Health (18-24): Current Problems

BC


May 12, 2020


COVID-19

“Colonialism of the Curve: Indigenous Communities and Bad Covid Data”.

Yellowhead Institute – release of Policy Brief: “Colonialism of the Curve: Indigenous Communities and Bad Covid Data”.
There is wide discrepancy on COVID-19 related health data from Indigenous Services Canada (ISC) and provincial health authorities:

  • There is no agency or organization in Canada reliably recording and releasing Covid-19 data that indicates whether or not a person is Indigenous.
  • The division of powers between provincial and federal government has gradually displaced and disrupted Indigenous governance over time.
  • ISC only gathers on-reserve data which eliminates over 50% of the Indigenous population who live off-reserve
  • Canadian federalism was established to serve Canadians and consequently maintains discrimination and sub-standard service delivery in on-reserve communities.
  • This jurisdictional fight between provinces and the federal government, where both claim the other is responsible for services, more often than not leaves Indigenous people without any services.

Through publicly available data—media reports, Band Council updates to members, local reports and obituaries—a team of researchers supported by Yellowhead has compiled and verified many more cases.

  • ISC: COVID-19 cases = 175; Deaths = 2
  • Yellowhead: COVID-19 cases = 465; Deaths = 7

The same gaps in data collection exist in child welfare and were a primary reason why the National Inquiry on Missing and Murdered Indigenous Women and Girls were unable to definitively identify the number of Indigenous women who have been murdered or are missing. Publicly accessible data makes it easier for Indigenous people to seek accountability from leaders, and to independently evaluate and measure the efficacy of interventions by all levels of government, including our own Indigenous leadership. In fact, this is probably one of the reasons why we don’t have it.


February 3, 2022


Systemic Racism

“Remembering Keegan – a BC First Nations Case Study Reflection”

Feb. 23, 2022: First Nations Health Authority – FNHA today announced the public release of its report titled “Remembering Keegan – a BC First Nations Case Study Reflection”. Keegan Combes was a 29-year old First Nations man who died in hospital in 2015 following delayed diagnosis and clinical management of a treatable accidental poisoning.

Remembering K​eegan” is part of ongoing anti-Indigenous racism actions in BC’s health care system that includes a number of other reports, reviews, recommendations and the formation of a provincial task team. It is also a tool meant to inform and guide the pursuit of definitive change and to support the establishment of a cultural safety standard within the health care system.

First Nations have a deeply rooted culture and tradition of storytelling as one of the ways of passing on knowledge. Storytelling is a traditional method used to teach about cultural beliefs, values, customs, rituals, history, practices, relationships, and ways of life. 

First Nations storytelling is a foundation for wholistic learning, relationship building and experiential learning. This Case Study Reflection is a narrative tool for health professionals to learn from and to reflect on the personal and systemic biases that shape their practice, and to encourage conversations leading to safer health care environments and experiences for First Nations and Indigenous people, so that what happened to Keegan never happens to others.

A first of its kind report produced by the FNHA, Remembering Keegan provides an in-depth look at the different paths that could have led to culturally safe care, offers clear examples of what Cultural Safety and Humility should look like, and how it could have contr​ibuted to a different outcome. The report also explores intersectionality, the interconnected nature of social categorizations such as race, class, abilities and gender, encountered by BC’s frontline healthcare workers in the care of their patients.

Loved and remembered by many, Keegan Combes was a local chess champion, grade ten piano player, and high-school graduate living with developmental disabilities.

In the aftermath of the incidents leading to his death, Keegan’s family, the BC Coroners Service, Fraser Health, and the FNHA committed to working together on building a better health care system to deliver culturally safe and equitable services to all Indigenous people in the Fraser Salish region. A plaque and artwork in Keegan’s honour were unveiled at the hospital during a ceremony on the fourth anniversary of his passing. You will find the Healing Hands of Friendship Commemorative plaque outside of the Chilliwack General Hospital affirming this first ste of commitment.

Keegan brought together Stó:lō and Coast Salish leaders to transform the health system from a sickness model to a wellness model of care. He is a transformer stone for the region. Telling Keegan’s story is important as a way to bear witness, document culturally unsafe encounters within the health care system, and contribute to changing the system to prevent similar deaths or harm in the future. Keegan’s legacy has been to help shape the Cultural Safety and Humility transformation that is currently underway in BC’s health system.

https://www.fnha.ca/Documents/FNHA-Remembering-Keegan.pdf


February 9, 2021


COVID-19

Access to COVID-19 Data

Government of BC – A coalition of First Nations and BC’s Provincial Health Officer have negotiated and are signing information sharing agreements that provide more detailed information about COVID-19 case numbers in nearby communities, and will enable the nations to make more informed decisions on safety measures, and provide risk guidance to their members. The agreements’ preamble makes clear that the nations do not view them as providing completely satisfactory disclosure, and they believe systemic change must still occur in BC’s healthcare system Under the terms of the agreements, the Provincial Health Officer will provide the Heiltsuk Nation, Nuu-chah-nulth Tribal Council Member Nations, and Tsilhqot’in National Government with frequent reports listing the number of COVID-19 cases in proximate communities, and certain thresholds must be met before the nations can disclose the number of cases in a community in their public risk statements


December 17, 2020


COVID-19

Access to COVID-19 Data

BC Information and Privacy Commissioner – Michael McEvoy has rejected the Ministry of Health’s arguments that Public Health Act emergency powers override its duty of public interest disclosure but determined on the facts of the case before him that section 25 of the Freedom of Information and Protection of Privacy Act (FIPPA) did not require the Ministry of Health to release requested COVID-19 information to the Heiltsuk Tribal Council, Tsilhqot’in National Government, and Nuu-chahnulth Tribal Council. he held that, while COVID-19 creates a risk of significant harm to the public, sufficient information is already available on COVID-19 cases to enable the public, and the complainant governments, to take steps to avoid or mitigate the risks connected with COVID-19.


