Health (18-24): Current Problems

Systemic Racism

February 3, 2022


“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.

November 22, 2018

AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

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.

July 22, 2022

Fed. Govt.

CMA condemns forced and coerced sterilization

In response to the Standing Senate Committee on Human Rights’ report The Scars that We Carry: Forced and Coerced Sterilization of Persons in Canada – Part II Opens in a new window, the Canadian Medical Association (CMA) unequivocally denounces the practices of forced and coerced sterilization.

As the report details, forced and coerced sterilization have a long history in Canada. Laws and government policies rooted in racism and discrimination sought to reduce births in First Nations, Inuit and Métis communities, Black communities, and among people with intersecting vulnerabilities relating to social and structural determinants of health, ethnicity and disability. These practices have had a disproportionate impact on equity-relevant groups and those experiencing structural vulnerabilities in Canada. The medical profession must acknowledge its role and commit to upholding its ethical obligations.

The act of sterilization without informed and uncoerced patient consent is an absolute violation of fundamental tenets of medical ethics and the medical profession’s fundamental commitment to respect for persons, as articulated by the CMA Code of Ethics and Professionalism. The CMA supports the Senate committee’s recommendations to prohibit these practices and enhance training and regulation of medical professionals to halt these practices in the future.

Dr. Katharine Smart
CMA President

The Scars that We Carry: Forced and Coerced Sterilization of Persons in Canada – Part II

Survivors of forced and coerced sterilization deserve government apology, compensation: Senate committee

Ottawa – The federal government should compensate and apologize to all people who were subjected to forced and coerced sterilization, the Senate Committee on Human Rights said in a report released Thursday, July 14, 2022.

The report, The scars that we carry: Forced and Coerced Sterilization of Persons in Canada – Part II, outlines the committee’s findings from the second part of its study into this deeply disturbing practice, which persists today and disproportionately affects vulnerable and marginalized groups in Canada, including Indigenous women, Black and racialized women, and people with disabilities.

Survivors described how they were stripped of their ability to conceive without their free, prior and informed consent at moments of extreme vulnerability. Some were as young as 14 and coerced through confinement, manipulation or threats; others were simply not consulted before the procedure. Many survivors attributed their sterilization to racism in Canada’s health-care system.

The report includes 11 other recommendations aimed at ending forced and coerced sterilization in Canada, including a specific Criminal Code prohibition, increased investments in community-based midwifery in northern and remote communities, and a national plan to collect and publish anonymized data on forced and coerced sterilization.

The committee extends its heartfelt gratitude to the survivors who testified. The absence of data on forced and coerced sterilization placed a heavy burden on them to come forward and share their personal stories and lived experiences; their brave decision to do so was integral to the completion of this report.

Quick Facts
  • Sterilization is a surgical procedure to prevent conception. Forced or coerced sterilization occurs when the procedure is performed without the patient’s free, prior and informed consent. This often has profound physical and psychological effects on survivors.
  • The practice of forced and coerced sterilization of marginalized and vulnerable groups — including Indigenous women, Black women, people with disabilities and intersex children — has a long history in Canada; cases of forced or coerced sterilization have been reported as recently as 2019.
  • Reproductive rights are considered part of the right to security of the person guaranteed by section 7 of the Canadian Charter of Rights and Freedoms as well as numerous international law instruments.
  • Class action lawsuits have been brought forward in Saskatchewan, Manitoba, Ontario, British Columbia, Quebec, New Brunswick, Nova Scotia and Alberta on behalf of Indigenous women who say they were subjected to forced or coerced sterilizations.
  • The Senate Committee on Human Rights conducted a preliminary study of forced and coerced sterilization in Canada between 2019 and 2021. The committee released its first report on the subject in June 2021.

November 9, 2019


Coroner investigating systemic racism at Thunder Bay Hospital

Toronto Star – A 19-year old First Nations man taken to the hospital by ambulance in obvious distress was escorted off the hospital property three hours later by security staff. Apparently, escorting Indigenous people who are seeking medical care off of hospital property is common practice. The would be patient ultimately committed suicide at a remote part of nearby Lakehead University.

An internal review of the case by the hospital “concluded that appropriate actions were taken and that the right decisions were made by clinical staff based on the information provided to them and the patient’s presentation.”
Tanya Talaga, Toronto Star. An investigation is currently underway by Ontario’s chief coroner, Dirk Huyer. He told me it will look for any “potential systemic issues that may have played a role in contributing to the death — policies, procedures, steps taken.” It will also examine whether this death is part of a pattern — and make any recommendations necessary to break that pattern.

October 5, 2021


Coroners Report into death of Joyce Echaquan

APTN – The existence of systemic racism in the way Joyce Echaquan was treated in a Quebec hospital is undeniable, coroner Gehane Kamel said Tuesday, a few days after releasing her report on the Atikamekw mother’s controversial death. Kamel recommended the government recognize the existence of systemic racism and make a commitment to root it out of institutions.

“It is unacceptable that large sections of our society deny such a well-documented reality.” When asked if the mother of seven would still be alive if she were a white woman, Kamel replied: “I think so.” But despite the coroner’s recommendation, the Legault government has steadfastly denied systemic racism exists in the province. In a press melee held Tuesday – at the same time as the Echaquan family’s press conference – Legault doubled down on his denial of Quebec’s systemic issues. “Yes, there is some racism in Quebec – but less than many other places,” Legault told reporters. “The only place where I don’t agree is when we say that there’s a ‘system.’ Because for me, a system is coming from upstairs, coming from the top people – and I don’t see this in the health care system.”

One of her recommendatons to the Québec government was “to recognize the existence of systemic racism within our institutions and make a commitment to contribute to its elimination”.

Other Recommendations:

For the Quebec government

  • Recognize the existence of systemic racism within our institutions and make a commitment to contribute to its elimination.

For the regional health authority that governs the hospital in Joliette, Que., where Echaquan died

  • Ensure the effective integration of the Atikamekw liaison officer into the hospital, in particular by involving them with care teams.
  • Ensure notes in medical files reflect the reality of how patients are being cared for.
  • Review the nurses-to-orderlies ratio based on standards recognized at the provincial level in order to provide safe services to the population.
  • Maintain periodic training on the establishment’s code of ethics, restraint measures, the monitoring of patients following a fall, and record management.
  • Quickly set up training and activities for the inclusion of Indigenous culture that is coordinated with the community of Manawan.
  • Improve the nurse/nursing assistant model and ensure that each has a clear understanding of their roles.

