c a r i b o u h... t h e T NMU's Retinal and Foot Programs
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c a r i b o u h... t h e T NMU's Retinal and Foot Programs
the caribou heard 1st Quarter 2008 In this Issue Dr. Nichole Riese Steps Down............................. 2 CIRCLE Study............... 2 2008 Summer Students.. 3 Rural Elective Week...... 3 Announcements............. 3 Book Review: Cornwall Cree Nation................... 3 Photo Ops..............4 & 5 CBC Reports on Retinal Screening Program....... 6 My Big Fat Diet............ 6 Community Therapy Assistant (CTA) Program.7 Rankin Therapy Services Moves............................ 8 Recipes.......................... 9 Word Puzzle................. 10 Photo Contest.............. 10 Full Colour copy of this and past Newsletters are on our website: http://umanitoba. ca/faculties/ medicine/units/ Your link to and from the North Volume 6, No. 1 NMU's Retinal and Foot Programs Expand T he NMU is expanding the Diabetic Foot Nurse Clinician Outreach and Retinal Screening Programs. On 9 June 2008 Diabetic Foot Nurse, Myra Ibabao and Retinal Screening Nurses, Ava Halpin and Eileen Koop started with the NMU by attending an Aboriginal Awareness Workshop on the 9th and 10th. With this addition of staff these Retinal Nurses Eileen Koop and Ava Halpin Programs can now expand into the and Diabetic Foot Nurse Myra Ibabao communities of Beren's River, Poplar River, and Little Grand Rapids. Currently the Programs are in Norway House, Garden Hill, Red Sucker Lake, St. Theresa Point, and Wasagamach. The Foot Program provides continuity of care by means of regular, monthly diabetic foot clinics for people with diabetic foot complications or those at imminent risk of developing complications. By providing care the nurse is able to assist community health care teams with the prevention of ulcerations, amputations, and other foot complications that can be devastating. The nurse's scope of practice allows her to: prescribe antibiotics similar to FNIHB guidelines, debride complicated wounds, perform radical nail resections, bone debridement, vascular studies via Doppler (toe pressures), initial interpretation of radiology films, ordering of laboratory investigations, and basic emergent casting for unstable fractures. Public presentations as needed to community and nursing station staff regarding limb complications due to diabetes are also provided. The Diabetic Retinal Screening Program provides eye examinations in accordance with the Canadian Diabetes Association Guidelines. The examinations conducted by the Retinal Screening Nurse are performed using specialised photographic equipment. These photographs specifically look for diabetic retinopathy as well as other eye problems that may or may not be related to diabetes: cataracts, glaucoma, and macular degeneration. The digital images are uploaded to a web-server where they are viewed and interpreted by an ophthalmologist. The ophthalmologist is able to diagnose levels of diabetic retinopathy as well as other ophthalmology concerns including cataracts and glaucoma. s Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication the caribou heard 1st Quarter 2008 Volume 6, No. 1 Dr. Nichole Riese Steps Down By Dr. Bruce Martin A t the end of June 2008 Dr. Nichole Riese stepped down as Associate Director of the NMU. Nichole has had a long standing commitment to the health care and health status of Canada's Aboriginal Peoples. This commitment has spanned two full decades and has included not only the populations served by the University of Manitoba but also the Anishanaabe of Northwestern Ontario and the James Bay Cree. Nichole joined us when she returned from Ontario in 1993 to embark on and thereafter complete her Masters in Community Health Sciences. She has been tireless in her commitment to program development, administration, and the daunting challenges of health human resources that have evolved in the past decade. She has routinely provided clinical care to all communities served by the NMU and provided on-site mentorship for our community physicians. Nichole was always willing to provide locum support at a moment's notice. She selflessly sacrificed personal time to provide essential services in times of need and specifically when and where others chose not to come forward. To seek relief from the rigours of these activities she additionally worked with MSF as a source of respite. She has been well recognised by undergraduate students due to her creditability as a clinician, role model, and educator. She has been similarly highly regarded by consultants in all of our program areas. Dr. Nichole Riese I am pleased Nichole has chosen to continue her relationship with the Department of Community Health Sciences. She will