December 17, 2020


COVID-19

Access to COVID-19 Data

HEILTSUK & NUU-CHAH-NULTH TERRITORIES – First Nations leaders issued a joint statement in response to the OIPC Commissioner’s ruling this morning on their application for an order for the Ministry of Health to disclose COVID-19 information under section 25(1)(a) of the Freedom of Information and Protection of Privacy Act (FIPPA): “We are angry and disappointed by today’s ruling which will continue to allow the Ministry of Health to withhold the life-saving information we have been requesting since the COVID-19 pandemic began.

BC’s colonial system of government has failed us yet again by failing to recognize us as the self-governing nations we are. We filed this application because we vowed to use every legal tool to protect our people. Today’s ruling shows us the limits of these tools, because BC and its laws won’t recognize us, or work with us, on a true government-to-government basis, despite saying the right words and passing legislation like the Declaration on the Rights of Indigenous People (DRIPA). If the Ministry of Health and British Columbia have any interest in doing the right thing, they will come to the table immediately and work with us to develop information sharing agreements that can help keep our people safe. Today’s ruling underlines the urgency of this need:

The Commissioner at several points in his ruling, highlights the need to enact legislation to provide for information sharing that facilitates self-government for First Nations. He quotes heavily in his ruling from Mary Ellen Turpel-Lafond’s recent report on systemic racism, In Plain Sight.
The decision underscores the inability of the Freedom of Information and Privacy Protection Act (FIPPA) – in its current form – to facilitate nation-to-nation information sharing that meets the needs of First Nations.


December 1, 2020


COVID-19

Access to COVID-19 Data

BELLA BELLA, BRITISH COLUMBIA – A coalition of First Nations leaders who have been calling on BC’s Ministry of Health to share COVID-19 case information with their governments for months, say they feel vindicated by Mary Ellen Turpel-Lafond’s report on systemic racism, and expect BC’s provincial health officer and Minister of Health, to implement the report’s recommendations immediately, including addressing COVID-19 information sharing. Turpel-Lafond’s report finds pandemic is magnifying racism and disproportionally impacting Indigenous people, including a lack of “timely and complete sharing of data related to positive or presumptive cases of COVID in or near First Nations Communities.”


September 5, 2020


COVID-19

Access to COVID-19 Data

NationTalk – A coalition of First Nations is escalating its efforts to receive potentially life-saving COVID-19 information from the BC Ministry of Health, by applying to the Information and Privacy Commissioner for an order to disclose proximate case information about the location (not personal identity) of confirmed and presumptive COVID-19 cases near their communities. The application, which was filed by the Heiltsuk Nation, Nuu-chah-nulth Tribal Council and Tsilhqot’in National Government, is supported by several other First Nations, civil society groups, and doctors. A public campaign (https://keepsafecampaign.com) has been launched with LeadNow, asking British Columbians to call on the government to release the information.

The nations have filed their application on the basis that the BC government’s refusal to share information violates Section 25 of the Freedom of Information and Protection of Privacy Act (FIPPA), which states that a Minister “must” disclose information about a risk of significant harm to an affected group of people. The nations also contend in their application that BC’s own Declaration on the Rights of Indigenous Peoples Act (DRIPA) requires that government “must take all measures necessary” to ensure the laws of BC are consistent with the UN Declaration on the Rights of Indigenous people (UNDRIP), which includes rights to self-determination, self-government and to develop and determine programs for maintaining the health and well-being of Indigenous people.


September 29, 2020


Ongoing Health Crisis

Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”

Community Food Centres (CFC) – Release of “Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”. Even before COVID-19, food insecurity affected nearly 4.5 million Canadians. In the first two months of the pandemic, that number grew by 39 per cent. Food insecurity now affects one in seven people, disproportionately impacting low-income and Black, Indigenous and People of Colour (BIPOC) communities. “Beyond Hunger illustrates that food insecurity is about equity and income,” says Saul. “We urgently need a national solution that goes beyond emergency food assistance. We need a solution founded in solid policy that addresses inadequate social programs, systemic racism and precarious employment.”

Why Food Insecurity happens in Canada:

  • People are stuck in low wage and precarious jobs
  • Canadians are struggling with a rising cost of living
  • Colonialism and systemic racism
  • Low social assistance rates trap people in poverty
  • More and more people are living alone
  • Food in the North is unaffordable

Findings:

  • 81% say it takes a toll on their physical health
  • 79% say it impacts their mental health
  • 57% say it is harder to find and keep a good job
  • 53% say it is a barrier to finding meaning in life
  • 58% say it limits their ability to take part in social activities
  • 46% say it limits their ability to celebrate their culture

We believe government policy is necessary to address the real cause of food insecurity. Policy is what will increase incomes and make life more affordable — for everyone. Here are four policy changes for the federal government to act on:

  1. Invest in income supports for low income Canadians
    • Increase income benefits for single adults who suffer disproportionately from food insecurity by:
      • Ensuring low-wage workers have equal access to Employment Insurance
      • Improving existing tax benefits so they provide more income by making them refundable
      • Creating a tax credit specifically for working-age adults
    • Ensure low-income Canadians, especially First Nations living on reserve, have better access to tax filing supports and benefit services
  2. Make life more affordable for Canadians
    • Speed up the implementation of the Canada Housing Benefit, which supports people who can’t afford their housing
    • Increase federal funding for early learning and child care
    • Move forward with a universal public pharmacare program
  3. Set targets and improve reporting on food security
    • Set targets to reduce food insecurity
    • Ensure Statistics Canada reports on food insecurity annually and collects better race-based data
  4. Ensure progress on food insecurity is achieved equitably
    • In partnership with Northern leadership, continue to reform Nutrition North Canada
    • In partnership with Indigenous leadership, create an Indigenous food sovereignty fund
    • In partnership with Black communities, create a fund to decrease food insecurity for Black Canadians
    • Apply a racial equity lens to all poverty and food-security policies

https://cfccanada.ca/getmedia/57f5f963-af88-4a86-bda9-b98c21910b28/FINAL-BH-PDF-EN.aspx?_ga=2.197064812.159489303.1604624936-1692352870.1604624936


