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Breaking the Cycle: Confronting Healthcare Disparities for Indigenous Peoples in Canada

It’s time to bridge the inequalities

The government of Canada has worked over the years to achieve reconciliation with Indigenous peoples through a restored engagement between nations, governments, the Inuit, and the Crown, stemming from an underlying basic acknowledgment of rights, respect, cooperation, and partnership as the cornerstone for revolutionary change. The United Nations Declaration on the Rights of Indigenous Peoples Act (UNDRIP) provides a framework for the Government of Canada’s implementation of the rights of Indigenous Peoples, which was created after UN Special Rapporteur Jose Martinez Cobo released a study about the systemic discrimination of Indigenous peoples worldwide. It affirms the UNDRIP’s status as an international human rights act with applicability in Canadian law, which is especially significant with the increasing number of Indigenous peoples in Canada. According to the 2016 census results from Statistics Canada, 13,100 Indigenous people were living in the Montreal agglomeration and 34,745 in the greater Montreal metropolitan area, a statistic that grew to a total of 46,085 Indigenous identities in 2021 according to the census. This makes for a very large increase solely in the Montreal metropolitan area, with additional significant growth of 1.9 per cent per year, totaling 8 per cent, of the Indigenous population in Canada from 2016 to 2021.

Health is a basic human right, and yet there are unacceptable disparities between Indigenous and non-Indigenous peoples across Canada. A long-lasting legacy of colonialism and institutional racism means they are more likely to endure persistent poverty, impediments to housing, education, and food insecurities, all of which contribute to chronic illnesses and other health issues. They encounter racism when seeking healthcare, a lack of cultural safety, and a lack of resources dedicated to Indigenous health. A relevant example is the death of an Atikamekw woman, Joyce Echaquan, in a hospital in Quebec back in September 28, 2020. Prior to her passing, Echaquan captured a Facebook Live video in which she experienced racist harassment from medical staff. Echaquan’s passing, according to coroner Gehane Kamel, is another instance of the institutionalized hatred leveled at Indigenous people in Quebec. Following Echaquan’s passing, a petition was started to acknowledge the racism against Indigenous peoples in governmental institutions in Quebec. In an address to the House of Commons, Prime Minister Justin Trudeau acknowledged that institutional racism had a part in Echaquan’s passing, calling this “the worst form of racism” and “systemic racism.” Despite these reports and long apologies, the Indigenous community in Canada claims that there hasn’t been enough done to combat prejudice in healthcare. Joyce Echaquan’s case, according to Mary Jane McCallum, a professor at the University of Winnipeg and the holder of the Canada Research Chair in Indigenous People, History and Archives, “does not tell us anything new.” “Our health system was built on racial segregation,”McCallum says. “White supremacy and colonialism is in the fabric of our being – it is the air we breathe and the water we drink in Canada.”

The introduction of Bill 32, created to “establish the cultural safety approach within the health and social services network” in Quebec, has further exacerbated these long-lasting issues, contributing to growing dissatisfaction within a variety of organizations, including the College of Physicians and Indigenous communities. This legislation, while aimed at reforming the healthcare system, has been widely criticized for failing to recognize the existence of systemic racism within the province, particularly within the medical field. Its inability to address the deeply entrenched biases and discriminatory practices has not only perpetuated disparities in healthcare access and quality but has also ignited a fervent response from Indigenous communities who demand recognition, justice, and equity in healthcare provisions. In this context, the complex interplay between Indigenous societies, healthcare, and the shortcomings of Bill 32 underscores the urgent need for comprehensive reform and a deeper acknowledgment of historical and ongoing inequities.

On the morning of Wednesday 13, 2023, the Joyce’s Principle Office walked out of the meeting to review Bill 32. The organization’s leader declared that she was prouder of Quebecers than of their government, claiming that the majority of Quebecers are aware that systemic racism exists in the health care system and that the bill’s First Nations engagement was insufficient. “Cultural safety cannot be achieved in a health and social services network[…]without recognition of the obvious. The network as it has been designed contains policies, programs, and services that discriminate against Indigenous realities,” said Jennifer Petiquay-Dufresne, the executive director of the Joyce Principle Office. Among the bill’s critics is Dr.Vollant, an Innu surgeon at Notre- Dame Hospital who also spoke at the committee on Wednesday and made the claim that the right for cultural safety in health care patients is urgent and would like to see the acknowledgment of systemic racism in Bill 32, which should have been drafted by First Nations in the first place.

After countless years of racism and tragic incidents within the Indigenous community in the healthcare system, it is time for the Government to take serious measures and recognize the problem at its root, as the platitudes that have taken place so far are not nearly enough to guarantee a safe future for Indigenous communities in Canada.