10. Cancer Is Discovered Among Labrador Eskimos

This book, as a review of northern frontier evidence on malignant disease, requires two sections about Labrador. Chapter 6 covered nearly 200 years from the 1752 start of Moravian mission activity to the publication in 1925 of the book Health Conditions and Disease Incidence among the Eskimos of Labrador by Dr. Samuel King Hutton. The present chapter will deal with the first report of native cancer there in 1935, and with the increasing frequency of reports since then, down to 1957. For the allegedly cancer-free centuries I depend chiefly on the personal observations of Dr. Hutton and on his study of Moravian health records. For the admittedly cancerous recent time I depend mainly on letters and other manuscript information from Superintendent the Reverend F. W. Peacock, whom correspondence reaches at Happy Valley, Labrador, Province of Newfoundland — as indeed letters will reach Dr. Hutton at the chief British mission base for Labrador of the Moravian Church, London, England.

It is the view of most of the medical missionaries I have cited, from Dr. Albert Schweitzer in Africa to Dr. Joseph Romig in Alaska, that cancer is a disease of the civilized. It is therefore necessary to consider this question: In what sense had the Moravian Eskimos of Labrador become civilized between their giving full allegiance to Christianity around 1804 and the appearance in 1925 of Dr. Hutton's book reporting failure in his search for cancer; and in what sense, if any, are the Labrador Eskimos more civilized, now that malignant disease has come to be as frequently reported from among them as it is from among the French of Paris or the English of London?

Civilization, as reflected in the Europeanization of diet, has been pictured in the earlier Labrador chapter and will be elaborated here. To some extent housing and clothing will also be considered. Dr. Hutton and Superintendent Peacock have separately reported on civilization as reflected by book learning and social change, Hutton in his book, Among the Eskimos of Labrador (1912) and Peacock in a Master of Arts thesis on the sociology of Labrador. I shall not use these reports, however, in the following discussion, for their essence is condensed in an even more readily available source, Labrador: The Country and the People, by Wilfred T. Grenfell and others (London and New York, 1909). For sidelights on the Moravians the time of the Grenfell publication is just right, since 1909 falls within the period 1902-13 which Hutton particularly describes. This book's chief author, Sir Wilfred Grenfell, M.D., was himself a medical missionary serving a white community adjoining the Moravian Eskimo district and overlapping it somewhat; and among Grenfell's co-authors was Dr. William Stewart Wallace, one of Canada's foremost historians, for many years editor of the Champlain Society's magnificent series of frontier publications and now librarian emeritus of Toronto University.

In a historical introduction, Dr. Wallace mentions Scandinavian contacts with the Eskimos of Labrador around A.D. 1000 and sketching the history of the region beginning with John Cabot in 1498, Dr. Wallace says, “There remains to be told the story of the Moravian missionaries. No more wonderful story of missionary effort has ever awaited the pen of the reporter; and yet the work of the Moravian Mission in Labrador has been little known. It was in 1752 that the United Society of Brethren first attempted to found a mission among the Eskimos. It ended in failure.” Wallace then tells of the attempts to establish a permanent mission which were finally successful in 1771.

“In 1773 the British government sent out Lieutenant Curtis, R.N., as a commissioner to report on the progress of the mission. Some sentences from this report may be transcribed: ‘... Their house is called Nain ... They have a few swivels mounted, although they have no occasion for them, as the Indians [Eskimos] are awed more by their amiable conduct than by arms ... The natives love and respect them ... The progress which the mission has made in civilizing the Indians is wonderful’.

“... Everything, however, did not go smoothly at first. About 1787 a mysterious person named Makko, a French Canadian (says the historian of the mission), who combined the character of a merchant and Roman Catholic priest, succeeded in enticing a number of the Eskimos away from the Brethren ... It was not until 1804, says one of the missionaries, that the fruits of the mission began to appear.”

