In our recent coverage of the topic of systemic racism, our team has explored its meaning and implications within the healthcare system, with a particular focus on its impact on Indigenous communities. However, it is important to illustrate how systemic racism manifests in real-world scenarios, providing a microcosmic view of the broader social issue. While there are numerous examples, one recent event in Canada that accurately illustrates systemic racism in action is the case of Joyce Echaquan. This tragic incident has drawn significant attention to the racism experienced by Indigenous peoples in Canada, underscoring how it exacerbates inequalities and perpetuates systemic injustices that contribute to poor health outcomes and even death within Indigenous communities (Browne et al. 223).

On September 26, 2020, Joyce Echaquan, a 37-year-old Atikamekw woman and mother of seven, was admitted to the emergency department of the Centre hospitalier de Lanaudière in Joliette, Quebec, for severe stomach pain (Akoodie 2; Shaheen-Hussain et al. 1763). Distrusting medical staff and not fluent in French, Echaquan frequently recorded Facebook Live videos during her hospital visits, relying on her cousin to translate (Kestler-D’Amours). On September 28, she used the platform to share her distress with her family about the treatment she was receiving from hospital staff (Shaheen-Hussain et al. 1763). During the live video, Echaquan was subjected to degrading stereotypes, including racist, sexist, and violent remarks from healthcare workers (Akoodie 2; Shaheen-Hussain et al. 1763). Tragically, after being administered powerful sedatives without proper supervision and enduring potentially harmful maneuvers, such as supine restraint performed without supervision for 40 minutes, she died from pulmonary edema caused by cardiogenic shock (Kamel 20).

Echaquan’s experience is, unfortunately, not unique among Indigenous people in Canada (Shaheen-Hussain et al. 1763). Her case exemplifies the systemic racism and prejudice that many Indigenous individuals face within the Canadian healthcare system. The discrimination that she endured was undoubtedly a contributing factor to her death, which could have been avoided (Kamel 20). This tragic outcome stems from systemic discrimination and racist practices rooted in stereotypes, societal misconceptions, and the lack of cultural competence among healthcare workers (Wylie and McConkey 40). Racial biases against Indigenous peoples play a significant role in shaping healthcare providers' interactions with their patients. In fact, many providers often blame Indigenous individuals for their health conditions, largely due to their inadequate training that fails to acknowledge the social determinants of health or the generational effects of colonization and its major influence on the current health and well-being of Indigenous peoples  (Wylie and McConkey 42). Indeed, healthcare institutions in Canada are founded on racial discrimination, designed primarily to cater to white populations while neglecting the needs of Indigenous peoples through discrimination, biased treatment, barriers to access, underfunding of healthcare services, and cultural insensitivity (Wylie and McConkey 42). Consequently, healthcare workers are ill-equipped to provide adequate or culturally safe care for Indigenous patients as they lack an understanding of their unique needs and challenges.

Works Cited

Akoodie, A. “Urban Indigenous Forum: Addressing Systemic Racism in hHealthcare.” National Association of Friendship Centres, 2021, pp. 1–25. 20.500.12592/wdvcxg.

Browne, Annette J., et al. “Addressing Anti-Indigenous Racism in Canadian Health Systems: Multi-tiered Approaches Are Required.” Canadian Journal of Public Health, vol. 113, no. 2, 2022, pp. 222–226. https://doi.org/10.17269/s41997-021-00598-1.

Kamel, G. “Investigation Report: Law on the Investigation of the Causes and Circumstances of Death for the Protection of Human Life Concerning the Death of Joyce Echaquan.” Government of Quebec, 2020, pp. 1–65. https://www.coroner.gouv.qc.ca/fileadmin/Enquetes_publiques/2020-06375-40_002__1__sans_logo_anglais.pdf.

Kestler-D’Amours, J. “Indigenous Peoples Fear Racism in Hospitals. Joyce Echaquan’s Death Made It Worse.” Vice, Oct. 6 2020, https://www.vice.com/en/article/indigenous-peoples-fear-racism-in-hospitals-joyce-echaquans-death-made-it-worse/

Shaheen-Hussain, Samir, Alisa Lombard, and Suzy Basile. “Confronting Medical Colonialism and Obstetric Violence in Canada.” The Lancet, vol. 401, no. 10390, 2023, pp. 1763–1765. ProQuest, https://doi.org/10.1016/S0140-6736(23)01007-3.

Wylie, L., and McConkey, S. “Insiders’ Insight: Discrimination Against Indigenous Peoples Through the Eyes of Health Care Professionals.” Journal of Racial and Ethnic Health Disparities, vol. 6, no. 1, May 2019, pp. 37–45. https://doi.org/10.1007/s40615-018-0495-9.