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The tragic death of Joyce Echaquan does not tolerate institutional inertia when it comes to access, without discrimination, to health care and social services for Indigenous people. That’s the essential idea behind Joyce’s Principle, a document created by the Council of the Atikamekw Nation and the Atikamekw Council of Manawan, which was delivered to the federal and provincial governments on November 16.

The governing Coalition Avenir Québec, however, appears to have a higher tolerance for institutional inertia after it rejected an attempt by Liberal MNA Gregory Kelley to have the document adopted and implemented by the National Assembly November 24, objecting to the term “systemic racism” in the document.

Echaquan’s death on September 28 at a Joliette hospital was shocking even for those accustomed to the discrimination routinely faced by Indigenous people in public systems. After admitting herself to hospital with stomach pains, the 37-year-old Atikamekw mother of seven filmed hospital staff making racist insults at her shortly before she died.

“She fought until the end, wanting people to know what was going on with her,” said Atikamekw Grand Chief Constant Awashish. “[Joyce’s Principle] was initiated by leaders to come up with this document. We started with a few lines then asked the public for suggestions about what should be in the principle. A lot of people responded.”

Awashish told the Nation the idea is modelled on Jordan’s Principle, the child-first and needs-based commitment to ensure First Nations children receive equitable access to all government services. Joyce’s Principle similarly intends to guarantee Indigenous people have equitable access to health and social services without discrimination.

“It focuses on education and sensitization for government-Indigenous relations so that our rights are respected,” explained Awashish. “With Joyce’s Principle, we talk about the healthcare system, but we could say the same thing about all levels. People have distorted views of First Nations.”

The document begins a statement by Echaquan’s husband, Carol Dubé, expressing his wish that her death didn’t occur in vain and that “no one ever again falls victim to systemic racism.” Acknowledging this last term is integral to the document, despite Premier François Legault’s refusal to admit it exists.

“All the people who communicated with us agree there is systemic racism, but still the government does not recognize it,” asserted Awashish. “It’s recognizing we were the ones colonized with a system put in place against us. That’s what we call systemic racism. That’s what Mr. Legault doesn’t understand.”

Awashish argued political rhetoric regularly paints Indigenous groups as opposed to development and continues to perpetuate stereotypes that have grown over centuries. A solution highlighted in Joyce’s Principle calls for a massive re-education, particularly for healthcare workers.

It demands schools, professional orders and healthcare agencies offer training programs for cultural sensitization and that the Quebec government establish an ombudsperson’s office for Indigenous health and finance awareness campaigns to educate the general public about Indigenous issues. The document also specifically asks Legault to acknowledge systemic racism.

“That’s a form of discrimination talking that way when you’re the premier of the province,” Awashish insisted. “We have to change the whole mentality. Government has its part to do with training and awareness at all levels. We have to make the general population understand if we do well socially, everyone’s going to win.”

Joyce’s Principle demands that all Indigenous people have an equal right to the highest standard of physical and mental health, with a right to traditional medicines and the conservation of their vital medicinal plants, animals and minerals. It says the government must recognize Indigenous rights to autonomy and self-determination in matters of health and social services.

On November 6, Quebec announced $15 million to train healthcare workers in providing better and more culturally safe care for Indigenous people, while compensating liaison officers to accompany Indigenous people through the healthcare system. This cultural safety was a key recommendation of the Viens Commission report, released over a year ago.

“The $15 million is a good start but we’re going to keep working on the government to make sure it’s moving in the right direction,” Awashish stated. “Now what kind of curriculum is going to be taught to the non-Native staff? I regularly talk with [Indigenous Affairs] Minister Lafrenière and we want to work with him to improve the situation.”

Awashish said this funding is encouraging but he doubts it will be enough to overcome the huge gaps in Indigenous sensitivity at all levels of society. He’s also skeptical of the government’s committee on racism that includes no First Nations.

“We’ll wait a couple of months to see how the government is dealing with First Nations and where it’s trying to go,” explained Awashish. “There’s a lot of questions about how they see us and where they want to go. We’ll give them a chance. Hopefully they’re doing concrete action in good faith.”

With growing distrust of public services among Indigenous people, Awashish reported his community members are afraid to go to hospitals. Since the recent deaths of Echaquan and Atikamekw man Georges Herve Awashish, more people are wondering if racism played a role in the past deaths of family members in hospital.

“We have to keep talking about it, to keep the government on its toes on this matter,” said Awashish. “How many people talk bad about First Nations when we go into a hospital? There are a lot of questions our people are asking. We have to make sure the government ensures our people’s safety.”

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