As the COVID-19 pandemic has kept health care issues at the forefront of the Canadian consciousness, a pediatrician and McGill Assistant Professor in Medicine took home two prizes at the Quebec Writers’ Federation Literary Awards, held on Nov. 24 at Montreal’s Lion d’Or.
Dr. Samir Shaheen-Hussain’s book Fighting for a Hand to Hold: Confronting Medical Colonialism Against Indigenous Children in Canada won both the Mavis Gallant Prize for Non-Fiction and the Concordia University First Book Prize at the annual award night, honouring the best in English-language literature in Quebec.
The book has been widely hailed as a searing indictment of the Canadian medical establishment and its historical – and ongoing – role in the displacement, colonization and genocide of Indigenous peoples in Canada.
Systemic racism alive and well
The book’s title reflects Shaheen-Hussain’s experience as an emergency room physician at the Montreal Children’s Hospital, where he would often see Eeyou and Inuit children airlifted from remote northern communities for emergency care. Until 2018, it had been Quebec government policy to forbid parents or caregivers from accompanying the child on their trip south, leaving the child cut off from everything they’ve known – their families, and in many cases, their language – as they received treatment. Shaheen-Hussain says the inspiration for the book began with a campaign launched by healthcare providers in Quebec to end that policy.
“The idea for the book started germinating during the 2018 #aHand2Hold campaign, after then-health minister Gaétan Barrette’s comments perpetuating anti-Indigenous stereotypes were made public on June 21, 2018, National Indigenous Peoples Day,” he said.
During a pre-electoral visit to a Muslim community centre on Montreal’s South Shore, the Liberal health minister confirmed the policy change, but then suggested that “there will be at least one instance in the next six months” where news reports would surface of an intoxicated parent being barred from accompanying their child down south.
“Most of the media coverage and public response was critical of what he had said, but the news died down within a few days. Disappointingly, the demand for Barrette’s resignation coming from Indigenous politicians, leaders, artists and activists was not taken up in any meaningful way by the public or by most politicians. The premier of Quebec, Philippe Couillard, stood by Barrette. François Legault, head of the Coalition Avenir Québec (CAQ), then in the opposition, stayed silent about Barrette’s comments.”
A few months later, François Legault and the CAQ defeated the Liberals in the 2018 general election. Since becoming premier, Legault has repeatedly denied the existence of systemic racism in Quebec.
During the #aHand2Hold campaign, Shaheen-Hussain was twice invited to testify as an expert witness at the Public Inquiry Commission on Relations Between Indigenous Peoples and Certain Public Services in Quebec, basing his presentations on the contributions and feedback provided by impacted families, as well as the campaign’s supporters. The research, interviews, exchanges, and discussions that went into preparing his testimonies about “medical colonialism” led to his writing the manuscript for the book in the summer of 2019.
The roots of medical colonialism
Shaheen-Hussain notes that the notion of “medical colonialism” goes back to beginning of European settlement – the medical practices brought to this continent by Europeans began to dominate, and then supersede traditional forms of health and healing knowledge. “Indigenous peoples have not only been ‘othered’, but they have been systematically dehumanized,” he said.
Shaheen-Hussain says that dehumanization continued through often-disregarded crimes and medical violence inflicted upon Indigenous children, including fomented smallpox epidemics, avoidable tuberculosis deaths, experimentation and abuse at residential schools, Indian Hospitals, reserves, forced and coerced sterilization, child abduction and disappearances.
“In the book I propose that ‘medical colonialism’ refers to ‘a culture or ideology, rooted in systemic anti-Indigenous racism, that uses medical practices and policies to establish, maintain, and/or advance a genocidal colonial project.’” he said. “Medical colonialism persists to this day because of the pervasive culture of systemic anti-Indigenous racism in the Canadian public health care system, and in capitalist settler society at large.”
The statistics, Shaheen-Hussain says, support his assertions – he notes that infant mortality among Inuit is close to three times higher than among non-Indigenous infants across Canada, and that the mortality rate among First Nations youth between the ages of 10 and 19 is about twice as high as the national average. For Indigenous girls and young women between the ages of 15 and 19, that rate is almost five times higher than average.
Bringing about change
Shaheen-Hussain says federal and provincial governments already have some of the answers when it comes to redressing these imbalances.
“As a minimal first step, provincial and federal governments must implement the recommendations from the reviews, inquiries, and commissions that they themselves created,” Shaheen-Hussain said. “Specific to healthcare, there is the In Plain Sight review conducted by lawyer and former provincial court judge Mary Ellen Turpel-Lafond, mandated by British Columbia’s Minister of Health to address Indigenous-specific racism and discrimination in 2020. Before that, there were several voluminous and comprehensive reports that included health- and healthcare-related recommendations: the Royal Commission on Aboriginal Peoples, the Truth and Reconciliation Commission of Canada, the National Inquiry into Missing and Murdered Indigenous Women and Girls, and the Public Inquiry Commission on relations between Indigenous Peoples and Certain Public Services in Quebec.”
Shaheen-Hussain also points to the coroner’s report on the much-publicized 2020 death of Joyce Echaquan, an Atikamekw woman who was admitted to a hospital in the Lanaudière community of St-Charles-Borromée with stomach pains. She was given morphine to ease her pain, despite her concerns that she would have an adverse reaction to the painkiller. Later, while still in pain, she livestreamed two hospital employees insulting her in unflattering terms. She died later that day, and the video she shot went viral.
“More specific to the province of Quebec, the government must not only recognize the existence of systemic racism within our institutions, but it must commit to its elimination, as recommended by coroner Géhane Kamel following her public inquiry into Joyce Echaquan’s preventable death,” Shaheen-Hussain said. “Beyond policies and legislation, I would argue that educators and healthcare providers must take leadership from Indigenous communities to support self-determination and resurgence movements, which are intrinsically tied to autonomy, sovereignty and land. This implies solidarity from those of us who are not Indigenous.”