The legacy of segregated
hospitals haunts Indigenous

On a brisk spring day in 1965, Annie Michael stepped onto an airplane for the first time.

The 10-year-old had tested positive for tuberculosis, the airborne disease that had ravaged her hometown of Niaqunngut, a remote Baffin Island community southeast of Iqaluit. Her southbound flight was the first leg of a days-long journey to the Queen Mary Hospital for Tuberculous Children in Toronto.

While Michael’s stay at the hospital was meant to cure her potentially deadly condition, the experience left damage of another kind.

When she arrived, hospital staff cut Michael’s long, dark hair into a shaggy bob. She met stern nurses who enforced a strict dress code — tunics and crisp, white blouses — and slapped young patients with rulers for punishment. Michael struggled to process the strange sights and sounds of the bustling sanatorium, and was only allowed to speak to her parents by phone once a month, for 10 minutes.

"They wanted us to dress like the white people, eat like the white people. We were savages to them."

Even her name was different: The English-speaking staff called her Annie E7-1261, her government-supplied “Eskimo” identification number.

“They wanted us to dress like the white people, eat like the white people,” Michael, now 63, recalled. “We were savages to them.”

Michael was among thousands of Indigenous people across Canada who endured a similar experience. For decades, Indigenous children and adults were treated at tuberculosis sanatoriums as well as in segregated, government-run “Indian hospitals.”

Some survivors say they experienced psychological and physical abuse and lost the ability to speak their own language. There are even reports that some patients endured medical experiments at the hands of hospital staff.

Researchers who have explored these accounts say the intended purpose was to separate Indigenous people from the broader community, and that much like residential schools, this health care system was built on a combination of government policy and widespread racism. But unlike the school system that has underpinned a conversation about reconciliation and financial compensation, these hospitals remain largely hidden in the shadows of Canadian history and weren’t included in the Indian Residential Schools Settlement Agreement.

CBC spoke to numerous hospital survivors and researchers about this segregated health-care system, as well as activists hoping to broaden the conversation about reconciliation and expose how decades of isolation and mistreatment have harmed First Nations and Inuit communities to this day.

Annie Michael said her year-and-a-half stay at the Queen Mary, thousands of kilometres from her loved ones, left a lasting impact.

“It was hell on earth for me.”

* * *

The Queen Mary Hospital for Tuberculous Children officially opened its doors on June 3, 1913. With two pillars on each side of its main entrance, the stately brick building was the newest addition to a manicured hospital complex in west-end Toronto, alongside the Toronto Hospital for Consumptives, which had been established in 1904.

Initially, provincial tuberculosis sanatoriums focused on treatment of the disease among the general population, not Indigenous communities specifically. But that started to shift as the rise of effective antibiotics lowered infection rates. Sanatoriums across the country slowly emptied, and in many cases, Indigenous patients from remote communities began to fill the spaces vacated by the non-Indigenous population.

The Queen Mary Hospital for Tuberculous Children opened on June 3, 1913, as part of a sanatorium complex in west-end Toronto. (West Park Healthcare Centre archives)

The Queen Mary Hospital for Tuberculous Children opened on June 3, 1913, as part of a sanatorium complex in west-end Toronto. (West Park Healthcare Centre archives)

The Queen Mary Hospital for Tuberculous Children opened on June 3, 1913, as part of a sanatorium complex in west-end Toronto. (West Park Healthcare Centre archives)

The Queen Mary Hospital was no exception. According to hospital archives, Indigenous admissions at the Queen Mary were dropping by the 1960s — from 350 Inuit and First Nations admissions in 1959 to less than 170 by 1962. But eight years before the hospital finally shut down in 1970, a government program meant to curb the prevalence of tuberculosis began bringing in more Inuit patients.

Michael was one of them, and the memories of her stay — which lasted from May 1965 to January 1967 — continue to haunt her a half-century later.

Earlier this month, she visited the former hospital site for the first time in years. The location now houses another health care facility. Walking by a Queen Mary heritage plaque while bundled up in a red parka and a beaver-fur hat, Michael gazed around the snow-covered grounds, her eyes glinting in the sunlight.

“I hated it here,” she said.

