Native communities in Montreal are disproportionately afflicted by a latent form of tuberculosis (TB), a McGill study has found.
After taking skin tests from 141 subjects, researchers found that 17.7 per cent of the aboriginal participants were carrying a latent TB infection, whereas only 4.3 per cent of the general population is afflicted by the illness.
“It’s probably been like this for quite a while, and it becomes a problem when it turns into active TB,” said Mary Ellen Macdonald, a professor of oral health and society in the McGill Faculty of Dentistry, and one of the lead researchers.
“There are communities of new migrants who are bringing their health problems when they come to Canada. If they are living in poverty, then those also living in poverty are more likely to catch the active disease,” Macdonald added.
While the inactive form of TB can be carried without any indication of adverse health effects, a weak immune system may allow the bacteria to mutate into the active form, at which point symptoms may become more evident and the disease can be transmitted to others.
The McGill study began following an alarming increase in active TB infections within aboriginal communities in 2002. The researchers worked to uncover the causes of the outbreaks in partnership with the Native Friendship Centre – a non-profit organization run by members of the aboriginal community that focuses on urban aboriginals, some of whom are deemed “at-risk” of homelessness and social marginalization.
Macdonald noted that part of the aboriginal subset studied by researchers included youth and individuals who have lost their jobs and homes through drug and alcohol addiction.
Though researchers notified infected subjects if they were carrying TB, many could not access adequate treatment because they did not have a medicare card, required by most hospitals.
However, Médicins du monde, CLSC Sanguinet and Hôpital St-Luc provided medical care to individuals without the cards, according to Brett Pineau, the executive director of the Native Friendship Centre.
Health professionals have the prerogative to contain those infected with TB, as it is highly infectious. Some subjects were hesitant or simply refused care, however, as they were afraid of being contained and forced into treatment.
Macdonald attributed the fear of treatment to the historical marginalization of the aboriginal community, and adding that ideas of containment run parallel to the community’s experiences in residential schools and sanatoriums.
“They have been isolated – culturally, socially, linguistically so. It has not been pleasant and all those memories are conjured up whenever TB is brought up,” Macdonald said.
Pineau, however, said the Native Friendship Centre is hopeful that the study will have some positive outcomes. He hoped that a healing centre could be established that properly addresses the cultural needs of the aboriginal community through cooperation with McGill and other groups.
“The TB study was the first step in positioning ourselves into identifying priorities for our community, specifically in regards to health,” Pineau said.
But a lack of resources, thus far has proven to be a major setback.
“Expanded funding toward health priorities – whether that be increased research, construction of a new centre, or increased resources devoted to a purpose – would certainly go a long way,” Pineau said.
Macdonald echoed similar thoughts. “Ultimately there should be a health clinic run for and by aboriginals – there are many interesting examples across the country but I don’t think it’s in the political will,” she said.
Macdonald advised that health authorities listen to the clientele of the Native Friendship Centre and sh also said authorities should strategize in a culturally sensitive way. Seek innovative solutions rather than strictly adhere to the conventions of the public health system.
“It’s coming up with creative strategies, knowing the clientele, and knowing how they can help themselves,” Macdonald said.