Justice for Joyce Echaquan means justice for our whole healthcare system

no one should have to factor racism into their quality of care. bret kavanaugh via Unsplash

We must treat the anti-Indigenous disease

[Content warning: this article deals with racism and medical violence.] 

Joyce Echaquan, an Atikamekw mother of seven, died in a Joliette, Quebec hospital on September 28. One of her last acts was to record hospital staff, including a nurse and an orderly who were later fired, making vicious and degrading racist taunts towards her, including telling Echaquan she’d be better off dead. Echaquan’s death – the cause of which has not been determined at press time – and the horrific circumstances in which she died have so far launched a public inquiry in Quebec as well as a lawsuit against the hospital by Echaquan’s family. But the limitations of a public inquiry when it comes to providing justice or systemic change should be immediately obvious, given that Echaquan died almost a year to the day after another, similar public inquiry in Quebec. This was the inquiry which released 142 recommendations meant to improve Indigenous peoples’ access to government services in that province. 

One of the recommendations of the Viens Commission – the inquiry that released results a year before Echaquan died – was “the adoption by the National Assembly of a motion to recognize and implement the United Nations Declaration on the Rights of Indigenous Peoples, as well as the adoption of a law to ensure that the provisions of this Declaration are incorporated into Québec’s legislative corpus.” UNDRIP turned 13 years in September, and the recommendation that it now be formally adopted and enshrined in Quebec law is a reminder of how long colonial governments and governing bodies have been dragging their feet on making the barest minimum of commitments to ensuring the rights of Indigenous people are not violated when they access services on their own land. 

In 2015, the Truth and Reconciliation Commission called “upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law and constitutional law, and under the Treaties.” The TRC also called on the federal government to provide funding for Aboriginal healing centres and to recognize the value of Indigenous healing practices and ensure that they would be incorporated into the treatment of any Indigenous person who requested them. 

In not implementing these recommendations swiftly and uniformly, the government sends the message to healthcare providers that it’s okay to discriminate against Indigenous people, that it’s okay to provide them with substandard care. This isn’t to say that racist healthcare providers are not responsible for their actions and should not be held accountable for them, only that it is much easier to get away with and justify being racist when you work in a racist institution. 

Settler Canadians should be outraged at the treatment that Echaquan experienced as she died, but they also need to recognize that her experience was not an aberration from the norm, but a standard component of the care that Indigenous people experience in Canadian medical institutions. For many Indigenous people in Canada, the hospital or medical centre is a site of violence at the same time that it is a site of necessary treatment. There is no one in any position of power or authority in this country who is unaware of this. And for people like Joyce Echaquan, Brian Sinclair, and the hundreds of women who were sterilized against their will, the hospital is a site where the state carries out genocide with public funds. 

Joyce Echaquan left behind a husband, seven children, and a community that loved her. Her life mattered and her death is a loss. The institutional, structural, and social changes that are necessary for building a healthcare system that does not allow people like her to die as she died are known to us. So when people do die as she died, we should see that as intentional. Perhaps the Canadian government and Joliette hospital didn’t set out to let Joyce Echaquan, specifically, die under horrific circumstances, but they created and maintained a system in which they knew that people like her would die under horrific circumstances. 

In the face of hundreds of recommendations, countless inquiries, and a UN declaration, the provincial and federal governments of Canada have knowingly upheld a healthcare system that discriminates against Indigenous people to the point that they may lose their lives. And for as long as this goes on, this country can’t say it has universal healthcare. 

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