LA RONGE, Sask. - Doctors in La Ronge, Sask., have treated 27 cases of scurvy within the last six months, bringing to light the severe impact of food insecurity in the province’s North.
Dr. Jeff Irvine told the news website larongeNow that a colleague was surprised to diagnose a case in May.
“The physician started to get some red flags from his other patients and started noticing that there’s even more signs and symptoms of scurvy in these other patients," Irvine said.
"So they started testing more and more, and we’re finding more and more scurvy cases because of that now.”
The Lac La Ronge Indian Band hired Irvine to chair an investigation into vitamin C deficiency among members and the wider community. Of 50 vitamin C blood tests, 27 were confirmed to be deficient, pointing to scurvy, and 10 showed low levels. All patients were over 20 years old and 79 per cent were Indigenous.
Scurvy symptoms vary from fatigue and joint pain to hair changes, wounds not healing and loss of teeth.
The first case in La Ronge came almost by fluke. One of Dr. Yoseph Atreyu’s patients came to him with joint pain and, during examination, Atreyu noticed a curious pattern of corkscrew hairs on the person’s knee. He ordered a blood test, which showed vitamin C levels low enough to match a scurvy diagnosis.
Atreyu said he had thought scurvy would be a long shot.
"This person wasn’t low economic status, had a good paying job, ate well and was still having the issue,” he said. "This was the first case that I’ve confirmed. But thinking back in the past, I do wonder if I’ve seen it before."
It’s also led him to wonder about more vulnerable populations, including children.
"I just don’t want to expose them to a poke for something that I know I can treat. I have been prescribing vitamin C a lot," he said, noting some kids are coming to the clinic with low energy and dental issues symptomatic of scurvy.
Atreyu said in his research the only data he could draw upon was a nutritional status study in 2013. For the Prairies region, the sampling came from two urban sites. The overall results suggested 3.9 per cent of ϳԹs face vitamin C deficiency.
When looking for data for La Ronge or the Far North, there was none, something Irvine and Atreyu hope to change.
Despite scurvy’s rarity in modern medicine, the La Ronge diagnoses aligned with findings from a recent First Nations Food, Nutrition and Environment survey, which revealed 42 per cent of respondents couldn’t afford balanced meals. A 2022 Saskatchewan Health Authority report noted the average weekly cost of nutritious food for a family of four was about $291, rising to $358 in the North and $464 in the Far North.
Fresh produce is hard to come by in the La Ronge area, and foraging for it has seasonal limitations.
For local retailers, co-ordinating a delivery of fresh food isn’t usually worth the minimal profit. The long travel distance leads to spoilage and fuel costs increase the consumer price.
Traditional foods like rosehip, Labrador tea, spruce needles, fireweed and mint have higher levels of vitamin C. Moderate amounts can be found in animal heart, liver and kidneys. But obtaining those foods is weather-dependent.
Further north, the problem intensifies, and the solution for many is out of reach. The more pressing issue is the ongoing stress of meeting basic needs, including stable housing.
“You can’t be talking to people about healthy eating when they don’t have a place to live,” Irvine said.
In assessing how widespread the problem is, the test for scurvy suffers from similar challenges to food transport.
Samples must be kept in darkness at temperatures below -70 C and, because of limited lab capabilities in La Ronge, they are shipped on dry ice to a lab in Regina lab for testing.
In the Far North, these requirements present too large of a logistical hurdle, meaning blood drawing can only happen in La Ronge.
The doctors aim to obtain federal funding to get a more detailed picture of scurvy’s impacts. Atreyu and Irvine hope to partner with other doctors in Saskatchewan and share their findings nationally.
It costs about 33 cents a month to buy enough vitamin C over-the-counter to satisfy the body's needs, Atreyu said, but it's a matter of getting that information out to the masses.
“It’s a disease with a known cure." (larongeNOW)
This report by ϳԹ was first published Nov. 15, 2024.
