Current Reality

Sources for the above are from StatsCan.

Jan. 28, 2021: CTV – Indigenous Services Minister Marc Miller announced the co-development of a distinctions-based health legislation aimed at giving First Nations, Metis and Inuit people control over the delivery of health care in their communities. The announcement came at the conclusion of a two-day virtual meeting on anti-Indigenous racism in Canada’s health care system. Miller noted that the task is complicated by the fact that delivery of health care is jealously guarded provincial jurisdiction. But he said all provinces and territories were represented during the two-day meeting and all seem committed, to varying degrees, to tackling racism in the health system.

In her recent economic update. Finance Minister Chrystia Freeland committed $15.6 million over two years to support the development of Indigenous health care legislation in partnership with First Nations, Inuit and Metis leaders.

Calls to Action

There are seven Health Calls to Action. To find out more about each Call to Action, including government responses and progress to date, visit the links below.

indigenouswatchdog.org/call-to-action-18/(opens in a new tab)

Call to Action #18Recognize and implement healthcare rights of Indigenous peoples
Call to Action #19Establish measurable goals to identify and close health gaps
Call to Action #20Address distinct needs of Métis, Inuit and off-reserve First Nations
Call to Action #21Provide ongoing funding for existing and new Aboriginal Healing Centres
Call to Action #22Recognize value of Indigenous healing practices and use in health system
Call to Action #23Increase the hiring and retention of Indigenous healthcare workers
Call to Action #24All students to take a course in Indigenous culture and awareness training

Three of the most alarming health-related problems within the Indigenous world are Suicide, Drinking Water Advisories and Food Insecurity in the north. All three are endemic throughout the country and have devastating effects. Given their profound impact on Indigenous people’s lives, the following sections on National Suicide Prevention, Drinking Water Advisories and Food Insecurity address these issues.

Suicide PreventionNational strategies and action plans
Drinking Water AdvisoriesWhat are they? What are the current issues?
Food InsecurityIssues and recommended Inuit solutions

Call to Action Status Updates

For an updated summary of the TRC Calls to Action, including all Health Calls to Action, click here (PDF 205 KB).

Current Problems and Issues in Indigenous Health

Government Responses to COVID-19

Manitoba Government has left the Métis out of its COVID-19 vaccine task force and plans no vaccination clinics targeted to them

Jan. 15, 2021: Winnipeg Free Press – government has left the Métis out of its COVID-19 vaccine task force and plans no vaccination clinics targeted to them. That’s despite Premier Brian Pallister having said he’s committed to including Métis people in the vaccine rollout, guided by reconciliation. Emails obtained by the Free Press show provincial officials have asked the Manitoba Metis Federation to help combat vaccine hesitancy, and to possibly help Métis people travel to vaccination super sites in cities.

Yet there is still no invitation to any group that decides the order of precedence for vaccines, despite First Nations being appointed to that task force on Dec. 18 and receiving doses a week ago.

“The voices of Métis people are being heard through the process,” the premier said. That rings hollow to Chartrand, who says towns that have large Métis populations have medical needs similar to reserves, and should be part of the initial rollout. He feels the Pallister government is punishing the federation over a protracted dispute over a Hydro payout and “playing political games at a time when lives are at risk.”

Since the pandemic stared, Chartrand has been in conflict with the province over a data-sharing pact similar to ones with First Nations and Inuit officials.

24 civil society groups attending the third ever meeting of Federal/Provincial /Territory Ministers responsible for human rights “condemned the obstructive attitude of some governments” in advancing international human rights obligations

Nov. 12, 2020: NationTalk – 24 civil society groups attending the third ever meeting of Federal, Provincial, Territory Ministers responsible for human rights “condemned the obstructive attitude of some governments” in advancing international human rights obligations. Groups had pressed governments to commit to nation-wide law reform that will legally require governments to adopt a collaborative, accountable, consistent, transparent, well-coordinated approach to effectively implementing international human rights obligations in Canada. No commitment was made. Two governments boycotted the meeting:

  • The government of Quebec opposed included references to “systemic” racism in the final communiqué, a position that blatantly ignores the undeniable reality of deeply-rooted systemic racism in the province and across Canada, and thus reaffirms systemic racism as a nationwide reality.
  • The government of Alberta considers that the province is not bound to report on or engage with international instruments or mechanisms to which it is not a Party, a position that contravenes international law which makes it clear that federalism is no excuse or justification for failing to comply with international obligations.

In 2017, meeting for the first time in 29 years, ministers made several commitments to strengthen their collaboration in protecting human rights across Canada:

  • Ministers had taken account of the Truth and Reconciliation Commission’s call on federal, provincial and territorial governments to “fully adopt and implement” the UN Declaration on the Rights of Indigenous Peoples. It is a shocking and unacceptable omission to see no reference to the Declaration in the final communiqué from this week’s meeting.
  • During the past eight months of responding to the COVID-19 pandemic, no government has applied – equitably or otherwise – an explicit economic, social, cultural, and environmental rights framework to analyze the problems laid bare, or to structure solutions.

A widely-endorsed proposal in April 2020 from 302 civil society groups, Indigenous peoples’ organizations and a broad spectrum of subject matter experts to federal, provincial, territorial and municipal governments to institute meaningful human rights oversight of their COVID-19 responses has not been taken up by any government in the country.

At the current meeting, Ministers discussed the human rights implications of the COVID-19 pandemic and agreed that it is “important that human rights principles be considered in the development of plans for a strong and equitable recovery from the pandemic for all Canadians” but in no way acknowledged or even referenced social and economic rights. The proposal for human rights oversight of COVID-19 responses was not addressed.

COVID-19 statistics don’t reflect the reality for Indigenous people living in cities

Nov. 19, 2020: Toronto Star – COVID-19 is negatively impacting both on-reserve and off-reserve Indigenous populations. “Hospitalizations and intensive-care rates are sky high for off-reserve populations and testing is low. Both on and off reserves, about 18% of tests come back positive. The issues identified by Janet Smylie, research chair in Indigenous health knowledge and information at Well Living House at St. Michael’s Hospital in Toronto is threefold:

  • Urban Indigenous people are not included in federal statistics nor are they “included in new initiatives to collect statistics on a disaggregated basis to take into account minorities
  • They check all the boxes for being at high risk for catching COVID-19
  • Due to health delivery being delivered by the provinces, Indigenous data is fragmented as a result of “decades of entrenched jurisdictional conflict and passing the buck”

The trends in Manitoba could be indicative of broader trends impacting urban indigenous communities in other provinces and sound, reliable data is essential to inform decisions. “Resources could be allocated to a fragile segment of the population in a way that is both effective and meaningful”. The National Association of Friendship Centres is at the frontline of delivering services to the urban Indigenous population with centres across the country. “Staff at the centres are constantly scrambling for extra space, resources and personal protective equipment to handle the safety demands of the virus.” Jocelyn Formsma, Executive Director, NAFC

Southern Chiefs Organization in Manitoba seek increased funding and resources to contain COVID-19

Nov. 2, 2020 – Southern Chiefs Organization is making an urgent appeal to all levels of government to free up increased funding and resources to contain COVID-19 in First Nations where the test positivity rate among First Nations is 11% vs the provincial average of 8.6%. Manitoba has the worst case count per capita in Canada including daily outbreaks in hospitals, personal care homes, jails, and remote communities. “The provincial government had six months to prepare for this second wave of the virus,” added Grand Chief Daniels. “Instead of being adequately prepared, we are now bearing witness to the tragic loss of life and system collapse after years of so-called reorganization and red tape reduction.”

Today, the province announced that it will finally reactivate its incident command structure, to help “provide clear direction and ensure co-ordinated efforts are put in place to address the situation.” This is another example of how the Manitoba government is failing to keep First Nations and all Manitobans safe. The command structure was deactivated months ago, and it has taken the province until now to reactivate it, despite the alarming increases in cases which began many weeks ago.

As of October 31, 2020, 26 First Nation communities across Canada have reported two or more active cases with 17 of them located in Manitoba. There were 516 active cases in the province among First Nation people, 171 of them on reserve.

“If the province’s system is on the verge of collapse, imagine what that could mean for First Nation’s health care resources,” remarked Grand Chief Daniels. “Thanks to centuries of colonization, we have been dealing with an infrastructure backlog for generations. Add to that the challenges of a global pandemic and you have a recipe for disaster.”

Along with a call for improved transparency, action and accountability from the province, SCO is calling on the federal government to fast track the release of $200 million in recently announced funding to provide support to First Nations. That money will be immediately used to help build critical infrastructure including badly needed isolation units as well as upgrades for health, social, and educational facilities.

COVID-19 outbreak at Keeyask Dam construction site in Manitoba is pitting First Nations at risk

Nov. 2, 2020 – Manitoba Keewatinowi Okimakanak (MKO) Inc. is issuing this statement along with the four Cree Nations that are in a partnership with Manitoba Hydro in the construction and operation of the Keeyask Generating Station in Northern Manitoba. The four First Nations are: Tataskweyak Cree Nation, Fox Lake Cree Nation, War Lake First Nation, and York Factory Cree Nation. On October 22, 2020, the first case of COVID-19 was confirmed at the Keeyask site. Since then, an unspecified number of COVID-19 tests have been done on staff. Yesterday, First Nations leaders learned that additional positive cases have been confirmed and many more cases are presumed positives. Almost 10% of the workforce is now in isolation.

MKO and the four First Nations are demanding that the Province of Manitoba immediately declare the Keeyask construction site as code red under the province’s pandemic response system. The First Nations are asking the province to take aggressive action to bring the epidemic under control. MKO and the First Nations are extremely concerned about the lack of information Manitoba Hydro has provided on the spread of this virus. People from the four First Nations work at Keeyask and fear that people may have unknowingly brought COVID-19 back to their home communities before the first case of COVID-19 was detected on October 22. Manitoba Hydro cannot confirm on what date the virus may have appeared on site. The First Nations are working closely with public health officials to determine next steps.

Since the pandemic began in March 2020, MKO First Nations have expressed concerns about Manitoba Hydro’s plans for the Keeyask construction site. Manitoba Hydro has more than 750 employees at Keeyask who come and go from the site on rotating shifts—most employees have 21 days on and 7 days off. Manitoba Hydro has staff working at the site from various parts of Canada, including a current COVID-19 hotspot—Winnipeg.

“I commend the First Nations leaders who have worked diligently to try to protect our people. The provincial government must take aggressive action at the Keeyask construction site as there is an uncontrolled epidemic taking place. This site is not providing any hydro-electric power at this point, it is not an essential operation. MKO asserts that Manitoba Hydro and the Government of Manitoba need to put people before profits,” shared MKO Grand Chief Garrison Settee.

Indigenous coalition wants BC Government to release proximate COVID-19 information

Feb. 9, 2021: Government of BC – A coalition of First Nations and BC’s Provincial Health Officer have negotiated and are signing information sharing agreements that provide more detailed information about COVID-19 case numbers in nearby communities, and will enable the nations to make more informed decisions on safety measures, and provide risk guidance to their members. The agreements’ preamble makes clear that the nations do not view them as providing completely satisfactory disclosure, and they believe systemic change must still occur in BC’s healthcare system Under the terms of the agreements, the Provincial Health Officer will provide the Heiltsuk Nation, Nuu-chah-nulth Tribal Council Member Nations, and Tsilhqot’in National Government with frequent reports listing the number of COVID-19 cases in proximate communities, and certain thresholds must be met before the nations can disclose the number of cases in a community in their public risk statements

Dec. 17, 2020: HEILTSUK & NUU-CHAH-NULTH TERRITORIES – First Nations leaders issued a joint statement in response to the OIPC Commissioner’s ruling this morning on their application for an order for the Ministry of Health to disclose COVID-19 information under section 25(1)(a) of the Freedom of Information and Protection of Privacy Act (FIPPA): “We are angry and disappointed by today’s ruling which will continue to allow the Ministry of Health to withhold the life-saving information we have been requesting since the COVID-19 pandemic began.

