Alvin Fiddler is Grand Chief of Nishnawbe Aski Nation, representing 49 First Nations in the territory of Treaty No. 9 and the Ontario portion of Treaty No. 5 in Northern Ontario.
On Sept. 26, paramedics in Thunder Bay found a 19-year-old man from Mishkeegogamang First Nation who was in distress, having trouble breathing. They decided to take him by ambulance to the Thunder Bay Regional Health Sciences Centre emergency room, where – intoxicated and confused – he had difficulty articulating his condition and became agitated.
According to hospital officials, the triage team then took his vitals and determined that nothing was “medically” wrong. He was asked to leave, and then forced to leave – held up by security staff linked arm-in-arm because he could barely walk. At one point, he fell on his way off the hospital property and security watched to make sure he got back up to continue on his way, out of sight and out of mind.
Tragically, this young man’s final destination was steps away from where he fell. He was found hanging by his own sweatshirt nearby. It was later revealed by his family, and confirmed by the hospital, that the young man had a long history of suicidal ideation – something that a vitals test couldn’t have identified, but a check of his medical records might have.
Senior hospital officials initially stated that all “appropriate” actions were taken, but changed their position when challenged during a meeting with the family and me in early December. There, they said they had failed this young man and his family and they promised to review their policies. The province’s chief coroner is now investigating “potential systemic issues that may have played a role in contributing to the death.”
It seems officials missed the opportunity to make changes after the hospital went through a restructuring a few years ago by failing to meaningfully include Indigenous voices at all levels of its governance. They also appear to have missed the chance after a 2010 coroner’s investigation into the death of Kenneth Berg, a man with schizophrenia who, after having a head wound bandaged up, was released at about 11 p.m. in the wintertime, after buses had stopped running. Five months later, after the ice thawed, he was found in a drainage ditch several kilometres from the hospital.
These tragedies have something in common: Both men presented to the hospital with conditions that are the most stigmatized. Addictions, intoxication and psychiatric disorders present hurdles that most people still can’t seem to tolerate or approach from a place of empathetic understanding – especially when you add on the issue of race. But when this is true even of those we trust to care for the most vulnerable, something needs to change.
Add to this the reality that First Nation people have always been segregated in their health care. I was born in Sioux Lookout at an Indian hospital, one of nearly 20 across the country. There was a system for us and a system for everyone else; one was far better than the other. While Indian hospitals may no longer be operational, this system of segregation still echoes today – from the way our health care is managed, if you can call it that, through Canada’s First Nation Inuit Health Branch, to the under-equipped nursing stations and the scarcity of doctors, nurses, dentists or any other regulated health professionals that appear in our First Nation communities.
It is against this background that we feel compelled to act when these tragedies occur.
There is an empathy gap when it comes to certain “others,” and it is especially necessary for institutions to face this head-on. Employing First Nation patient navigators, advocates and board members is important, but these cannot act as substitutes for adequate clinical, holistic care. The hospital cannot become reliant on non-clinical roles occupied by select First Nation individuals to replace what every health-care worker ought to know and practise. To expect “advocates” to do all of the heavy lifting to persuade workers to look past race or other differences is just another form of colonialism.
Hospitals should present a welcoming environment where vulnerable people receive the care they need. It’s time for the Thunder Bay Regional Health Sciences Centre to start practising health care from an anti-oppression, trauma-informed framework. When our young people continue to die after trying to access services designed to be inaccessible to them, simply training staff on the protocols of pow-wows and the Seven Grandfather Teachings is not enough.
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