Structures of Indifference: An Indigenous Life and Death in a Canadian City

McCallum, M.J.L., & Perry, A. (2018). Structures of Indifference: An Indigenous Life and Death in a Canadian City. Winnipeg: University of Manitoba Press. 

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Book Overview: 

While Canada is praised worldwide for its focus on multiculturalism and our success in sustaining and progressing our society and economy towards inclusivity and equality, one group of people are consistently ignored within political, economic, and socio discussions -- Indigenous communities. In Structures of Indifference: An Indigenous Life and Death in a Canadian City by Adele Perry and Mary Jane Logan McCallum, the case of Brian Sinclair is used as a symbol of the mistreatment Indigenous people face in the Canadian system, with the lack of medical services resulting in Sinclair’s eventual death in a hospital due to neglect (Perry & McCallum, 2018). As we examine the consequences of decades of governmental oversight and lack of resources in indigenous communities, the history of the struggle between Indigenous people and colonial settlers point to deeply-rooted problems that allow for these unprotected citizens to fall through the ever-widening gap in the Canadian system. Unfortunately, Sinclair’s passing did not mitigate these issues in Canada since racial discrimination and social isolation towards Indigenous peoples still occurs. However, it did help bring this problem to light. Sinclair was sadly subject to poor policies and procedures of processing patients in the ER, but he was ignored and this cannot be over sighted (Perry & McCallum, 2018). 

The book, fortunately, highlighted the beacon of hope that is “Jordan’s Principle”, which is a child prioritizing and needs-based approach used in Canada to guarantee that Indigenous children living on and off-reserve will receive equal access to government-funded social and health services (Perry & McCallum, 2018). This optimistic approach was sadly created after the death of a five-year-old boy in a Winnipeg hospital, which was a key focal point for Perry and McCallum to address (Perry & McCallum, 2018). The little boy, Jordan, alas had to deal with hardships at such a young age, including dealing with a rare muscular disorder, but also never residing in a home with his family (Perry & McCallum, 2018). This misfortune was a result of poor government service delivery since the federal and provincial governments could not reach an agreement on how to deliver proper home care to Jordan (Perry & McCallum, 2018). Certainly, “Jordan’s Principle” has helped to alleviate the unfairness in the healthcare system towards Indigenous communities (Perry & McCallum, 2018), but the novel also illustrated that there is still much more that needs to be done to solve the problems in this population in Canada.

About the Authors:

 Image Source: https://www.uwinnipeg.ca/indigenous/

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Mary Jane Logan McCallum is an exceptional historian with great ambition to unfold the stories of Aboriginal women. Her work focuses on how Indigenous Peoples in the latter twentieth Century have navigated certain social geographies including health, education, and labour. As a member of the Munsee Delaware Nation and an associate professor in the Department of History at the University of Winnipeg, she provides eloquent explanatory narratives about the lives of Indigenous Peoples in Canada and has published several scholarly books and articles contributing to the field of modern Aboriginal history. Her first book entitled “Indigenous Women, Work and History: 1940-1980” (2014), investigates the challenges that Indigenous women face in the workforce while disclosing colonial discourses that are embedded in provincial education and placement programs. Her current research project includes “Indigenous History of Tuberculosis in Manitoba 1930-1980,” which is a CIHR-funded project and where she is examining the history of tuberculosis in Manitoba regarding Indigenous communities and how it has been managed. In her work, Mary McCallum not only unveils and recognizes the impact of colonialism today in Canada but also celebrates the cultures, traditions, languages, and resilience of Indigenous communities. 

The University of Winnipeg. Mary Jane McCallum. Retrieved from 
                http://www.uwinnipeg.ca/history/faculty-staff/mary-jane-mccallum.html

     

Image Source: https://aptnnews.ca/2019/01/30/frequent-short-term-water-problems-new-norm-for-many-

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Adele Perry is a Canadian historian specializing in the history of migration, gender, and colonialism in Western Canada during the nineteenth and twentieth Centuries and has been a Distinguished Professor of History at the University of Manitoba. Notably, she is an outstanding researcher having held a Tier I Canada Research Chair from 2003 to 2014, being Chair of the Canadian Committee on Women’s History, and the past President of the Canadian Historical Association. Her knowledge and expertise in the discipline of Social History is unparalleled which has provided for an in-depth and critical analysis of Brian Sinclair’s story. She has made important contributions to the field by publishing major works of scholarship including “On the Edge of Empire: Gender, Race, and the Making of British Columbia, 1849-1871 (2001), and Colonial Relations: The Douglas-Connolly Family and the Nineteenth-Century Imperial World (2015). Her current work focuses on the impact settler colonialism has had on the provision of water by Winnipeg's municipality to the community, entitled “Aqueduct: Colonialism, Resources and the Histories We Remember” (2016). As a scholar and researcher, Adele Perry has played a crucial role in altering the national narrative of colonization by examining it from Indigenous perspectives as well as helping to elucidate how overlapping categories of identity impact individuals and institutions. 