November 22, 2018


Systemic Racism

Call for national investigation into forced sterilizations

Senator Murray Sinclair, former Chair of the TRC, says Canada needs a national investigation to find out how common coerced sterilizations are among Indigenous women and how they’ve been allowed to continue for so long.
http://nationtalk.ca/story/usw-joint-statement-calling-on-canada-to-end-sterilization-without-consent


September 21, 2017


Health Care Reform

Canada Health Act flaws

Healthy Debates – “Indigenous health services often hampered by legislative confusion“. The federal and provincial governments negotiate health transfers based on the Canada Health Act, which specifies the conditions and criteria required of provincial health insurance programs. It doesn’t mention First Nations and Inuit peoples, Métis and non-status or off-reserve Indigenous peoples who are covered by the Indian Act.

This lack of clarity – and lack of policies for providing Indigenous health services – has historically been used by both the federal government and provinces to narrowly define their responsibilities toward Indigenous health. It’s created bureaucratic delays that leave Indigenous peoples waiting for care or medications readily available to non-Indigenous Canadians. And it’s created gaps in care between Indigenous and non-status and First Nations people living off-reserve.

“The move to a new fiscal relationship is significant,” Grand Chief Doug Kelly, chair of the First Nations Health Authority of BC says. Leaving Indigenous people out of health care discussions and program design hasn’t worked. Instead, he says, First Nations communities should be empowered to identify their priorities and develop a plan. Once costs are attached, communities would negotiate with the government for transfer payments. Groups like the First Nations Health Managers Association that Marion Crowe, Executive Director represents, have been working to prepare communities for the eventual transfer of responsibility, focusing on developing health human resource and health administrative capacity within First Nations communities.


November 2, 2020


Health Care Reform

Canada’s Constitution embeds discrimination

Policy Options – Canada’s history of colonization has laid the foundation for the implementation of racist health policy and the delivery of culturally unsafe health care, resulting in health disparities that are disproportionately experienced by Indigenous Peoples. Since the establishment of the Indian Act in 1867, Canada’s Constitution has continued to support and maintain discriminatory and inequitable practices and policies that negatively impact the health of Indigenous Peoples. The result is that Canada’s current health-care model is in and of itself a determinant of ill health for Indigenous Peoples. The authors recommend specific policy changes to address these issues:

  • Lack of availability and accessibility to culturally safe health care for Indigenous people in Canada
  • Canada’s long history of implementing racist and sexist policies oppress Indigenous Peoples and place them in inequitable spaces.
  • Indigenous women routinely experience systemic racism, institutional racism, a lack of cultural safety and sexism

Recommendations to make substantial changes to its health policies and legislations:

  • a collaborative approach that engages Indigenous Peoples and their communities in generating culturally safe and relevant health policies.
  • adequate distinctions-based programming and reporting mechanisms,
  • additional support of Indigenous-led research,
  • recruitment of Indigenous health-care personnel and
  • the integration of traditional healing practices in Canada’s health care model.
  • the creation of an ombudsman specific to Indigenous health should be established at the national, regional and local levels to ensure Indigenous Peoples feel safe to report inequities and experiences of mistreatment.

The TRC has advocated for cultural safety training and an increase in Indigenous health professionals in Canada’s health-care system, further supporting our health policy recommendations.Many of the health disparities experienced by Indigenous Peoples correlate to social, economic and political factors, suggesting that the foundation of Canada’s systems and thus its health care are inherently discriminatory.

https://policyoptions.irpp.org/magazines/november-2020/excising-racism-from-health-care-requires-indigenous-collaboration/


January 28, 2021


Systemic Racism

Emergency Meeting on Indigenous Health

Assembly of First Nations – AFN National Chief Perry Bellegarde reiterated recommendations and called for urgency in addressing systemic racism in Canada’s health care systems at a two-day virtual meeting with federal, provincial and territorial ministers and Metis and Inuit leaders that ended today. The meeting, convened by Indigenous Services Minister Marc Miller, Crown-Indigenous Relations Minister Carolyn Bennett and Health Minister Patty Hajdu, gathered Indigenous leaders and health system experts to discuss short and long-term strategies to eliminate anti-Indigenous racism in Canada’s health care systems.

It is the second of its kind since the death of Joyce Echaquan in hospital September 2020. “There seems to be a shared sense of responsibility by all parties to addressing racism in the health care system, but until First Nations and Indigenous peoples are treated with the respect, quality of care and attention they deserve, meetings of this nature will not have the impact that’s required,” said National Chief Bellegarde. “Implementation of recommendations and reporting on their progress and outcomes will be essential


October 16, 2020


Systemic Racism

Emergency Meeting on Indigenous Health

Emergency meeting on racism in Canada’s healthcare system.

AFN recommendations to all levels of government:

  • Work directly with First Nations to ensure that Indigenous Peoples feel safe accessing health care services.
  • Quebec needs to work with First Nations to fully implement the Viens Commission Report’s recommendations.
  • Canada must conduct an immediate review of the Canada Health Transfers and the Canada Health Act, to ensure quality health care is being provided to Indigenous Peoples.
  • The federal, provincial, and territorial governments must listen to Indigenous Peoples on the need for a healthcare Ombudsperson.
  • The Provinces and Territories must work with educational institutions to ensure a more expansive curriculum for all health care providers

July 14, 2016


Ongoing Health Crisis

Fire protection on reserves

NationTalk – There is no national fire protection code that mandates fire safety standards or enforcement on reserves. All other jurisdictions in Canada including provinces, territories, and other federal jurisdictions (such as military bases, airports, and seaports) have established building and fire codes. The Aboriginal Firefighters Association of Canada (AFAC), NIFSC’s parent organization, supports the development of a national First Nations Fire Protection Act and is willing to work with First Nations leadership as a technical resource.

