Cree diabetes rate soars in Quebec

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A new study reports Quebec Crees have one of the world's highest diabetes rates. Cree officials charge that the Quebec government has ignored years of warning about the epidemic.

Almost 13 per cent of Cree women giving birth have gestational diabetes, a form of the illness that occurs during pregnancy, according to a two-year study published in the Canadian Medical Association Journal in May. The rate is twice the North American average and the second-highest rate reported for an Aboriginal group worldwide.

Cree officials called on the provincial government to fulfill its 1975 promise in the James Bay and Northern Quebec Agreement to fund Cree health services at the same level as elsewhere in Quebec.

"It's quite shocking for me. The diabetes epidemic is overtaking our health services," said Bill Namagoose, executive director of the Grand Council of the Crees. "It's a time bomb. It's five minutes to noon on this issue."

Namagoose said Cree health care is "vastly under funded" and he criticized the Quebec government for cutting off negotiations with Crees on health care and other issues in February. Quebec Native Affairs Minister Guy Chevrette said in a Feb. 10 letter the talks were suspended because Crees had filed a $600-million lawsuit against Quebec, Ottawa and the forestry industry last summer. In the lawsuit, Crees say clear-cut logging has left their territory a barren wasteland, even though their traditional hunting-and-trapping lifestyle was supposed to be protected by the James Bay Agreement.

Namagoose accused Quebec of trying to blackmail the Crees into dropping the lawsuit.

"Health should not be used as a political pawn," he said.

The Quebec Health Ministry was caught off-guard by the news, with ministry officials scrambling to find out more about the Cree diabetes epidemic in response to calls from journalists. Nicole Bastien, spokeswoman for Quebec Health Minister Pauline Marois, said she wasn't aware of the high Cree diabetes rate. She promised to call back with a response to Namagoose's allegations, but never did and didn't return several subsequent calls.

Gestational diabetes normally goes away after pregnancy, but a woman who's had it is more likely to need a caesarian section and get diabetes later in life. Her baby also has more of a chance of birth trauma and being born overweight, said Elizabeth Robinson, a Cree Health Board doctor who co-authored the new study.

Robinson said gestational diabetes is just a part of the problem. As of May 1998, 10 per cent of Crees over 15 years of age were diagnosed with some type of diabetes, more than double the Canadian average of four per cent, according to health board figures. The number of cases shot up 20 per cent in just one year.

Dr. Robert Harris, a public-health specialist in the Chisasibi Hospital, said the actual numbers are almost certainly much higher because many people with diabetes aren't diagnosed for years.

"What we usually find is if we screen everybody, the rate doubles."

Nurses report the numbers just keep on rising. The community of Mistissini, for example, now has more than 300 people diagnosed with diabetes, up from 223 cases last year, said Alice Wapachee, a health worker in Mistissini. The new figure means 18 per cent of Mistissini residents , 15-years-old and up, have diabetes, one of the world's highest rates.

The variety of diabetes most common to Crees - Type II diabetes - is linked to poor diet, inadequate exercise and stress. It can cause blindness, impotence, bad circulation and kidney failure.

Harris said Aboriginal people are facing diabetes explosions around the world because of lifestyle changes often brought on by development projects. Harris blamed the Cree diabetes epidemic on Hydro-Quebec's hydro-electric dams and clear-cutting that have forced many Crees to abandon their traditional ways of life. The flooding left fish - an excellent food to prevent diabetes - with high mercury concentrations that makes it inedible.In 1975, the year the James Bay Agreement was signed, diabetes was virtually unheard of in James Bay; only three Crees had the illness.

Harris said most Crees are aware they need to improve their diet and exercise more, but require support from health and community officials, support that's lacking due to bare-bones funding levels.

Crees have mounted grassroots efforts to deal with the illness. On April 9, several dozen Crees marched into Mistissini after a 1,370-kilometre fundraising walk aimed at buying a dialysis machine for the hospital in nearby Chibougamau, a non-Native mining town. People with diabetes often need dialysis several times a week if their kidneys give out, but for most Crees the nearest machine is hundreds of kilometres away; the province wouldn't pay for one closer to home.

The walkers left Whapmagoostui on snowshoe and dogsled on Feb. 1, and braved minus-50 degree temperatures as they wound their way through nine Cree communities. Their journey raised more than $300,000.