Sunday, August 22, 2010
A Saturday Afternoon Bike Ride
It is August 21st today, and we finally had a birth yesterday. I was on second call, so the “baby midwife” as the second midwife is called here. The woman was an young primip, who had developed slightly elevated blood pressure about five weeks ago. She also had proteinurea (for you non-medical types protein in her urine) at 28weeks. Nobody had thought it was significant. A student was taking care of her, which is the norm here, and a senior midwife did each visit with them. The senior midwives are largely southern,and do not speak Inutittut, which is the language that is used for maternity appointments.
Two weeks ago I was asked to help with a visit, which I did, but seeing the blood pressures, insisted on a consult. Blood tests were ordered before the consult, and the student figured out which tubes were needed, and took the blood. (Yes we do our own blood taking here.) So we began checking blood pressure twice a week. This last week however, the blood pressure was high enough to need another consult. We started a more normal, for me course of care...twice weekly blood pressure, once weekly blood tests, and twice weekly NST’s (non stress tests).
There is no fetal monitor here. Non Stress tests are done by using a Doppler and two people, one to count and one to write. The fetal heart is taken for six seconds and then announced, then there is a four second rest. This is repeated for twenty minutes. The writer takes down all the numbers and plots them. When the twenty minutes is up they are joined, and you can get a line that shows if there are accelerations or not.
We did this Thursday, but as her pressures were very labile, we consulted again. The docs said to take her blood pressure again at the end of the day, and if it was high to let them know. It was, so consultation again. The MD’s decided that she should be induced with cervadil that night, and hopefully would go into labour. She was to remain in hospital, but under the care of the nurses, not the midwives, although she was staying in maternity.
This always causes a bit of stress for the nurses. They are not OB nurses, and the hospital is largely chronic care. There are twenty beds, and really is largely extended care. The building provides care for the whole community, but where in some communities there are group homes for seniors, there is not here. The seniors that need help are in the hospital, and so are the handicapped, who cannot be cared for at home. There are also a few beds for the babies and children with lung problems, and others who need to be observed. There is usually no surgery, and when there is, as there was last week, it is very specific. Last week a dentist was here taking out children’s teeth. Apparently they do orthodontics under an anaesthetic as well. (I do not know this for sure but was told that by the Inuit Midwives.)
Anyway, the woman went into labour, and had an extremely precipitous PIH birth. Mainly she went from three centimetres to birth in less than two and a half hours. Of course there were decels, a shoulder dystocia and a PPH. Typical PIH birth and only a little fast for an Inuit primip. But all this was done with no heart monitor, or additional monitoring. (It worries me slightly because I am the senior midwife here in September, and it is not something that I will do. So, there may be some battles with the director or the physicians. Am hoping there is just no more PIH. This is the second case since I have been here, although the other lady was from another community).
When the client was not having so many contractions, first thing in the morning, the student who was working with her said...”maybe we need a little synto” to get her going. Quite cavalier really. Luckily she delivered without oxytocin.
After delivery and overnight a postpartum worker took care of her. Post partum workers are women who take care of the women and baby dyad. They work eight hour shifts, so probably three postpartum workers and one or two trainees took care of this couple.. And there are always numerous family and friends at the maternity as well.
At two this afternoon I went to the maternity to discharge the baby. The first call midwife was already there, having dealt with a miscarriage, and had said she would do the baby as well. She had a different student with her, who really did need more experience, so I decided to leave. Told the other midwife I was going out on the road to the Hudson’s Bay so she gave me the walkie talkie. Apparently the phones do not work out there. Mind you, no cell phones work here. There is talk of getting a company to get them working for the Bay and Ungava coast, but who knows if the rumors are true or not.
She also suggested that I take the bike and go out. What bike?? Turns out there is a bike in the apartment building (six apartments only) that does not belong to anyone, and everyone uses. It seemed like a good idea.
">
Went to the co-op, and got an avocado then back to the apartment. Forgot my camera, but did pick up water and took the walkie talkie, which is large, and headed out. The bike is purple. It matched my hair. The sky was overcast, but it was warm, and thank goodness I only wore my bug shirt. It also saved my arms and back.
As I rode off the realization quickly came as to why this bike was “free”. The gears did not work. Instead of ten or twenty, there are perhaps two gears. Not great for going up and down hills on gravel roads, but better than nothing, and it could take me further than my feet.
I rode through town and out the other side, following the road to the Bay. Before the houses ended, the gravel started, and it is heavy gravel, so the going was a little rough. There were a few bugs, but on the bike they were not noticeable.
I went over the first hill, and then I started to see things. There were mushrooms everywhere. Now fresh picked mushrooms are lovely, usually, but there are some poisonous ones here, and they are red. So, finally I got off the bike, took my water out of the bag I was carrying and started to collect mushrooms. Like all wild mushrooms it is advisable not to take the really big ones, because they have worms and maggots in them. Worms is what are in them here, and in the south you can often find the maggots after the worms.
So I was carefully checking out the mushrooms, and suddenly noticed that the blueberries and blackberries were ripe, so also picked some of them. Now the blueberries and blackberries are the size of small huckleberries, but they grow very close to the ground. I got enough for some youghert, so was happy with that, and about five mushrooms, and four puffballs.
Back on the bike, and riding along, and I suddenly saw little orange aupicks. These are Arctic raspberries, and they are orange in colour when they are ripe. They grow one on a stalk, so at first I thought they were flowers. Each little one is about two inches high and the berry sticks up from the stalk. They are delicious.
Of course while I was picking the berries, the bugs picked me. I realized I was being bitten on the face, but afterwards realized I was bitten inside my ear. It is quite odd to feel yourself being bitten inside your ear canal, and scratching with your finger to find a fly under your nail. Then you know that you are in trouble. Hearing becomes different, and you get a little vertigo as your ear canal closes from swelling.
As I had been riding a number of quads had passed me. They rode down the road and then off on little trails, and the riders were also collecting berries. You could see the quad drive off, slow down and the riders looking for what looked liked good areas. Picking berries here requires only a small container. The size means you are unlikely to get anything close to a bucket, and a small jar of jam can take a whole afternoon of picking. Of course if it is the aupicks, a number go into your mouth as well.
I felt very lucky and turned around to go home. I had not made it as far as the Bay, but had mushrooms, puff balls, aupicks, blueberries and black berries. Then I also noticed the little red mushrooms that were everywhere. I am going to go back and take my camera. There were so many little things to make the camera useful.
Rode home, having a good ride, although not that far really, maybe two or three miles, and got the filthy bike into the building.
Got upstairs and opened my bag. One of the puffballs was past its best and the ride had opened it, and its slimy contents. It went in the garbage. The other two will be my breakfast, with a mushroom as well, sautéed, put on toast with a little cheese grilled on them. And if nobody takes the bike tomorrow, the walkie talkie and camera and I will be repeating this little trip. If the bike is busy, then will have to decide if we are busy enough for me not to go out, as I am still on call. Either way it will be a fun day.
Two weeks ago I was asked to help with a visit, which I did, but seeing the blood pressures, insisted on a consult. Blood tests were ordered before the consult, and the student figured out which tubes were needed, and took the blood. (Yes we do our own blood taking here.) So we began checking blood pressure twice a week. This last week however, the blood pressure was high enough to need another consult. We started a more normal, for me course of care...twice weekly blood pressure, once weekly blood tests, and twice weekly NST’s (non stress tests).
There is no fetal monitor here. Non Stress tests are done by using a Doppler and two people, one to count and one to write. The fetal heart is taken for six seconds and then announced, then there is a four second rest. This is repeated for twenty minutes. The writer takes down all the numbers and plots them. When the twenty minutes is up they are joined, and you can get a line that shows if there are accelerations or not.
We did this Thursday, but as her pressures were very labile, we consulted again. The docs said to take her blood pressure again at the end of the day, and if it was high to let them know. It was, so consultation again. The MD’s decided that she should be induced with cervadil that night, and hopefully would go into labour. She was to remain in hospital, but under the care of the nurses, not the midwives, although she was staying in maternity.
This always causes a bit of stress for the nurses. They are not OB nurses, and the hospital is largely chronic care. There are twenty beds, and really is largely extended care. The building provides care for the whole community, but where in some communities there are group homes for seniors, there is not here. The seniors that need help are in the hospital, and so are the handicapped, who cannot be cared for at home. There are also a few beds for the babies and children with lung problems, and others who need to be observed. There is usually no surgery, and when there is, as there was last week, it is very specific. Last week a dentist was here taking out children’s teeth. Apparently they do orthodontics under an anaesthetic as well. (I do not know this for sure but was told that by the Inuit Midwives.)
Anyway, the woman went into labour, and had an extremely precipitous PIH birth. Mainly she went from three centimetres to birth in less than two and a half hours. Of course there were decels, a shoulder dystocia and a PPH. Typical PIH birth and only a little fast for an Inuit primip. But all this was done with no heart monitor, or additional monitoring. (It worries me slightly because I am the senior midwife here in September, and it is not something that I will do. So, there may be some battles with the director or the physicians. Am hoping there is just no more PIH. This is the second case since I have been here, although the other lady was from another community).
When the client was not having so many contractions, first thing in the morning, the student who was working with her said...”maybe we need a little synto” to get her going. Quite cavalier really. Luckily she delivered without oxytocin.
