The Story of Joannassie

Names have been changed.

There has been a sad story happening for the last couple of weeks. Joannassie is a young man in his early twenties who has been diagnosed with paranoid schyzophrenia. It is quite severe and he hears evil voices telling him to kill himself which has tried to do a couple of times. There are no psychological services hear in Salluit and the care is primarily through social services, nursing and the family physician. It is not enough.

He is very much liked by the staff here. Unfortunately his family is unable to provide him with the support he needs and he goes off his medication frequently. Last week his mother locked him in his room for three days and three nights without food or water. When he was brought to the nursing station, he was severely dehydrated and was kept over night on iv.

It was clear that more support was needed and so the nurses agreed to provide him with meals three times a day and a job was found for him a few hours a week with the community nurse so that he would be able to have his own money. His friend Odi who also works with the community nurse as an interpreter took him to the coop and helped him open an account and got him a bank card. This was he could by his own food.

Joannassie loved coming to work and had a good week.

Last weekend though, I was at the clinic and it turned out that he had been having a bad weekend and so was put in isolation. Isolation is the room outside my office door and it is a locked room with nothing in it but a mattress. It is primarily used for anyone who is on suicide watch. It is used quite frequently. Joannassie was kept there for the weekend until his meds kicked in I guess.

Unfortunately, when Odi who watching him he took him outside't for a smoke, Joannassie tried to take off (no shoes, no coat) and would have killed himself if Odi hadn't tackled him to the ground. Odi was trying to stop his freind from killing himself. Joannassie beat up Odi pretty badly waiting for the cops to come. I tried to help Odi but the nurses held me back.

They were finally able to medivac Joannassie to Montreal where he was to be put in a residential program. Good news I suppose in that he would at least be treated for his illness. Bad knews though as he would be even more isolated and not able to speak French or English very well.

Odi told me that he didn't care about his injuries he just wanted help his friend.

Turns out there was no room in the residential program. Six month waiting period.

Joannassi will return tomorrow.

Alot can happen in six months.

Polar Bears

There was a rumour last week that two polar bears were in the neighborhood. I have continued to go on my walk everyday but admittedly with some trepidation.

Yesterday when I arrived at work I found out the two bears had been hunted and their bodies would be arriving for the skinning ceremony. With much anticipation we waited and watched out the maternity window for the arrival of the ski-doos. They finally arrived mid morning and a few of us hopped in the truck to watch.

There were indeed two bears - a little one and the mother. The father had been killed the day before and had already been skinned and butchered.

We stayed and watched the skinning of the mother bear and took lots of pictures. It was a beautiful sunny morning and there was certainly an air of celebration as more and more of the village made their way down to the ice.

The meat was butchered and what is not eaten fresh will be put in the storage freezer where any of the villagers can help themselves. This is the same for all of the meat and fish. There is a coop price given to the hunter or the fisherman and the food is then offered to any of the Inuk.

Tonight I will be going over to the docs house for bear stew. I will try it, I have to.

I feel a little like Michaelle Jean.

Pics to follow when I get back to Toronto.

Baby

Healthy baby boy born May 16th. Both mom and baby fine and healthy.

It was a long night and the wind and snow howled at around 70 km an hour outside the maternity. Out the window we watched the wind change direction and move completely from the south to the east to the north throughout the night. The sun came up around three.

As always, the baby was born in the wee hours of the morning. I was so excited to be able to turn the string of lights in the maternity window on to announce to the village that the baby had arrived.

As I looked out the window and down to the Hudson Strait I realized that the wind and snow had completely stopped. Completely. With the arrival of the baby, the storm disappeared.

Go figure.

Blizzard

It is day two of a massive blizzard that is not expected to let up until Sunday. All air travel (including medivac) has been shut down.

I have been trying to get a 19 year old pre-eclamptic women out since yesterday. I would have gotten her on an plane two days ago but she 'conveniently' disappeared for three days.

The decision has been made to induce her here rather than wait out the storm. Am feeling confident as we have an amazing team. Because of the storm, two visiting doctors have been stranded here including a pediatrician. The nurses are very excited about having a baby tonight.

It's hard not to feel excited too when you have a team behind you who are excited and supportive and skilled.

