“Symbol of the IGA”: The International Grenfell Association hospital ship Strathcona and the 1970 mass tuberculosis survey of northern Labrador

The Strathcona III in Labrador. Source: Among the Deep Sea Fishers 68, no. 4 (January 1971): 105. Photo courtesy of Memorial University Digital Archives Initiative.

John R.H. Matchim

Since the Canadian Coast Guard icebreaker Amundsen was reactivated in 2004 it has conducted multiple mass health surveys of Inuit communities across the Canadian Arctic. In 2004 and 2017 surveys organized by the Nunavik Regional Board of Health and Social Services and Laval University’s Population Health Unit asked some 2,000 residents questions about housing, family violence, addictions, food insecurity and the reappearance of tuberculosis. While its promoters spoke of improved community health outcomes and “empowerment,” the data was also used “to compare the current situation with the health and social repercussions of the Plan Nord,” Quebec’s contentious programme of northern industrialization.[1] Another pair of surveys, conducted in 2007 and 2008, was funded by the federal government as part of the 2007-08 International Polar Year, and its researchers interviewed and examined adults and children in Nunatsiavut, Kitikmeot, and Inuvialuit regions. Launched to great fanfare, the surveys have been criticized for a lack of transparency and withholding of research findings.[2]

The Amundsen was a critical component of these surveys, providing researchers and governments with a platform that could move technology and people through adverse Artic conditions and sustain them for months at a time. But the Amundsen is just the latest of a long line of ships that have provided governments, companies and health care providers with a means to extend authority, monitor populations, and carry out research in a vast territory that challenges conventional methods of governance. Indeed, news of the Amundsen’s planned visit in 2004 awakened painful memories of the C.D. Howe, another icebreaker that conducted tuberculosis surveys during the 1960s and forcibly removed Inuit to sanitoria in southern Ontario.[3] Drawing upon my on-going research of the International Grenfell Association (IGA), a semi-autonomous health care provider active in Labrador until 1981, this piece will provide some historical context for the contemporary health surveys of the Amundsen. In particular, it will highlight the IGA’s mass tuberculosis survey of Inuit communities in northern Labrador, conducted by the hospital ship Strathcona III in the summer of 1970.

The IGA has its origins in the 1890s when the British physician Wilfrid Grenfell was despatched to Labrador by the London-based National Mission to Deep Sea Fishermen (NMDSF), an evangelical organization that provided medical assistance to British trawler crews at sea. By 1900 the Grenfell Medical Mission (incorporated as the IGA in 1914) was firmly established in northern Newfoundland and southeastern Labrador. One of the IGA’s most valuable assets – both as a medical platform and publicity symbol – was the purpose-built hospital ship Strathcona. Built by the Devon shipyard of Philip and Son in 1899, the Strathcona was equipped with a modern dispensary and x-ray apparatus, possibly the first designed for use at sea.[4] In addition to providing basic clinical services the Strathcona also acted as a marine ambulance, floating court, and a travelling church.

While the Strathcona was an indispensable part of the IGA’s social and medical work, maintaining a hospital ship was expensive and not always possible. When Newfoundland confederated with Canada in 1949, the IGA hospital ‘ship’ was the tiny Maraval, a converted wooden yacht brought to Labrador twenty years before. However, following Confederation the IGA expanded its medical reach to include the Inuit communities of northern Labrador, until recently the preserve of the Moravian Mission, and the federal government provided additional funding “to treat Native tuberculosis patients.”[5]  Northern expansion and tuberculosis control was a difficult proposition, given the region’s remote population and lack of infrastructure, and the IGA participated in the forced relocation of two of the most isolated Inuit communities in the late 1950s.[6] However, while centralization caused considerable hardship for the ‘resettled’ communities, tuberculosis persisted.

The failure to control tuberculosis was frustrating for an organization that routinely made claims of social and medical progress in all areas since Confederation. To resolve this frustrating impasse the IGA turned in 1970 to the Strathcona III, a purpose-built hospital ship constructed in 1966 that was equipped with a full x-ray clinic. This was not to be the first ship-mounted x-ray survey for tuberculosis conducted by the IGA: in the late 1940s it had used the Maraval to experiment with x-ray surveys, and shortly after Confederation the first “total x-ray survey of Labrador North” was made using the RCMP cutter McBrien.[7] But the Strathcona III offered a major leap in capability. With an ice-reinforced hull. shallow keel, radar and depth sounder the Strathcona III could safely navigate the narrow fjords of northern Labrador frequented by Inuit and Innu communities during the summer. In the summer of 1970, the Strathcona III was despatched north with instructions to remove anybody who showed signs positive for the disease.

While the construction and deployment of the Strathcona III was likely shaped by the IGA’s experience with the Maraval and the McBrien, the 1970 survey also had significant parallels to the federal government’s Eastern Arctic Patrol (EAP), which was supported by the aforementioned C.D. Howe. The EAP was a multi-department initiative that used the C.D. Howe to supply goods to remote northern communities, transport federal personnel, carry out scientific expeditions and administer justice. The C.D. Howe was also designed with a well-equipped medical section and separate quarters for Inuit patients who showed signs positive for tuberculosis. Since the C.D. Howe could only spend one or two days in each community, the ship’s doctors adopted what Pat Sandiford Grygier called a “production-line” system.[8] Before the C.D. Howe arrived at a community, the local priest, RCMP officer or Hudson’s Bay Company factor was expected to gather residents for x-ray examination. If a patient was showing signs positive for tuberculosis, they were immediately sent below deck, unable to make arrangements for their families or even to say goodbye. 

