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Nunavut's chief public health officer discusses territory's health care challenges

Nunavut News asked Dr. Michael Patterson, Nunavut's chief public health officer, about the top three challenges faced by Nunavut's Department of Health. Patterson discussed the challenges in no hierarchical order. This interview has been edited for length and clarity.

Dr. Michael Patterson has been serving as Nunavut’s chief public health officer since Oct. 2018. Photo courtesy by Dept. Of Health

Nunavut News: What are the top three challenges presently faced by Nunavut Health care?

Dr. Michael Patterson: Strengthening and improving our health information systems. Things that let us do performance surveillance in terms of keeping track of illness across the territory. They let us register vaccinations at a territorial level, so we can monitor how many children are up to date on their vaccinations and releasing public reports. The public at large has more up to date information on the health status in Nunavut.

Continuing efforts with health protection (is another), a good chunk of that is working on communicable diseases. So tuberculosis is one. Sexually transmitted infections would be another one. And there's no question for some of the communicable diseases ... Nunavummiut face a higher burden than the national average. So, there's work to be done on that.

Working with the acute care system of health for the people who provide direct hands on medical care. Working with them on initiatives like cancer screening and facilitating opportunities ... to show that there's proper territorial-wide screening programs for cancer and a number of other illnesses that are of concern to Nunavummiut.

NN: Why is strengthening and improving health information systems a challenge?

Patterson: Some of it is a capacity issue in terms of hiring and retaining staff, who can do the work. Some of it is kind of specialized. These are people who are trained as epidemiologists. So, they've got a fair amount of education in medical epidemiology, analyzing and storing data. Another challenge that is outside of our control is information bandwidth. Internet connections in Nunavut are not as reliable and not as fast as they are in the south. So, that creates challenges for us because a lot of the health information systems work more efficiently over computers in robust networks.

The infrastructure in Nunavut isn't the same as it is in the south ... we're relying on satellite connections, things are slower, they're more susceptible to weather. And those challenges feed back to making it a challenge for us to keep up to date on health information.

NN: What makes the "continuing efforts with health protection" a challenge?

Patterson: The communicable diseases ... there's a number of reasons and it depends with each of the illnesses. The underlying causes may be slightly different. Some of them have to do with housing and food security. Although the health system has limited ability to directly improve those, we still have work to do in terms of controlling the illnesses, to mitigate the effects of those other challenges and to advocate for improvement in those circumstances.

So with sexually transmitted infections ... there's a number of reasons why we may not understand all of them, but having a younger population certainly contributes to that. There's the medical aspect of screening and treating for infections.
There's also the educational aspect of teaching Nunavummiut about safer sex and initiatives that may also reduce rates of illness.

NN: Why is the third challenge you listed difficult?

Patterson: Screening for cancers and other illnesses that may not be causing symptoms right now, but may cause symptoms five or ten years down the road ... it's because of capacity issues. Staff have to focus on what's in front of them right now.
It's about building the proper the systems and policies to allow for the screening to happen.
Then sometimes it's also based on infrastructure ... that transmission of information back and forth.

And sometimes it's also about trying to find capacity in the south. For the colorectal cancer screening, it's not just enough to get tested for the blood and stool. There's people who need colonoscopies done and finding ways to get those done in the south is sometimes a challenge.