c a r i b o u h... t h e Raising Diabetes Awareness Among Poplar River's Youth

the
caribou heard
2014, June
In this Issue
5 NMU Programs���������������� 3
Your link to and from the North
Volume 12, No. 2
Raising Diabetes Awareness Among
Poplar River's Youth
Announcements������������������� 5
Rural Week�������������������������� 6
National Aboriginal Day..... 8
Library Services���������������� 10
T
A copy of this and
past Newsletters
are on our website
at the following
URL:
http://tiny.cc/nmu_
news/
Google: J.A. Hildes Northern
Medical Unit
he cold drizzly weather on the
11th of June didn't deter the
students of Poplar River Elementary
School from walking 3 km from the
bridge to the Nursing Station. Nor
did it dampen the enthusiasm of the
volunteers and the organisers in
making the Annual Walk a success.
A Community event
organised by the Northern
Store's, Richard Martel; the
Nursing Station's NIC, Edith
Martel; ADI/CHR worker,
Rosalie Franklin; CHR, Rose
Klippenstein; and a number of
volunteers and speakers.
Even though youth see first hand
what some family members with diabetes go through, not all youth
know about the causes of diabetes; that it can be prevented or
delayed; and, because of the increase in Type 2 Diabetes amongst
the young, they too are at risk. Engaging in events such as this, along
with other community initiatives, helps to raise the awareness that
simple things like getting regular exercise and eating healthy food
lower that risk.
Congratulations everyone on a successful event.
...more photos inside
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
the caribou heard
2014, June
Volume 12, No. 2
5 NMU Programs for the Prevention and Treatment
of Diabetes Complications
by Dr. Frank Duerksen
Dr. Frank Duerksen is a retired orthopaedic surgeon. Dr. Duerksen's first trip for the NMU was in 1975 and his
last in 2008 when he retired. He worked in Churchill, Rankin Inlet, and later in Norway House. He initiated the
Diabetic Foot Clinic at HSC, was Medical Director of Rehab Engineering, and initiated the visits of two orthotists
to First Nation Communities. Together with Dr. John Embil they initiated the Diabetic Foot Care Program in 2002.
He also started the Cast Technician Program in Norway House. In addition to his work in Northern Canada and
Winnipeg, Dr. Duerksen is an expert in leprosy reconstructive surgery in South America and Africa. Throughout
his career he would travel between Paraguay (his birth country), Winnipeg, Northern Manitoba, and Nunavut.
Photo by Dr Mario Dascal, Diabetic Foot Surgeon
T
Vince Choy, Registered Orthopaedic Technologist in the Cast Room, HSC
he J. A. Hildes Northern Medical Unit
provides several services to some of the
Northern First Nations Communities to prevent
and treat complications from diabetes. Most
of these services have been covered in the
Caribou Herd:
1. Diabetic Foot Care Program: Two Nurses
provide foot care prevention and treatment
to 14 communities. The main activities
are: educate, examine feet regularly, treat
common problems like nail deformities or
Page 2
calluses; refer problem cases to the Diabetic
Foot Clinic at the Health Sciences Centre
to prevent further major complications; and
prescribe insoles and shoes for Orthotics.
2. Retinal Screening: Two Nurses photograph
the retina as seen through the ocular
microscope and an ophthalmologist in
Winnipeg checks these photographs and
decides on further action to be taken.
3. The Island Lake Regional Renal Health Unit
in Garden Hill: This Dialysis Unit serves
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
2014, June
the caribou heard
Volume 12, No. 2
5 NMU Programs
usually takes 10-12 weeks in a TCC to heal
a foot ulcer. The TCC for bone fractures is
used usually for 6-8 months. It takes twice
as much time to heal bone fractures in
diabetic patients. The normal sequence for
the first cast to be changed is at one week,
then at two weeks, then at three or four
weeks, and from there on every four to six
weeks.
continued
four communities. In the past the patient on
dialysis had to move to Winnipeg, usually an
elderly person, separated for good from their
family and community.
Two which have not having been covered are:
4. Orthotic Service: Two orthotists provide
custom made insoles and shoes to four
communities. This saves many trips to
Winnipeg.