The University of Manitoba. Adele Perry. Retrieved from 
                  http://umanitoba.ca/faculties/arts/departments/history/members/perry.html

Canadian Historical Association. Executive, Council and Committees of the CHA. Retrieved 

          from https://cha-shc.ca/english/about-the-cha/executive-and-council-members.html

Reading Guide Questions:

Questions Answered by: Andrew Miller (AM), Daniela Veliz (DV), Rachel Wood (RW), and Stephanie Tai (ST)

1) What are some policies the Province of Manitoba and/or the City of Winnipeg implemented that led to the disenfranchisement in treatment that Indigenous Peoples experienced?

DV: The Manitoba Liquor Act which was passed in 1928 inhibited permits to be issued to Indigenous Peoples and restricted their access to spaces where alcoholic beverages were sold. This was an explicit type of formal segregation which facilitated the emergence of specific discourses to be made about Indigenous people in relation to the consumption of substances. Additionally, the Intoxicated Persons Detention Act which allows police to detain an individual without criminal charges, enables prejudices to be formed against specific members of society, for them to be criminalized and be denied health services as they are deemed to “just be intoxicated.” For instance, this tenacious assumption about Indigenous people which has clearly been woven into policies (as the ones mentioned above), can justify the misrecognition of patients of not being in need of urgent care, which is altogether racist and unwarranted. In the case of Brian Sinclair, he was repeatedly misrecognized as intoxicated when that was not true, he had a serious medical problem that needed to be attended to (Perry & McCallum, 2018). Policies further legitimate and perpetuate particular discourses which are important to acknowledge as it influences how Indigenous people are treated and are inhibited from accessing institutional services.

2) If the First Nations population had similar access to hospitals and treatment, do you think the case of Brian Sinclair would have occurred? Do you think equal access would mean equal treatment? Why or why not?

ST: Yes, within the hierarchy of governmental distribution of resources, there is still a smaller, community-level indifference that would cause similar if not the same situation happening to areas of less affluence. Indigenous areas already face major uncertainties when accessing resources that the country promised all citizens, but the equalization of this distribution remains questionable to those who do not have enough of a voice in parliament. This idea that with the equalization of access to these governmental resources would result in a more balanced healthcare system is ideological when considering the already lacking in the funding of programs and systems in place, with many already struggling to stay afloat within a barrage of funding cuts and reductions in personnel, it will be even harder to establish brand new resources to distribute to other parts of the country that see a significantly smaller population, in turn also restriction the quality of resources that these regions will receive. 

3) As a social policy analyst, what changes would you make today in order to improve how accessible institutional services are for Indigenous communities across Canada?

AM: I believe that if the First Nations population had equal access to treatment as regular Canadians, I still believe the case of Brian Sinclair would have occurred. The paradigm that Indigenous populations are understood as has a root of systemic prejudice. Historically they are viewed in a way where their struggles are not highlighted and atrocities are overshadowed. Additionally, the structure of the city of Winnipeg and the hospital perpetuate colonial ideologies, in hidden ways such as the street names. I believe changing social policy can only make small changes in the way indigenous people are treated in the healthcare system. Social policy is only as powerful as its interpretation and with racist historical ideology that has roots in individual minds, I believe the quality of care would still be second hand to those of white Canadians.

4) While reading, did you find a change in the narrative in the description of Indigenous communities’ experience in Winnipeg? And if so, does that change how you understand the policy implications that affect them?

RW: In this part of the novel, I felt that it was somewhat similar to other parts of the novel, in particular, the Brian Sinclair section. However, I can see why it could be interpreted as a different narrative than other sections. More specifically, the Indigenous communities in Winnipeg in the present seem to experience similar instances of racism and violence as the Indigenous populations endured in residential schools (Perry & McCallum, 2018). As mentioned in the novel, the child welfare system in Winnipeg is similar to residential schools because of up to ninety percent of children in some sort of care experience similar levels of violence and neglect (Perry & McCallum, 2018). Also, the hospitals seem to exhibit comparable treatment of Indigenous people as colonialism did due to the regulations and neglect these patients encounter. This revelation helped me to better understand the policy implications because I was unfamiliar with the Indigenous communities experiencing harsher conditions in Winnipeg. I would have thought since a majority of the population was Indigenous, the provincial government would prioritize their health and wellbeing more.

