'It's not a place for healing'
Cambridge Bay man recounts struggles with medical travel system
Laura Busch
Northern News Services
Published Monday, May 19, 2014
Cambridge Bay
When it comes to medical care, Nunavummiut know why they must often travel far away from their home community to receive treatment - it is just one of the many realities of where they live.
But one Cambridge Bay man is speaking out against what he calls a broken system, where people are too often sent away alone when they are ill and have no other option than to stay in the sub-par living conditions offered by government contractors.
"Hopefully I don't get in trouble for this, but someone has to say this before something serious happens," said William Palvialuk while speaking with Nunavut News/North at Stanton Territorial Hospital in Yellowknife last month. "I just want to see the medical system in a better way."
Palvialuk said his struggle navigating the health care system is just one of many examples. While his case may not be the most extreme in terms of hardship, he wanted to share what he went through in the hopes other Nunavummiut may also speak up and demand a more respectful health care system.
Palvialuk's troubles started in 2009 when his doctor scheduled hip-replacement surgery.
At that time, he was told he did not qualify for a medical escort because there would be services available in Yellowknife to help him.
"They say you don't need an escort. With a major operation like that, how am I going to get around? You know, how am I going to get dressed?" he asked.
After an unsuccessful attempt to change Kitikmeot Medical Travel's decision, Palvialuk decided to pay for his wife and two young children, aged six and eight, to travel to Yellowknife with him. Since they were not covered under medical travel, they also had to pay for a place to stay. He estimates the entire six-week experience cost about $8,000.
Since then, his financial situation has changed and when he found out he needed a second hip replaced this past February, Palvialuk was worried. However, this time he did qualify for an escort, and he, his wife and his two children were covered for a three-week stay at the Larga Kitikmeot Boarding Home, where medical travel patients from the Kitikmeot can stay while being treated at Stanton Territorial Hospital.
But the trouble didn't end there. With between 40 and 50 patients staying at the boarding home, the place is "always overcrowded," he said.
"It's really filthy and dirty," said Palvialuk. "There are little babies crawling around and it's so filthy."
The morning before Palvialuk spoke with Nunavut News/North, he and his wife were again staying at the Larga Kitikmeot Boarding Home and were woken up at 6 a.m. by an intoxicated woman barging into their room.
Despite signs stating there is a zero-tolerance policy for alcohol, Palvialuk said he has often seen people drinking and intoxicated there. As a recovering alcoholic, Palvialuk said he understands why the easy access to alcohol in Yellowknife means patients and their escorts often drink while in the city on medical travel, but the boarding home should follow its own rules for kicking troublemakers out, he said.
"It's not a place for healing. Nobody gets rest," he said.
Right now, Palvialuk's main concerns are providing patients with a clean, safe place to stay and fixing miscommunication between medical travel staff who approve or deny medical escorts, and the doctors who treat patients. Too often, patients are denied a medical escort only to get to the hospital to be asked where their escort is, he said.
"I have seen elders without escorts," he said. "My wife doesn't speak good English or read, and there is no one to help her with how to take her medication."
The Department of Health outlines four criteria for qualifying for medical travel - the need for legal consent, mental or physical conditions, where interpretive services are not available, and where an escort is required to participate in a client's treatment program.
The latter is determined within the Nunavut health care system, and the government recognizes the need for improved communication between doctors in the south and medical professionals within Nunavut communities, said Rosemary Keenaina, acting deputy minister of Health.
"It's a matter of communication between the medical professional where the client is and they should be dialoguing with the medical professional in Nunavut because the recommendation and approval for a medical escort is done within Nunavut," she said. "This is an area that we are talking about. Seeing how we can make lines of communication better."
In terms of the state of the boarding home, Keenaina could not comment to specifics because, while the GN holds the contract for the service, the home is run by a private contractor. Calls to the private contractor were not returned.
In general, it is expected that all boarding homes where Nunavummiut residents stay should provide a clean bed, transportation to and from medical appointments, meals and transportation back to the airport when the time comes to return home.
Since coming to the decision to speak out about the problems he sees within the medical travel system, Palvialuk wrote a letter to his MLA Keith Peterson. More than a month has gone by since and he has yet to hear a response.
As an Inuk who attended residential school in Yellowknife, Churchill, Man., and Inuvik, Palvialuk was taught at a young age to stay quiet and not to disagree with those in charge.
"I used to be a real quiet person, afraid all the time. I'm trying to get over my fear right now," he said. "Something has to get done. So, hopefully, if somebody says something, they'll finally see it and something will happen."
