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A picture of Joyce Echaquan during a vigil in front of the hospital where she died in Joliette, Que., on Sept. 29, 2020.

Paul Chiasson/The Canadian Press

As a coroner’s court in Quebec continues to wrestle with the raw details of 37-year-old Atikamekw woman Joyce Echaquan’s torment at the hands of her supposed caregivers in a hospital in Joliette, Que., some truth-telling occurred among some of Canada’s most elite doctors, one province away.

On May 20, physicians from the University of Toronto took time out from their overloaded days fighting the pandemic to hold a special Zoom session during the division of general surgery’s annual assembly. The topic: how to deal with anti-Indigenous racism in the hospitals and health systems they work in.

Many of the physicians had taken part in Operation Remote Immunity, which brought COVID-19 vaccines to northern First Nations in Treaty #9 and Treaty #5. They had been stunned to see that Ontario First Nations have nothing remotely resembling access to Canada’s universal health care system, especially given the absence of many of the social determinants of health, such as proper housing, high schools or even clean water.

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For the doctors, the trip was a moment – one that hit them in the heart and recalibrated their vision of the Canada they thought they knew. A pediatric surgeon named Jacob Langer admitted that it wasn’t until his son Ben, also a doctor, began working in the northern town of Sioux Lookout, Ont., that his eyes were opened; he became one of the loudest proponents for change on the call.

When he spoke, I thought of Brody Meekis, a four-year-old from Sandy Lake First Nation who died in 2014 of strep throat, an illness that can be easily cured with antibiotics. Pediatricians are a rarity in Nishnawbe Aski Nation due in part to an outdated funding model.

The doctors spoke of new research in the Canadian Medical Association Journal, presented by anesthesiologist and author Jason McVicar. He found that there was little good-quality data available on postoperative outcomes for Indigenous Peoples, but that what does exist reveals higher rates of death and adverse events after surgery, coupled with huge problems trying to access surgery in the first place.

The CMAJ findings were not a great surprise to Lisa Richardson and other Indigenous physicians and health advocates at the assembly. NAN Grand Chief Alvin Fiddler and I addressed the group; my second book, All Our Relations, centred on racism in Canada’s health care system. (For the record, the assembly made a donation of thanks for my participation to the Mashkawi-manidoo bimaadiziwn Spirit to Soar Fund for Indigenous youth in Thunder Bay.)

Dr. McVicar’s report added another layer of proof concerning the crisis of anti-Indigenous racism inside Canada’s health system – as if anyone needed more.

Listen to the testimony at the inquest into last year’s death of Ms. Echaquan, and you’ll hear refreshingly sharp comments and hard questions from lawyer-appointed coroner Géhane Kamel. Ms. Echaquan had recorded the hospital staff’s racist taunts; they told the Atikamekw mother of seven she was stupid, a drain on the health system and would be better off dead. The patient beside Ms. Echaquan at the time testified that she heard her cry: “You are letting me die.”

The inquest heard that Ms. Echaquan and members of her community were afraid to go to the hospital because of the reputation of the nurses. Imagine, being petrified of hospitals because of racism – in Canada.

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And it isn’t just happening in Quebec. Read the eye-opening investigation into Indigenous-specific racism in B.C. by Mary Ellen Turpel-Lafond, which found, after consulting 9,000 people, that Indigenous Peoples don’t feel safe accessing health care or interacting with staff. The report said that Indigenous health workers felt that anti-Indigenous racism does not “get enough time, attention or resourcing” in their organizations, yet everyone knows it is a problem.

An open secret of harm: That is an Indigenous reality.

Sit with that for a moment.

Then listen to lawyer Christa Big Canoe, a member of the Brian Sinclair Working Group – a body of nurses, doctors and lawyers created after Mr. Sinclair’s death in a Winnipeg emergency room in 2008 to address racism in health. A double amputee, Mr. Sinclair was left for 34 hours in the hospital’s waiting room because staff assumed he was just drunk and sleeping it off; he died of complications from a bladder infection.

Ms. Big Canoe said we need national legislation to mandate that hospitals and administrators institute anti-racist policies and accountability measures. “There should be consequences when it comes to human life,” she said. “There has to be a uniform approach across the country.”

She reminded me that it took years before an inquest was held into Mr. Sinclair’s death, and even though that came with recommendations, no one was charged or fired.

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That is what happens when there is no accountability. And that’s what will continue to happen until Canada shows that the unnecessary loss of Indigenous life is a tragedy worthy of punishment.

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