I recently returned to Ottawa after living in the arctic for a year and a half.
I was a regional dietitian at the Inuvik Regional Hospital in Inuvik, Northwest Territories (NWT). Inuvik is located in the Beaufort Delta (Beau-Del) region in the northernmost corner of the NWT, where the epic Mackenzie River meets the icy Beaufort Sea. The Beau-Del is also home to seven other communities with populations from 100-850. Four of these communities are only accessible by plane or ice road (in the winter the delta tributaries freeze and the government creates “roads”), while three are connected by the Dempster Highway, which starts in Whitehorse and reaches north to Inuvik (though the highway was extended to Tuktoyaktuk this summer). Don’t let its name fool you – the Dempster highway is no more than a dirt and gravel road that is regularly shut down due to inclement weather.
The northern portion of the Beaufort Delta region in NWT.
Driving the Dempster Highway from Fort McPherson to Inuvik, Feb 2016
As I’m sure you can imagine, the region is remote. Very remote.
One of my responsibilities as a regional dietitian was providing nutrition services to the outlying communities, which I did through community visits and telehealth.
Naturally, the community visits were the more exciting way to provide service, but they were also the (significantly!) more expensive way so their frequency was minimal. My first community visit was to Sachs Harbour, an Inuvialuit hamlet with no more than 100 souls, located on Banks Island across the Beaufort Sea. It was January, one of the coldest and darkest months of the year when the sun barely flirts above the horizon. It’s a windy community, which makes for a cutting cold. On my first morning there, I pressed into the 30km/hr arctic wind as I trekked the deserted road dark as midnight from the B&B to the health centre. Before my visit, an occupational therapist colleague, who had been to Sachs two months earlier, told me that a community resident advised her to stay off the roads or carry a weapon to avoid a polar bear attack. Needless to say, I was very alert during my walk to the health centre! Luckily for me, January isn’t polar bear season in Sachs.
At lunchtime, there was just enough light outside to get a better look at Sachs and investigate the grocery store situation, so I donned my winter gear and headed out into the cloudy day. It was a terrifically disorienting experience to look upon a world and not know where the snowy expanse of land met the gray wintry sky. Unable to discern a road in the snow due to the dim light and gray conditions, I decided the best way to reach the grocery store 200 meters away across a snowy field was to carve a straight path. Big mistake. I spent 10 minutes clambering through snow as deep as my knees, arriving at the grocery store in a sweaty state. On the return trip I used my previously carved footsteps to ease the trek.
Looking towards the grocery store in Sachs Harbour
The grocery store was a pleasant surprise. Small to be sure, but stocked with more healthy options than I expected for such a tiny community. Among the small collection of groceries I found frozen kale, canned kidney beans, dried fruit, wild rice, whole wheat flour, almonds, bags of apples, bags of carrots, milk and yogurt. The prices were steep – no surprise there. I don’t remember specific numbers, but the price of food is steep wherever you go in the north.
Back at the health centre, I sat down with clients, some of whom I had previously met with over telehealth. I provided nutrition counselling for diabetes, gestational diabetes, and high cholesterol. I then visited a grade 6/7/8 split class and gave a presentation on sugary beverages (which are consumed like water in the desert among many northerners), and then took the kids to the school kitchen to bake a healthy apricot whole grain square. Oftentimes in the north one goes grocery shopping with a list and must make substitutions because items are out of stock or were never stocked to begin with. The kids and I ended up making a raisin whole grain square, and it was delicious!
Plane from Sachs to Inuvik, with the glowing moon in background. Have to wear your winter gear on these flights!
Community visits were infrequent due to budget limitations, so I had to rely on telehealth to counsel clients in the outlying communities, like Sachs Harbour.
Telehealth is the NWT’s videoconferencing system for connecting remote and rural communities to healthcare providers like dietitians, speech language pathologists, physiotherapists and doctors. I typically had a few telehealth appointments each week to provide nutrition counselling to patients seeking help with weight management, diabetes, high blood pressure, gluten-free eating, digestive disorders, swallowing dysfunction, malnutrition and underweight, etc. In addition to my weekly one-on-one sessions, I and my dietitian colleague, Janna, delivered a 3-month long healthy eating program over telehealth to the Beau-Del communities, something that had never been done before.
Me (left) and Janna in the telehealth room, delivering the Feast on Health Program we developed
My positive experience of being able to reach people who wouldn’t otherwise have access to a dietitian has inspired me to bring online nutrition counselling to Project Nutrition. Online counselling takes place…online. Booking your appointment can also be done online HERE. Sensitive and private information is shared during counselling sessions, so to ensure my clients’ privacy and confidentiality, I have chosen an online videoconferencing platform that complies with Canada’s Personal Health Information Protection Act (PHIPA). In other words, the video is encrypted and secure.
Obviously online appointments can benefit people in rural areas, but they can also benefit urbanites, too. Online appointments save time and allow for flexibility in scheduling. City dwellers don’t have to commute to and from an appointment, nor travel across town at rush hour. Online counselling also allows clients to choose the dietitian they would prefer to work with, regardless of where that dietitian is located, with a few exceptions…
Unfortunately, residents of BC, Alberta and PEI are unable to access Project Nutrition’s online counselling due to restrictions imposed by those provinces. If you’re from one of those provinces, I’m sure there are wonderful dietitians in your area who would be more than happy to work with you.
Thanks for reading!