be involved in sustaining research activities in First Nations communities and will have an ongoing commitment to teaching. I trust my thanks to her for her relentless support will be echoed by all invividuals with whom she has worked.s CIRCLE Study in Garden Hill & Wasagamack E ven though Nichole is stepping down as our Associate Director she will be working for the NMU as Site Investigator for the project ‘Canadian First Nations Diabetes Clinical Management Epidemiology Study’ (CIRCLE). CIRCLE's purpose is to collect information to provide an understanding of the current management of Type 2 diabetes in First Nations communities. At the end of May the NMU's two new Research Assistants, George Flett of Garden Hill and Joseph Harper of Wasagamack spent two days training at the University of Western Ontario in London, Ontario. Both George and Joe will be auditing charts in Garden Hill and Wasagamack. Fifty (50) charts from each community will be audited. Nichole will be making trips to each community to lend assistance with the audits. The RA's will ask those 18 years of age or older with Type Page 2 2 Diabetes for permission to audit their charts. No charts will be looked at without a patient’s consent. George and Joe will also invite healthcare staff to complete a short questionnaire regarding the healthcare services available in their communities and also the staffs’ experience of problems they face delivering diabetes care. Other investigators are from the Universities of Alberta, Saskatchewan, Western Ontario, Toronto; Queen's, McGill, and Memorial Universities; Chisasibi First Nation; Indigenous Physicians Association of Canada; and Newfoundland and Labrador Centre for Health Information. The information from the study will be used to suggest ways to improve diabetes programs and health care for First Nations Canadians with Type 2 Diabetes. Nichole hopes this study will push health care funders to provide computerised chronic disease management systems in all communities. s Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication 1st Quarter 2008 the caribou heard Volume 6, No. 1 Let Me Introduce to you Rural Elective Week ...our 2008 Summer Students NMU Placements Baker Lake - Sagar Choksey Repulse Bay - Aaron Webb May, 20-23, 2008 - Rural Elective Week is a mandatory part of the University's Med I curriculum Garden Hill - Rajat Jayas Sanikiluaq - Laura Gilbert - Shelley Mott Red Sucker Lake/Wasagamach - Anita Hegg - Ashley Blais Poplar River - Karen Kwok Rankin Inlet - Aaron Guinn - Dana Delapenha (Med Rehab Student PT1 Announcements We are very happy to announce Dr, Perry Gall and wife, Batya are the proud parents of a baby girl Sarah. Joy Langrell, is our new transcriptioinst. Joy also works part time at the U of M, Department of Surgery, Administrative Office at HSC. Carolina Maniquis and Ann Lou Balbin left the Island Lake Regional Renal Health Program in January 2008. We wish them all the best. Erick Chacon will be starting in Garden Hill at the Island Lake Regional Renal Health Program on July 28, 2008 as a Clinical Nurse Specialist after he completes the Manitoba Nephrology Nursing Course at the Health Sciences Centre. Erick comes to us from Toronto but his career path has taken him all across Canada. His ten years of Nephrology experience will be an asset in providing care to patients from diagnosis to renal replacement therapy. We wish him al lthe best. Dr. April Boyd, Vascular Surgeon made her first visit to Norway House in May with Diabetic Foot Nurse, Stephanie Piper. Dr. William Miller, Psychiatry made his first visit to Coral Harbour in June. After more than a ten year absence Dr. Eric Stearns will again be providing us with his services. He will be going to Baker Lake, Arviat, Coral Harbour, and Repulse Bay. Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication Rankin Inlet - Joanna Colledge - Mark Vendramelli Sanikiluaq - Shelley Mott - Jessica Spence Cornwall Cree Nation T here really isn't a Cornwall Cree Nation — instead it is the title of a book written by Dr. Alan Davis of the UK. Although fictional the book was inspired by Dr. Davis' experience with the NMU in 2002. Davis writes of Dr. Philip Cormack, a GP from Cornwall who is facing burn-out and divorce. Having fond memories of a charming town on the prairies where he spent a student elective, Cormack sets out on what he thinks will be a sabbatical in Canada to the fictional Jackfish Lake. No idyllic town this; instead Cormack finds himself on an isolated reserve where deprivation and despair abound. The people seem unwelcoming, his medical skills are taxed to the limit, and he fears he simply will not cope. Witty, darkly comical, and populated with quirky characters whom Cormack befriends this book is very entertaining. A must