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GOACOM BIOGRAPHY SERIES
LETTERS FROM MARIA
Maria Fraser (nee Fernandes ) is a Health Nurse Repulse Bay, in the North West Territories of
Canada.
To locate Repulse Bay on the map of Canada, follow the Arctic Circle ( lat. 67.5 deg)
westward, to intersect the west side of the Hudson Bay.
The residents of this eastern Arctic area are called Inuit. They have chosen Iqaluit as
the capital of the Nunavut territory which will be established in 1999.
June 1996 ~A DAY IN THE LIFE OF A NURSE IN REPULSE BAY
April 1996 ~MEDICAL EMERGENCY AT REPULSE BAY
- December 1995 ~ CHRISTMAS IN THE ARCTIC
A DAY IN THE LIFE OF A NURSE IN REPULSE BAY
By Maria Fraser (nee Fernandes)
Today is 2nd June 1996. It is the time of the year that the sun never sets. At the Arctic
Circle, we enjoy 24 hours of daylight. By 23.00 hours, it tends to get slightly dusky. I am writing
this article at 20.00 hours and the brightness can be compared to a summer's day in Toronto. The
snow and ice are starting to melt and everywhere streams of water gush down the rocky soil form,
with little children in rubber boots having fun. The Hudson Bay is still frozen and in the distance I
can see a blue haze where the waters are starting to thaw.
It's Sunday and this weekend was my turn to be on call. Between Friday at 17.00 hours
and today I have had four emergency calls: One woman in premature labour, a child with tonsillitis
and high fever, a newborn with a high fever and a terminally-ill, 53-year-old woman suffering from
Cancer of the lung and needing an increase of her Morphine dosage. The latter was a a visit to her
home.With an all terrain vehicle, it took five minutes to get through the rain and mud.
My normal work hours are 08.30 hours to 17.00 hours. On call commences after that till
the next morning at 08.30 hours. I carry a Radio Phone whenever I have to leave the Health Centre
to go grocery shopping, do a house call or go for my daily 4km walk.
In the winter when the temperatures drop to -45 degrees, my attire changes to a down-filled
parka and pants. I prefer wearing seal-skin cammuks (boots) as they are much warmer and lighter
than the heavy sorrels. When the temperature drops to -50, I prefer to wear cariboo skin cammuks.
My mitts are made of husky dog fur. These are the warmest. The poor husky was a pup and had a
chicken bone stuck in its throat that was too far for me to reach. The hunter decided to shoot the
dog. Nothing is wasted here! the skin was used to make mitts that the hunter's wife sewed for me. I
still use them in the winter and they are a treasure to me as this lady was also my patient suffering
from terminal cancer of the breast. The summers are very quiet in Repulse Bay as most of the
community camp out on the land in search of fish and cariboo. They are nomads and this is part of
their culture to live off the land. The children collect little berries supposed to be rich in Vitamin C.
this is the only time of the year that they can build stores of Vitamin C. I have noticed that, due to
vitamin deficiency, the children are very prone to respiratory illnesses.
The community, made up of 560 residents, enjoy a comparatively healthy lifestyle,
considering the lack of nutritious food, adequate housing and lack of employment. It's almost
summer when the Sea-Lift comes from Montreal to bring our food supplies for the year. The
beginning of August is a happy day for everyone. Food that is not obtainable at the grocery store,
such as meat and frozen vegetables will be on the sea-lift. Sugar, tea, coffee and flour can be
bought at the store, but each item costs four times as much.
As for me, I cannot do without our Goan dishes and have therefore stocked up on spices
from Kenya when I was in Nairobi, last summer. I did bring back Kenya tea and coffee which will
last me quite a while, as I only use it as a treat now and then.
The Roman Catholic Mission was started by an Oblate Priest from France. He has been in
the north for 46 years. All that I needed to know about the people I obtained-valid information
about their culture and habits. The priest speaks fluent Inukitut and the Mass is in Inukitut. I wish
I had more time to learn this language. It would help me arrive at the right diagnoses immediately
rather than the tedious route of going through an interpreter. I must say that the people are intuitive
to understand who we are.
Nothing can grow in Repulse Bay, as the ground is permafrost. The dead are not buried,
but placed in wooden coffins on the land and covered with rocks in the cemetery. Even the
strongest blizzards and gales cannot move the rocks. The priest, however, has started his own
greenhouse and already he has lettuce, spring onions, radishes and flowers. He is away on his
annual retreat in Ottawa and I have volunteered to water his plants. Of course, he lets me help
myself to the fresh vegetables when they are ready.
I have to end here as I have just been called by a teenager with abdominal pain. Greetings
to all my friends and relatives. Maria Fraser (nee Fernandes).
MEDICAL EMERGENCY AT REPULSE BAY.
By Maria Fraser (nee Fernandes).
It began on February, 16, at about 1.45 p.m., with the outside temperature -60 C. Shiela, a
19 year old Inuit woman collapsed on the doorstep of the local grocery store, and within minutes
was only responsive to painful stimuli. The local residents rush her on a skidoo over rough terrain
to the Health Centre. On arrival, Shiela was in a state of shock, her pulse barely palpable, blood
pressure 70/0. She had marked pallor and was unresponsive to verbal command. The two
registered nurses at the Health Centre immediately commenced resuscitative measures. Two large
bore intra-venous lines were started in each arm at 14.10 hours. Normal Saline and Lactated
Ringers solution were now infusing at a high rate to bring up her blood-pressure. Oxygen was
administered via a face mask.