BC’s colonial system of government has failed us yet again by failing to recognize us as the self-governing nations we are. We filed this application because we vowed to use every legal tool to protect our people. Today’s ruling shows us the limits of these tools, because BC and its laws won’t recognize us, or work with us, on a true government-to-government basis, despite saying the right words and passing legislation like the Declaration on the Rights of Indigenous People (DRIPA). If the Ministry of Health and British Columbia have any interest in doing the right thing, they will come to the table immediately and work with us to develop information sharing agreements that can help keep our people safe. Today’s ruling underlines the urgency of this need:

  • The Commissioner at several points in his ruling, highlights the need to enact legislation to provide for information sharing that facilitates self-government for First Nations. He quotes heavily in his ruling from Mary Ellen Turpel-Lafond’s recent report on systemic racism, In Plain Sight.
  • The decision underscores the inability of the Freedom of Information and Privacy Protection Act (FIPPA) – in its current form – to facilitate nation-to-nation information sharing that meets the needs of First Nations.

Dec. 17, 2020 – BC Information and Privacy Commissioner Michael McEvoy has rejected the Ministry of Health’s arguments that Public Health Act emergency powers override its duty of public interest disclosure but determined on the facts of the case before him that section 25 of the Freedom of Information and Protection of Privacy Act (FIPPA) did not require the Ministry of Health to release requested COVID-19 information to the Heiltsuk Tribal Council, Tsilhqot’in National Government, and Nuu-chahnulth Tribal Council. he held that, while COVID-19 creates a risk of significant harm to the public, sufficient information is already available on COVID-19 cases to enable the public, and the complainant governments, to take steps to avoid or mitigate the risks connected with COVID-19.

Dec. 1, 2020 – A coalition of First Nations leaders who have been calling on BC’s Ministry of Health to share COVID-19 case information with their governments for months, say they feel vindicated by Mary Ellen Turpel-Lafond’s report on systemic racism, and expect BC’s provincial health officer and Minister of Health, to implement the report’s recommendations immediately, including addressing COVID-19 information sharing. Turpel-Lafond’s report finds pandemic is magnifying racism and disproportionally impacting Indigenous people, including a lack of “timely and complete sharing of data related to positive or presumptive cases of COVID in or near First Nations Communities.”

Sept. 15, 2020: NationTalk – A coalition of First Nations is escalating its efforts to receive potentially life-saving COVID-19 information from the BC Ministry of Health, by applying to the Information and Privacy Commissioner for an order to disclose proximate case information about the location (not personal identity) of confirmed and presumptive COVID-19 cases near their communities. The application, which was filed by the Heiltsuk Nation, Nuu-chah-nulth Tribal Council and Tsilhqot’in National Government, is supported by several other First Nations, civil society groups, and doctors. A public campaign (https://keepsafecampaign.com) has been launched with LeadNow, asking British Columbians to call on the government to release the information.

The nations have filed their application on the basis that the BC government’s refusal to share information violates Section 25 of the Freedom of Information and Protection of Privacy Act (FIPPA), which states that a Minister “must” disclose information about a risk of significant harm to an affected group of people. The nations also contend in their application that BC’s own Declaration on the Rights of Indigenous Peoples Act (DRIPA) requires that government “must take all measures necessary” to ensure the laws of BC are consistent with the UN Declaration on the Rights of Indigenous people (UNDRIP), which includes rights to self-determination, self-government and to develop and determine programs for maintaining the health and well-being of Indigenous people.

Failure of BC Government to respond to multiple requests from BC First Nations for information and resources to protect them from COVID-19

Jan. 8.2021: Prince George Citizen – An open letter written by Wet’suwet’en Ts’ako ze’ (female chiefs) is being backed by 400 health care workers in B.C. calling on the province to close work camps during the pandemic. A letter addressed to Dr. Bonnie Henry, B.C.’s provincial health officer on Dec. 16, 2020, penned by Dr. Bilal Bagha, was signed by more than 650 people. “We unequivocally support the recommendations of the Wet’suwet’en Ts’ako ze’ and Skiy ze’ in their letter to you on the widespread and deadly racism and discrimination experienced by Indigenous peoples in the health care system in B.C.,” the letter states. “As health professionals working on the frontlines, we see firsthand the brunt of the devastation caused to communities by the dual public health emergencies of the climate crisis and COVID-19 pandemic — which both

Dec. 15, 2020: The Tyee – Wet’suwet’en Elders in Witset have identified five COVID-19 cases directly linked “to workers returning from job sites at an LNG Canada plant in Kitimat and the Coastal GasLink pipeline camps closer to home. Those have led to spread of the virus within their community…That spread — the second cluster of cases there in recent months — began two weeks ago, around the time 22 Ts’ako ze’ (female chiefs) wrote to provincial health officer Dr. Bonnie Henry expressing concerns about work camps continuing to operate on Wet’suwet’en territory during the pandemic. Violet Gellenbeck, one of the chiefs who signed the letter, says they’re still waiting for an answer.

In their letter, Ts’ako ze’ representing the nation’s five clans expressed particular concern with three camps on Wet’suwet’en territory in Burns Lake, south of Houston and near the Unist’ot’en Healing Centre. Gellenbeck says camp workers who test positive for the disease are sent home without consideration for who they live with or their ability to self-isolate. The letter from the Wet’suwet’en Ts’ako ze’ was followed on Dec. 5 by a letter written by Ron Mitchell, Hereditary Chief Hagwilnegh, on behalf of the nation’s Dinï’ze, or male chiefs. Hundreds of health and social workers have also signed an open letter to Henry expressing concern about the camps. Last week, the Union of BC Indian Chiefs also called on the province to close the camps.

June 25, 2020: News 1130 – The Heiltsuk, Nuu-chah-nulth, and Tsilhqot’in nations say the provincial government didn’t consult them before throwing the doors open to non-essential travel. Their priority, they say, is protecting elders and Indigenous leaders say basic safety measures are not yet in place to be able to welcome travellers to their communities.

June 24, 2020: Globe and Mail – First Nations are among the most vulnerable populations in B.C., with the most to lose – the loss of an elder represents a loss of language, culture and history. First Nations are still waiting for the BC government to respond to repeated requests for more information and resources to protect communities and fulfill the following four basic measures:

  • An information-sharing agreement to ensure early reporting of suspected and confirmed cases in nearby regions to Indigenous governments;
  • screening methods to ensure travellers seeking to enter Indigenous territory are not symptomatic or infected with the virus; \
  • rapid-testing mechanisms available that can prioritize Indigenous and remote communities – in fact, there are currently just two rapid testing kits for all Indigenous communities in B.C.

And finally, funding for culturally safe contact-tracing that can increase the likelihood of effective tracing in the event of an outbreak, and reduce the risk of racist interactions with the health care system of the sort the government has decried.

We continue to call on the B.C. government to consult and meet with us, on a nation-to-nation basis, to begin implementing the four safety measures on an urgent basis, and to discuss the underlying issue of systemic racism, which appears to be driving the status quo of putting Indigenous lives at risk.

https://www.theglobeandmail.com/opinion/article-bcs-covid-19-re-opening-plans-continue-to-put-indigenous-people-at/

Manitoba Métis Federation sues province over COVID-19 data sharing agreement

Sept. 13, 2020: Manitoba Métis Federation (MMF) – MMF filed a complaint with the Manitoba Human Rights Commission against the Government of Manitoba, the Honourable Cameron Friesen – Minister of Health, Seniors and Active Living – and Dr. Brent Roussin, Manitoba’s Chief Provincial Public Health Officer. The complaint states that the Manitoba Métis Community has been subject to discrimination and systemic discrimination by the Manitoba Government as well as Manitoba’s lead health official throughout the COVID-19 pandemic.

“Dr. Roussin said in the media months ago that the province was prepared to engage with the Manitoba Métis on a data sharing agreement. We sent letters intended to initiate the discussions necessary to reach an agreement with Manitoba, but never received a positive response.” The MMF notes that it was engaged with Manitoba in early April but was told by the province that self-identification was sufficient evidence of someone being Métis. Discussions with the province came to a halt after we requested that Métis Citizens be verified by the MMF”.

“Sharing incorrect data created by those who falsely identify as Métis comes with a number of problems. We want to ensure that our resources are being used in an effective way that benefits the Métis Nation and indeed all Manitobans.” The MMF sent several letters between the months of April and August requesting Manitoba engage in a data sharing agreement whereby the MMF can confirm the identity of those who self-identify as Métis, but never received a formal response.

“Because of the lack of a data sharing agreement, a Métis Nation Citizen could get sick and we have no way of being notified,” said MMF Minister of Health Frances Chartrand. “We have been forced to rely on word of mouth from the Manitoba Métis Community to tell us that a Métis Citizen has contracted COVID-19 and is in need of our support. Any data analyzed by the province using false identifications of Métis would not be useful.”

First Nations protest against Manitoba Hydro Keeyask project due to COVID-19 health concerns.

May 21, 2020: CBC – Members of the four First Nation community partners of Manitoba Hydro’s Keeyask project (Tataskweyak, Fox Lake, War Lake and York Factory) have launched protests to protect their communities from COVID-19. Hydro is switching out the current 600 on-site employees with an outside group of 1000 some of whom are from outside Manitoba. The Manitoba Court of Queen’s Bench issued an injunction on Monday, ordering the blockade be removed and Hydro be granted access to the construction site. The injunction was served on Wednesday by members of the RCMP.

Chief Doreen Spence “ripped that injunction [and] put it on the ground,” Tataskweyak band Coun. Nathan Neckoway said Thursday morning.

A number of Tataskweyak Cree Nation community members who are concerned about the possible spread of COVID-19 started blocking Provincial Road 280 and the north access road to the Manitoba Hydro Keeyask work site on the weekend, in an attempt to stop a worker shift change scheduled for Tuesday. After the injunction was delivered, Fox Lake First Nation put up their own blockade on the Keeyask south access road.

May 20, 2020 – CBC We were not included in the discussion of the plan for the shift change,” said Robert Wavey, a band member and spokesperson for Fox Lake Cree Nation. “It was given to [First Nations] after Hydro came up with their plan.” “Our First Nations leaders do not want to see a repeat of what is happening in La Loche, Sask.,” Settee said in the letter, referencing a COVID-19 outbreak in the northern and largely Indigenous town, which affected more than 100 people.

Discrepancy in COVID-19 health data on Indigenous people from federal, provincial and territory government health sources

May 12, 2020: Yellowhead Institute release of Policy Brief: “Colonialism of the Curve: Indigenous Communities and Bad Covid Data”. There is wide discrepancy on COVID-19 related health data from Indigenous Services Canada  (ISC) and provincial health authorities:

  • There is no agency or organization in Canada reliably recording and releasing Covid-19 data that indicates whether or not a person is Indigenous.
  • The division of powers between provincial and federal government has gradually displaced and disrupted Indigenous governance over time.
  • ISC only gathers on-reserve data which eliminates over 50% of the Indigenous population who live off-reserve
  • Canadian federalism was established to serve Canadians and consequently maintains discrimination and sub-standard service delivery in on-reserve communities.
  • This jurisdictional fight between provinces and the federal government, where both claim the other is responsible for services, more often than not leaves Indigenous people without any services.

Through publicly available data—media reports, Band Council updates to members, local reports and obituaries—a team of researchers supported by Yellowhead has compiled and verified many more cases.

  • ISC: COVID-19 cases = 175; Deaths = 2
  • Yellowhead: COVID-19 cases = 465; Deaths = 7

The same gaps in data collection exist in child welfare and were a primary reason why the National Inquiry on Missing and Murdered Indigenous Women and Girls were unable to definitively identify the number of Indigenous women who have been murdered or are missing.

Publicly accessible data makes it easier for Indigenous people to seek accountability from leaders, and to independently evaluate and measure the efficacy of interventions by all levels of government, including our own Indigenous leadership. In fact, this is probably one of the reasons why we don’t have it.

Reducing risk to Indigenous inmates of becoming infected by COVID-19

April 20, 2020 – First Nations leadership across BC is united in calling for immediate action to protect incarcerated peoples amidst the COVID-19 pandemic. The COVID-19 outbreak at the Mission Institution is now the third largest outbreak in the Province of BC, with the first inmate tragically passing away on April 15, 2020. Senior health and corrections officials have verified that almost 40% of the confirmed cases of COVID-19 at Mission Institution are among Indigenous inmates despite Indigenous people making up just 5% of the population in BC.