In the absence of legislation act or regulations, AFAC and the NIFSC are addressing identified gaps to improve fire safety in Indigenous communities by supporting them in creating fire safety standards, doing fire protection and response research, and establishing fire safety bylaws and building standards. Indigenous Peoples across Canada are over 5 times more likely to die in a fire compared to the rest of the population. That number increases to over 10 times for First Nations people living on reserve. Inuit are over 17 times more likely to die in a fire than non-Indigenous people. Rates among Métis were higher than non-Indigenous estimates (2.1), but these rates were not significantly different.

Fire-related injuries resulting in hospitalization are also disproportionate to Indigenous Peoples. First Nations people are over 4 times more likely, Métis are over 1.5 times more likely, and Inuit are over 5 times more likely than non-Indigenous people to be hospitalized due to fire-related injuries.

What has led to this situation?

Many social determinants contribute to the higher fire-related mortality among Indigenous Peoples. These include poverty, inadequate housing conditions, housing without smoke alarms, and more.

Core capital funding provided by Indigenous Services Canada (ISC), which includes funding for fire protection, is flexible. This means community leadership can use designated fire protection funds if the community has more immediate or pressing needs (e.g., a school needing repairs or social housing maintenance). Without a fire protection mandate or regulatory maintenance of fire protection standards for Indigenous communities, fire services and fire and life safety can be deprioritized or forgotten.
https://nationtalk.ca/story/new-study-shows-that-indigenous-peoples-across-canada-are-between-5-and-17-times-more-likely-to-die-in-a-fire-compared-to-the-rest-of-the-population

How the NIFC Project will help Indigenous Communities

  • Offer culturally sensitive and relevant fire and life safety training and education programs that are created for and delivered by Indigenous Peoples. These services are available to First Nations populations living on reserve, leadership, and individuals working or volunteering in emergency services.
  • Launched close to 80 programs and services that provide training and ongoing support to more than 600 First Nations communities in Canada. Programs include:
    • education, support, and training in the areas of community fire safety, community governance support, community infrastructure and engineering support, fire department management, fire investigation services, and fire department operations.
    • Training, education programs and services being offered by the NIFSC Project have not previously been available to First Nations communities, whereas they have been available in most other communities in Canada
  • improve fire-related mortality and morbidity amongst Indigenous Peoples is through more accurate data collection. The creation of the National Incident Reporting System (NIRS) will, over time, provide the data regarding fire incidents in Indigenous communities that has been missing.

October 21, 2020


Ongoing Health Crisis

Food Insecurity

The Narwhal – Human Rights Watch released “My fear is Losing Everything: Climate Crisis and First Nations’ Right to Food” in Canada. The report details how longer and more intense forest fire seasons, permafrost degradation, volatile weather patterns and increased levels of precipitation are all affecting wildlife habitat and, in turn, harvesting efforts. The report also outlines how there are more hunting and foraging risks due to warming temperatures. For instance, it’s harder — and sometimes impossible — to hunt caribou because the ice and permafrost they travel on isn’t stable enough for hunters.

“Climate change threatens to decimate these food systems, risking further serious consequences for livelihoods and health,” the report states. The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

Human Rights Watch lays out several recommendations for the federal government, including that:

  • Canada deem the right to food a basic human right
  • strengthen its climate change policies to reduce emissions
  • improve climate adaptation measures in First Nations and
  • support a transition toward renewable energy, including for First Nations, in the COVID-19 stimulus package

https://thenarwhal.ca/climate-change-indigenous-food-insecurity-report/


December 10, 2018


Systemic Racism

Forced Sterilizations

72 organizations endorse the joint statement from Amnesty International Canada, the Native Women’s Association of Canada, and Action Canada for Sexual Health and Rights, calling for government action to #DefendConsent and end #ForcedSterilization of Indigenous women in Canada

Canadian Press – All the women interviewed felt that the health system had not served their needs, and they had felt powerless to do anything about it. Aboriginal women who have had such an experience that prevents them from accessing health care are aware that they are higher risk for negative consequences of health problems that are preventable or treatable if diagnosed early; they still cannot get past their distrust. In its submission to the UN committee, the law firm said there has been no effort at a comprehensive review to understand the scale of the problem or the conditions that make forced sterilizations possible.


March 17, 2020


COVID-19

H1N1 and Systemic Racism

Globe and Mail – Despite accounting for just under 5 per cent of the Canadian population, Indigenous people were 25 per cent of those admitted to ICUs during the first wave of H1N1. First Nations children were 21 per cent of the paediatric patients admitted to ICUs during both waves. This led to sad and tragic outcomes. Indigenous peoples represented 17.6 per cent of the reported deaths in the first wave and 8.9 per cent of reported deaths in the second.These figures likely reflect the lack of timely interventions and diagnoses that plague communities who depend on understaffed nursing stations for their health-care needs, as well as jurisdictional squabbling about roles and responsibilities.

John Borrows is Canada Research Chair in Indigenous Law at the University of Victoria Law School writing with Constance MacIntosh, Viscount Bennett Professor of Law at Schulich School of Law at Dalhousie University


December 1, 2021


Systemic Racism

In Plain Sight Report

Victoria Times Colonist – Fewer than half of the 24 recommendations to address Indigenous-specific racism in the province’s health-care system have been fully implemented on the one-year anniversary of the In Plain Sight report. Mary Ellen Turpel-Lafond said she’s been “closely” monitoring progress:

  • apologies issued by health system leaders and regulatory bodies,
  • a critical amendment to the B.C. Human Rights Code to include Indigenous identity as a protected ground from discrimination, and
  • the hiring of Indigenous senior leaders across health authorities and the Health Ministry to lead change from the inside.