Michael said she constantly felt homesick. She wrote regularly to her family, and often cried to her mother during their monthly phone calls. The experience was jarring for a child who hadn’t left her community before. Michael had never seen people of different skin colours. She had also never eaten hospital food — a rotation of bland salads, meat and potatoes — which was nothing like her traditional Inuit diet of mostly whale, caribou and seal.

While some of the nurses helped make the hospital feel more like home, by taking the children on day trips to the zoo, others intimidated their young charges by ignoring them or slapping their hands as punishment, Michael recalled.

“That’s how I learned about white people,” Michael said, laughing for a brief moment. “Being manipulated, dominated by white people.”

She’s not the only former patient who noticed a culture of racism and intimidation. Less than a year after Michael was released from the sanatorium, Teresa Leon, a blond-haired eight-year-old from Toronto, spent three months in the facility.

Leon recalled being the only non-Indigenous child there for most of her short stay. Soon after her arrival, she noticed staff members treated her differently than the Inuit and First Nations children. While the Indigenous kids were given daily needles for tuberculosis treatment, Leon was given pills. When she asked a nurse why, she was told it was because the other children couldn’t be trusted to take their medication.

Leon, who is now 59 and living in Mexico, also witnessed multiple instances of mistreatment, including an uncomfortable tuberculosis test that involved slowly pushing a tube down children's throats and into their lungs. She believes hospital staff allowed student nurses to practice this method on Indigenous patients.

As punishment for uncooperative young patients, Leon recalled, some nurses would tie them face down on a stretcher and shove it up against the railing of a staircase in the middle of the hospital, forcing them to peer down at the ground several floors below.

“It was like torture,” said Leon. “These punishments were really barbaric and bizarre.”

* * *

In recent years, stories of two-tier treatment have bubbled up from former patients of various types of health-care facilities.

The many provincial sanatoriums at times cared for large numbers of Indigenous patients, but there were separate “Indian hospitals” that were developed for a narrower purpose. Church-run hospital facilities catering to Indigenous patients popped up in the 1800s, and government-run facilities opened their doors in the decades that followed. Indian Health Services, which became a branch of the Department of National Health and Welfare established in 1944, founded most of the institutions in the years following the Second World War.

Researchers estimate there were roughly 20 to 30 “Indian hospitals” in Canada, operating on and off until around the 1980s.

Sanatoriums and fully segregated hospitals were a fixture in towns across the country. There was the Whitehorse Indian Hospital in the Yukon; Fort Qu'Appelle Indian Hospital in Saskatchewan; Parc Savard Hospital in Quebec City; the Sanatorium on the Mountain in Hamilton, Ont.; Frobisher Bay Indian Hospital on Baffin Island; and dozens more.

While on the surface the two were distinct, with sanatoriums focusing on tuberculosis and “Indian hospitals” on general health care — from maternity to disease treatment — the same mindset applied, according to historian Maureen Lux.

For more than a decade, the Brock University professor dug through government archives and spoke to Indigenous community members for her 2016 book, Separate Beds: A History of Indian Hospitals in Canada.

During an interview in her St. Catharines, Ont., office, Lux described her understanding of “Indian hospitals.” Underfunded, intentionally overcrowded and often in isolated areas, she believes the facilities were a cheap federal government alternative to treating Indigenous people in community hospitals. She said in some cases, state-of-the-art local hospitals and separate Indigenous-only facilities could be found in the same communities, only reinforcing a two-tier system of care.

A letter sent by Manitoba’s acting superintendent of medical services in the early 1940s highlights her point. Addressed to a staff member at a paper mill in Pine Falls, Man., the letter from Canada’s federal archives notes that residents contributing to the upkeep of the local “white hospital” objected to “Indians being treated in that hospital.”

The point of segregated hospitals was not to help Indigenous populations, Lux explained, but to keep disease-ridden “Indians” away from the rest of society.

* * *

That sense of otherness was evident not only in government policy but in the questionable treatment of Indigenous patients at the hands of hospital staff in facilities across the country.

At the Charles Camsell Indian Hospital in Edmonton, which began admitting patients in 1945, there were instances of forced sterilization, said researcher and documentarian Miranda Jimmy, who interviewed numerous survivors and hospital staff for a documentary released by the Edmonton Heritage Council in 2016.