For the College des medecins du Quebec, the province’s order of physicians

  • Review the quality of the medical care given by the doctor responsible for family medicine and by the medical resident in gastroenterology to Ms. Echaquan during her hospitalization in September 2020.
    For the Ordre des infirmieres et infirmiers du Quebec, the province’s nurses order
  • Examine the quality of care of nurses’ services provided to Ms. Echaquan during her hospitalization.
  • Review the integration practices of college-level nursing candidates in emergency departments across hospitals in the province.
  • Include in the school curriculum training on the care of Indigenous patients that takes into consideration the realities of Indigenous communities.
  • Establish with Indigenous communities a greater offer of internships for both nurses and medical residents.
    Quebec’s Human Rights Commission condemned the “systemic discrimination suffered by Indigenous Peoples, particularly in the health sector.” Echaquan’s death, president Philippe-André Tessier said in a statement, serves as a “tragic reminder of this reality and of the need for concerted and sustained action to address it.”

The Grand Chief of the Atikamekw Nation Council, Constant Awashish, called on the government to act swiftly and implement the recommendations put forward by the Viens commission.

September 15, 2017


Death of Brian Sinclair

CBC – Brian Sinclair was killed by racism on Sept. 21, 2008. He was ignored for 34 hours, despite his need for urgent medical care, because medical professionals made negative assumptions about him based solely on his appearance. Anti-Indigenous bias is an endemic problem in Canadian health care:

  • The hospital authority denied that stereotyping had anything to do with Mr. Sinclair’s death.
  • The government of Manitoba refused to hold a public inquiry.
  • The inquest into Mr. Sinclair’s death sidelined issues of race and social marginalization.
  • Regulatory bodies have been slow to implement any changes, if at all, and
  • no one has been held accountable for professional misconduct or criminal neglect.

The findings of the Manitoba Ombudsman rely on the government’s health and justice departments “appraising their own progress.”

The Brian Sinclair Working group was formed to examine the role of racism in the death of Brian Sinclair and in the inquest that followed, in order to highlight ongoing structural and systemic anti-Indigenous racism in our contemporary health and legal systems. The Sinclair family and the Sinclair Working Group have called for a public inquiry to explore the underlying systemic racism in the delivery of Health services to Indigenous populations. The Working Group aims to release a final report in 2018. The interim report “Ignored to Death” was issued Sept. 2017

February 26, 2021


Death of Joyce Echaquan

Montreal Gazette – Québec Indigenous Affairs Minister Ian Lafrenière, Health Minister Christian Dubé and interim Lanaudière health authority director Caroline Barbir announced along with Atikamekw chief Paul-Émile Ottawa announced the following changes:

* the creation of a reconciliation committee
* the addition to the health authority’s management of a liaison officer responsible for relations with the Atikamekw community
* a commissioner to deal with complaints from Indigenous users concerning the quality of services received at the institution. Both posts will be filled by members of the community
* a seat on the health authority’s board of directors will be reserved for an Indigenous candidate
* all health authority employees will be obliged to complete a training course, the content of which will be approved by the Atikamekw community

Finally, Dubé said the changes announced for the Lanaudière region’s health authority could serve as a model for reforms he intends to carry out throughout all of the health care network, with modifications for certain regions.

February 11, 2021


Death of Joyce Echaquan

Indigenous Services Canada – Minister of Indigenous Services, the Honourable Marc Miller, highlighted funding of $2 million to the Conseil de la Nation Atikamekw and the Conseil des Atikamekw de Manawan, Joyce’s community, to advance their work and advocacy for the implementation of Joyce’s Principle. With this funding, the Atikamekw, including the community members of Manawan, will be able to develop tools and training, promote Joyce’s Principle to healthcare professionals, and educate First Nations on their rights when using the healthcare systems. These funds will also be used to organize meetings with non-Indigenous Peoples on fighting racism.

December 15, 2020


Death of Joyce Echaquan

Release of “Racism in Québec: ZERO TOLERANCE. Report of the Groupe d’action contre le racism” by the Québec government that had no Indigenous representation. The Atikamekw nation says the 25 recommendations to counter racism raises more questions than answers. “Concrete proposals were offered in the brief for Joyce’s Principle to achieve changes with an impact on all health and social services. However, these do not seem to have been taken into account in the recommendations offered. We hope that the awakening linked to Joyce’s death will lead to some groundwork.”

Recommendations specific to Indigenous People (14-25)

14. Include in the national anti-racism awareness campaign a specific component on the realities of Indigenous peoples, to continually inform the public about the racism and discrimination experienced by First Nations and Inuit people.
15. Make the professional orders aware of the importance of training their members on Indigenous realities.
16. Make the history and current realities of Indigenous people in Québec a mandatory part of initial teacher training programs.
17. Change the academic curriculum at the primary and secondary levels to update concepts related to the history, cultures, heritage and current realities of Indigenous peoples in Québec and Canada and their impact on society.
18. Introduce continual, mandatory training on Indigenous realities for government employees.
19. End the informal practice of prohibiting people from speaking Indigenous languages while receiving public services.
20. Make the ban on random police stops mandatory.
21. Add Indigenous social services workers to some police services to create mixed patrol teams.
22. Increase the resources of Indigenous community organizations that promote access to justice for First Nations and Inuit people.
23. Improve the capacity of the justice system to address the heritage and life trajectory of Indigenous offenders by granting more resources for the use of the Gladue principle specific to First Nations and Inuit people.
24. Improve the quality and availability of interpretation services in Indigenous languages for better access to justice.
25. Increase resources allocated to off-reserve housing.

November 10, 2020


Death of Joyce Echaquan

Québec Government – is investing $3.1M in Joliette “to enable the relocation and enlargement of the Centre d’amitié autochtone de Lanaudière (CAAL), an Indigenous community organization founded in 2001. Its mission is to improve the living conditions of Indigenous people living in or passing through the Joliette region by providing a number of support services, assistance and information through programs specially designed for Indigenous families.” The Centre will provide:

  • Consultation offices and a community room and kitchen;
  • Spaces to promote Indigenous history, arts and cultures;
  • Spaces for social economy activities;
  • Spaces that can be shared with partners;
  • Rooms dedicated to the CAAL’s Mirerimowin clinic;
  • A residential annex
  • An early childhood centre (CPE), a child-minding service and a playroom;
  • Administrative offices

November 6, 2020


Death of Joyce Echaquan

The Québec government will invest $15 million to implement targeted actions to enhance cultural safety for members of First Nations and Inuit in the health and social services sector. This announcement follows several calls to action by the Public Inquiry Commission on relations between Indigenous Peoples and certain public services in Québec.