5. Total Contact Casting (TCC) in Norway
House: (Vince Choy) The standard treatment
for a plantar foot ulcer (wound) and for broken
bones in diabetic feet is the total contact cast
(TCC). The TCC is a special cast with very
little padding. The cast distributes the weight
bearing over the whole lower leg and foot. It
takes off about 60% of the weight. It speeds
up the healing of the ulcer and prevents
further fractures of the bones in the foot
(Charcot foot) that would eventually lead to
total destruction and amputation of the foot. It
Special training and care is necessary for
the application of the TCC. Vince Choy
is a Registered Orthopaedic Technologist
Advanced Standing. He is very well trained and
experienced in applying TCC’s and he spends
two days, twice per month in Norway House.
He changes the TCC’s that are needed, saving
many air trips for patients and their escorts
to Winnipeg. He also helps the local staff by
applying casts on patients with fractures.
These are unique programs that benefit
a number of First Nations Communities.
Community members do not have to leave their
homes for treatments or assessments resulting
in significant cost savings by reducing travel.
s
Garden Hill, Renal Health Unit Staff and children, Jennifer Esau, Nancy Mentuck, Kevin Esau, Chester Miller (on the
table), Grant McDougall-Beardy, Natasha McDougall-Beardy, Deanna Miller, Phoenix Mentuck, Tamara Mentuck her baby,
Brianna.
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
Page 3
the caribou heard
2014, June
Volume 12, No. 2
Poplar River Walk for Diabetes Photos
Food Prep Crew: (L to R) Linda Bittern, Virginia
Bathenchuk, and Joan Nugent, RN.
3 BBQ's were fired up for hotdogs and hamburgers (food
provided by the Northern Store) to feed the hungry group
after the long walk.
Community Member, Edith Hammond helping out with the
hotdog stand.
Along with the hotdogs & hamburgers there was lots of
fruit and veggies
Smiling faces all around, good exercise, good food, and
good fun
CHR, Rose Klippenstein holding Banner for the Walk.
Page 4
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
2014, June
the caribou heard
Volume 12, No. 2
Announcements
R
eluctantly we said good-bye to our financial
o
a
C
y
h
t
a
K
assistant of two years, Kathy Cao. Kathy
was offered a position at Fort Garry in Extended
Education as a budget Budget Analyst. This
is a fantastic career move for Kathy but we will
miss her laughter, friendship, and Joie de vivre.
Kathy, we wish you everything good life has to
offer.
A new psychiatrist, Dr. Polina (Lina) Anang
will begin travelling in August to Repulse Bay.
Dr. Anang is filling the shoes of long time NMU
psychiatrist, Dr. Keith Hildahl.
Dr. Hildahl recently retired after traveling to the
Kivalliq since February of 1989. At the time, the
Kivalliq was the Keewatin District of the NWT.
We wish Dr. Hildahl a happy retirement and
thank him for his committment to northern health
over these last 25 years.
We also said good-bye to Dr. Martin Nguetsop
who is going into the Radiology Residency
Program. Dr. Nguetsop came from the N/R
Residency Program to us in August of 2011 and
worked in Norway House and Hodgson. We
wish him all the best in the next phase of his
medical career.
Welcome to Dr. Christina Katopodis who has
joined Dr. Gerry McCarthy's practice. Christina
travelled with Dr. McCarthy quite a bit during her
residency and will be alternating trips with Dr.
McCarthy.
Drs. Cal Bergen, Nadin Gilroy, and Adrienne
Morrow, who all come from the N/R Residency
Program, will all be starting in Norway House
this summer. In addiition, Dr. Morrow just
completed her Public Health Residency with
Community Health Sciences. Congratulations
Dr. Morrow.
The Northern Medical Unit Specialist Program is
expanding into other communities and regions
in the province. In response to these changes,
Lori Thiessen's role will slowly transition to
support ongoing program development and
supervision of the day to day co-ordination of the
Specialist Program.
Dr.
Kei
th
Hild
ahl
Dr. Moffatt will continue as our Specialist
Program Advisor in his role as Senior Medical
Consultant.
