Old Keyam – A Framework for Examining Disproportionate Experience of Tuberculosis Among Aboriginal Peoples of the Canadian Prairies

  • Kathleen McMullin Department of Community Health & Epidemiology, University of Saskatchewan, Prince Albert, Saskatchewan
  • Sylvia Abonyi Community Health and Epidemiology, University of Saskatchewan; Canada Research Chairs Program, University of Saskatchewan
  • Maria Mayan Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta
  • Pamela Orr Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba
  • Carmen Lopez-Hille Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba
  • Malcolm King Institute of Aboriginal Peoples’ Health, Canadian Institutes of Health Research, Edmonton, Alberta; Department of Medicine, University of Alberta, Edmonton, Alberta
  • Jody Boffa Department of Family Medicine, University of Calgary, Calgary, Alberta
  • Richard Long Department of Medicine, University of Alberta, Edmonton, Alberta; Tuberculosis Program Evaluation and Research Unit, Edmonton, Alberta
Keywords: Cree, tuberculosis, colonialism, Aboriginal Peoples, healthcare


On the Canadian Prairies, First Nations and Métis peoples are disproportionately affected by tuberculosis (TB) compared to other Canadians. Statistics show enduring transmission and high rates of active TB disease. Despite awareness of the social determinants of TB transmission—such as substance abuse, comorbidities, and basic needs being unmet—transmission and outbreaks continue to occur among Aboriginal people. The Determinants of Tuberculosis Transmission project is a mixed methods, interdisciplinary study that used quantitative questionnaires and qualitative interviews to look more closely at patients’ experiences of TB. Provincial Network Committees (PNCs) comprised of Elders, traditionalists, community-based TB workers, and health researchers in three participating provinces guided the project from inception through to data analysis, interpretation, and dissemination. The collaborative efforts of the patients, the research team, and the PNCs uncovered a continuing influence of colonization in TB transmission. Overwhelming feelings of apathy and despair for the hold that TB continues to have in the lives of patients, families, and communities is captured by the Cree word “keyam,” which may be translated as “to give up” or to ask, “What is the use?” This paper explores the concept of keyam in relation to TB transmission.