Thank you. What is the wish of the committee? Previous agreement was to deal with Tabled Document 91-12(3), Northwest Territories AIDS Project - Review, and Tabled Document 92-12(3), HIV and AIDS in the NWT in 1993. Mr. Koe.

Mr. Chairman, this committee would like to deal with Tabled Document 91-12(3), Northwest Territories AIDS Project - Review and Tabled Document 92-12(3), HIV and AIDS in the NWT in 1993. Thank you.

Is the committee agreed?

Agreed.

---Agreed

Thank you. Ms. Mike, do you wish to invite witnesses at this time? Ms. Mike, do you have opening remarks at this time?

Thank you, Mr. Chairman. Yes, I do.

Proceed.

Qujannamiik, Mr. Chairman. Since AIDS has been recognized as a serious threat, the number of infections seem to be increasing slowly in the NWT. There was some hope that NWT residents would accept the information about the disease and how to protect themselves but, over the past year, the number of reported cases has almost doubled and now totals 24. Of these, six are known to have died from AIDS and another six have left the NWT. Those persons who were infected early in the epidemic were infected outside of the NWT. More recently, infections are increasingly being acquired in the NWT.

A major effort has been made to ensure that all NWT residents were made aware of the risk of infection and how to protect themselves. In spite of knowing about the risk, there is evidence that many people are not taking action. We must convince everyone, no matter where they live, that they risk infection with HIV if they engage in unprotected sex. I have asked Dr. Ian Gilchrist, chief medical health officer for the NWT, to tell you what is known about the current situation and what we can do about it. Thank you, Mr. Chairman.

Thank you, Madam Minister. Does the committee agree that the Minister can bring in the witness?

Agreed.

---Agreed

Proceed, Madam Minister. Sergeant-at-Arms, please escort the witness to the witness table.

I have been informed that the witness is not available at this time. We will take a short break and come back when the witness is ready. Thank you.

---SHORT RECESS

I would like to call the committee back to order. I would ask the Minister if her witnesses are now available to come in.

Thank you, Mr. Chairman. I am now ready to bring in the witnesses.

All right. We will ask the Sergeant-at-Arms to assist the witnesses to the witness table.

Thank you. Madam Minister, would you please introduce your witnesses, for the record.

Thank you, Mr. Chairman. I have with me Dr. Gilchrist and the assistant deputy minister, Elaine Berthelet. Thank you.

Thank you, Madam Minister. Does the Minister have any further comments at this point?

No, I do not. If there are any comments or questions, Dr. Gilchrist will be able to respond to the questions you may have.

Thank you, Madam Minister. Do any of the Members have any general comments to make? Mr. Lewis.

General Comments

Thanks, Mr. Chairman. The two documents which were tabled in the Assembly and moved into committee of the whole, so we could have public discussion, even though it may be a short one, came about as a result of an initiative of the Department of Health to brief all Members in our Caucus on the nature of the problem as the Department of Health perceived it. Members took that to mean that when the officials requested they have a meeting with each Member, that this is something that they really want to pay particular attention to. It was for that reason we attended that meeting and took the concerns of the department very seriously, and felt even though we have a very busy schedule, it is fairly clear that we have crowded our agenda to such an extent that this topic, which is of great concern to the department, is probably not going to get the kind of exposure we would like to give it.

The reason I believe we should at least spend some time on it, is that it is one of the issues surrounded in mystery for many people. Right throughout the ages you have had these killer diseases, plagues and things which have frightened people. The reason for that, of course, is very often the public is either mislead or they have not taken the trouble to inform themselves about the nature of the problem so it is like a boogie man, a frightening thing that just sits there and is a menace. Everyone wants to find an easy, simple solution.

One of the things that bothers me a little bit, Mr. Chairman, and maybe my thinking is just old fashioned and maybe I am a little out of date, but what I hear from many people is that we could solve this, we could go a long way to solving it if somehow we could publicize the threat that surrounds us. If there are 15, 16 or 200 people, if we knew who all those people were then we would lick it because we would know what to avoid. It would no longer be a boogie man or a mystery, we could identify it by the names of the people who are a threat to us as a society. That is the way people used to think a couple hundred years ago, where if you saw someone who was a treat you would put a mark on their forehead or something which would identify that person as being a threat. It may be that if we were to take that approach you may get the kinds of reactions that, for the long-term health and security of our communities, it would not really solve it.