Amanda Abele (Hospital Based) and Mary
Carey (Kivalliq & Kitikmeot) will be assisting Lori
with co-ordination activities for the Specialist
Programs.
Doing cartwheels around the office are our
Retinal Screening Nurses, Amy Dytnerski and
Gitane Ouelet who just learned they obtained
their Canadian Diabetes Educator Certification.
Congratulations!!!!
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
Page 5
the caribou heard
2014, June
Volume 12, No. 2
Another Successful
Rural Week
R
ural Week is a one week
learning experience for all
first year medical students. It
provides an opportunity for
the students to get first-hand
experience and exposure to not
just rural and northern medicine
but rural and northern life. It is
also an opportunity for participating
communities to showcase
themselves and promote the
opportunities and benefits of rural
and northern medicine.
It takes the efforts of numerous
preceptors, health care
professionals, and countless
community volunteers to provide
students with rural medicine and
community experiences. Dr. Anne
Durcan (NMU, Director Inuit Heath)
Med I's Kiilmeny Melnick and Out on the land in Sanikiluaq, fishing mussels,
in her other role as Education Coand making bannock & smores
ordinator, Undergraduate Rural
most helpful and happy teaching and answers the
Medical Education successfully
student's questions.
co-ordinates the week in conjunction with the
Other support staff
Office of Rural and Northern Health. And helping
Most were able
to contribute to
and community
to participate in
The instructor I
that success is the
members made the
community events,
NMU's Kathy Risk
had made my rural
experience very
such as High School
who co-ordinates
week. He was a very
enjoyable. Everyone
Presentations, tours
dedicated teacher and the student's
of the communities,
was extremely kind,
travel to some of
hunting for mussels
was giving me lessons the northern and
welcoming, and
and sea urchins,
I hope to reflect on
helpful.
Inuit communities
smudge and pipe
as I continue both
participating in the
ceremony. And
my education and
Week.
most would have liked to have experienced more
eventually my career
community events, culture, and way of life.
The feedback
in medicine.
from students was
One student reflected the others in the "Most
wonderfully positive
Liked" question on the feedback form:
with respect to their
preceptors. Most were happy with the teaching,
"I really enjoyed getting to live on a reserve and
guidance, patience, and assisting in a variety of
see first hand what life on a reserve is like. I think
settings. Although, at times in some communities,
this is an integral experience for physicians, even
clinics were so busy there was very little time for
those practicing in urban centres, as you will still
teaching.
have to see these patients. I really enjoyed being
in a rural setting where I could fish. I thoroughly
High praise was given for all the health care staff
enjoyed speaking with the locals and learning from
from nurses to medical drivers. Many commented
the nursing staff." s
how everyone was incredibly supportative and
“
“
”
”
Page 6
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
2014, June
Volume 12, No. 2
ITA YATAI: A
Symposium on
Traditional Knowledge
Yellowknife, NWT
Start:09/19/2014
End:09/21/2014
Timezone: Canada/Pacific
The Tłı̨chǫ Government, the
Government of the Northwest
Territories and Canadian Polar
Commissi,on are co-hosting a multievent symposium to advance the use of
Traditional Knowledge.
Overview
The symposium will comprise four
companion events Friday though
Sunday:
• A kick-off event in Behchokǫ̀ in
honour of Aboriginal elders, with
invitations to leaders, symposium
VIPs, major sponsors, and key
presenters
the caribou heard
INIHKD & Manitoba
NEAHR Conference
2014
5 - 10 October 2014
This conference builds on the INIKHD’s
international gathering held every two
years that is dedicated to improving the
lives of Indigenous peoples globally
through Indigenous and community-led
research, health services, and workforce
development. This year’s conference
will include a focus on Indigenous health
research in true collaboration and mentoring
new investigators and graduate students.
In October 2014 this gathering will be taking
place in Winnipeg, Manitoba, Canada.