A diagnosis was made of a definate ruptured ectopic pregnancy, as soon as the call was
received from the grocery store manager. An emergency medical evacuation was arranged for the
patient to be transferred to Churchill, Manitoba, and then subsequently to a Winnipeg hospital
operating room.
Shiela's prior health condition was well known, as she had visited the Health Centre the
day before for other personal reasons and in passing remarked to the nurse there "I am not sure if I
may be pregnant!" Upon testing her, she was found to be Gravindex positive. He gestation was 8
weeks according to her dates and on bi-manual exam. Knowing her previous obstetric history of an
ectopic pregnancy in the last year, 1995, the immediate reaction was to exclude the possibility of
another ectopic pregnancy. The plan had been to transfer her at he next commercially available
flight to a hospital for an ultrasound exam to exclude an ectopic pregnancy. It was fortunate that
Sheila was not able to board the aircraft on the morning of February 16th. Had she done so, the
plane would have been in the air for only an hour before Sheila would have experienced a sharp
pain in her lower abdomen.
At 16.00 hours, Shiela was showing signs of renal failure and again her blood-pressure
was recording 70 diastolic and her pulse barely 60. Blood drawn from a venous site in the forearm
showed rose-coloured fluid. This was all the crystalliods that had been infused into her. Her
abdominal girth was increasing in size, and her body was odematous. Her breathing was
compromised due to the fact that her diaphagram was literally pushed up be the increasing build-up
of fluids in her abdomen. It was evident that she was in impending danger, with the medical
evacuation unit more than four hours away. The doctor was contacted at the hospital for further
advise as to Shiela's management. The response was to give her whole blood if there was any.
Obtaining fresh blood is not in the mandate of the nurses at the health Centre. However,
the doctor had given permission to phlebotomize any O negative and O positive resident. The only
patients previously screened were pregnant mothers. These women were routinely screened for
Hepatitis. That afternoon 14 women donated blood which was rapidly transfused into Shiela. After
the first three units were transfused, her blood pressure was 100 diastolic. This was a promising
sign and Shiela was responding to verbal commands. Transfusions were continued till 20.00 hours
when the plane with three doctors and a flight nurse arrived to the rescue.
As Shiela was now stabilized and her haemoglobin was reading 10 she was intubated and a
further 3 sites of intra-venous access was established. The plane left Repulse Bay at 22.30 hour
with Shiela for transport to Yellowknife, a four hour flight with one stop enroute for re-fuelling.
Postscript by Nurse Maria Fraser (nee Fernandes).
I did not get to bed that night until I had heard of the outcome from the surgeon. Shiela
was a
fighter and she had made it with the help of everyone who took part in saving her life. This has
been a tremendous lesson to everyone here in Repulse Bay. It surprised me to learn that one of the
women who donated blood had last year attempted suicide as life had no meaning for her, yet she
was there wanting to save Shiela.
I believe that all events occur for a purpose, and in this instance conclude that the team
effort of the whole community played an important role in saving a life. Everyone was generous in
their time, prayers, blood and above all in their love for Shiela, who at the time of this writing is
back in Repulse Bay. (End)
December 1995 ~ CHRISTMAS IN THE ARCTIC
This is my fifth Christmas in Repulse Bay. We are situated on the Arctic Circle on the
western side of the Hudson Bay. The temperatures today are -30 deg. C to -35 deg. C.
There are pleasant days with the clear skies and the storm days leading to a 'white-out'. Nobody
steps outside their home for fear of getting lost in the barren tundra.
We wear down-filled parkas and pants when outside the home. The main occupation of the
inhabitants is hunting and trapping. Polar Bear fur is sold for $100 a sq. foot. Caribou meat,
arctic-char, seal, walrus and berries in the summer months are food resources. Groceries are flown-
in three times a week and are very expensive. Air-freight is very expensive. I order my supplies on
the sea-lift that comes once a year in August. That's when the waters in the Hudson Bay open. In
the winter we only have two hours of daylight. In the summer it never gets dark! In order to sleep I
have to darken my windows!
My work here as a nurse is very challenging as there is no doctor here. The closest hospital
contact is a four hour flight away. I communicate with the doctor for complicated cases by
telephone. We do not have a computer, and as yet not a touch-tone telephone. Telephone is via
satellite. I can telephone my brothers in England, and in Italy, but there are noticeable delays in the
communicating.
The simplicity of the people makes Christmas what it should actually be, of peace and
happiness. Christmas is not commercialized as material goods are unobtainable. The people live
on the bare necessities and have to hunt for their food.
I certainly enjoy Christmas here. It has a very special meaning and does not take very
much to make someone else happy. At the Health Centre, each year we organize a small get
together of the elders and the sick who may not be here the next year. I look forward to preparing a
meal and to bake for the elders and to see them sharing their wealth of experience in he Cold North,
and for having survived this long.
A Very Happy Christmas to you, and all the friends that I may know in Toronto, and the
rest of the world. Here is a Goan Girl, from Nairobi, Kenya, who is not afraid of the cold!
Maria Fraser (nee Fernandes).
Notes: - Maria attended the Goan Secondary School, Nairobi; Class of 1963.
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