read for those who have worked in the north. To order this book go to: http://www.amolibros.co.uk/ johnstonhope/page4.html Page 3 the caribou heard 1st Quarter 2008 Volume 6, No. 1 Photo Ops NMU Receptionist, Iryna Tsybukh at our NMU Staff CPR Training Course. The course was taught by Sylvia Sunstrum (HR) and attended by Julie Creasey, Joy Langrell, Kathy Risk, and Iryna Tsybukh Groove FM's Morning DJ, Dan Michaels and staff bring us muffins, coffee, and coffee mugs for winning their morning "Breakfast with Groove FM Contest". Thanks to Michelle Vandenbroeck for entering us. Plaque dedicated on 27 September 2007 at Churchill Hospital JOHN A HILDES C.M. M.D. (1918 - 1984) Physician, Board Member, Director of the Northern Medical Unit, Member of the Order of Canada. A grateful community honours a true champion of Northern Healthcare whose hard work made his vision a reality in the Churchill Health Centre. Page 4 Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication 1st Quarter 2008 Volume 6, No. 1 the caribou heard Photo Ops As a Key Note Speaker at a Nursing Students conference, Susan Aglukark expressed her desire to visit with groups focused on the development of Aboriginal Health Education. She is seen here at the University's Centre for Aboriginal Health Education with Dr. Catherine Cook, Director of the Centre and former Associate Director of the NMU and Clara Kalit, Interpreter at the Kivalliq Inuit Centre. At the Centre Susan visited with some of the University's students enrolled in medicine, nursing, and med-rehab. In January water problems in Garden Hill resulted in the relocation of the Renal Health Staff and patients to Thompson for a week. Here the staff is pictured with the Thompson Hospital Dialysis Staff. 1st Row: Carolina Maniquis, Evelyn Zaragosa 2nd Row: Gladys Wood, Marion Licera 3rd Row: Anne Lou Balbin, Hazel (Thompson), Mirasol Salacup 4th Row: Adam, Mike (Thompson) The NMU's two new Research Assistants, George Flett of Garden Hill and Joseph Harper of Wasagamack on their way to training at the University of Western Ontario in London, Ontario. They are shown here in the Winnipeg office where they met with Dr. Nichole Riese (Site Investigator) before their trip. George and Joe will be RA's on Canadian First Nations Diabetes Clinical Management Epidemiology Study (CIRCLE). See article on Page 2. Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication Page 5 the caribou heard 1st Quarter 2008 Volume 6, No. 1 CBC Reports on Retinal Screening Program Reprinted from ww.cbc.ca/canada/manitoba/story/2007/12/07/eye-screening.html D iabetic patients in northern Manitoba no longer have to leave their communities for eye exams, thanks to a new, $3-million eye-screening program. Through the program, a nurse takes pictures of a patient's eyes with a special type of digital camera, then sends the pictures to a specialist in Winnipeg for diagnosis. The system should allow diabetic patients to get an exam, diagnosis, and treatment within two weeks, helping diagnose retinal problems that, left untreated, could lead to blindness. "The nice thing from our side is that this increases our efficiency," said Dr. Ravi Dookeran, an eye surgeon at the Misericordia Health Centre in Winnipeg. Former Retinal Screening Nurse, Linda Taitley conducting an exam "We have been able to reach out to a community that, quite frankly, it was just too difficult — to leave a busy practice, take time out, fly up north, really not see as many patients as we would like to in the time given, and then come back to return to an overflowing practice." The system reduces the waiting time for diabetic patients from six months to two weeks, Dookeran said. Northern nurse Linda Taitley said the program is already making a difference, pointing to the case of a 33-yearold diabetic man who had a serious eye problem detected and surgery within a week. "At the point he was at, he still had a pretty decent level of visual acuity, but had it continued, it would have progressed to blindness," she said. So far, about 400 Manitobans with diabetes have had their eyes screened using the new technology. About a quarter of them were referred to a specialist. s My Big Fat Diet Aired on CBC Newsworld, The Lens, 11 March 2008 Described as: "Supersize Me meets Northern Exposure in My Big Fat Diet when the Namgis First Nation of Alert Bay gives up sugar and junk food, returning to a traditional style of eating for a year to fight obesity and diabetes." "My Big Fat Diet chronicles how the Namgis First Nation goes cold turkey and gives up sugar and junk food for a year in a diet study sponsored by Health Canada and the University of British Columbia. Through the stories of six people, it documents a medical and cultural experiment that may be the first