An estimated 600 people including health
service providers, Indigenous community
members, researchers, and policy
formulator attendees will share in the
showcasing and honouring of Indigenousled knowledge development in research,
education & training, and health service
models. http://inihkd2014-neahr2014.com
• One-day scholarly symposium at the
Explorer Hotel
• “TEDx Tłı̨chǫ”: a one-day TEDx
podium event at the Explorer Hotel
• A companion Traditional Knowledge
Festival incorporating booth
displays, cultural demonstrations,
and a book fair
For More Information:
http://nativemaps.org/node/3905
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
Page 7
the caribou heard
2014, June
Volume 12, No. 2
National Aboriginal Day 21 June 2014
Held on Friday, the 20th of June at the U of M/HSC Complex
O
nce again The Section of First Nations, Métis, and Inuit Health along with the University's
Aboriginal Health Library, Aboriginal Services at HSC, and CancerCareManitoba, First Nations,
Métis, & Inuit Cancer Control did a bang up job putting on the day's festivities.
This year there was a Ceremonial Blessing of the soon to be Medicine Wheel Garden of Indigenous
Learning. The Garden will be located in the green space off Bannatyne right across from the Old
Basic Medical Entrance. The arrangments for this portion of Aboriginal Day were made by Ft. Garry's,
Indigenous Achievement.
New this year were booths showcasing aboriginal health programs at the University, HSC, and
CancerCare. Congratulations to the Committee Members for providing a wonderful day for all who
attended. It gets better every year!! s
Sylvia Boudreau of HSC's Aboriginal Health Services
Craft Vendors in Brodie Centre
Page 8
Amy Dytnerski, Diabetic Retinal Screeing Nurse & Ava
Halpin, Diabetic Foot Nurse
Medicine Wheel Garden Blessing
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
2014, June
Volume 12, No. 2
the caribou heard
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
Page 9
the caribou heard
2014, June
Volume 12, No. 2
Library Services to the Kivalliq Region &
Sanikiluaq
Submitted by: Janice Linton
Aboriginal Health Librarian and Liaison Librarian for Community Health Sciences
As they are published, new books are being
shipped in June and late summer to Kivalliq
Health Centres and Medical Rehabilitation
Services in Rankin Inlet.
Don’t forget that library services are available all
year round for health care providers working in
the Kivalliq communities and Sanikiluaq
Library & Information Services Include:
Literature Searches to find the information you
need for patient care, program development
and evaluation, continuing education, and
professional development.
Document Delivery Sending you journal
articles, reports and information wherever and
whenever you need it.
Contact Janice Linton, Aboriginal Health
Librarian & Liaison Librarian for Community
Health Sciences, for information on Kivalliq
Library Services [email protected]
A selection of new articles relevant to patient
care in Canada and Nunavut
(1) Athwal L, Marchuk B, Laforêt-Fliesser Y,
Castanza J, Davis L, Lasalle M. Adaptation
of a Best Practice Guideline to Strengthen
Client-Centered Care in Public Health.
Public Health Nursing 2014;31(2):134-143.
(2) Do MT, Fréchette M, McFaull S, Denning B,
(2) Bains A, Pakseresht M, Roache C, Beck
L, Sheehy T, Gittelsohn J, et al. Healthy
Foods North improves diet among Inuit and
Inuvialuit women of childbearing age in
Arctic Canada. Journal of Human Nutrition
and Dietetics 2014;27(SUPPL2):175-185.
(3) Cheung J, Goodman KJ, Girgis S,
Bailey R, Morse J, Fedorak RN, et al.
Disease manifestations of Helicobacter
Page 10
pylori infection in Arctic Canada: Using
epidemiology to address community
concerns. BMJ Open 2014;4(1).
(4) Findlay L, Kohen D, Miller A.
Developmental milestones among
aboriginal children in Canada. Paediatrics
and Child Health (Canada) 2014;19(5):241246.
(5) Ford JD, Willox AC, Chatwood S, Furgal
C, Harper S, Mauro I, et al. Adapting to the
effects of climate change on Inuit health.
Am J Public Health 2014;104(SUPPL.
3):e9-e17.
(6) Freeman T, Jolley G, Baum F, Lawless A,
Javanparast S, Labonté R. Community
assessment workshops: A group method
for gathering client experiences of health
services. Health and Social Care in the
Community 2014;22(1):47-56.