But much more work is needed, Turpel-Lafond said. “In the meantime, Indigenous Peoples have continued to be disproportionately harmed and oppressed, and they continue to die as a result of the impacts of racism and the twin public health emergencies.” Turpel-Lafond said the province has not used available tools to uphold obligations under the Declaration on the Rights of Indigenous Peoples Act to address anti-Indigenous racism as it relates to the right to health — including the right to traditional medicines, access without discrimination to health and social services.


April 23, 2021


Systemic Racism

In Plain Sight Report

Budget 2021 invested $45 million over three years to respond to the recommendations of the “In Plain Sight” report on systemic anti-Indigenous racism in the healthcare system:

Expand First Nations cultural safety and humility training and Indigenous liaisons within each regional health authority
Address systemic racism against Indigenous people in the health care system through training, education, and
prioritizing hiring of a more diverse health care workforce that better reflects all the people of B.C.


February 5, 2021


Systemic Racism

In Plain Sight Report

Toronto Star – Health Minister Adrian Dix provided an update on his government’s progress on implementing the original 24 recommendations. He said his government is providing funding for 32 Indigenous health liaisons in health authorities across the province, of which nine are already in place. It has also ensured that each health authority board has at least two Indigenous members, he said. A toll-free number and email established during the review will remain active so Indigenous people can report their experiences of racism in the health-care system, he added. The province has also appointed Dawn Thomas as the new associate deputy minister of Indigenous health, and struck a task force to drive the implementation of the recommendations.


December 1, 2020


Systemic Racism

In Plain Sight Report

Métis Nations of BC is calling on the B.C. government to urgently implement all the recommendations found in Mary Ellen Turpel-Lafond’s report…and its 24 recommendations in an expedited timeframe. This includes implementing the recommendation, “that the Ministry of Health establish a structured senior level health relationship table with MNBC, and direct health authorities to enter into Letters of Understanding with MNBC and Métis Chartered Communities that establish a collaborative relationship with clear and measurable outcomes.” The report found that B.C. needs to expand Métis participation in health decision-making and that the expectations of health authorities to engage with MNBC are not widespread or codified. MNBC is calling on the Ministry of Health and Minister Adrian Dix to establish the BC-Métis Nation Health Leadership Table in the first six months of 2021. While the First Nations Health Authority receives an annual budget of $60 million – with no mandate to care for Métis people – MNBC only receives $200,000 annually to service the health needs of over 90,000 citizens and self-identified Métis across the province.


December 1, 2020


Systemic Racism

In Plain Sight Report

Toronto Star – The independent investigation – touted as the first complete review of racism in a Canadian health-care system – released its report “In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care“. The investigation has found pervasive systemic racism against Indigenous people in this province based on the following findings:

  1. Widespread Indigenous-specific stereotyping, racism and discrimination exist in the B.C. health care system.
  2. Racism limits access to medical treatment and negatively affects the health and wellness of Indigenous peoples in B.C.
  3. Indigenous women and girls are disproportionately impacted by Indigenous-specific racism in the health care system.
  4. Current public health emergencies magnify racism and vulnerabilities and disproportionately impact Indigenous peoples.
  5. Indigenous health care workers face significant racism and discrimination in their work and study environments
  6. Current education and training programs are inadequate to address Indigenous-specific racism in health care.
  7. Complaints processes in the health care system do not work for Indigenous peoples.
  8. Indigenous health practices and knowledge are not integrated into the health care system in a meaningful and consistent way.
  9. There is insufficient integration, or “hard-wiring” of Indigenous cultural safety throughout the health care system.
  10. Indigenous structures and roles in health decision- making need to be strengthened.
  11. There is no accountability for eliminating Indigenous- specific racism in the B.C. health care system, including system-wide data and monitoring of progress.

The report calls for a “Renewed Foundation” built on three foundational elements to addressing the legacy of colonialism in the health care system:

  1. Racism in the health care system is a reflection of a lack of respect and implementation of the basic human rights of Indigenous peoples.
  2. Racism within the health care system is integrated with, and in many aspects indivisible from, broader patterns and conditions throughout society.
  3. While those who experience the problem of racism in the health care system must be intimately involved in developing solutions, we know that the responsibility and burdens of this work lie with non-Indigenous individuals, communities, organizations and governments.

“In Plain Sight” concludes with 24 detailed recommendations for stakeholders in the health-care system in BC but also emphasizes that many of the Observations, Findings and Recommendations have implications for the federal government as responsibility for health is an area of shared and overlapping jurisdiction and authority, especially in relation to Indigenous peoples. As the scope of this review was specific to B.C., Recommendations have not been directed to the federal government. However, tangible and urgent action is needed by the federal government, as well as national health organizations, to address Indigenous-specific racism in the health care system.

The Review has identified a number of areas where federal actions could be helpful to eliminate all forms of discrimination against Indigenous peoples. Examples of such necessary action include:

  1. Federal legislation to specifically implement the UN Declaration to bring the federal laws, policies and practices in conformity with the Indigenous human rights, principles and standards in the UN Declaration.
  2. Federal Indigenous-specific health legislation and other legislative amendments which explicitly make cultural safety a desired outcome or requirement of quality within Canada’s health care system, affirming Indigenous peoples’ individual and collective rights to health, facilitate Indigenous authority over their health services, and assure consistency with the minimum standards in the UN Declaration.
  3. Federal health regulatory standards that address anti-racism, cultural humility and trauma- informed practices.
  4. Active co-operation by the federal government consistent with the standards of the UN Declaration to make necessary changes to the First Nations health governance structure in B.C.
  5. Direct support by national health organizations to identify measures and tools to address

https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Full-Report.pdf


July 9, 2020


Systemic Racism

In Plain Sight Report

Government of BC – An independent investigation into Indigenous-specific racism in British Columbia’s health care system was launched today by former judge and provincial child advocate Mary Ellen Turpel-Lafond. Appointed by Health Minister Adrian Dix on June 19 after highly disturbing allegations of racism in B.C. Emergency rooms came to light, Turpel-Lafond has now assembled her team for the “Addressing Racism” investigation, established her terms of reference and launched a survey to collect and assess the experiences of First Nations, Métis and Inuit people when they access health care. “Our task is to address the specific incidents that have been reported, as well as to gauge the levels of systemic and individual racism that Indigenous people face when using the health care system in general,” Turpel-Lafond said. After examining the systemic racism that occurs in the health system, the investigation will make a number of recommendations designed to prompt necessary improvements.


