Nunavut has the country’s highest rate of avoidable deaths due to a variety of causes such as being given the wrong medication, leading some experts to call it a health care crisis.

According to an analysis of data provided by the Canadian Institute for Health Information (CIHI), the rate of avoidable deaths for residents of Nunavut is double that of all the other provinces and territories. Avoidable deaths are characterized by CIHI as deaths that could have been avoided through better treatment or prevention efforts. The avoidable death rate tells a lot about the effectiveness of health policies, health promotion, and health care in a given area. This means the lower the rate, the higher the quality of health care being given.

This graph compares the total number of people who died an avoidable death in Nunavut versus the national median during different time periods over the course of eight years.

The high rate is alarming and serves as evidence of the larger health care emergency that’s been facing Nunavut for some time now. The territory has been dealing with systemic problems for years.

Hannah Uniuqsaraq, a communications officer at Nunavut Tunngavik Inc. (NTI), an Inuit land claims organization, describes how there hasn’t been any visible improvement in terms of fixing the territory’s health care problems.

“People have blamed the government for inadequate action,” said Uniuqsaraq. “Problems are everywhere. Many people end up overdue for care.”

In March of this year, the auditor general of Canada also released a report which pointed to a number of causes for this health care crisis. While people were directly affected by inappropriate prescriptions, wrong vaccine doses and inaccurate diagnoses, the report also pointed to systemic issues. Nunavut’s Department of Health was failing to support staff at health centres across the territory, procedures were being disregarded by staff, and major deficits in staff recruitment and training bogged down the system. Existing staff received inadequate cultural and technical training.

“The territory’s health institutions are constantly finding themselves with vacant positions and the high use of temporary staff affect continuity and quality of care,” the report stated.

The department also failed to track incidents relating to patient care, therefore rendering them unable to identify any trends. All of these factors and more are said to have contributed to the premature deaths befalling the people of Nunavut. The report ended up giving 17 recommendations to improve care in the territory.

Connie Siedule, the executive director of Ottawa’s Akausivik Inuit Family Health Team, a clinic that specializes in the care and treatment of Inuit persons, said that the need for proper care for the Inuit is particularly great.

“The problems facing the Inuit in Nunavut are especially complicated. Besides Nunavut’s own health care woes, Inuit deal with additional problems due to their language and culture being at odds with today’s systems,” said Siedule. “I’ve also seen so many of them being referred to clinics outside of Nunavut.”

An annual survey on Nunavut’s Inuit culture and society in 2008 by NTI also found that the Inuit are particularly susceptible to Nunavut’s health care pitfalls. The language barrier was an issue faced in many health centres, where some physicians are unable to speak Inuktitut and are without any interpreters.

Stories about preventable deaths of Inuit people have populated the news over the years. In 2015, the government of Nunavut apologized for the death of a three-month-old Inuit baby, whose health issues were left undiagnosed by the health center the family sought care from.

It doesn’t look like the territory’s deeply flawed health care system is going to rectify its problems any time soon, as its avoidable death rates have stayed consistent over the past decade. Meanwhile, reports are surfacing every couple of years recommending measures to combat the system’s many ills, but the people of Nunavut have yet to see any real change.