of its kind in North America." If you missed this documentary you can find out more information on the study at: http://www.cbc.ca/thelens/bigfatdiet/ Page 6 Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication 1st Quarter 2008 Volume 6, No. 1 the caribou heard Community Therapy Assistant (CTA) Program by Tracy Miller Mifflin, MScPT Senior Instructor, Community Therapy Assistant Program Nunatta Campus, Nunavut Arctic College O n May 12, 2008 an exciting new diploma program got off the ground after six years of planning, preparation, and consultation. The Community Therapy Assistant (CTA) program was launched at Nunatta Campus in Iqaluit with a class of eight students from across the territory. The CTA program was created to train Nunavummiut to assist in the delivery of rehabilitation services. The rehabilitation disciplines are: Physiotherapy, Occupational therapy, Speech-language pathology, and Audiology Rehabilitation professionals (sometimes collectively called “therapists”) are typically located in the regional centres of Iqaluit, Rankin Inlet, and Cambridge Bay. However, they are responsible for clients throughout the territory. Nunavut’s vast geographic area, sparse population distribution, and high rate of disability present challenges in meeting the territory’s rehabilitation needs. While disability rates among Inuit have been reported at nearly twice the national average, the per capita rehabilitation staffing levels in Nunavut remain significantly lower than the rest of Canada. Community Therapy Assistants will augment the quality, quantity, and continuity of rehabilitation services in Nunavut. These skilled paraprofessionals will be qualified to carry out treatment programs as directed by supervising health professional in the regional centre. Remote supervision will be achieved through a variety of technologies, including email, fax, telephone, and Telehealth videoconferencing. Examples of a Community Therapy Assistant’s duties might include performing hearing screenings, leading a children’s literacy group, performing wheelchair repairs, and assisting an elder with a home exercise program. CTAs also have an important and highly respected role to play as the community, culture, and language experts on the rehabilitation team. Their knowledge of their communities and culture will help to ensure that treatment plans and assessment methods are appropriate and relevant to clients. They will also serve to improve the efficiency and cost-effectiveness of rehabilitation professionals’ visits to the remote communities, acting as dedicated assistants, interpreters, and cultural links to the communities. Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication The Community Therapy Assistant program will be delivered over four semesters, interspersed with five clinical placements. Students will gain specific knowledge regarding the rehabilitation disciplines of physiotherapy, occupational therapy, speech-language pathology and audiology; and the therapeutic skills required for assisting in the delivery of rehabilitation programs in Nunavut. These skills will be taught in classroom, lab, and clinical placement settings. Students will also learn about the broad concepts of health, wellness, and rehabilitation, and gain English and communication skills. They will receive a foundation in human anatomy, physiology, and the medical conditions encountered by the rehabilitation disciplines in Nunavut, and become skilled at interpreting these concepts in both English and Inuktitut. Students will acquire knowledge required to link Inuit and southern Canadian health practices and beliefs in order to most effectively present rehabilitation concepts to community members. An ongoing focus on ethical practice, professional behaviours, and independent learning will equip students with the skills necessary to succeed on their own in the workplace. Entrance criteria were designed to obtain students with a combination of maturity, caregiving experience, and motivation to work in the field of rehabilitation. Almost all our students bring previous experience working in a health care setting to the program. The successful commencement of the CTA program represents the culmination of years of hard work, planning, and collaboration from a wide variety of individuals, institutions, and departments. Contributions from three colleges (NAC, College of the North Atlantic, and Yukon College), health managers from the GN and the Northern Medical Unit at the University of Manitoba, rehabilitation professionals from across the country, community members from Nunavut, and representatives from NTI and other GN departments were all instrumental in creating this high-calibre program. s Page 7 the caribou heard 1st Quarter 2008 Volume 