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Dr. Marina Ulanova reflects on 13 years of discovery

Dr. Marina Ulanova has been studying Haemophilus influenzae infection in Northwestern Ontario for the entirety of her 13 years as a faculty member at the Northern Ontario School of Medicine.

Despite its name, Haemophilus influenzae has nothing to do with the flu, says Ulanova. While the flu is caused by the influenza virus, Haemophilus influenzae is a bacterial infection. There are several types of Haemophilus influenzae, which can cause invasive infections, leading to serious illnesses including pneumonia, meningitis, sepsis and epiglottitis, all of which can result in permanent disability or death.

Prior to 1990, Haemophilus influenzae type B (HiB) was the most common cause of pediatric meningitis in Canada, according to data from the Public Health Agency of Canada. In the early nineties, a vaccine targeting this specific type of the bacteria became widely available, after which HiB infections became incredibly rare.

However, as the rate of HiB infections in Canada began to decline, infections caused by other types of the Haemophilus influenzae bacteria began to increase, specifically type A (HiA).

Throughout her tenure at NOSM, Ulanova and her research team have made numerous significant discoveries about HiA, including its prevalence in Northwestern Ontario and in Indigenous versus non-Indigenous populations in the region, as well as about natural immune defenses against this infection.

A study led by Ulanova found that 50 per cent of invasive Haemophilus influenzae disease in Northwestern Ontario since 2002 have been caused by HiA, compared with 5 per cent in the rest of the province. Moreover, it appears that Northwestern Ontario has one of the highest incidence rates of invasive HiA disease in any region in the country, second only to Nunavut.

Her research team also discovered that the rate of HiA invasive disease was much higher in Indigenous populations in the region when compared to non-Indigenous populations.

Data from her team’s research has contributed significantly to the development of a new HiA vaccine currently being tested by the National Research Council.

Ulanova says she is proud that her research has been able to both identify a problem and contribute to the solution.

“When I first started this research, Canada’s Immunization Monitoring Program ACTive (IMPACT) was only reporting cases of invasive HiA disease from 12 Canadian pediatric hospitals, and the closest ones were in Winnipeg and Ottawa,” she says. “Our region was just not represented in their data. So we really were out in front of this, and we were able to identify how significant a problem was for the people of Northwestern Ontario as we found serious cases of this infection affecting young children in First Nations communities.”

The opportunities to collaborate with physicians, students and Indigenous communities, including the Nishnawbe Aski Nation, in the province have allowed her to research clinical questions relevant to the population that NOSM serves, and helped her to contribute to improving the quality of care that population receives.

“Before I came to NOSM, I did basic science research, which allowed me to address a lot of interesting questions, but it never really went beyond the lab,” says Ulanova. “Now, to see the real impact my research has had, that’s an incredible feeling, and it’s NOSM that made it possible.”

 

Read more stories like this one int he latest edition of The Scope.

‘What’s good about our relationships,
and how can we create more of that?

Noojamadaa: Helping build healthy relationships within Anishnawbek communities

Marion Maar, Associate Professor of Medical Anthropology at the Northern Ontario School of Medicine (NOSM), together with First Nations communities of Manitoulin Island and LU Master of Indigenous relations graduate, Beaudin Bennett, has created Noojamadaa, an educational photo exhibit exploring healthy relationships in First Nations families and communities.

Before coming to NOSM, Maar was a researcher with an Aboriginal Health Access Centre on Manitoulin Island for eight years. Because of her longstanding relationship with the communities, she was approached about working on a community-based research project to address intimate partner violence.

Research has shown Indigenous women experience intimate partner violence at a higher rate than non-Indigenous women, with significant health and social consequences, says Maar, but many primary-care practitioners need to learn more about what their role should be in addressing it.

Maar says some of the goals of the research project are to understand the context of intimate partner violence and the role of primary care practitioners in addressing violence their patients experience at home, and what kind of training and resources they need to better fulfill that role.

She says the communities chose to begin the research through a photo exhibit exploring healthy relationships among the Anishnawbek. Participating women explained that in order to reduce intimate partner violence, relationships needed to be healed not only between spouses, but also with their families, communities, the Nation and the environment.

“It’s a difficult topic, and the communities decided that creating awareness was the first step,” says Maar. “The communities didn’t want to take a negative approach to it, or have Indigenous people reduced to a statistic. Communities asked: ‘What’s good about our relationships, and how can we create more of that?”

Randy Trudeau is one of the facilitators of Noojamadaa. A hunter, fisherman, trapper and artist, Trudeau says he wanted to share the healing power of building a relationship with the land.

After being approached by the research team to participate in the project, Trudeau agreed to allow a photographer to shadow him throughout his day to day life, taking photos to demonstrate how he has built a relationship with his environment.

“I find that throughout all I’ve gone through in my life, all the traumas, my healer has always been nature,” he says. “So I’ve dedicated my life to living off the land, living peacefully and learning ways to heal myself, and teaching other men to do the same.”

The exhibit has expanded to include art that displays healthy relationships, and Trudeau has also contributed paintings to the exhibit.

To date, Noojamadaa has been displayed in diverse venues, including at the Laurentian University School of Architecture, the Debajehmujig Creation Centre in Manitowaning, and the Sudbury District Health Unit, McMaster University and Queen’s Park. The exhibit is also accredited for continuing education.

The project was initially funded by the Women’s Xchange $15K Challenge, but additional funding from the Canadian Institutes of Health Research (CIHR) was provided to explore a holistic approach to address violence, trauma and opioid addictions.

“The CHIR grant will help us to increase collaboration and relationship building with all relevant service sectors, including mental health, social services, child protection, justice and police so we can better develop and coordinate roles of each sector in addressing intimate partner violence, and underlying issues including addictions, in a culturally safe way,” says Maar.

Read more stories like this one in the latest edition of The Scope.

Indigenous Health Research

Three NOSM faculty members have contributed to the recently published Indigenous Research: Theories, Practices and Relationships.

This edited collection provides readers with concrete and in-depth examples of how to overcome the challenges of Indigenous research with respect to Indigenous worldviews, epistemologies and ontology. In collaboration with their communities, and with guidance from Elders and other traditional knowledge keepers, each contributor links their personal narrative of Indigenous research to current discussions and debates.

Dr. Lorrilee McGregor, Assistant Professor of Indigenous Health, wrote a chapter titled Conducting Community-Based Research in First Nation Communities. Dr. Marion Maar, Associate Professor of Medical Anthropology, and Dr. Darrel Manitowabi, Interim Director of the Indigenous Affairs Unit and Assistant Professor of Medical Anthropology, co-authored a chapter titled Applying Indigenous Health Community-Based Participatory Research.

For more information about Indigenous Research: Theories, Practices and Relationships, visit https://bit.ly/2IlFfe5

NOSM University