October 16, 2020


Death of Joyce Echaquan

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

October 2, 2020


Death of Joyce Echaquan

Québec government announced the launch of a public inquiry under the coroner’s office.

September 30, 2020


Death of Joyce Echaquan

Montreal Gazette – “In her last moments, while tied to a hospital bed, Joyce Echaquan, a 37 year-old Atikamekw woman, pleaded for someone to help her. Instead, a video she recorded shows she received disparaging and condescending remarks — at a time when Québec continues to grapple with the larger question of systemic racism.” The Québec coroner’s office is investigating the death that Premier François Legault insists is not reflective of systemic racism within the Québec Health system despite that conclusion being found by the Viens Commission from one year ago.

“One professor told the commission the situation is so dire many Indigenous people will avoid going to the hospital over fears of being discriminated against. For those who have to go, they mentally prepare themselves first for the treatment they’ll be subjected to…Echaquan had grown so wary of hospital staff that she would often record Facebook live videos from her bed, her cousin said”.

Québec’s Human Rights Commission condemned the “systemic discrimination suffered by Indigenous Peoples, particularly in the health sector.” Echaquan’s death, president Philippe-André Tessier said in a statement, serves as a “tragic reminder of this reality and of the need for concerted and sustained action to address it.” The Grand Chief of the Atikamekw Nation Council, Constant Awashish, called on the government to act swiftly and implement the recommendations put forward by the Viens commission.

November 16, 2020


Death of Joyce Echaquan – Joyce’s Principle

The Council of the Atikamekw of Manawan (CDAM) and the Council of the Atikamekw Nation (CAN) –  have submitted a brief for “Joyce’s Principle” to Francis Legault, the Premier of Québec and Prime Minister Justin Trudeau. Québec Government has rejected adopting Joyce’s Principle “a call to action and commitment to governments to facilitate the transition towards health and social services systems that are safer and free from discrimination for Indigenous people across Québec and Canada.

Joyce’s Principle makes specific reference to Article 24 of the United Nations Declaration of the Rights of Indigenous Peoples:

  • Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals. Indigenous individuals also have the right to access, without any discrimination, to all social and health services.
  • Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

On Nov. 24, 2020 the Québec National Assembly refused to adopt Joyce’s Principle due its explicit reference to systemic racism within Québec.

January 17, 2022


Discrimination in Niagara Health System

Niagara Chapter-Native Women – The NCNW Board of Directors is asking for a full Coroner’s Inquest into the death of Heather Winterstein, 24, who passed away while in the care of Niagara Health System on Dec 10, 2021. We call for the Coroner’s Inquest to address the long-standing issues of discrimination against Indigenous people, particularly Indigenous Women and to fulfill the family’s wishes to ensure that this “never happens to another family”.
“Unfortunately, this is not an isolated incident.’ She says “an eerily similar story occurred when Brent Sky 32, an Ojibway man from Shoal Lake reserve, was transported 90 kilometres by ambulance to Lake of the Woods District Hospital in Kenora.” He was suffering with an extremely severe headache and painful vision. He was seen in the emergency room and sent on his way with 3 Ibuprofen pills, (readily available over the counter). He travelled back home – alone – by bus. Speaking to his parents that evening, he still complained of the headache and pain in his eyes. The following morning his father found him dead. He died of a brain bleed. This was October 27, reported in a CBC article posted on December 13, 2021, “just 3 days after Heather’s Dec. 10 death,’’ said Brant.

December 17, 2021


Discrimination in Niagara Health System

Toronto Star – Niagara Ontario Health Team Planning Table (NOHT) has voiced its support for an investigation into the circumstances surrounding the death of Heather Winterstein, an Indigenous woman who collapsed and died in the emergency room at the St. Catharines site of Niagara Health.

Carol Stewart-Kirkby, co-lead for the health team, said there is a need to acknowledge systemic racism exists, confront anti-Indigenous bias and seek change. “This incident is a tragic reminder of the urgent need to work to understand how the legacy of colonization continues to impact health-care systems,” Stewart-Kirby said. “Our thoughts are focused on supporting the people most directly involved.”

Winterstein had visited the emergency room on Dec. 9. Complaining of pain, she was given Tylenol and sent home. She was brought back to the hospital by ambulance the next day, complaining of severe back pain and later died before seeing a doctor. Her family was told Heather died as the result of a strep A infection.
Niagara Health announced it would be conducting an internal investigation into Winterstein’s death and had invited her family and Indigenous leaders in Niagara to be a part of it and a broader investigation that would consider the experiences of Indigenous people in the health-care system in Niagara.

January 28, 2021

AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

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

AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

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

December 17, 2019


Environment and Health

Canada’s National Observer – Repeated failure by government authorities to conduct a comprehensive baseline health study as recommended by the Alberta Cancer Board (supported by the province’s governing health authority, Alberta Health Services) in 2009. In Fort Chipewyan a community of roughly 1,200 people, the study found, you would expect to see 39 cases of cancer. Instead, it found 51 cases, a difference of 30.7 per cent. The Athabaska River flows through Canada’s oil patch, giving rise to the theory that the oil-and-gas industry is responsible for the illnesses, having poisoned people for years by contaminating the environment. Government bodies and researchers have challenged that theory, leading to a call for a new more conclusive health study that could provide real answers.

Athabasca Chipewyan First Nation and Mikisew Cree First Nation pooled their resources to fund research. With some additional funding from Health Canada, a three-year, $1-million study was led by Stephane McLachlan, a professor at the University of Manitoba. His findings released in 2014 measured contaminants not only in water but also in beavers, ducks, fish, moose and muskrats — animals consumed as part of a traditional diet for those who continue to live off the land in the Peace-Athabasca Delta. He concluded that the animals contained high concentrations of pollutants such as carcinogenic polycyclic aromatic hydrocarbons and heavy metals such as arsenic, mercury, cadmium and selenium. All of these are by-products of extracting and upgrading bitumen. Arsenic in particular has been linked to increased risk of biliary tract cancer.

