Wave of infant deaths in Nunavik

The police found 12 lifeless infants in Nunavik last year. Shocked by this number of deaths occurring in obscure or unexplained circumstances, the chief of the police of the region alerted the office of the coroner of Quebec. In charge of all these files, coroner Geneviève Thériault believes that there is cause for concern.

Jasmine’s body was still warm when a relative discovered it. Upon entering the family room, he found the 2-month-old lying on her side, her mouth pressed against her father’s back. As he took her in his arms, he noticed that she had stopped breathing.

Unable to get the emergency line, he decided to get help by all-terrain vehicle. Upon arriving at the scene, officers found the small stretcher on a pillow. An officer carried her to the patrol car, where one of his colleagues attempted to resuscitate her as they drove to the dispensary in this small northern village. Despite the maneuvers that the medical staff continued for an hour, the little one did not come back to life. The causes of his death remain unexplained. His death was classified as sudden infant death syndrome by the coroner’s office.

In this investigation into the deaths of children who were the subject of coroner’s inquests, The duty chose not to publish the surnames of the babies or the names of the villages where these dramas occurred so as not to add to the pain of their loved ones. The duty unsuccessfully sought interviews with these families. The Nunavik Health and Social Services Board also declined our requests to interview Inuit midwives.

” [L’année] 2021 has been catastrophic,” Nunavik police chief Jean-Pierre Larose said on the phone. Shocked by the accumulation of cases similar to that of little Jasmine, Chief Larose decided to alert the coroner’s office in April 2021, when 5 deaths had already occurred.

“There were about 2 deaths per year since I took office in 2018. In 2021, there were more than all those caused by the pandemic [10]. It doesn’t make sense. »

Coroner Geneviève Thériault has been mandated to shed light on the situation. She looked into the circumstances of Jasmine’s death and those of 11 other children under the age of three whose deaths occurred in obscure or unexplained circumstances last year in Nunavik. The first five files analyzed to date by the coroner are classified in the Sudden Infant Death Syndrome category.

“In Puvirnituq, when you arrive at the airport, when you turn the corner, there is a Quebec flag. Each time, I close my eyes and wonder if he’s going to be at half mast. It is at half mast when there are deaths in the village, and there are months when it never gets up,” says Marie-Laure Vachon, a midwife in Nunavik for three and a half years. The deaths of children”, it is a subject which everyone speaks about, especially the nurses of the dispensaries. When there are deaths, it stirs the whole community. Everyone knows each other,” says M.me Vachon.

Although she has not yet finished writing all the files for 2021, coroner Thériault already affirms in one of her reports made public that there is a “disproportionate number of deaths of infants in Nunavik compared to the rest of the province”. “There is cause for concern,” she wrote.

The infant mortality rate in Nunavik is almost 7 times higher than in the rest of Quebec (according to the 2016 census statistics, the most recent available).

The duty analyzed the coroner’s reports from 2015 to 2021 concerning the deaths of children under the age of one in the North: 31 Inuit children died in Nunavik (13,000 inhabitants) compared to 7 in Terres-Cries-de-la- Baie-James (20,000 inhabitants).

Sudden Infant Death Syndrome

According to our compilation, Sudden Infant Death Syndrome (SIDS) is the leading cause of death for these babies in Nunavik, followed by lung infections. SIDS is defined as the sudden death of a child under one year of age that remains unexplained after a thorough investigation. It usually occurs during sleep and most often between the ages of two and four months. While we don’t know the causes of SIDS, we know the risk factors.

The day before her death, little Jasmine and her parents went to a friend’s house. The 2-month-old’s father shared his mattress with her, laying her on a pillow. The coroner’s report mentions that the father was tired and had consumed cannabis in the evening. Jasmine was found lifeless against him in the early morning. “The fatigue and drug use could affect his alertness, and it is possible that he did not notice that Jasmine had slipped from the pillow on which she had been placed […] Nevertheless, […] Jasmine could have already died in her sleep before slipping to her father,” the coroner said in her report.

In the socio-economic context of Nunavik, the risk factors for sudden infant death syndrome are increased tenfold. Experts cite smoking (during and after pregnancy) and putting the infant to sleep face down as the two most important risk factors.

