Opinion

Improving indigenous health starts with reconciliation: Anna Banerji

'From what I’ve seen over the past 20 years as a physician, researcher and health advocate, indigenous people have suffered human rights abuses on a daily basis,' says Dr. Anna Banerji. And that has a huge impact on indigenous health.

'Daily attack on basic needs such of food, water, housing, safety has great impact on indigenous health.'

Many indigenous communities in Canada lack clean water and adequate housing. The Aggark kids live in a two-bedroom house with a total of 12 people. (Vincent Desrosiers/CBC)

The Universal Declaration of Human Rights states: "Everyone has the right to a standard of living adequate for the health of himself and of his family, including food, clothing, housing and medical care and necessary social services”

I have realized that in Canada these rights are upheld only if you are non-indigenous in Canada.

From what I’ve seen over the past 20 years as a physician, researcher and health advocate, indigenous people have suffered human rights abuses on a daily basis. Today, in our land of plenty, indigenous children suffer malnutrition and many are actually starving. Hundreds of indigenous communities lack clean water and adequate housing. Indigenous children receive less funding for education per child than their non-indigenous counterparts. Many indigenous women and girls don’t live in safety.

This daily attack on the basic needs such of food, water, housing, safety (the determinants of health) has a great impact on indigenous health.

I’ve also witnessed bias and blatant discrimination by health providers against Indgienous PeoplesRecently, our two-tiered health system allowed a First Nations man to die while waiting 34 hours in an emergency department without being seen.

My own research has demonstrated that rural Inuit infants have the highest rates of admission for lung infections in the world due to the RSV virus – but still don’t receive the RSV antibody, something given to their southern counterparts with lower rates of infection and less severe disease. To add insult to injury, my research shows it would be cheaper to prevent than to treat this disease in many rural communities.  

Where did these discrepancies start?

So much of the health issues that face Indgienous Peoples are rooted in the history of colonization, which continues today. They are rooted in the history of Indgienous Peoples' relationship with Canada through treaties that were to be based in indigenous values such as sharing and reciprocity -- but these treaties have been met with betrayal.

For some the truth is uncomfortable, for many just inconvenient.- Anna Banerji

Discriminatory policies, such as the Indian Act, still form the basis of a unilateral relationship with many First Nations peoples. Residential schools inflicted physical and sexual abuse, neglect, and abduction of infants at birth by the government and the clergy.

What would be the impact of having our children taken away, beaten if they spoke English or practised traditional customs (for example, Christianity or other religions), starved and physically and sexually abused? Why did Canadians accept these discriminatory practices?

For some the truth is uncomfortable, for many just inconvenient. Others are in complete denial. I believe that most Canadians just don’t know the truth.

Change in the air

A few months ago I had the privilege of chairing the Indigenous Health Conference: Challenging Health Inequities through the University of Toronto. It was the first national conference geared towards health care providers to help them become more culturally competent providers.

Through the voices of Indgienous Peoples, the conference created dialogue between indigenous and non-indigenous participants. Doctors and nurses were listening, not only to medical topics, but about history and politics and human rights impacting health. They came to hear the truth. We were sold out.

On Nov. 20, 2014, in response to a panel lead by Dr. Michael Dan, Bernie Farber and former AFN national chief Phil Fontaine, approximately 450 conference participants unanimously made a declaration in the belief “that a genocide took place against First Nations peoples by the Canadian government." The Toronto Declaration 2014.

The medical profession is starting to listen.

Change will happen. Young Indgienous Peoples in ever increasing numbers are becoming highly educated. Many are passionate about justice and equity and restitution and will be a formidable force as seen by the Idle No More movement.

Canadians are now starting to hear the truth, and are starting to believe that reconciliation and restitution are required to right the historical injustice. A growing number of Canadians are disturbed by the inequalities and want a Canada that is fair and equitable for all.

There is the growing recognition that governments need to be accountable to the people, and we have power to influence political decisions. Change will come, because it is the right thing to do.

No health without reconciliation

I have learned that for many Indgienous Peoples there can be no health without healing, and no healing without reconciliation and restitution.  Solutions may come from within indigenous communities, but the oppression from without needs to stop.

We need to use a human rights framework to ensure that all Canadians have equitable access to basic needs. A growing number of Canadians believe that food and water insecurity in this country is unacceptable, as are the double standards in our health and education systems.

We must negotiate with and for indigenous populations in a fair manner as equal partners and fundamentally change our relationship with Indgienous Peoples for the better.  This is in the interest of all Canadians.

After all health is a human right.

Dr. Anna Banerji is a pediatric infectious, tropical disease specialist and global health specialist. She is the Director of Global and Indigenous Health, for Continuing Professional Development, for the Faculty of Medicine, University of Toronto. Dr. Anna Banerji will take part in a panel discussion, Reconciliation in Canada: The Way Forward, at Massey College in Toronto, Jan 7.