After an abusive nurse video, Indigenous Canada seeks health reform


MAANAUAN, Quebec – As Joyce Echaquin, a 37-year-old Indigenous mother of seven grappled with pain in a Quebec hospital, in the last hours of her life, a torrent of insults began.

A nurse at Juliette Hospital in Quebec reprimanded Mrs. Ichaquan, who had just started a Facebook Live video recording, telling her husband to come and get her, she said, because the hospital was over treating her.

By the time Ms Echaquan, who had been suffering from heart problems, died – about two hours later on Monday in late September 2020 – the video had begun to spark outrage across Canada. It eventually reverberated around the world, and became a powerful symbol of how different it is to show off Canada. Comprehensive healthcare system Indigenous treats.

Indigenous leaders and health experts in Canada say 1.7 million indigenous people They suffer a healthcare crisis, fueled in part by racial prejudice, shortening life spans, exacerbating chronic diseases and undermining their quality of life.

The 2019 report of retired Quebec Supreme Court justice, Jacques Vince, He concluded that bias in Quebec’s healthcare system had “serious consequences” for Indigenous people, including late diagnoses and doctors who, in some cases, refused to perform medical evaluations or prescribe diagnostic examinations and tests as well as “appropriate medication”.

according to 2019 Federal Public Health Agency ReportIndigenous Canada has a life expectancy of about 70 to 75 years compared to 82 years for non-Aborigines, while infant mortality rates are at least twice as high. They also suffer from a high incidence of diseases such as diabetes, asthma and obesity, the report said.

Carol Dube, the husband of Mrs. Ichakuan, said in an interview with Atikamiko First Nations A preserve in Manauan, about 150 miles north of Montreal.

Amid a national outcry over the video, Prime Minister Justin Trudeau told the House of Commons that it depicted “the worst forms of racism at a time when someone desperately needed help”.

“This is yet another example of systemic racism, which is, quite simply, unacceptable in Canada,” he said.

After posting the video of Ms. Ishkan, the nurse eviction. The Quebec Public Examining Judge’s investigation is examining the events that led to her death on September 28, 2020, with results expected to be published in the coming weeks.

During the investigation, the nurse in the video apologized to Ms Ishqawan’s family and testified that she had reached a breaking point, which was exacerbated by the pandemic. She insisted that she did not insult Ms. Ichakan because she was indigenous.

Marys Poparte Who in April became chief executive of the regional health authority responsible for Juliette Hospital, in southwest Quebec, said in an interview that what happened to Ms. Ichakan was “unacceptable”. She did not comment on the details of her case but stressed recent efforts to build bridges, including appointing a member of the Atikamiko group to Ms. Ichakuan as first deputy and promoting cultural sensitivity training for medical staff.

But the broader changes that the indigenous people sought were out of reach.

On the day of her death, breathing hard and possibly in a coma, Mrs. Ichakan was left for at least 11 minutes without being properly monitored, before she went into cardiac arrest, Dr. Alan Fadiboncourt, an emergency physician at the Montreal Heart Institute, wrote in an expert report submitted to the commission of inquiry.

He said prejudices are very endemic to the health care system Alisha Tokiapek, a social worker in Inuk from Nonavik, a remote area in northern Quebec, tried to “pass her white” on her trips to the doctor. She said she removed her traditional beaded earrings before hospital checks.

She noted that when she was pregnant with her daughter, doctors stereotyped her as a drug or alcohol addict, and asked her five times during the same visit if she had a substance abuse problem. “When I answer ‘no’, they ask me, ‘Are you sure. Not even a little?”

Concealing her original identity “could be the difference between receiving or not receiving treatment, and between life and death,” she said.

Canada Indigenous citizens They often live in remote reserves with insufficient access to clean drinking water, medical treatment, or emergency services.

Exacerbating health care challenges, indigenous leaders say, is Intergenerational trauma suffered by the indigenous people.