July 11, 2022

First Nations Health Managers Association to launch “RISE Against Racism” campaign

Akwesasne, Traditional Mohawk Territory, Ontario — Indigenous Services Canada: Accessing quality health services can be a stressful experience. Anti-Indigenous racism in Canada’s health systems, such as discriminatory language in interactions with patients and negative stereotyping that influences care decisions, can have a negative impact on health outcomes. That is why the First Nations Health Managers Association, in partnership with the First Peoples Wellness Circle and the Thunderbird Partnership Foundation, are working to change problematic language and perceptions within the context of health systems through the RISE Against Racism campaign.

Focusing on hospitals, health care providers, health authorities and medical schools, this campaign will work to change problematic biases and perceptions by promoting mutual respect, understanding and empathy toward Indigenous Peoples seeking health services. After its official launch later this year, the campaign will include print marketing, a series of television interviews, radio interviews and commercials, as well as public service messaging to communities informing them of available resources.

Indigenous Services Canada is supporting this work with a $400K contribution in 2021-2022 and $480K in 2022-2023. This investment is part of $126.7 million allocated through Budget 2021 over three years to address anti-Indigenous racism in Canada’s health systems. The Government of Canada remains committed to working with provincial and territorial governments, Indigenous partners and health providers to increase safety and respect for Indigenous Peoples in Canada’s health systems.


“RISE Against Racism is an important campaign that will help to address anti-Indigenous racism that has persisted in Canada’s health systems for far too long. I commend the First Nations Health Managers Association, along with the First Peoples Wellness Circle and the Thunderbird Partnership Foundation, on their hard work and vision to launch this campaign, as it will help to foster better experiences and outcomes for Indigenous Peoples when they access health care.”

The Honourable Patty Hajdu
Minister of Indigenous Services

“Working together with our partners―the Thunderbird Partnership Foundation and the First Peoples Wellness Circle―provides an opportunity to incorporate our collective strengths, voices, and values into this campaign. We collectively call on Canada and our allies to RISE against racism.”

Marion Crowe
First Nations Health Managers Association

Quick facts

  • Budget 2021 has committed $126.7 million over three years to foster health systems where Indigenous Peoples are respected and safe.
  • This investment aligns with the federal response to improve access to culturally safe services, with a focus on services for Indigenous women, 2SLGBTQQIA+ people, persons with disabilities and other marginalized groups who may experience intersecting discrimination.

Related products

Associated links


For more information, media may contact:

Alison Murphy
Press Secretary
Office of the Honourable Patty Hajdu
Minister of Indigenous Services

Media Relations
Indigenous Services Canada

Marion Crowe
First Nations Health Managers Association

May 17, 2021


Forced sterilization in Québec

The Université du Québec en Abitibi-Témiscamingue (UQAT) and the First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) – in collaboration with several partners gathered within a regional committee, call on everyone to participate in research on free and informed consent and imposed sterilization, including obstetric violence, among First Nations and Inuit women in Quebec. The research is launched jointly with the Council of Elected Women of the Assembly of First Nations Quebec-Labrador (AFNQL), Quebec Native Women, the Cree Women of Eeyou Istchee Association, the Regroupement des centres d’amitié autochtones du Québec, the Office of Senator Yvonne Boyer, the Nunavik Regional Board of Health and Social Services as well as the Cree Board of Health and Social Services of James Bay. The regional committee invites First Nations and Inuit women to testify on a personal experience or that of a loved one.

This research is part of the work of the Canada Research Chair on Indigenous Women’s Issues at UQAT, led by Professor Suzy Basile. More specifically, this is the theme of the research of doctoral student in Indigenous Studies at UQAT, Patricia Bouchard. “This research takes place in a context where the Quebec government has chosen not to participate in the federal working group on forced sterilization of Indigenous women in Canada, underway since 2018, while we have come to the conclusion, in particular by the development of a literature review carried out by the Laboratoire de recherche Mikwatisiw of UQAT, that there is a glaring lack of relevant data on this topic in Quebec. In light of these facts, it seemed essential to us to compile a portrait of the situation in order to better understand it and measure its impacts,” says Professor Basile. This research therefore aims to document this phenomenon and the circumstances in which these medical procedures might have been performed in order to identify certain trends, if any. It will also be an opportunity to give a voice to First Nations and Inuit women who may have experienced obstetric violence by allowing them to share their experience and traumas.

“Last year, the sad circumstances surrounding the death of Joyce Echaquan shed light on the acts of systemic discrimination experienced by First Nations and Inuit women in Quebec health institutions. In this sense, this research is of crucial importance; in addition to demonstrating the violence that our women, sisters and daughters might have suffered, it is a first step towards achieving healthier practices and quality services,” indicated Marjolaine Siouï, Executive Director of the FNQLHSSC.

December 10, 2018

AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

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.

July 22, 2017


Forced Sterilizations in Saskatoon hospitals

CBC – Indigenous women were coerced into having a tubal ligation in Saskatoon hospitals while still in labour. A class action lawsuit was initiated on October 5, 2017 by two affected women in the Saskatoon Health Region. Now about 60 women are part of the lawsuit.

CBC – Nov. 18, 2018 – Authorities should very carefully read Article 2 of the Convention on the Prevention and Punishment of the Crime of Genocide adopted by the UN in 1948”, Romeo Saganash, an NDP MP said. “It says that “genocide” includes any acts committed with the intent to destroy, in whole or in part, a national, ethnic, racial or religious group, such as by “imposing measures intended to prevent births within the group.”

July 12, 2021


Human Rights complaints

The Southern Chiefs’ Organization (SCO) – fully supports the human rights complaints filed this week on behalf of First Nation citizens living in what is now Manitoba.

Three human rights complaints were filed against the federal government this week alleging systemic discrimination as well as a failure to provide proper services where they were needed for First Nation adults with disabilities. The Public Interest Law Centre brought the complaints on behalf of two First Nation people, both of whom are from southern First Nations. “We have laws and principles, such as Jordan’s Principle, to protect First Nation people and ensure our citizens finally receive the full and proper care that they deserve. Clearly and unfortunately, the system continues to fail us despite these laws,” stated SCO Grand Chief Jerry Daniels. “Though we are continually let down by colonial governments in this country, it is heartening to see First Nation citizens standing up for their rights and demanding better treatment and the substantive equality they deserve.”

