing in our backyard right now is a once-in-a-lifetime opportunity.

It's imperative we do what's necessary for the people of our region to realize the maximum potential from these projects.

It's time to get busy and shine as brightly as the gold we're after!

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More freedom to vote
NWT News/North - Monday, April 5, 2010

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Municipal councils in the North and small community governments across the country have similar challenges. Most notably is the ability of councillors to be perceived as impartial while making a decision.

In municipalities with only hundreds or a few thousand people, councillors often work and volunteer heavily in the community, so decisions around the council table will inevitably overlap.

Hay River council recently experienced an extreme example when three councillors were forced to declare a conflict of interest - a fourth, who was not present, would have also been in conflict -- when dealing with a land sale between the GNWT and the town. Each of the four councillors is employed by the GNWT.

Deputy mayor Mike Maher, who works for the GNWT, said it would be hard for him and the other three councillors to be effective in their roles due to the amount of business the town does with the territorial government. He's right, Eliminating half of council from voting during issues dealing with the GNWT does not make sense, especially considering most items will have no measurable affect on the councillors. It seems far more likely that a conflict would exist only when dealing with the department a councillor works for.

Otherwise the town will frequently be in a situation where half of its elected body will be unable to vote on issues and some will be of even greater importance than selling some real estate. Obviously that is not a situation conducive to an effective and representative government.

According to David Kravitz, with Municipal and Community Affairs, the Conflict of Interest Act does not differentiate between large and small employers and, indeed, the councillors would have been in conflict had they voted on the land sale.

Mayor Kelly Schofield advised as much, but he shouldn't be so willing to accept the definition without question. This is a situation where council should advocate for change so it isn't hampered by overly-stringent legislation in future votes.

Although the Conflict of Interest Act allows a vote to be held as long as two councillors are not in conflict a council cannot be considered effective if that situation arises an a regular basis. Who wants two councillors making crucial decisions?

If four councillors in Hay River are barred from voting on a regular basis it will greatly diminish the democratic process there, and this situation likely hinders other communities as well.

Broadening the definition of employee in the Conflict of Interest Act could solve the problem in Hay River.

Although relaxing definitions in law may result in some disputes going to the Conflict Commissioner, it would also ensure councils are not hamstrung by a sweeping and unnecessarily limiting section of the act.

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High expectations
Nunavut News/North - Monday, April 5, 2010

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Nunavut turned 11 on April 1 and a goal of an 85 per cent Inuit workforce within the territorial government has yet to be achieved.

That has sparked frustration from some quarters, a call for persistence and patience from others.

The latter camp has it right.

Auditor general Sheila Fraser released yet another report in March that shows the Government of Nunavut is bumbling and stumbling, in some ways, on its way to putting Inuit in bureaucratic positions, particularly senior ones.

Nunavut beneficiaries represent 51 per cent of the GN overall, but only 23 per cent among middle and upper management.

Doing her own job extremely well, Fraser pointed out some of the troubling aspects of how the GN functions, even if it just barely functions in some respects. There are close to 800 vacant positions, which is almost 23 per cent of government jobs. It takes 318 days, on average, to fill a position.

The fallout from this shows up in many facets of life, like repeatedly trying to get service from various departments only to be put through to voicemail, not a real human being with solutions to problems. That can be maddening.

Another example of the consequences came recently in the Nunavut Court of Justice, where a GN-filed case over "bad gasoline" has been moving at a snail's pace for several years. Justice Earl Johnson noted that there are many complicating factors in the case, but wrote that one of them was "high turnover of staff in the territorial government."

The GN's goal of reaching 85 per cent Inuit employment by 2020 simply isn't realistic, according to Fraser.

This could be viewed as disheartening, but let's remember that there have been some real signs of progress. The GN's 51 per cent Inuit workforce is up from 42 per cent in 2002. Beyond that, Inuit represent a whopping 94 per cent of GN administrative jobs in the territory. That's impressive.

To keep progressing into the higher-paying jobs with greater responsibility, more training and education is required. That is happening, as Nunavut News/North's Degrees of Success special edition showed just last week, highlighting the growing number of college students and the demand that a burgeoning exploration and mining industry is creating for Inuit employees. To their advantage, there is competition for their coveted skills and services, which will allow them to choose whether to work in the public or private sector. That's a good choice to have.

Clearly the GN must do a better job of recruitment and retention overall. Fraser did find that the Department of Education is doing some things right by filling jobs more quickly - 43 days on average - and has working strategies to recruit Inuit educators. The government should pay close attention and adopt some of the successful tactics employed in that department.

In the meantime, while we shouldn't let go of our objectives, we have to take a step back and realize how far we've come. There's a long road ahead with many classroom and office-based lessons to learn, but, day by day, we're getting there.