POUVIRNITOUK – Even though residents of Quebec's Far North are surrounded by vast bodies of water as far as the eye can see, they lack a reliable water supply.
This not only affects the health of citizens due to the spread of diseases, but also reduces the quality of medical care and forces healthcare workers to get creative to help their patients.
Inuulitsivik Medical Center, located in Puvirnituq, serves seven communities along the Hudson Bay coast. According to Dr. Vincent Rochette-Coulombe, who is beginning his third year as a doctor at the facility, the facility regularly runs out of water.
According to him, the lack of water directly affects patients. He gives the example of chest drainage, which requires inserting a tube into an opening created between two ribs.
“You don't have water to wash your hands. The glove breaks and you wash your hands with Purell,” he said. “It doesn't make any sense. Basic hygiene measures are required and sometimes we fail to do them,” he said.
Rafaelle Duran, a nurse at the Inukjuak Community Health Center (CLSC), has a similar but equally painful story.
“We, a team of two nurses and a doctor, ended up covered in blood and secretions,” she said. “To wash, you need running water to avoid infecting other patients. This time we washed our hands with water bottles.”
Her colleague Luce Bujold Tremblay, who is working as a nurse for the first time in the North, is shocked by the number of sterile water bottles being used. “It's very expensive, but we overuse them because if we don't have water, we have no choice but to use it,” she said.
Water is essential for all types of health care, from dentistry to childbirth. Margaret Mina, who has been a midwife at CLSC Inukjuak for 20 years, regularly faces the problem of waterless births. Just last summer, CLSC ran out of water for two weeks.
“(Women) are bleeding when they give birth. We always have to wash them, and when there is no water, it is impossible and disgusting,” she said. “We have to use water bottles.”
Meena says water shortages mean new mothers don't wash their hands often enough when they bring their babies home, leading to more viruses in both mothers and babies.
A bout of influenza or respiratory syncytial virus (RSV) can be dangerous for a one-week-old baby, sometimes requiring intubation or an air ambulance ride, Mina said.
Nunavik children also often suffer from dehydration after fevers, said Raphaelle Carpentier, a traveling nurse who has spent the last year and a half traveling to various villages along Hudson Bay.
“The number one piece of advice we give to parents is to make sure babies and children get as much fluid as possible,” she said. “We tell them to give them water all day and encourage them to drink.” Sometimes, she says, parents answer: “But I don’t have water at home. I’ll try to go buy it.”
Bottled water in Nunavik is not cheap – about $15 for a 4 liter bottle.
“They can't afford to buy water, so we give them water bottles again… but sometimes we don't have that either,” Carpentier said. “It becomes very risky. There are children who come back and don't get rehydrated because the parents simply don't have water at home.”
Some then have to be given intravenous fluids, “even though this could have been avoided if they had water at home,” she said.
A lack of water in the home means handwashing will be shorter, showering will be less frequent, and washing dishes and clothes may be delayed for several days. Nunavik health authorities acknowledge that Indigenous people are suffering the consequences and that the problems are not new.
In 2004, a health survey of Inuit in Nunavik found that lack of access to water resulted in Inuit exposure to parasites and gastrointestinal diseases.
“There is no doubt that the lack of water and the inability to wash clothes and sheets contribute to the spread of infections,” Rochette-Coulombe said. In his practice in the North, he sees “a huge number of severe skin infections,” including in children.
“Sometimes they come in for a consultation and it’s really hard, we have to give a lot of antibiotics,” he said.
Eczema is one of the skin problems that is usually treated with creams. But Carpentier says it's also important to practice good skin hygiene to avoid infection. Antibiotics are necessary, the nurse explains, because patients cannot shower or wash clothes regularly.
Last spring, the village of Puvirnituk faced a severe water shortage that left residents without a steady supply for weeks after the water supply froze during a snowstorm. Water trucks were also unable to collect water at the pumping station due to extreme weather conditions on icy, snow-covered roads.
Hospital patients had to be evacuated by air because their safety could not be ensured. People were admitted to the hospital only in very urgent cases.
It was impossible to even flush the toilet, according to Dr. Yasen Cholakov, a public health physician and director of infectious diseases at the Nunavik Regional Health Authority. “No one wants to see such a situation in a medical institution,” Cholakov said.
Public Health was investigating what Cholakov called “very alarming situations of community-acquired pneumonia” during the week-long water shortage. “So, serious lung infections, which are almost certainly due to the fact that these diseases are much more easily transmitted because people can't maintain normal sanitation measures,” he said.
Rochette-Coulombe, who witnessed the crisis, remembers the outbreak of gastroenteritis that followed. “It just needs to take hold and it spreads like wildfire,” he said. “Gastroinfection is very contagious, even if you wash your hands. Then you can't bathe, you can't wash your hands, you can't flush the toilet, it's terrible,” he said.
Lack of housing only exacerbates water shortages. Viruses spread easily in crowded environments.
During the water crisis, some residents had to obtain water directly from natural sources. Cholakov noted that water in Nunavik is usually “very, very clean” if it is boiled first. “If people boil it, they usually eliminate any risk of infection,” he said. “But if they drink it directly, sometimes there can be pathogens in the water.”
“The situation in Puvirnituka, I think due to bad luck, was worse than usual,” he said. But problems such as access to water arise year after year in several communities in Nunavik, said Cholakov, who is calling on authorities to improve the region's fragile water infrastructure.
This report by The Canadian Press was first published Nov. 23, 2025.
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Catherine Desautels was supported by the Michener Foundation, which awarded her a Michener-Deacon Fellowship in Investigative Journalism in 2025 to report on the impact of lack of access to water in Nunavik's Indigenous communities. This article is the second in a series of four reports.
