Nunavut's new chief public health officer looks forward to taking on northern challenges

Nunavut's incoming chief public health officer says he's looking forward to tackling some of the challenges in the territory.

Late last month, the Department of Health announced Dr. Sean Wachtel would be taking over for Dr. Michael Patterson as the territory's top doctor. Wachtel has worked clinically in some Nunavut communities in the past.

Wachtel spoke with Qulliq host Eli Qaqqasiq-Taqtu this week about his new role.

This interview has been edited for clarity and length.

Can you tell us a little bit about yourself?

I'm originally from the U.K. I'm Canadian, now — I've been in Canada for just a bit over 12 years. I originally qualified in the U.K. in medicine, in 1994. That seems like a long time ago. I'm trained firstly in internal medicine, and then family practice, and following the completion of my training, I was a general practitioner for a little while.

Then I went to work in the far east. I went to southeast Asia working for a company, looking after people who needed to be repatriated to hospitals from remote areas, from whatever country in southeast Asia.

Then I in fact joined the U.K.'s Royal Air Force and I served for five years. Following completion of my commission with the Air Force, I immigrated to Canada.

Once in Canada, I worked in the ER for about five years before undertaking further training in public health and preventive medicine at UBC in Vancouver. Following that, I worked for two years for the First Nations Health Authority here in B.C. and then I moved health authorities authorities to work for interior health as the senior medical director for Aboriginal health, and that position finished. There was a term contract and that finished in the summer.

And then I applied for the position up here and of course was delighted to be appointed.

What do you know about Nunavut, knowing we have different system in this country?

I've been working in Nunavut clinically since about 2019. I met Dr. Francois de Wet at a conference back in 2019 and we got talking, and he told me what a wonderful territory Nunavut is. So I started coming up to do some clinical work on a temporary basis, locum work.

I came first to Iqaluit and then I mostly worked in Kivalliq, and I started coming back to Kivalliq at the beginning of this year, around April.

So I was rotating in there and I've worked in Rankin Inlet, I've worked in Arviat, and it's a beautiful, beautiful territory. I was really touched by the warmth of the people that I've met, and the resilience of the population, as well as the actual territory itself — the landscape is just stunning and beautiful.

Through my work with the First Nations Health authority, I learned so much about the Inuit people and also our Indigenous people in Canada and in B.C. and the journey of these peoples over the last few 100 years, which has led us to the place we are. Of course there are some unique aspects to Nunavut, but many of the principles are shared, and although the peoples are very different from nation to nation, I think the way that the journey has evolved has certain similarities.

But of course there are many unique aspects, not least the language, that I look forward to to learning as we go forwards.

Now that you are in a role of chief public health officer for Nunavut, how does it make you feel?

Honestly very humbled. I realized that this is a really important position, to support the elected government of the day, to promote and protect the health of the population of the entire territory. And although in terms of numbers, it's a relatively small population for a territory or province, we really do have some very unique challenges going forwards. 

There's the health-care system itself, which is serving a population that's geographically quite isolated and not all services are available within the territory. So we have our contracts with other provinces to provide services that can't be provided in-territory.

There's the legacy of colonization that has taken a heavy toll on the population. And that's one of the biggest challenges I see going forwards, along with also climate change.

I'm excited to take the position, but I also approach it with a huge sense of responsibility going forward to continue the work that's been done to date and of course, coming out of the pandemic, which I think was dealt with extremely well by the Department of Health and by Dr. Patterson.

We have to face up to these new challenges and that may include a resurgence of COVID, but there are also these structural elements that I've mentioned that we need to start addressing.

How important is to you to be Nunavut's top doctor?

It's important to me personally because I find it immensely satisfying to undertake this kind of work, and particularly in a territory with a population that, to be honest, over the centuries has not been historically well-served by the federal government. And I've been quite heartened to see the change in approach and opinion and attitude from the federal government to try and make up for these historical injustices.

So we're ready to be part of that process. To me, it's really a huge privilege and I feel honoured, quite frankly, to be in this position.

What will you be doing as a new chief public health officer for Nunavut?

Over the short term, the plan will be to get to know the territory better and also the staff that I'll be working with directly. I will be travelling out to the different regions, particularly those which I haven't visited previously. I'll be visiting our public health stations and leading our public health staff on the ground who are doing the day-to-day work.

Then the actual work itself for public health would involve supporting those very staff — the staff doing the day-to-day work — and also of course the government. So I would spend a considerable amount of time supporting the decision making of the elected government, and that usually involves giving my opinion on scientific evidence and providing options for decision-makers to make the best decision for the population of the territory.

And then the other piece of the job is to advocate for the territory and the people that live within it at various federal tables and other tables.

An example of that would be anti-racism work — I think we have an excellent policy window at the moment to move forward that agenda and to continue work on putting right the historical injustices that have been suffered by all Indigenous people and in particular the Inuit people.

And how are we doing for COVID-19 in Nunavut?

We're really in the post-pandemic recovery phase of the pandemic response. We are aware that COVID-19 is still out there and we do still see people with COVID-19 infections, but the response in Nunavut to the pandemic was really, really good, and the harm to the population and the people was really minimised by the prompt and decisive actions of the Department of Health and Dr. Patterson. So although we still see it, I'm really pleased to say that the population here has access to the most up-to-date treatments available anywhere in the world. The vaccination campaign has been a great success and in common with most of the world's population. We're now seeing a degree of immunity for this virus in most people. So the threat to the population is much reduced. And of course we also have a lot more knowledge about the the virus that we're dealing with.

It continues to evolve, and although it's become perhaps more transmissible, it's become less dangerous to the human population. So I think we're actually in quite a good place at the moment, but we shouldn't get complacent. It's still a threat, particularly to people with certain risk factors.

Can you tell us about how you plan on managing COVID-19 in Nunavut?

I think it's still important for people to get vaccinated, to get their boosters, and that is particularly the case for people living with chronic diseases.

And those programs will continue, the vaccination programs. In terms of the other measures, of course, there's no longer a travel ban and masking is only mandatory within health-care facilities. I do support that. I think it's right that we do our utmost to protect the most vulnerable people in our territory and those of course are people who are in hospital for whatever reason.

In terms of how things evolve more widely, the emphasis I think is on individuals now to protect people around them. They can do that by continuing to practise hand hygiene — just using a hand cleanser, washing your hands frequently — social distancing and also wearing masks indoors or in densely populated situations.

There are no plans to make that compulsory again, but masks are scientifically proven to help reduce the risk of all respiratory infections, in fact, not just COVID.

So that's where we are. The emphasis now has really moved from what we would mandate at a population level more to individual responsibility and we also continue to support individual decision-making with information, with accessibility to vaccines and so forth.

The details of the programming and services going forward will need to be worked out with the public health staff and the government through the Department of Health.

Is there any more information people should know that we didn't talk about in terms of your new role?

I think just to know that a huge amount of work goes on that people never see. The success of public health is the absence of bad things, because we're all about prevention. So I would just like to pay tribute to the public health staff on the ground and the Department of Health and of course our elected leaders who put a tremendous amount of work in day-to-day to prevent bad things from happening to the population. That's not always visible to people who don't necessarily know how the system functions, and sometimes something will come out in the press, and people will be exposed to a certain perspective that may not reflect the huge amount of work that is undertaken with the best of intentions.

I would just, once again, thank people for allowing me to come and work here, to be a guest in this beautiful territory and I'll look forward to physically getting here as soon as I can. I'm a victim of the frequent flight cancellations at this time of year just now, but I'll get there shortly.