Innu surgeon pleads for reforms at coroner's inquiry into Joyce Echaquan's death

Innu surgeon Dr. Stanley Vollant says even he didn't believe some Indigenous people who told him they were afraid to go to the hospital and didn't think they'd receive equal care, despite having experienced racism himself during his medical studies.

That's how pervasive he said systemic racism is in Quebec's health care and educational systems.

Vollant was testifying at a coroner's inquiry into the death of 37-year-old Joyce Echaquan, before giving a number of recommendations on how the system could be improved.

Vollant, who is a surgeon at Montreal's Notre-Dame hospital, said he felt ashamed when he saw the video Echaquan posted before her death on Sept. 28, 2020, in which she had to endure racist taunts from the medical staff at the Joliette hospital.

'There cannot be another Joyce, but unfortunately there will be.- Dr. Stanley Vollant

"It shook me to my core, in my being as an Indigenous person," said Vollant. He said he felt guilty he hadn't followed up on the complaints he had heard in previous years, including during a 6,000-kilometre journey that took him across Quebec's 11 Indigenous communities over several years.

"I was passive. But now I have a mission to talk about this, to make sure it never happens again in Joyce's memory."

"There cannot be another Joyce, but unfortunately there will be," Vollant said.

All staff working in Quebec's health-care system, from doctors to janitors, should be trained to offer culturally safe spaces for Indigenous patients.

"It has to start with the person sweeping the floor in the hallway. It's important to look at health care globally to make sure it is a safe space for Indigenous people."

'Watchdog' for racism

Vollant looked back at the rampant racism he experienced growing up and during his medical studies. 

Originally from Pessamit, on Quebec's North Shore, Vollant was raised by his grandparents. It was his grandfather who encouraged him to pursue higher education.

"He told me you have to learn their laws and their science to be able to defend yourself, and defend your territory," Vollant said.

He was regularly bullied and beaten up in high school, and was told by other students he wasn't smart enough to get his diploma. "That became a motivation to show them I could," he said.

Even during his residency at Montreal's Notre-Dame hospital, where he thought "educated people" wouldn't be so racist, he said he was insulted every day, as the Oka crisis unfolded.

"I was called a kawish, a savage, a road blocker," said Vollant. "For me it was like a slap in the face — racism exists in the medical world, and systemic racism is integral, and invisible within the health-care process."

The Quebec government has so far refused to acknowledge the existence of systemic racism in Quebec. Vollant said with Echaquan's video as evidence, that can no longer be negated.

"Denying the evidence is symptomatic that systemic racism is even more deeply rooted," said Vollant.

Still, he'd prefer to push forward to see solutions put in place, rather than being blocked by semantics. 

He said those solutions have been presented time and time again, by various government commissions, including the provincial inquiry into the government's relations with Indigenous people, the Viens Commission.

"I'm tired of commissions, we already know the answers," said Vollant. "We need to take action."

'Medical colonialism'

Dr. Samir Shaheen-Hussain, a professor at McGill University's faculty of medicine, also gave his recommendations on Monday.  He said the government should recognize the problem of systemic racism sooner rather than later.

"Every day that goes by where we don't recognize medical colonialism, or systemic racism, as existing, we are letting people suffer because we're not addressing the underlying issues," he said.

Shaheen-Hussain said several professional orders, including the Quebec College of Physicians, have taken steps in recognizing the impact of racism in hospital rooms and doctors' offices.

In his lengthy testimony, Shaheen-Hussain described his shock at hearing health-care workers at the Joliette hospital insult Echaquan through "racist and misogynist" remarks.

"I can't describe those words as being anything else than hateful," he said.

Shaheen-Hussain compared Echaquan's death to that of Brian Sinclair, who died in a Winnipeg hospital's emergency room after being ignored by staff for 34 hours, because they assumed he was homeless, intoxicated or had already been seen and was waiting for a ride. 

"Joyce wasn't ignored to death, she was rather scorned to death."

Some measures being put in place

During the hearings on Monday, the director of Indigenous affairs for Quebec's Health Ministry, Julie Gauthier, presented some of the actions being taken by the province.

Liaison officers are being hired in different regions to accompany Indigenous patients, Gauthier said. 

The $15-million investment announced by Quebec Indigenous Affairs Minister Ian Lafrenière last November is also allowing cultural safety training to be rolled out across the province, Gauthier said.

"Cultural safety is clearly a government priority now," she said.

Last week, the province also announced a $27-million investment to help urban Indigenous communities tailor health and social services to the people they serve.

Coroner Géhane Kamel said she was encouraged to see actual measures on paper.

But Dr. Jacques Ramsay, who is co-presiding the inquiry, asked if the ministry itself didn't lack credibility, since it did not have a single Indigenous staff member.

Gauthier said she had tried recruiting Indigenous personnel and hadn't found any candidates within the government's recruitment system.

Partners within Indigenous communities are however now central to the creation of policies, Gauthier said, and are solicited to put in place new programs. 

"All our projects have to be done with our partners on the ground," said Gauthier.