Health care delivery in an Inuit settlement : a study of conflict and congruence in Inuit adaptation to the cosmopolitan medical system

Abstract

This thesis is a descriptive study of health care in the Inuit settlement of Gjoa Haven, N.W.T. The purpose of the research was primarily to describe and analyse the interactional networks of health and illness related behaviour that are associated with the Nursing Station. The cultural and organizational background of the administrators and nurses who provide medical services to Inuit are described, as are the attitudes and beliefs held by Inuit about illness and about the health care delivery system.The thesis examines the acculturation of Inuit beliefs and practices related to illness throughout the contact period and focuses particularly on the changing role of the Inuit healer, the anqatquq or shaman. Various influences such as epidemic diseases, missionary activity, and changing economic orientations that have contributed to Inuit dependency patterns and changed beliefs about illness, its causes and cures, are detailed.Theoretically, the thesis is partly a study of the replacement of a traditional medical system by the cosmopolitan medical system and the gradual attenuation of the traditional curer's role. It is also an examination of the manner in which the conflict resulting from differences in attitudes between administrators, nurses and Inuit, affects the delivery and utilization of health services in Gjoa Haven. It demonstrates that where problems occur they are as much a result of conflict between administrators and nurses, as they are due to conflict between nurses and Inuit.The substantive portion of the thesis examines specific domains of interaction such. as health education, agency coordination and native participation and points out areas where failure occurs in each of these arenas. Recommendations are included that suggest strategies for improving the effectiveness of health care delivery and ultimately the health levels of the Inuit population.