It was Maggie the senior Inuit student who reminded me of this.

Miracle Worker

I asked and he came. Well I sort of dragged him from his truck, fed him wine and he fixed most of my things. I still don't have cable or the internet but at least I can eat and shower.

Yesterday I spent the day flying across the coast with a medivac of a 34 week pregnant woman threatening preterm labour. The plane was delayed on the tarmac because of mechanical issues as her contractions got closer together but we made it to PUV in time to transfer her. Exciting day and I made it back in the evening on the next flight out. She is to remain in PUV where they were able to stop her labour but will be watched for a few days.

Beautiful sunny day here today and about -18 with the wind chill. They keep promising me that the snow will melt quickly once the weather warms up. It should given that it is light now for about 19 hours a day.

Roughing it.

Here are some pics of my beautiful house. The house is so big that I have a yoga studio. Unfortunately, I have no stove, no microwave, no tv/cable, no internet, no hot water and no blinds on the windows. I don't know how many more toasted bagels I can eat. I am going to get some towels on my bedroom window because the sun is rising at about 4:20 and my body is telling me to get up and start drinking coffee.

I am moving from somewhat bummed to somewhat depressed but surely help will arrive soon in the form of a capable electrician/plumber/cable guy.

On a more positive note, I was warmly welcomed be everyone here and it felt good to be back. If I wasn't on call this weekend, I would have been off on a fishing weekend with my adventurous friend Kelly and some Inu. Kelly ate raw fish head and ptarmigan intestines and said she had the best weekend of her entire life.

Ok apparently I can't upload pics at the moment - sorry, hopefully coming soon.

Spring in Salluit

I'm back for a five week stint. Much harder for the kids and Alex to say goodbye this time as the novelty of "mummy going to the arctic" has worn off.

Although it is technically the beginning of spring, currently there is a pretty impressive storm happening and it is about -17. By the time I leave, the snow will be gone and the ice will start its steady retreat.

Everyone in the village is itching to get out fishing and many villagers have gone camping this weekend on a fishing trip.

No signs of the caribou but tens of thousands are expected soon.

Been busy at the maternity with a medivac for a probable appendicitis late last night. Have a 34 weeker threatening preterm labour with increasing blood pressure so could be a busy weekend and one woman is showing ominous signs of an MS diagnosis. I feel more like a GP than a midwife today.

I am sitting in my old apartment stealing the internet as my internet is not up and running in the newly renovated (and spacious) midwife's house. No cable yet either, and the burners on the brand new stove went caput in the middle of my curry. Somewhat bummed.

No pics yet - sorry.

Last Days in Salluit

It is Tuesday night, just got home from my walk and realized that I need to do a final blog as I leave Thursday morning.

Rather than go on and on, I thought I would list some of my favorite things about Salluit:

The smiling Inuit people of the arctic.

Interprofessional health care.

My sweet apartment with the view of the mountains.

Making Kamiq.

Potlucks.

My father's arctic parka.

Huskies.

The extreme weather.

My laptop.

The mouintains and the Hudson Strait.


Here is what I am looking forward to having again.

Alex, Claire, Sam, Ed, Hector and Joey.

Hockey.

Wine.

My friends.

My kitchen.

My pillow.


Thank you Salluit for giving me this adventure, I look forward to seeing you in the spring.

Making Kamituinaq

A couple of times a year the elder women teach the younger women how to make kamituiaq or kamiq for short. These are the boots made out of seal skin or caribou skin and their fur. The men and children are not invited to this teaching and it takes place over a number of weeks.

I was invited to go and watch with my friend Kelly and they let me take some pictures.

The men hunt the seal and prepare them for the women who either dry the skins with the fur on or take the fur off and the inner layer of fat off. They dry these skins also it is time to sew the pieces together they chew on the leather to make it soft.

There was a big bucket of raw seal in the room for when the women got hungry and sometimes they ate it with bread.

The women use a traditional knife to skin and cut the seal but I can't remember it's name. They sharpen it often with a bigger knife and don't even need to watch what they are doing. It is very sharp and they always have a box of bandaids available.

The smell in the room was very strong.

Kelly was very brave and ate three pieces of raw seal but I wasn't so brave.

It was very special to be invited to watch.

