User:Allanaaaaaaa/Inuit Tuberculosis evacuees

The Inuit tuberculosis epidemic refers to a wave of infections that generally started in the 1940s. The epidemic is notable for Canadian government interference, which resulted in high numbers of the Inuit population being forcibly evacuated from their Northern communities and sent to lower provinces for treatment and forcible confinement in dedicated hospitals.

History
Inuit populations had been hit by various diseases brought by European settlers and missionaries, including tuberculosis, smallpox, measles, mumps, diptheria, typhoid, and influenza, from the 19th century onwards. These exposures to new diseases reduced the population by as much as 90%. At best, waves of infection are partially documented. Tuberculosis moved more slowly, but by 1950, one in five Inuit people were infected.

In 1946, the national government began a large-scale operation, run under the auspices of the Advisory Committee for the Control and Prevention of Tuberculosis among Indians, to isolate and reduce the occurrence of the disease in Northern populations. This included surveys of infection as well as forcible removal and confinement of those infected. The federal government made the choice not to build hospitals in the North but to evacuate infected individuals to the south of Canada and invest in facilities there. Several sanatoria, referred to as Indian Hospitals, were opened in Ontario and Quebec to accept evacuees, such as the Moose Factory Indian Hospital, opened in 1949, to "isolate the disease" on an island. The first state-run Indian Hospital was Charles Camsell Indian Hospital in Edmonton, opened in 1946 after converting an Indian residential school into a medical facility.

Part of the national operation were ships dedicated to carrying TB-infected passengers from Northern Canada to the sanatoria. One such ship was the C.D. Howe, part of the Eastern Arctic Patrol or Eastern Arctic Medical Patrol, a ship which was specially fitted after 1946 with medical facilities quarantined away from crew quarters, which ran from 1950 to 1969. The ships were equipped with X-Ray technology to diagnose infections, and patients were marked on the hand with identifying numbers and the results of their tests. The Western Arctic Patrol mostly delivered patients to the hospital in Edmonton; the Eastern, to Hamilton.

Some rates of removal have been quoted as 5,240 Inuit people from 1953 and 1961, compared to a total population in the Eastern Arctic of about 11,500. From 1950 to 1965, 1,274 Inuit and Cree patients were removed from their communities and placed in institutional care in Hamilton, Ontario alone. At this hospital, Inuit patients carved and sold around 200 soapstone pieces a month, with the hospital taking a 30% commission on all sales. The total value of Inuit art sold through this process was over $10,000CAD per year.

Settler medical professionals believed the "Indian TB" was a strain that posed a threat to the settler population, misunderstanding at the time the process of immunity through exposure, and the Indigenous populations' lack of resistance to the disease brought unknowingly by settler carriers. The Inuit populations was considered to be "racially careless" about their health and containing the spread of the disease.

A particularly strong wave of the epidemic started in 1952. Canadian settler medical professionals attribute the spread of the disease, besides the Indigenous populations' lack of immunity, to overcrowded living conditions in Inuit communities - after forcible relocation by the Canadian government - and weakened constitutions through limited food supplies. Tuberculosis spread easily through the Inuit and First Nations populations, including in Canadian Indian residential schools, where healthy children were routinely exposed to infected children and poor sanitary conditions and ventilation contributed to the spread. In one school, the death toll was as high as 69%.

Studies show that"In the 1950s tuberculosis became a grave problem with the mortality rate approaching 1% per annum and the incident rate almost 3%. The annual risk of infection has been estimated at 25% per annum. These are probably the highest rates recorded anywhere in the world in the 20th century."Medical professionals continue to congratulate themselves on successfully stemming the tide of the disease through such interventions of forcible removal of infected individuals from their homes. Canadian hospitals employed both vaccination and drug therapy to stem infection in healthy individuals.

Conditions
Research conducted by Oloffson, Holson, and Partridge describes the conditions endured by Inuit communities during the diagnosis process:"Being told that they had to leave with the hospital boat or airplane to go to a hospital in the South was a frightening experience for most of the patients.... Many were diagnosed while still asymptomatic, and as such there was often great confusion as to why they were being taken from their homes and families. Even when they were aware of their condition, it was not always made clear to the patients where they were being taken or if they would ever be returned, contributing to an atmosphere of fear and desperation. In some cases, Inuit who knew that they were seriously ill would hide out on the land once they had heard that the hospital boat was arriving. In these situations, a helicopter, originally intended to fly ahead of the boat to check ice conditions or bring medical personnel to shore if the boat could not dock, was used to survey the land, find anyone hiding, and bring them to the boat for examination."Selway states that while leaving their homes for treatment was not mandatory, most Inuit people felt pressured in a way that could not be considered consensual.

When a person had a tuberculosis diagnosis confirmed, they were rarely allowed back into their communities. Evacuees could not go ashore to collect their belongings, say good-bye, or make arrangements for their families - children were often adopted by neighbours and family members in Inuit communities. "Children, even infants, who were diagnosed with TB would be taken from their parents and sent with the boat. Men and women would be forced to leave their families behind ... at times left without a father to hunt or a mother to make clothes or care for the children. Evacuees in turn faced great emotional distress, knowing that it would be difficult for their family to survive without them. As exemplified in the quote above, so great was the desperation, that the minister would often marry couples when one of them had to leave for the hospital, in order to sanctify the union while there was still time to do so."Many evacuees were sent to institutions with English- and French-speaking staff, which made communication difficult. There are high rates of reported depression in patients. People forcibly transported and confined in sanatoria were often given little information about their treatment and rights:"“Perhaps you are wondering why you are brought down from your home leaving your friends and perhaps family behind. The reason is that you are sick, and if you were left at home, you may endanger those at home. So you are here to get well again… But do not be afraid. Nobody here will harm you.”– Mountain Views, Hamilton Sanatorium, 1955"Some patients were tied to their beds and suffered other abuses from hospital staff. Most were on strict bed rest and some lost the ability to walk after several years of confinement. There are documented cases of hospital staff putting casts on the legs of patients who would not comply. Children who did such things as sit up in bed or put a foot on the floor were punished by being strapped, spanked, or being forced to wear a straitjacket for a period of time.

Besides drugs, surgical procedures were performed on patients, including the intentional collapsing of lungs and removal of ribs, causing deformities.

The average stay in sanatoria ranged depending on the availability of drug treatments introduced in the 1940s; In 1949, at the Mountain Sanatorium in Hamilton, a patient stayed for an average of 562 days; in 1956, the average stay was 332 days.

Documentation was uneven at best; people's names were written down incorrectly, sometimes resulting in a cured patient being sent home to the wrong area, or the family of a dead patient not being notified. Many patients who returned home after their confinement found it difficult to readjust to their culture, having forgotten skills and languages.

Legacy
Many northern communities still have high rates of infection for TB, despite improvements in vaccination in the late 20th and early 21st centuries.

As in the case of the Indian residential schools, many family members and community members are still searching for closure after the deaths and disappearances of their loved ones, including looking for the locations of grave sites.

The Canadian government has yet to perform any reconciliatory efforts or offer any apologies for the forcible confinement of Inuit people. As of fall 2017, government officials have started to meet with Inuit representatives to discuss access to archival documents and begin the process.

Notable Inuit people confined for tuberculosis
Kenojuak Ashevak, confined from 1952 to 1955

Mosha Michael, confined in childhood

Depictions in culture

 * The Necessities of Life, a film released in 2008, tells the story of an evacuee being sent to a sanatorium in Quebec City in 1952, where he meets and befriends an infected orphan child.