“Never Say DIE!” An Ethnographic Epidemiology of Helicobacter pylori Infection and Risk Perceptions in Aklavik, NWT

Abstract

<p><em>Helicobacter pylori </em>is a bacterial infection of the stomach lining known to cause ulcers and stomach cancer This infection has become a major concern of Indigenous peoples living in the Northwest Territories, where <em>H. pylori </em>infection and stomach cancer are more prevalent relative to much of southern Canada and the United States. I joined the Canadian North <em>Helicobacter pylori</em> (CAN<em>Help</em>) Working Group in 2010 to conduct participant observation in the Aklavik <em>H. pylori </em>Project (AHPP) and identify ways that ethnography can be integrated into the ongoing multi-pronged research that incorporates epidemiology, microbiology, gastroenterology, knowledge translation, and the development of public health policy.</p> <p>Between September, 2011 and June, 2012, I lived as a participant observer in Aklavik. I led an epidemiological study of the incidence and re-infection of <em>H. pylori </em>infection. I examined how different risk perceptions emerge from processes of “making sense” of <em>H. pylori </em>as a “pathogen” or as a “contaminant” and described how these different constructions influence people’s behaviours. Ethnography, in this way, can make visible the lenses through which different groups of actors perceive, experience, and react to <em>H. pylori </em>infection. The recognition that the social inequities most strongly associated with <em>H. pylori </em>infection and re-infection that exist today are the result of Aklavik’s colonial history is one example of a space in which different lenses can be brought into a shared focus. From such shared understandings, consensus knowledge can be built collaboratively between outside researchers and Indigenous Arctic communities in an ongoing, and community-driven, research project. Furthermore, I critically examined the definition and use of the “household” as a level-unit of risk assessment and have outlined steps for assessing possible risk factors as these are distributed across multi-household extended kin groups that can be identified and followed in long-term research.</p>