This time is an important time for the women and for teaching.

NASA calls Salluit

I forget to mention that the International Space Station called Salluit last week. The elementary school was chosen by NASA for a phone call from space. It was a very big event and the community was very proud. We all went to the school at 8 in the morning and waited while mission control in California called and got everything set up. There were a couple of NASA type people from Ottawa there choreographing everything including showing a couple of videos ahead of time, sound checks etc.

The children had obviously been preparing for a long time and had decorated the entire school with various space related crafts and projects.

I think almost everyone from the village was in attendance.

Contact occurred around nine and 15 children had been chosen to ask their prepared questions. It was really cool and the astronaut gave us a live feed tour of the space station - floating about the entire time.

One interesting fact:It would take 2 minutes and 17 seconds to fly from Salluit to Montreal in the space station, that is how fast it is travelling.

Sunday Brunch

Was invited to Sunday Brunch at Kelly's apartment. In attendance were the nurses Kelly, Mirianne, Rene, and Andre Luc and the doctor Annie with 5 month old Maxime. We had a huge spread of smoothies, bacon omelette's, bannock, french cheeses, fruit, cinnamon buns, brownies, lattes - the best food I have eaten so far!

We all arrived in our pajamas - all flannel pj's.

After Andre Luc took me for a snowmobile ride up one of the trails through the mountains - terrifying and so much fun! Next week he says I will drive it myself.

Making friends here is similar to going away to camp. By necessity you spend alot of time together and become quite close - and then you say goodbye till the next session.

The Health Centre

Quiet week on the midwifery front - one call out to assess abdominal pain and saw some northern lights on the way back home at three in the morning.

The students practiced their iv techniques as you can see in the pics. Lucky for me they decided my veins were't good enough. Unlucky for Jonassee as he had nice big fat veins. Jonassee is the office manager and pretty much runs the health centre.

Got invited to go kite skiing this weekend with the nurses. We'll head out on the snowmobiles to the middle of the Hudson Straight where there is some good wind. Hopefully no polar bears.

Maggie is going to drop off an arctic char this weekend from her husband's fishing trip. Hopefully it will be cleaned and ready to throw in the oven.

Lab Monday

Today I had two students with me for the entire day. I am slowly figuring things out clinically. The students like to see me fail first and then help later. They seem to think it is funny. I am taking it as a good sign that they are starting to accept me.

After lunch I took a call from a mom, whose 4 month old was having a seizure. She put her baby into the hood of her coat, hopped on to her snowmobile and made their way down to the health centre pretty darn quick. I helped triage the baby whose temp was 41, heart rate 240, and clearly very uncomfortable. They recently had to medivac four babies to Montreal with meningitis so they were on pretty high alert for this little girl. So incredible watching the nurses and the doctor all working together as a team, blood work, an iv, O2 sats, antibiotics. One nurse was even giving the baby a cool sponge bath. They were all so sweet to the baby and so respectful to the mom. Seems by the end of the day they were happy with her and diagnosed a probable urinary tract infection, to be kept overnight and treated locally.

It was a good day and went by very quickly.

I will get some pics of the nurses and the doc soon.

Valentine's Day

Have not made it up the mountain yet. Instead went for a long walk in to the village for some provisions. $64.00 worth or provisions: bagels, pasta, cereal, milk, peas, ground beef, a movie, bag of chips.

Absolutely beautiful day here today, I think it is about -20, no wind, sunny. It is actually impressively sunny given that the sun never rises higher than about my shoulder.

Look out my window every night in hopes of hearing and seeing some northern lights, but nothing so far.

Apologies for posting the same pics - it's not me I swear.

End of Week 1

Well I have now been in Salluit for one week. It has been a most pleasant week. I am less afraid of the cold now and have stopped putting pretty much everything I own on just to walk to work which can take as little as 90 seconds if I take the quick way.

I love my long walk home after work and always say hello to Buddy, Cutie, Fluffy and Taly, the beautiful huskies who are being trained to pull the sled. There are two new puppies now who arrived from Quebec and who will be trained as well for the team.

I have been invited to a crib tournament tonight at the docs house and if I can get out of my pj's might go.

My scope of practice has expanded significantly and am now treating sexually transmitted infections, put the vacumm together and read the manual just in case, and gave a depo shot today.