After delivery and overnight a postpartum worker took care of her. Post partum workers are women who take care of the women and baby dyad. They work eight hour shifts, so probably three postpartum workers and one or two trainees took care of this couple.. And there are always numerous family and friends at the maternity as well.
At two this afternoon I went to the maternity to discharge the baby. The first call midwife was already there, having dealt with a miscarriage, and had said she would do the baby as well. She had a different student with her, who really did need more experience, so I decided to leave. Told the other midwife I was going out on the road to the Hudson’s Bay so she gave me the walkie talkie. Apparently the phones do not work out there. Mind you, no cell phones work here. There is talk of getting a company to get them working for the Bay and Ungava coast, but who knows if the rumors are true or not.
She also suggested that I take the bike and go out. What bike?? Turns out there is a bike in the apartment building (six apartments only) that does not belong to anyone, and everyone uses. It seemed like a good idea.
">
Went to the co-op, and got an avocado then back to the apartment. Forgot my camera, but did pick up water and took the walkie talkie, which is large, and headed out. The bike is purple. It matched my hair. The sky was overcast, but it was warm, and thank goodness I only wore my bug shirt. It also saved my arms and back.
As I rode off the realization quickly came as to why this bike was “free”. The gears did not work. Instead of ten or twenty, there are perhaps two gears. Not great for going up and down hills on gravel roads, but better than nothing, and it could take me further than my feet.
I rode through town and out the other side, following the road to the Bay. Before the houses ended, the gravel started, and it is heavy gravel, so the going was a little rough. There were a few bugs, but on the bike they were not noticeable.
I went over the first hill, and then I started to see things. There were mushrooms everywhere. Now fresh picked mushrooms are lovely, usually, but there are some poisonous ones here, and they are red. So, finally I got off the bike, took my water out of the bag I was carrying and started to collect mushrooms. Like all wild mushrooms it is advisable not to take the really big ones, because they have worms and maggots in them. Worms is what are in them here, and in the south you can often find the maggots after the worms.
So I was carefully checking out the mushrooms, and suddenly noticed that the blueberries and blackberries were ripe, so also picked some of them. Now the blueberries and blackberries are the size of small huckleberries, but they grow very close to the ground. I got enough for some youghert, so was happy with that, and about five mushrooms, and four puffballs.
Back on the bike, and riding along, and I suddenly saw little orange aupicks. These are Arctic raspberries, and they are orange in colour when they are ripe. They grow one on a stalk, so at first I thought they were flowers. Each little one is about two inches high and the berry sticks up from the stalk. They are delicious.
Of course while I was picking the berries, the bugs picked me. I realized I was being bitten on the face, but afterwards realized I was bitten inside my ear. It is quite odd to feel yourself being bitten inside your ear canal, and scratching with your finger to find a fly under your nail. Then you know that you are in trouble. Hearing becomes different, and you get a little vertigo as your ear canal closes from swelling.
As I had been riding a number of quads had passed me. They rode down the road and then off on little trails, and the riders were also collecting berries. You could see the quad drive off, slow down and the riders looking for what looked liked good areas. Picking berries here requires only a small container. The size means you are unlikely to get anything close to a bucket, and a small jar of jam can take a whole afternoon of picking. Of course if it is the aupicks, a number go into your mouth as well.
I felt very lucky and turned around to go home. I had not made it as far as the Bay, but had mushrooms, puff balls, aupicks, blueberries and black berries. Then I also noticed the little red mushrooms that were everywhere. I am going to go back and take my camera. There were so many little things to make the camera useful.
Rode home, having a good ride, although not that far really, maybe two or three miles, and got the filthy bike into the building.
Got upstairs and opened my bag. One of the puffballs was past its best and the ride had opened it, and its slimy contents. It went in the garbage. The other two will be my breakfast, with a mushroom as well, sautéed, put on toast with a little cheese grilled on them. And if nobody takes the bike tomorrow, the walkie talkie and camera and I will be repeating this little trip. If the bike is busy, then will have to decide if we are busy enough for me not to go out, as I am still on call. Either way it will be a fun day.
Monday, August 9, 2010
Welcome to Puvirnituq
<<
Welcome to Puvirnituq
Well maybe, or maybe not. As I sit here, nursing my hot, itchy sore ear and cheek, covered in bug bites, am not sure about the welcome. Have been here a little over a week, and have been here been on call the whole time. Likely we will have a birth tonight or tomorrow, and since I am first on call, it will mean more busy times. At least here we do not have to be at work from 9 to 5 if we have been up all night.
Arriving here was lovely. My camera battery died just prior to getting near to PUV, as Puvirnituq is affectionately called, or POV short for something similar that used to be the town’s name. The amazing thing is all the water, as it seems to be all over the north. In PUV though, you add colour. The water has amazing colours, and as there are drop off s a few metres off all the Islands there are an amazing array of colours in the water.
I did a medevac to Umiujaq, one village below Inukjuak and about an hour, by plane, south of here, and was surprised to see trees. Well, honestly they are not trees as you and I know them, but they were four to six feet tall, and grew in little clusters here and there. Our driver said they had one really big one...about seven to eight feet tall. They were really proud of that tree. It was also very verdant and green in the village. Unfortunately it was also heaving rain, and we were in a rush, so could not take photos. A woman had given birth there, which is not supposed to happen, and I had to check out everything and make sure the 36 week baby was okay.
She was fine and dandy, and had already breastfed by the time we got there.
As we arrived though, we got a call saying we would be heading to Salluit, for another patient, not maternity. So, it was, can you do this as fast as possible please, but at the same time teach the nurses because they will be doing follow up on this Mum and baby, and they have not done it previously. Not surprising as Umiujaq is only 400 people. Their pregnant ladies usually leave at 36 weeks and go to PUV, or somewhere else, to deliver. Some go to Inukjuak as it is closer, and many have relatives living there. (I thought about suggesting we check out their Northern store to see if there was any bread, but since we were in a rush, decided it was not a good idea. Also the Northern was the size of a normal house, so thought their stock might not be so large.)
a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxzpp51G1S5MEZJJ5A_YsqCuxsyGbEBdlQeGoSNmmML_6XJYpmvVha54UX6hSbObaLWhBjlhRz9PMpGPOvEoSAEUy3vlg5UHLbYlHM5TT0jOMlGtMCLNBGKZlyX2Gpl0OXspMAvoButQ/s1600/medevac+1+9+Umiujaq+terminal.JPG">
We drove back to the airport and were then told that we were taking two more patients from there, as the sched (scheduled flight) had not been able to land there due to weather. Prior to leaving PUV we had also been told we might not be able to land due to weather, but if we did not make it we would go to Kuujjuarapik and get more fuel, then try again on the way back. Luckily we did not do that.
Just before we took off, with the two extra patients with us, the pilot told the nurse that we had to stop off at Inukjuak, for an emergency. Oh well, what is one more person. The weather there was great. Now remember that these villages are about 35 minutes flight time from one another, and PUV is another 35 minutes north of Inukjuak. The weather systems are all different. So, we got into the clouds, and it was amazing to me that instruments can tell you where you are, because the whole flight seemed the same...in the middle of fog. But we successfully took off and landed several times that day. Inukjuak was quite nice, once we were under the clouds, and we landed without incident, picked up a patient on a stretcher and their escort and were off to PUV. The nurse was also told that there was no way they could land at Salluit, due to weather.
Well, as I started to say, it is amazing the differences a few miles make to the plant life in this region. Inukjuak is a beautiful green colour. There are masses of berries and grasses, and everything is very green. They also have the beautiful colours of the waters there, and the village itself is between the Inukjuak river and the Hudson’s Bay. It is a town of approximately 1600, with the highest number of people per capita on welfare, in the whole Quebec, according to the Midwives there. And judging from the number of food coupons we gave out there compared to PUV, it is a statement I believe. (There is a food coupon program for pregnant women and nursing mothers up here. I am not sure if it is Quebec wide, but suspect now.)
This time landing in PUV, my camera was at the ready. I snapped pictures and got some beautiful shots of the islands and the water. Lots of reds in the rocks and water colour, but the land is not green as it is further south. Everything here is much browner, despite the rain that has been prevalent since I arrived. I was also told by one of the midwives that the bugs were not bad here because the caribou had been through already. She said that when the caribou herd goes through the area, the bugs follow it. Not my personal opinion, as I am wearing my bug shirt, even if everyone thinks it is “cute”.
My previous medevac had been to Salluit. It was in the middle of the night, so did not take my camera, which was quite silly. It is light here by five am, so there were lots of photos that could have been taken and Salluit is truly beautiful. It is on a fjord in between two hills, well, hills if you live in BC, but the people here have said mountains. It is all in your perspective. The sun was rising as we left and it really was beautiful. Only problem with Salluit is the weather, which is very iffy most of the time. Even in summer you can get stuck there for three or four days because of fog, clouds, or the plane just not being able to land.
PUV has two stores, the Northern and the Co-op. Anyone who has been reading my blogs or facebook notes will know that this is the norm here. The Northern is a chain which used to, and may still, belong to the Hudson’s Bay Company. The Co-op’s are stores belonging to the Inuit of each village. In some places they say the Northern is for the southerners and the Co-Op is for the Inuit. I have not found this to be particularly true. Everyone seems to shop in both, depending on what they want. And if you want snack food or pop they both have an amazing variety!
