Ni cta ni akohikon: That hurts me.

Carol pe ntamici: Carol, come see me.

Ni taci sa micta mackikikatakoiin: They are overdosing me on drugs.

Wipatc tca: Do it quickly.

Those were the chilling words of Joyce Echaquan, broadcasting live from Facebook on September 28, 2020 at 10:27 am (English translation provided).

On September 26, 2020, Joyce Echaquan went to De Lanaudière Hospital in Joliette, Quebec.  She was suffering from severe stomach pain.  Two days later, she was desperate.  She reached out for help through Facebook.  She did not trust that she was getting the help she needed at the hospital.

On September 28, 2020, at 12:44 p.m., Joyce died of heart failure. Joyce’s death generated global attention because she also live-streamed on Facebook the racist taunts she endured from hospital staff shortly before her death. This led to a coroner’s investigation. On September 8, 2021, Coroner Géhane Kamel released her investigative report into the circumstances of Joyce’s death.

Coroner Kamel concluded that racism was a contributing factor in Joyce’s death. We learn from coroner Kamel’s investigative report that shortly after Joyce arrived at the hospital, she was labeled as a drug addict.  As a result, her appeals for help where not taken seriously.  When she cried out in pain, she was not believed.

Despite the absence of evidence, the label of addiction followed Joyce throughout her time in the hospital. When she became agitated, they treated her like someone in withdrawal.  She was physically restrained and sedated.  When hospital staff saw her fall from her bed, they left her on the floor.

After Joyce passed away, witnesses at the hospital overheard the health care workers present expressing how glad they were that Joyce had finally died and would no longer be a nuisance. Their actual words are vile, too violent in their import to bear repeating here.  They speak of utter disregard for Joyce’s humanity and for the humanity of all Indigenous people.

The coroner’s primary recommendation regarding the death of Joyce Echaquan was for the government of Quebec to recognize the existence of systemic racism within its institutions and make a commitment to contribute to its elimination.

Quebec Premier François Legault, however, refuses to recognize that there is systemic racism in the province.

So why do medical staff treating Indigenous patients fail in their care?

The answer is not just, as Premier Legault suggests, that there are a “few bad apples.” Rather, there is a persistent myth that underpins Canadian society, including the medical profession. As Dr. Sherene Razack establishes in her book, Dying from Improvement: Inquests and Inquiries into Indigenous Deaths in Custody, the persistent myth is that Indigenous peoples are mysteriously damaged, inferior people (typically alcoholic) who are always on the brink of dying, a people on whom care would be wasted.

In Canada, the myth of the ‘sick’ Indigenous person serves a purpose.  It helps justify possession of Indigenous lands.  Settlers believe in their own legitimacy and right to hold Indigenous lands by imagining Indigenous people as unfit to do so themselves. The power of the myth in health care is that neglect of Indigenous patients is the outcome, regardless of the conscious intent.

What can we do?

We know what does not work: tinkering around the edges of the existing system.  Cultural sensitivity training and similar programs have been in place for decades.  Indigenous people are still dying in care.

To address systemic racism, we need systemic change.  It must be acknowledged that:

1. Lands in Canada are occupied and continue to be stolen. Colonialism continues apace.

2. Settlers are invested in, and benefit from, the perpetuation of the myth of the sick Indigenous person.

3. Racist perceptions about Indigenous people are ingrained in Canadian society, which leads to direct harm when Indigenous people enter the health care system.

There are opportunities to reform how health care is provided for Indigenous people in Canada.  The federal government’s 2021 budget proposes to invest $1.4 billion over five years, beginning in 2021-22, and $40.6 million ongoing, to maintain essential healthcare services for First Nations and Inuit, continue work to transform First Nations health systems and respond to the health impacts of climate change.

This funding will not solve the problem of systemic racism in health care on its own. But it is a start.  First Nations can begin planning now on how to use these funds to better serve their members by growing their local health care capacity and to work toward preventing more tragic loss of life.

Finally, we must remember Joyce was a 37-year-old Atikamekw mother of seven. Her home community was Manawan First Nation.  She was a person.  She deserved dignity and help.  She received neither.  We must demand better.

Benjamin Brookwell is an attorney.

Image credit: Shutterstock.com