Lynn Lau
Northern News Services

Inuvik (Oct 28/02) - After more than 10 years working in Nunavut, Dr. Gerry Uswak, a pediatric dentist, was pleased to see that Inuvik had some trees, however scrubby they might be.

Last week, the 38-year-old moved here to take on the role of chief executive officer for the Inuvik Health and Social Services Authority.

News/North: What does a pediatric dentist do? I thought most babies didn't have teeth to worry about.

Gerry Uswak: It's a specialty area of dentistry. Children start to get their teeth at the age of one, and in the North, there's a really high incidence of baby bottle tooth decay. So between the ages of two and five years old, we put them to sleep under general anaesthetic and restore their teeth with silver crowns.

N/N: Why would something like that be so prevalent?

GU: We have a population that's in transition from a traditional society moving towards a more Western society, and the introduction of refined sugars, carbohydrates and convenience foods. The baby bottle is being used far too long and people are using inappropriate fluids like apple juice and Kool-Aid. There's also a lower level of breast feeding.

N/N: Did you see similar problems when you were doing your clinics in Bolivia (South America)?

GU: Whichever aboriginal group had access to convenience foods like pop and candy, we noticed significant rates of decay. If you had more traditional groups using country foods, the decay rates were less.

N/N: In the early '90s, you went to the University of Carolina to complete a specialization in public health. What made you want to move from dentistry to administration?

GU: In dentistry, you're treating one patient at a time. In public health, you're developing programs and providing for the health promotion, disease prevention and treatment of an entire population.

N/N: What keeps bringing you back to the North?

GU: It's a challenge to provide for the clients' needs. It's an opportunity to make a significant difference, and positively impact health.

N/N: Doesn't that opportunity exist as well in the South?

GU: No, here the challenges are still significant in a lot of respects. The intricacies of providing health and social services are a lot more difficult given how the North is spread out over a large geographic area. In the South everyone has better opportunities to seek treatment.

N/N: A lot of these treatments have been available in the North for many decades, yet we keep hearing that Northerners are unhealthier, smoke more, exercise less, are more obese, more likely to get diabetes, and on and on, when compared to southern Canadians. Why do you think that is?

GU: Early on in the development of the territories, the people didn't have the opportunity to participate in health-care delivery. It was just bringing in doctors from the South once a year, who would come in and say this is what you need and there was no explanation. Now governments and health-care organizations appreciate that there are distinct cultural groups and you can't treat everyone with the same southern model. One size does not fit all.

N/N: How has the health care model changed?

GU: Nowadays we realize we have to inform the clients why things need to be done, and we have to understand that it may not be important to them.

For instance if in the North there's teen pregnancy, in the South, it's a given we want to reduce teenage pregnancy. But in some parts of Canada, teenage pregnancies are not seen as a problem because there are available families to adopt the children out. In some instances there needs to be a change in perception and that's where public education comes in. But on the other hand, we can become educated that there are other ways of doing things.

For instance we're starting to realize there are alternatives to providing medical services outside western medicine. Allied health-care practitioners like midwives, can complement the existing system.

N/N: What would you like to see in health and social services delivery?

GU: We have to have our clients choosing to lead healthy lives. We like them to become stakeholders and direct participants in their own health and social services care, so it's a co-operative enterprise.

That's the way for our communities to become healthy. It's not just a top down mentality. There has to be grassroots community interventions. If we all work together, it will be more successful.