6, No. 1 Dr. Emoke óó Szathmáry, 10th President and Vice-Chancellor of the University of Manitoba along with husband, Dr. George Reilly are presented with a polar bear rug at a Presidential Farewell Event held at Bannatyne Campus. The rug was specially prepared by the community of Sanikiluaq in honour of Dr. Szathmáry's retirement from the University. Rankin Inlet Therapy Services Moves by Dana Delapenha, Med-Rehab 2008 Summer Student in Rankin Inlet T he long awaited move of Rankin Inlet's Therapy Services into the newly renovated Wellness Centre took place in June 2008. Currently there is an Occupational Therapist (Sarah Browne), a Physiotherapist (Francine Mach), and we are actively seeking a Speech-Language Pathologist. Therapy Services shares the Wellness Centre with Public Health, Midwifery, and Home Care. The Public Health Nurses see children and adults from the community for vaccinations, education, communicable diseases etc. There are about four to five Midwives who see women and babies, one Home Care Nurse who generally sees five to six clients per day in their homes or at the Health Centre. The Wellness Centre also has Clerk Interpreters to support the program areas. Page 8 Gym Room at the new Wellness Centre Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication 1st Quarter 2008 the caribou heard Volume 6, No. 1 Love and Prayer Help Couple Survive Fall Through Ice by Maria Fraser This article first appeared at Christmas 2007 in the Goan Voice, a Website for Canadian Ex-Patriots of Goa, India. Maria's parents are from Goa. M aria Fraser nee Fernandes, is a Registered Out-post Nurse and has been working in Repulse Bay, Eastern Arctic Nunavut since 1990. Repulse Bay is on the west of Hudson Bay on the Arctic Circle, above the 65th parallel, population approximately 1,000. Maria was born and grew up in Nairobi, Kenya which is on the Equator. She says her nursing experience gained in the remote out-post region in Northern Kenya facilitated her work here on the remote tundra of Northern Canada. On the 14th October 2007 an Inuit couple in their mid fifties set out to cariboo hunt. Dressed in cariboo clothing, John and Goretti got ready with some hot tea in a thermos and some bannock. John had his snowmobile (skidoo) primed the night before. He started it that Sunday morning and Goretti and he headed out of town to a spot known to have herds of cariboo. John's oldest son and son-in-law were to join them later in the afternoon. The temperature outside was -30 degrees C and dropped even further with the windchill to -35 degrees C. It was obvious the men in this family knew this spot well. All they had to guide them on the road were previous skidoo tracts leading them to the place. An hour and a half out of town they spotted two hunters in the distance who had just caught cariboo and were heading home. They waved to each other. John followed the cariboo tracts and soon came accross his first cariboo and shot it . A few seconds later he shot his second cariboo. The rest of the herd got closer but soon left on seeing the dead cariboo. John and Goretti went ahead to hide behind a hill till the rest of the herd were out of the way. They got to the kill and not having their sled (komatik) with them decided to tie the cariboo with a rope to their skidoo, dragging it along the snow and ice packed tundra. Crossing over thick sheets of icy glass-like lakes - all of a sudden the skidoo started to sink through what appeared to be an eight inch thick ice sheet. Soon both Goretti and John found themselves submerged in icy water. Goretti afraid, started to panic, grabbing anything she could get her hands on - on one side the ice edge and the other the antlers of the now floating caribou. She watched her flask of tea and the bag of bannock sink to the bottom of the fresh water lake. The skidoo also was out of sight in a matter of minutes. Goretti's waterlogged Sorrel boots were making her legs feel more and more heavy and she felt she was being pulled down. She hurridly kicked of her waterlogged boots. Dressed in her cariboo outfit and a pair of socks she struggled to keep afloat holding the ice edge with one hand and the cariboo antler with the other. “ John said they have to stay alive for their grandchildren ” Her husband John had also removed his boots. He was struggling to hold onto a breaking ice edge and was holding on to the ice edge which kept breaking and he grabbed the next edge and with his right hand. He removed his binoculars and with it endeavoured to clump some snow on the ice edge to form a kind of peg to lever himself onto the ice edge. John had his rifle trapped accross his chest and tried to remove the strap over his head but the strap if the rifle kept getting caught in the hood of his parka. He felt his