April 23, 2020: The Indigenous Bar Association (IBA) Calls Upon Federal, Provincial and Territorial Justice Ministers and Attorneys General to Immediately Release low-risk Indigenous Inmates over COVID-19.Specifically, we call for the immediate release of incarcerated Indigenous people and the following actions:

  • Immediately and minimally, carry-out the release of Indigenous inmates that are low-risk, non-violent, nearly eligible for parole, nearing sentence end, over 50 years of age, pregnant women, those offenders who are able to be adequately supervised in the community, and those at heightened risk due to pre-existing medical and chronic health conditions;
  • The release of inmates described above to apply to federal and provincial correctional facilities, including all remand, youth and short-term detentions centres;
  • For those that absolutely cannot be released, ensure:
    • Full access to medical and mental health care;
    • Full and equitable access to personal protective equipment, medical grade sanitizer and cleaning agents, personal hygiene products, and other critical supplies, with invariable availability of these supplies to all inmates and correction workers (including officers, administrators, and all other employees and contractors);
    • Access to enhanced cultural supports during heightened safety measures, ensuring any quarantine of those incarcerated is carried out in the least traumatic way, in an attempt to mitigate resurgence of traumatic experiences or intergenerational effects of the legacy of colonialism;
  • In accordance with domestic and international laws and conventions, ensure that institutions do not use isolation methods that are akin to segregation punishment for infected inmates, specifically:
    • Individuals should not serve longer than 15 days in segregation, isolation, solitary confinement, medical removal or administrative removal;
    • Those who are segregated within the 15-day limit are given access to daily use of shower, telephone, and recreational facilities;
    • Those who are segregated are given daily access to mental health professionals in attempt to mitigate the lasting damage done by isolation;
  • Implement the short and long-term measures identified recently by the Union of British Columbia Indian Chiefs in their open letter dated March 24, 2020; and
  • Correctional Services Canada and all provincial correctional jurisdictions implement the recommendations of the Correctional Investigator of Canada, Dr. Ivan Zinger and take notice of specific requests by Indigenous organizations and communities.  
Protecting the health of oilsands workers is more important than protecting the health of Indigenous people as evidenced by the suspension of environmental monitoring by Alberta Energy Regulator

May 8, 2020 – Clean Tech Canada (anadian Manufacturing) – The leader of a Fort McKay First Nation surrounded by oilsands development is frustrated by the Alberta Energy Regulator’s decision to suspend a wide array of environmental reporting requirements for oil sands companies over public-health concerns raised by the COVID-19 pandemic by the Imperial Oil, Suncor, Syncrude and Canadian Natural Resources Ltd. don’t have to perform much of the testing and monitoring originally required in their licences. The regulator says some programs are to resume by the end of September, but most have no restart date. The latest exemptions specifically relieve operators of the following:

  • Monitoring most ground and surface water, unless it enters the environmental
  • most all wildlife and bird monitoring is suspended
  • Air-quality programs, including one for the First Nations community of Fort McKay, have been reduced, along with many other conditions of the companies’ licences
  • Testing for leaks of methane, a powerful greenhouse gas, has been suspended
  • Wetlands monitoring and research is gone until further notice
  • Water that escapes from storm ponds no longer must be tested

The decisions to suspend environmental monitoring were made unilaterally. We were not notified—in fact, we would have had no idea this had occurred if it had not been revealed in the press,” stated Mel Grandjamb, Chief of Fort McKay First Nation. Consultation would have enabled us to inform the regulator how its monitoring decisions impact our Nations. Both we and the industry would have been better served by the clarity that consultation would have contributed to these decisions.”

In the days leading up to these decisions, our representatives sat AER, government and industry representatives to provide oversight to environmental monitoring programs under the Oil Sands Monitoring Program. The fact AER did not mention once it was considering suspending monitoring, some of which may overlap with program work, is very disappointing. This neglect does not encourage reconciliation. In March, the Canadian Association of Petroleum Producers requested that the federal government relax several regulatory and policy activities, including an indefinite suspension of all consultation with industry to develop new environmental policies. At the same time, industry has lobbied the provincial government to resume consultation with Indigenous communities to advance projects despite the closure of our communities due to COVID-19 pandemic responses.

June 23. 2020 – All temporarily suspended reporting and monitoring requirements will come back into effect on July 15, 2020. The Alberta Energy Regulator’s (AER) decision to end its temporary suspensions follows steps taken by the Government of Alberta, including the repeal of Ministerial Order 219/2020 and Ministerial Order 17/2020.http://nationtalk.ca/story/aer-temporarily-suspended-requirements-to-resume-july-15

Failure of all governments to protect Indigenous people from H1N1 pandemic (27.8% of all infections in Canada in 2009 were Indigenous)

Mar. 17, 2020: Globe and Mail – Despite accounting for just under 5 per cent of the Canadian population, Indigenous people  were 25 per cent of those admitted to ICUs during the first wave of H1N1. First Nations children were 21 per cent of the paediatric patients admitted to ICUs during both waves. This led to sad and tragic outcomes. Indigenous peoples represented 17.6 per cent of the reported deaths in the first wave and 8.9 per cent of reported deaths in the second.

These figures likely reflect the lack of timely interventions and diagnoses that plague communities who depend on understaffed nursing stations for their health-care needs, as well as jurisdictional squabbling about roles and responsibilities.

John Borrows is Canada Research Chair in Indigenous Law at the University of Victoria Law School writing with Constance MacIntosh, Viscount Bennett Professor of Law at Schulich School of Law at Dalhousie University

Systemic Racism in Health
Premier Doug Ford uses a racist comment to Kiiwetinoong NDP Sol Mamakwa

Mar. 23, 2021: Sudbury.com – “The member flew in [to] get his vaccine, so thank you for doing that and kind of jumping the line,” Ford said. “I talked to a few chiefs that were pretty upset about that for flying into the community that he doesn’t belong to, but that’s not here nor there.” Premier Doug Ford commenting in the legislature. on March 1.

In reality, Kiiwetinoong MPP Sol Mamakwa was invited to “lead by example” by travelling to Sandy Lake First Nation to receive his second vaccination publicly (He got his first for the same reason in Muskrat Dam First Nation). Many Indigenous people are hesitant to get a vaccine from a government that has treated them so poorly and some communities only had 10- to 20-per cent turnout.  After his demonstration, Sandy Lake had an increase to 99-per-cent turnout for the second dose that same week.

“The way Ford treated me, I was floored by it,” said Mamakwa. “I thought, maybe he just doesn’t know what I was asking? Then, I started thinking about the disrespect that he has shown to Indigenous people, not just me, but also the lack of compassion and the indifference that exists there.”

Mamakwa said it is the moment that confirmed his view of the premier. 

“What he said, it showed me the real Doug Ford,” said Mamakwa. “It’s not just an attack on me, but it’s an attack on Indigenous people.”

“The holding of racist stereotypes that we saw at Question Period, if you hold those ideas about us as First Nations people, it makes sense that our people will continue not to trust the government. To see this exhibited at the highest political level in Ontario is not acceptable.” He said it even lessens the hope that many have that there will be a solution to the deep-seated issues within First Nation communities.

Joint Submission to the Expert Mechanism on the Rights of Indigenous People”: Study on the rights of the Indigenous child under the United Nations Declaration on the Rights of Indigenous Peoples”

Mar. 2, 2021: The Manitoba Advocate for Children and Youth (MACY) and the First Nations Health and Social Secretariat of Manitoba submitted a report that discusses “the international and national human rights framework as it relates to structural inequalities and Indigenous children’s right to continuous improvement of health with a particular focus on infant mortality and youth suicide in Manitoba, Canada. Specific issues raised for discussion include …the rights to life, physical and mental integrity, liberty and security of person, access to justice (preamble, and articles, 6, 7, 8, 22 and 43) and non-discrimination, health, housing (as part of the right to an adequate standard of living and non-discrimination), culture, and education (articles 14, 17, 21)”. The focus on Manitoba includes:

  • one in two First Nations children, one in four Metis, one in four Inuit, and one in six non-Indigenous children in Manitoba live in poverty, all higher than in Canada overall.
  • Indigenous infants account for between 20-30% of live births in Manitoba between 2009 and 2018, but represent at least 57% of sleep-related infant deaths
  • Only 24 of 63 First Nations communities in Manitoba have maternal-child health programs, some of which are ‘pilot’ programs that lack permanent or sustainable funding.
  • 20 of 22 suicides of female youth between 2012 and 2019 and who were involved with the child welfare system were Indigenous.
  • while approximately 26% of the child population in Manitoba are Indigenous, they account for approximately 90% of children in the care of child and family service agencies
  • 78% of children, youth, and young adults served by the Manitoba Advocate for Children and Youth through ongoing advocacy supports during the 2019/20 fiscal year were Indigenous.
  • A study of the overlap between Manitoba’s child welfare and justice systems found that close to one-third of children in care were later charged with a crime as a youth (age 12-17). This study confirmed that the child welfare system in Manitoba serves as a ‘pipeline’ to the youth criminal justice system
  • Indigenous youth in Manitoba are 16 times more likely to be incarcerated than non-Indigenous youth
  • In 2016, only 48% of Indigenous students graduated high school “on-time”, compared to 86% of their non-Indigenous counterparts

Recommendations form the “Joint Submission to the Expert Mechanism on the Rights of Indigenous People”: Study on the rights of the Indigenous child under the United Nations Declaration on the Rights of Indigenous Peoples”

ONE: Take steps to include the voices, experiences, perspectives, and testimony of Indigenous children and youth to the largest extent possible in any decision or work that may affect them, as enshrined by Article 12 of the UN Convention of the Rights of the Child.

TWO: Acknowledge the ongoing work towards reconciliation and the fulfillment of Indigenous children’s rights in Canada by evaluating and commenting on the Government of Canada’s compliance with the Truth and Reconciliation Commission of Canada’s 94 Calls to Actions designed to redress the legacy of residential schools and advance the process of reconciliation in Canada and recommendations made in Honouring the Truth, Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.

THREE: Recognize the self-determination of Indigenous Peoples by highlighting Indigenous-led initiatives to fulfill the rights of Indigenous children including maternal- child health programs and youth suicide prevention programs that provide children with the culturally appropriate services they are entitled to receive.

FOUR: Through the development of this study, create opportunities for Indigenous practitioners and advocates around the world to come together to generate connections, and share information and best practices

FIVE: In order to understand the differential experiences of Indigenous children and youth, the challenges they face, as well as existing gaps in the social determinants of health, it is imperative that governments systematically collect data on Indigenous ancestry, with attention to the principles of ownership, control, access, possession (OCAP®) and principles of Ethical Métis Research. Currently, this gap in information prevents a full understanding of the structural inequalities facing Indigenous children and youth.

SIX: Ensure ethical considerations are upheld and respected in all aspects of this study and any research or data collection involving Indigenous Peoples, and Indigenous children in particular, conducted by governments and other parties. Ethical considerations concerning research for and by Indigenous Peoples should involve free prior informed consent on a collective and individual basis; principles are followed to ensure Indigenous ownership, control, access, and possession of their own data and information; and all research should be respectful and benefit Indigenous Peoples.

SEVEN: Examine the role of fiscal policies that continuously underfund services for Indigenous infants, children, and their families (including schools, mental health services, and prenatal and postnatal supports) as a barrier for the realization of Indigenous children’s right to health.

EIGHT: Recognize the centrality of addressing Indigenous child poverty at the national level as a necessary condition of fulfilling Indigenous children’s right to non- discrimination and health.

NINE: Prioritize analysis of the role of the child welfare system and ongoing apprehension of Indigenous children from their families as this is in direct violation of the right of Indigenous children to a family life, to health, to culture, and to a future.

Supplemental Report to “In Plain Sight: Racism in BC Health Care System

Feb. 4, 2021: Toronto Star – Mary Ellen Turpel-Lafond released a supplemental data report Thursday that shows Indigenous people in B.C. are much more likely to feel unsafe in health-care settings, to feel they are never included in care decisions and to feel they receive poorer service than others.

“Taken together, these … reports clearly demonstrate the need for immediate, principled and comprehensive efforts to eliminate all forms of prejudice and discrimination against Indigenous Peoples in the B.C. health-care system,” she writes in the new document.