What those fruits were, Dr. Grenfell reports as an Anglican and as a medical missionary serving the primarily English settlers of the Labrador territory adjoining that of the Moravian Eskimos. This viewpoint is apparent throughout the book but especially in the chapter “The People of the Coast.” Speaking of Labrador as politically belonging to Newfoundland, Grenfell says:

“Education in both Newfoundland and Labrador is another very difficult problem. It is rendered almost impossible to solve owing to the denominational system of schools. A recent visitor, writing in an American paper, expresses himself as follows, and his views I entirely agree with:

“‘... The island is a poor and sparsely settled country; yet its education is completely in the hands of the churches ... In the smaller settlements there may be a Methodist, an Anglican, a Roman Catholic, and even a Salvation Army separate school ... This is the logical outcome of the denominational idea. It ... bids fair to postpone forever any real unification of the people.”

But this denominationalism did not greatly interfere with the Moravians, who, according to Grenfell, served around 1909 some 1,300 Eskimos out of a total Labrador white and native population of about 4,000, most of the whites being of English descent. Says Grenfell:

“The best educated people in the country at present are the Eskimos. Almost without exception they can read and write. Many can play musical instruments, and know the value of things. These accomplishments, entirely and solely due to the Moravian missionaries, have largely helped them to hold their own in trade, a faculty for want of which almost every aboriginal race is apt to suffer so severely.

“I have known an Eskimo called in to read and to write a letter for a Newfoundland fisherman, and I have had more than once to ask one to help me by playing our own harmonium for us at a service, because not one of a large [white] audience could do so. I have heard more than one Eskimo stand up and deliver an excellent impromptu speech.

“Reading the [government's] Newfoundland Blue Books, reporting the numbers able to read and write in Labrador, I acquired an entirely erroneous estimate of the peoples accomplishments in those directions. Our white population is still very illiterate. Some headway has, however, been made in late years, and literature and loan libraries distributed through the Labrador Mission are now accessible along the coast, and are creating [among the English-descended residents] a love for reading.”

Like practically all writers on the Labrador of the last hundred years, Grenfell is worried by the inroads of European disease among the native population. “The sicknesses of the coast are not indigenous. In the past seventeen years there have been grippe; a few cases of small-pox imported by a schooner from the Gulf [of St. Lawrence]; scarlet fever brought from Newfoundland by a steamer; one small outbreak of diphtheria in the Straits on the arrival of the summer visitors; and in the summer a few sporadic cases of typhoid.

“The Eskimos brought back from the Chicago Exposition [of 1893, where they were exhibited] typhoid of a very virulent type which killed several hundred of them; and, from the Buffalo Exposition [where they were also exhibited], diphtheria, which is still [in 1909] raging amongst them and has destroyed many. An epidemic of grippe ... killed sixty in the neighborhood of Okkak. The worst enemy of the Eskimo is, again, tuberculosis and from that, in one form or another, most of the people die ... On the other hand, so healthful is the country that I have no hesitation recommending it for neurotics, or even to persons with a disposition for tuberculosis.”

In a chapter recommending the reindeer industry to Labrador, Dr. Grenfell confirms Dr. Hutton on the poor nourishment of white Labrador babies (in contrast with the good nourishment of Eskimo babies of the time). Dr. Grenfell wants reindeer meat and milk especially for these European babies that suffer from “rickets, scurvy, multiple neuritis, blindness from corneal ulceration, and other diseases of insufficient nourishment rife among a people enjoying a bracing pure air, undefiled by human or other exhalations, and in a country entirely free of endemic diseases ... We were wont to see ill-fed mothers, without milk to suckle their babies, chewing hard bread and thus, after predigesting it in their mouths, trying to maintain life in their wizened offspring ...”

In relation to the seal-meat-eating Eskimos just north of his own white and forest Indian mission field, Dr. Grenfell makes no reference to cancer, perhaps because he agreed with the Moravians, and the rest of the medical missionaries of the northern frontier, that malignant diseases were not to be expected among primitive peoples. This reticence on cancer holds for his account of a visit in 1905 to the Moravian missions north of him. (The following pertinent quotations are taken from the 1922 revised edition of Labrador.)

