KINNGAIT/CAPE DORSET
A report delving into the actions of the Government of Nunavut's Department of Health after the 2012 death of a three-month-old infant in Cape Dorset will make dozens of recommendations.

Katherine Peterson, the retired lawyer contracted by the GN to carry out the investigation before an Oct. 31 deadline, spoke with Nunavut News/North Oct. 27. She began her investigation Feb. 25 and was in the process of crafting recommendations. There will likely be at least 25 to 30, she said.

"A number of the recommendations, I would think, would go to government processes, which is not terribly exciting but terribly important," said Peterson. "How government works. How government responds. And are there areas in which both the working and the responsiveness of the government can be improved? I anticipate that will be the bulk of what the recommendations will be about. Significantly, that's what they asked me to do."

Peterson indicated to Health Minister Paul Okalik that "it may be there is a context to matters that happened in Cape Dorset and some of that context may occur prior to the death of baby Makibi. And if that's the case, they have to be included."

As it turned out, Peterson did include circumstances in Cape Dorset prior to the infant's death.

As well, Peterson acknowledges that there is much "skepticism bordering on cynicism" in the public's mind regarding her investigation.

"When people have painful experiences dealing with the government, whether it's in a labour relations matter or whether it's in respect to health-care delivery, wherever it is, it's hard for people to trust that anybody looking into that will understand the nature of that mistrust and that pain," she said.

"I think that's a very legitimate concern. If I was in the shoes of the parents of baby Makibi, I think I would, as a parent, say, 'Well, that's fine and good, but where does that end up at the end of the day? How can I trust someone hired by the government and paid by the government to be objective about the government?'"

But she says, ultimately, the parents and the public will have to decide whether it was a process that had objectivity and integrity or not.

It was on Feb. 24 Okalik announced to the legislative assembly an independent investigation was moving forward.

"The purpose of this review is to determine what steps were taken in the wake of Makibi's death and whether the steps taken were appropriate in the circumstances," said Okalik at the time.

"The review will also focus more generally on what procedures are currently in place within GN departments for receiving and responding to complaints regarding nursing care in Nunavut, and whether they were followed in this case."

The infant Makibi Akesuk Timilak possibly died of a treatable viral infection, although Nunavut's chief coroner, Padma Suramala, stated in June that the evidence suggests to her the cause of death should be classified as undetermined.

In the aftermath, accusations amongst nurses and GN staff circulated widely, with one media outlet presenting an in-depth investigation with contributions from a whistle-blower nurse, Gwen Slade. Slade then launched a petition calling for a judicial review that was tabled in the legislative assembly. The spotlight fell on another nurse who was at the Cape Dorset Health Centre at the time, registered nurse Debbie McKeown, who allegedly refused to see the infant at the time.

Peterson said her own investigation was "a bit of a learning curve."

"I have never worked in the public sector or in government. Understanding the structure of the Government of Nunavut and the Department of Health was where I started."

Peterson then began collecting documents and talking with people.

"Trying to focus those inquiries and that reading on the terms of reference set out by the Minister," she said.

"The department forwarded to me mountains of documents."

She says 17 binders would be an underestimate.

Peterson tried to speak to as many people as possible in person. She travelled to speak with Slade, who lives in Ontario. She travelled to Cape Dorset to speak with the infant's parents, people in the community and to visit the health centre. She also travelled to Pangnirtung, where the regional office for the Department of Health is located, as well as to Iqaluit where the human resources, employee relations and health employees were located.

The only person Peterson was unable to speak with was McKeown, who had retained a lawyer and had matters before the Nunavut Court of Justice.

"I don't have anything to say about that, rightly or wrongly. That's their decision. I feel it was unfortunate because I felt that she would have something to offer that would be important. But there's not much I can do about that. I don't have powers of subpoena or anything like that," said Peterson.

Peterson read through all the material and began to develop a picture of events and timelines.

"While I'm not a flip-chart paper with coloured markers on the wall kind of person, I was eventually reduced to that to try to map out for myself the timelines of events and how things happened and who was involved at any given point in time."

Peterson took four trips to Nunavut, returning home in Ontario between trips to further re-focus.

"I found people very co-operative. Despite some pretty painful circumstances of some individuals, and I think of the parents of baby Makibi, they were willing to speak with me.

"It sounds smaller than what it is. People often have to relive painful experiences when they have to talk about them again. I never take for granted people's willingness to speak with me."

Peterson says she did form a picture of what took place, but says writing about it proved more difficult than understanding the events which occurred at the same time in different places.

The final report is expected Nov. 31.

Peterson says the month between the draft and final reports is so the Department of Health has a chance to look at the recommendations and "probably figure out, I would hope, whether there are steps they can take to deal with some of those issues."

"The department will not edit the draft report," stated Department of Health spokesperson Ron Wassink by e-mail. "The findings will be first addressed with the affected family before it is released to the public."

Okalik said in the legislative assembly the week before the report was due that if he continues as minister after the leadership review taking place during this sitting of the assembly, he would personally go to Cape Dorset.

"I will want to go and be a part of that visit to Cape Dorset to present the results because we will need to properly report to the parents of that young infant as to what we found. We have to be more apparent in these things," he said.

Wassink said the recommendations stemming from Peterson's report will be reviewed and the department will plan next steps taking into consideration those recommendations.