The report comes as Indigenous people across B.C. are speaking out, including the Nuxalk Nation in Bella Coola where hundreds of COVID-19 vaccine doses were abruptly withdrawn and a woman in Kitimat whose baby was stillborn after she says a hospital turned her away.

Her supplemental report is based on results of surveys, submissions to her team and patient complaints, as well as hard data on how Indigenous people use health care and the outcomes they experience. Almost 9,000 people directly shared their perspectives through surveys and submissions, while about 185,000 Indigenous individuals are reflected in the health sector data.

Indigenous survey respondents were significantly more likely to feel unsafe in health facilities. For example, in emergency rooms, 16 per cent felt “not at all safe” and 57 per cent felt “somewhat unsafe,” compared with five and 38 per cent of non-Indigenous people, respectively. Other findings include:

  • 23% of Indigenous respondents reported they “always” received poorer service than others
  • 24 per cent treated as though they were dishonest,
  • 26 per cent treated as if they are drunk or asked about substance abuse and
  • 14 per cent treated like bad parents.
  • Some 67 per cent of Indigenous respondents reported they had experienced discrimination from health-care staff based on ancestry, compared to 5% of non-Indigenous respondents.
  • Only 16 per cent of all Indigenous respondents reported never having been discriminated against for any reason listed while receiving health care.

Turpel-Lafond’s team also conducted a survey of health-care workers, of which 35 per cent said they had witnessed racism or discrimination directed to Indigenous patients, family or friends. The number increased to 59 per cent for Indigenous health-care workers who responded.

Incident of systemic racism involving the City of Winnipeg Fire Department

Feb. 3, 2021:Southern Chiefs Organization – SCO is asking Mayor Brian Bowman along with Fire and Paramedic Services Chief, John Lane, and all relevant officials to take immediate disciplinary action as it relates to an incident of systemic racism. City of Winnipeg firefighters ignored repeated requests for help from a paramedic who was trying to administer care to an Indigenous woman who had been stabbed in the throat. The incident occurred in October of last year. The third-party probe also revealed the firefighters failed to provide medical care to the patient and delayed transportation of the patient to the hospital. The report goes on to show that one of the firefighters who then rode in the ambulance with the victim continued to refuse to assist with her care.

According to the Winnipeg Free Press, during interviews with the investigator, one of the firefighters repeatedly referred to the incident as “just another call in the North End” and claimed that “Black Lives Matter had made martyrs out of career criminals.” SCO is in the midst of revealing even more incidents of systemic racism. A soon to be released survey takes a hard look at racism in healthcare. Initial findings reveal an overwhelmingly consistent pattern of discrimination, neglect, and even abuse. An astounding 92% of survey respondents either strongly agreed or agreed with the statement that “racism is a problem in Manitoba’s healthcare system.” More than half of respondents are deterred from seeking medical help due to experiences of racism within the health care system.

Native Women’s Association of Canada’s participation in a 2-day national forum on anti-Indigenous racism in Canada’s health care systems – after the death of Joyce Echaquan – was marginalized resulting in Indigenous women’s voices not being heard

Jan. 28, 2021: Native Women’s Association of Canada – At a two-day meeting at which the issue of anti-Indigenous racism in Canada’s healthcare systems will be addressed by federal, provincial, and territorial governments as well as representatives of the First Nations, Métis and Inuit, NWAC is not being permitted to give more broadly based opening remarks Wednesday, along with other male-led National Indigenous Organizations. Had NWAC been permitted to speak at the meeting’s opening, said Ms. Whitman, NWAC president “we would have explained that Indigenous women, girls, and gender-diverse persons are disproportionately affected by systemic racism and violence in healthcare.” Instead, NWAC’s remarks the following day will be confined to the two narrower questions put by the government around “identifying diversity and intersectionality actions”.

The problem of racism in healthcare delivery moved to the forefront of national consciousness last year when Canadians heard the horrific and discriminatory remarks directed at Joyce Echaquan, an Indigenous woman, as she lay in her deathbed at a hospital in Quebec. “It is Indigenous women who have been subjected to forced sterilizations. It is Indigenous women, girls and 2SLGBTQQIA people who have been the targets of violence that a National Inquiry found to be a genocide, and which forces many of us to seek medical treatment,” said Ms. Whitman.

“It is a problem to which we, at NWAC, have given much thought because it so profoundly affects our members,” she said. “We will be offering some ideas about ways to tackle racism in healthcare settings during the five minutes we have been allotted at the meeting on Thursday. But we would like the government to demonstrate that it is just as interested in hearing the voices of Indigenous women on this issue as it is in hearing the voices of Indigenous men.”

The experiences of Indigenous women, girls, and gender-diverse persons in the healthcare system are not the same as those of men. Success in defeating racism depends on our ability to recognize each other as inextricably linked partners in this task.

Death of Joyce Echaquan provides clear evidence of systemic racism in Quebec health care system

Feb. 26, 2021: Montreal Gazette – Québec Indigenous Affairs Minister Ian Lafrenière, Health Minister Christian Dubé and interim Lanaudière health authority director Caroline Barbir announced along with Atikamekw chief Paul-Émile Ottawa announced the following changes:

  • the creation of a reconciliation committee
  • the addition to the health authority’s management of a liaison officer responsible for relations with the Atikamekw community
  • a commissioner to deal with complaints from Indigenous users concerning the quality of services received at the institution. Both posts will be filled by members of the community
  • a seat on the health authority’s board of directors will be reserved for an Indigenous candidate
  • all health authority employees will be obliged to complete a training course, the content of which will be approved by the Atikamekw community

Finally, Dubé said the changes announced for the Lanaudière region’s health authority could serve as a model for reforms he intends to carry out throughout all of the health care network, with modifications for certain regions.

Feb. 11, 2021: Indigenous Services Canada – Minister of Indigenous Services, the Honourable Marc Miller, highlighted funding of $2 million to the Conseil de la Nation Atikamekw and the Conseil des Atikamekw de Manawan, Joyce’s community, to advance their work and advocacy for the implementation of Joyce’s Principle. With this funding, the Atikamekw, including the community members of Manawan, will be able to develop tools and training, promote Joyce’s Principle to healthcare professionals, and educate First Nations on their rights when using the healthcare systems. These funds will also be used to organize meetings with non-Indigenous Peoples on fighting racism.

Dec. 15, 2020 – Release of “Racism in Québec: ZERO TOLERANCE. Report of the Groupe d’action contre le racism” by the Québec government that had no Indigenous representation. The Atikamekw nation says the 25 recommendations to counter racism raises more questions than answers. “Concrete proposals were offered in the brief for Joyce’s Principle to achieve changes with an impact on all health and social services. However, these do not seem to have been taken into account in the recommendations offered. We hope that the awakening linked to Joyce’s death will lead to some groundwork.”

Recommendations specific to Indigenous People (14-25)

  1. Include in the national anti-racism awareness campaign a specific component on the realities of Indigenous peoples, to continually inform the public about the racism and discrimination experienced by First Nations and Inuit people.
  2. Make the professional orders aware of the importance of training their members on Indigenous realities.
  3. Make the history and current realities of Indigenous people in Québec a mandatory part of initial teacher training programs.
  4. Change the academic curriculum at the primary and secondary levels to update concepts related to the history, cultures, heritage and current realities of Indigenous peoples in Québec and Canada and their impact on society.
  5. Introduce continual, mandatory training on Indigenous realities for government employees.
  6. End the informal practice of prohibiting people from speaking Indigenous languages while receiving public services.
  7. Make the ban on random police stops mandatory.
  8. Add Indigenous social services workers to some police services to create mixed patrol teams.
  9. Increase the resources of Indigenous community organizations that promote access to justice for First Nations and Inuit people.
  10. Improve the capacity of the justice system to address the heritage and life trajectory of Indigenous offenders by granting more resources for the use of the Gladue principle specific to First Nations and Inuit people.
  11. Improve the quality and availability of interpretation services in Indigenous languages for better access to justice.
  12. Increase resources allocated to off-reserve housing.

Nov. 16, 2020: The Council of the Atikamekw of Manawan (CDAM) and the Council of the Atikamekw Nation (CAN) have submitted a brief for “Joyce’s Principle” to Francis Legault, the Premier of Québec and Prime Minister Justin Trudeau.  Québec Government has rejected adopting Joyce’s Principle “a call to action and commitment to governments to facilitate the transition towards health and social services systems that are safer and free from discrimination for Indigenous people across Québec and Canada. Joyce’s Principle makes specific reference to Article 24 of the United Nations Declaration of the Rights of Indigenous Peoples:

  1. Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals. Indigenous individuals also have the right to access, without any discrimination, to all social and health services.
  2. Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

On Nov. 24, 2020 the Québec National Assembly refused to adopt Joyce’s Principle due its explicit reference to systemic racism within Québec.

Nov. 10, 2020 – Québec Government is investing $3.1M in Joliette “to enable the relocation and enlargement of the Centre d’amitié autochtone de Lanaudière (CAAL), an Indigenous community organization founded in 2001. Its mission is to improve the living conditions of Indigenous people living in or passing through the Joliette region by providing a number of support services, assistance and information through programs specially designed for Indigenous families.” The Centre will provide:

  • Consultation offices and a community room and kitchen;
  • Spaces to promote Indigenous history, arts and cultures;
  • Spaces for social economy activities;
  • Spaces that can be shared with partners;
  • Rooms dedicated to the CAAL’s Mirerimowin clinic;
  • A residential annex
  • An early childhood centre (CPE), a child-minding service and a playroom;
  • Administrative offices

Nov. 6, 2020 – The Québec government will invest $15 million to implement targeted actions to enhance cultural safety for members of First Nations and Inuit in the health and social services sector. This announcement follows several calls to action by the Public Inquiry Commission on relations between Indigenous Peoples and certain public services in Québec. 

Oct. 16, 2020 – Emergency meeting on racism in Canada’s healthcare system. AFN recommendations to all levels of government:

  1. Work directly with First Nations to ensure that Indigenous Peoples feel safe accessing health care services.
  2. Quebec needs to work with First Nations to fully implement the Viens Commission Report’s recommendations.
  3. Canada must conduct an immediate review of the Canada Health Transfers and the Canada Health Act, to ensure quality health care is being provided to Indigenous Peoples.
  4. The federal, provincial, and territorial governments must listen to Indigenous Peoples on the need for a healthcare Ombudsperson.
  5. The Provinces and Territories must work with educational institutions to ensure a more expansive curriculum for all health

Oct. 2, 2020 – Québec government announced the launch of a public inquiry under the coroner’s office.

Sept. 30, 2020: Montreal Gazette – “In her last moments, while tied to a hospital bed, Joyce Echaquan, a 37 year-old Atikamekw woman, pleaded for someone to help her. Instead, a video she recorded shows she received disparaging and condescending remarks — at a time when Québec continues to grapple with the larger question of systemic racism.” The Québec coroner’s office is investigating the death that Premier François Legault insists is not reflective of systemic racism within the Québec Health system despite that conclusion being found by the Viens Commission from one year ago.

“One professor told the commission the situation is so dire many Indigenous people will avoid going to the hospital over fears of being discriminated against. For those who have to go, they mentally prepare themselves first for the treatment they’ll be subjected to…Echaquan had grown so wary of hospital staff that she would often record Facebook live videos from her bed, her cousin said”.

Québec’s Human Rights Commission condemned the “systemic discrimination suffered by Indigenous Peoples, particularly in the health sector.” Echaquan’s death, president Philippe-André Tessier said in a statement, serves as a “tragic reminder of this reality and of the need for concerted and sustained action to address it.” The Grand Chief of the Atikamekw Nation Council, Constant Awashish, called on the government to act swiftly and implement the recommendations put forward by the Viens commission. 