The largest facility of its kind, the Camsell was the setting for 125 sterilizations of First Nations and Inuit patients from 1971 to 1974 alone, according to government data cited in a 2012 journal article by Karen Stote, a professor at Wilfred Laurier University.

Some survivors and researchers also believe overly aggressive treatments or medical experimentation took place at some hospital sites. Lux said many survivors she spoke to shared stories of major chest surgeries that weren’t being performed on non-Indigenous patients. At the Camsell, she said, one surgeon doing these procedures preferred to use a local anesthetic to a general one.

Surrounded by English-speaking hospital staff for years, Wesley’s Ojibway language faded away.

“Patients were actually conscious while their chests were opened up, their ribs sawn and removed,” Lux said. “This was not a one-off or an unusual occurrence.”

Gerald McIvor says that’s what happened to his brother Michael. The pair grew up in Sandy Bay First Nation in Manitoba, and when Michael was four years old, he was taken more than 200 kilometres south to the Ninette sanatorium for tuberculosis treatment. He didn’t come home for four years.

When he finally returned, Michael McIvor shared stories of having surgery to remove parts of his ribs and one of his lungs, something he believed was a medical experiment. “He had a massive scar on his back,” recalled Gerald McIvor.

Other scars were psychological. Elise Wesley recalled spending three or four years — she isn’t quite sure — in segregated hospitals for tuberculosis treatment. Her time away from home in northern Ontario included a brief stay at a facility in Sioux Lookout, then a longer one in the Fort William Indian Hospital Sanatorium, which opened in 1935 in what is now Thunder Bay, Ont.

Surrounded by English-speaking hospital staff for years, Wesley’s Ojibway language faded away. It was a lonely existence.

“I couldn't see my mom, or any of my family, my brothers and sisters. I could write to them once in a while, but my money was so limited,” she recalled. Every so often, Wesley said, one of the training nurses would give her a stamp so she could write her family a letter.

During Wesley’s time away, her father died in a car accident and her mother remarried. In 1964, when Wesley finally returned to the Naicatchewenin First Nation at the age of 11, her Ojibway was so poor she couldn’t communicate with her remaining family.

In other instances, family members simply never returned. Of the thousands of Inuit who went south for tuberculosis treatment throughout the 1950s and 1960s, many were shuffled between hospitals, often dying without their family’s knowledge, due to poor record keeping. For many families, the final resting places of their loved ones remain a mystery.

Ry Moran heard about these kinds of experiences repeatedly in his conversations with thousands of Indigenous community members during the Truth and Reconciliation Commission.

“There was just an overall lack of dialogue, an overall lack of consent, generally in place with Indigenous health for a very long period of time in this country,” said Moran, who is now director of the National Centre for Truth and Reconciliation, the Manitoba-based organization tasked with sharing the findings gathered by the TRC.

“That’s left many people in this country wondering what exactly happened … to them or their loved ones.”

* * *

In recent years, lingering questions are being coupled with a call for action. Indigenous advocates across the country are now involved in a growing push to gain recognition for the decades-long health-care system many say has had an large impact on the health of Indigenous populations.

In Manitoba, Gerald McIvor is pulling together research and plaintiffs in hopes of filing a class-action lawsuit on behalf of all Indigenous segregated health-care survivors and their families. In northern Ontario, activists are fighting to have the Fort William Indian Hospital Sanatorium added to the residential school settlement agreement, despite an Ontario Superior Court justice ruling earlier this month that the facility doesn’t satisfy the criteria needed.

The concerns are also on the radar of the federal government. In a statement, the office of minister Carolyn Bennett, who oversees Crown-Indigenous Relations and Northern Affairs, said it is “aware of allegations of abuse, a loss of culture and possible medical experimentation at some of these facilities.”

“We are committed to moving forward together past this sad and terrible chapter in our history towards a renewed relationship,” the statement continued.

A working group called Nanilavut — which means “Let’s Find Them” in Inuktitut — is among the government’s efforts. A partnership with Inuit leadership, the initiative is meant to help locate family members who passed away while undergoing medical treatment and create a database of records of those who were sent away for treatment at facilities in the south.

The federal government also hopes to continue increasing First Nations’ control of the health-care system and improve integration with provincial systems, the statement concludes.