(7) Kaplan A. Canadian guidelines for acute
bacterial rhinosinusitis. Canadian Family
Physician 2014;60(3):227-234+e149e156.
(8) Magee LA, Pels A, Helewa M, Rey E, Von
Dadelszen P. Diagnosis, evaluation, and
management of the hypertensive disorders
of pregnancy. Pregnancy Hypertension
2014;4(2):105-145.
(9) McIsaac KE, Lou W, Sellen D, Young TK.
Exclusive breastfeeding among Canadian
Inuit: Results from the Nunavut Inuit Child
Health Survey. Journal of Human Lactation
2014;30(2):229-241.
(10) Pakseresht M, Lang R, Rittmueller S,
Roache C, Sheehy T, Batal M, et al. Food
expenditure patterns in the Canadian Arctic
show cause for concern for obesity and
chronic disease. International Journal of
Behavioral Nutrition and Physical Activity
2014;11(1).
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
2014, June
Volume 12, No. 2
(11) Statham S, Ford J, Berrang-Ford L,
Lardeau M-,Gough W, Siewierski R.
Anomalous climatic conditions during
winter 2010-2011 and vulnerability of the
traditional Inuit food system in Iqaluit,
Nunavut. Polar Rec 2014.
(12) Valery PC, Moore SP, Meiklejohn J, Bray
F. International variations in childhood
cancer in indigenous populations: A
systematic review. The Lancet Oncology
2014;15(2):e90-103.
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the caribou heard
16th International Congress
on Circumpolar Health
Oulu, Finland
8 - 12 June 2015
The congress will focus on human
health and well-being in the Arctic
and northern areas. It is open for
everyone interested in Arctic issues,
especially scientists, researchers,
health care professionals, policy
analysts, government agency
representatives, and community
leaders.
The congress is organised by the
Thule Institute, University of Oulu in
collaboration with the International
Union of Circumpolar Health (IUCH),
the Nordic Society for Circumpolar
Health, the Society of Arctic Health
and Biology, and the Rokua Health &
Spa.
The InternationaI Congress on
Circumpolar Health (ICCH) series
are arranged every three years in
Arctic countries or countries related
to Arctic issues. First congress of
the series was arranged in 1967, and
it was previously hosted by Oulu in
1971.
For more information: http://icch16.oulu.fi
Facebook: https://www.facebook.com/
icch16
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication
Page 11
the caribou heard
Advanced Trauma
Life Support®
Course for Doctors
This Course fills up
Fast - Register Early
The Advanced Trauma Life
Support® Course is publshed
by the American College of
Surgeons and provides a
framework for the management of the injured patient. It
is intended to allow the single doctor in a rural hospital
to effectively assess and manage multiple trauma.
The Course 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.
The next advanced Trauma Life Support® Provider/
Refresher Courses will be held:
2014
- September 12-13 and 13-14
- November 14-15 and 15-16
Please contact ATLS Department of Surgery:
AE402 - 840 Sherbrook Street
Winnipeg MB R3A 1S1
Phone: 787-2394
Fax: 787-4618
Email: [email protected]
Page 12
2014, June
Volume 12, No. 2
Send us Your
Announcements, Photos, and
Stories
Please send us your announcements:
accomplishments, births, marriages,
engagements, and community events
Photos of staff (administrative and health
care providers) for the newsletter would be
greatly appreciated as well as photos of the
communities you work.
Also, if you have a story or experience you
would like to share in the Newsletter please
send it in.
When you submit a photo it is with the
understanding it might be put in the
newsletter and we do not require written
permission to use it. If we would like to use
it for promotional materials (eg: brochures)
a photo release form must be signed.
Photos of patients in a medical context and
children are not used without the subject/
guardian(s) written permission.
Julie Creasey:
[email protected]
the
caribou heard
The Caribou Heard is published by the J. A. Hildes
Northern Medical Unit, Section of First Nations, Métis,
and Inuit Health 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.
University of Manitoba, Faculty of Health Sciences, College of Medicine
Section of First Nations, Métis and Inuit Health, J.A. Hildes Northern Medical Unit Publication