AFN recommendations to eliminate systemic racism in Indigenous health care

Jan. 28-29, 2021: Assembly of First Nations – AFN National Chief Perry Bellegarde reiterated recommendations and called for urgency in addressing systemic racism in Canada’s health care systems at a two-day virtual meeting with federal, provincial and territorial ministers and Metis and Inuit leaders that ended today. The meeting, convened by Indigenous Services Minister Marc Miller, Crown-Indigenous Relations Minister Carolyn Bennett and Health Minister Patty Hajdu, gathered Indigenous leaders and health system experts to discuss short and long-term strategies to eliminate anti-Indigenous racism in Canada’s health care systems. It is the second of its kind since the death of Joyce Echaquan in hospital September 2020. “There seems to be a shared sense of responsibility by all parties to addressing racism in the health care system, but until First Nations and Indigenous peoples are treated with the respect, quality of care and attention they deserve, meetings of this nature will not have the impact that’s required,” said National Chief Bellegarde. “Implementation of recommendations and reporting on their progress and outcomes will be essential

Oct. 16, 2020 – Emergency meeting on racism in Canada’s healthcare system. AFN recommendations to all levels of government:

  • Work directly with First Nations to ensure that Indigenous Peoples feel safe accessing health care services.
  • Quebec needs to work with First Nations to fully implement the Viens Commission Report’s recommendations.
  • Canada must conduct an immediate review of the Canada Health Transfers and the Canada Health Act, to ensure quality health care is being provided to Indigenous Peoples.
  • The federal, provincial, and territorial governments must listen to Indigenous Peoples on the need for a healthcare Ombudsperson.
  • The Provinces and Territories must work with educational institutions to ensure a more expansive curriculum for all health care providers
Independent investigation into systemic racism within the BC Health Care system

Feb. 5, 2021:Toronto Star – Health Minister Adrian Dix provided an update on his government’s progress on implementing the original 24 recommendations. He said his government is providing funding for 32 Indigenous health liaisons in health authorities across the province, of which nine are already in place. It has also ensured that each health authority board has at least two Indigenous members, he said. A toll-free number and email established during the review will remain active so Indigenous people can report their experiences of racism in the health-care system, he added. The province has also appointed Dawn Thomas as the new associate deputy minister of Indigenous health, and struck a task force to drive the implementation of the recommendations.

December 1, 2020: Toronto Star – The independent investigation – touted as the first complete review of racism in a Canadian health-care system – released its report “In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care“. The investigation has found pervasive systemic racism against Indigenous people in this province based on the following findings:

  1. Widespread Indigenous-specific stereotyping, racism and discrimination exist in the B.C. health care system.
  2. Racism limits access to medical treatment and negatively affects the health and wellness of Indigenous peoples in B.C.
  3. Indigenous women and girls are disproportionately impacted by Indigenous-specific racism in the health care system.
  4. Current public health emergencies magnify racism and vulnerabilities and disproportionately impact Indigenous peoples.
  5. Indigenous health care workers face significant racism and discrimination in their work and study environments
  6. Current education and training programs are inadequate to address Indigenous-specific racism in health care.
  7. Complaints processes in the health care system do not work for Indigenous peoples.
  8. Indigenous health practices and knowledge are not integrated into the health care system in a meaningful and consistent way.
  9. There is insufficient integration, or “hard-wiring” of Indigenous cultural safety throughout the health care system.
  10. Indigenous structures and roles in health decision- making need to be strengthened.
  11. There is no accountability for eliminating Indigenous- specific racism in the B.C. health care system, including system-wide data and monitoring of progress.

The report calls for a “Renewed Foundation” built on three foundational elements to addressing the legacy of colonialism in the health care system:

  1. Racism in the health care system is a reflection of a lack of respect and implementation of the basic human rights of Indigenous peoples.
  2. Racism within the health care system is integrated with, and in many aspects indivisible from, broader patterns and conditions throughout society.
  3. While those who experience the problem of racism in the health care system must be intimately involved in developing solutions, we know that the responsibility and burdens of this work lie with non-Indigenous individuals, communities, organizations and governments.

In Plain Sight” concludes with 24 detailed recommendations for stakeholders in the health-care system in BC but also emphasizes that many of the Observations, Findings and Recommendations have implications for the federal government as responsibility for health is an area of shared and overlapping jurisdiction and authority, especially in relation to Indigenous peoples. As the scope of this review was specific to B.C., Recommendations have not been directed to the federal government. However, tangible and urgent action is needed by the federal government, as well as national health organizations, to address Indigenous-specific racism in the health care system.

The Review has identified a number of areas where federal actions could be helpful to eliminate all forms of discrimination against Indigenous peoples. Examples of such necessary action include:

  • Federal legislation to specifically implement the UN Declaration to bring the federal laws, policies and practices in conformity with the Indigenous human rights, principles and standards in the UN Declaration.
  • Federal Indigenous-specific health legislation and other legislative amendments which explicitly make cultural safety a desired outcome or requirement of quality within Canada’s health care system, affirming Indigenous peoples’ individual and collective rights to health, facilitate Indigenous authority over their health services, and assure consistency with the minimum standards in the UN Declaration.
  • Federal health regulatory standards that address anti-racism, cultural humility and trauma- informed practices.
  • Active co-operation by the federal government consistent with the standards of the UN Declaration to make necessary changes to the First Nations health governance structure in B.C.
  • Direct support by national health organizations to identify measures and tools to address

Dec. 1, 2020 – Métis Nations of BC is calling on the B.C. government to urgently implement all the recommendations found in Mary Ellen Turpel-Lafond’s report…and its 24 recommendations in an expedited timeframe. This includes implementing the recommendation, “that the Ministry of Health establish a structured senior level health relationship table with MNBC, and direct health authorities to enter into Letters of Understanding with MNBC and Métis Chartered Communities that establish a collaborative relationship with clear and measurable outcomes.” The report found that B.C. needs to expand Métis participation in health decision-making and that the expectations of health authorities to engage with MNBC are not widespread or codified. MNBC is calling on the Ministry of Health and Minister Adrian Dix to establish the BC-Métis Nation Health Leadership Table in the first six months of 2021. While the First Nations Health Authority receives an annual budget of $60 million – with no mandate to care for Métis people – MNBC only receives $200,000 annually to service the health needs of over 90,000 citizens and self-identified Métis across the province.

July 9, 2020Government of BC – An independent investigation into Indigenous-specific racism in British Columbia’s health care system was launched today by former judge and provincial child advocate Mary Ellen Turpel-Lafond. Appointed by Health Minister Adrian Dix on June 19 after highly disturbing allegations of racism in B.C. Emergency rooms came to light, Turpel-Lafond has now assembled her team for the “Addressing Racism” investigation, established her terms of reference and launched a survey to collect and assess the experiences of First Nations, Métis and Inuit people when they access health care. “Our task is to address the specific incidents that have been reported, as well as to gauge the levels of systemic and individual racism that Indigenous people face when using the health care system in general,” Turpel-Lafond said. After examining the systemic racism that occurs in the health system, the investigation will make a number of recommendations designed to prompt necessary improvements.

June 19, 2020: NationTalk – First Nations, Métis and Inuit patients seeking emergency medical services in British Columbia are often assumed to be intoxicated and denied medical assessments, contributing to worsening health conditions resulting in unnecessary harm or death. This is according to information obtained by Métis Nation BC and the BC Association of Aboriginal Friendship Centres. Additionally, the parties have notified the First Nations Health Authority of this concern.

Participants within the San’yas Indigenous Cultural Safety Training program detail thousands of cases of racism in healthcare, resulting in the harm of Indigenous patients. In a recent training session, a program participant disclosed a common game played within B.C. hospital emergency rooms, where physicians, nurses and other staff try to guess the blood alcohol concentration (BAC) of Indigenous patients. The winner of the game guesses closest to the BAC – without going over.

The Province of B.C. has yet to enforce standardized anti-racism training for health service workers. BC Association of Aboriginal Friendship Centres and Métis Nation of BC – Indigenous leadership are calling upon the Ministry of Health to accept the following four recommendations:

  1. A public inquiry into Indigenous specific racism in health care in B.C with a focus on hospitals and emergency departments.
  2. Ensure that all front-line staff are required to take mandatory First Nations, Métis and Inuit training that results in increased health professional personal accountability in the delivery of safe health care.
  3. Commit to structural and systemic changes to dismantle indigenous specific racism to ensure culturally safe health care experiences for Indigenous people.
  4. Ensure that Indigenous governments play a stronger role in the development and implementation of anti-racism programs and training throughout BC.
Timmins Police Service, Timmins and District Hospital, Cochrane District Social Services Administration Board for discrimination against Indigenous people

Feb. 5, 2020 – Timmins The Daily Press – On the second anniversary of the deaths of Joey Knapaysweet and Agnes Sutherland, the Ontario Human Rights Commission (OHRC) announced it has filed an application with the Human Rights Tribunal of Ontario (HRTO) alleging discrimination based on Indigenous ancestry by public service providers in Timmins, Ontario.

The February 2018 deaths of Joey Knapaysweet and Agnes Sutherland highlight the serious and sometimes tragic result of systemic discrimination against First Nations peoples in Northern Ontario. Both Joey Knapaysweet and Agnes Sutherland traveled to Timmins from Fort Albany First Nation, more than 400 km away, to access health services that were not available in their community. These circumstances left them particularly vulnerable to discrimination.

The OHRC acts in the public interest and is committed to ensuring that Indigenous peoples receive equal access to essential services consistent with their unique cultural and language needs, pursuant to the Ontario Human Rights Code and consistent with the UN Declaration on the Rights of Indigenous Peoples. The OHRC is seeking a variety of public interest remedies, including requiring the respondents to:

  • Engage with Indigenous communities to understand their concerns and needs
  • Develop policies and provide training to ensure that their services are delivered in a culturally competent and safe manner, free of discrimination
  • Develop a human resources plan to promote and expand the hiring and promotion of Indigenous staff
  • Collect human rights-based data to identify problems and monitor solutions.
Health Canada, Government of Canada and Government of Alberta’s refusal to conduct a baseline health survey as recommended by provincial health organizations

Dec. 17, 2019: Canada’s National Observer – Repeated failure by government authorities to conduct a comprehensive baseline health study as recommended by the Alberta Cancer Board (supported by the province’s governing health authority, Alberta Health Services) in 2009. In Fort Chipewyan a community of roughly 1,200 people, the study found, you would expect to see 39 cases of cancer. Instead, it found 51 cases, a difference of 30.7 per cent. The Athabaska River flows through Canada’s oil patch, giving rise to the theory that the oil-and-gas industry is responsible for the illnesses, having poisoned people for years by contaminating the environment. Government bodies and researchers have challenged that theory, leading to a call for a new more conclusive health study that could provide real answers.

Athabasca Chipewyan First Nation and Mikisew Cree First Nation pooled their resources to fund research. With some additional funding from Health Canada, a three-year, $1-million study was led by Stephane McLachlan, a professor at the University of Manitoba. His findings released in 2014 measured contaminants not only in water but also in beavers, ducks, fish, moose and muskrats — animals consumed as part of a traditional diet for those who continue to live off the land in the Peace-Athabasca Delta. He concluded that the animals contained high concentrations of pollutants such as carcinogenic polycyclic aromatic hydrocarbons and heavy metals such as arsenic, mercury, cadmium and selenium. All of these are by-products of extracting and upgrading bitumen. Arsenic in particular has been linked to increased risk of biliary tract cancer.

Accepted practice of Thunder Bay Regional Hospital security escorting Indigenous patients in need of medical care off of hospital property

Nov. 9, 2019: Toronto Star – A 19-year old First Nations man taken to the hospital by ambulance in obvious distress was escorted off the hospital property three hours later by security staff. Apparently, escorting Indigenous people who are seeking medical care off of hospital property is common practice. The would be patient ultimately committed suicide at a remote part of nearby Lakehead University. 

An internal review of the case by the hospital “concluded that appropriate actions were taken and that the right decisions were made by clinical staff based on the information provided to them and the patient’s presentation.” 
Tanya Talaga, Toronto Star

An investigation is currently underway by Ontario’s chief coroner, Dirk Huyer. He told me it will look for any “potential systemic issues that may have played a role in contributing to the death — policies, procedures, steps taken.” It will also examine whether this death is part of a pattern — and make any recommendations necessary to break that pattern.

