The fate of Joyce Echaquan, an Indigenous woman who died in a Quebec hospital after filming staff insulting her, is a tragic example of the systemic racism many Indigenous people face when accessing health services in Canada, advocates and patients say.
The Atikamekw mother of seven died soon after she filmed herself from her hospital bed last Monday while she was in clear distress and pleading for help. Toward the end of the video, which was streamed live, two female hospital staff enter her room and are heard making degrading comments, including calling her stupid and saying she’d be better off dead.
The video has created widespread indignation, several inquiries and a lawsuit from Echaquan’s family against the hospital where she died in Joliette, Que. But Yvonne Boyer, a Metis Canadian senator, lawyer, and former nurse, says what happened to Echaquan was in no way a surprise.
“For every Joyce Echaquan that comes forward, there’s a hundred that have not been heard,” she said in a phone interview.
Echaquan’s partner, Carol Dube, says he believes she died as a result of the racism she and many other Indigenous people face.
“I’m convinced that my partner is dead because systemic racism contaminated the Joliette hospital. It killed my partner,” he told a news conference Friday at which his lawyer announced a lawsuit and a criminal complaint against the hospital.
Frederick Edwards, a Cree man from Manitoba, said he has faced racism and stereotypes throughout his life while trying to access health care.
He remembers being in unbearable pain before going to an emergency room in Winnipeg about seven years ago, after having already seeing multiple doctors who couldn’t provide a diagnosis. He says he was shocked when the triage nurse immediately told him to shut up and sit down — treatment that made him feel “worthless.”
After being made to wait, then seeing a doctor who dismissed his symptoms, his phone rang as he waited in the ER: a doctor he had seen previously had results of a blood test showing that his health was at serious risk. He was rushed to surgery at another hospital because his gallbladder had ruptured.
“I don’t like hospitals because of so many bad experiences,” Edwards, a communications professional, said in an interview. “This is just one of them.”
Boyer said discrimination in the health-care system is “pervasive,” spanning every province and territory.
As an example, she cited legal actions being mounted in Alberta, Saskatchewan and British Columbia by Indigenous women who allege they were forced or coerced into undergoing sterilization procedures.
Accounts from Indigenous women in 2015 about forced sterilizations in Saskatchewan led to hundreds more coming forward with similar stories from across the country. A report into the Saskatchewan tubal ligations found the women felt profiled and powerless and concluded racism exists within the health-care system.
Boyer said she received another email from a Canadian Indigenous woman alleging a coerced procedure on Thursday, suggesting such practices are not just a relic of the past.
The issue of health-care discrimination was also raised in the case of Brian Sinclair, a 45-year-old Indigenous man who died of sepsis in 2008 after sitting in a Winnipeg hospital in his wheelchair for 34 hours.
Later it was discovered that staff assumed he was homeless or intoxicated. By the time his body was discovered, rigor mortis had set in. An inquest into the death made recommendations about structural changes to how hospitals conduct triage, but family members have said it didn’t address the real issue — racism in the health-care system.
Mary Jane Logan McCallum, a member of the Munsee Delaware Nation in Ontario and co-author of a book about Sinclair’s death, said racism continues to be a significant barrier to proper health care for Indigenous people. They fear facing stereotypes, having their symptoms ignored or being left to die without treatment.
“This is not a one-off for Indigenous people,” McCallum said in reference to the deaths of Sinclair and Echaquan. “This is absolutely part of the way that many Indigenous people prepare themselves to go to the hospital.”
In Montreal, Nakuset, the executive director of the Native Women’s Shelter, said situations like Echaquan’s are “heartbreakingly normal.”
Over the last 20 years of directing the shelter, she says she’s seen and heard of countless instances of racism, including a Cree patient being told to go to a Mohawk reserve for treatment and an Inuk woman leaving a health-care facility in tears after being rebuffed while seeking treatment for an addiction.
It’s so bad, she said, that the shelter has taken to sending support workers with patients to the hospital, partly to witness and document racist incidents.
Quebec Premier François Legault has denounced Echaquan’s treatment as “unacceptable,” and on Saturday, deputy premier Geneviève Guilbault announced that she has asked the coroner’s office to order a public inquest into the death. The two health-care workers heard in the video have been fired. But Legault has consistently maintained there is no systemic racism in the province.
Echaquan’s death took place almost a year to the day after a public inquiry released 142 recommendations aimed at improving Indigenous people’s access to government services in Quebec. Though Quebec’s minister responsible for Indigenous affairs said this week that dozens of those recommendations have been implemented, both Boyer and Nakuset question her claim.
After all the inquests and recommendations, both women feel that little real change has occurred.
“How are you ever supposed to fix (systemic racism) if people believe it doesn’t exist?” Boyer said in reference to Legault.
She said there needs to be a “national response” that sets clear standards for hospitals and clear consequences for those who violate them.
Nakuset, who organized a protest in downtown Montreal on Saturday, is hopeful that what happened to Echaquan could be a turning point for Canada, the way the death of George Floyd during an arrest by police in Minnesota galvanized the Black Lives Matter movement in the United States.
She believes there’s still hope for change, but only if Canadians from all backgrounds demand it.
“The only way that we can make changes as a society is to show up, because actions speak louder than words,” she said.