The hospital here is divided into three areas. It has Nursing, the Department, and the Maternity. Nursing is where you go for an appointment, or if you need to see a doctor, although you see a nurse really, and if you are seriously ill, or have some problem that you will need to go south for, you see a doctor. This seems to be similar to Rankin. The doctors are considered the specialists of the south and the nurses are considered the GP’s of the south. There is a lab, a pharmacy, X-rays and usually ultrasound department, and everyone from the whole Hudson’s Bay coast of Quebec comes to this hospital for these services. The Department is the in patient services. I believe they have 20 beds but many are chronic care, and they also have an emergency department. Maternity has three birthing rooms, each with a double bed and chest of drawers. A tray is brought in for a birth that has most of the necessary equipment on it. There is also a clinic room, bathroom, office, storage room and emergency room. There is no baby stuff set up in the birth rooms. If there is a problem you take the baby to the emergency room. They have no EFM’s.
Other villages have health centres that consist of two or more nurses, and doctors either full time or sometimes depending on the size of the community. They seem to handle emergencies, and general health very well. If there is an emergency a plane is sent from PUV to the community, to pick up the patient. They are then screened here, and if necessary, sent by jet to Montreal. There seem to be jets to Montreal every day, but I have been told this seems to be the case right now, but is not in reality true.
I was told by Midwives in Inukjuak that years ago Inukjuak was to have the Hudson’s Bay hospital, but some old men in town thought it was a bad idea. They said they were quite mad at those men because there were now no jobs in that town, and PUV had jobs. PUV is the same size as Inukjuak, but it seems to have more problems as well. Both towns are friendly, but there are more jobs and money here, and it seems, more alcohol, drugs and violence. It may be my perception, and certainly it is nothing like a large town in the south, but the demeanor here is different than in the other villages. Having said that, I am liking it here just as much as in Inukjuak. It has its own flavour and character, as do all the northern villages.
To finish the medevac story, the woman we picked up in Umiujaq was with us til about six thirty that evening, when a Challenger jet came to take her and another patient to Montreal. I got home about seven and was called again at one thirty in the morning to go back to Inukjuak for another patient. The flying isn’t exhausting, but everything around it is. Getting ready, getting equipment, knowing the general information about the patient you are going to get, but not really knowing what you will be doing, and generally flying by the seat of your pants (pun). It does make the work a little more exciting. I am sure that if we have any normal births, (no births so far) it will be even more fun to be here.
So, I am enjoying the wind and rain and sun, the plants and ocean, knowing that by a month from now the temperature will have dropped and we will be experiencing very different weather. The berries will be picked and mushrooms harvested, and everyone will be getting ready for winter. Until then I will just observe all the wonderful changes of the north.
Welcome to Puvirnituq
Well maybe, or maybe not. As I sit here, nursing my hot, itchy sore ear and cheek, covered in bug bites, am not sure about the welcome. Have been here a little over a week, and have been here been on call the whole time. Likely we will have a birth tonight or tomorrow, and since I am first on call, it will mean more busy times. At least here we do not have to be at work from 9 to 5 if we have been up all night.
Arriving here was lovely. My camera battery died just prior to getting near to PUV, as Puvirnituq is affectionately called, or POV short for something similar that used to be the town’s name. The amazing thing is all the water, as it seems to be all over the north. In PUV though, you add colour. The water has amazing colours, and as there are drop off s a few metres off all the Islands there are an amazing array of colours in the water.
I did a medevac to Umiujaq, one village below Inukjuak and about an hour, by plane, south of here, and was surprised to see trees. Well, honestly they are not trees as you and I know them, but they were four to six feet tall, and grew in little clusters here and there. Our driver said they had one really big one...about seven to eight feet tall. They were really proud of that tree. It was also very verdant and green in the village. Unfortunately it was also heaving rain, and we were in a rush, so could not take photos. A woman had given birth there, which is not supposed to happen, and I had to check out everything and make sure the 36 week baby was okay.
She was fine and dandy, and had already breastfed by the time we got there.
As we arrived though, we got a call saying we would be heading to Salluit, for another patient, not maternity. So, it was, can you do this as fast as possible please, but at the same time teach the nurses because they will be doing follow up on this Mum and baby, and they have not done it previously. Not surprising as Umiujaq is only 400 people. Their pregnant ladies usually leave at 36 weeks and go to PUV, or somewhere else, to deliver. Some go to Inukjuak as it is closer, and many have relatives living there. (I thought about suggesting we check out their Northern store to see if there was any bread, but since we were in a rush, decided it was not a good idea. Also the Northern was the size of a normal house, so thought their stock might not be so large.)
a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxzpp51G1S5MEZJJ5A_YsqCuxsyGbEBdlQeGoSNmmML_6XJYpmvVha54UX6hSbObaLWhBjlhRz9PMpGPOvEoSAEUy3vlg5UHLbYlHM5TT0jOMlGtMCLNBGKZlyX2Gpl0OXspMAvoButQ/s1600/medevac+1+9+Umiujaq+terminal.JPG">
We drove back to the airport and were then told that we were taking two more patients from there, as the sched (scheduled flight) had not been able to land there due to weather. Prior to leaving PUV we had also been told we might not be able to land due to weather, but if we did not make it we would go to Kuujjuarapik and get more fuel, then try again on the way back. Luckily we did not do that.
Just before we took off, with the two extra patients with us, the pilot told the nurse that we had to stop off at Inukjuak, for an emergency. Oh well, what is one more person. The weather there was great. Now remember that these villages are about 35 minutes flight time from one another, and PUV is another 35 minutes north of Inukjuak. The weather systems are all different. So, we got into the clouds, and it was amazing to me that instruments can tell you where you are, because the whole flight seemed the same...in the middle of fog. But we successfully took off and landed several times that day. Inukjuak was quite nice, once we were under the clouds, and we landed without incident, picked up a patient on a stretcher and their escort and were off to PUV. The nurse was also told that there was no way they could land at Salluit, due to weather.
Well, as I started to say, it is amazing the differences a few miles make to the plant life in this region. Inukjuak is a beautiful green colour. There are masses of berries and grasses, and everything is very green. They also have the beautiful colours of the waters there, and the village itself is between the Inukjuak river and the Hudson’s Bay. It is a town of approximately 1600, with the highest number of people per capita on welfare, in the whole Quebec, according to the Midwives there. And judging from the number of food coupons we gave out there compared to PUV, it is a statement I believe. (There is a food coupon program for pregnant women and nursing mothers up here. I am not sure if it is Quebec wide, but suspect now.)
This time landing in PUV, my camera was at the ready. I snapped pictures and got some beautiful shots of the islands and the water. Lots of reds in the rocks and water colour, but the land is not green as it is further south. Everything here is much browner, despite the rain that has been prevalent since I arrived. I was also told by one of the midwives that the bugs were not bad here because the caribou had been through already. She said that when the caribou herd goes through the area, the bugs follow it. Not my personal opinion, as I am wearing my bug shirt, even if everyone thinks it is “cute”.
My previous medevac had been to Salluit. It was in the middle of the night, so did not take my camera, which was quite silly. It is light here by five am, so there were lots of photos that could have been taken and Salluit is truly beautiful. It is on a fjord in between two hills, well, hills if you live in BC, but the people here have said mountains. It is all in your perspective. The sun was rising as we left and it really was beautiful. Only problem with Salluit is the weather, which is very iffy most of the time. Even in summer you can get stuck there for three or four days because of fog, clouds, or the plane just not being able to land.
PUV has two stores, the Northern and the Co-op. Anyone who has been reading my blogs or facebook notes will know that this is the norm here. The Northern is a chain which used to, and may still, belong to the Hudson’s Bay Company. The Co-op’s are stores belonging to the Inuit of each village. In some places they say the Northern is for the southerners and the Co-Op is for the Inuit. I have not found this to be particularly true. Everyone seems to shop in both, depending on what they want. And if you want snack food or pop they both have an amazing variety!
The hospital here is divided into three areas. It has Nursing, the Department, and the Maternity. Nursing is where you go for an appointment, or if you need to see a doctor, although you see a nurse really, and if you are seriously ill, or have some problem that you will need to go south for, you see a doctor. This seems to be similar to Rankin. The doctors are considered the specialists of the south and the nurses are considered the GP’s of the south. There is a lab, a pharmacy, X-rays and usually ultrasound department, and everyone from the whole Hudson’s Bay coast of Quebec comes to this hospital for these services. The Department is the in patient services. I believe they have 20 beds but many are chronic care, and they also have an emergency department. Maternity has three birthing rooms, each with a double bed and chest of drawers. A tray is brought in for a birth that has most of the necessary equipment on it. There is also a clinic room, bathroom, office, storage room and emergency room. There is no baby stuff set up in the birth rooms. If there is a problem you take the baby to the emergency room. They have no EFM’s.
Other villages have health centres that consist of two or more nurses, and doctors either full time or sometimes depending on the size of the community. They seem to handle emergencies, and general health very well. If there is an emergency a plane is sent from PUV to the community, to pick up the patient. They are then screened here, and if necessary, sent by jet to Montreal. There seem to be jets to Montreal every day, but I have been told this seems to be the case right now, but is not in reality true.