That is a concern I have, it is a boogie man and people want to find a simple solution. However, I do not think the simple solution is the one that is going to work. The way, from my point of view, this could be resolved is if we find a way of stripping the ignorance. If you can say that this is the nature of it, as we learn more we will find better ways of informing people so it is no longer a mystery or frightening thing. If we just take advantage of what we know and what we learn, we can solve it. The three solutions given to us were clearly laid out. We know exactly what the treat is. If we do these three things we eliminate that fear and that danger, and we should be able to have a fairly healthy population.

I may have just stated a very over-simplified approach in dealing with this issue, but that is the feeling I have. People want to find some quick solution, a pill you can just take and you are safe, or a list of names of people to keep away from. I think if we would allow the medical people to repeat for us what they believe are the obvious things we have to do, we will protect ourselves from this plague of the twentieth century.

I know we come up against problems from time to time, but eventually we come up with a solution. It may be what we have now is just an interim solution, but it seems to me, from what I have heard, that this is one that if people are prepared to change their behaviour, could work. That is the trick, how do you change people's behaviours? My question would be how do you get people to change their behaviour?

Thank you, Mr. Lewis. Would you like to respond, Madam Minister?

Thank you, Mr. Chairman. I will let Dr. Gilchrist respond.

Dr. Gilchrist.

Thank you, Mr. Chairman. We were fortunate enough to have a chance to meet with Caucus a few days ago. I appreciated that because I think the solution which Mr. Lewis is referring to is a solution which is going to come from multiple sources. One of the problems and challenges which I think we all face with regard to the control of AIDS is that health problems, often if not usually, are seen as having a solution in the care and treatment of the sick. However, AIDS is a perfect example of where that is not the case. The only real answer to AIDS lies in prevention. Prevention is not at all the special expert area of health people. It is an area which anyone can get into and it has been really gratifying to me, to

note the preventive lead with regard to AIDS which has come from trustees of regional health boards, patient and dedicated CHRs, community groups, friendship centres, the media and from Members of this Legislative Assembly. Health professionals have taken part in that but they alone are not going to solve this problem. The problem, as Mr. Lewis has suggested, is one of actually changing the very way we are, and of changing the things which we do.

The things which we have been learning about the virus have also been leading us to look at other things which we do not know, especially about our reproductive systems and our sexuality. This area of intimacy has very appropriately been protected by our modesty and our privacy. Our reproductive systems are a source of joy to us because they give us our children whom we love. It gives us comfort and bodily pleasure and it is an area about which we do not speak easily. We do not know much about the behaviours related to it which can put us at risk and how they differ from group to group, person to person, community to community and culture to culture.

In a sense, we are having to learn two things at once. We are having to learn about a mysterious predator, a virus which has come unexpectedly among us, and we are having to learn about how we behave and how the two interact to put us at risk. What is happening here is not very different from what is happening in the rest of Canada except one thing above all that is different. If I could I would like to outline what we know, in point form, about it.

The most important point, I think, is the difference between us and the south in the sense that most of our cases are being spread between men and women the same way they are in most parts of the world, but in a different way from what occurs in the large cities of the United States and Canada.

The solutions which Mr. Lewis refers to, I do not think there are any easy ones. It is one of those situations where a fragmented approach is not going to work. Individuals, nurses, doctors, health regions and communities hide from this issue. The solution will come much more slowly and much more painfully than if all were to work together on this. Neither the virus nor our sexuality recognizes any boundaries. We need to continue to have accurate and rapid information and reporting. We need to study the situation carefully and to share the information we receive. We need to continue to learn what we do not understand about the virus and about ourselves. We need to look to community leaders and the public and not just count on health professionals in order to find a way to deal with this.

I took note of Mr. Lewis' remarks a few days ago, including his reminder from Bishop Sperry that we need to remember, when we look at serious matters such as this, the good news, and there is some. It looks as if the numbers of cases of other sexually transmitted diseases, the ones you get in exactly the same way you get HIV or AIDS have fell down last year. The numbers were down for the first time in a long time. Just maybe the message about the risk that we all face from AIDS is getting through. Certainly, there have been many impressive messages, carried by the department and regional health boards and others, that we have learned from others and have shared with others.

Mr. Chairman, Members of this Assembly have been particularly important in helping to deliver the message. Many have worked long and hard and many have real extensive knowledge of the elements of the problem. I want to thank them for helping me, as your chief medical health officer, in my mandate to try to deal with this issue. I want to assure you that support and help with this burden will be always welcomed and I will endeavour to inform the Minister on each step of the way as to what we know and what we can or cannot, or may or may not be able to do in a technical sense. Thank you, Mr. Chairman.

Thank you, Dr. Gilchrist. Are there any other questions or comments? Mr. Lewis.