Where Indigenous people can get health care without feeling afraid

The idea is simple, says Jennifer Brazeau, executive director of the Native Friendship Centre in Quebec’s Lanaudiere region: provide “a culturally secure space” where Indigenous people can get health care without feeling afraid.

Brazeau said a reluctance to seek health services in Joliette, Que., has grown over the past month after an Atikamekw mother of seven died in a local hospital after filming staff hurling racial slurs at her.

Joyce Echaquan’s Sept. 28 death has shaken the province, raising questions about systemic racism in health care and leading to calls for the provincial government to both recognize the problem and take concrete action to stop it.

In Joliette, where about two per cent of the city’s 47,000 residents identifies as Indigenous, Brazeau said the long-standing need for a clinic where members of the community feel safe is more pressing than ever.

The proximity clinic, called Mirerimowin, will welcome its first patients Tuesday afternoon in a room at the Native Friendship Centre in the city about 75 kilometres northeast of Montreal.

“When we launched this, we even had pregnant women wanting to know if they could have their babies here, because they don’t want to go to the hospital,” Brazeau said in a recent interview.

The clinic will operate two afternoons per month, serving patients who are Indigenous and do not already have access to a doctor. Patients need to make appointments, and if the clinic cannot accommodate their needs, staff will try to guide and accompany them to other services, Brazeau said.

Dr. Samuel Boudreault, a Universite Laval professor and a physician in a family medicine group that is affiliated with the regional health agency, is one of two doctors volunteering at the clinic.

He said the doctors as well as medical residents will collaborate with social workers at the Native Friendship Centre to make sure patients are comfortable and get medical followups after their treatment.

"There is part of the population — and I think Indigenous people are clearly part of that — that does not have as easy access to the health system as the average person," Boudreault said in an interview Monday.

Joliette's proximity clinic is not the first of its kind in Quebec. Native Friendship Centres opened similar facilities in recent years in Val d’Or, over 500 kilometres north of Montreal in the Abitibi-Temiscamingue region, and in La Tuque in central Quebec.

The model works because it allows Indigenous people to feel more at ease accessing care, said Sebastien Brodeur-Girard, professor in the Indigenous studies department at Universite du Quebec en Abitibi-Temiscamingue.

“People are scared,” said Brodeur-Girard, who was on the research team of a provincial inquiry known as the Viens Commission, which concluded last year that systemic discrimination against Indigenous peoples exists in Quebec’s public services.

He said several people testified during the Viens Commission hearings about being discriminated against when seeking health care in Joliette, and complaints had been filed long before Echaquan’s death.

“Joliette’s case is not exceptional," Brodeur-Girard said in an interview, adding that similar issues exist across Quebec and Canada.

“Knowing they will be poorly received, that they will be pushed aside, that they won’t be believed, that they will be subjected to discriminatory comments, some (Indigenous) people will avoid going to the hospital until it’s too late,” he said.

That’s something Brazeau hopes the proximity clinic will help tackle, but the project has limited resources and for now it will only be able to see eight patients per month.

Brazeau said she participated in a meeting in June with the local health agency and asked for material resources and medical personnel to be able to keep the clinic open one full day per week.

“So far they haven’t mobilized to get any of those resources, and so we’re making do with what we have," she said. "We got a massage table as an exam table, and the doctor will bring his equipment with him.”

In an email, a spokeswoman for the regional health agency, Helene Gaboury, said the agency is aiding the clinic because doctors from the family medicine group are involved, and they are technically agency employees.

Gaboury said the doctors who offer services at the clinic will bring the equipment they need with them, "like when they provide at-home support.”

Asked what the regional health agency is doing to make sure Indigenous people feel safe accessing services, she said it held a workshop for staff over two days in mid-October to raise awareness on the realities Indigenous people face. It is also working with the Universite du Quebec en Abitibi-Temiscamingue “to offer mandatory training for all staff and physicians" beginning at the end of November, Gaboury added.

Brazeau said the Native Friendship Centre needs more support from the health agency, however, if it wants to expand the clinic to meet the community's needs.

Quebec also needs to recognize that systemic racism exists against Indigenous people if it wants to fix the problem, she said: "It would be important for them to listen to us. That’s the first step."

This report by The Canadian Press was first published Oct. 27, 2020.