UBC Pediatric resident Dr. Jacob Rozmus examines a child in a First Nation’s Health Clinic - photo courtesy of Brighter Smiles

UBC Reports | Vol. 52 | No. 11 | Nov. 2, 2006

Remote Community Engages UBC to Tackle Diabetes

By Hilary Thomson

It’s a heck of a commute.

But the five-member team from UBC’s Dept. of Pediatrics had no complaints about clambering aboard a float plane crammed with equipment to travel 630 km. to Hartley Bay, a remote First Nations community on B.C.’s northwest coast, to participate in a unique research collaboration.

The September 2006 trip was UBC’s response to a request from the community for a Type 2 diabetes (T2D) screening study among children and teens in the 200-resident village, the first phase of a study that will grow to include screening in larger sister communities of Kitkatla and Port Simpson. A total of 400 children will be involved in the study — the first such investigation among B.C. Aboriginal communities.

Situated 140 kms. southeast of Prince Rupert, the tiny community — part of the Tsimsian Nation — was in the news in March 2006 following the nearby sinking of a B.C. ferry.

UBC Pediatrics Prof. Andrew Macnab and members of the UBC Pediatric Residency Program have been working with the Hartley Bay community for four years on a variety of projects. They have developed, in collaboration with community members, an immunization program, a school-based oral health program and well child clinics.

When a child attending a clinic was diagnosed with T2D, village leaders requested an education and screening study.

“The project brings unique and considerable benefits to both the communities and to our pediatric residents,” says Macnab. “It’s hugely important for our future doctors to witness the health challenges of these remote communities, but also to experience that these villages are highly functioning, with leaders trying to do their best with the resources they have available.”

Macnab and pediatric residents conducted diabetes screening for all 32 Hartley Bay children. Results showed a second child had T2D.

“This disease can be fought with education,” says Cam Hill, a community member and teacher at the Hartley Bay School. “It’s especially important for youth and young parents to understand how devastating this disease can be. We can’t falter on what we’re trying to achieve here — we need to keep up with new information and technologies.”

Hill, who has three young children himself, says it’s very encouraging to see kids that were at risk becoming more active, and the community becoming more educated about diabetes and its impact on native populations.
He says the biggest challenge of the screening program was developing trust.

“We didn’t want to be guinea pigs. Seeing familiar faces on a regular basis helped everyone feel more comfortable and eager to do what it takes to make their community a healthier place.”

“We were welcomed to the community and had the chance to participate in local and cultural events,” says resident Jacob Rozmus. “It’s a very rewarding partnership that allows us to tackle issues unique to a remote First Nations community.”

A precursor to the screening was a collaboratively designed education project where community members kept food diaries, and used that information in a “Smart Meals” program to share knowledge about buying, storing and cooking nutritious food, including healthier alternatives for favourite feast foods.

Ensuring a supply of healthy food is no small task for Hartley Bay families, since the nearest store is in Prince Rupert, accessible only twice a week via a 3.5-hour (one-way) ferry trip. In addition, access to medical care in remote villages is highly variable with few child health programs.

Working with remote First Nations communities on health issues brings sociological, ethical and practical challenges, but it can be done, says Macnab.

“It’s quite amazing to have community-driven research requests stemming from a partnership between two very different cultures,” he says.

The next step in the research involves working with First Nations shamans in the Nass Valley in northwestern B.C. to examine the effectiveness of a traditional diabetes treatment that uses a common plant, Devil’s Club. Macnab and community members will run a trial to determine the plant’s chemical profile as well as its medicinal effectiveness compared to a placebo.

Hartley Bay projects have recently been expanded to include UBC Dept. of Family Practice students, residents, and faculty.

Support for this research has been provided by the UBC Faculty of Medicine Special Populations Fund and the Lawson Foundation.