5) How has your perspective changed/not changed as a result of reading the novel? Additionally, if you had the opportunity to add/remove something from the book what would It be?

AM: My perspective has slightly changed as a result of reading the book. I am more aware of the bias I have internalized from a child regarding indigenous people. Being more aware of my bias challenges me to accept my limitations on my real knowledge of indigenous people and culture and how it is my personal responsibility to inform myself on this subject. An action step that I will take is that when I begin to think about my initial thoughts around indigenous people, I will question the validity and how I could be potentially wrong with my thinking. Overall this book provides insight on the limitations I have in the subject of indigenous policy in Canada, and it will remain a starting ground for future knowledge.

DV: This book has furthered my understanding on how colonization is perpetuated in the Canadian healthcare system by limiting the quality and access of services to Indigenous Peoples. Canadians praise themselves for having a public healthcare system that provides coverage for healthcare needs, that is inclusive and equal to all who are Canadian. It is easy to be blinded by such narratives, while it is great that a large quantity is publicly funded, it nevertheless denies the discrimination that occurs in its practices towards Indigenous Peoples as informed by this book. This book has helped me gain a better understanding of the structural barriers that Indigenous Peoples face in their daily lives; just for being a visible minority, particularly an Indigenous individual, one is not treated the same as other patients. This book has shown me the importance of being aware of ethnocentric discourses that are entrenched in Canadian policies as they institutionalize discriminatory narratives. Moreover, it has proved that some policies must be amended in order for equal treatment in the healthcare system to be obtained. Although in the conclusion section, TRC’s Call to Action is mentioned regarding how to address the role that healthcare has played in colonialism, it would have been greatly beneficial for the authors to explicitly delineate the specific measures and policies that are necessary to abolish racism and colonialism, in addition to how Indigenous communities that are subject to being treated differently can ensure to have a greater voice.

ST: This book was an introduction for me into the lives of indigenous citizens in our country, and the inequalities that they face even in a modern era that calls for equality for all. The lack of services they have access to should be a concern to not just the government, but private citizens as well who have the power to change their neighborhoods and communities to be more inviting and inclusive of these indigenous individuals. While the subject of food insecurity is popular when talking about the hardships that indigenous people in the North of Canada face, the lack of access to healthcare, Brian Sinclair faced should be of greater importance as one of the major points in our constitution. More should be done and I will now be more vigilant of the Indigenous inequalities in the country when participating in citizenship roles and daily current event monitoring.

RW: From my perspective, I would say the novel, if anything, has helped to further build my understanding of the treatment of the Indigenous communities in Canada. I wouldn’t say my opinion has changed but rather broadened. As a First Nations individual myself, I already had an idea of the negative experiences endured by my culture. I knew that healthcare was always never prioritized for Indigenous communities, but that it is also incredibly difficult to receive equitable healthcare services on reserves and in remote locations, such as Nunavut and Yukon. My perspective was altered somewhat after reading the Winnipeg section of the novel because it provided an enlightening point of view of the tumultuous experiences in Winnipeg within hospitals, prisons, and the child welfare system. I was really surprised to learn that Indigenous communities appear to suffer worse conditions in Winnipeg, where a high proportion of the population is Indigenous than in other provinces. I would have thought their health and wellbeing was more important in provinces that had a higher population of Indigenous people, but it is truly hard to hear that most provinces are similar in this regard. To make the novel more powerful and influential, I would have added a chapter about the cases of the missing Indigenous women in Canada since this is a very controversial and important topic within the Indigenous community. It is crucial to highlight this because it shows another side as to how the Indigenous population is not taken seriously and is neglected since police have not solved many of these cases and no one has found a solution to prevent Indigenous women from going missing.

Complementary Reads:

1. For those interested in the lack of health services for First Peoples on a global scale: All Our Relations: Finding the Path Forward by Tanya Talaga  

Image Source: https://houseofanansi.com/blogs/anansi/2018-cbc-massey-lectures

2. For those interested in failed policies that have perpetuated Indigenous women to be targets of violence: Violence Against Indigenous Women: Literature, Activism, Resistance 

Image Source: https://www.wlupress.wlu.ca/Books/V/Violence-Against-Indigenous-Women

Structures of Indifference Page Written By: Andrew Miller, Daniela Veliz, Rachel Wood, and Stephanie Tai

Overview: Stephanie Tai and Rachel Wood

About the Authors: Daniela Veliz

Reading Guide Questions Written By: Andrew Miller