Aidan Wilson from Peguis First Nation and Carly Sinclair from Sagkeeng Anicinabe First Nation have both experienced discrimination when seeking essential health care and services. Aidan was forced to leave Peguis First Nation and live in Winnipeg due to challenges receiving help and services for his disabilities. Living in Winnipeg has meant separation from his community and culture, and this separation was highlighted in the complaint. “The federal government continues to not only discriminate against our people but also separate them from their home, extended family, and community,” said Peguis First Nation Chief Glenn Hudson. “It’s unimaginable to me that at a time when the truth of the destruction caused by residential schools and separating children from their homes is finally coming to light for all of Canada to see, the federal government continues to contribute to the separation of our communities. It’s heartbreaking that Aidan and his family cannot live where they want to, with their people, due to systemic failures.”

Carly Sinclair has a rare neurological disorder caused by a mosquito bite, and she does not receive regular doctor’s visits and is excluded from many aspects of daily life that most Canadians take for granted. “Carly has suffered needlessly,” stated Sagkeeng Anicinabe First Nation Chief Derrick Henderson. “All First Nations should receive adequate and full services and care for their citizens with disabilities, the same as Canadians living off reserve. This should include our adult citizens, especially those who received inadequate access to services as children and now continue to be discriminated against as adults.”

Jordan’s Principle, named after Jordan River Anderson who passed away while in hospital in Manitoba as provincial and federal governments fought over which order of government would pay for his care, legally requires that First Nation children with disabilities receive the support and care they need when and where the need them, regardless of jurisdiction. Unfortunately, this principle does not extend to adults.

December 1, 2021


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


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


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


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

December 1, 2020


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.

July 9, 2020


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


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


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.

March 2, 2021


Infant mortality and youth suicide

The Manitoba Advocate for Children and Youth (MACY) and the First Nations Health and Social Secretariat of Manitoba – submitted a report that discusses “the international and national human rights framework as it relates to structural inequalities and Indigenous children’s right to continuous improvement of health with a particular focus on infant mortality and youth suicide in Manitoba, Canada. Specific issues raised for discussion include …the rights to life, physical and mental integrity, liberty and security of person, access to justice (preamble, and articles, 6, 7, 8, 22 and 43) and non-discrimination, health, housing (as part of the right to an adequate standard of living and non-discrimination), culture, and education (articles 14, 17, 21)”.

The focus on Manitoba includes:

  • one in two First Nations children, one in four Metis, one in four Inuit, and one in six non-Indigenous children in Manitoba live in poverty, all higher than in Canada overall.
  • Indigenous infants account for between 20-30% of live births in Manitoba between 2009 and 2018, but represent at least 57% of sleep-related infant deaths
  • Only 24 of 63 First Nations communities in Manitoba have maternal-child health programs, some of which are ‘pilot’ programs that lack permanent or sustainable funding.
  • 20 of 22 suicides of female youth between 2012 and 2019 and who were involved with the child welfare system were Indigenous.
  • while approximately 26% of the child population in Manitoba are Indigenous, they account for approximately
  • 90% of children in the care of child and family service agencies
  • 78% of children, youth, and young adults served by the Manitoba Advocate for Children and Youth through ongoing advocacy supports during the 2019/20 fiscal year were Indigenous.
  • A study of the overlap between Manitoba’s child welfare and justice systems found that close to one-third of children in care were later charged with a crime as a youth (age 12-17). This study confirmed that the child welfare system in Manitoba serves as a ‘pipeline’ to the youth criminal justice system
  • Indigenous youth in Manitoba are 16 times more likely to be incarcerated than non-Indigenous youth
  • In 2016, only 48% of Indigenous students graduated high school “on-time”, compared to 86% of their non-Indigenous counterparts

Recommendations form the “Joint Submission to the Expert Mechanism on the Rights of Indigenous People”: Study on the rights of the Indigenous child under the United Nations Declaration on the Rights of Indigenous Peoples”

ONE: Take steps to include the voices, experiences, perspectives, and testimony of Indigenous children and youth to the largest extent possible in any decision or work that may affect them, as enshrined by Article 12 of the UN Convention of the Rights of the Child.

TWO: Acknowledge the ongoing work towards reconciliation and the fulfillment of Indigenous children’s rights in Canada by evaluating and commenting on the Government of Canada’s compliance with the Truth and Reconciliation Commission of Canada’s 94 Calls to Actions designed to redress the legacy of residential schools and advance the process of reconciliation in Canada and recommendations made in Honouring the Truth, Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.

THREE: Recognize the self-determination of Indigenous Peoples by highlighting Indigenous-led initiatives to fulfill the rights of Indigenous children including maternal- child health programs and youth suicide prevention programs that provide children with the culturally appropriate services they are entitled to receive.

FOUR: Through the development of this study, create opportunities for Indigenous practitioners and advocates around the world to come together to generate connections, and share information and best practices

FIVE: In order to understand the differential experiences of Indigenous children and youth, the challenges they face, as well as existing gaps in the social determinants of health, it is imperative that governments systematically collect data on Indigenous ancestry, with attention to the principles of ownership, control, access, possession (OCAP®) and principles of Ethical Métis Research. Currently, this gap in information prevents a full understanding of the structural inequalities facing Indigenous children and youth.

SIX: Ensure ethical considerations are upheld and respected in all aspects of this study and any research or data collection involving Indigenous Peoples, and Indigenous children in particular, conducted by governments and other parties. Ethical considerations concerning research for and by Indigenous Peoples should involve free prior informed consent on a collective and individual basis; principles are followed to ensure Indigenous ownership, control, access, and possession of their own data and information; and all research should be respectful and benefit Indigenous Peoples.

SEVEN: Examine the role of fiscal policies that continuously underfund services for Indigenous infants, children, and their families (including schools, mental health services, and prenatal and postnatal supports) as a barrier for the realization of Indigenous children’s right to health.

EIGHT: Recognize the centrality of addressing Indigenous child poverty at the national level as a necessary condition of fulfilling Indigenous children’s right to non- discrimination and health.

NINE: Prioritize analysis of the role of the child welfare system and ongoing apprehension of Indigenous children from their families as this is in direct violation of the right of Indigenous children to a family life, to health, to culture, and to a future.

May 27, 2022


Manitoba First Nations leaders declare State of Emergency in Health Services in the north

NationTalk: (Brokenhead Ojibway Nation) – Late afternoon May 24, 2022, the Keewatinohk Inniniw Okimowin Council (KIOC) of elected leaders unanimously declared a state of emergency on health services. The elected leaders are Chiefs and Councilors who collectively represent 23 First Nations in Manitoba’s north. The motion calling for the declaration came about during a two-day meeting of the KIOC, held to make important decisions on health transformation.

