Parents of Makibi Timilak angry at scope of external review

Nunavut's health minister announced this week that an external review into Makibi Timilak's case will focus on events after his death, which has his parents angered and searching for an explanation.

​Three-month-old Makibi died of a viral infection in April 2012 after after Debbie McKeown, a nurse at the Cape Dorset Health Centre, allegedly refused to see him. McKeown was later promoted to the community's top nursing position.

In November, Nunavut's then-health minister Monica Ell ordered an external review of how the department mishandled the case of McKeown, who faces numerous allegations.

On Tuesday, the current Health minister Okalik announced in the legislative assembly that the department had commissioned lawyer Katherine Peterson to conduct the review.

"The purpose of this review is to determine what steps were taken in the wake of Makibi’s death and whether the steps taken were appropriate in the circumstances," stated Okalik.

Luutaaq Qaumagiaq, Makibi's father, says the government of Nunavut should focus on the conduct of McKeown leading up to his son's death. McKeown had numerous complaints lodged against her during her time in Cape Dorset, particularly in the months before Makibi's death.

"Makes me feel mad and angry because before he died there were reports against [the nurse] and they're not going to look into that? She put all the people of Cape Dorset in danger," says Qaumagiaq.

"Why aren't they reviewing the complaints before my son died?"

Qaumagiaq also reacted to the news that McKeown is fighting her suspension from work, seeking reinstatement of her licence as a registered nurse.

"She put a lot of people in danger, refusing to see sick people, saying she's too busy when she's on call, she's too busy to look at a patient when she's supposed to see the patient," says Qaumagiaq.

"I'm afraid that this might happen to someone again."

'I don't believe you can separate those two timelines'

On the night of Makibi's death, his mother, Neevee Akesuk, called Cape Dorset's 24/7 community health centre. McKeown, the nurse on call, refused to see Makibi, telling Akesuk to bring him in the morning. Both the regional nurse’s college and the government of Nunavut had previously been alerted to problems with McKeown.

Elise Van Schaik, a former Director of Health Programs for the territory's Qikiqtaaluk South region, says that a review that doesn't include the events leading up to Makibi's death is too narrow.

"I don't believe you can separate those two timelines," says Van Schaik. "Because it informs what happens after.

"It's very disheartening and very disappointing to see a health department, who clearly is aware of and can recognize that any event preceding such a tragedy like this is critical in understanding the whole story."

Minister Okalik says that although the scope of the review does not expressly include the events prior to Makibi's death, the reviewer will be given leeway to investigate those events if she chooses.

"I leave that open to the reviewer," he says. "The possibilities are there for the external reviewer to carry out more extensive work that needs to be done."

Okalik says Peterson will meet with Qaumagiaq​ and Akesuk during her review.​

Review's independence called into question

However, because Peterson was selected by the government department under review, critics have called into question whether her report can be truly independent.

"When a department hires a lawyer to investigate itself, it lends itself to a situation where there's more chance for bias versus a process where, say... they would appoint a reviewer with the ministry of health paying the bills, so to speak," says Van Schaik,

"But the relationship is much closer than it would have been if it was truly external."

Okalik disagrees, saying Peterson, who is from Yellowknife was chosen because she has experience in the North, but has never worked for the Department of Health.

"I want to ensure that there's independence and at the same time someone who's familiar with Nunavut and the work that's done here," says Okalik.

According to Van Schaik, though, that's simply not enough.

"There's an underlying current of mistrust in the health care system that really needs to be addressed," she says.

"And I think when there's a process such as this type of review that's being authored, it only builds on that mistrust."

The external review is expected to be completed by Nov. 30.