Unlike the early expeditions mounted by the EAP, the IGA made some effort to provide Inuit patients with a translator. Additionally, while Inuit removed to southern Ontario by the EAP remained in sanitoria there for years, and sometimes for the rest of their lives, the IGA’s own sanitorium in North West River was closer to home. Nevertheless, the IGA’s patrol was carried out with speed, and Inuit removed to North West River remained there for as long as it was “necessary to get a consistently negative sputum.”[9] Furthermore, the Strathcona III’s survey included an IGA photographer, and a number of patient photographs were published (almost certainly without consent) in the pages of the IGA’s in-house magazine.  

The 1970 mass tuberculosis survey began in early July, but towards the end of that month the Strathcona III was suddenly rushed to the far north of Labrador. As the supervising physician Anthony Paddon explained: “we decided to send her directly to Nain non-stop as the Eskimo fishermen north of Nain were due to start migrating shortly, and it was felt essential to reach them while their locations were known.”[10] The Strathcona’s first stopping point was Seglak Bay. “Sad to say,” Paddon wrote, “in this port we picked up active TB, and also in those in the north.”[11] Around six people were taken from their boats in Seglak, and Paddon does not specify how the separation of families was managed. If they were removed by air ambulance, the process would have been swift as well as bewildering, although it is not clear if aircraft were employed in this particular operation. 

The Strathcona travelled as far north as the Torngat Mountains where 17 Inuit fishers were “found.”[12] Reflecting the IGA’s frustration with the persistence of tuberculosis – a frustration that risked forgetting the victim for the disease – Paddon described the patrol as an “assault” on the disease, with “eradication” the only acceptable outcome.[13] At this point the Strathcona’s “X-Ray score,” as Paddon called, it was nearing 900, but he was “determined to make it complete to the last man.”[14] The x-ray “score” ultimately reached 3,500, and the Strathcona III’s ability to extend the IGA’s medical gaze into even the remotest parts of Labrador is reflected in Paddon’s ominous remark that for Inuit communities the ship was the “symbol of the IGA.”[15]

The Marine Trader, formerly the Strathcona III, in St. John’s harbour today. Photo courtesy of Zach Bonnell Photography.

At the end of the voyage Paddon praised the capabilities of the Strathcona III, writing that “in the far North the most perfect vehicle for carrying out our medical work” was still a well-equipped ship.[17] However, the Strathcona III was a technological solution to a disease with complex social and historical origins, and the IGA made little effort to understand the communities subjected to its gaze. As Peter Evans wrote, IGA x-ray surveys “peered into the bodies of Inuit children and adults, pathologizing their lifestyles and placing tuberculosis squarely at the centre of the knot of related concerns – from housing to diet to transportation.”[17] These shortcomings are worth remembering as, fifty years later, the Amundsen carries “outside expertise” on medical surveys throughout the Canadian Arctic.[18] While the postwar Canadian state pursued a number of programs designed to centralize rural-remote populations, the mobility and endurance provided by ships continues to play an important – if often overlooked – role in the Canadian state’s administration of the Arctic.

John R.H. Matchim is a PhD candidate with the University of New Brunswick’s Department of History. His research examines rural-remote health care in northern Newfoundland and Labrador.

[1] Nunavik Regional Board of Health and Social Services, “What is Qanuilirpitaa? 2017” (May 2020).

[2] Editorial, “Qanuippitali: IPY’s biggest dud,” Nunatsiak News (8 May 2012).

[3] Graeme Smith, “Ship’s passage opens old wounds for Inuit,” The Globe and Mail (10 July 2004). 

[4] Ronald Rompkey, Grenfell of Labrador: A Biography (Montreal and Kingston: McGill-Queen’s University Press, 2009), 101.

[5] Heidi Coombs-Thorne, “Nursing with the Grenfell Mission in Northern Newfoundland and Labrador, 1939-1981,” (PhD dissertation, University of New Brunswick, 2010), 77-78.

[6] For more on the relocation of Hebron and Nutak see Peter Evans, “Abandoned and Ousted by the State: The Relocations from Nutak and Hebron, 1956-1959,” in Settlement, Subsistence and Change Among the Labrador Inuit: The Nunatsiavummiut Experience, ed. Andrea Proctor, David C. Natcher, and Lawrence Felt, 85-120 (Winnipeg: University of Manitoba Press, 2012).

[7] W. Anthony Paddon, “Tuberculosis in Labrador Today,” The Northern Light 27 (March 1972): 10.

[8] Pat Sandiford Grygier, A Long Way from Home: The tuberculosis epidemic among the Inuit (Montreal and Kingston: McGill-Queen’s University Press, 1994), 88.

[9] Paddon, “Tuberculosis in Labrador Today,” 11.

[10] W. Anthony Paddon, “Northern Medical Patrol: Part II,” ADSF 69, no. 1 (April 1971): 2.

[11] Paddon, “Northern Medical Patrol: Part II,” 7.

[12] Paddon, “Northern Medical Patrol: Part II,” 7.

[13] Paddon, “Northern Medical Patrol: Part II,” 7.

[14] Paddon, “Northern Medical Patrol: Part II,” 7.

[15] Paddon, “Northern Medical Patrol: Part II,” 9.

[16] Paddon, “Northern Medical Patrol: Part II,” 9.

[17] Evans, “Abandoned and Ousted by the State,” 94.

[18] Nunavik Regional Board of Health and Social Services, “Qanuilirpitaa 2017: General Facts Sheet” (May 2020).