June 19, 2020


Systemic Racism

In Plain Sight Report

NationTalk – First Nations, Métis and Inuit patients seeking emergency medical services in British Columbia are often assumed to be intoxicated and denied medical assessments, contributing to worsening health conditions resulting in unnecessary harm or death. This is according to information obtained by Métis Nation BC and the BC Association of Aboriginal Friendship Centres. Additionally, the parties have notified the First Nations Health Authority of this concern.

Participants within the San’yas Indigenous Cultural Safety Training program detail thousands of cases of racism in healthcare, resulting in the harm of Indigenous patients. In a recent training session, a program participant disclosed a common game played within B.C. hospital emergency rooms, where physicians, nurses and other staff try to guess the blood alcohol concentration (BAC) of Indigenous patients. The winner of the game guesses closest to the BAC – without going over.

The Province of B.C. has yet to enforce standardized anti-racism training for health service workers. BC Association of Aboriginal Friendship Centres and Métis Nation of BC – Indigenous leadership are calling upon the Ministry of Health to accept the following four recommendations:

  1. A public inquiry into Indigenous specific racism in health care in B.C with a focus on hospitals and emergency departments.
  2. Ensure that all front-line staff are required to take mandatory First Nations, Métis and Inuit training that results in increased health professional personal accountability in the delivery of safe health care.
  3. Commit to structural and systemic changes to dismantle indigenous specific racism to ensure culturally safe health care experiences for Indigenous people.
  4. Ensure that Indigenous governments play a stronger role in the development and implementation of anti-racism programs and training throughout BC.

February 4, 2021


Systemic Racism

In Plain Sight: Supplemental Report

Toronto Star – Mary Ellen Turpel-Lafond released a supplemental data report Thursday that shows Indigenous people in B.C. are much more likely to feel unsafe in health-care settings, to feel they are never included in care decisions and to feel they receive poorer service than others.

“Taken together, these … reports clearly demonstrate the need for immediate, principled and comprehensive efforts to eliminate all forms of prejudice and discrimination against Indigenous Peoples in the B.C. health-care system,” she writes in the new document. The report comes as Indigenous people across B.C. are speaking out, including the Nuxalk Nation in Bella Coola where hundreds of COVID-19 vaccine doses were abruptly withdrawn and a woman in Kitimat whose baby was stillborn after she says a hospital turned her away.

Her supplemental report is based on results of surveys, submissions to her team and patient complaints, as well as hard data on how Indigenous people use health care and the outcomes they experience. Almost 9,000 people directly shared their perspectives through surveys and submissions, while about 185,000 Indigenous individuals are reflected in the health sector data.

Indigenous survey respondents were significantly more likely to feel unsafe in health facilities. For example, in emergency rooms, 16 per cent felt “not at all safe” and 57 per cent felt “somewhat unsafe,” compared with five and 38 per cent of non-Indigenous people, respectively. Other findings include:

  • 23% of Indigenous respondents reported they “always” received poorer service than others
  • 24 per cent treated as though they were dishonest,
  • 26 per cent treated as if they are drunk or asked about substance abuse and
  • 14 per cent treated like bad parents.
  • Some 67 per cent of Indigenous respondents reported they had experienced discrimination from health-care staff based on ancestry, compared to 5% of non-Indigenous respondents.
  • Only 16 per cent of all Indigenous respondents reported never having been discriminated against for any reason listed while receiving health care.

Turpel-Lafond’s team also conducted a survey of health-care workers, of which 35 per cent said they had witnessed racism or discrimination directed to Indigenous patients, family or friends. The number increased to 59 per cent for Indigenous health-care workers who responded.
https://engage.gov.bc.ca/app/uploads/sites/613/2021/02/In-Plain-Sight-Data-Report_Dec2020.pdf1_.pdf


April 20, 2020


COVID-19

Incarcerated prisoners

First Nations leadership across BC is united in calling for immediate action to protect incarcerated peoples amidst the COVID-19 pandemic. The COVID-19 outbreak at the Mission Institution is now the third largest outbreak in the Province of BC, with the first inmate tragically passing away on April 15, 2020. Senior health and corrections officials have verified that almost 40% of the confirmed cases of COVID-19 at Mission Institution are among Indigenous inmates despite Indigenous people making up just 5% of the population in BC.


November 19, 2020


COVID-19

Problems with Indigenous COVID-19 data

Toronto Star – COVID-19 is negatively impacting both on-reserve and off-reserve Indigenous populations. “Hospitalizations and intensive-care rates are sky high for off-reserve populations and testing is low. Both on and off reserves, about 18% of tests come back positive. The issues identified by Janet Smylie, research chair in Indigenous health knowledge and information at Well Living House at St. Michael’s Hospital in Toronto is threefold:

  1. Urban Indigenous people are not included in federal statistics nor are they “included in new initiatives to collect statistics on a disaggregated basis to take into account minorities
  2. They check all the boxes for being at high risk for catching COVID-19
  3. Due to health delivery being delivered by the provinces, Indigenous data is fragmented as a result of “decades of entrenched jurisdictional conflict and passing the buck”
  4. The trends in Manitoba could be indicative of broader trends impacting urban indigenous communities in other provinces and sound, reliable data is essential to inform decisions.