Discussion turned to the critical nursing shortage that will impact all 21 of Manitoba’s federal nursing stations, placing First Nations people in actual peril because of the much longer wait times to be seen in the Nursing Stations where a minimum standard of care is already stretched to breaking.

While the nursing stations are not to close, the ‘open to emergencies’ only policy has been put in place by the federal government across Manitoba for at least the week of May 16 to 23, 2022. What this means is that the number of nurses able to support a community is so low that they can only support emergencies. “Who would bring their family member there knowing that the services are stretched that thin? To protest, we should gather a busload of patients from our communities and bring them south all at once to access services” stated Chief Monias, Interim Chair, KIOC and further that “We are calling on the government to come to a round table and discuss solutions immediately”.

Nursing Stations dilemma a symptom of system neglect akin to Jordan’s Principle for all First Nations people.

Dr. Barry Lavallee, Chief Executive Officer of Keewatinohk Inniniw Minoayawin (KIM) Inc. applauded the declaration;

  • Nursing shortages,
  • shortages in physician-led care,
  • limited access to diagnostic care,
  • lack of appropriate health infrastructure in communities, and
  • the lack of a coordinated systems-based response for urgent and emergent issues like the nursing shortage

– all of this is racism, full stop, and has been worsening instead of improving over time. System leaders have nothing to be proud of and should really hang their heads in shame. Many will try to lay blame on the pandemic but that is only one of the contributing factors. The truth is that although the pandemic has shed new light on gaps in care and really, the ‘Jordan’s Principle’ of health services for First Nations people overall – it is time for systems to stand in discomfort and take the hits for their neglect due to racism.”

A roundtable discussion with the federal and provincial governments to address immediate, short term, medium- and long-term solutions for issues such as but not limited to:

  • Long standing shortages of nurses and physicians for northern First Nations, ambulatory and medical transportation related issues, and a lack of preventative health care
  • Health infrastructure on reserves which is long overdue for modernization
  • Modernization of the 1964 Agreement
  • Improving the federal and provincial integrated response system for urgent and emergent crises
  • Systemic racism

“With respect to KIM and ‘taking over’ First Nations health services in the north, we are eager for this to happen. We are short staffed in our community – with nursing as well as security. When we go to Thompson there is nothing there to look after patients that need special care. When we travel to Winnipeg or Brandon, the care is available. Why can’t we get the same care in Thompson?”, Councillor Cheyenne Spence, Nisichawayasihk Cree Nation.

“It is a mess. This is systemic racism. Thompson General Hospital has become a triage center. We need to look at ways to take control – make our own policies, services, and facilities up north instead of sending them down south. As peoples, we are still ‘in care’ and must change that.” Councillor Donnie McKay, Pimicikamak.

“Our nursing station has a certain number of FTE nurses allocated, but we never hit that number. They sometimes work from 8:00 am in the morning to 4:00 am the next morning. This is very concerning. We would not want a nurse who did double time to assess patients. There could be misdiagnosis and medication errors. These issues place lives at risk”, Councillor Shirley Robinson, Pimicikamak.

June 9, 2021


Missing Indigenous Children

Montreal Gazette – The day after being appointed a special adviser to Québec on the issue of missing Indigenous children, Anne Panasuk said Wednesday she believes systemic racism exists in the province — in direct contrast to the ruling Coalition Avenir Québec’s insistence it does not. The consequences of not recognizing systemic racism are demonstrated by the fact Quebec does not have clear health care files on Indigenous communities, Liberal Leader Dominique Anglade said. Ms Panasuk will advise the government on Bill 79 “An Act to authorize the communication of personal information to the families of Indigenous children who went missing or died after being admitted to an institution”.

September 7, 2021


Missing Indigenous children in Québec

Toronto Star – According to the most recent estimate of Awacak, a group which brings together bereaved families, at least 200 indigenous children have disappeared or died after being admitted to a hospital in Quebec. A number that makes sense, confirms the office of Ian Lafrenière, Quebec’s Minister Responsible for Indigenous Affairs. On Sept. 1, Bill 79 (An Act to authorize the communication of personal information to the families of Indigenous children who went missing or died after being admitted to an institution) take effect. The bill allows personal information to be communicated to the families – and not only to the parents – of Indigenous children who have disappeared or died following admission to a Quebec health establishment. It gives access to medical archives and those of religious congregations.

The cases of Indigenous children who disappeared or died in the same circumstances as Line were documented in the supplementary report on Quebec of the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) in the country in 2019. The story is almost always the same: an Indigenous child would get sick, they were sent outside the community to be treated in the nearest hospital, but never returned. And the parents were left without answers. Such cases have been reported in Quebec since the 1940s and until the late 1970s. Without commenting on any of the testimonies recounted during this report, Alain Arsenault, Awacak’s legal advisor. Arsenault affirms that in some of her files, “clues suggest” the same modus operandi as during the “’60s Scoop”, where children were taken from their families for adoption in Canada and the United States.

Bill 79 allows members of an Indigenous family to make an official request to the Family Support Team, active since Sept. 1. This team should assist families in their research. Bill 79 applies to health and social services establishments, religious organizations or congregations. It does not include residential schools, unless a resident has died after being admitted to hospital. The legislation covers the period before Dec. 31, 1992. A family can apply until September 2031. The law also gives the Minister Responsible for Indigenous Affairs the power to investigate in the event of a refusal to disclose “information likely to reveal the circumstances surrounding the disappearance or death of a child.” The Minister must submit an annual report no later than March 31 of each year.

April 29, 2022


Missing Indigenous Children: Initial Review of 55 missing children

Bill 79, An Act to authorize the communication of personal information to the families of Indigenous children who went missing or died after being admitted to an institution

NationTalk: During a tribute held in the community of Pakuashipi in the Côte-Nord region to the courage of the families of Indigenous children who went missing or died,  Minister Responsible for Indigenous Affairs Ian Lafrenière noted the submission of the first annual report on the application of the “Act to authorize the communication of personal  information to the families of Indigenous children who went missing or died after being admitted to an institution“. Accompanied by the members of the monitoring committee on the carrying out of the Act comprising representatives of Indigenous organizations and the Opposition parties, the Minister visited the community, which was the first to break the silence on the fate of its children, to symbolically submit the report to the bereaved families.

