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Trigger warning: This article contains details of death, medical negligence and discrimination.
“Sakihitowin means love,” Pearl Gambler says, recalling the day she gave her daughter her name.
It was the day Sakihitowin was born — and died.
From Bigstone Cree Nation, Gambler entered Edmonton’s Misericordia Hospital on June 11, 2020, and experienced a series of events that she can only characterize as traumatic and discriminatory.
“They really made me feel ‘less than’ as a woman … and my baby,” says Gambler, “it really kills me … how she was treated.”
In November 2022, Gambler’s story made national headlines when she filed a lawsuit against Covenant Health and her obstetrician claiming she and her baby were neglected throughout their stay. The statement of claim, dated Oct. 12 of that same year, alleges a male nurse stood watching Gambler scream for help while she gave birth prematurely.
“Covenant Health is vicariously liable for the actions and omissions of its employees including nurses, interns and residents,” the statement of claim reads in part.
Before she could hold her baby, a nurse informed Gambler that her daughter was gone. Gambler claims no physician had been called to assess the baby.
“That's like the worst pain to ever feel, and I don’t mean physical. I mean heart-wrenching, break-your-heart-in-pieces pain, shatter-my-spirit pain,” says Gambler.
In its statement of defence, Covenant Health said it “provided Ms. Gambler with compassionate hospital and nursing care throughout the entirety of her admission in accordance with the standard of care.”
The allegations of the lawsuit have not yet been tested in court.
Gambler’s story reflects that of many Indigenous patients across the country who say they continue to experience racism in the very places meant to care for them.
As part of our Surviving Hate investigation, the Humber College StoryLab and Canada’s National Observer gathered and analyzed 151 publicized allegations of anti-Indigenous racism in hospitals across Canada, including Gambler’s, who agreed to share her story.
Some of the oldest cases date back to the 1950s, while the most recent case collected happened this year.
About 60 per cent of these incidents occurred after 2015, the year the Truth and Reconciliation Commission published its Calls to Action, which demanded dismantling “the systemic racism that leads to worse health outcomes, premature death, and limited economic opportunities” for Indigenous Peoples in Canada.
This includes Joyce Echaquan, who live-streamed the racist abuse she received from health-care workers moments before she died in September 2020.
“It’s not uncommon in health-care systems to have a day where something severe happens … but a week goes by and everyone goes off and does things the same way they always did,” says Alika Lafontaine, the first Indigenous president of the Canadian Medical Association.
Driving pattern of harm, neglect and death in hospitals
According to Indigenous health experts and critics, Surviving Hate's findings show anti-Indigenous racism continues to drive a pattern of neglect, harm and death in hospitals across the country.
The team identified and confirmed 86 incidents using news media and/or public statements, press releases and testimonies. Sixty five incidents were verified by speaking directly with victims or family members of those who died, mining official testimonies, investigations, inquiries, court records, confirming with health authorities, coroners reports, and large-scale reports on indigenous-specific racism in healthcare. The result is a snapshot of a larger problem that has not yet been archived on a national scale.
According to the data collected so far, about 50 per cent of patients or families alleged they felt the physical or mental health issue they presented was neglected, dismissed, or at times, not treated at all. In almost 30 per cent of incidents, it was alleged that health-care staff were negligent or careless during their treatment of the patient.
Just over a quarter of the incidents collected by Surviving Hate involved the death of a patient.
Patients or families also alleged verbal or physical abuse of the person receiving care by hospital staff in 34 per cent of the incidents we collected.
“One male nurse, he went up to me and he said, ‘Did you even pay taxes?’” alleges Leesee Qaqasiq of Pangnirtung, Nunavut, after being medically evacuated to Ottawa Hospital’s Civic Campus for a fractured pelvis in October 2020.
The Surviving Hate investigation also found that in about a quarter of the incidents, Indigenous patients alleged they were stereotyped or dismissed as drug-seeking, drunk, or alcoholic.
