Joyce Echaquan, a 37-year-old Atikamekw woman, was killed in a Joliette hospital on September 28, 2020. After entering the hospital with severe stomach pain on September 24, she was subjected to persistent anti-Indigenous racism, and complained to nurses that she was being overmedicated. She was prescribed morphine despite her family informing hospital staff that she was allergic to the drug and had a pre-existing heart condition, which led to a cardiac arrest. As she was dying, Echaquan live-streamed on Facebook, where hospital workers were caught making blatantly racist remarks, using slurs, and completely ignoring her suffering. Joyce Echaquan’s experience is not uncommon: it reflects a greater system of anti-Indigenous violence. On Sunday, October 11, less than one month after Echaquan’s death, a 53-year-old Atikamekw man named Georges-Hervé Awashish died shortly after telling his family that nurses had been making racist remarks towards him. He had filed a formal complaint with the hospital two weeks prior.
Many showed their solidarity and outrage about Echaquan’s death at a protest titled “Justice for Joyce” organized in Montreal by Iskweu on Saturday, October 3. Rallies were also held in Toronto and Vancouver. Superficial steps are being taken in response to the situation: as of October 16, one nurse and one orderly who were involved have been fired, and the health authority in Lanaudière has started an internal investigation. Quebec Public Security Minister Genevieve Guilbault has announced that she has asked the coroner’s office to conduct a public inquiry into Echaquan’s death. On Friday, October 2, Quebec Premier Francois Legault met with the Atikamekw Nation Grand Chief Constant Awashish and the chiefs of the three Atikamekw communities in Quebec, ultimately stating that the staff at Joliette would be trained on how to better provide services for Indigenous patients. This training would be “offered throughout the health-care network.” According to the Montreal Gazette, the CIUSSS du Saguenay—Lac-Saint-Jean, which oversees the Chicoutimi Hospital, has also launched an investigation surrounding Awashish’s death. However, these band-aid solutions are far from sufficient. Having government agencies investigate themselves often serves as a distraction rather than a long-term solution.
While these steps aren’t unimportant, they only address individual acts of racism, and are not constructive to solving the inequity of the healthcare system. There need to be significant structural and ideological changes in the Canadian medical system. Marilee Nowgesic, chief executive officer at the Canadian Indigenous Nurses Association, is calling for a mandatory cultural competency and humility training program for health-care professionals. In an interview with the CBC, Nowgesic stated that “These should not be elective courses. […] At some point everyone is going to have an encounter with an Indigenous person in their health profession. Let’s give them the tools to make that treatment or that treatment plan with their clients a positive outcome.” Canada’s and Quebec’s healthcare systems have long histories of anti-Indigenous racism which must be recognized and changed. Practices such as isolating Indigenous children with medical needs from their families and communities, forced sterilization of women, blatantly racist assumptions about credibility and pain tolerance, provincial and federal negligence of proper medical infrastructure in Indigenous communities, and the barriers that an Indigenous person may have to face in order to seek medical treatment are only a few of the myriad of ways in which Canadian Health care has oppressed and continues to oppress Indigenous peoples.
The provincial and federal governments must honour their commitments to reforming the healthcare system to be inclusive and anti-racist. In September 2019, Quebec Superior Court Justice Jacques Viens released a report containing 142 calls to action to address systemic racism in the province after a provincial inquiry. Nakuset, the executive director of the Native Women’s Shelter, called out the former Indigenous Affairs Minister Sylvie D’Amours for claiming to have enacted 51 of the 142 calls to action: “Please show me where [they are], cause it ain’t happening here,” she said in an interview with Huffington Post. Furthermore, despite the Truth and Reconciliation Commission Report’s publication in 2015, only 9 of its 94 recommendations have been implemented by the federal government, and none are in the area of healthcare.
Indigenous voices must be prioritized in government efforts to address systemic racism in the Quebec healthcare system. Contrary to the testimonies of Indigenous and other racialized communities, Premier Legault maintains that systemic racism does not exist in Quebec. This is not only ignorant, but actively harmful. Despite what Legault claims, the institution’s actions speak the loudest: the newly named Indigenous Affairs Minister in the province, Ian Lafrenière, is a former officer with the SPVM. This choice is alarming, considering that the police have historically and continuously contributed to the systemic oppression of Indigenous peoples. Both Legault and Lafrenière believe that Lafrenière’s experience as a police officer is an asset to his role. This is a disturbing reminder of the government’s attitude towards Indigenous communities, given that Lafrenière represents an institution that deliberately criminalizes Indigenous peoples while denying the practice of racial profiling among its officers.
We must also recognize that racism does not exist in a vacuum: medical schools, including the one at McGill, contribute to the anti-Indigenous racism of the healthcare system. Dr. Samir Shaheen-Hussain, a Montreal physician and assistant professor in the Faculty of Medicine at McGill University, stated, “It’s not enough for one faculty of medicine or of nursing in the province to implement practices… It has to be across the board.” We can pressure the school to make concrete changes in its curriculum by contacting the Vice-Principal (Health Affairs) & Dean Dr. David Eidelman at 514-398-3524 or firstname.lastname@example.org. You can also contact the medical schools at Université Laval, Université de Montreal, and Université de Sherbrooke to request changes in their programs.
If you have the means to do so, support Joyce Echaquan’s family directly by donating to their official GoFundMe page. At the moment, there are no official ways to support Georges-Hervé Awashish’s family.
We must also demand wider institutional change. Support initiatives to make healthcare more accessible to Indigenous communities, such as the Indigenous Health Centre of Tiohtià:ke. Pressure the Quebec government to enact the recommendations of the Viens commission report by contacting Premier Francois Legault at Francois.Legault.ASSO@assnat.qc.ca and Indigenous Affairs Minister Ian Lafrenière at email@example.com.