I was told by Midwives in Inukjuak that years ago Inukjuak was to have the Hudson’s Bay hospital, but some old men in town thought it was a bad idea. They said they were quite mad at those men because there were now no jobs in that town, and PUV had jobs. PUV is the same size as Inukjuak, but it seems to have more problems as well. Both towns are friendly, but there are more jobs and money here, and it seems, more alcohol, drugs and violence. It may be my perception, and certainly it is nothing like a large town in the south, but the demeanor here is different than in the other villages. Having said that, I am liking it here just as much as in Inukjuak. It has its own flavour and character, as do all the northern villages.
To finish the medevac story, the woman we picked up in Umiujaq was with us til about six thirty that evening, when a Challenger jet came to take her and another patient to Montreal. I got home about seven and was called again at one thirty in the morning to go back to Inukjuak for another patient. The flying isn’t exhausting, but everything around it is. Getting ready, getting equipment, knowing the general information about the patient you are going to get, but not really knowing what you will be doing, and generally flying by the seat of your pants (pun). It does make the work a little more exciting. I am sure that if we have any normal births, (no births so far) it will be even more fun to be here.
So, I am enjoying the wind and rain and sun, the plants and ocean, knowing that by a month from now the temperature will have dropped and we will be experiencing very different weather. The berries will be picked and mushrooms harvested, and everyone will be getting ready for winter. Until then I will just observe all the wonderful changes of the north.
Saturday, July 17, 2010
Today was a beautiful day. It is July 17th and I decided that a walk to the “waterfall” would be good. I also went last weekend, but it was raining and horrible. My thought was that the bugs would not be there to bother me. Wrong again. This weekend the wind was blowing at 35-50 km an hour so the bugs were not too bad. They were so bad this week that yesterday I ordered the “original bug shirt” which I am hoping will come asap. It has screens so you can zip up a hood and not be bothered by bugs in your face. It also has screens in the sides so you have lots of air and mobility.
In the south we would call the “waterfall” rapids. They are beautiful and the walk is probably about 2-3 km, along the Inukjuak River. Going along the road from this house to the beach I followed the road to the airport. This is a friendly little town and everyone says hello, or waves from their atvs and cars. The road is paved, but has large potholes that everybody drives around, so you have to be careful when you are near these, and give vehicles a wide berth.
As soon as the houses end the flowers start. It is quite amazing how large they are in comparison to Rankin. Today I was thinking that some of these very large flowers looked like the Arctic Saxifrage in Rankin, but much bigger. As you approach the turnoff for the river and sandbank, where there were people fishing, there were many more flowers and bushes.
The walk itself is along the river, and you can either walk along the top of the bank or on the rocks by the water. I chose to walk along the rocks today, and last weekend walked part way along the rocks as well. Only problem last weekend was that they were quite slippery. Today, they were not, but you had to watch your two feet much of the time, to avoid them moving...same as on any river trail.
Of course, there was no shade today. There are no trees. This week I did a comparison of latitudes because I was interested in where villages were in relation to each other, on opposite sides of the Hudson’s Bay. Although Inukjuak has no trees, it is further south than Churchill, which does, they are only a few minutes of latitude apart. Puvirnituq is about 2 degrees north of here...about 140 miles and Rankin is about 4 ½ degrees north of here, so about 310 miles north of here. It is obvious that latitude is not the only factor in “no trees”. The breeze was beautiful and part way there I took off my jacket, and rolled up my short sleeves to try and get a tan.
From the time I turned off the road until I was back in the village birds were screaming at me. I think they nest in the small bushes or rocks. They were most annoyed with me travelling through their territory. I would have liked a photo, but they were not sitting still long enough for that. If they were bigger I think their tactic would have been dive bombing!!
As you get further along the river, there in one section where walking on the rocks is difficult. I did it today but last weekend did not. I chose to walk along the top of the embankment instead, where there were masses of small bushes, lichens, and berries. At first I thought I was walking on moss, and then looked more closely and realized that they were berries, which now I know to be cloudberries, and they make wonderful tea.
Today the walk was along the river itself, and sitting on some of the rocks just watching the world go by. Last weekend there was a man fishing, in the rain, on the other side of the river, by the falls. He got there by red kayak, and during the week, when discussing weekend activities, realized it was one of the docs who is here. He if permanent, more or less, going to a number of villages but living basically in Inukjuak, and has the comforts to make life fun here. He said he caught two fish, and there was a huge one that got away.
One can well imagine that large fish inhabit this river. It is deep in sections, and quite flat, as is the land here. There are seals that come and hunt/fish in this area, and I was very excited this week to see one while out, just fishing around the river. I suspect that is not a good activity for seals here, as they are hunted and eaten. However, hopefully, that one was not. I know it is not terribly exciting to see seals when you live on the east or west coast, however, as I had seen almost no wildlife in the Arctic, it was great to see...even a seal.
There are actually two rapids, not very far apart. They are quite pretty, and I expect would be fun to “run”. Today the whole area was green and verdant. It was surprising how much greener it can get with rain, only because it already seemed so green.
Both walks I came home by the top of the embankment. Last weekend was a mass of bugs. I had on a waterproof/windproof jacket with long sleeves, and spent my time trying to keep them away from my face. It was so bad that when I tried to take a picture, I had four mosquitoes on my hand. Quickly put my camera away and pulled hands back into my sleeves once the picture was taken. Today it did not seem to be too bad, but surprisingly, since there was so much wind, there were little flies up on the embankment. Luckily they were nothing like the mosquitoes last week.
I came home very happy to have gone both times, and enjoying the beautiful sunshine, today, and the lovely scenery.
Saturday, July 10, 2010
THE FIRST WEEK IN INUKJUAK
First weeks in new communities and at new jobs can be challenging. Inukjuak was no exception. I arrived Friday afternoon, and later than expected, since I was not expected! Nobody met me at the airport, and there are no taxis here. The health centre has a driver who picks up and drops off, and in a pinch, so do nurses and other staff.
My first afternoon started at 16:00 and everyone left at 17:00. That seems to be the same all over the Northern areas. The midwives were still seeing some clients on Friday afternoon at this time, because they had three births last week, so we still doing post partums. And all visits were done in Inuktituk. It was interesting to watch, as the student midwives conducted part of each visit.
At 17:00 I was given directions back to my house...not too difficult as Inukjuak only has a population of 1700 so is quite small. I walked up the road from the health centre, past the co-op on the right, and the municipal office, also on the right, then the school was on my left and I turned right just by the church. There is only one school and only one church in this village, so that was easy. My building was the green one just down the hill from the church. It was easy. But I needed groceries, and was told that the Northern, just below (down the hill) from the Co-op had more produce and better prices. Prices were much better, on many things than Rankin Inlet. Of course I was not as far north. Transport prices depend on how far north you are, at least in Nunavik. That was not so noticeable in the Kivalliq, the region where Rankin, Coral Harbour, Repulse Bay and Arviat are located.
The weekend was a write off. I got settled, cleaned, went shopping and for a walk. I had no internet service and no TV so was a bit on my own. It worked out fine though. Read all the “Welcome to Inukjuak information and the orientation to the work here. Found out on Monday that it was almost all old and not relevant anymore!! It talked about the role of the “southern” midwife being to teach and supervise the students, plan education for the midwives and help out as necessary. By Tuesday it was very clear that I was here as a locum, and mainly to be a second midwife at births.
I was asked what my specialty was. The student who was here this week actually came and asked me to do something for her on routine lab work. The program here is totally apprenticeship, and although there is quite a lot written, doing a hand out on the routine lab work here was very useful to me. There are tests they do here routinely that I have not heard of previously. So, my computer came to work with me, and I prepared a handout of all the tests routinely done here, and why they are done.
The biggest insight for me was that the Midwives are not necessarily familiar with why they do tests, but just that they are protocols, they have been told to do them, and they do. So, the job entails being on call for births, doing the odd bit of education, and sitting on your thumbs, or doing whatever has not been done. There are three midwives here, two student midwives and they appear to do about 40 births a year.
The health centre staff work largely in French. (This is Quebec after all.) The nurses and doctors are bilingual, English and French. The Inuit are largely bilingual, English and Inuktituk. There are also clerk/translators who work the front desk and help as necessary with translation. The health centre is very friendly.
The town is small, and the Midwives said that Inukjuak has the largest population on social assistance in Nunavik. The houses all appear in relatively good condition. In this community there is no pumped water or sewage. The water and sewage trucks come to the houses every day but Sunday. (We do not do laundry on Saturday or Sunday because of this.) The water comes from up the Inukjuak River, and I am not sure how they get it here. When walking today I saw a building called the water building, and am wondering if water is actually pumped there and then delivered by the trucks. Sewage is taken daily, by small tanker truck, to the sewage lakes. It is allowed to settle there, and I understand that it goes from there to the ocean, eventually.
In orientation books it said that you need to boil the water before you drink it here. By Monday I asked the midwives if they did this for their families. No, they did not. They suggested that I might want to because my body might not be used to some bacteria they had here. I had boiled water before making tea and coffee, and had already started a routine of boiling a kettle in the evening, then moving it to the Brita in the fridge before I want to bed. That way I had boiled drinking water. What I did not realize is that the water is to be boiled for fifteen minutes before you drink it. There would be nothing left! I am now boiling water for tea and coffee, and at night boiling some for the brita. So far, I have no stomach bugs from the water.
Roads here are mostly paved. The people drive, mostly, ATV’s. These do not have to be licensed, and nobody wears helmets. There are some cars on the road, maybe one to every seven or eight ATV’s. The boats are bigger than they were in Nunavut. There are lots, and they use E-Z loaders and pull the smaller ones behind their ATV’s. Today, while walking, I watched a woman with a trailer behind her ATV, pulling camping gear and children. The average number of people on an ATV is probably 3. Although lots of people are sole drivers there are also lots with three and four people on them.