“I'm told I'm having drug withdrawal or I have alcohol-induced seizures,” says Kennedy McKay from Saskatoon, Sask., who has epilepsy and went to Yorkton Regional Health Centre in 2017.
Qaqasiq and McKay's alleged incidents were recorded in Surviving Hate's database based on interviews conducted by the Surviving Hate team and previous media coverage. Our investigation was unable to independently verify their allegations.
“The indifference (of hospitals) comes from this idea that they just simply do not deserve care,” says Mary Jane Logan McCallum, Canada Research Chair in Indigenous People, History and Archives and a professor of history at the University of Winnipeg.
McCallum says it stems from a history of racial segregation in Canada’s health-care system and a failure to consult or allow Indigenous people to shape that system.
And that exclusion continues. In February, several Indigenous leaders said they were not invited to federal discussions about the allocation of funds from the Canada Health Transfer, which provides long-term health-care funding for provinces and territories.
“Never in the history of Canada have they meaningfully included First Nations in those discussions,” said Grand Chief Jerry Daniels of the Southern Chiefs’ Organization at a Jan 30 press conference on the topic.
“When you're talking about servicing health and creating better outcomes, you can't do it without First Nations leading that … because our citizens are the ones who are impacted the most,” says Grand Chief Daniels.
Canada lacks tracking mechanism
Canada lacks a mechanism for tracking incidents of racism in hospitals on a provincial or even national scale.
Surviving Hate contacted Statistics Canada, Health Canada, Indigenous Services Canada and the Canadian Institute for Health Information — a national organization that conducts health research — about whether they track incidents or complaints of racism in hospitals. The queries revealed there is no federal effort in place.
Asked about federal data collection, Health Canada spokesperson Natalie Mohamed says that while tracking complaints falls under provincial jurisdiction, understanding discrimination in health care requires improving the disaggregated data collection.
The Surviving Hate team also contacted the ministers of health in each province and territory. The majority said they largely leave it up to their health authorities and regions to track incidents of racism in hospitals, where methods of tracking complaints vary.
One outlier is the In Plain Sight report, which collected accounts of Indigenous-specific racism in health care across British Columbia.
Manitoba also recently announced it will be the first province to collect race-based data in hospitals starting this month, however, this doesn't account for tracking actual incidents of discrimination in hospitals and will be based on a voluntary declaration of “race, ethnicity or Indigenous identity when (patients) receive care at hospitals.”
The Manitoba, Alberta and Ontario health ministries did not respond to Surviving Hate’s queries before publication time.
All human rights commissions and tribunals, Colleges of Physicians and Colleges of Nurses across the country were contacted. Here, too, there was no comprehensive tracking of incidents of racism in hospitals.
Baby ‘gasping’ for air after birth: medical records
Wearing two braids in her hair and a shirt that read: “Strong, resilient, Indigenous,” Pearl Gambler, just over 19 weeks pregnant with her third child, walked into the maternity ward at Misericordia Hospital the evening of June 11, 2020.
Her obstetrician sent her there after Gambler reported having cramps. She was told a bed was waiting for her.
In an exclusive interview with Surviving Hate, Gambler recounted how the nurse at the intake desk “looked me up and down, looked at my partner, and said, ‘There’s nothing here for you.’” Gambler was sent to the emergency room, and the couple waited overnight for a room.
The nurse turned to another colleague and handed the chart over.
“She said, ‘I don't know what you're gonna do with her,’” recalls Gambler.
The next morning, two physicians told Gambler a cervical exam risked causing further contractions. Less than two hours later, her obstetrician and a nurse performed the exam. Gambler says she refused several times before consenting under duress.
She started giving birth prematurely.
In pain, Gambler told hospital staff the baby was coming and asked for help. Gambler says no one came to her aid.
She alleges a male nurse stood watching her scream for help before leaving the room. It was about 20 to 30 minutes before several other nurses arrived, Gambler says.