The Act came into force on September 1, 2021. It seeks to support Indigenous families in their quest to get answers concerning their children who went missing or died after being admitted to an institution prior to December 31, 1992. On February 28, 2022, six months after the Act came into force, the Minister revealed that 35 families had already approached the Direction de soutien aux familles, Anne Panasuk, the special family support advisor, or the Association des familles Awacak to formulate requests to search for 55 children. The government is determined to do all that it can to assist the families and those who follow them in their quest for the truth.

Through the legislation, the Québec government wishes to help the families and their communities shed light on the fate of their children. Everyone concerned hopes in this way to grasp the circumstances in which the children went missing or died, find out where they are, if they are still alive, or learn about their burial place.

April 9, 2021


Nurses told to leave First Nation during pandemic

Globe and Mail – For the past two weeks, during a global pandemic, Pikangikum First Nation – a Northern Ontario community of nearly 3,600, located along the Berens River near the Manitoba border – has operated without a fully equipped police service or access to proper medical care…On March 19, Chief Owen and the band council expelled the community’s 10-member Ontario Provincial Police force after misconduct allegations surfaced against officers, including claims of sexual and physical assault of women who had been brought into custody. An investigation into the allegations is now being conducted by the Special Investigations Unit, the body that investigates Ontario’s police.

But when the police left Pikangikum, the nurses there were also forced to leave, as per instruction by Indigenous Services Canada, or ISC. They were uprooted from their homes and patients, told to grab their bags and head out.

February 5, 2020


OHRC claims discrimination in accessing health services in Timmins

Timmins The Daily Press – On the second anniversary of the deaths of Joey Knapaysweet and Agnes Sutherland, the Ontario Human Rights Commission (OHRC) announced it has filed an application with the Human Rights Tribunal of Ontario (HRTO) alleging discrimination based on Indigenous ancestry by public service providers in Timmins, Ontario. The February 2018 deaths of Joey Knapaysweet and Agnes Sutherland highlight the serious and sometimes tragic result of systemic discrimination against First Nations peoples in Northern Ontario. Both Joey Knapaysweet and Agnes Sutherland traveled to Timmins from Fort Albany First Nation, more than 400 km away, to access health services that were not available in their community. These circumstances left them particularly vulnerable to discrimination.

The OHRC acts in the public interest and is committed to ensuring that Indigenous peoples receive equal access to essential services consistent with their unique cultural and language needs, pursuant to the Ontario Human Rights Code and consistent with the UN Declaration on the Rights of Indigenous Peoples. The OHRC is seeking a variety of public interest remedies, including requiring the respondents to:

  • Engage with Indigenous communities to understand their concerns and needs
  • Develop policies and provide training to ensure that their services are delivered in a culturally competent and safe manner, free of discrimination
  • Develop a human resources plan to promote and expand the hiring and promotion of Indigenous staff
  • Collect human rights-based data to identify problems and monitor solutions.

March 23, 2021


Premier’s racist comment – “The member flew in [to] get his vaccine, so thank you for doing that and kind of jumping the line,” Ford said. “I talked to a few chiefs that were pretty upset about that for flying into the community that he doesn’t belong to, but that’s not here nor there.” Premier Doug Ford commenting in the legislature. on March 1. In reality, Kiiwetinoong MPP Sol Mamakwa was invited to “lead by example” by travelling to Sandy Lake First Nation to receive his second vaccination publicly (He got his first for the same reason in Muskrat Dam First Nation). Many Indigenous people are hesitant to get a vaccine from a government that has treated them so poorly and some communities only had 10- to 20-per cent turnout. After his demonstration, Sandy Lake had an increase to 99-per-cent turnout for the second dose that same week.

“The way Ford treated me, I was floored by it,” said Mamakwa. “I thought, maybe he just doesn’t know what I was asking? Then, I started thinking about the disrespect that he has shown to Indigenous people, not just me, but also the lack of compassion and the indifference that exists there.” Mamakwa said it is the moment that confirmed his view of the premier. “What he said, it showed me the real Doug Ford,” said Mamakwa. “It’s not just an attack on me, but it’s an attack on Indigenous people.”

“The holding of racist stereotypes that we saw at Question Period, if you hold those ideas about us as First Nations people, it makes sense that our people will continue not to trust the government. To see this exhibited at the highest political level in Ontario is not acceptable.” He said it even lessens the hope that many have that there will be a solution to the deep-seated issues within First Nation communities.

January 28, 2021

AB, BC, Fed. Govt., MB, NB, NL, NS, NT, NU, ON, PE, QC, SK, YT

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

February 3, 2021


Racism in Winnipeg Fire Dept.

Southern Chiefs Organization – SCO is asking Mayor Brian Bowman along with Fire and Paramedic Services Chief, John Lane, and all relevant officials to take immediate disciplinary action as it relates to an incident of systemic racism. City of Winnipeg firefighters ignored repeated requests for help from a paramedic who was trying to administer care to an Indigenous woman who had been stabbed in the throat. The incident occurred in October of last year. The third-party probe also revealed the firefighters failed to provide medical care to the patient and delayed transportation of the patient to the hospital. The report goes on to show that one of the firefighters who then rode in the ambulance with the victim continued to refuse to assist with her care.

According to the Winnipeg Free Press, during interviews with the investigator, one of the firefighters repeatedly referred to the incident as “just another call in the North End” and claimed that “Black Lives Matter had made martyrs out of career criminals.” SCO is in the midst of revealing even more incidents of systemic racism. A soon to be released survey takes a hard look at racism in healthcare. Initial findings reveal an overwhelmingly consistent pattern of discrimination, neglect, and even abuse. An astounding 92% of survey respondents either strongly agreed or agreed with the statement that “racism is a problem in Manitoba’s healthcare system.” More than half of respondents are deterred from seeking medical help due to experiences of racism within the health care system.

June 27, 2022


Reproductive control of Indigenous women continues around the world, say survivors and researchers

Survivors of forced sterilization and coerced contraception from Canada, Peru and Indonesia will meet with researchers to share stories, heal and advocate for change.

University of Alberta: The full extent of reproductive control practices around the world is not known, but they have been historically — and continue to be — targeted at Indigenous, poor and migrant women, according to principal investigator Denise Spitzer, professor in the School of Public Health and former Canada Research Chair in Gender, Migration and Health.

“This non-consensual control over a woman’s reproduction is a continuum of colonial violence, whether it’s part of the past or the times that we’re in now,” says steering committee member Josie Auger, associate professor at Athabasca University and author of My People’s Blood: Indigenous Sexual Health Recovery.