breathing getting shallower as he got deeper into the freezing waters. He said to Goretti that whatever happens he is not going to let them sink to the bottom of the lake. He would hold onto Goretti and the two of them would remain frozen above water, holding each other. He wanted his family to find them together. Fresh water lakes are very slippery unlike the salt water ocean according to John who is a well seasoned hunter in the territory. John managed to get both his feet on to the ice edge with his body still under the water. Goretti said that she could no longer hold on and exclaimed that she was going to let go. John said that they have to stay alive for their children continued next page Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication Page 9 the caribou heard Couple Survive Fall continued from Page 10 and grandchildren and asked Goretti to pray. Goretti prayed aloud. John held on to Goretti's wrist that was holding the edge of the ice and with his other hand on the peg that he had fashioned manouvered his body on to the ice edge. He quickly proceeded to pull Goretti out of the water on to the edge. They had been in the frigid waters for about half an hour. Their feet were frozen and they could barely walk. Goretti and John began to crawl on her hands and knees hoping that their son would soon be there to rescue them. John felt he was going to black out as he got up to walk. He was exhausted and worried. There was no sign of their son. They crawled toward a spot where John had his sled and a box of cariboo skins, this took an hour to reach. Goretti was tired and exhausted and did not wish to crawl anymore. John was determined to get to the box and encouraged Goretti saying that they had children and grandchildren waiting for them and that they had to be together this Christmas. After an hour's struggle in the cold and their hands and feet with no feeling from extreme cold temperatures, they managed to reach their box of cariboo skins. The skins were dry. John laid down the skins and Goretti sat down shivering. John helped her remove her cold parka and covered her with dry skins. They removed their wet socks tried and wrung out as much of the water and put them on again. He did the same for himself when suddenly he heard sounds in the still, cold air. There were three all terrain vehicles(hondas) in the distance. He tried to wave to them. The first two hondas kept going ahead and did not see them. The third honda did and turned around and headed towards them. The other two hondas seeing that the third was not following, also turned around and followed the honda tracks and came to John's and Goretti's rescue. These hunters had hot tea that they quickly poured for John and Goretti. They removed their own parkas and dry windpants and gave these to John and Goretti to wear. One of the ladies on the honda removed her inner sweater and duffle socks and gave these to Goretti. The rescurers got Goretti and the other lady onto the sled that John had and they all headed back to town to the health centre where I work. It took them two hours to reach us at the health centre. 1st Quarter 2008 Volume 6, No. 1 hypothermic state. John happened to be in better shape and was coherent enough to tell us to attend to Goretti first. Today, almost two months later Goretti and John are thankfull for the gift of life and being able to be with their family this Christmas. Goretti says that this experience has brought the family much more closer - especially between those who had drifted apart. This is going to be a very special Christmas for this family as they celebrate the gift of life in their home. Goretti and John have 6 children, 19 grandchildren, 1 great- grand child and another great grand child due Dec.16th 2007. Goretti and John have permitted me to write and share their dramatic courage and faith with you all. Send us Your Photos, Announcements, and Stories Please send us your announcements: accomplishments, births, marriages, engagements, events, and photos for the Newsletter or Website Image Gallery. Photos of staff (administrative and health care providers) for the newsletter would be greatly appreciated. Also, if you have a story you would like to share in the Newsletter please send it in. Please send to: Julie Creasey creasey@ cc.umanitoba.ca Goretti did not remember being in the Health Centre. On arrival her core temperature was 30 degrees C. All the nurses worked hard to get her out her Page 10 Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication 1st Quarter 2008 Volume 6, No. 1 Recipes Rhubarb Sauce Don't know what to do with all that rhubarb this summer? This sauce can be used as a base for smoothies, strudels, compotes, pies, stirred into vanilla yogurt, poured over ice-cream, and anything