Some Indigenous communities are too short-staffed to perform lifesaving procedures, McGill study finds.

Indigenous communities in northern Quebec face significant hurdles to healthcare access. The Nunavik region is remote, with limited transportation options and extreme weather conditions. As a result, its population faces lower life expectancy and poorer health outcomes.

New findings from McGill University provide a blueprint to address Nunavik’s urgent healthcare needs by offering concrete evidence for discussions with policymakers.

The study, published in the Canadian Journal of Surgery, examines surgical and trauma care capacity in the region, revealing concerning disparities and the importance of expanding telehealth services. The research team assessed key healthcare facilities, including the Ungava Tulattavik Health Centre (UTHC), the Inuulitsivik Health Centre (IHC), and 12 local community services centres (CLSCs) in villages along the Hudson Bay and Ungava Bay coasts.

Glaring disparities in healthcare access

The researchers scored the health centres on a 10-point scale based on various factors. Across all facilities, staff and resources emerged as glaring deficiencies, despite equipment and supplies being readily available. As for surgeries, the Inuulitsivik Health Centre (IHC) had the highest capacity at 6.7, while CLSCs in villages along the Ungava Bay coast scored lowest at 5.5. Similarly, the team observed a disparity in hospitals’ capacity to handle serious injuries. The IHC scored highest at 7.2, while CLSCs in villages along the Hudson Bay coast scored lowest at 5.5.

“These results will not be surprising to anyone who works in these settings. However, they provide an important baseline for future capacity-building programs, as well as specific targets for improvement, notably the recruitment and retention of skilled personnel,” said Dr. Evan Wong, Assistant Professor of Surgery at McGill University, Investigator in the Surgical and Interventional Sciences (SIS) Program at the Research Institute of the McGill University Health Centre (RI-MUHC), and the study’s co-author.

Barriers to telehealth

Telehealth services, such as virtual doctor visits, grew significantly during the COVID-19 pandemic and are especially useful in remote regions. This study found that while the need for telehealth is high at all facilities, none are fully prepared to implement it. Researchers point to funding, administrative support, and physical spaces as a few of the significant barriers.

Based on the findings, the research team is advocating for decisive action to address healthcare inequality in the region. They include making it easier for rural doctors to communicate remotely with urban specialists, creating training programs for healthcare workers in small towns to manage surgeries and serious injuries, and finding new ways to encourage doctors and nurses to work in remote areas.

“This important work highlights a striking disparity that exists within the Quebec healthcare system in terms of the Indigenous population and the impact of injuries on their health outcomes. While the conclusions are concerning, they highlight an excellent opportunity for strengthening regional partnerships between hospitals ‘down south’ and our partner hospitals in Nunavik,” explains Dr. Jeremy Grushka, study co-author, who is also a researcher in the SIS Program at the RI-MUHC and an Assistant Professor of Surgery at McGill University.

About the study

Surgical, trauma and telehealth capacity in Indigenous communities in Northern Quebec: a cross-sectional survey” by A. Kis et al was published in the Canadian Journal of Surgery.

About McGill University

Founded in Montreal, Quebec, in 1821, McGill University is Canada’s top ranked medical doctoral university. McGill is consistently ranked as one of the top universities, both nationally and internationally. It is a world-renowned institution of higher learning with research activities spanning three campuses, 12 faculties, 14 professional schools, 300 programs of study and over 39,000 students, including more than 10,400 graduate students. McGill attracts students from over 150 countries around the world, its 12,000 international students making up 30% of the student body. Over half of McGill students claim a first language other than English, including approximately 20% of our students who say French is their mother tongue.

About the Research Institute of the MUHC

The Research Institute of the McGill University Health Centre (RI-MUHC) is a world-renowned biomedical and healthcare research centre. The Institute, which is affiliated with the Faculty of Medicine of McGill University, is the research arm of the McGill University Health Centre (MUHC) – an academic health centre located in Montreal, Canada, that has a mandate to focus on complex care within its community. The RI-MUHC supports over 420 researchers and close to 1,200 research trainees devoted to a broad spectrum of fundamental, clinical and health outcomes research at the Glen and the Montreal General Hospital sites of the MUHC. Its research facilities offer a dynamic multidisciplinary environment that fosters collaboration and leverages discovery aimed at improving the health of individual patients across their lifespan. The RI-MUHC is supported in part by the Fonds de recherche du Québec – Santé (FRQS).