On Jan. 15, 2023, Justin Flett arrived at the emergency room at St. Anthony’s Hospital, in the Pas, Manitoba.
According to Flett’s statement of claim, submitted to the Court of King’s Bench of Manitoba in December and as reported by CBC News and APTN, he told the triage nurse he was experiencing distressing abdominal pain.
Flett was assigned a triage score of five, which is intended for non-urgent low-priority cases. The statement of claim alleges that the physician who finally saw Flett insinuated that he was hungover, saying something to the effect of: “I don’t know what to tell you, we don’t treat you here for hangovers.”. Flett was not given diagnostic tests, imaging, a physical examination or pain medication.
In a statement made through his lawyer, Flett said, “I knew that there was something seriously wrong with me and this doctor didn’t seem to want to take me seriously or help me. In that moment, I just felt worthless.”
Flett is a father of six, a building contractor, a resident of Winnipeg and a citizen of Tataskweyak First Nation.
Flett’s statement of claim says he endured an 11-hour bus trip to Winnipeg to seek the care he needed while in severe pain and without other healthcare alternatives.
Once in Winnipeg, Flett called 911 and requested an ambulance. He was instructed by the operator to take a taxi to Seven Oaks Hospital. There he was triaged as a priority but still told to wait.
He finally underwent surgery for acute appendicitis more than 30 hours after he first sought care. The surgery left Flett with complications.
Flett is suing the Winnipeg and Northern Regional health authorities as well as an ER doctor, accusing them of racism and failing to provide timely care.
As scholars of Indigenous and settler colonial history, we see Flett’s story within an enduring pattern of anti-Indigenous medical racism.
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A pattern of anti-Indigenous medical racism
Brian Sinclair is not here to personally tell his version of what happened in the 34 hours he spent in September 2008 in the emergency room of a major Winnipeg hospital.
Sinclair, a middle-aged Anishinaabe man, died from what is normally an easily treated infection. In our 2018 book, Structures of Indifference: An Indigenous Life and Death in a Canadian City, we show how Sinclair’s tragic and unnecessary death reveals some painful truths about the ongoing history of settler colonialism, and how its legacies continue to devalue Indigenous life.
Sinclair’s death and Flett’s accusations can only be understood within a history of settler colonialism and segregated medical care that is exemplified by the “Indian hospitals” that ran from the 1920s to the 1980s. They must also be understood in context of a society that blames Indigenous people for their own deaths.
Sinclair was assumed to be drunk by medical staff and did not receive timely or adequate care, while Flett accuses medical authorities in Manitoba of the same treatment.
These types of experiences are not particular to Manitoba, but are mirrored by incidents of medical racism across Canada.
Tania Dick, Dzawada̱ʼenux̱w registered nurse and current Indigenous Nursing Lead at the University of British Columbia, explained to CBC’s The Current in 2018 that many Indigenous families have their own “Brian Sinclair story.”
This includes the family of Joyce Echaquan. Echaquan was a 34-year-old Atikamew mother of six, who recorded hospital staff hurling racial slurs at her while withholding medical treatment causing her death in a hospital north of Montréal in September 2020.
Inadequate treatment
Both Echequan’s and Sinclair’s families and communities made sure that their deaths did not go unnoticed.
In Sinclair’s case, an inquest and a number of reports resulted in significant changes to the way that patients are triaged and managed.
Echaquan’s experience led to an inquest and the development of Joyce’s Principle, which aims to “guarantee to all Indigenous people the right of equitable access, without any discrimination, to all social and health services.”
These cases have helped fuel a growing awareness about anti-Indigenous medical racism, including among organizations of medical professionals.
Apologies and pledges
Two years ago, the College of Physicians and Surgeons of Manitoba (CPSM) apologized and accepted responsibility for failing to fairly treat Indigenous patients and they pledged to take action against anti-Indigenous racism.
And last year, the Canadian Medical Association (CMA) also acknowledged the racism and discrimination that Indigenous patients and health care providers face. They apologized and pledged to “act against anti-Indigenous racism in health care.”
When we discuss these stories and the apologies in our classrooms we find our students know it is time to think beyond quick fixes and surface remedies. Rather, we need to address racism and colonialism as powerful determinants of health.
The inquests, reports and apologies appear to have fallen short. Flett’s lawsuit claims that his treatment violated Sections 7 and 15 of the Canadian Charter of Rights and Freedoms. It seeks damages under Section 24.1, which says that those whose rights or freedoms have been violated can seek remedies from the courts.
It is a good time for us all to think about the ongoing costs of anti-Indigenous racism in Canada’s past and present.