There are few dogs visible here. Apparently they all live out of town, where they will not bother anyone with their howling, and someone goes out and feeds them every day or two. I have seen no cats, and no wildlife, other than birds and bugs.
Although it can be windy here, it is nothing like the places I visited in Nunavut. There definitely are bugs, and I am using bug spray, which is not making a lot of difference. There are mosquitoes, same size as in the south, and black flies, and these tiny bugs that swarm you when you walk. It is annoying, but part of what I should have anticipated. Bugs bother the Inuit as much as they bother the southerners. Yesterday someone left the back door of the health centre open, because it was muggy. We closed all our doors, and still somehow we were swatting moszies all afternoon. Finally one of the Midwives declared that if there were two more we should close the door. It was closed about three minutes later!
The land here is beautiful. There is more definition that Rankin had. Inukjuak is on the end of a peninsula between the Inukjuak River and the Hudson’s Bay. There are Islands off the Bay side. It is not as cold as Rankin, being further south, and so has more flowers and bushes, and they grow larger. Today, while walking, I saw lupins and daisies. The daisies were 3-4 cm across, which is very large by northern standards. There was also Arctic cotton, but it was a good fifteen inches tall. The lupins were not huge, but were over a foot tall, with beautiful purple and pink colours. The only flowers that reminded me of Rankin were tiny white stars, and they are the same size, but taller. I suspect the height is due to less wind and less cold. There are also grasses, not to make a lawn, but marsh type grasses. When you look across the river you see grass green.
The weather is cool. It has been foggy for several days, rained twice and have needed my hoody and waterproof jacket two days. Two days it was also warm enough to not have on a hoody...except for the bugs. The teens and children swim in the river. One of the interesting things is an upside down sled, extended, and used as a pier. Watching some teens one day is when I realized they dislike the bugs as much as others. The swearing as they got out of the water and were trying to swat them was English. I had thought all the words myself!
I am understanding why the “southern” midwives say they use Inukjuak as a retreat. There is a hotel here, but no restaurant or coffee shop. There is no industry. The people fish, hunt and carve, or not. There are a few jobs in the Co-op, the Northern, the arena, pumping gas, sewage and water and for the municipality. There are a few jobs at the health centre and at the half way house for mental patients. Other than that, there is not much happening here, relating to work.
This village, like many Inuit villages, has a much smaller population in the summer, because the families are out on the land. Where exactly, I am not sure. Walking today, I did get to the outskirts of town, which is not far, and the roads turn to gravel and there were many ATV’s and some cars going along them. If I am lucky, maybe it will be a trip I take before I leave this little village. In the meantime I am enjoying what is here and the slow pace of the workload and friendly smiles and hellos of the people.
Wednesday, July 7, 2010
Flying used to be exciting. Sometimes it still is, but more in the destination than in the flying itself. The first three or four times I flew to Europe, there was adrenaline pumping just getting on the plane. It is not like that any more. Now it is getting organized, figuring out what I need on the plane, or what I have to take because of weight restrictions, and just doing it. Lots of waiting, in the check-in line, in the security line, at the gate, going to have ID checked, and finally, at the plane itself, waiting to get to my seat.
Still the idea of the new place is exciting, and coming to Inukjuak was no exception. Leaving Vancouver is always interesting. The mountains and ocean are beautiful, as long as you can see them before cloud cover. On this trip the cloud cover was quite low. So, it was sea, low levels of mountains, and then clouds. I had a good book, “Plain Truth” by Jodi Picoult, and was very glad. I had some snack food. Had planned to have sandwiches, but had managed to burn the cauliflower, while I was multitasking before leaving. Obviously my multitasking ability is disintegrating, or maybe it was just trying to get one too many things organized. I did have cherries.
Over the prairies the clouds dissipated somewhat, so patchy fields could be seen some of the time. Then we hit clouds again, so could see patchy lakes through northern Ontario, and haze over the Ottawa Valley. The allergy index there much have been really high on the first of July, as we could see the shimmer and colour of poor air quality. Then finally we arrived in Montreal.
The airport was much smaller than I remembered, but have only used it previously on international flights, and this was domestic. It took over half an hour for the luggage to begin to arrive, and about two thirds of it was off in another ten minutes. And then the rest of us waited. Finally it all came. However, the end zipper on my hockey bag had broken, so the whole end was open. Don’t think anything fell out, as it was wool and food, but probably will not know for sure until I realize that one specific thing is missing. Had thought that if it opened there might be wool unwinding all over the conveyor belt...now that would have been a sight.
Outside the terminal I asked somebody where the hotel shuttles came. They told me and I went to look for mine. There were two...one for the Hilton and one for another hotel. Finally I asked someone if he knew when the one to Quality Inn came by. He asked which Quality Inn? I got out my paperwork and he said that was his hotel. Turned out the sign for the Quality Inn was small and on the door of the shuttle to the Hilton. They are next door to one another. So, got my own personal shuttle to the hotel. The driver was great. He helped with the luggage, and after a tip he found me bags for the items in the pocket of the hockey bag.
I checked in, and pushed the airport style luggage carrier to my room. On the way there was a man carrying two “Coronas”. I asked where he got them, and he replied, “In the Bar of course”. Of Course. In Quebec you can carry your drinks to your room, and enjoy them there. I went to the bar, and enjoyed my corona there!!
It was now 23:30 Quebec time. I had a 05:45 wake up call as I was catching the shuttle back to the airport at 06:30. The driver had suggested that I could go at 06:00, which was appropriate for an 08:00 flight, but that if I did mind going quickly, the later shuttle would be fine. Problem was that in BC it was only 20:30. I read, watched TV and turned off the light about an hour later. And of course, nothing happened. So by 04:15 I gave up, got up and messed around in the room until the wake up call. Had morning coffee, decaf, in the room, and headed downstairs, having repacked my baggage, for 06:20.
The evening before had packed all the excess into plastic bags inside a big plastic bag. Realized in the early morning that Inuit air was not concerned about how much bags weighed. I did not have to worry about overweight the same way, and the overweight piece had been the hockey bag. I put bags of wool into my suitcase and managed to get it all in. My hockey bag looked a mess, but it was closed, and nothing would come out the middle part. (And it will be replaced before my next northern exploit).
I went to the airport, and checked in. The small misadventures occurred again. The quote I had of $6.15 per kg for overweight was to the first destination of the plane. There were four, and Inukjuak was last, so it was $13.00 per kg. Oh well. I had already decided that it was all coming. I only had 53kg, which was 23kg overweight. I did not mind. Luckily, they do not weight your carry on baggage!!
Went to the gate, and thought I would check out the one concession stand in this small part of the airport. They were very slow so did not get the yoghurt parfait, and was later very glad. Our flight was called. We walked to the plane, following the instructions to stay within the white lines. (For those of you who have not flown in small planes, they do not come to the regular gates. You go outside, rain, shine, or snow, and walk to them, and up the stairs. Usually they are also parked at the ends of the terminals, so you have to walk further to get to the gates they are at.) There was no seat designation, and I had two seats to myself the whole way to Inukjuak. I must have been giving off the “leave me alone” vibes really well.
And then the adventure began. Leaving Montreal was great, and there was lots to see as there is leaving any big city. However, clouds were probably at about 2000 feet, so once above them, it was time to read again. There is a magazine in the north called “Above and Beyond”. I think First Air actually publishes it, but they had it in Inuit Air flights. It was a particularly good issue, with an article about an elder who lived in various places in the North and about finding dinosaur bones in the Arctic.
Almost as soon as we left we were served breakfast. They offered hot or cold. The hot was eggs, so I chose the cold. It was vanilla yogurt with oranges, orange juice, a croissant with three kinds of cheese, fruit and cretons. A very nice breakfast, and was so glad that yoghurt parfait had not been purchased.
As we went over northern Quebec the cloud cover disappeared, and we could see the forest below, and many lakes. It was beautiful.
Our first stop was to be Kuujjuarapik, and it was a three hour flight there. As we were getting closer it was noticeable that there were still trees. Once we landed and could see them, they were Churchill type trees, but with greater girth. They were mostly 3-6 feet high, but quite round, as there was less wind there than in Churchill. There was also masses of water, but the rock underneath the surface was mostly red, so it was like looking down on these red lakes with tiny trees all around. When you fly in BC the trees do not seem individual, because there are so many. Flying into this village the trees all looked completely separate.
We had to refuel in Kuujjuarapik, and were told it would take 30 minutes. I got out my camera to take pictures of the trees. Went out of the terminal and put the camera on, and to my eyes to focus...battery empty. So, you will not see pictures of the little Christmas trees.
After about an hour we were to get back on the plane. I was surprised because in this airport they had security. There was nobody manning it, but there were lots of signs about what you could and could not take. Our plane only had 30 seats, so perhaps they have some larger planes and have security for those. This is the first northern town where I have seen anything about security.
We then had a thirty minute flight to Sanikilluaq. Sani, as it is affectionately known in Rankin Inlet, is actually part of Nunavut, rather than Nunavik (northern Quebec). It is on the Belcher Islands. Flying into the area was really interesting. There were small icebergs all over the area, and probably the sea ice was just breaking up. There were also patches of snow everywhere. (It was July 2nd so thought that might have all disappeared.) We did not get off the plane, and could not see much of the village from the airport.