“I screamed and I screamed from the top of my lungs to help her. How could [they] not hear me scream?” says Gambler.
One nurse cut her umbilical cord and asked if she wanted to hold her daughter. Gambler says she was then told by the same nurse Sakihitowin had died. According to the statement of claim, no physician was called to assess Sakihitowin after her birth.
After hemorrhaging for six hours, Gambler was prepared for surgery to remove the placenta. A staff member asked if she was going to take her “specimen” home, in reference to her daughter. They also tried to talk her out of a burial, according to Gambler.
“When I requested my files, I knew everything was wrong … but I felt so helpless,” says Gambler, after receiving medical records six months after her daughter’s funeral.
According to physicians’ notes obtained by Surviving Hate, Sakihitowin had been taking “gasping” breaths about 32 minutes after her birth despite Gambler being told she had died.
The hospital has yet to provide Gambler with Sakihitowin’s time of death.
Fighting for justice
On Nov. 3, 2022, Gambler and Treaty 8 Grand Chief Arthur Noskey spoke out about the incident at a news conference. Bigstone Cree Nation is a member community of Treaty 8.
“Indigenous lives continue to be less important in Alberta’s health-care system,” Noskey said at the conference.
In Alberta, a 2022 study published in the Canadian Medical Association Journal found that First Nations patients in Alberta are less likely to be categorized as needing urgent medical care during triage than other patients.
Gambler is seeking about $1.3 million in damages from Covenant Health and the obstetrician.
The statement of claim alleges they failed to properly assess, monitor and provide proper medical care for Gambler and her baby during her preterm labour “in part or in whole due to Ms. Gambler’s race.” It also claims they failed to manage the delivery and medical care for Gambler’s baby after she was born alive.
Gambler’s lawyer, Shelagh McGregor of Weir Bowen LLP, says a large portion of her clients who have experienced birth injuries and allege medical negligence are visible minorities.
“There was a lack of humanity afforded to Pearl and her daughter,” says McGregor.
The Alberta health authority and Gambler’s obstetrician denied these allegations in their December 2022 and March 8, 2023 statements of defence.
Surviving Hate repeatedly contacted Covenant Health for comment, but did not receive a response before publication time.
Gambler also says she filed complaints with the College of Registered Nurses of Alberta, College of Physicians & Surgeons of Alberta, and the Alberta Human Rights Commission.
The two colleges and the human rights commission do not make their complaints public unless a decision is reached. Gambler was unable to show us her official complaints because they are still being reviewed. However, she does confirm that the complaints are being heard.
Calls for a national repository and greater accountability
Some advocates say a national repository of incidents of racism in health care is critically needed.
“To not track these things is acknowledging that there’s nothing wrong,” says Sol Mamakwa, Ontario NDP MPP (Kiiwetinoong) and official Opposition critic for Indigenous affairs, while underscoring the importance of Indigenous-led data collection.
Mamakwa says that though more incidents of racism have recently reached the public eye, this shouldn’t deter tracking. For those with lived experience, he says, it’s a crucial step forward.
“We cannot just continue to not comment on it … We cannot just say, ‘That's just common sense,'" says Mamakwa.
There are also criticisms of existing mechanisms for accountability.
While incidents of racism can be addressed through official procedures within hospitals, professional regulatory bodies and human rights commissions, their consequences often amount to a slap on the wrist, according to several patients and families interviewed for this story.
Meanwhile, convictions for criminal negligence causing death in health care are rare. Though not always a feasible option for families, civil cases alleging malpractice are far more common for those wanting to address the discrimination they say they've faced.
“It comes down to the imbalance of power, and there's a circling of the wagons that happens when a patient makes an allegation. They all protect each other," says Shelagh McGregor.
“I’ve seen some pretty terrible negligence resulting in death and I’ve never seen anybody get reported to the police, let alone charged.”