“Resources could be allocated to a fragile segment of the population in a way that is both effective and meaningful”. The National Association of Friendship Centres is at the frontline of delivering services to the urban Indigenous population with centres across the country. “Staff at the centres are constantly scrambling for extra space, resources and personal protective equipment to handle the safety demands of the virus.” Jocelyn Formsma, Executive Director, NAFC


January 28, 2021


Systemic Racism

Racism against Indigenous womern

Native Women’s Association of Canada – At a two-day meeting at which the issue of anti-Indigenous racism in Canada’s healthcare systems will be addressed by federal, provincial, and territorial governments as well as representatives of the First Nations, Métis and Inuit, NWAC is not being permitted to give more broadly based opening remarks Wednesday, along with other male-led National Indigenous Organizations. Had NWAC been permitted to speak at the meeting’s opening, said Ms. Whitman, NWAC president “we would have explained that Indigenous women, girls, and gender-diverse persons are disproportionately affected by systemic racism and violence in healthcare.” Instead, NWAC’s remarks the following day will be confined to the two narrower questions put by the government around “identifying diversity and intersectionality actions”.

The problem of racism in healthcare delivery moved to the forefront of national consciousness last year when Canadians heard the horrific and discriminatory remarks directed at Joyce Echaquan, an Indigenous woman, as she lay in her deathbed at a hospital in Quebec. “It is Indigenous women who have been subjected to forced sterilizations. It is Indigenous women, girls and 2SLGBTQQIA people who have been the targets of violence that a National Inquiry found to be a genocide, and which forces many of us to seek medical treatment,” said Ms. Whitman.

“It is a problem to which we, at NWAC, have given much thought because it so profoundly affects our members,” she said. “We will be offering some ideas about ways to tackle racism in healthcare settings during the five minutes we have been allotted at the meeting on Thursday. But we would like the government to demonstrate that it is just as interested in hearing the voices of Indigenous women on this issue as it is in hearing the voices of Indigenous men.”

The experiences of Indigenous women, girls, and gender-diverse persons in the healthcare system are not the same as those of men. Success in defeating racism depends on our ability to recognize each other as inextricably linked partners in this task


April 23, 2020


COVID-19

Release of at-risk Indigenous inmates

The Indigenous Bar Association (IBA)– Calls Upon Federal, Provincial and Territorial Justice Ministers and Attorneys General to Immediately Release low-risk Indigenous Inmates over COVID-19.Specifically, we call for the immediate release of incarcerated Indigenous people and the following actions:

  • Immediately and minimally, carry-out the release of Indigenous inmates that are low-risk, non-violent, nearly eligible for parole, nearing sentence end, over 50 years of age, pregnant women, those offenders who are able to be adequately supervised in the community, and those at heightened risk due to pre-existing medical and chronic health conditions;
  • The release of inmates described above to apply to federal and provincial correctional facilities, including all remand, youth and short-term detentions centres;
    • For those that absolutely cannot be released, ensure:
    • Full access to medical and mental health care;]]
    • Full and equitable access to personal protective equipment, medical grade sanitizer and cleaning agents, personal hygiene products, and other critical supplies, with invariable availability of these supplies to all inmates and correction workers (including officers, administrators, and all other employees and contractors);
  • Access to enhanced cultural supports during heightened safety measures, ensuring any quarantine of those incarcerated is carried out in the least traumatic way, in an attempt to mitigate resurgence of traumatic experiences or intergenerational effects of the legacy of colonialism;
  • In accordance with domestic and international laws and conventions, ensure that institutions do not use isolation methods that are akin to segregation punishment for infected inmates, specifically:
    • Individuals should not serve longer than 15 days in segregation, isolation, solitary confinement, medical removal or administrative removal;
    • Those who are segregated within the 15-day limit are given access to daily use of shower, telephone, and recreational facilities;
    • Those who are segregated are given daily access to mental health professionals in attempt to mitigate the lasting damage done by isolation;
  • Implement the short and long-term measures identified recently by the Union of British Columbia Indian Chiefs in their open letter dated March 24, 2020; and
  • Correctional Services Canada and all provincial correctional jurisdictions implement the recommendations of the Correctional Investigator of Canada, Dr. Ivan Zinger and take notice of specific requests by Indigenous organizations and communities.

Protecting the health of oilsands workers is more important than protecting the health of Indigenous people as evidenced by the suspension of environmental monitoring by Alberta Energy Regulator


November 12, 2020


COVID-19

Systemic Racism at federal, provincial, territory ministers human rights meeting

NationTalk – 24 civil society groups attending the third ever meeting of Federal, Provincial, Territory Ministers responsible for human rights “condemned the obstructive attitude of some governments” in advancing international human rights obligations. Groups had pressed governments to commit to nation-wide law reform that will legally require governments to adopt a collaborative, accountable, consistent, transparent, well-coordinated approach to effectively implementing international human rights obligations in Canada. No commitment was made. Two governments boycotted the meeting:

The government of Quebec opposed included references to “systemic” racism in the final communiqué, a position that blatantly ignores the undeniable reality of deeply-rooted systemic racism in the province and across Canada, and thus reaffirms systemic racism as a nationwide reality.
The government of Alberta considers that the province is not bound to report on or engage with international instruments or mechanisms to which it is not a Party, a position that contravenes international law which makes it clear that federalism is no excuse or justification for failing to comply with international obligations.
In 2017, meeting for the first time in 29 years, ministers made several commitments to strengthen their collaboration in protecting human rights across Canada:

Ministers had taken account of the Truth and Reconciliation Commission’s call on federal, provincial and territorial governments to “fully adopt and implement” the UN Declaration on the Rights of Indigenous Peoples. It is a shocking and unacceptable omission to see no reference to the Declaration in the final communiqué from this week’s meeting.
During the past eight months of responding to the COVID-19 pandemic, no government has applied – equitably or otherwise – an explicit economic, social, cultural, and environmental rights framework to analyze the problems laid bare, or to structure solutions.
A widely-endorsed proposal in April 2020 from 302 civil society groups, Indigenous peoples’ organizations and a broad spectrum of subject matter experts to federal, provincial, territorial and municipal governments to institute meaningful human rights oversight of their COVID-19 responses has not been taken up by any government in the country.