The weekend weather is supposed to be beautiful and sunny and I plan to walk to the top of the mountain overlooking the fjord that runs alongside the village and take some shots of the Hudson Straight.

How the SUV came to Salluit

How the SUV Came to Salluit, by Andrea Lennox

Thre years ago the villagers of Salluit travelled by snowmobile, dog-sled, boat or plane. A couple of years ago, a big mining company started mining a few kilometres from Salluit. The land belong to the village of Salluit. This was a problem for the big mining company. It was quickly resolved however, by giving each man, woman, child and baby 40,000.00 dollars.

Now the villagers felt very rich.

They each went out and bought themselves an SUV.

Instead of two Great Lakes freighters arriving the next summer, three came. One freighter was filled with oil. One was filled with building material, medical supplies and food. The last freighter was filled with SUV's.

The last freighter was filled with SUV's.

Day 2 of clinic

Now that crazy lab Monday is over, the health centre seems much calmer. The water is back after no water yesterday and so now the toilets are flushing and hands are getting washed. Water is filled up in the tanks of the houses and the buildings every other day or so and sewage is emptied from the tanks. Not the same tanks. Tough to run a health centre/birth centre/emergency room without water. Didn't seem to stress anyone out too much so I guess it happens fairly often.

I bought two soapstone carvings last night from Maaley Alaku the "carver man" as he refers to himself. He spends the day hunting or fishing and carving soapstone while he waits. His hands are always very black and he would like to sell me something every day if he could.

From my living room window, watched a snowmobile take a couple of tele-skiers up the mountain - I think they were there most of the day, taking the easy way up and the fun way down. A few kids tobogganing too.

Here are a couple of pics of the students and the Maternity.

First Day of Clinic

Walking to work this morning watched a 'sundog' peeking over the mountain as the sun attempted it's slow climb.

Monday is lab day. This means that everyone in the entire village who needs some labs done are supposed to come before 11:30 so that the tubes can be spun and prepared and can get to the plane for the afternoon flight. The system seems to work.

The midwife that I am replacing (Jennie) left also on the afternoon plane. The midwifery student of the afternoon disappeared for seemingly an eternity and I was left trying to figure out what today with three women who showed up at once. One client helped me find a form for another client because she knew where we kept them. Confidentiality does not seem to exist, nor does seem to need to exist.

The health centre is buzzing with various health care needs: one family doc, 4 or five nurses, a dentist, maternity, social services. The offices of social services seem to take up most of the square footage.

It was a very pleasant day and I took the long route home to say hello to my new friends: 4 huskies and two puppies.

Sunday the 8th

Went to a party last night at the doctors house and played guitar hero. Pretty cold walking home, -45 with the wind chill.

The wind seems to blow 24 hours a day. Today is supposed to be warmer with only a windchill of -30.

Watched a red fox walking along the mountainside outside my livingroom window this morning. They are supposed to be white at this time of year, it seems to be confused.

Heading over to the health centre soon to do some work to get ready for the week and then a little walk later today.

Saturday in Salluit

I am starting to settle in. Jennie and I are staying in our apartment until she departs for the south on Monday.

I arrived after an incredible flight first stopping at the top of James Bay to drop off a few people and refuel. The land was certainly rugged and could feel the cold. Our next stop was in PUV where the land was treeless and barren and very flat. Said goodbye to most of my new friends from the plane and the remaining four of us flew on to Salluit. Suddenly mountains arrive as we flew over the Hudson Straight, took a wide sweep and there was Salluit nestled in an inlet surrounded by treeless mountains.

Spent today orienting myself at the clinic, a couple of incredible walks and now getting ready to go to a gathering at the docs house.

Funeral for a young man murdered in Montreal and body arrived yesterday.

It is currently -45 with the wind chill. Jennie got frostbite on her cheeks walking back from the funeral but didn't seem to mind.

I am cozy in my winter gear.

February 5, 2009

Safely arrived in Montreal and hanging in my hotel room. Sadly had to leave a bunch of yummy items in the car as my suitcase weighed too much.

Tough goodbye's to the kids and Alex.

Leaving 7:45 tomorrow morning and should get in to Salluit in the early afternoon.