How this Kanien’kehá:ka community asserted its sovereignty over health care
The Kateri Memorial Hospital Centre completed a $28 million expansion and renovation in 2019.Steve Rompré/Radio-Canada
June is National Indigenous History Month. To celebrate our accomplishments, CBC Indigenous is highlighting First Nations, Inuit and Métis trailblazers in law, medicine, science, sports — and beyond.
CBC Indigenous: Retired nurse Wendy Skye-Delaronde sits at her kitchen table, flipping through a booklet of memories of her 45 years working at Tsi Tehsakotitsén:tha Kateri Memorial Hospital Centre.
Like many in Kahnawà:ke, Skye-Delaronde takes pride in having a hospital in her own community.
“This is ours; nobody’s going to take it away,” she said.
“It’s ours, and you can decide what’s best for your own people.”
In Kanien’kéha, or the Mohawk language, Tsi Tehsakotitsén:tha means “the place where they heal us.”
This place has been helping heal the community for over 100 years, and remains the only hospital of its kind run by a First Nation in Quebec.
It’s an integrated health centre, and consists of a clinic with a growing list of services and a long-term care facility. It has faced decades of challenges but has also made strides when it comes to asserting its independence.
Sky-Delaronde is emotional thinking about the amount of work done over the years to keep the centre open so that patients wouldn’t have to go to a nursing home far from the community.
“It would be very sad for them because my own mother was there, and I appreciate just going around the corner,” she said.
The early days
The hospital, first housed in a former railway hotel, was opened by the Jesuits in September 1905 as Hôpital du Sacré-Coeur de Caughnawaga. A French woman named Adele Perronno administered the hospital until her retirement in 1919 when she handed duties over to an order of nursing nuns.
Then in 1955, tired of financial woes and a building in need of repairs, the nuns packed up and left. All they left behind were six beds still occupied by patients.
Not wanting the hospital to close, volunteers took over everything from administration to nursing. Newspaper articles from the time reported how donations and fundraisers like bingos were funding salaries and supplies.
The Kateri Memorial Hospital in the early 1980s (Kateri Memorial Hospital Centre)
The hospital’s nursery. The maternity and pediatric sections of the hospital closed in 1967 due to a lack of funding. (Kanien’kehá:ka Onkwawén:na Rootitióhkwa Language and Cultural Centre)
Louise McComber was the first executive director of the Kateri Memorial Hospital Centre. She took over administrative duties when the religious order of nursing nuns left Kahnawà:ke (Kateri Memorial Hospital Centre)
The eastern view of the Kateri Memorial Hospital Centre (Kanien’kehá:ka Onkwawén:na Rootitióhkwa Language and Cultural Centre)
“You’d hear the stories about how people used to do their jobs and then go to the hospital to volunteer to make sure it kept running, to make sure it was moving forward,” said Valerie Diabo, the current executive director of the hospital.
Looking back at all that was done to keep the health centre going, and to keep control of it, it shows the community’s resilience, she said.
“This is why we have our hospital today.”
Gaining control of services
After the nuns left, the hospital was administered and largely staffed by the community but the federal government still supplied doctors, dentists, and community health nurses.
“Some were not of the highest quality. Kahnawà:ke’s vision was to gain control of health,” said Dr. Ann C. Macaulay, former medical director.
In 1970, after numerous meetings, the federal government agreed to transfer control over health services to Kahnawà:ke, while paying for doctors. A few years later the centre also took over community health nursing and dental services.
Macaulay wrote in a 1988 academic paper that the most important factor in the success of the Kateri Hospital has been the community’s control.
“This autonomy has allowed the health services to grow slowly but steadily from within, and to adapt itself to meet the specific needs and gain the trust of the people of Kahnawà:ke,” she wrote.
Advocating for a new building
Even though Kahnawà:ke had gained control of its health care, the deteriorating hospital building no longer met the needs of the growing community.
“We were worried about fire all the time,” June Delisle, former executive director, told CBC News in 1986.
“We hung tin cans on the ceiling so that the rain wouldn’t come on our patients. The corridors were too narrow.”
Efforts to rectify the situation had been ongoing for many years, but changes in health jurisdiction added to the challenges.
“The federal government always said that ‘we are not responsible for building capital funding.’ And the province, of course, said, ‘well, we don’t have the money,’” said Donald Horne, a former member of the board of directors and council chief.
“It was a constant ping pong battle … back and forth and it was very, very frustrating.”
They finally got a promise in 1984 following years of intense political negotiations.
The Parti Québécois government under Premier René Lévesque agreed to fund the $4 million construction of a new building, while the hospital maintained its autonomy.
“That principle of community control was paramount,” said Horne.
Horne was one of the negotiators. He said having Lévesque and his deputy premier Camille Laurin visit the hospital was key.
“It just so happened that it was on a day that was so blustery, the windows were rattling, and we had him go take a ride on that old elevator,” said Horne.
“His eyes were about this big because that thing was rattling and shaking. He turned around and he said to Camille, ‘This will not be acceptable.’”
The new building opened in 1986.
A growing future
Kahnawà:ke celebrated the 40th anniversary of the provincial funding agreement on April 24. Horne and his fellow negotiators were honoured.
Mohawk Council of Kahnawà:ke Grand Chief Kahsennahawe Sky-Deer said the hospital holds a special place for her and her family. “Three of my grandparents were here in the long term care and I think sometimes, you know, we take for granted that we have something like this in our backyard,” she said.
Donald Horne was gifted a beaded medallion during the 40th anniversary event to commemorate the historic hospital agreement. (Ka’nhehsí:io Deer/CBC)
The hospital has also completed another round of renovations and expansion in 2019 to meet the needs of a growing community. That includes things like a new wing with 73 beds for long-term and short-term care, a renovated outpatient clinic, a new medical imaging department and a traditional medicine unit.
“My hope for the future is that we get more services to take care of our own people,” said Diabo.
“The significance of the hospital is to be able to get your care within your community and for community members to be taken care of by community members as much as we can possibly do that.”
While the hospital has made leaps and bounds in the century since its humble beginnings, Skye-Delaronde says the history, and the struggles, need to be remembered.
“The younger people have to understand that this does not fall from the sky, all this stuff. You got to work for it,” she said.
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