Image by Jeangagnon

On September 28, 2020, 37-year old Joyce Echaquan passed away shortly after filming medical staff insulting her in a live Facebook video, in an incident many have speculated to be murder. An Atikamekw woman, Echaquan was one of 1.6 million Indigenous citizens across Canada. Her death has ignited a public dialogue regarding the rampant racism and discrimination against Indigenous peoples present throughout Canadian healthcare, a practice rooted in colonialism that continues to this day.

A mother of seven, Echaquan initially checked herself into Centre hospitalier de Lanaudiere in Joliette, Quebec after experiencing stomach pains. Echaquan often recorded videos during hospital visits as a protective method due to her lack of trust in the staff. As she began live streaming on this particular visit, Echaquan could be heard saying in her native language that she was worried that the doctors had given her too much morphine, something to which she had adverse reactions. Throughout the disturbing video, Echaquan cries in distress as a nurse is heard stating “you made some bad choices, my dear,” while another asks “what are your children going to think, seeing you like this?” Echaquan is seen grimacing as nurses call her “stupid as hell” and that she is “good at having sex, more than anything else.” The hospital has begun an internal review into Echaquan’s case, while the government has launched three investigations that will look into her case and general practices specific to the Centre hospitalier de Lanaudiere. Her death will also be the subject of an inquest by the Quebec coroner, with hearings expected to begin in 2021. While Quebec premier Francois Legault announced that at least two employees present at the time of Echaquan’s death have been fired, Legault has been criticized for his denial of systemic racism as a contributing factor to Echaquan’s passing. Carol Dube, Echaquan’s partner, stated at a news conference on October 2, 2020, that he is “convinced that my partner is dead because systemic racism contaminated the Joliette hospital.”

Brian Sinclair/Global News   

While Echaquan’s passing has deeply resonated with the Canadian public, her case is not the first incident of an Indigenous person being failed by the healthcare system in recent years. In 2018, 45-year old Brian Sinclair was found dead in a Winnipeg, Manitoba emergency room after waiting 34 hours without being treated for his severe bladder infection. A double amputee, he was sent to Winnipeg’s Health Sciences Centre to have a catheter changed and stayed in the hospital for over a day without ever being seen. An inquest into his death found that healthcare workers had assumed that Sinclair was simply drunk, “sleeping it off,” or was homeless. The final report concluded that Sinclair had a treatable bladder infection and that his death was completely preventable. The stereotypes made about Sinclair and Echaquan while in healthcare settings are prevalent throughout Canada, as assumptions of alcohol and substance abuse, poverty, and sexual promiscuity have long been derogatory conjectures made about Indigenous persons in Canada. A 2017 joint presentation from the First Nations Health Authority and the British Colombia Patient Safety and Quality Council found over 3,800 examples of stereotyping against Indigenous peoples in 2014, with “alcoholic” being the most common.

Discrimination against Indigenous peoples in Canada is not limited to these publicized incidents and remains rampant throughout Canada’s state-run healthcare service. This past June, physicians and nurses in British Colombia were accused of allegedly betting on the blood alcohol levels of Indigenous patients. Métis Nation British Colombia (MNBC), the governing body for Métis in British Colombia, revealed that this game is widespread and pervasive, often referred to as “The Price is Right.” A 2015 report entitled “First Peoples, Second Class Treatment” revealed that racism against Indigenous peoples in the health care system contributes to poorer health outcomes among Indigenous peoples across Canada. This stems in part from former government policies rooted in colonialism regarding segregation and residential schools. Harmful procedures that contribute to these outcomes include misdiagnosis, delay or denial of service, improper procedure, and the withholding of pain medication for Indigenous patients. Meanwhile, a 2019 report detailed 15 pages worth of “shocking and disturbing” incidents of racism and discrimination against Indigenous peoples in healthcare across the Canadian province of British Colombia. The COVID-19 pandemic has further highlighted this discrimination, as the federal government has encouraged the public to wear masks, socially distance and regularly wash their hands — however, nearly a quarter of Indigenous persons in Canada live in overcrowded homes, while 61 Indigenous Nations haven’t had access to clean water in the past year. As revealed by Dr. Barry Lavallee, a professor at the University of Manitoba and the director of education for the Indigenous Institute of Health and Healing/Ongomiizwin, “Medicine and health always sees itself as benevolent and caring for people. It’s not true for many Indigenous people, it’s a violent encounter.”

Joyce Echaquan and her partner Carol Dube/Facebook

A procedure that has been prevalent throughout the systemic discrimination of Indigenous persons in Canadian healthcare is the forced sterilization of Indigenous women, a practice that goes back many decades. Both Alberta and British Colombia enacted legislation allowing for sterilization in the 1930s, laws that were only phased out in 1972 and 1973 respectively. In Alberta, sterilization laws in 1937 removed consent requirements for women diagnosed as “mentally defective.” At the time, Indigenous peoples were subjected to IQ testing in order to establish mental deficiency as a diagnosis for sterilization. Over 1000 Indigenous women were sterilized in Canada between 1966 and 1976, according to researcher and author of “An Act of Genocide” Karen Stote. Health providers were encouraged to carry out “family planning” practices on Indigenous populations, believing they were helping impoverished Indigenous communities by shrinking family units and lessening the burden of more mouths to feed. As recently as 2018, Indigenous women in Canada have claimed that practices are still happening. Brenda Pelletier and Tracy Bannab both came forward in the province of Saskatchewan, revealing that they were pressured by staff to sign consent forms for tubal ligations while giving birth in hospitals. A class-action lawsuit led by Indigenous rights attorney Alisa Lombard represents over 100 Indigenous women across Canada who were coerced or forced into sterilization procedures. They are calling for reforms to the healthcare system, in addition to CAD$7 million in damages.

Canada’s healthcare system contains disturbing histories of racism against Indigenous peoples, discrimination that unfortunately still appears to exist today. Joyce Echaquan’s tragic death exposes a number of disturbing practices taking place in the nation’s health care services —stereotyping, harmful procedures, historical targeting of Indigenous women, and outright racism. Unfortunately, the preventable passing of Echaquan is not an isolated event, but a consequence of systemic discrimination throughout the Canadian healthcare system.