Doctor. Samir Shaheen-Hussain, An assistant professor of medicine at McGill University in Montreal, who has written a book on colonial policies against indigenous children, said the traumatic experiences, including the forced sterilization of indigenous girls and women between 1920 and 1970, provoked a “deep distrust” of the system. Health Care Among Indigenous Communities.

Manawan, The Atikamekw First Nations Reserve, where Mrs. Echaquan lived, is at the end of a 50-mile unpaved dirt road on the shores of Lake Métabeskéga.

Mrs. Ichakuan’s portrait is ubiquitous in the reserve – on hats, posters, and plaques – often accompanied by the words, “Justice for Joyce”. Mourners live at her grave, which Features a simple wooden cross covered with purple ribbons and pendants.

Sipi Flemish, There have been several outbreaks of Covid-19 since the pandemic began, with around 39 cases and two deaths linked to Covid, said the deputy head of the Atikamekw First Nations community.

Mr. Flamand He said the lack of access to health care in Manawan has long been a problem. The nearest public hospital – Juliet Hospital where Mrs. Echakuan died – is at least a two and a half hour drive away. After two decades of lobbying the county government, The reserve gets its first ambulance but not until 2018, two years after an 8-year-old girl drowned while her parents waited in vain for an ambulance.

Francine Moart, a nurse and director of health services for the reserve, said the community has nursing services 24 hours a day, and family doctors rotate there three days a month. But she lamented that there was no full-time doctor, no gynecologist There are no radiology services.

She said budgets have been overrun, with the federal and provincial governments squabbling over who is responsible for paying the bills. While the health care of Canadians is the responsibility of the provinces or territories, the laws of the nineteenth century that still govern the lives of Indigenous peoples state that their health care is a federal responsibility. As a result, she said, both governments tried to “shirk responsibility.”

In 2007, Jordan River Anderson, a 5-year-old Cree boy from Manitoba with a rare muscle disorder, died in hospital after his discharge was delayed by two years because the federal and provincial governments could not agree on who would fund him. home care In response, Parliament passed a 2007 law requiring that child assistance be given priority over whoever paid the bill.

Mr. Dobby said Mrs. Echaquan, one of seven siblings, was a devoted mother who loved making moose stew for their families, nature and fishing. He said she was so fond of animals that he avoided hunting in their presence.

There were also conflicts. People who know the family said the couple were under severe financial pressure. Mr. Dobby quit his job as a firefighter to help take care of the children. After Ms. Ishakuan’s brother drowned in 2012, they said, she became depressed and turned to amphetamines, but she overcame her addiction.

Mr. Dube said Ms. Eshakuan feared Juliet Hospital, as she had previously faced prejudice, including pressure on her to have abortions in 2013 and 2017. Mr. Martin Maynard said that after becoming pregnant, she was sterilized at a different hospital in 2020, without Free and informed consent, which increased her mistrust of hospitals.

Mr Dube said he was unable to accompany his wife to the hospital due to the epidemiological restrictions, and learned of the video it is now spreading from a neighbour. As news of the video spread throughout the reserve, he said one of his teenage sons saw it while he was at school. Then his 20-year-old daughter, Mary Wassiana, was rushed to Juliet Hospital, where the receptionist refused to help her, he said.

When she finally found her mother after a frantic search in the emergency room, she was pale and unresponsive, and under the supervision of a student nurse, according to Mr. Martin Maynard.

He said that under Quebec health regulations, a nursing student should not be held responsible for an unstable patient.

After Ms. Ichakan’s death, Indigenous community leaders called for the province to adopt policies that promote equitable access to Indigenous health care, which they described in detail in a document titled “The Joyce Doctrine.” But Quebec’s premiere government, François Legault, rejected the document because it explicitly mentioned “systemic racism”.

Ewan Sophis, a spokesman for Mr Legault, said the government was committed to combating racism and, among other measures, had invested $15 million to train health care workers to ensure Indigenous peoples feel “culturally safe”.

He said the government does not believe that systemic racism exists in the territory.

Fjusa Isai contributed reporting from Toronto.

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