"I really don't understand that (Tutcho's letter)," chief executive officer Ray Scott said. "Sahtu is part of the Inuvik region, but people from the Sahtu -- Deline in particular -- are given the choice."

Scott said 394 residents from Deline, Norman Wells and Tulita were referred for outside care between April 1997 and January 1998.

"Forty-four chose to come to Inuvik," Scott said. "Twenty-one were for dental (care) and only 23 were for medical care."

But in his letter, Tutcho explained how Sahtu Dene have few ties with the people of Inuvik and their language has little in common with the aboriginal languages spoken in Inuvik.

By comparison, "the Slavey dialects spoken in the Yellowknife area are understood by our people," Tutcho wrote.

Tutcho said many Sahtu Dene now live in Yellowknife, while few live in Inuvik. Further, when they travel, it's usually to Yellowknife rather than Inuvik.

The results, according to Tutcho, are that Sahtu Dene who are hospitalized in Inuvik are isolated from their language, culture and friends and family. The situation is more serious for elders, who speak little English.

Tutcho suggested the Sahtu should have its own health board, or as a minimum be included in the Yellowknife region.

The habit of overlooking the integrity of the Sahtu is present in other departments as well, according to Tutcho.

"The GNWT departments in Inuvik often seem to regard us as second-class citizens," he wrote.