Government of Manitoba for refusing to conduct a public inquiry into the death of an Indigenous man, Brian Sinclair, who died as a direct result of institutional racism at the Winnipeg Health Sciences Centre

Sept. 15, 2017: CBC – Brian Sinclair was killed by racism on Sept. 21, 2008.  He was ignored for 34 hours, despite his need for urgent medical care, because medical professionals made negative assumptions about him based solely on his appearance. Anti-Indigenous bias is an endemic problem in Canadian health care:

  • The hospital authority denied that stereotyping had anything to do with Mr. Sinclair’s death.
  • The government of Manitoba refused to hold a public inquiry.
  • The inquest into Mr. Sinclair’s death sidelined issues of race and social marginalization.
  • Regulatory bodies have been slow to implement any changes, if at all, and
  • no one has been held accountable for professional misconduct or criminal neglect.

The findings of the Manitoba Ombudsman rely on the government’s health and justice departments “appraising their own progress.” http://s3.documentcloud.org/documents/5782400/Brian-Sinclair-Final-Report-En.pdf.

The Brian Sinclair Working group was formed to examine the role of racism in the death of Brian Sinclair and in the inquest that followed, in order to highlight ongoing structural and systemic anti-Indigenous racism in our contemporary health and legal systems. The Sinclair family and the Sinclair Working Group have called for a public inquiry to explore the underlying systemic racism in the delivery of Health services to Indigenous populations. The Working Group aims to release a final report in 2018. The interim report “Ignored to Death” was issued Sept. 2017

Sept, 2017 – “Out of Sight: A summary of the events leading up to Brian Sinclair’s death and the inquest that examined it and the Interim Recommendations of the Brian Sinclair Working Group”. Over-all recommendation:
We recommend that all stakeholders in the healthcare system (including the federal government, the provincial government, Regional Health Authorities, unions, professional organizations, and post-secondary institutions involved in the delivery of professional programs) adopt anti-racist policies and implementation strategies that include committing resources to providing anti-racist training and supporting independent investigations when complaints are filed.
http://ignoredtodeathmanitoba.ca/index.php/2017/09/15/out-of-sight-interim-report-of-the-sinclair-working-group/

Saskatoon Health Region for forcing Indigenous women to undergo tubal ligations while in labour

July 22, 2017 -Indigenous women were coerced into having a tubal ligation in Saskatoon hospitals while still in labour. A class action lawsuit was initiated on October 5, 2017 by two affected women in the Saskatoon Health Region. (CBC). Now about 60 women are part of the lawsuit. Authorities should very carefully read Article 2 of the Convention on the Prevention and Punishment of the Crime of Genocide adopted by the UN in 1948”, Romeo Saganash, an NDP MP said. “It says that “genocide” includes any acts committed with the intent to destroy, in whole or in part, a national, ethnic, racial or religious group, such as by “imposing measures intended to prevent births within the group.”

Dec. 10, 2018 – 72 organizations endorse the joint statement from Amnesty International Canada, the Native Women’s Association of Canada, and Action Canada for Sexual Health and Rights, calling for government action to #DefendConsent and end #ForcedSterilization of Indigenous women in Canada 

All the women interviewed felt that the health system had not served their needs, and they had felt powerless to do anything about it. Aboriginal women who have had such an experience that prevents them from accessing health care are aware that they are higher risk for negative consequences of health problems that are preventable or treatable if diagnosed early; they still cannot get past their distrust. In its submission to the UN committee, the law firm said there has been no effort at a comprehensive review to understand the scale of the problem or the conditions that make forced sterilizations possible. (Canadian Press)

Nov. 22, 2018 – Senator Murray Sinclair, former Chair of the TRC, says Canada needs a national investigation to find out how common coerced sterilizations are among Indigenous women and how they’ve been allowed to continue for so long.
http://nationtalk.ca/story/usw-joint-statement-calling-on-canada-to-end-sterilization-without-consent

Health Care Reform

The Government of Manitoba’s Bill 56 usurps First Nations jurisdiction and infringes on constitutionally protected rights

Mar. 5, 2021: Assembly of Manitoba Chiefs – The AMC stands in condemnation of the Province’s unjustified intrusion on the jurisdiction of First Nations through the tabling of Bill 56. Bill 56 removes section 9.4 of The Smoking and Vapour Products Control Amendment Act (the “Smoking Act”), which “exempts lands reserved for Indians and federal lands” from the application of the Smoking Act. The tabling of Bill 56 follows the Province’s underhanded attempt in July 2020 to ban smoking in VLT areas on First Nations reserves under COVID-19 emergency orders. In response to that attempt, AMC Grand Chief Arlen Dumas stated, “it is unacceptable and disheartening that the Pallister government and the Province would attempt to use the current COVID-19 health crisis to unilaterally usurp First Nations autonomy under the guise of a public health order.” In response to the COVID-19 emergency order, Brokenhead Ojibway Nation filed a judicial review against Manitoba and the Manitoba Liquor and Lotteries Corporation.

Bill 56 is the Province proceeding with further steps to usurp First Nations jurisdiction. The Province failed to consult with any First Nations and is seen as a further attempt by the Province to control and limit constitutionally recognized and protected rights of First Nations. AMC and its members will continue to bring jurisdictional challenges through the court systems and fight as long as it takes for First Nations to receive autonomy. The Premier continues to refuse all First Nations attempts to resolve jurisdictional conflicts and appears content to continue his government’s thinly veiled practices of systemic racism,” said Grand Chief Dumas.

“Any attempt by the Province to change the Smoking Act regarding First Nations reserves in Manitoba is illegitimate and unconstitutional. This issue goes far beyond smoking bans as it holds ill-considered constitutional ramifications and sets negative precedence of provinces overstepping and interfering with constitutionally recognized and protected rights of First Nations

Release of “Our Children, Our Future: The Health and Well-Being of First Nation Children in Manitoba

Dec. 9, 2020 – “Our Children, Our Future: The Health and Well-being of First Nations Children in Manitoba” released by Manitoba Centre for Health Policy (MCHP) looks at the health and well-being of registered First Nations children living on-reserve and off-reserve in Manitoba. The purpose of this report is to provide a sound baseline measure of how First Nations children in Manitoba are doing in order to determine if the children’s lives are improving as a result of these calls to action.

Summary of Results: (Indigenous vs Non-Indigenous)

Teen Pregnancy (per 1000):            107 vs 18     6 x greater

Teen Births (per 1000):                    87 vs 11       8x greater

Breastfeeding (per 100):                  61 vs 90       33% less

Diabetes (per 100K):                        875 vs 43     20 x greater

Dental Surgeries (per 1000)             32 vs 1)        32 x greater

These findings clearly show that an enormous amount of work is required in virtually every area – health, social, education and justice – to improve First Nations children’s lives. There is an urgent need for equitable access to equitable services, and the nature of these services should be self-determined, planned and implemented by First Nations people. An important aspect that should be included in this work is a clearer understanding and articulation of the traditional knowledges, languages and values that were stripped from so many First Nations by colonialist practices and policies. First Nations Peoples hold these cultural knowledges and values in their memory and within themselves. Collectively, as First Nations and as Manitobans, we should revive them as we begin to address gaps in the key areas this report describes and work to improve First Nations children’s health, education and social outcomes.

The data presented in this report can inform and guide us in changing our approach to First Nations programming, policies and decision-making. The profound hope of the research team is that this report will promote equity in funding for First Nations children and that Indigenous and non-Indigenous people can work in a more collaborative and unified way to address the gaps. In so doing, and in the true tradition of honoring First Nations ways of doing, knowing and being, we strive to be “wholistic” in our approaches to clear the path for First Nations children to live and thrive in our province.

Knowledge Keeper recommendations:

It is with this in mind we make these declarations:

  1. Urgent action is needed in the development of a unified and seamless health care system to ensure our children have equitable access to all provincially funded health and social services.
  2. Urgent action is needed to eliminate discrimination and racism at all levels of the health care system, beginning with health care providers and extending to policies that place First Nations people at an unfair advantage.
  3. Urgent action is needed in the educational system that allows for the provision of equitable funding.
  4. Urgent action is needed to fund and support land- based or culturally appropriate educational models.
  5. Urgent action is needed in the creation of fair and culturally appropriate assessment tools in the educational system.
  6. Urgent action is needed to restore our languages by the wide implementation of First Nations language programs in all schools and support for full language emersion in our schools on reserve.
  7. Urgent action needed for supports and services that are planned by and put in place by First Nations people and must be funded at the same level as services for other Canadian children in the child welfare system.
  8. Urgent action is needed to completely overhaul the child welfare system and discontinue the colonial practice of child removal and any incentives that support this practice.
  9. Urgent action is needed to acknowledge existing Knowledge Keepers grandmother’s and grandfather’s circles so that they have meaningful and legitimate authority to oversee and ensure that all proceeding urgent calls for action are implemented.
Recommendations for health care reform by developing culturally safe health policies and programs to remake an inherently racist system

Nov. 2, 2020: Policy Options – Canada’s history of colonization has laid the foundation for the implementation of racist health policy and the delivery of culturally unsafe health care, resulting in health disparities that are disproportionately experienced by Indigenous Peoples. Since the establishment of the Indian Act in 1867, Canada’s Constitution has continued to support and maintain discriminatory and inequitable practices and policies that negatively impact the health of Indigenous Peoples. The result is that Canada’s current health-care model is in and of itself a determinant of ill health for Indigenous Peoples. The authors recommend specific policy changes  to address these issues:

  • Lack of availability and accessibility to culturally safe health care for Indigenous people in Canada
  • Canada’s long history of implementing racist and sexist policies oppress Indigenous Peoples and place them in inequitable spaces. 
  • Indigenous women routinely experience systemic racism, institutional racism, a lack of cultural safety and sexism

Recommendations to make substantial changes to its health policies and legislations:

  • a collaborative approach that engages Indigenous Peoples and their communities in generating culturally safe and relevant health policies.
  • adequate distinctions-based programming and reporting mechanisms,
  • additional support of Indigenous-led research,
  • recruitment of Indigenous health-care personnel and
  • the integration of traditional healing practices in Canada’s health care model.
  • the creation of an ombudsman specific to Indigenous health should be established at the national, regional and local levels to ensure Indigenous Peoples feel safe to report inequities and experiences of mistreatment.

The TRC has advocated for cultural safety training and an increase in Indigenous health professionals in Canada’s health-care system, further supporting our health policy recommendations.Many of the health disparities experienced by Indigenous Peoples correlate to social, economic and political factors, suggesting that the foundation of Canada’s systems and thus its health care are inherently discriminatory.

https://policyoptions.irpp.org/magazines/november-2020/excising-racism-from-health-care-requires-indigenous-collaboration/

Canada Health Act fails the health needs of Inuit women and girls

Oct. 15, 2020: Pauktuutit Women of Canada – President Kudloo calls for additional funding to improve health determinants for Inuit women and girls and a focus on youth to increase Inuit health providers. She will also will highlight how the Canada Health Act is failing Inuit women and girls when she participates in a national meeting to address racism in the healthcare system on Oct. 16. Kudloo will also table recommendations to address racism experienced by Inuit women and children in the healthcare system. In addition, she will highlight the role systemic racism plays in health determinants for Inuit women which lead to poorer health outcomes, relative to other women in Canada.

“For Inuit women and girls, healthcare services fail most of the five basic principles of the Canada Health Act: accessibility, comprehensiveness, universality, portability, and public administration,” said Kudloo. “This is important because under the federal legislation, provincial and territorial health insurance programs must conform to the conditions of the legislation to receive federal transfer payments, under the Canada Health Transfer.” Systemic racism is also a key factor in many of the well‐known determinants of health, including employment, education, justice and income. Racism negatively impacts Inuit students’ success in graduating high school. It also limits their goals for post‐secondary education, including becoming a health professional. In addition, racism contributes to a lack of employment opportunities and the marginalization of Inuit in the workplace, including in well‐paying jobs in the healthcare system.