Our third stop was thirty minutes away in Umiujaq. There were lots of snow patches going into the airport but no ice. Again we did not leave the plane.
And finally we were on to Inukjuak. I realized that I was getting excited. Lots of anticipation about what this village would be like, where I would be staying for a month. There were patches of snow, but no snow ice. The terminal was tiny and very crowded. They had a conveyor for the luggage but it was about 6 feet long so everything was taken off as it arrived. There were lots of people in this tiny space, and outside smoking. Turned out that this flight turned around and went back, and everyone had to change flights, to go further north.
My luggage finally came, but there was nobody from the health centre to pick me up. I sighed and asked at the desk, when they were less busy, for the number to the health centre. They said someone had been there, but had left. I tried to call. Kept getting the “please hang up immediately and try again later” message. Of course, it was said first in Inuktituk, then in French and thirdly in English. As the flights left, and there were only two or three of us left in the terminal I went and talked to the clerk again. I had not been calling the area code. This time I got through first time.
The health centre had been expecting me on Saturday, and not on Friday. They came to get me, dropped my luggage off at my apartment (a one bedroom, for me only), and drove me to the health centre.
Once again flying has taken me to another adventure, and another place and time. I am truly looking forward to this month in Inukjuak, with the midwives, the beautiful scenery, the lovely women, and just being North again.
Still the idea of the new place is exciting, and coming to Inukjuak was no exception. Leaving Vancouver is always interesting. The mountains and ocean are beautiful, as long as you can see them before cloud cover. On this trip the cloud cover was quite low. So, it was sea, low levels of mountains, and then clouds. I had a good book, “Plain Truth” by Jodi Picoult, and was very glad. I had some snack food. Had planned to have sandwiches, but had managed to burn the cauliflower, while I was multitasking before leaving. Obviously my multitasking ability is disintegrating, or maybe it was just trying to get one too many things organized. I did have cherries.
Over the prairies the clouds dissipated somewhat, so patchy fields could be seen some of the time. Then we hit clouds again, so could see patchy lakes through northern Ontario, and haze over the Ottawa Valley. The allergy index there much have been really high on the first of July, as we could see the shimmer and colour of poor air quality. Then finally we arrived in Montreal.
The airport was much smaller than I remembered, but have only used it previously on international flights, and this was domestic. It took over half an hour for the luggage to begin to arrive, and about two thirds of it was off in another ten minutes. And then the rest of us waited. Finally it all came. However, the end zipper on my hockey bag had broken, so the whole end was open. Don’t think anything fell out, as it was wool and food, but probably will not know for sure until I realize that one specific thing is missing. Had thought that if it opened there might be wool unwinding all over the conveyor belt...now that would have been a sight.
Outside the terminal I asked somebody where the hotel shuttles came. They told me and I went to look for mine. There were two...one for the Hilton and one for another hotel. Finally I asked someone if he knew when the one to Quality Inn came by. He asked which Quality Inn? I got out my paperwork and he said that was his hotel. Turned out the sign for the Quality Inn was small and on the door of the shuttle to the Hilton. They are next door to one another. So, got my own personal shuttle to the hotel. The driver was great. He helped with the luggage, and after a tip he found me bags for the items in the pocket of the hockey bag.
I checked in, and pushed the airport style luggage carrier to my room. On the way there was a man carrying two “Coronas”. I asked where he got them, and he replied, “In the Bar of course”. Of Course. In Quebec you can carry your drinks to your room, and enjoy them there. I went to the bar, and enjoyed my corona there!!
It was now 23:30 Quebec time. I had a 05:45 wake up call as I was catching the shuttle back to the airport at 06:30. The driver had suggested that I could go at 06:00, which was appropriate for an 08:00 flight, but that if I did mind going quickly, the later shuttle would be fine. Problem was that in BC it was only 20:30. I read, watched TV and turned off the light about an hour later. And of course, nothing happened. So by 04:15 I gave up, got up and messed around in the room until the wake up call. Had morning coffee, decaf, in the room, and headed downstairs, having repacked my baggage, for 06:20.
The evening before had packed all the excess into plastic bags inside a big plastic bag. Realized in the early morning that Inuit air was not concerned about how much bags weighed. I did not have to worry about overweight the same way, and the overweight piece had been the hockey bag. I put bags of wool into my suitcase and managed to get it all in. My hockey bag looked a mess, but it was closed, and nothing would come out the middle part. (And it will be replaced before my next northern exploit).
I went to the airport, and checked in. The small misadventures occurred again. The quote I had of $6.15 per kg for overweight was to the first destination of the plane. There were four, and Inukjuak was last, so it was $13.00 per kg. Oh well. I had already decided that it was all coming. I only had 53kg, which was 23kg overweight. I did not mind. Luckily, they do not weight your carry on baggage!!
Went to the gate, and thought I would check out the one concession stand in this small part of the airport. They were very slow so did not get the yoghurt parfait, and was later very glad. Our flight was called. We walked to the plane, following the instructions to stay within the white lines. (For those of you who have not flown in small planes, they do not come to the regular gates. You go outside, rain, shine, or snow, and walk to them, and up the stairs. Usually they are also parked at the ends of the terminals, so you have to walk further to get to the gates they are at.) There was no seat designation, and I had two seats to myself the whole way to Inukjuak. I must have been giving off the “leave me alone” vibes really well.
And then the adventure began. Leaving Montreal was great, and there was lots to see as there is leaving any big city. However, clouds were probably at about 2000 feet, so once above them, it was time to read again. There is a magazine in the north called “Above and Beyond”. I think First Air actually publishes it, but they had it in Inuit Air flights. It was a particularly good issue, with an article about an elder who lived in various places in the North and about finding dinosaur bones in the Arctic.
Almost as soon as we left we were served breakfast. They offered hot or cold. The hot was eggs, so I chose the cold. It was vanilla yogurt with oranges, orange juice, a croissant with three kinds of cheese, fruit and cretons. A very nice breakfast, and was so glad that yoghurt parfait had not been purchased.
As we went over northern Quebec the cloud cover disappeared, and we could see the forest below, and many lakes. It was beautiful.
Our first stop was to be Kuujjuarapik, and it was a three hour flight there. As we were getting closer it was noticeable that there were still trees. Once we landed and could see them, they were Churchill type trees, but with greater girth. They were mostly 3-6 feet high, but quite round, as there was less wind there than in Churchill. There was also masses of water, but the rock underneath the surface was mostly red, so it was like looking down on these red lakes with tiny trees all around. When you fly in BC the trees do not seem individual, because there are so many. Flying into this village the trees all looked completely separate.
We had to refuel in Kuujjuarapik, and were told it would take 30 minutes. I got out my camera to take pictures of the trees. Went out of the terminal and put the camera on, and to my eyes to focus...battery empty. So, you will not see pictures of the little Christmas trees.
After about an hour we were to get back on the plane. I was surprised because in this airport they had security. There was nobody manning it, but there were lots of signs about what you could and could not take. Our plane only had 30 seats, so perhaps they have some larger planes and have security for those. This is the first northern town where I have seen anything about security.
We then had a thirty minute flight to Sanikilluaq. Sani, as it is affectionately known in Rankin Inlet, is actually part of Nunavut, rather than Nunavik (northern Quebec). It is on the Belcher Islands. Flying into the area was really interesting. There were small icebergs all over the area, and probably the sea ice was just breaking up. There were also patches of snow everywhere. (It was July 2nd so thought that might have all disappeared.) We did not get off the plane, and could not see much of the village from the airport.
Our third stop was thirty minutes away in Umiujaq. There were lots of snow patches going into the airport but no ice. Again we did not leave the plane.
And finally we were on to Inukjuak. I realized that I was getting excited. Lots of anticipation about what this village would be like, where I would be staying for a month. There were patches of snow, but no snow ice. The terminal was tiny and very crowded. They had a conveyor for the luggage but it was about 6 feet long so everything was taken off as it arrived. There were lots of people in this tiny space, and outside smoking. Turned out that this flight turned around and went back, and everyone had to change flights, to go further north.
My luggage finally came, but there was nobody from the health centre to pick me up. I sighed and asked at the desk, when they were less busy, for the number to the health centre. They said someone had been there, but had left. I tried to call. Kept getting the “please hang up immediately and try again later” message. Of course, it was said first in Inuktituk, then in French and thirdly in English. As the flights left, and there were only two or three of us left in the terminal I went and talked to the clerk again. I had not been calling the area code. This time I got through first time.
The health centre had been expecting me on Saturday, and not on Friday. They came to get me, dropped my luggage off at my apartment (a one bedroom, for me only), and drove me to the health centre.
Once again flying has taken me to another adventure, and another place and time. I am truly looking forward to this month in Inukjuak, with the midwives, the beautiful scenery, the lovely women, and just being North again.
Tuesday, May 11, 2010
Finally, Going to Sleep in the Igloo!!
I could not believe my good luck. After last weekend, which was the last weekend that we could arrange for me to be off call, and the blizzards that happened that week, there definitely seemed to be little chance of me going out and sleeping in the igloo. Then the Midwifery Supervisor said to me…”of course, we will try and arrange it. We can have a nurse go on call for you”. The excitement was palpable, except that after all the hype I really thought it would not happen, again.