“At present the Moravians have flour stations. The most northerly ... is Cape Chidley. Here the Eskimos, attracted by the excellent seal-fishery, have gathered from the northeast coast and from Ungava Bay ... The missionary in charge at present is a splendid specimen of humanity ... One leaves the station regretting that so few should be there to benefit, humble and glad that men of such type still live to adorn the human race.”

About a hundred miles to the southeast Grenfell passed an Eskimo settlement that he did not so much admire — for special reasons, among which was the fact that these people were “much more dependent upon the missionary, upon his supply of [European] clothing, and upon his European food, than [was] good for them.”

Another hundred miles to the southeast brought Grenfell to Hebron. “Its Eskimos have been wisely taught by the Brethren to segregate and not congregate ... This would be today probably the most creditable settlement of the Eskimos, had it not been for the carrying of several families to show them to the curious at the Exhibitions at Chicago, Buffalo and elsewhere. Few returned, and they richer only in those heirlooms of civilization, the germs of specific diseases, which most effectively put a stop to the growth of the community and left a diseased and miserable people, to be a constant danger” to the rest of the Eskimos.

About 40 miles south of Hebron, Grenfell reached Okkak, the largest of the Moravian stations. “It is within the northern limit of trees ... the annual census shows that during the fifty years previous to 1902 the congregation was steadily growing ... This station was entirely blotted out in 1919 by Spanish Influenza. Out of 365 Eskimos 300 perished, including every single adult male ... when Nain was destroyed by fire in 1921 a large portion of that congregation returned to reopen Okkak.”

At the southward end of his journey, as he approached his own mission some ninety miles south of Okkak, Dr. Grenfell found “Nain, the fifth station ... [It] is at once the head station of the Brethren, the seat of the Bishop, who is also a German consul, and is of the oldest standing. Its well-tended vegetable patches, the tidy paths through the woods ... The prim flower garden, and the orthodox tea house ... combine to transport the visitor momentarily to German homes which these good men have left, never to return ...

“This station is the head of the trade, too. For the mission is an industrial one; and therein, to my mind, lies its immense value. It not only tends to the mind and spirit, but it looks after the ‘vile body.’ Had it not been so for the last one hundred and fifty years, there would now be no bodies through which to get at souls. There can be no question the Moravians have so far saved the native population for Labrador. The more numerous Eskimos that once flourished between Hopedale, their southernmost Eskimo station, and Anticosti Island, are gone almost to a single man. Eskimos once were numerous on both sides of the strait of Belle Isle. At Battle and at Cartwright in 1800 they were numerous. Contact with white men has blotted them out like chalk from a blackboard ...

“The casual reporter visiting Labrador has more than once severely criticised the trade methods of the Brethren ... They have been stigmatized as robbers and oppressors. Indeed they have been so misunderstood that their Conference has seriously considered abandoning their trading altogether. Were they to do so, there would in a very brief time be no need for their spiritual ministrations ... They look after the poor, feed the infirm and helpless, tend the sick, educate the children ...

“Some ninety miles south again is Hopedale, the sixth station. It is the southern boundary of the tribe now, and one cannot visit the station without feeling forcibly that the fringe is ravelling out, and that the race in Labrador is facing its inevitable doom ...”

This “inevitable doom” must have seemed even blacker to the Moravian medical missionaries who had dreamed it could be staved off indefinitely by avoiding the Europeanization of the food — by inducing healthy people to remain healthy through continuing to eat the raw foods which they loved and which they could secure in ample quantity from their own land and waters.

Ruefully Superintendent Peacock admits that the best they were able to do was to slow up Europeanization by a few generations. Among the first subversive influences, tending toward eventual dependence on the white man, was the fact that the Eskimos contracted first the tobacco habit and then the tea habit. Thereafter followed gradually the use of bread, salt, and sugar; then came increased cooking and the use of hot drinks. Still it was possible as late as the period 1902-13 for Dr. Hutton to conclude from his own observation that “cookery holds a very secondary place in the preparation of food.”