Recommendations

  • Increased funding to ensure the principles of the Canada Health Act ‐‐ including accessibility, comprehensiveness and universality ‐‐ are upheld for Inuit women and girls wherever they live, and that there are sufficient and sustainable health resources in each community.
  • Ensuring anti‐racism and cultural safety in education so Inuit children and youth receive STEM outreach programs; high school students receive counselling about the path to becoming a health professional; safe and respectful post‐secondary classrooms; as well as clinical settings that are free of racism and discrimination.
  • Training, recruiting, retaining, and mentoring Inuit staff and healthcare providers at all levels of the health system; as well as creating working and learning environments where Inuit knowledge, leadership and enterprise are valued.
  • Culturally aware and appropriate training to ensure all students training to work in healthcare, as well as present‐day healthcare staff, receive cultural awareness training regarding Inuit history and culture. Students and healthcare workers should also receive gender‐based violence training and those working in Inuit communities should receive Inuktut language training.
  • Inuit‐informed delivery of healthcare so that Elders, community leaders, women and youth are involved in the design and delivery of healthcare programs and services for their people and communities.
Release of Unicef Report Card on Child Well-Being

Sept. 8, 2020: NationTalk – Release of Unicef “Innocenti Report Card 16: Worlds of Influence – Understanding What Shapes Child Well-being in Rich Countries” where Canada placed in the bottom 10 of 38 countries. In fact, all four countries with large Indigenous populations – who all initially opposed The United Nations Declaration the Rights of Indigenous People – ALL placed in the bottom 8: (Canada # 30, Australia # 32, New Zealand # 35 and the United States # 36) and experts attribute this to the poor health outcomes of Indigenous kids.

Unicef issued “Top 5 Policies to Defend Childhood in 2020” on Dec. 30, 2019 one of which # 3 “Ensure Fairness for indigenous Children.” The federal government should adopt the Spirit Bear Plan proposed by the First Nations Child and Family Caring Society and endorsed by the Chiefs of the Assembly of First Nations to permanently end funding shortfalls in the services provided to First Nations children. First Nations children and families living on reserve and in the Territories receive public services funded by the federal government. Since Confederation, these services have fallen significantly short of what other Canadians receive. In 2015, the Truth and Reconciliation Commission released its Calls to Action, including a call to achieve parity for First Nations, Inuit and Métis children. Equitable spending on public services for children including clean water, health care, education and protection is their right.

Federal Government and Government of Ontario for ongoing failure to address access to health issues in Nishnawbe Aski Nation who have declared a Public Health Emergency across NAN territory

Oct. 23, 2019 – Nishnawbe Aski Nation (NAN) Resolution 16/04 Call for Declaration of Public Health Emergency. The Sioux Lookout Chiefs Committee on Health and the NAN Executive declared a Health and Public Health Emergency for First Nations across NAN territory.  This Declaration was not made lightly.  It was forced into existence by decades of perpetual crisis and persistent health care inequities at the NAN community level.  The Declaration is an assertion of the inherent Treaty rights of NAN members to equal opportunities for health, including access to appropriate, timely, high-quality health care, regardless of where they live, what they have or who they are.

In order to exercise our self-determination over health we need to bring back accountability, responsibility and resource allocation to our communities.  This involves changing the current colonial system to a new system that is based on the needs and priorities of our communities. This led to the execution of a trilateral commitment document: The Charter of Relationship Principles Governing Health System Transformation in NAN Territory (the Charter) which was mandated by NAN Resolution 17/21. The Charter was signed by the Parties (Grand Chief Alvin Fiddler, Minister Jane Philpott and Minister Eric Hoskins) on July 24, 2017.

In order to support the NAN Health Transformation process, the governments agreed to several actions, including:

  • Developing new approaches to improve the health and health access, including access at the community level.
  • Supporting the ability of First Nations communities and organizations to deliver their own services.
  • Proposing policy reform and exploring legislative changes to design a new health system for NAN territory, including sustainable funding models and decision-making structures.
  • Removing barriers caused by jurisdiction, funding, policy, culture and structures so that First Nations can deliver better plan, design and manage their own services

NAN is a political territorial organization representing 49 First Nation communities within northern Ontario with the total population of membership (on and off reserve) around 45,000 people. http://www.nan.on.ca/upload/documents/mushkikiw-wiichihiitiiwin-gathering-fina.pdf

July 9, 2020 – Minister of Indigenous Services, announced $2,657,560 to support the Nishnawbe Aski Nation (NAN) Mental Health and Addictions Pandemic Response Program, a unique First Nation-led initiative responding to the specific health needs of community members in northern Ontario. It will identify the mental health and wellness services that are already available, and bridge the existing gaps so that every individual can have access to culturally safe and community based mental health services when needed. Keewaytinook Okimakanak (KO) eHealth and Sioux Lookout First Nations Health Authority (SLFNHA) will run the program, which is designed to provide community members with equal access to high-quality, culturally safe substance use treatment and mental health services with direct input from communities. The services will be coordinated, delivered and promoted by the Regional Health Authorities, Tribal Councils, and community organizations within the NAN region, and will offer access to 24/7 culturally appropriate crisis supports, triage and live service navigation, improved usage of tele-mental health supports, and will help eliminate duplication in existing mental health and problematic substance use services.

Government of Ontario for failure to consult First Nations on Bill C-74 “The People’s Health Care Act, 2019

Feb. 28, 2019 – Bill-74 “The People’s Health Care Act, 2019” does not contain recognition of First Nations jurisdiction in health area and specifically Articles 18 and 23, of the United Nations Declaration on the Rights of Indigenous Peoples, have not been recognized, as there has been no consultation with First Nations in developing this legislation. (Chiefs of Ontario)

This legislation is set to create a new Agency called Ontario Health, which will be formed by dissolving the province’s 14 Local Health Integration Networks (LHINs) and merging their duties with those of six other health agencies, including Cancer Care Ontario and eHealth Ontario. First Nations must be involved in the conversation if we are to improve the overall health of First Nations in Ontario,” said Ontario Regional Chief RoseAnne Archibald. “We hope for a continued collaboration between First Nations and the Government of Ontario, so First Nations can provide a recommended approach that will lead to overall healthcare improvement and address the gap within First Nations healthcare. “

Federal, Provincial, Territory Governments for failure to include Indigenous health within the Canadian Health Act

Sept. 21, 2017: Healthy Debates – “Indigenous health services often hampered by legislative confusion“. The federal and provincial governments negotiate health transfers based on the Canada Health Act, which specifies the conditions and criteria required of provincial health insurance programs. It doesn’t mention First Nations and Inuit peoples, Métis and non-status or off-reserve Indigenous peoples who are covered by the Indian Act.

This lack of clarity – and lack of policies for providing Indigenous health services – has historically been used by both the federal government and provinces to narrowly define their responsibilities toward Indigenous health. It’s created bureaucratic delays that leave Indigenous peoples waiting for care or medications readily available to non-Indigenous Canadians. And it’s created gaps in care between Indigenous and non-status and First Nations people living off-reserve.

“The move to a new fiscal relationship is significant,” Grand Chief Doug Kelly, chair of the First Nations Health Authority of BC says. Leaving Indigenous people out of health care discussions and program design hasn’t worked. Instead, he says, First Nations communities should be empowered to identify their priorities and develop a plan. Once costs are attached, communities would negotiate with the government for transfer payments. Groups like the First Nations Health Managers Association that Marion Crowe, Executive Director represents, have been working to prepare communities for the eventual transfer of responsibility, focusing on developing health human resource and health administrative capacity within First Nations communities.

Government of Manitoba for worsening health outcomes of First Nations people comparing data from 2015 – 17 vs 2002.

Sept. 17, 2019University of Manitoba Today – Joint study by the First Nations Health and Social Secretariat of Manitoba (FNHSSM) and the Manitoba Centre for Health Policy (MCHP) in the Rady Faculty of Health Sciences at the University of Manitoba, “The Health Status of and Access to Healthcare by Registered First Nation Peoples in Manitoba” compares health data collected in 2015-2017 with the results of a study the MCHP published in 2002.
“When we look at health status and health-care access, the inequities between First Nation people and all other Manitobans have gotten worse, according to many indicators,” said Leona Star, a Cree woman who is director of research at FNHSSM and co-led the study. For example, the First Nations life expectancy from birth in 2002 was 7 years lower than for the non-Indigenous population; in 2019 First Nations life expectancy from birth is now 11 years lower.

Other disturbing trends:

  • First Nation people’s rate of premature mortality (death before age 75): 2002 = 2x other Manitobans; 2019 =now 3x
  • Suicide rates for First Nations people = 5 x higher
  • Suicide attempts by First Nations people = 6x higher

As we have now documented that health inequities have increased since 2002, we propose the following specific actions: 

  1. Annual reporting on progress in addressing gaps in health and access to healthcare; 
  2. Development of strategic initiatives for equitable access to intervention and prevention measures (including addressing racism in the health system through mandatory cultural safety training for all staff, hiring of First Nation providers, new human resource policies for safe reporting of racist incidents); 
  3. Development of short- and long-term plans for the training and hiring of First Nation healthcare professionals; 
  4. Further development of research partnerships among MCHP, MHSAL, FNHSSM and Manitoba First Nations; 
  5. Setting First Nations on the path to borderless healthcare delivery by improving access to primary care healthcare that is designed and delivered through First Nations-led partnerships. 

http://mchp-appserv.cpe.umanitoba.ca/reference//FN_Report_web.pdf

Government of Quebec infringing on First Nations Aboriginal treaty rights by their failure to consult with First Nations on Bill 61’s impact on their health

June 5, 2020 – Bill 61, an omnibus bill (An Act to stimulate the economy of Quebec and mitigate the consequences of the state of health emergency), declared on March 13, 2020 due to the COVID-19 pandemic and tabled earlier this week by the CAQ government cannot be misused by the Quebec government to minimize its duty to consult First Nations and reduce the application of already low environmental standards to a minimum. It cannot take advantage of the current context to put the health of our populations on the back burner, nor can it more openly infringe First Nations’ Aboriginal and treaty rights,” said AFNQL Chief Ghislain Picard.

There is an opportunity here for the provincial government to put its words into action and listen to First Nations who are looking for a balance between their own economic recovery and the protection of their territories. In any case, as we have decades of experience of being excluded from the decisions that affect our communities, we will continue to do what it takes to ensure that our governments have a voice when it comes to the development of our non-ceded territories and resources,” concluded the Chief of the AFNQL.

Ongoing Health Crises
There is no national fire protection code that mandates fire safety or enforcement on reserves

Mar. 24, 2021: NationTalk – There is no national fire protection code that mandates fire safety standards or enforcement on reserves. All other jurisdictions in Canada including provinces, territories, and other federal jurisdictions (such as military bases, airports, and seaports) have established building and fire codes. The Aboriginal Firefighters Association of Canada (AFAC), NIFSC’s parent organization, supports the development of a national First Nations Fire Protection Act and is willing to work with First Nations leadership as a technical resource.

In the absence of legislation act or regulations, AFAC and the NIFSC are addressing identified gaps to improve fire safety in Indigenous communities by supporting them in creating fire safety standards, doing fire protection and response research, and establishing fire safety bylaws and building standards. Indigenous Peoples across Canada are over 5 times more likely to die in a fire compared to the rest of the population. That number increases to over 10 times for First Nations people living on reserve. Inuit are over 17 times more likely to die in a fire than non-Indigenous people. Rates among Métis were higher than non-Indigenous estimates (2.1), but these rates were not significantly different.

Fire-related injuries resulting in hospitalization are also disproportionate to Indigenous Peoples. First Nations people are over 4 times more likely, Métis are over 1.5 times more likely, and Inuit are over 5 times more likely than non-Indigenous people to be hospitalized due to fire-related injuries.

What has led to this situation?

Many social determinants contribute to the higher fire-related mortality among Indigenous Peoples. These include poverty, inadequate housing conditions, housing without smoke alarms, and more.

Core capital funding provided by Indigenous Services Canada (ISC), which includes funding for fire protection, is flexible. This means community leadership can use designated fire protection funds if the community has more immediate or pressing needs (e.g., a school needing repairs or social housing maintenance). Without a fire protection mandate or regulatory maintenance of fire protection standards for Indigenous communities, fire services and fire and life safety can be deprioritized or forgotten. For more information please visit the ISC website.https://nationtalk.ca/story/new-study-shows-that-indigenous-peoples-across-canada-are-between-5-and-17-times-more-likely-to-die-in-a-fire-compared-to-the-rest-of-the-population

How the NIFC Project will help Indigenous Communities

  • Offer culturally sensitive and relevant fire and life safety training and education programs that are created for and delivered by Indigenous Peoples. These services are available to First Nations populations living on reserve, leadership, and individuals working or volunteering in emergency services.
  • Launched close to 80 programs and services that provide training and ongoing support to more than 600 First Nations communities in Canada. Programs include education, support, and training in the areas of community fire safety, community governance support, community infrastructure and engineering support, fire department management, fire investigation services, and fire department operations. Training, education programs and services being offered by the NIFSC Project have not previously been available to First Nations communities, whereas they have been available in most other communities in Canada
  • improve fire-related mortality and morbidity amongst Indigenous Peoples is through more accurate data collection. The creation of the National Incident Reporting System (NIRS) will, over time, provide the data regarding fire incidents in Indigenous communities that has been missing.
Lack of access to basic health services in Inuit Nunangat

Inuit life expectancy is 10 years shorter than the average Canadian, according to Statistics Canada.