At the current meeting, Ministers discussed the human rights implications of the COVID-19 pandemic and agreed that it is “important that human rights principles be considered in the development of plans for a strong and equitable recovery from the pandemic for all Canadians” but in no way acknowledged or even referenced social and economic rights. The proposal for human rights oversight of COVID-19 responses was not addressed.


September 8, 2020


Health Care Reform

Unicef “Innocenti Report Card 16”

NationTalk – Release of Unicef “Innocenti Report Card 16: Worlds of Influence – Understanding What Shapes Child Well-being in Rich Countries” where Canada placed in the bottom 10 of 38 countries. In fact, all four countries with large Indigenous populations – who all initially opposed The United Nations Declaration the Rights of Indigenous People – ALL placed in the bottom 8: (Canada # 30, Australia # 32, New Zealand # 35 and the United States # 36) and experts attribute this to the poor health outcomes of Indigenous kids.

Unicef issued “Top 5 Policies to Defend Childhood in 2020” on Dec. 30, 2019 one of which # 3 “Ensure Fairness for indigenous Children.” The federal government should adopt the Spirit Bear Plan proposed by the First Nations Child and Family Caring Society and endorsed by the Chiefs of the Assembly of First Nations to permanently end funding shortfalls in the services provided to First Nations children. First Nations children and families living on reserve and in the Territories receive public services funded by the federal government. Since Confederation, these services have fallen significantly short of what other Canadians receive. In 2015, the Truth and Reconciliation Commission released its Calls to Action, including a call to achieve parity for First Nations, Inuit and Métis children. Equitable spending on public services for children including clean water, health care, education and protection is their right.


January 8, 2021


COVID-19

Work Camps and COVID-19

Prince George Citizen – An open letter written by Wet’suwet’en Ts’ako ze’ (female chiefs) is being backed by 400 health care workers in B.C. calling on the province to close work camps during the pandemic. A letter addressed to Dr. Bonnie Henry, B.C.’s provincial health officer on Dec. 16, 2020, penned by Dr. Bilal Bagha, was signed by more than 650 people. “We unequivocally support the recommendations of the Wet’suwet’en Ts’ako ze’ and Skiy ze’ in their letter to you on the widespread and deadly racism and discrimination experienced by Indigenous peoples in the health care system in B.C.,” the letter states. “As health professionals working on the frontlines, we see firsthand the brunt of the devastation caused to communities by the dual public health emergencies of the climate crisis and COVID-19 pandemic — which both


December 15, 2020


COVID-19

Work Camps and COVID-19

The Tyee – Wet’suwet’en Elders in Witset have identified five COVID-19 cases directly linked “to workers returning from job sites at an LNG Canada plant in Kitimat and the Coastal GasLink pipeline camps closer to home. Those have led to spread of the virus within their community…That spread — the second cluster of cases there in recent months — began two weeks ago, around the time 22 Ts’ako ze’ (female chiefs) wrote to provincial health officer Dr. Bonnie Henry expressing concerns about work camps continuing to operate on Wet’suwet’en territory during the pandemic. Violet Gellenbeck, one of the chiefs who signed the letter, says they’re still waiting for an answer.

In their letter, Ts’ako ze’ representing the nation’s five clans expressed particular concern with three camps on Wet’suwet’en territory in Burns Lake, south of Houston and near the Unist’ot’en Healing Centre. Gellenbeck says camp workers who test positive for the disease are sent home without consideration for who they live with or their ability to self-isolate. The letter from the Wet’suwet’en Ts’ako ze’ was followed on Dec. 5 by a letter written by Ron Mitchell, Hereditary Chief Hagwilnegh, on behalf of the nation’s Dinï’ze, or male chiefs. Hundreds of health and social workers have also signed an open letter to Henry expressing concern about the camps. Last week, the Union of BC Indian Chiefs also called on the province to close the camps.


June 25, 2020


COVID-19

Work Camps and COVID-19

News 1130 – The Heiltsuk, Nuu-chah-nulth, and Tsilhqot’in nations say the provincial government didn’t consult them before throwing the doors open to non-essential travel. Their priority, they say, is protecting elders and Indigenous leaders say basic safety measures are not yet in place to be able to welcome travellers to their communities.


June 24, 2020


COVID-19

Work Camps and COVID-19

Globe and Mail – First Nations are among the most vulnerable populations in B.C., with the most to lose – the loss of an elder represents a loss of language, culture and history. First Nations are still waiting for the BC government to respond to repeated requests for more information and resources to protect communities and fulfill the following four basic measures:

  • An information-sharing agreement to ensure early reporting of suspected and confirmed cases in nearby regions to Indigenous governments;
  • screening methods to ensure travellers seeking to enter Indigenous territory are not symptomatic or infected with the virus;
  • rapid-testing mechanisms available that can prioritize Indigenous and remote communities – in fact, there are currently just two rapid testing kits for all Indigenous communities in B.C.
  • And finally, funding for culturally safe contact-tracing that can increase the likelihood of effective tracing in the event of an outbreak, and reduce the risk of racist interactions with the health care system of the sort the government has decried.

We continue to call on the B.C. government to consult and meet with us, on a nation-to-nation basis, to begin implementing the four safety measures on an urgent basis, and to discuss the underlying issue of systemic racism, which appears to be driving the status quo of putting Indigenous lives at risk.

https://www.theglobeandmail.com/opinion/article-bcs-covid-19-re-opening-plans-continue-to-put-indigenous-people-at/