Luckily I was wrong. Where the previous weekend, which was Easter we had planned to go on Friday, with a default on Saturday, and another on Sunday, this time, we were going Saturday after activities that needed doing. It meant not leaving until 17:00. Late, I thought.
So at 17:00 I went over to Dawn’s home. She and Leslie were coming along with Taffy, one of the dogs. Originally Dawn said we would take Mitzi as well, for our own entertainment. Mitzi is a puppy, about 6-8 months old. It would have been hilarious watching her help pull the komatik (sled), as she LOVED to pull, but had no idea about anything except playing with other dogs. However, she was having her first heat, so that would not work with the other dogs, many of whom were still male.
Dawn and Leslie had everything packed, so we moved it all (food, clothing, rifle, first aid kit, etc) out to the sled and the skido, which Leslie was riding, and packed it down. We then untied Taffy, said goodbye to Mitzi and Jack (another dog), and pulled the sled behind the skido to the dog lot.
The sled dogs heard us coming and were so excited. They always are. These dogs love to race or pull, depending on their strength and the length of their legs. Those with longer legs and shorter fur usually race (and are known for being less smart). Those with longer fur usually pull. We repacked everything onto the komatik and the skido (although I had unpacked the skido thinking we were all going on the komatik, and then it was repacked). The dogs were put into harnesses and then ran, or were walked to their places. Dawn ran to the back of the komatik and we were off.
We raced out of Johnson’s Cove and around the bend, then as the dogs had finished their initial burst of energy we went past Rankin, and through the skido racing area. The sun was beautiful and sun dogs were present as we rode along. Due to the blizzards that week the sea ice was quite rough. We had to watch where we were going as the komatik was up and down with the drifts. The dogs tried to go around most of them, or avoid areas with unstable drifts totally. This is one of the jobs of the lead dogs, to sort the exact route.
About two hours later, we could see a group of rocks ahead of us. It did not look like there was any way through the rocks. The skido came over and Leslie asked where the route was. As we got closer it was obvious, and, of course, the dogs knew exactly where they were going. Through the rocks and the cabin was soon visible. The igloo was built behind the cabin, so that persons going on Toomie tours could have the opportunity of staying overnight.
We arrived at about 20:00. It was beautiful. The sun was still relatively high in the sky. The sundogs were around the sun. The snow was brilliant. We tethered the dogs, except Taffy. She had free range as she was the look out. If a polar bear came nearby she would warn us, and Dawn could go out with rifle and scare them away. The rifle was strictly for protection on this trip. We then went around the cabin and down to get ice for water and check out the igloo.
It was sad. You could tell where it had been, and that it was not in good shape. Dawn put a foot on the top and it caved. It is not supposed to do that, but the sun had been so hot that it had melted. We could see the furs still in there, where we would have slept. Apparently they were well used, as the dogs, Taffy and Jack, had been loose on a previous trip and had decided to sleep on them, and bite them, and tear them apart. So, really there were bits of fur on the sleeping ledges. I took some pictures and accepted the fact that we would be sleeping in the cabin that night.
As we went back Dawn picked up a piece of ice, slung it over her shoulder and walked. A very funny sight, sort of like a caveman, with his ice over his shoulder. This though was ice from a lake that had been cut especially for water, and we would be melting it on the coleman stove. It was our water supply for the night.
We went inside. The cabin is small. It is one room, with a small loft for sleeping, which would not be good if you were claustrophobic. The ceiling was about 3 feet high above the sleeping pad, in the middle. Sleeping bags were good to 100 below 0 so we knew we would be warm. Needless to say, when we finally went to bed, we did wear hats, sweaters and long underwear, and took hot water bottles.
But first, we had to warm up. The cabin heated up remarkably quickly with the coleman stove. We started out in jackets, vests, sweaters, scarves and slowly took everything off. The water was melted, and we also had tea left in the thermos, so fortified tea was the first order. Then we had supper...rockin morrocan stew...a mix of yams and chick peas with assorted other veggies. By 21:30 it was dark. We went outside and were greeted by the Northern Lights. This is not usually a good time for them, but they were gamboling across the sky beautifully, just for our night out. While we were out Taffy decided to get off the fur of the komatik and come and visit, or maybe pretend that she was guarding us well.
(One of the questions everyone has is about voiding when you are out. There are no facilities. It is -10 or colder. What do you do? You find a place downwind, and you are FAST. Everyone is concerned about how cold they will get, but really, it is your hands that get cold. Everything else stays okay for the one or two minutes you are bare.)
We played Sequencing, a good card game that is easily played by the light of a Coleman lamp, and then decided to retire.
There was no noise at all. In the forest you hear the trees shuffling in the wind. You hear birds singing, and animals pawing. In the snow above the tree line, you hear nothing. Luckily, for us, we continued to hear nothing through the night, there were no polar bears.
Morning came, but not so early. We were up about 7am. Time for breakfast...eggs, bannock, toast and oatmeal. Delicious. We messed around in the cabin, cleaning for the next folks to use it, talking, laughing and then packed up.
I had been trying, for several weeks, to take a video of the dogs, as they left. They are so excited and cannot wait to get going. As we packed the komatik the dogs started to stand up and get excited. Some started to shake. They knew what was happening. After everything was packed up, we attached them to their ropes, fan style. One needs to understand that this has to be a very fast process. The brakes on the komatik will not necessarily hold back the dogs, as they love to run. Once the last dog is in their place, everyone has to be in their places except the musher. They then have to run to the back of the komatik, release the brake, or untie the sled and you are off. And it is fast.
Coming out to the cabin had not been such fun for the dogs. The temperature was almost up to 0 degrees, and they are not as comfortable in that. This morning it was -10 and that is a very happy temperature for them.
Dawn jumped on the komatik, yelled "ati", although that was almost unnecessary. The dogs can feel as soon as the sled is loose and are off.
We passed all the same sights, in reverse. I had given my camera to Leslie and she took some good pictures and videos of us riding back to town. We had brilliant sunshine again, and another beautiful Arctic day. The sea ice was no smoother, the skido riders were practicing, and the dogs were happy.
We unloaded everything, put the dogs back in their places in the dog lot, and left them very happy. We all headed home for showers and late lunches.
Although sleeping in an igloo had been a great dream, the trip itself was amazing. One day, I may be lucky enough to actually sleep in an igloo, but for the moment, dog sled rides, and being "on the land" is enough. It was a fine adventure.
Saturday, May 1, 2010
The Drumdancer Competition
THE DRUMDANCER COMPETITION.
The drumdancers and singers themselves sat at the end of the centre and in chairs in the middle of the centre. Observers sat around the edges and some on the floor, mostly children. There were many elders that I had not seen previously, and everybody also brought their children. So, lots of activity was happening. 
Drums have always been one of my favourite things. Most people seem to feel the same way. Nothing is better than bagpipes and drums, except perhaps drums by themselves, although the bagpipes add such an eeriness that you feel your kundalini energy rising in your backbone when you listen to them.
So, when I heard there was a drumdancer competition coming to Rankin I was totally excited. And then I heard it would be after I left. Yes, "I heard" is the correct way to describe this event. Nobody seemed to know about it until a few days before it was announced, other than that there was to be one. One of the reasons, for sure, that people did not know about it, is that many of my friends do not speak Inuktituk, and so do not listen to local radio, which they could not understand, but which makes all the announcements for the community. (Local radio is 
great.)
great.)You can phone in with an announcement at any time. They will put it on, and replies, may come in. Some divers wanted meat...it was put on the air, and they received muskox, caribou, whale. I wanted a bear carving, so another midwife put out the announcement that if you had a really nice bear carving to come to the Wellness centre the next day at 11. My carving arrived. It works very well. You can also hear announcements like...Lila Tatty, phone home. Local radio is a great communication tool.
One of the Midwives mentioned at work one day that the Drumdancer competition started that evening. Okay, what time...don't know, where...community centre, and they would listen to the announcements and let me know.
That afternoon we learned it started at 6:00. When would it end....when it did!! Obvious. So that night I went over to the community centre at 7:30 and it was in full swing. At first it was interesting to watch everything that was going on.
The drumdancers and singers themselves sat at the end of the centre and in chairs in the middle of the centre. Observers sat around the edges and some on the floor, mostly children. There were many elders that I had not seen previously, and everybody also brought their children. So, lots of activity was happening.The first night I was mesmerized by the singers and the drumming itself. There were about 6-10 singers that rotated in and out. They sang different chants, which I later learned were the stories that the drummers were acting out. The singers ranged in age from teenagers to elders.
There were also a few women. The Midwives said that it was actually traditional for some women, but not many to be storytellers.
The drumdancers, I later learned, did not actually hit the fabric part of their drums, but rather the frame. The frames were moved back and forth so they could hit first one side and then the other.
After the 
competition was over one of the Midwives was travelling, and taking a drum to a friend. She told me that she had helped make it and it took at least four people. You had to take the wood and bend it, by hand, to form a ring, and then cover it with fabric. They were all fabric, although older pictures show them as fur. Drumdancing is quite strenuous, and a fur drum would be heavy and harder to use.
competition was over one of the Midwives was travelling, and taking a drum to a friend. She told me that she had helped make it and it took at least four people. You had to take the wood and bend it, by hand, to form a ring, and then cover it with fabric. They were all fabric, although older pictures show them as fur. Drumdancing is quite strenuous, and a fur drum would be heavy and harder to use.At the end of the evening I left with many questions. Most of the answers came from our receptionists and Midwives the next day. One of the most important questions was about shamanism in the North. Drumdancers, though, are not shamans, but story tellers. There have always been a few female drumdancers. They dance to various legends, and talk about hunts, but different areas have different costumes, different looking drums, and different types of legends. 