“In Puvirnituq, at least 90% of the population smokes. Women will not necessarily quit smoking during their pregnancy,” explains Marie-Laure Vachon, midwife in Nunavik, who accompanies women throughout their pregnancy and after childbirth. “I have so many socio-economic factors to consider. We will first protect women from fetal alcoholism and domestic violence. The cigarette comes a little last, she admits, resigned.

The Nunavik Regional Board of Health and Social Services indicates that, like everywhere else in Quebec, future parents are informed of the measures to take to reduce the risk of sudden infant death syndrome. “But putting them in place is difficult when you share your accommodation with several people,” said coroner Thériault.

Too few accommodations

Visiting relatives, Annie-Joy, 4 months, fell asleep with her mother on a foam mattress for two people placed on the floor. At their feet was another child. The little girl’s father was lying on the floor. When they woke up, Annie-Joy was not breathing.

“Several risk factors for sudden infant death syndrome were present, such as exposure to smoke during gestation and after birth, exposure to alcohol and cannabis during gestation, bed sharing, presence of ‘pillows and blankets in the bed,’ says Coroner Thériault’s report.

Died a few weeks later, little James, 1 month, grew up in the same conditions as Annie-Joy. He was found at dawn in cardiorespiratory arrest on his baby mattress on the ground, still swaddled in his blanket. “It is also possible that the fact that five other people were sleeping in the same room was an additional risk factor even if the child slept alone on his mattress”, indicates the report analyzing his death.

In Nunavik, 60% of children under 6 grow up in overcrowded homes. “We have to talk about the deaths of babies, but, too easily, the prejudice that will emerge is that they are not good parents. It’s hard to be a good parent when you have to live at 15 in a house, “says the DD Faisca Richer, consultant physician at the Nunavik Regional Public Health Branch, who has dedicated her career to Aboriginal health.

The DD Richer is categorical: this lack of housing has a direct impact on the health of Nunavimmiut. “Even if the parents will have been made aware of smoking outside, that does not mean that all the people under the same roof will do so. When there are 15 and the young couple is not the owner of the accommodation, they cannot force everyone to smoke outside. So babies are going to be exposed to more smoking,” says Dr.D Rich.

In order to prevent sudden infant death syndrome, distributions of baby beds have been organized locally. “When everyone is in bed, there are mattresses everywhere. When we did our distribution, the cribs ended up in the trash because there was no place to put them! Co-sleeping will increase in circumstances like this. The mother has a mattress and five children. She is going to sleep with her young children, ”explains the DD Rich.

A difficult backlog

What solutions can be envisaged to change the situation?

“Building houses”, sighs the DD Rich. “We have to build houses. Parents are often distraught and in tow of where they can live. They will have a place of their own when their children grow up,” she adds.

Nunavik has nearly 13,000 inhabitants, 97% of whom live in social housing. In November 2021, 1184 households were waiting for housing. A situation that continues to worsen year after year since the number of new constructions cannot keep up with the birth rate, which is 2.5 times that of the rest of Quebec.

“There are 800 missing each year because, even if we build 150, we cannot catch up with the birth rate, which is higher in the North”, indicates Marie-Christine Vanier, acting deputy director general of the ‘Kativik Municipal Housing Office.

“It’s not easy to fix. Even if we wanted to inject big, big sums and build 800 homes tomorrow, the prices of materials have exploded. The labor comes from the South. Bringing them to the North… It’s complex,” continues Mme Vanier. In addition, the pandemic has slowed construction considerably.

A public health problem

“Proportionally, the region had to deal with more cases of COVID in four months than there were in Montreal in two years…”, launches the DD Faisca Richer.

The DD Richer explains that this surge in COVID-19 cases is a perfect illustration of the health problems caused by the lack of housing.

“It entered a village and it went crazy. There is a certain proportion of Sudden Infant Death Syndromes that are actually respiratory infections. We see babies coughing. A coughing baby doesn’t make sense! ” laments the DD Rich.

She believes that the housing shortage should be considered a public health problem.

“The Inuit have their responsibilities and they will take charge when they have the opportunity to do so. But, right now, we already have to build houses. […] That’s the scandal, ”she says.

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