Nunavut Gender Based Violence Traumatic Brain Injury

Gender-based violence (GBV) is an important public health and human rights issue that includes intimate partner violence. Intimate partner violence (IPV) is characterized by physical, sexual or emotional abuse or controlling behaviors inflicted by a current or former spouse or intimate partner. In Canada, IPV is strikingly prevalent and heavily impacts women living in Nunavut. In Nunavut, the rate of violent crime experienced by women is nearly 13 times higher than the national average, with women representing almost two-thirds of police-reported crime victims (Pauktuutit Inuit Women of Canada, 2019; Statistics Canada, 2018). Among the most common yet often under-recognized injuries sustained by survivors of IPV is traumatic brain injury (TBI), which can range from concussion to more severe structural injuries (e.g. skull fractures, intracranial hemorrhage). Survivors of IPV can experience episodes of non-fatal strangulation that can result in hypoxic-ischemic brain injuries. In addition to TBI, survivors of IPV can also experience injuries to the face including complex orbital, maxillofacial, and mandibular injuries as well as injuries to other parts of their body. Those who experience IPV are also at risk of developing features of mental health conditions such as anxiety, depression, post-traumatic stress disorders as well as other medical conditions.

Optimizing clinical outcomes following acute GBV TBI requires timely access to emergency medical care and interdisciplinary healthcare professionals including those with expertise in neurosurgery, plastic surgery, ophthalmology, orthopedic surgery, obstetrics and gynecology. It is also important that patients receive coordinated access to shelters and temporary housing as needed as well as victim, family, criminal justice, legal, and culturally-based mental health and wellness services that can support patients and their families. Without access to this standard of care, patients are at risk of developing persistent and untreated symptoms or returning to environments where they are at risk of recurrent abuse that can result in additional and potentially life-threatening injuries. Unfortunately, those living within the territory of Nunavut do not have access to interdisciplinary physicians and allied health professionals with expertise in GBV TBI within their home communities.

To address this significant gap in care, this program aims to improve access to specialized care for survivors of GBV TBI and non-fatal strangulation injuries in Nunavut.

Nunavut Gender Based Violence

Traumatic Brain Injury Program

Patients who meet strict referral criteria may be referred to the Gender-Based Violence Traumatic Brain Injury Program:

Youth or adults who sustain head trauma including head injury, concussion, structural brain injury (e.g. intracranial hemorrhage) or injuries secondary to non-fatal strangulation, that is directly caused by GBV (including intimate partner violence and injuries that occur in the setting of other forms of GBV including human trafficking);
Patients who live in ANY community within the territory of Nunavut

To refer a patient, physicians and nurses must fax a completed Nunavut Gender-Based Violence Traumatic Brain Injury Program Referral Form to the Pan Am Concussion Program at 204-927-2768.

Referral forms can be found at (www.panamclinic.org/departments/concussion-program/). Healthcare providers who require assistance determining whether patients are eligible for referral through the program may contact the clinic at 204-927-2766.

All patients will ideally undergo an in-person consultation in Winnipeg. Future follow-up care will be arranged via telemedicine (in-person video-conferencing) or in-person based on patient preference. All patients managed through the program will connected to community-based medical and supportive services as available.