Sarah Speizer Reeleder
During the H1N1 crisis in 2009, when leaders of remote First Nations communities in Manitoba requested help from the federal government to ensure the lowest fatalities, they were given body bags. Needless to say, Indigenous nations hoped the federal government’s approach would be much different when it came to confronting COVID-19.
There are shocking health inequalities when comparing Indigenous and non-Indigenous peoples, but these inequalities did not happen by accident. The colonial structure and its attempt to assimilate Indigenous peoples into the dominant Canadian culture is the primary reason for these inequities. Inuit and First Nations people have been forcibly displaced into remote communities and/or reserves that were almost or entirely uninhabitable and lacking in resources. In contrast, traditional lands rich in resources were claimed and taken over by colonial powers. Additionally, in the past, public health practices to deal with Indigenous peoples included sending them off to “Indian Hospitals” far away from their families and communities. Many were never heard from again. Moreover, First Nations people are governed by the Indian Act.
The Indian Act is a Canadian federal law that created and oversees Indian status, bands (similar to municipalities), and reserves. The Indian Act’s conception had as its goal to terminate cultural, social, economic, and political ways of being for First Nations. Under the Indian Act, First Nations people were restricted to their reserves unless they had special permission to leave, were unable to practice their languages and cultures, and gender-based restrictions to status decided who could be considered an “Indian” and who could be pushed off the reserve and forced to live away from family and community members.
The Sixties Scoop and Indian Residential Schools were policies aimed to ensure children were separated from their families and cultures due to the widespread idea that Indigenous peoples were unfit as parents and the government’s willingness to assimilate Indigenous peoples in Canada. The Sixties Scoop was a mass takeover of children so that white families could adopt them in Canada, the United States, or in Europe. Birth certificates were often mysteriously destroyed or amended to list the children’s adoptive parents as their birth parents, making it incredibly difficult for the children to find their way back to their families and communities. Indian Residential Schools involved the Canadian state forcibly abducting children to be re-educated in abusive and toxic schools, where children were abused physically, sexually, and emotionally. Children were unable to acknowledge their heritages, practice their cultures, or speak their languages. Often, when children returned home, they were no longer able to communicate with their families. The last residential school did not close until 1996. Today, Indigenous children are still disproportionately represented in Canada’s child welfare system.
Rampant, systemic discrimination also exists against Indigenous peoples in the social, criminal justice and health care spheres. As mentioned earlier, there is a gendered component to the lived discrimination of Indigenous peoples. Indigenous women are more likely to be killed by male partners than non-Indigenous women and are overrepresented as victims of femicide. While only 3% of the Canadian population is Indigenous and female, they represent 10% of female homicide victims and, in Saskatchewan, almost 59% of missing women and girls are of Indigenous heritage. Unfortunately, police co-ordination in investigating missing and murdered Indigenous women and girls is lacking. According to Statistics Canada, the proportion of developmental vulnerability in early childhood is twice as high among Indigenous children than non-Indigenous children. Furthermore, Indigenous peoples have higher household food insecurity rates and working poverty rates than non-Indigenous people. Suicide and self-inflicted injuries are the leading causes of death for First Nations people under 45 years of age. Suicide rates for Inuit youth are among the highest in the world, representing eleven times the national average.
The intergenerational trauma produced by colonization has adverse effects on Indigenous peoples’ health. Indigenous peoples in Canada have a consistently lower life expectancy and higher rates of unintentional injury mortality. Indigenous peoples also have higher rates of pre-existing health conditions. The prevalence of arthritis, asthma, diabetes, and obesity is higher in Indigenous peoples than in non-Indigenous Canadians. Indigenous peoples are also more likely to be living with a disability or poor oral health. The incidence of active tuberculosis among the Inuit is 300 times the rate among non-Indigenous Canadians. First Nations people living on-reserve have an active tuberculosis incidence rate of 32 times non-Indigenous Canadians. All of these issues can lead to a higher risk of COVID-19.
Due to previous neglect by health authorities during earlier disease outbreaks, including the above-mentioned H1N1 crisis, Indigenous nations have been able to do relatively well during the COVID-19 pandemic compared to the general public because they created their own public health strategies founded in Indigenous ways of being. While the Canadian federal government was slow to act until Indigenous peoples expressed persistent concern about the pandemic, funding was given to Indigenous communities for their directed use. This bypassed the typical colonial structures that usually control Indigenous nations’ funding. Amid this success, some Indigenous communities still experienced hardships, outlined in the following paragraphs.
