Indigenous Peoples Fear Racism in Hospitals. Joyce Echaquan's Death Made It Worse

“The trust is gone,” said Sipi Flamand, about the feeling that is permeating this week in Manawan, an Atikamekw community after a disturbing video shared on social media showed an Atikamekw woman crying out for help shortly before she died in a Quebec hospital.

Joyce Echaquan, a 37-year-old mother of seven, writhed in pain at the facility in Joliette, Quebec, about 70 kilometres north of Montreal, where she had gone to seek help for stomach pain, as staff called her an idiot, told her that she was only good for sex, and said she was better off dead.

Her death on Monday and the racial slurs she experienced in her last hours have fuelled outrage across Canada, and spurred growing calls for systemic changes to how Indigenous peoples are treated in the province, especially in the health care sector.

“That video is shocking and unreal,” Flamand, vice-chief of the Atikamekw of Manawan council, told VICE News. “I don’t have the words to explain how I feel about it. But that’s what people in the community had deplored for years.”

Indigenous peoples in Manawan and other communities across Quebec have talked about systemic discrimination in provincial institutions for decades. But with no concrete changes in sight, people are becoming increasingly fearful of accessing health care and other services.

“We’ve already had an increase of people calling us, saying that they don’t feel safe, that they’re not well, or their parents are at the hospital and they’re worried for them,” said Jennifer Brazeau, executive director of the Native Friendship Centre of Lanaudiere in Joliette.

The drive from Manawan to Joliette takes about two hours along a dangerous logging road that is used by large trucks, Brazeau said, and that journey, combined with the anxiety many people feel about seeking care, means Atikamekw community members go for treatment in the city only when they must.

That “causes people to have maybe a small medical issue turn into a large medical issue—making it something life-threatening—before they finally end up going to get treatment, so it’s like a snowball effect,” she told VICE News.

“I’ve heard dozens of stories of people having to live through abuse while they’re seeking treatment.”

Echaquan herself was uneasy in hospitals, her cousin Karine Echaquan told VICE News via Facebook Messenger.

Karine, who works as an interpreter, said Joyce had been in and out of hospitals since 2014 and did not speak and understand French very well. She would record the doctor and ask her to translate what was said, Karine said.

“She would often tell me what she was going through,” her cousin said. “She was misunderstood and very wary of hospitals.”

During a news conference last week, Echaquan’s partner Carol Dube also told reporters that Indigenous people are discriminated against in Quebec and that Joyce died because “systemic racism contaminated Joliette hospital.”

The regional health agency for the Lanaudiere region did not immediately respond to VICE News’ request for comment Tuesday.

But in a statement on September 28, the agency said the type of “unacceptable” comments heard in Echaquan's video are not tolerated among members of its personnel. “It is essential to continue and put in place concrete action in collaboration with the Atikamekw community,” it said.

Abuse allegations in health care in Joliette go back years, however. The chief of Manawan, Paul-Emile Ottawa, told Radio-Canada last week that about 50 complaints have been made against the hospital, but they were rejected.

Enquete, Radio-Canada’s investigative news show, reported in 2017 that Atikamekw women who gave birth at a former hospital in the city in the 1970s were told their children had died. But parents were never shown any death certificates, and a deep sense of mistrust fuelled speculation that their children were taken away. It turns out some were placed in foster homes without their parents’ knowledge or consent.

Atikamekw community members also told a commission investigating systemic discrimination against Indigenous people in Quebec about their mistreatment at the Joliette hospital, and how they had to go elsewhere to get proper care.

During a Viens Commission hearing in September 2018, Alland Flamand from Manawan said he felt “abandoned by the state” after he had to go to back and forth to Joliette hospital five times in 2017 to try to get treatment for severe back pain.

He said that staff at the hospital kept prescribing him painkillers and sending him home, even though his pain was worsening. On his fourth visit to the hospital, he said he overheard staff saying he was “only there to get narcotics.”

Flamand finally went to a hospital in Trois-Rivieres, about 100 kilometres east of Joliette, where he said doctors ran tests to discover that he had a herniated disc and conducted emergency surgery. “I told them what had happened… They couldn’t believe it, how I was treated at Joliette hospital,” he testified.

In its final report released last year, the Viens Commission found that “prejudice against Indigenous people remains very widespread in interactions between caregivers and patients” in Quebec. It said Indigenous peoples face systemic discrimination in public services across the province.

Genevieve Sioui, the Indigenous community engagement coordinator at Concordia University in Montreal and a member of the Huron-Wendat Nation, said “the history of Joliette hospital is really tainted for the community, tainted by horror stories.”

Sioui, who worked in Joliette for four years, said systemic racism in the city goes beyond health care, however, with some of the most blatant examples in employment and housing. “Families have trouble getting housing,” she said, which forces many to leave the city.

The provincial association of Native Friendship Centres (RCAAQ) surveyed 50 Indigenous people living in Joliette between 2016 and 2018: it found that 69 per cent of respondents said they experienced racism in public institutions there.

“It’s not an isolated incident. This is not a one-off thing,” Brazeau said. “Indigenous people across the country have been decrying their treatment in public institutions that are supposed to be there to help you in a time of need. It shouldn’t take a livestreaming on Facebook for someone to be believed.”

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