When life-threatening emergencies occur in tiny and distant Greenlandic settlements, what happens?
The reality is tough, tells Executive Medical Officer of Greenland, Anne-Marie Ulrik.
Fifty-seven, give or take. That’s the number of inhabitants who live in the northernmost settlement in Greenland, Siorapaluk. Located 77 degrees North, it’s a quiet and isolated village surrounded by grand mountains, ice and the cold sea. Traditional living is inevitable up here; hunting walrus, polar bears and seal is the way of life.
You can imagine that for a village this size, everybody’s hit when tragedy strikes. Certainly, this was the case in 2013 when ill-prepared traditional food prompted a bizarre turn of deadly events.
GREENLANDIC TRADITIONAL FOOD GONE WRONG
Like everywhere else in the world, Greenlandic traditional cuisine is influenced by the surrounding nature. Life wasn’t easy for the Inuit ancestors, who lived in harsh polar conditions without the ease of modern technology. Learning traditional ways of preserving food was necessary for survival.
Unfortunately for the residents of Siaropaluk last year, a special traditional meal of eider birds in a seal buried underground was not prepared properly. The food became toxic and resulted in the death of a man. Due to his old age, nobody suspected that he had suffered from botulism, a toxic form of food poisoning. Suspicions only arose when six other people got sick after the same meal was served again at the man’s funeral. The man’s own daughter also died.
There is need for more awareness to hygienic food preparation. “It seldom occurs, but there have been previous cases of botulism due to the bad preparation of traditional Greenlandic food. We’ve had around 16 cases in the past twenty years, though not all of them were fatal,” says Anne-Marie Ulrik, who is responsible for the quality and delivery of medical services in Greenland.
“It’s very toxic because it paralyses the patients, and they can’t breathe by themselves. You have to put them into a ventilator – the doctors and nurses are not so skilled in the peripheral districts, but most will be able to incubate and ventilate them for awhile. That’s a problem when you are living so far away from a major hospital in Greenland.”
WHAT HAPPENS IN A MEDICAL EMERGENCY?
While there is a health worker and settlement health station in Siorapaluk, there is no daily doctor. A doctor will visit a settlement four times a year, and in the meantime technology (called ‘tele-medicin’, or ‘Pipaluk’) is used to help bring specialists closer to the settlements. A patient can be hooked onto this technology and it will transmit ‘real-time’ data to a specialist who can interpret it.
When patients are sick, they are transported to the nearest medical center, where they can receive basic treatment and care, and be stabilized for transportation to a higher level hospital. In this case the sick were transported to nearby Qaanaaq (formerly Thule or new Thule), a city with 680 residents. Because it was so serious, the patients were evacuated to the main hospital in Nuuk, Greenland. It’s the only hospital in Greenland that offers intensive care.
An emergency procedure like this takes vital time.
“These are the conditions if you choose to live in Greenland in a settlement, or a small town with a basic health center. Hypothetically, it could have taken 10 to 12 hours on a weekend to evacuate a patient from Siorapaluk to the hospital in Nuuk,” said Ulrik.
“Evacuation is is one of the most expensive things we do in the Greenlandic health system. A normal evacuation is about 120,000 DKK for transportation alone. To evacuate someone to Denmark it costs about 250,000 DKK, so we only do it when it is very necessary. Last year we had 175 normal evacuations, and 25 to Denmark. It’s all paid for by the state – the health system is in general free in Greenland.”
DOCTORS FOR THE FUTURE
The Greenlandic health system has unique problems due to the size of the country and spread out population.
“We work on a very narrow budget – it’s not an expensive system, but because of the challenges of logistics, a lot of the expenses are not used on treatment and care. It’s not ideal.
“We also lack the doctors we need. There are Greenlandic medical students currently getting trained in Denmark, but it will take about 10 to 15 years for them to operate properly in a hospital,” explains Ulrik. “Because of the lack of personnel, I would also like to have the nurses and health assistants educated to be able to do much more of the basic medical work than they can today.
“We’re hoping to use technology more, and also cooperate further with Iceland for specific cases. It’s closer, and the hospital in Reykjavik is smaller than a typical one in Denmark, so we hope it will be more efficient to treat patients. It’s been something we’ve talked about for many years, but we hope this can become an actuality.”
This article written by Tanny Por was first published on Discovery Channel’s Animal Planet blog for Ice Cold Gold.