In Northern Canada, where communities are usually small and isolated, medical infrastructure is minimal, and doctors are only sometimes available, flying south for medical procedures is a common occurrence. According to Statistics Canada, 82% of Inuit living in Northern Canada do not have a family doctor. Moreover, the crowded, poorly ventilated, filled with mould, and rotting housing standard in Northern Canada have already led to tuberculosis and whooping cough outbreaks. These same conditions put communities at a higher risk for COVID-19. In November, a COVID-19 outbreak in Nunavut, one of Canada’s Northern Territories, highlighted the health inequalities present in Canada’s North. For example, none of the communities in Nunavut experiencing COVID-19 had a hospital. While there is a hospital in Iqaluit, the capital of Nunavut, it does not have an intensive care unit, and it is more than 620 miles away from Arviat, the community that had the most infections. Therefore, those in Nunavut who got seriously ill had to be flown to Southern Canada for specialized care, where resources have already been spread thin due to the COVID-19 outbreaks in Canada’s southern provinces that have already filled intensive care units. Hopefully, the highlighting of the inequalities in healthcare infrastructure in Northern Canada will lead to improvements after the pandemic.
When the Liberal Party of Canada won the federal election in 2015, they promised to end all the boil-water orders in First Nations communities within five years. In December 2020, they announced they would not meet that deadline. A Boil-water order is a recommendation to boil tap water for at least one minute before drinking it, using it to wash produce, or using it for brushing teeth. The root causes of boil-water orders stem directly from colonialism. As mentioned earlier, First Nation communities were forced to relocate to areas where resource extraction puts stress on drinking water sources. While 97 boil-water advisories have been lifted since 2016, 59 remain in 41 communities, and numerous advisories have been in place for more than a decade. The lack of access to sufficient, safe, and accessible water in First Nations communities is particularly concerning during the COVID-19 pandemic, where access to clean water and sanitation is essential. Moreover, excessive water boiling leads to mould that deteriorates housing. Neskantaga First Nation in Northern Ontario has had a boil-water advisory in place for 25 years. In September 2019, the community declared a state of emergency after a water pump failed, forcing the evacuation of 255 people. One year later, in October 2020, residents were again forced to evacuate due to an oily sheen in their reservoir. The community had to be flown to Thunder Bay, Ontario, where they stayed in a hotel for two months while also dealing with the hardships that come with living during a pandemic. While the Neskantaga First Nation members have now safely returned home, they should have never had to deal with these issues for so long.
Many Indigenous communities have locked down because of the COVID-19 pandemic by putting up roadblocks or barricades to keep visitors out. However, certain worksites located near Indigenous communities have continued their projects throughout the pandemic. One such project is the Coastal GasLink (LNG) pipeline being built in northwestern British Columbia on unceded and unsurrendered Wet’suwet’en land, where there have already been multiple COVID-19 outbreaks among workers. In an open letter to Dr. Bonnie Henry, British Columbia’s Provincial Health Officer, female chiefs within the five clans of the Wet’suwet’en nation, Gidimt’en, Likhsilyu, Likhts’amisyu, Tsayu, and C’ilhts’ëkhyu, have requested that oil and gas work no longer be classified as an essential service. They argue that, due to colonization, only 2.9 percent of language speakers remain. Furthermore, Indigenous peoples are at increased risk of COVID-19 due to underlying health concerns. Any unnecessary death of a language speaker would have intergenerational effects on maintaining these clans’ languages and cultures. Therefore, the decision to bring transient workers into these communities’ territories places economic gain over community members’ lives. Moreover, with British Columbia’s adoption of the United Nations Declaration on the Rights of Indigenous Peoples, any work on Indigenous land requires free, prior, and informed consent of the Indigenous communities living on the land. The Wet’suwet’en chiefs who signed this letter do not consent to this work taking place. It remains to be seen whether the rights of the Wet’suwet’en nation will be respected.
It must be clearly articulated that the success of Indigenous communities in Canada, when faced by COVID-19, was due to their ability to make their own decisions for their respective nations. Indigenous sovereignty is vital when it comes to developing well-informed healthcare practices.