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Home » Wellness » Often Neglected, TB Is the World’s Biggest Infectious Disease Threat
Trevor Stratton

Trevor Stratton

Citizen of the Mississaugas of the Credit First Nation

Tuberculosis is still a health threat in Canada, especially among First Nations, Métis and Inuit communities.

Many Canadians may think tuberculosis (TB) is a thing of the past, but 1.5 million people die from TB each year, making it the leading infectious disease killer in the world.

Caused by bacteria, TB is spread when people with lung TB cough, sneeze or spit. Every year, 10 million people become ill with the disease, most often in low- and middle-income countries but TB is present all over the world. In Canada, the rate of TB among First Nations living on reserve is more than 40 times higher than the Canadian-born non-Indigenous population. In Inuit Nunangat, the rate is more than 300 times higher.1

Symptoms of TB include a cough, fever, weight loss, chest pain and breathlessness. Treatment is long and can cause many side effects.

Trevor Stratton, a citizen of the Mississaugas of the Credit First Nation near Toronto with mixed English and Ojibwe heritage is the coordinator for the International Indigenous Working Group on HIV and AIDS for the non-profit organization, Communities, Alliances & Networks. Stratton remembers his grandmother telling him how she contracted TB while attending a residential school. “That legacy is still there, with huge housing shortages on First Nations and in Inuit hamlets in the Arctic, causing overcrowding,” he says.

Overcrowding, poor ventilation among factors leading to spread of TB

Overcrowding is one of the factors that cause the spread of TB, along with food insecurity, poor ventilation and having certain illnesses, such as diabetes or HIV.1 Stratton says mistrust of the healthcare system also contributes.

“Indigenous people don’t want to go to the hospital or see a doctor,” Stratton says. “There is a fear of institutions like schools, hospitals and jails, which is rooted in colonialism and past experiences or those of family members. So if people get sick, they may not seek medical attention.”

Stigma is another contributor, Stratton says. “People see others who carry a particular disease, whether it’s HIV or TB not being treated well or being discriminated against. So they don’t get tested. They don’t want that same experience,” he says.

Communities, Alliances & Networks recently expanded its mandate from a focus solely on HIV and AIDS to include sexually-transmitted and blood-borne infections, hepatitis C, mental health, aging, and TB. Stratton says the organization is leveraging the lessons learned from HIV — where advocates have been successful in bringing about patient-driven care, improved access to drugs and expanded funding for research—to make an impact on TB.

A common, united voice will help raise awareness of TB

“In the HIV response, we pulled together people living with HIV and family members and used their common voice,” Stratton says, adding that the response needs to move past doctors and researchers to include Indigenous and non-Indigenous political leaders and the wider community.

Stratton also stresses the importance of including Indigenous people at every step. “We need the support of politicians and the wider population but Indigenous people need to be the ones making the decisions,” he says. “This relates back to the Truth and Reconciliation Commission of Canada recommendations and the United Nations Declaration on the Rights of Indigenous Peoples, in particular, the duty to consult Indigenous people on anything that affects them.

“You need to talk to the people and help in an equitable way, where others are not leading us. They’re standing beside us and getting to know us and building that trust and rapport so that we can work together equitably.”


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