Tansi Nîtôtemtik,
Today’s post is related to the Calls to Action regarding the Canadian healthcare system and Indigenous peoples:
23. We call upon all levels of government to:
i. Increase the number of Aboriginal professionals working in the health-care field.
ii. Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
iii. Provide cultural competency training for all healthcare professionals.[1]
24. We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.[2]
These Calls to Action are vital when it comes to Indigenous people’s experiences with the healthcare system.
For someone who isn’t Indigenous, a visit to the doctor, hospital, or emergency room, may be annoying, uncomfortable, or inconvenient. For someone who is Indigenous, the same type of visit may also be filled with implicit and explicit racism, discrimination, physical force, or neglect. They may be treated poorly or even refused care.[3]
Racial stereotypes held by healthcare providers, negatively impact the care Indigenous patients receive, which in turn adversely affects these patients’ health outcomes. These harmful stereotypes include assumptions that Indigenous people make use of emergency services in inappropriate ways, that they are most likely intoxicated or abusing substances, and that they are unfit parents. [4]
These dangerous and unfounded assumptions underlie the unjust treatment of Indigenous peoples in the healthcare system, including the use of disrespectful “tone and body language,” racial slurs, physical violence, or even not being treated at all.[5] These presumptions also influence care providers' decisions to involve police or child services when they normally wouldn’t, which can detrimentally alter the course of an Indigenous person’s life forever.[6]
Discrimination by health care providers means that Indigenous people face poorer health outcomes when using services, and also means they are less likely to seek help in the first place. Mistreatment and bad experiences within the healthcare system are significant barriers to Indigenous people accessing health services, and are accompanied by the very real fears that they will be belittled, assumed to be intoxicated, not have their concerns taken seriously, or even have their children taken away if they seek medical attention.[7]
Racial stereotypes and discriminatory treatment from health care providers towards Indigenous peoples are not only harmful and unjust, they can result in death.
In 2008, Brian Sinclair died in a Winnipeg emergency waiting room from an untreated bladder infection. Health providers did not treat him, even after he waited for 34 hours, because they assumed he was intoxicated or homeless. He was 45 years old.[8]
In 2015, Keegan Combes died in a British Columbia hospital, from poisoning. Health providers assumed he was intoxicated, and did not treat him in time. He was 29 years old.[9]
In 2020, Joyce Echaquan died in a Quebec hospital, while health providers restrained and verbally abused her. The investigation found that “systemic racism contributed to her death.” She was 37 years old.[10]
The preventable deaths of these Indigenous people, and every other instance of discrimination against Indigenous people in the Canadian healthcare system, demonstrate the immediate need for change and the importance of fulfilling Calls to Action 23 and 24. The government of Canada lays out what has been happening to address these Calls to Action, but these steps are not enough.
For example, a recent nursing graduate from the University of Calgary shared that they never had to take a course that was specifically focused on Indigenous health issues, meaning that there was no course mandated to satisfy Call to Action 24. Instead, Indigenous health issues were briefly discussed in other courses.
Additionally, a doctor who graduated this year from the University of Calgary shared that, while Indigenous health issues were discussed within different courses, there was not a specific course solely dedicated to these issues.
Without further action, Indigenous people will continue to be mistreated, discriminated against, and left to die within the healthcare system. There must be greater progress and improvement within the Canadian healthcare system, because the mistreatment, discrimination, and neglect of Indigenous peoples is unacceptable, and cannot be permitted to continue.
Until next time,
Team Reconcili-ACTION YEG
[1] Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada (Ottawa: Public Works and Government Services Canada, 2015) at 322-323. [2] Ibid at 323. [3] Billie Allan & Janet Smylie, “First Peoples, Second Class Treatment: The Role of Racism in the Health and Well-being of Indigenous Peoples in Canada” (Toronto, Ontario: Wellesley Institute, 2015) at 28. [4] Patrick McLane et al, “Impacts of Racism on First Nations Patients’ Emergency Care: Results of a Thematic Analysis of Healthcare Provider Interviews in Alberta, Canada” (2022) 22:1 BMC Health Services Research at 5-6. [5] Supra note 4 at 9. [6] Ibid at 8. [7] Supra note 3 at 27. [8] Ibid at 2. [9] Ibid. [10] Ibid.