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Will First Nations’ input fit the bill?

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The Assembly of First Nations Quebec-Labrador (AFNQL) agreed that a decision recognizing the existence of systemic discrimination raises vital concerns. 

The AFNQL put out a press release after the arbitration tribunal’s decision on August 23, just under three weeks before the beginning of the special consultations on Bill 32, “an Act to introduce the cultural safety approach within the health and social services network,” with the first session slated for September 12.

“I think our biggest concern has been the lack of real involvement of First Nations within the development of this plan. I think a lot of what Quebec has decided to do is kind of go on their own to address some of the inequalities that arose from the Viens Commission, but more importantly, from the Joyce Echaquan incident, and of course, the principal that relayed afterwards from that,” said Derek Montour, president of the First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC).

Montour will be among those presenting recommendations during the special consultations on the bill at the Quebec National Assembly. 

If the input of First Nations is not taken into account, he said, the bill will more likely be a surface-level type of attempt at addressing the issue instead of affecting real change.

“Quebec refusing to acknowledge that there is systemic discrimination and outright say it, that’s a concern, because then how truly does the government see that it’s necessary to make systemic and systematic changes within the system that really is discriminatory?”

The press release also denotes the difference between cultural safety and cultural awareness – a distinction identified by the National Institute of Public health of Quebec (NIPHQ) – and Montour believes the bill leans more towards the latter, again, because of the lack of involvement from Indigenous people. 

“The fact remains that working on the recognition of systemic racism, which is currently unresolved, will make it possible to work on the root cause of the problem,” said Marjolaine Étienne, president of Quebec Native Women. 

As an organization that represents the voice of Indigenous women across the province and advocates for their rights, she said it’s important to take into account that the majority of women are reliant on governmental health care services and cited the report revealing the accounts of forced sterilization of Indigenous women across Quebec. 

“I dare hope that our recommendations will be taken into account,” she said. 

“It’s important to take into account the issues and realities of First Nations women in Quebec when it comes to using services in settings such as hospitals.”

Testimonies from Indigenous patients of discriminatory treatment in the healthcare system are far from being isolated cases. Dozens of people came forward with similar experiences after The Eastern Door‘s reporting on the birth experience of Kaniehtisakhe Albany at Anna Laberge Hospital, followed by Heather Snow’s experience in the hospital’s Mental Health Clinic. 

More recently, Katsitsaha:wi McComber-Diabo, who gave birth to her fourth child at Anna Laberge this April, also shared her story at the same hospital. 

In the early hours of the morning, she asked three times to change rooms since the nurses were “very loud, disrespectful, banging around outside my room at all hours of the night,” she said  – and it’s only when she spoke French, the last time she asked, that she noticed a shift in their attitude towards her. “They knew I wasn’t like, you’re going to be pushed around, like, you know, and my wishes are going to be respected while I’m here.”

After settling into the new room and finally resting after a sleepless night, the nurse came to check in on them, but Diabo-McComber asked for a few more hours of rest since the baby had just fallen asleep. 

“And she has the nerves to say to me that, if I’m too tired, then maybe she should take my baby from me,” she said. “That comment really pushed me off the edge… it just felt so culturally insensitive, and say that to me,” she said, citing First Nation women’s experiences of having their newborns confiscated upon birth and ending up in the system. 

Right before leaving the hospital, Kerry Diabo, Diabo-McComber’s husband and father of the newborn, also found himself in an uncomfortable conversation with the doctor who discharged them when she learned that the newborn is Diabo’s ninth child. “She was highly suggesting that we stop having kids,” he said, adding that she suggested Diabo get a vasectomy. 

To that, he responded, “No, not me. I’m building a nation.” The doctor then walked away, Diabo said. 

“It’s just ignorance and disrespect towards Natives,” said Diabo.

Neither Diabo-McComber nor her husband filed a complaint, saying they felt uncomfortable even trying. 

After two weeks, the couple found out, from the callus on the baby’s bone, that his collar bone had broken. But they decided against returning to the hospital. “Their negligence and their disrespect pushed me out the door so fast that I felt like it went undiagnosed or whatever, you know? Because I just felt so uncomfortable being there.”

“The CISSS de la Montérégie-Ouest (CISSSMO) would like to reiterate that any form of discrimination will not be tolerated in our facilities,” said the communications department of the CISSSMO in a statement to The Eastern Door. They went on to cite a handful of programs and initiatives they’re implementing over the past two years to better accommodate Indigenous patients, including a collaboration of CISSSMO with KSCS and KMHC to “tackle challenges and respond to the issues of the community.”

“We will be attentive to the recommendations of Bill 32 and will apply the measures dictated by the government,” they said. 

But so far, interactions with staff in healthcare institutions tainted but discriminatory treatment and remarks seem to be reoccurring. 

A lack of education, awareness, and proper understanding of the history of the land is partly the root cause of the problem according to Montour. “That’s why we get so much racism and discrimination is because ignorance just is part and parcel to the system,” he said. 

Montour characterizes the bill as a “good attempt” on behalf of the government, but still has his reservations. “I just don’t think they’re going far enough and deep enough to actually make concrete changes,” he said. 

Quebec’s stance in terms of cultural safety and cultural responsibility towards Indigenous people goes beyond health care institutions. It involves their input on issues like rights to the land, said Montour, citing that Quebec is an absent partner on the seigneurie land claim happening currently. 

“This is an opportunity that Quebec had. And if they don’t really institute concrete, cultural safety aspects and objectives, then it will take longer to get to a place of eliminating or addressing the systemic discrimination that exists.”

“Government obligations can only be imposed through law. This is why we have proposed a bill that would require the Health and Social Services network to incorporate culturally safe practices in each of its establishments in partnership with neighboring communities and Indigenous organizations. These local partnerships are where we hope to see First Nations and Inuit involvement. I am proud that the government cannot interfere in independent tribunal decision-making, though I very much understand the frustration behind this particular outcome,” said Ian Lafrenière, the minister responsible for relations with the First Nations and the Inuit. 

This article was originally published in print on Friday, September 1, in issue 32.35 of The Eastern Door. It was updated to include the response from Ian Lafrenière, which was received after deadline.

Nanor is a reporter and copy editor with The Eastern Door. She was previously the managing editor and creative director at The Link.

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Nanor is a reporter and copy editor with The Eastern Door. She was previously the managing editor and creative director at The Link.