else you can think of. 3/4 cup sugar or sugar substitute (to taste) 1/4 cup orange juice 4 cups chopped fresh rhubarb In a medium saucepan stir together sugar and orange juice. Stir in rhubarb and bring to a boil over medium high heat. Reduce heat to medium and simmer, stirring occasionally until rhubarb is tender, 5 to 7 minutes. Transfer to airtight container. Cool, cover, and refrigerate for up to 1 week or put in freezer. Rhubarb Smoothie 1/2 cup rhubarb sauce base 1/2 cup frozen berries of your choice 1 scoop vanilla frozen yogurt Mix ingredients in a blender. This makes a thick shake. If you want it a bit thinner add some milk or soy milk. the caribou heard Advanced Trauma Life Support® Course This Course fills up Fast - Register Early The Advanced Trauma Life Support® Course for physicians teaches a systematic approach for the effective assessment and resuscitation of the severely traumatised patient. The 2 day course consists of: • pre-course test • didactic and interactive core content lectures • practical skill stations • surgical skill station • triage scenarios • initial assessment and management skill station • post-course test Upon completion of the course physicians should feel confident in the concepts and principles of primary and secondary assessment, establishing management priorities, initiating resuscitative measures and demonstrating the practical skills used in the initial assessment and management of patients with multiple injuries. A verification card is provided upon successful completion of the course and is valid for 4 years from the date of issue. a student refresher course must then be taken to maintain ATLS® provider status. October 7-18, 2008. All other courses have been filled. 2009 courses have not yet been announced. Please contact ATLS Department of Surgery, Children's Hospital, 787-7374. We also have application forms in the NMU office. Sauteed Potatoes and Leeks Trying to figure out how to use up all those potatoes and leeks from the garden this year? Try this recipe - almost like potato leek soup but without all the calories. 2 tbl Butter 2 Leeks, sliced 4 large Potatoes cooked in skins 1/4 tsp Celery seed pinch Parsely, chopped salt and pepper to taste Heat butter in frying pan. Add leeks and cover pan, cook 8 to 10 minutes over low heat. Peel potatoes and cut into thick slices, add to frying pan Season and sprinkle in celery seed, mix well and cook uncovered 7 to 8 minutes over medium heat. Sprinkle with chopped parsely and serve immediately. Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication Page 11 the caribou heard 1st Quarter 2008 Volume 6, No. 1 Word Puzzle E O R S O H C A N B E S B Z N P R B O D P R D S U J H K T R H I U R M O S T Q T Y O L L O U I A T R A E W C T D W K E P M C R N K N D W E E S N A N O A C E R C E R M M H W O I H E I F I V C E X O U P L P F F T E N Q Z D A A C T I O N Y C D K R D R R A N K Q J C H A S Q B C Q I Z F D U E U T M Y B G S N R X V Y T N K C S W W E M F J K R O T C E J O R P R P I E J M K D X T V D T H E A R E Q D X T ACTION NACHOS C ADVENTURE POPCORN P BUTTER PROJECTOR CANDY ROMANCE COMEDY SCREEN S DRAMA SHOWS U B DRINKS THEATRE J G T U G L HORROR TICKETS J X G H K A D H D Q H A I M S Christmas Card Photo Contest Many photos are submitted to the NMU by staff, students, and physicians. In 2007 we decided to choose one of these photos to put on our Christmas Card. Image Gallery on Website The image gallery gives potential health care providers and those with the NMU an opportunity to see pictures of all communities, facilities, and accommodations. We need pictures of accommodations and facilities in all the communities we serve. If you have any photos please send to: Julie at: creasey@ cc.umanitoba.ca Any other pictures would also be welcome. In 2007 we featured a photo by Dr. John Warnica of snow buntings in Nunavut. The idea was well received so we thought we would make a tradition of it. If you would like to have your photo featured on the 2008 card all you have to do is send in a "holiday looking" photo to: creasey@ cc.umanitoba.ca by 30 September 2008. The only criteria is it must have been taken in one of the communities we service. We will contact the winner by e-mail and announce the winner's name in our Winter 2008 Newsletter. Page 12 the caribou heard The Caribou Heard is published by the J. A. Hildes Northern Medical Unit, A Division of the Department of Community Health Sciences at the University of Manitoba Submissions can be made to Julie Creasey at T162770 Bannatyne Avenue, Winnipeg MB, R3E 0W3, [email protected] Phone: 204-789-3510 Fax: 204-774-8919 Opinions expressed on these pages may or may not be the opinions of the Editors. Faculty of Medicine, University of Manitoba J.A. Hildes Northern Medical Unit Publication