Quebec doctor asks peers to 'stop dragging our feet' in fight against systemic racism

Dr. Pascale Breault's patients at the health clinic in Manawan, Que., an AtikamekwFirst Nations reserve about 200kilometres north of Montreal, often begged hernot tosend them to the hospital inJoliettefor treatment, "for fear ofnot being understood, of not being heard, of being denigrated."

The family physician shared her experience in a Facebook post this week, as the Atikamekw community mourned the loss of Joyce Echaquan, 37, who died on Sept. 28 at the Centre hospitalierde Lanaudirein Joliette.

Before her death, two days after being admitted to the hospital with stomach pains, the mother of sevenused her phone to record medical staff hurling racial slurs and insults at her. A nurse and an orderly have since been fired, and a number of investigations have been launched.

In an interview with CBC News, Breault, who is white,candidly looked back on herconversations with her patients, realizing she'd often tried to convince themto go to the Joliette hospital, despite their fears.

"At best, I'd tell them, 'I don't have a choice but to send you down to Joliette.' In the worst cases, I was giving them a justification, which was not based on their narrativebut on mine," she said.

Her Facebook statement, which calls on all health-care providers to examine their role in perpetuating systemic racism in Quebecand to "stop dragging our feet," has been signed by 257 Quebec doctors.

"A big part of this comes with self-reflection this is why I wrote the piece," Breaultsaid.

Her colleague at the Manawan pediatric clinic, Jolianne Ottawa, said that over her years working in health care, including at the Joliette hospital, she continued to see discriminatory practicesand tried to bring them to the attention of her peers, without success.

Ottawa, who is currently completing her nursing degree at Laval University,was a nursingintern there in 2003 when a senior nurse told her group of students "to be careful when taking the blood sugar levels of Indians, because they have dirty nails."

It was just one of many racist incidents she said she witnessed and flagged as inappropriate during the following six months thereand during her career as a health-care worker in Manawan.

Ottawa brought those concerns to the Quebec government in 2018through her testimony at the Viens Commission, which was launched toinquire intothe public services received by Quebec's Indigenous people.

"I often said, 'Are you going to wait for a tragedy before doing something'?" Ottawa told CBC.

The tragedy ended uphitting her own family: Her cousin, Carol Dub, isEchaquan's spouse.

"This morning, he told me that he's lost his queen. It just broke me," Ottawa said over the phone.

The Echaquan family has voiced its frustrationwithQuebec Premier Franois Legault for his refusal to acknowledge systemic racismin Quebec, and they withdrew hisinvitation toattendEchaquan's funeral, held Tuesdayin Manawan.

Legault issued a public apologyin the National Assembly. On Thursday, he said he was going to "get involved personally" to fast-track the implementationof the 142recommendations issued in the Viens report, 34 of which are targeted at health and social services.

"We have to be two to negotiate," said Legault. "We have 11 nations: some of them don't want to sit with us, some are asking for too much money it's not easy."

Some health boards have made progress

In Ottawa's view, hearing the executive director of theCISSS de Lanaudire, Daniel Castonguay, sayhe was "shocked" to learn ofsuch racist remarks among his staff shows that the administration of the regional health board has not taken any steps toaddress racism.

"We need to have people from the community sitting on their board of directorsor taking part in their action plan," she said.

Some regional health boards have made more progress on that front, including at the CISSS Cte-Nord, onQuebec's North Shore.

Later this month, the board of directorsof the CISSS Cte-Nord will begin discussions, in collaboration withInnu leaders in the area, to establish priorities for the health services needed in the community, said Dale Walker, aliaison officerfor the region's Indigenouspatients.

"The needs are growing, the population is aging," Walker said.

EightInnuvillages and oneNaskapi community with a total population of nearly 15,000 rely on the hospitals inSept-lesand Baie-Comeau for health care.

The CISSS Cte-Nordhas provided the services of an interpreter for several yearsin Innu, Naskapi and English, in both Sept-les and Baie-Comeau.

That's also the case at the hospital in the city of La Tuque, in the Mauricieregion of Quebec, where an Atikamekw interpreter is on sitefive days a weekto accompany patients from Wemotaci, a First Nations reserve.

Cultural practices integrated

Access to health care in one's mother tongueis crucial, said Mary Coon, a Cree elder who recently retired from the Wemotaci Health Centre as a consultant. It's particularly importantwhen dealing with mental health problems or trauma, she said.

"People go tocentres and can't speak their language," Coon said, making it much more difficult "to deal with the hurt they carry."

She witnessed the gradual introduction of culturally sensitivepractices atthe hospital in La Tuque, 115 kilometres east of Wemotaci.

Women can now bring home their placentas after childbirth to bury them, a traditional Atikamekw custom that honours the child's first home, Coon said.

Over the summer, renovations at the hospitalalso included the construction of a larger family roomto allowAtikamekw families to gather to accompanyelders in palliative care.

The La Tuque and Trois-Rivires hospitals are under the umbrella organization of the CIUSSSde la MauricieCentre-du-Qubec, which hired Jennifer Petiquayas itsliaison officer in December 2018.

Petiquaysaid she helps administratorsadapt policies and ensures the files of Indigenous patients "don't fall through the cracks"when they are followed by both their local health centre andthe larger hospitals.

"The CIUSSS saw this as a priority and made the effort that was needed," Petiquay said.

She also offers cultural sensitivity training to staff within the CIUSSS.

"Ideally every single employee would follow this kind of training, so that's something we'll be thinking about," Petiquay said.

The CISSS de Lanaudirerefused CBC's interview request.

In an e-mailed statement, a spokesperson said Daniel Castonguay has been in contact with Manawan Chief Paul-mile Ottawa. A meeting is set to be held shortly, which will allow an "updated portrait of the next steps to be taken."