As someone who lives in an Inuit region in a province within an Atlantic FNIHB region, there is a serious disconnect. The people most disconnected are we, the Inuit, who are engaged with FNIHB but not engaged with the province, which has responsibility for our public health. That's a real challenge.
In fact, if you read the document on TB control for Canada, there's no clarity around who is responsible for Inuit. It contradicts itself, and again today I've heard another contradiction, particularly for Nunavik and Nunatsiavut in Quebec and in the Province of Newfoundland and Labrador.
I suggest that's part of the problem. The Canadian Tuberculosis Standards has only one paragraph that addresses special concerns for remote and isolated communities. For those of us looking for guidance on practice, it doesn't fit. In that paragraph on page 266 it suggests there are particular challenges, and perhaps extra mobile test units need to be brought to a community. If they are not, who do you then hold responsible?