Northern communities hit - Doctors pinpoint TB causes

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The recent outbreak of tuberculosis at Little Buffalo and Cadotte Lake is a testimony to the inferior health and economic conditions among Alberta's underprivileged according to the medical consulting officer to the Peace River Health Unit, Dr. Graham Clarkson.

TB is nothing new to the affected communities which are about 100 km northeast of Peace River and have been noted for substandard housing, health and economics. Five or six years ago, unsanitary water conditions raised controversy and minor outbreaks of TB had occurred.

Little Buffalo is home to approximately 200 Indians and 100 Metis while Cadotte is basically a Metis community of about 200.

Dr. Clarkson thinks, "the principle source of the infection to be a young woman in her 20s," but adds "we're not sure yet." He is quick to fault poor housing, outdoor toilets and the lack of running water which he claims "is not conducive to cleanliness", one of the contributing factors to the disease.

As of Aug. 31, 27 people had been admitted to Edmonton's Aberhart Hospital with eight being diagnosed to have infectious TB. The other 16, says Dr. Hodes, the regional medical officer for Medical Services Branch, Edmonton, "were not positive for infectious TB but have another form which is not infectious." Recent reports say that all are progressing satisfactorily.

"It's a big outbreak," says Hodes, who notes that in recent years there were two other significant outbreaks in Alberta. One was about two years ago at Janvier in northeastern Alberta and the other at Eden Valley earlier this year.

Hodes maintains that such outbreaks in northern or isolated communities occur periodically. The culprit, he adds, is usually sanitary conditions although it is not the sole basis for an outbreak.

"The main reason is someone what had TB, maybe 20 or 30 years ago, either wasn't treated properly or didn't take their medication or wasn't treated at all," he says.

Clarkson informed Windspeaker on Sept. 1 that 24 individuals are on active treatment for the disease which "was bad enough to gallop at quite a pace."

In response to the situation, Clarkson reports they have screened (given TB sensitivity skin tests) 229 people from Little Buffalo and 170 from Cadotte. As well, 146 were chest X-rayed at Little Buffalo and 36 at Cadotte.

Two tested victims are one years of age; one is 23-months old and another is three yeas old says Clarkson. A seven-month old child he adds, has miliary TB, a type which can be fatal if not discovered and treated in its early stages.

Although the age range of individuals is varied, "it's young children, adolescents and the old that are at greatest risk," states Clarkson.

For now, the patients will remain at Aberhart until it is safe for them to be returned home. That may be three or four weeks away and they will need to take medication ? liquid form for children, pills for adults ? for up to a year says Hodes.

To many, tuberculosis is a misunderstood ailment. At one time, particularly during the '20s and '30s, it ran rampant in may Native communities, so much so that the Charles Camsell Hospital in Edmonton became an exclusive hospital for Native TB patients.

Generally speaking TB is a bacteria which spreads through the lymphatic channels and blood stream. Lymph vessels are similar to blood vessels and are the highways fo the bacteria which then attacks the body, especially the lungs.

The most common form of the disease is pulmonary TB. Clarkson explains that it is a characterized by loss of weight, fatigue, listlessness, night sweats (fever) and chest pains.

The "bug" may not stay just in the lungs, but spread to other body organs. If not checked, it can lead to meningitis or miliary TB. Both can be fatal.

Often the victim's physical condition has deteriorated for one or more reasons, says Hodes. If one is sick, develops a cold, lacks proper diet or eating habits, or lives in unclean surroundings (TB germs can live in dust for man months), they are targets, Hodes states.

Any person who has contracted TB at some time is not totally cured of it. The bacteria can remain in the body in a dormant (inactive) state for many, many years. However, if the condition of the carrier weakens, the TB germs reactivate and attack again.

But, if the victim takes proper care, they can carry the bacterial all their life and never fall victim to the disease.

To avoid a recurrence or spreading of the disease, carriers should maintain a good diet, exercise properly, keep clean houses and avoid overcrowding of homes says doctors.

Unfortunately, says Clarkson, the average of four persons per sleeping room in Native communities "is high by any standards."

AT the very least, people should wash their hands often and cover their mouth with a hanky when sneezing or coughing because the germs are carried in the air.

The medical officer says they are doing everything in their power to prevent further spreading during this outbreak. They are tracing contacts and movements of those afflicted and are co-operating closely with the province and the communities involved.

Clarkson praises the Provincial Tuberculosis Services for "responding very appropriately." He also commends the communities of Little Buffalo and Cadotte which he says were also very co-operative.

However, Dr. Clarkson is highly critical of how mainstream media performed during the outbreak and questions their ethics.

"I was appalled that the CBC are allowed in Aberhart to take photographs and none of the patients were asked for their permission. I think that's a scandal," Clarkson complains.

He adds that their attitude of Little Buffalo also levels criticism at mainstream society charging them with being prejudiced.

"If it was anyone other than a Native person, the attitude would be much different," he says. He speaks bitterly of provincial and federal government who, he accuses, are not tending to their needs nor their Treaty rights.

Of 200 ecorded and known cases of TB in Alberta in the past year, about 30 to 40% are estimated to have been Natives, says Dr. Hodes. That he concludes, is extremely high given the fact their population only constitutes a small percentage of the population.

The incidence of TB among Natives is purported to be anywhere from 10 to 15 times the national average.