Discrimination in Healthcare: How Indigenous Communities are Affected

by Carly Wigdor (Indigenous Affairs Student Initiative)

IASI is a newly-established graduate student-led initiative that aims to provide a platform to discuss Indigenous issues from a policy-focused lens. In conjunction with our Advisory Board, consisting of Bob Rae, Grand Chief Arlen Dumas and Professor Douglas Sanderson, we seek to promote awareness of Indigenous issues and encourage the enrolment of Indigenous students at the Munk School.

(I would first like to acknowledge that, while I am writing for the Indigenous Affairs Student Initiative, I am a non-Indigenous person.)

The consequences of settler colonialism continue to be endured among Indigenous communities across generations. While the federal government has emphasized its dedication in the pursuit of reconciliation, the lasting impact and history of complex Indigenous-settler relationships cannot easily be undone through empty promises. Beyond that, various institutions and laws uphold colonial norms and practices regarding Indigenous people to this day. 

On January 15, the Indigenous Affairs Student Initiative (IASI) held its first event of the year. The event focused on the shortcomings of healthcare provision to Indigenous communities across Canada, highlighting the institutional barriers to appropriate service delivery that are continuously neglected by the government. 

The IASI first welcomed Dr. Angela Mashford-Pringle, an Assistant Professor and the Associate Director of the Waakebiness-Bryce Institute for Indigenous Health at the Dalla Lana School of Public Health. Dr. Mashford-Pringle is from the Timiskaming First Nation in northern Quebec and her research predominantly focuses on the intersection between Indigenous health and education. 

After a land acknowledgement from an AISI executive, Dr. Mashford-Pringle discussed the importance of acknowledging the land we use for work, play, and living in our every-day activities. She emphasized the importance of reflecting on our impact on the land we use, the ways we acknowledge it, and how we need to consider our connection to the land in relation to climate change.

Dr. Mashford-Pringle provided a brief introduction into the complex history of Indigenous-settler relations, highlighting the occurrences that led to the current inadequate healthcare services in today’s context within Indigenous communities. Emphasis was particularly placed on the challenges related to navigating Canada’s federal structure and the intricate nature of the division of powers. An example of this challenge can be seen under the contexts of healthcare, a topic that lies under provincial jurisdiction, but is further complicated by the federal responsibility of Indigenous populations (referred to as “Indians” under the Constitution). This, she explained, is at the heart of issues pertaining to the Medicine Chest Clause and Jordan’s Principle.

The Medicine Chest Clause is a clause of Treaty No.6, signed in 1876, which orders “a medicine chest” to be kept “at the house of each Indian Agent for the use and benefit of the Indians.” In other words, a medicine chest should contains a supply of free medicine for the Indigenous people to use. This represents the extent of medical interventions at the time. However, the nature of medicine evolved over the course of centuries, with advancements in technology and an ever-growing list of needs, a simple medicine chest does not properly address the medical needs of Indigenous people presently.  Therefore, this clause is wrongly interpreted today, resulting in a lack of medical funding towards Indigenous communities, especially to those communities in more remote areas. 

Following the Medicine Chest Clause, Dr. Mashford-Pringle presented Jordan’s Principle, advocating for  proper child healthcare services on and off reserves. It tells the story of Jordan River Anderson, a First Nations child from the Norway House Cree Nation in Manitoba. He was born with a rare disease requiring round the clock care. Tensions emerged between the federal government and the Manitoba government, fighting over which jurisdiction was required to bear the costs of the young boy’s medical expenditures. Throughout this dispute, however, Jordan died in the hospital, having never gone home.

Dr. Anna Banerji spoke on similar issues she has come across through her research. Dr. Banerji a pediatric infectious and tropical disease specialist. She is the Director of Global and Indigenous Health at Continuing Professional Development in the Faculty of Medicine. Dr. Banerji is also the founder of the Indigenous Health Conference. She has conducted research on the prevalence of lower respiratory tract infections (LRTI) and respiratory syncytial virus (RSV) in Inuit babies. Her research focuses on infants on Baffin Island and found that a third of all Inuit infants on Baffin Island were hospitalized due to RSV. 

Dr. Banerji advocates for the provision of palivizumab, a vaccine that reduces complications associated with RSV, to these children. However, the Nunavut government currently only provides the vaccine to children who were born premature. While Inuit infants are the group at higher risk of disease, they are not considered to receive this vaccination. Instead, they are forced to travel off reserve to be hospitalized, incurring high travel and healthcare costs. Dr. Banerji explains that providing Inuit children with the vaccine would be a cheaper and more efficient method of treating the disease. Although her research is tried and tested, she has unfortunately ran into a lot of trouble when it comes to actually convincing the provincial government in acting on her evidence. 

Both Dr. Mashford-Pringle and Dr. Banerji discussed the continuing discrimination against Indigenous peoples on issues pertaining to healthcare. They have both experienced trials and tribulations in their work and lived experiences. They emphasized the importance of incorporating these ideas into policy to hold all orders of government accountable and provide all individuals the appropriate level of healthcare services. As future policy professionals, we must consider these and similar challenges in order to sufficiently serve all communities.

Dr. Banerji’s colleagues have created a petition to provide proper treatment to Inuit children suffering from RSV. If Dr. Banerji’s work has inspired you, please show your support in signing the petition, thank you.

https://tinyurl.com/vw233ta

Carly Wigdor is currently in her first year of the Master of Public Policy program at the Munk School of Global Affairs and Public Policy. She holds a Bachelor of Commerce with a major in Managing for Sustainability from McGill University. Her policy interests include social and environmental policy.

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