Feb. 17, 2021: Nunavut News – “Tackle lack of basic health care for Indigenous peoples, then worry about racism, Nunavut’s MP says”. Nunavut member of Parliament Mumilaaq Qaqqaq says the lack of medical care available in Nunavut currently is proof that the Government of Canada doesn’t care about Inuit. “The complaints I’m getting about health care are about access to health care more than about discrimination… (it’s) the shortage of resources in notable areas like mental health,” said Nunavut Conservative Senator Dennis Patterson. Nunavut Tunngavik Inc. (NTI) submitted a statement indicating that broader social conditions affect the health of Inuit in Nunavut, such as income, education, adequate housing, stress/trauma and food security.  

NTI also expressed support for the Canadian Public Health Association’s recommendations:

  • to adopt a formal statement condemning racism;
  • undertake system-wide reviews of regulations, policies, processes and practices to identify and remove any racist systems and approaches;
  • identify and remove racist laws, regulations, procedures and practices;
  • provide mandatory, rigorous and system-wide anti-racism and anti-oppression training for all staff and volunteers within their organizations;
  • enhance public health surveillance systems by collecting and analyzing race and ethnicity data in an appropriate and sensitive manner; and
  • monitor organizations for stereotyping, discrimination, and racist actions and take corrective actions.

“My Fear is Losing Everything: Climate Crisis and First Nations Right to Food in Canada

Oct. 21, 2020: The Narwhal – Human Rights Watch released “My fear is Losing Everything: Climate Crisis and First Nations’ Right to Food” in Canada. The report details how longer and more intense forest fire seasons, permafrost degradation, volatile weather patterns and increased levels of precipitation are all affecting wildlife habitat and, in turn, harvesting efforts.  The report also outlines how there are more hunting and foraging risks due to warming temperatures. For instance, it’s harder — and sometimes impossible — to hunt caribou because the ice and permafrost they travel on isn’t stable enough for hunters. 

“Climate change threatens to decimate these food systems, risking further serious consequences for livelihoods and health,” the report states. The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production.  Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production.  Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

Human Rights Watch lays out several recommendations for the federal government, including that:

  • Canada deem the right to food a basic human right
  • strengthen its climate change policies to reduce emissions
  •  improve climate adaptation measures in First Nations and
  • support a transition toward renewable energy, including for First Nations, in the COVID-19 stimulus package.

https://thenarwhal.ca/climate-change-indigenous-food-insecurity-report/https://www.hrw.org/report/2020/10/21/my-fear-losing-everything/climate-crisis-and-first-nations-right-food-canada – _ftn301

Beyond Hunger – The Hidden Impacts of Food Insecurity” Community Food Centre

Sept. 29, 2020: Community Food Centres (CFC) – Release of “Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”. Even before COVID-19, food insecurity affected nearly 4.5 million Canadians. In the first two months of the pandemic, that number grew by 39 per cent. Food insecurity now affects one in seven people, disproportionately impacting low-income and Black, Indigenous and People of Colour (BIPOC) communities. “Beyond Hunger illustrates that food insecurity is about equity and income,” says Saul. “We urgently need a national solution that goes beyond emergency food assistance. We need a solution founded in solid policy that addresses inadequate social programs, systemic racism and precarious employment.”

Why Food Insecurity happens in Canada”:

  • People are stuck in low wage and precarious jobs
  • Canadians are struggling with a rising cost of living
  • Colonialism and systemic racism
  • Low social assistance rates trap people in poverty
  • More and more people are living alone
  • Food in the North is unaffordable

Findings:

  • 81% say it takes a toll on their physical health
  • 79% say it impacts their mental health
  • 57% say it is harder to find and keep a good job
  • 53% say it is a barrier to finding meaning in life
  • 58% say it limits their ability to take part in social activities
  • 46% say it limits their ability to celebrate their culture

We believe government policy is necessary to address the real cause of food insecurity. Policy is what will increase incomes and make life more affordable — for everyone. Here are four policy changes for the federal government to act on:

  1. Invest in income supports for low income Canadians
    • Increase income benefits for single adults who suffer disproportionately from food insecurity by:
      • Ensuring low-wage workers have equal access to Employment Insurance
      • Improving existing tax benefits so they provide more income by making them refundable
      • Creating a tax credit specifically for working-age adults
    • Ensure low-income Canadians, especially First Nations living on reserve, have better access to tax filing supports and benefit services
  2. Make life more affordable for Canadians
    • Speed up the implementation of the Canada Housing Benefit, which supports people who can’t afford their housing
    • Increase federal funding for early learning and child care
    • Move forward with a universal public pharmacare program
  3. Set targets and improve reporting on food security
    • Set targets to reduce food insecurity
    • Ensure Statistics Canada reports on food insecurity annually and collects better race-based data
  4. Ensure progress on food insecurity is achieved equitably
    • In partnership with Northern leadership, continue to reform Nutrition North Canada
    • In partnership with Indigenous leadership, create an Indigenous food sovereignty fund
    • In partnership with Black communities, create a fund to decrease food insecurity for Black Canadians
    • Apply a racial equity lens to all poverty and food-security policies

https://cfccanada.ca/getmedia/57f5f963-af88-4a86-bda9-b98c21910b28/FINAL-BH-PDF-EN.aspx?_ga=2.197064812.159489303.1604624936-1692352870.1604624936

First Nations infant deaths by sudden infant death syndrome (SIDS) were 4.5 times higher in Manitoba than non-First Nations infants

Mar. 13, 2020 – Release of Manitoba Advocate for Children and Youth (2020): Safe and Sound: A Special Report on the Unexpected Sleep-Related Deaths of 145 Manitoba Infants” According to population projections, Indigenous infants account for between 20-30% of live births in Manitoba during the study period (Jan. 2009 – Dec. 2018), but represent 57% of sleep-related infant deaths. That translates to 83 First Nations and Métis infants.

This image has an empty alt attribute; its file name is Screen-Shot-2020-03-31-at-2.03.23-PM.png

Policies articulated in the Indian Act have excluded Indigenous Peoples from participation in economic life for generations, leading to intergenerational poverty. In evidence of ongoing systemic racism, many Indigenous families have unequal access to health services, they lack suitable stable housing, and access to clean drinking water. The health gap between Indigenous and non-Indigenous Manitobans is widening (Katz et al. 2019). Of the 13 recommendations, 7 are directed towards First Nations and Métis governments and various federal and provincial ministries.

https://manitobaadvocate.ca/wp- content/uploads/SafeSleep-Report.pdf

Government of Nunavut’s repeated failure to implement Canadian Paediatric Society recommendations to administer Palivizumab to all Inuit babies with respiratory issues

Oct. 20, 2019 : Globe and Mail – A group of doctors is urging officials in Nunavut to offer an effective but costly drug to all Inuit babies living in remote communities in the territory to protect them against a respiratory virus that disproportionately leads to their hospitalization. But Nunavut’s chief medical officer disagrees, saying there isn’t enough evidence to support such an approach. Palivizumab, the only available prophylactic treatment for RSV, is currently given to infants in Canada who are considered at high risk of complications, such as those born prematurely or who have underlying heart or lung conditions. But it is not routinely administered in Nunavut to healthy Inuit infants who are born at full term.

For most people, symptoms of RSV infection are indistinguishable from the common cold, although an estimated 1 to 3 per cent of infants in developing countries experience complications requiring hospitalization. Inuit babies in Canada, however, have an exceptionally high rate of RSV complications. Among some Inuit communities on Baffin Island, as many as half to two-thirds of babies are hospitalized with lower respiratory lung infections, mostly owing to RSV, according to Anna Banerji, an expert on Indigenous and refugee health and associate professor of pediatrics at the University of Toronto who helped start the petition. Although it is not entirely understood why, experts believe Inuit infants are disproportionately affected because of a combination of genetic and environmental factors, including food insecurity and a lack of adequate housing arising from a history of forced settlement.

Government of Manitoba for failing to address the overwhelming need for access to mental health and addiction services by Indigenous people

March 31, 2018 – Release of the Virgo Final Report: “Improving Access and Coordination of Mental Health and Addiction Services: A Provincial Strategy for all Manitobans” specifically emphasizes the discovery made during the system review that for almost every service encountered, the largest percentage of people being served were of Indigenous background. 

The report acknowledges the “history of colonization and historical trauma, and ongoing challenges with respect to social determinants of health. More importantly, we believe the overall system of services will not improve significantly in terms of access or coordination without a concerted and sustained effort to better meet the needs of the province’s Indigenous people.

Of the many issues brought forward unique to Indigenous people, two were particularly salient:

  • the need for more culturally informed services, including land-based programs, and support for those community members whose customary language is their own native language and who have trouble understanding words and concepts expressed in English. Last,
  • the “jurisdictional issue”— a fundamental challenge to be addressed going forward as it underlies significant issues related to access and coordination. This was one of the top priorities identified in the validation events.

Other specific issues identified previously with respect to the preceding Strategic Priorities, including,

  • the need for more local, and more flexible, services, including longer term treatment and pre-and post-treatment supports; 
  • the need for better integration of SUA and MH (substance use/addiction and mental health problems and illnesses) services; 
  • the need to fill specific gaps for youth and women; and 
  • a critical need for Withdrawal Management Services (WMS), transitional stabilization to support access to treatment, housing, transportation and crisis services, including post-crisis healing opportunities.

https://www.gov.mb.ca/health/mha/docs/mha_strategic_plan.pdf

Indigenous Health Surveys
Release of “Our Health Counts: Thunder Bay” an inclusive community-based health survey for Thunder Bay Indigenous people and part of the largest Indigenous population health study in Canada

Nov. 30, 2020: NetNewsLedger – The release of the Our Health Counts: Thunder Bay an inclusive community-based health survey for Thunder Bay Indigenous peoples and part of the largest Indigenous population health study in Canada. Participants were selected using respondent-driven sampling, a statistical method that uses social networks to recruit Indigenous people living in the city.

Data released from the survey focused on Indigenous adults’ and children’s experiences with the health care system in Thunder Bay show communities deeply rooted in their cultural traditions and identities, while facing several systemic barriers that adversely impact their health and wellbeing. “Specifically, the results of the Our Health Counts Thunder Bay study highlight the gap in access to culturally safe care for Indigenous peoples within public health, primary health, mental health, acute and long-term care. These results clarify the overall healthcare priorities of Indigenous people and specifically the need for Aboriginal Health Access Centres (AHAC) and centres of excellence in diabetes and mental health.

The survey found that the size of the Indigenous population in the Thunder Bay CMA is far larger than the previous figures released by Census Canada. The survey results summarized in a set of fact sheets, calculated the size of the FNIM adult population of Thunder Bay to be 29,778 (estimated range is 23,080-42,641). These survey number are more than three times higher than the FNIM population size estimate of 9,780 reported by the 2016 census, which most FNIM in Thunder Bay reported they did not complete.

The survey also captured FNIM communities’ challenges with access to health care and institutionalized racism.

  • Fifty per cent of adults surveyed in Thunder Bay have a primary care practitioner, compared to 90 per cent of adults in Ontario.
  • Almost half of the adults surveyed reported accessing emergency care in the past 12 months, compared to only 19 per cent of Ontarians.
  • Over two-thirds of participants reported experiencing racism.
  • One in three adults reported that they were treated unfairly by health care professionals because of their Indigenous identity.

The survey was co-led by Well Living House, an Indigenous health research unit at St. Michael’s Hospital, and Anishnawbe Mushkiki Aboriginal Health Access Centre.