Indigenous health expert Yvonne Boyer said that’s not enough. An Ottawa-based lawyer whose aunt spent a decade in a tuberculosis sanatorium in Fort Qu’appelle, Sask., Boyer believes there should be a complete structural overhaul of the health system.

In the interim, she feels there should be immediate changes to ensure there are more Indigenous people in positions of power and training to ensure all health-care providers understand the needs of First Nations, Metis and Inuit communities.

But the hospitals themselves, Boyer said, are just one piece of the puzzle. The bigger issue is the deeply entrenched theory that Indigenous people are “inferior” and incapable of making their own health decisions, a notion Boyer said permeates Canadian legislation and policies to this day.

“It’s no wonder there’s such ill health,” she said.

Indeed, Canadian public health data paints a dire picture. According to federal briefing documents from the Indigenous Services Department, the latest numbers show life expectancy for Indigenous people is 15 years shorter than for other Canadians, while infant mortality and disease rates are significantly higher.

As for tuberculosis, a disease that has been largely eradicated, infection rates for Indigenous populations are worse than those in most other communities. Among Inuit, the tuberculosis rate in 2015 was more than 270 times higher than the rate among Canadian-born non-Indigenous people, a staggering statistic that prompted the Inuit community and federal government to launch a task force aimed at tackling the crisis.

“If rates of disease that are happening in Indigenous communities were happening in white communities, I think it would be seen as a national emergency,” said Ian Mosby, a historian whose research exposing Canada’s nutritional experiments on Indigenous children in residential schools made headlines several years ago.

Martin-Hill believes the problems of the past are still present today.

Mosby said Canada’s “systemic underfunding” of Indigenous services today is on a continuum with the alleged medical experiments and segregated care of the past.

Dawn Martin-Hill, one of the founders of McMaster University’s Indigenous studies program, said structural barriers are tied to the health outcomes among First Nations and Inuit people, while systemic racism has led Indigenous people today to distrust modern, western health care.

She added that researchers are documenting stories of Indigenous patients receiving biased or “substandard” care in the Canadian health-care system — such as stroke patients being left on the floor because hospital staff believe they’re inebriated, and Cree-speaking women in Alberta who say health workers encourage them to have their “tubes cut.”

While tuberculosis sanatoriums, along with most “Indian hospitals,” have long shut their doors, Martin-Hill believes the problems of the past are still present today.

* * *

Annie Michael now lives in Donnacona, a town roughly 40 kilometres west of Quebec City, and occasionally comes to Toronto to visit her sister Raigelee Alorut.

Sitting together at Alorut’s kitchen table on a recent weekday, the sisters sliced muktuk, a traditional Inuit meal of frozen whale skin and blubber, and chatted in a mix of English and Inuktitut, sharing laughs and reminiscing about their family and friends.

Alorut is 53, a decade younger than Michael, and only learned what her sister experienced at an Ontario hospital later in life. Alorut said that their family was torn apart by government policies tied to medical treatment and education. After being diagnosed with tuberculosis, their father was sent to a Hamilton, Ont., sanatorium for five years. One brother, who was born with the disease, stayed with a family down south for nearly a decade. Their other six siblings spent time in residential schools or other institutions.

“We don’t want to be shameful any more talking about it,” Alorut said. “We have to be open and talk about it, and that’s the only way we could move forward into this healing process.”

Michael long kept her story private. She chose to share it now because she believes not enough people know what former patients like her endured. The experience, she said, made her feel alienated and helpless.

But Michael believes she was one of the lucky ones. In the end, she made it back to her family, went on to have children and grandchildren of her own, became a medical interpreter and now, in retirement, paints watercolour scenes of traditional Inuit life.

Yet after a lifetime of other memories, Michael can still remember, vividly, the moment hospital staff at the Queen Mary told her she could finally go home.

“I hugged my doctor. I was the happiest Inuk there, everybody dancing around — I’m going home! I’m going home!” Michael recalled.

“‘Lucky, lucky you,’ they said.”

UPDATED: Two Canadian law firms have filed a class-action lawsuit focusing on 29 "Indian hospitals" across the country. Read more here.

Top photograph: David Donnelly | Editing: Andre Mayer