By Dr. Suzanne Shoush, Contributor
Dr. Suzanne Shoush is a Sudanese/St’atl’imx physician, and the Indigenous Health Faculty Lead for the Department of Family and Community Medicine at the University of Toronto.
It’s been nine years since the Truth and Reconciliation Commission made 94 Calls to Action urging all levels of Canadian government to address the ongoing impact of residential schools. Progress has stalled. We asked three Indigenous writers how Canada can move the dial in the next year.
The Truth and Reconciliation Commission of Canada (TRC) was born out of the tremendous strength of Indigenous people. Opening with the powerful testimony of thousands and closing with 94 Calls to Action, it is a roadmap toward Reconciliation. It is the voices of those who survived through centuries of transgenerational atrocities, determined to hold this country to account, honour the truth, and change the future.
As a country we have struggled to find solutions that would crack open the pathway to reconciliation, largely because these voices have not been heard. Too many of the robust Calls to Action have yet to be meaningfully answered, including those that address health.
Indigenous people, by design, have the lowest amount of socio-economic privilege and political influence in this country, both of which are fundamental to good health. According to the World Health Organization, health is “not merely the absence of disease or infirmity,” but rather a state of “complete physical, mental, and social well-being.”
There continues to be a parallel universe in which we co-exist: despite our shared land we do not share a common history and we do not share a common present.
There is an astounding strength and breadth of knowledge that exists within Indigenous communities, rooted in kinship relations and Indigenous ways of knowing and being. Solutions already exist within these Indigenous systems. Indigenous people have the knowledge, strategic vision, intention and unique capability to address these gaps. This is a knowledge that is thousands of years older than colonization.
Canada was not designed to honour Indigenous ways of wellbeing — on the contrary, it was founded as a colony of a theocratic monarchy with the specific intention of advancing settler life. Canada relied on pervasive philosophies deeply rooted in anti-Indigenous racism to colonize the land, claim ownership of resources, and develop a sustained and legalized system for racial oppression within a democracy. This system is the Indian Act, which remains standing law in Canada today, albeit with amendments. Among the many egregious outcomes of this law was the creation of the Indian Residential School System (IRSS) — of which the TRC covered only a fraction, just the 139 out of 1,300 residential schools that received federal funding. The IRSS was officially recognized as an Act of Genocide by the House of Commons in October of 2022. The residential schools have now closed, but the structures of violence that birthed them remain largely intact.
Seven of the 94 Calls to Action specifically relate to health and the health-care system, with the goal of closing gaps in health outcomes faced by Indigenous people, yet in many cases the gaps have widened in the nine years since the release of the TRC, including an unprecedented drop in life expectancy for Indigenous people, found to have fallen by a shocking six years in British Columbia, and seven in Alberta.
The root cause of our health disparities is so specific, thus we require specific solutions. Call to Action 18 explicitly acknowledges these disparities are a “direct result of Canadian government policies” rooted in colonialism. To close the gaps, we must understand this and decolonize health care, returning health sovereignty to Indigenous people and communities.
Call to Action No. 18
We call 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, constitutional law, and under the Treaties.
This requires an ethical redistribution of resources that have long been hoarded in non-Indigenous communities. It requires a shift in which voices drive policy decisions and budget allocations, and even in how we define health-care workers. This must happen not only at the governmental levels, but at all levels of health-care organizations and institutions. Every day, leaders and ordinary people alike reinforce the status quo, using all the weight and inertia of our existing systems to continue as-is rather than get out of the way to allow progress. In the year ahead, it is incumbent on all health leaders to audit internal policies, resource distribution, and practices, and work with Indigenous communities to include addressing the Calls to Action on Health as a strategic priority.
Indigenous communities must be present in leadership positions at every level of health care, designing systems that actually work delivered by providers who can actually develop therapeutic relationships with communities. To close the gaps in health care, access, and outcomes we must listen to the deep wisdom of voices that predate colonialism, voices that carry the survival, love, and knowledge of our ancestors.
The Indian Residential Schools Crisis Line is available 24 hours a day for anyone experiencing pain or distress as a result of a residential school experience. Support is available at 1-866-925-4419.