‘A kaleidoscope of butterflies’
When Pearl Gambler sees butterflies, she knows her daughter is there with her.
She started to feel this presence at Sakihitowin’s funeral when she saw a flurry of butterflies suddenly come to rest on the casket and memorial table. They stayed briefly and flew away.
When it was time for Sakihitowin’s casket to be lowered into the ground, Gambler saw a single butterfly flutter up from the depths.
“I just stopped, and I held my breath,” she says. “I felt [like the] Creator has given her her wings now.”
She decided to make a space for Sakihitowin in her backyard — a large teacup planter she made with a butterfly and handwriting painted on the side. It reads, “Do all things with love.”
Though it’s incredibly difficult for Gambler to speak publicly about what happened, she says Sakihitowin gives her the strength to continue.
“If I do not share what happened, then there's a high possibility it's going to keep happening,” says Gambler. “I have to be her voice.”
Kunal Chaudhary is a freelance journalist and recent graduate of the University of King's College Journalism Program. His work has appeared in Spacing magazine, Canada’s National Observer, and the West End Phoenix. He is based in Toronto.
Danielle Orr is a freelance multimedia journalist and private investigator (OSINT) based in Ontario. She has worked as a reporter for several large-scale collaborative investigations and podcasts, and her work has appeared in the Toronto Star, Canada’s National Observer, Canadaland, The Local, and the Investigative Journalism Bureau. Danielle obtained her honours bachelors in criminology and socio-legal studies from the University of Toronto and graduate certificate in new media journalism from Sheridan College.
Martha Troian is an investigative journalist and producer who has worked with and contributed to media outlets across North America. She practices investigative journalism, data journalism, radio, and online storytelling. Experienced in both mainstream newsrooms and reporting independently, Martha has been involved with small- to large-scale collaborative projects that focus on data journalism, Indigenous politics, environmental issues, justice, and human rights issues. She obtained her master of journalism degree from Carleton University with a specialization in broadcast journalism, and a master of journalism from the University of King’s College with a specialization in investigative journalism. Martha is originally from Obishikokaang (Lac Seul First Nation).
Surviving Hate is a multi-year investigation into how racism, hate and discrimination affect Canadians — through the lens of public institutions. If you have experienced an incident involving racism or discrimination, you can also take the Surviving Hate survey.
Surviving Hate is a collaborative journalism project co-ordinated by Humber College's StoryLab seeking to fill the data gap on the reporting of hate crimes in Canada, with a focus on anti-Indigenous racism. Academic partners include the Investigative Journalism Bureau, Algonquin College, Trent University, the University of King’s College, Toronto Metropolitan University, Carleton University and the Centre for Human Rights Research at the University of Manitoba. Our media partners are Canada’s National Observer, the Toronto Star, TVOntario and JSource. Surviving Hate is supported by the Inspirit Foundation, Google News Initiative, Journalists for Human Rights and Humber College’s Office of Research and Innovation and Faculty of Media and Creative Arts.
Research credits: Janice Saji, David Weisz, Jianfu Lan, Ryan Running Rabbit, Hansil Mehta, Stephanie Roberts, Nitika Mishra
Help lines:
The Hope for Wellness Help Line is available to all Indigenous Peoples across Canada and provides immediate mental health crisis intervention and support. The service is available any time by phone at 1-855-242-3310 or by online chat on its website: https://www.hopeforwellness.ca/.
For those living in the North, Kamatsiaqtut Helpline offers 24/7 confidential mental health support and can be reached at 1-800-265-3333. Volunteers speak English, Inuktitut and French.
To view other mental health helplines in your province or territory, you can visit the following links:
The following corrections were made:
- The note about “gasping breaths” is a physician note, not a nursing note.
- It was less than two hours after the doctors said they didn’t want to do a cervical exam that the physician performed one, says Gambler and her lawyer.
- Gambler's story made headlines in November 2022.
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