One of the dances was done by an elder man and woman team. The woman was dancing and the man singing and drumming. After a time they switched places.
The competition went on for four nights. The third night it was followed by a square dance. Wanting to see this for myself, as there were many reports about them, I went to the community centre at 21:30. It was supposed to start at 21:00. Many adults were there, from teens to elders to dance, but the dance had not started. The drumdancers were putting on an impromptu performance, as there were so many people there, and no dancing yet. The square dances do not have callers. Many people say they are more like jigs, in that everyone knows the moves and goes out and dances. Apparently they are strenuous and everyone is in a sweat within five minutes of the start, and each dance goes on for at least twenty minutes. One of the nurses told me she had been asked to dance, and had literally been manoeuvred around the floor by all the dancers in her square. She said it was very hectic, and much fun.
The Friday night there was a community feast. I had been to two previously and knew that was not a place for a vegetarian (me), so had not gone. Feasts had changed somewhat in my nine months in the north. They now usually had servers. This one did not, and was much more traditional than most. The floor was laid out with large pieces of cardboard and the meat was placed on it for everyone to eat. The meat was raw or frozen, as is traditional, and you cut off what you want with your ulu, and usually eat it with your hands. I later wished that I had been there, since this does not happen all the time, but was similar to the Elder's picnic that was held just after my arrival in this community.
The feast was to be the end of the celebration, however, it turned out that there was lots of drumdancing after the feast. 
The last night seemed to be the best of the best. It included a demonstation of dancers from Cambridge Bay. This area in the western Arctic has quite different story telling than the east. They had three teens doing the demonstration, two girls and a guy. They took turns dancing, singing and drumming.
This last evening a dance done by a father and son team, with the son, about 6-8 years old was repeated. The young boy danced with his eyes closed, making appropriate yells and screechs in all the right places. They were quite amazing.
I felt very privileged to have been able to attend this event.
Sunday, April 18, 2010
March/April Blizzard
Life in the north involves blizzards!! They happen. The definition seems to be somewhat vague but usually involves low temperatures, low visibility, strong winds and blowing snow. Accumulations may not be big, but the blowing makes all the difference.
There are also Winter storm warnings. Not sure what the diffference is. The weather report at weatheroffice Nunavut (using google search engine) said that Monday March the 29th was a winter storm warning day. It was beautiful. The skies were deep azure and there were not clouds. Photos were taken. It is amazing how quickly things can change.
This was also the day that one of our patients developed high blood pressure. She was in for a regular 35 week appointment and her blood pressure was 152/98. Not terrible if you are near an obstetrician or a hospital. We had neither of these. Winnipeg was phoned. We were told to recheck it that evening and if it was still that high to medevac her out. If not she could take a sched (scheduled flight) the next day.
I went to take her blood pressure early that evening. It was down slightly 148/96, but it did not matter. We were in the beginnings of a blizzard and there were no planes leaving.
Walking to her house was difficult. She lived on one of the few roads that does not connect to main roads, so although she was only a block away as the crow flies, it was about 4 blocks to walk it. The winds were 60km an hour at this point.
Tuesday conditions were slightly better. We went to work, and waited for the e-mail that would tell us to leave work. We cancelled all our babies, as most of the Mum's walked to appointments with their babies in their amoutiq's. Work was not cancelled, but we did wonder how we were going to get home that evening. Road conditions were terrible.
That night there was a birth, and I was second on call. The first on call did not call me. Conditions were terrible. A nurse was sleeping at the health centre and she had obstetrical experience. The first on call midwife had to go and pick up the clients, from a bed and breakfast as they were from a Kivalliq community and not Rankin Inlet. She could not drive into the health centre because the drifts were so bad, and ended up parking at her own home and walking with the woman, her husband and three year old to the health centre. The baby was born less than an hour later.
The next morning I looked out the window and waited for a phone call. Usually they come before 8am saying that work is cancelled for the day. It did not come. Looking out the window I could see about three houses away. The blowing snow was phenomenal. We had no front stairs to our building because the drifts had covered them. Went outside to go to work. I had been advised to walk as the ploughs had not been through.
This week I was taking care of Mitzi, one of the midwive's Norwegian Elkhound puppy, and her house. Went there to make sure she was okay before work. Of course she had managed to wind her chain through the wood of the small porch and was now had the freedom of only about 18 inches of chain. I had to find a knife to push through the slats to free her. Then gave her a treat. And now the ploughs were going through. Figured I could drive to work.
This morning one of our midwives and the maternity care worker were to be at the school for a job fair. Our supervisor was taking a management course at the health centre, and I was to be the only person at the "wellness centre" to manage whatever patients walked in. Wednesday is an administration day.
I picked up the maternity care worker and we drove to the wellness centre. Roads were awful. Snow was flat and you could not tell where many of the drifts were, and many of them were eighteen inches deep. Ploughs had only done one lane on some of the roads, and none on others. You could not pass and at certain intersections you could not see what was coming.
We got to the wellness centre to find that the fair was cancelled, and so were the schools. As a result the midwife had to stay home and look after her 4 and 6 year olds. We also realized that I needed to go back to the health centre to pick up some paperwork. So, we tried again. Roads around the health centre are the worst in town. The wind blows off the sea ice and visibility is really poor, and the drifts are also bad wherever there is any protection at all, as in from the snow piled at the sides of the road. We did make it there, and then chose to drive around town (silly when I look back at it now) and take some pictures.
div>
We got back to the wellness centre about 30 minutes later and did do some work. It was obvious to everyone that it was just a matter of time before the e-mail message came that day. It finally did at 11:15, just announcing that Rankin Inlet government offices were closed until further notice.
Our high blood pressure lady lived very near the health centre and she went there about 10:30 to have her pressue checked. It was again high, but not as bad as it had been. However, she had some protein and some visual disturbances. Basically, there was nothing we could do.
We did get home, and spent the afternoon watching tv, playing facebook, cleaning. That night was stitch and bitch and conditions were somewhat better, in that you could walk, but not drive. Walked to the neighbours house and we had a very nice evening stitching and talking.
The next morning we again waited for the phone call that did not happen. Schools were also in this day. We needed to do a home visit on the woman who had birthed, and again cancelled all out postpartum visits so mothers would not have to walk in. I believe two women were seen that day, at 10am. Two of us went to do the home visit. We could not see driving. Visibility was bad enough that you could only see across the street, and not during gusts. With both of us looking out the car windows we could not see everything coming, and we could not see the drifts. The car that Birthing drives is called the Shitara, as it is older, and small. It made it to the bed and breakfast and back. While there though, we were phoned to tell us that it was now a blizzard day, and the wellness centre was being closed. It was 10:15.
I was on first call, so would need to walk to the blood pressure woman and check her, if conditions got any better. In the afternoon they did for a short period of time, so I walked to her house. I knew the short cuts, but it was still amazing getting there.
In Rankin, you can see where the drifts are, if visibility allows, or you are walking. What you cannot tell is the texture of the snow. You can walk across a drift and not sink into it at all, because the snow is so firm, and suddenly go down to your hip as the texture has changed. It is quite fun, if you are dressed adequately, and not in a rush.
Conditions improved over the next couple of hours, and the storm was supposed to end, and be followed by a very nice Easter weekend. I was going to go out on a dog sled to a cabin, with an igloo and sleep Friday night in the igloo.
By Thursday night, provisions in town were getting low. There was no milk in the stores, and no vegetables, but these were not as missed as milk.
Friday, Good Friday, the sun rose beautifully. Extra flights were put on. Our lady went out (and had her baby the next day. Often flying here seems to put women into labour), and I phoned about timing for dog sledding.
The weather forcast had changed. Now Friday was to be good, but a winter storm warning with high winds was to come up on Saturday. Our options were to go on Friday and plan to come back Sunday. We could wait and go Sunday and come back Monday. Or if the worst came we could go on Monday and come back Tuesday. I knew right away the latter would not work as the call schedule would not allow it.
Luckily we chose not to go. By Friday night we were in another blizzard. We did go dog sledding to exercise the dogs in the afternoon, and it was lovely, but conditions here change so quickly that there was no visibility and heavy winds by Friday night.
As it turned out we had another blizzard from Friday night til Monday morning. It was a very good thing we did not go out. However, conditions were good enough on Friday that several freight flights were made and the town was restocked.
/div>It was lovely to be able to have coffee with cream again, during the second blizzard.
One of the discussions that newbies have soon after arrival here is what to do during a blizzard. The general concensus is...stay home. Do whatever you can at home, but don't go out. We actually had a good time during these two blizzards, because although conditions were bad, you could see far enough...one house, that it was safe to go out, if you were not going too far, and stayed on the roads. We watched dvd's and movies, knitted, crochetted, read and used our computers. It's no wonder that everyone likes blizzard days...occasionally.
Subscribe to:
Posts (Atom)
About Me
- Jennesse
- I am a Midwife who is currently working in the Canadian North. I have been married, a single mother, a military wife, a midwife, a bakery assistant, working in a women's centre, a waitress. I have three grown children, who have seen quite a bit of the world, with their mother.