“The problem is far from settled,” said Manawan Chief Paul-Émile Ottawa and Atikamekw Nation Grand Chief Constant Awashish, stressing that systemic racism must be acknowledged in Quebec to move forward. “It’s a pretty big statement he made,” Awashish said. Legault’s words, he said, shocked and angered many. The Atikamekw woman from Manawan and mother of seven died at a hospital in Joliette, Que in late September 2020 after she posted a live stream on Facebook showing staff insulting and swearing at her. A Quebec coroner later ruled that her death was not of natural causes, but “accidental” because she did not receive the care she was entitled to. In the wake of Echaquan’s death, the Atikamekw Council of Manawan and the Atikamekw Nation Council (CNA) submitted a brief to both the provincial and federal governments outlining their demands for the Joyce Authority. Its aim is to guarantee all indigenous peoples the right to fair access to health and social services in the province. Manawan and CNA have continuously called for the principle to be implemented and systemic racism recognized since then. Constant Awashish, Grand Chief of the Atikamekw Nation, said the creation of Joyce’s Principle was an effort to bring about positive change. (Ivanoh Demers/Radio-Canada) Chased by the opposition during the debate, Legault signaled that there is no systemic racism in Quebec, stressing that it has already committed $200 million to improve the way health care and other public services are provided to indigenous people. He accused the opposition of engaging in “argument”. In October 2021, Coroner Géhane Kamel made a number of recommendations in her inquest into Echaquan’s death. The first was for the province to acknowledge the existence of systemic racism in its institutions. The prime minister has since refused to do so. Chief Sipi Flamand said that as long as the government refuses to acknowledge the existence of systemic racism, communities will struggle to build trust in the public health care system. To justify his remarks, François Legault invited his opponents to go to Joliet Hospital. In June 2021, Guy Niquay, an Atikamekw from Manawan, became the assistant chief executive of the regional health authority that oversees the hospital where Echaquan died. Since then, all staff working with CISSS de Lanaudière have been required to take part in 11 hours of cultural sensitivity training. But not everyone has followed it yet, according to an announcement by the regional health authority. Only 71 percent of staff participated in the second phase. The implementation of the third component started this September. “Obviously, for [Legault], putting an Atikamekw in senior management, creating cultural safety courses, the matter is settled. I think we live in two different worlds,” Awashish said. The great chief said that members of his nation continue to report incidents of racism. Between April 2021 and June 2022, nine complaints about the quality of services were made to the CISSS de Lanaudière complaints commissioner – four of which were based on discrimination and racism. This is a significant increase. between April 2015 and May 2021, it received 11 complaints. The health authority told Radio-Canada it believes the increase can be explained by greater confidence in the complaints office thanks to Niquay’s training and presence.
Echaquan’s family was shocked
Echaquan’s family were surprised to hear the prime minister imply that he had spoken to them to discuss her death. “In Joliette, [the problem] is resolved. I just talked to her husband. It’s settled,” Legault said during the debate. Patrick Martin-Ménard, the family’s lawyer, has since said that is not true. Echaquan’s family were surprised to hear the prime minister imply that he had spoken to them to discuss her death. Her husband Carol Dubé said they only met by chance after asking for a meeting for two years. (Ivanoh Demers/Radio-Canada) Carol Dubé, Echaquan’s wife, met the prime minister, but only by chance during the Pope’s visit to the Sainte-Anne-de-Beaupré shrine. The family had wanted to meet Legault for two years, Martin-Ménard said. The prime minister washing his hands of Echequan’s death through magical thinking reflects an old mindset and reproduces the dynamics that led to her death in the first place, the lawyer said.
recommendations
Coroner Géhane Kamel made eight recommendations to the regional health authority. According to its spokesperson, Pascale Lamy, most of these recommendations have already been implemented. An agreement with the Masko-Siwin Health Center in Manawan is currently being reviewed, which will continue the partnership between the two communities, Lamy said. Chief Sipi Flamand acknowledged that steps had been taken, but said more recommendations needed to be implemented, such as adopting the Joyce Principle. The coroner’s recommendations to the Lanaudière health authority include:
Ensuring the effective integration of Manawan’s liaison officer into the institution, especially through his participation in the care teams; Collaboration between the Manawan Clinic and the Lanaudière Hospital Center Emergency Department to ensure the transmission of medical information in real time. Ensuring that notes in medical records reflect the reality of a patient’s care. Review of nurse and patient attendant ratios based on provincially recognized standards. Implement an emergency management model based on the guiding principles of the province’s Emergency Management Guide. Maintain periodic training on the institution’s code of ethics, restraint measures, patient follow-up after a fall, and record keeping. Rapid organization of training and activities for the integration of indigenous culture, in consultation with the Manawan community. Improve the nursing/nursing assistant model and make sure everyone clearly understands their role.
Speaking in the National Assembly, Quebec Premier Francois Legault apologized to the family of Joyce Etchaquan in October 2020. (Jacques Boissinot/The Canadian Press) The medical examiner also asked the College of Physicians to review the quality of care provided to Echaquan by the physician and gastroenterologist at Joliette Hospital. The College told Radio-Canada’s Espaces Autochtones that its investigations are confidential, meaning it can neither confirm nor deny an investigation against a specific doctor. In addition to recognizing systemic racism in May 2021, the college has “taken several concrete actions to combat systemic racism in health care,” spokeswoman Leslie Labranche wrote in a statement. Quebec’s nursing mandate recognized the existence of systemic racism in July 2021. The Ordre des infirmières et infirmiers du Québec (OIIQ) also suspended the nurse who admitted making offensive comments to Echaquan for one year. It also does not say whether investigations have been conducted into other nurses who provided care to Joyce Echaquan, as they would be confidential. Awashish applauded the approach taken so far by the college and the nursing department. “They embraced the Joyce Principle, they recognized the systemic racism that indigenous peoples have experienced for decades,” he said. “I think it’s already showing more openness from the government.”
