PUPS

(Trigger warning for mentions of sexual assault, abuse, trauma)

I meet Mama dog during my very first contract up North. She is black with a white underside, and sweet chocolate-brown eyes. She gets a bit too excited when offered food or affection, not quite sure how to take all of it at once, often tangling up her legs in the yellow rope that ties her to the side of her house.

Mama lives outside, even on the coldest of winter days, with a large wooden doghouse as her shelter. It sounds cruel to us from down South, where we spoil our dogs and protect them like babies. But it’s the reality of the North, where homes are small and crowded and sometimes moldy, and some families don’t even have enough to feed their children at times. There is no vet, no spaying, no neutering, so the dogs continue to breed, and the ones who remain are the ones who survive. Skinny little Mama dog has a litter of five when I first meet her, clinging to her to suck out whatever milk they can get, and jumping to fight for her food when I go to feed her.

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We are closely following a newborn baby who has just come back to our community. He was flagged by social services shortly after his delivery down South when the nurses noticed that his parents weren’t feeding him. Both of his parents are a little developmentally delayed, and seem to have trouble grasping the fact that he must be fed every three hours. Despite being consistently underfed and having little weight gain, social services clears him to return to the community with his parents, with recommendations to watch and support this family closely.

I’m not sure whether to be frustrated or supportive at this decision. Back home, such an obvious risk for neglect would likely lead to the removal of the child from his parents’ care, or at least a discharge home with immense social supports and monitoring. Perhaps they don’t realize that we don’t have these resources up here. Perhaps they’ve decided that the risk of harm from separating the baby from his parents is greater. Perhaps they see so many cases like this up North that they have given up on intervening.

We book this baby for daily appointments to monitor his status. Unfortunately, his weight gain is negligible at best. His parents clearly love him, but have little understanding on how to care for him. His formula looks a little too watery in the bottle, and they can’t articulate to us how they’ve been mixing it. The midwife asks how many bottles he’s been taking each day.

“I think…two,” dad answers.

The midwife’s eyes widen. “Two? He needs eight in a day.”

But slowly, we make progress. One nurse sets an alarm on mom’s phone to go off every three hours when it’s feeding time. Someone comes up with simple picture instructions on how to properly mix formula and sterilize the bottles. His parents get better at changing his wet diaper promptly, and his terrible diaper rash starts to improve. It takes a village, and the work never ends, but perhaps the solutions we would choose down South aren’t always the only ones, or the right ones.

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Mama dog has another litter when I come up for my third contract. They look like the last batch, but these ones are a bit more shy. Of course, they can always be coaxed out with some food.

The owner, who knows we’ve been feeding them when we can, approaches one of my roommates at work and asks if we can find new homes for them, except for the one male pup that they want to keep. We excitedly arrange for crates and for a flight they can board to be sent to the SPCA. While we are here, the owner asks us to house and feed the remaining male puppy. We gladly agree, worried that he’ll die in the cold without the warmth of his mom and sisters.

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I am woken up early one morning by the ringing of my on-call phone.

“My granddaughter just showed up at my house with no jacket and no shoes! Now she can’t feel her feet!”

I meet the family at the health centre, and they are all flustered and panicked, and no one can give my a clear story of what happened. It seems that this little one has a history of sleepwalking, somehow climbed out of the window, and walked for 30 minutes, barefoot, to her relative’s house. It seems like a suspicious story, but I can’t seem to get any other clues out of them.

I treat her pain, and slowly rewarm her feet as I wait for the doctor to call me back. Her feet don’t look too bad, but I know it will take hours or days before the swelling and blistering peak, and we see the true extent of the damage. I sit down to chart and wait, and I catch snippets of her conversation with her mother.

“Did anyone touch you? Is it sore in front down there?” Her mom asks in a hushed voice.

Her daughter shakes her head adamantly. The urgency with which she does makes my skin crawl. This is certainly not the first time she has been asked this.

I approach her again, and she promises that she has no other injuries. I check her over carefully, finding no evidence of anything else. I hope I’m being unnecessarily suspicious, but I know this is a family with a volatile dynamic, and I have no way of knowing what goes on behind closed doors. All I can do is book her in to be reassessed daily. I flag her for our tiny social services team here, but her daily appointments are our only meager option to check in and make sure she is safe.

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The day finally comes to ship out Mama dog and three of her pups. I slide the rope off her neck and put on a leash, and she is overjoyed to explore past her usual two metre perimeter. Unfortunately, this is short-lived as we have to place her in a crate, and her pups in another. They are terrified and won’t stop squealing in the back as we drive them to the airport. They calm down when we sit in front of the crates and talk to them as we wait for them to get loaded, and then it’s time to say farewell.

I am horribly sad for the rest of the day. Perhaps, selfishly, because I have had to say goodbye to a gentle dog I’ve grown terribly fond of, whom I will never see again. But maybe also because I wish that all the other suffering I see up here could be solved just as easily. I can put a dog in a crate to send it to a better home, but I can’t take women out of abusive relationships that they don’t want to leave. I can’t break the cycle of alcoholism overnight. I can’t even begin to address the trauma of all the young people who have watched their loved ones take their own lives. I can’t extract children from households that I suspect are volatile or violent, when I have no evidence of it.

It is so difficult because I know what the solutions should look like in an ideal world, but these are not solutions that will come quickly or easily. And this can be the dark side of working with marginalized populations – the development of the white saviour complex. Those of us who are privileged march in with our first-world solutions, our idealized view of what should be done to “save” these people. This is the problem with binge-and-purge humanitarian work, where we swoop in with our fancy, temporary solutions, feel good about ourselves for the work we’ve done, and then we leave. But do we really leave the community in a better place than when we arrived?

In the 50s and 60s, Nunavut was ravaged by tuberculosis, with a third of the Inuit infected with this highly contagious and lethal disease. Our solution was to take the infected to treatment centres down South. Many died during treatment, and their families were never told. We thought we were doing the right thing – quarantining and treating the disease before it wiped out more of the population. But all the Inuit knew was that these people who did not speak their language stormed onto their land and took their loved ones, never to be seen again.

Abuse, neglect, alcoholism, trauma. How do we ever break the cycle? Some days, it feels impossible. Real, sustainable change can only happen if it comes from within the community. There are no easy right answers. It is a long, arduous road, and my heart is already tired. But we must keep going, slowly but surely, and most of all, together.