When you think about healthcare, do you always think of it as a necessity or a basic human right? Has it ever crossed your mind that for some people in Canada, it’s a luxury? A privilege maybe?
If you answered yes to these questions, consider yourself existing in a parallel universe alongside the reality lived by Indigenous individuals in Canada. To individuals residing in Indigenous communities, healthcare - even poor quality healthcare - may seem like a luxury, particularly for the women of the community. Imagine being told your life expectancy is 10 years shorter than an average Canadian (Gouldhawke, 2021). This is the statistic that Indigenous communities are confronted with day after day.
Canadian healthcare is a complex system “divided between provinces, territories, the federally-funded Non-Insured Health Benefits (NIHB) program for First Nations and Inuit, and finally limited Metis programs via Indigenous Services Canada” (Gouldhawke, 2021). This complexity, coupled with the geographic isolation of many Indigenous communities means that accessing care often takes an inordinate amount of time and commitment. The structural inequities embedded in the healthcare that communities receive is made worse by institutional racism that often leads Indigenous people to “strategically avoid public hospitals, when possible, in favor of clinics managed and staffed by Indigenous people” (Gouldhawke, 2021). However, not all healthcare needs can be met in this manner. For example, Indigenous women, particularly those living in rural or remote areas, are far less likely than other women in Canada to be able to access reproductive health services such as contraceptives and abortion, due to the costs associated with traveling to distant healthcare facilities to access those services (Dal Monte, 2022).
One social determinant of health that is particularly salient for Indigenous people in Canada is colonialism and the residential school system. While the Truth and Reconciliation Commission has been active for over a decade, it was not until recently that many Canadians became aware of the depth of the issue and the intergenerational trauma that it has caused. One crucial aspect of beginning to confront the truth of the issue, is to understand that residential schools were a systematic cultural genocide in which children “were made to feel inferior and worthless” due to their Indigenous descent (Robertson, 2018). This led many to be “haunted by this image of themselves for the rest of their lives”. Children were ripped away from their families in an attempt at “trying to civilize” them. For women, this act meant that their traditional roles as life-givers and caretakers in their communities - and the respect and honour that it brought - were also stripped away. By robbing mothers of their children, while simultaneously declaring that single mothers “were unfit to raise their children alone”, the residential schooling system, supported by the Church and the Canadian government, caused widespread mental trauma among Indigenous women (Robertson, 2018). While women were not the only ones deeply affected by the residential school system, men were not exposed to a systematic gendered loss of social status caused by the imposition of a patriarchal Christian social order that devalued women and considered both, women and children as the property of the male head of the household.
Many children experienced horrific sexual and physical abuse while in the residential school system. This abuse, carried out by authority figures such as religious leaders, priests, nuns, was often justified as punishment for bedwetting, speaking their own languages, or even interacting with opposite genders. This led many of these individuals to believe that all sexual relations were due to sin, instilling in them a “fear [of] such intimacy” and resulting in “unstable relationships…in their adulthood” (Robertson, 2018). In addition, while many Indigenous societies used natural methods to end pregnancies prior to colonization, the practice - and other family planning methods - was heavily stigmatized in the religious education imposed on Indigenous people forced to attend residential schools, leaving Indigenous women with less access to family planning methods and supports (Dal Monte, 2022).
When combined with the patriarchal values of the colonialist system, in which Indigenous women are subjected to the notion that they are both “inferior in a male-dominated society” and for their Indigenous parentage, this trauma and the lack of access to traditional social supports and healing is deeply mentally scarring. This helps “to explain why the cycle of abuse began and still continues in many Indigenous communities” (Robertson, 2018). Further supporting this point, a 2009 survey by Statistics Canada showed the severity of the issue, noting that many Indigenous “female victims of crime are relatively young and tend to be highly represented as victims of violence” (Brennan, 2011). The figure displayed below shows how Indigenous women in Canada are overrepresented as the victims of violence.
Figure 1: self-reported violent victimization of females, by Indigenous identity (Brennan for Statistics Canada, 2011)
Acknowledging the legacy of colonialism and the residential school system is crucial to understanding both, the current issues faced by Indigenous women in Canada and what is needed for Indigenous communities to begin to heal from our past. As Canadians, we need to advocate for removing the government’s neoliberal perspective from the forefront to show that this is not a “us” vs. “them” issue. All in all, bettering the mental and physical health of Indigenous communities needs to be seen through an egalitarian, feminist stance. Women of these communities should no longer be made to feel inferior, rather, we need them to have the space to reclaim their prominence in society so that they may lead us into the future and change the narrative.
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Thank you for shining a light and spreading awareness about this important topic.