Nursing shortage, overcrowded homes in Pimicikamak Cree Nation make tuberculosis cases difficult to monitor

The chief of a northern Manitoba First Nation says overcrowding and poor ac‐ cess to health-care services in his community can make tuberculosis cases harder to monitor and contain.

Pimicikamak Cree Nation, also known as Cross Lake, currently has three active cases of tuberculosis - a con‐ tagious and potentially fatal lung disease, but one which is also treatable and pre‐ ventable.

That's a relatively normal number of cases for the com‐ munity, said Chief David Mo‐ nias, but he believes more needs to be done to tackle the disease, and issues in his community that put residen‐ ts at risk of getting it.

"If you put [it] in the con‐ text of the lack of housing and the lack of resources, nurses and doctors in the community, and then being able to access medical ser‐ vices … you do run into risk of getting really sick and dy‐ ing," Monias told CBC News on Saturday.

Pimicikamak, which has more than 6,500 people liv‐ ing on reserve, struggles with a nursing shortage, making it difficult for people to get reg‐ ular checkups or get medical help there once they have contracted the illness.

"It's hard to monitor peo‐ ple when you're shortstaffed," said Monias.

Homes in the community also tend to be overcrowded, he said.

There are "multiple fami‐ lies living in one dwelling, and most of them only have one washroom," he said.

"When somebody gets sick, it's really hard to contain any illnesses or diseases or viruses from spreading from one person to the next. And that potentially could be very dangerous to our health."

Though the number of tu‐ berculosis cases has dropped dramatically since the mid20th century, "that's not seen equally across the globe," said Heejune Chang, a public health and preventative med‐ icine physician at the Win‐ nipeg Regional Health Au‐ thority.

"Canada sees somewhere in the ballpark of 1,500 to 2,000 [new] cases per year … and then Manitoba sees in the ballpark of, like, 150 to 200 cases per year," Chang said.

First Nations and Inuit populations tend to see high‐ er rates of the disease, she noted. Factors like over‐ crowding, poor ventilation in homes and poorer health are all associated with greater transmission of tuberculosis.

For those communities, "it's sort of like tuberculosis never really went away," said Chang.

Monias said the people with active cases are in their homes being monitored by physicians.

National strategy

Chang said she hopes Cana‐ da will adopt a national strategy to address the dis‐ ease, and that the public be‐ comes more aware of it, es‐ pecially with World Tubercu‐ losis Day being marked on March 24.

"Many people live their lives without really thinking about tuberculosis disease anymore," said Chang.

"There's a lot of work that could still be done."

That includes making medications and treatment for the disease more obtain‐ able and accessible, and hav‐ ing better support for patien‐ ts during the treatment pro‐ cess.

Monias also hopes for a national strategy, and says funding from governments for housing and clean drink‐ ing water is also needed.

People also need to know just how harmful the disease is, added Monias, who said his dad survived tuberculosis, but later struggled with lung problems.

"It's a silent killer … and attacks people without [them] knowing what the symptoms are," he said.

Hopefully, "they catch it before it spreads or gets worse."