“Indigenous peoples, who are vulnerable and marginalized, are looked at as the other and over time, have been institutionalized in prisons, Indian hospitals and mental institutions (where such practices have been carried out),” says Auger, an elected councillor for the Bigstone Cree Nation from 2014 to 2018. 

Physical and psychological scars

An estimated 200,000 to 350,000 women in Peru were forcibly sterilized in the 1990s under former president Alberto Fujimori and some are still seeking redress through the courts. 

“The idea was that you would control the reproductive capacities of Indigenous women as a way to control population and to somehow improve the economic development of the country,” says Spitzer. “The scars left behind are both physical and psychological.”

Some of the women faced partner violence and marriage breakdown as a result of their sterilization, Spitzer says. They lost the potential economic support of children and never had the opportunity to pass on their culture and language to the next generation. Their fundamental human right to decide whether to be a parent was taken away. 

In Indonesia in the 1990s, women were forcibly injected with a long-term contraceptive. Today, recruitment agencies compel Indonesian migrant workers to accept a long-term injectable contraceptive as a requirement of overseas deployment and they can be deported if they become pregnant. 

In Canada, Indigenous women were forcibly sterilized under various historic government policies including Alberta’s Sexual Sterilization Act, which was in force from 1928, when the eugenics movement was gaining momentum, until 1972. At that time Indigenous people represented about 2.5 per cent of the population but made up 25 per cent of those who were sterilized, according to Auger. 

A large number of sterilizations happened in Indian hospitals, where many women were forced to sign while in labour or otherwise medically vulnerable.

Reports of the practice continued long after the official policies were rescinded. And though coercive sterilization is recognized as a human rights violation, it is still not illegal under Canada’s Criminal Code. In 2017 Senator Yvonne Boyer and physician Judith Bartlett published their findings on allegations of coerced tubal ligations at Saskatoon hospitals. More than 100 women from across Canada are now part of a class action suit for forced sterilizations that occurred between 2000 and 2010. 

“This is the effect of colonization on our bodies. How can we have self-determination and sovereignty if we don’t have self-determination of even our sexual experiences and reproduction?” Auger asks.

Giving survivors a voice

The summit will involve three days of storytelling, ceremony and art, culminating in a public exhibit at the Whiskeyjack Art House on August 19, which may include photovoice, weaving, film, dance and other art.

“Everything that we are doing together has a healing orientation,” says Spitzer. “We will share stories to collectively analyze what is going on and take what we’ve learned back to the communities — to women who are survivors, but also to policy makers and to health professionals.”

The international research team includes survivors, advocates, doctors and academics from the University of Alberta, Hong Kong, Peru and Indonesia. Both Auger and Spitzer say medical education will be critical to making change and making sure Indigenous women who share these experiences are heard and believed. 

“We need to find ways to educate physicians about the pernicious ideas that underpin this practice and make them aware that this isn’t just something historical, it’s not isolated,” says Spitzer. “It’s happening now and it is really entrenched in racism and misogyny.”

The summit is the culmination of the first year of a three-year project, funded by the Kule Institute for Advanced Study, with additional funding from the Alberta Women’s Health Foundation through the Women and Children’s Health Research Institute, a Killam Cornerstone Grant and a Social Sciences and Humanities Research Council Connection Grant

The research agenda will be led by the survivors themselves. “We will spend time talking, laughing, crying, creating art together, whatever it takes,” Spitzer says. “It’s those good relationships that are really integral to doing good research.”

“Creating life is a gift that must be carried on in order for these cultures to survive,” says Auger.  “If only people could open their hearts and understand what it’s like (for survivors of reproductive coercion).” “Their choices were taken away.”

May 25, 2022


Wabano Centre for Aboriginal Health and Ottawa Aboriginal Coalition report finds systemic racism in Ontario Health Care

“The conclusions in this report are horrific but unfortunately, not surprising. Indigenous-specific racism is embedded in Canada’s colonial history, and only by taking responsibility can we achieve better health outcomes for Indigenous peoples in this country,” says Wabano’s Executive Director Allison Fisher. “And the time to take responsibility and swift action is now.”

The findings of anti-Indigenous racism are highlighted in the Coalition’s comprehensive report from the Share Your Story research project, entitled Indigenous-Specific Racism & Discrimination in Health Care Across the Champlain Region. The report uses the experiences and eye-witness accounts of more than 200 Indigenous people who sought health care services across the Champlain region to illustrate and highlight deeply embedded racist and stereotypical attitudes. “These stories of racism within the health care system are our truth.

Our people deserve to be able to speak our truth and we deserve to be heard,” says Ms. Fisher. The truth is that the report’s findings are shocking. Non-Indigenous health care providers working in hospital emergency departments and maternity wards especially, in paramedic services, and in community settings like clinics view Indigenous people as:

  • racially inferior;
  • diseased,
  • addicted,
  • mentally unwell;
  • a burden;
  • angry and aggressive; and
  • bad parents. 

Startlingly, the highest frequency of both overt and covert racism, negative stereotypes, and discrimination in the region occurs in hospital emergency departments and maternity wards (70.8% in Ottawa and 65.2% in rural communities), followed by community health clinic settings and paramedics.

The report outlines the following unsettling findings:

  • 76% of participants felt they could have received better service if they were able to hide their Indigenous identity
  • 26% of all reported incidents of anti-Indigenous racism also included one or more types of discrimination based on gender, sexual orientation, age, or disability
  • 78% reported that they sometimes or always experience anti-Indigenous racism in the health care system
  • 59% felt their experiences of racism and discrimination had negatively impacted their physical well-being
  • 73% felt their experiences of racism and discrimination had negatively impacted their mental well-being

The report concludes with 27 recommendations divided into seven themes, with additional recommendations couched within each theme:

  • Recommendation 1: Ownership (Courage)
  • Recommendation 2: Commitment to Equity & Collaboration (Respect)
  • Recommendation 3: Expectations (Truth)
  • Recommendation 4: Standards (Love)
  • Recommendation 5: Accountability (Humility)
  • Recommendation 6: Oversight (Honesty)
  • Recommendation 7: Continual Improvement and Renewal (Wisdom)

In addition to launching the report, the Coalition and Wabano have issued a declaration, asking the leaders of each political party in Ontario to sign, and commit to effecting systemic change. “These deeply embedded stereotypes continue to harm Indigenous people today. The institutions of power have the responsibility and duty to provide good health care, to also commit and make the necessary change, to stop the racist abuse. If we don’t, Indigenous people will continue to suffer harm,” says Ms. Fisher.