While he makes this observation on cooking as part of a suggested explanation as to why he could find no hearsay or other sign of cancer among the Labrador Eskimos, Dr. Hutton also makes, elsewhere, the general observations on the health of the Labrador Eskimo that “... his muscles are rested by a shorter period of sleep than is customary among civilized peoples. Men and women alike show the power of withstanding fatigue.” So long as their diet continued to consist exclusively of their own fresh foods, hardly cooked or raw, their robust health broke down only when they were exposed to European diseases against which they had no inherited immunity, such as the deadly measles and the almost equally deadly tuberculosis. But on the Europeanized diet they became prey to a swarm of other new diseases.

In a letter of December 11, 1957, Superintendent Peacock says of his predecessor, the Reverend Paul Hettasch (who came to Labrador in 1898, thus four years ahead of Dr. Hutton) that he “was deeply interested in things medical. Although he had had but a short medical course, he was a competent doctor and surgeon (minor), a very keen observer ... He ... had little use for the Eskimo who aped the white man ... I believe that Hettasch probably predated Dr. Hutton in his statement that cancer was unknown among the Eskimos. However, the Eskimos had for some time been exposed to a white man's diet when Hettasch came to the coast, although never to the extent they were after the Hudson's Bay Company took over the trade from the Moravian Mission in 1924.” Elsewhere Peacock says that there has been since 1943 a further increase in the Europeanization of the diet, on account of certain policies of the Newfoundland government.

Cancer among Labrador Europeans was, of course, well known to the Moravian mission, both from their own experience and that of the Grenfell mission to the south of them. In his letter of November 20, 1957, Superintendent Peacock says, “Previous to my coming to Labrador, Robert Ford [a Scot who may have had some Eskimo blood] ... died from a diagnosed cancer ...”

In the aforementioned letter of November 20, Superintendent Peacock reports what he believes to have been the first death of a Labrador Eskimo from a recognized cancer:

“When I first came to Labrador, in 1935, I was told [by the Reverend W. Perrett] that cancer never occurred among Eskimos. However, during the winter of 1935-26 an Eskimo, Michael Nochasak, became ill with abdominal trouble ... This man suffered intense pain and was removed to a hospital when navigation opened, and died of cancer.

“In 1936 I went to Nain from Hopedale and was again told, by the late Reverend Paul Hettasch, that cancer was unknown among the Eskimos. But during the following winter, 1937-38, an Eskimo woman, Leah Ikkusak, became ill, was later transferred to hospital, and returned home in 1940 with inoperable cancer of the womb. [She was the widow of the white man, Robert Ford: who had died of cancer.]

“In 1941 another Eskimo, Amos Martin, dled of cancel of the throat. Other cases between 1943 and 1945 in Nain were Boaz Obed, cancer of the stomach, and his wife Rosina, cancer of the womb. Then came Judith White, cancer of the breast (here was successful amputation). Then came two half-breed brothers, John and Amos Voisey, both of whom died of cancer of the throat and mouth. This was followed by John Samiat, Eskimo, cancer of the throat; then Karoline Kojak in 1955, cancer of the womb and breast. All these cases, with the exception of Nochasak, were at Nain and there were undoubtedly cases on other stations; all died with the exception of Mrs. Kojak who returned from hospital last summer and is still living.”

This paragraph was read in manuscript by Dr. Philip R. White, specialist in vegetable cancers but a general student of malignancy problems. He suggests that the paired junctions are remarkable and should not pass without remark — two men who die of stomach cancer whose respective wives die of womb cancer; and both of a pair of brothers who died of throat cancer. Numerous commentary possibilities rise to mind. However, with the foregoing analysis of the views expressed by northern medical missionaries in mind, it is fairly obvious what their suggestions would be. Believing that cancer is environmental in causation and chiefly nutritional, they would point out that husband and wife almost necessarily live in the same houses and eat the same foods prepared the same way. Like similarity would hold for brothers. So, why should not a nutritional disease be likely to strike these paired individuals within a few years of each other?

In the period during which Superintendent Hettasch believed cancer to have been nonexistent, from the earliest times to 1935, the native population numbered 1,200 or more. Since cancer began to be reported the Eskimo population has numbered about half this figure, varying from 500 to 700.



Chapter 11 >>