Care as Colonialism: Immigrant Health Workers at Canada’s Frontiers

Baijayanta Mukhopadhyay

A tiny street in the northeastern reaches of Montréal is named for Denis Jamet. His role in Canada’s history is central, although the inconvenience of this truth has now relegated him to an obscure crescent in the city’s suburban periphery. In 1615, he was plucked from the upper echelons of the Catholic Church in France to become the leader of its mission in North America. Father Jamet was of the Recollet order, considered superior to the Jesuits who had recently lost their mission in Port-Royal (Nova Scotia) to English colonists from Virginia. It also helped that the Recollets took a vow of poverty, lowering costs for an expedition across the ocean. During his visit in New France, Father Jamet led the first mass ever performed on what became known as the island of Montréal on June 24, 1615. Upon returning to the settlement of Québec City, he sent a letter back to his cardinal depicting what he deemed necessary for the advancement of Catholicism in this presumed “New World.” When he returned once more to the colony in 1620 with financial backing to build a convent, he endorsed a report by Samuel de Champlain to the King of France, espousing the need to preserve religion and enforce order in these new lands, with both concepts neatly packaged together in one missive.[1]

In his remaining two years in Québec, Denis Jamet worked to establish the church in this “New World,” counting on more and more Indigenous people to be baptised. His colleagues fanned out across the land, intent on saving souls amongst Huron-Wendat and Innu peoples for the continued glory of a church resurrecting itself in the Reformation’s aftermath. This process may have had its spiritual merits, but there was clear benefit to the French state as well. Many people amongst Indigenous nations willingly accepted baptism from these earnest foreigners as it seemed to cement new opportunities for trade. Whether Indigenous people knew that the French constitution demanded the expansion of the Church as a national mission is unclear, but they quickly became part of its empire of the soul. As the increasingly militarised economy of competing European powers became entrenched in eastern North America, the Jesuits, for instance, would only sell arms to those who converted to Christianity, underscoring the complicity between carers and colonizers.[2]

No street in even the smallest town is named after me, but every time I fly north to the circuit of Indigenous communities where I am now a regular doctor, I wonder about my similarities with Denis Jamet and his contemporaries. In that time, caring for the body paralleled caring for the soul. The first recognised hospital of Western medicine north of Mexico was l’Hôtel-Dieu de Québec, founded in 1640 by a duchess who asked an order of nursing nuns to provide care to the Huron-Wendat nation, who were vital to France’s plans in North America.[3] Hospitals at that time were called “houses of God” in French, perhaps a reference to the limited services they offered. In the 17th century, it was still the controversial cutting-edge of European science to profess that the heart pumped blood around the body.[4] Medical care provided in the medieval European tradition probably did not have better outcomes than the healing practices of Indigenous peoples, especially when compounded by the missionaries’ ignorance of the local pharmacopeia. Few interventions could have been provided to the heathen ill, already ravaged by smallpox, except perhaps for bloodletting and baptism.
Almost four centuries later, freshly arrived on these shores with bounding enthusiasm to do good in this adopted home, I myself climbed through the apprenticeship of medicine, embracing the opportunity to serve the state in areas where I was told health outcomes needed dire attention. Dutiful and eager, filled with a sense of righting injustice, I signed up in good faith to serve in these clinics that sit, squat and looming, in isolated communities across Canada. What does it mean for me to be part of institutions that arose only because of the arrival of colonists on this continent, tying the history of Canadian medicine to the history of economic imperialism? Not unlike French colonists before me, I industriously serve people in Indigenous territories, tending wounds, preaching about health, and encouraging change—the underlying motive of which is to accrue benefits to the emissary state. While much of what I do may arise out of my genuine concern for the well-being of my patients, there is a clear agenda that places me here: reduce the burden on Canada’s purse, ensure subjects function productively as well-oiled cogs within the machine administering colonial capitalism. And though there may be more evidence supporting what I do than colonial bloodletting, many parts of standard practice I provide remain founded on disputed science, built on knowledge that shifts under our feet, whether it be about cholesterol control or medications for the mind.

Seeing myself in them, I find it difficult to doubt the authenticity of French missionaries’ concern for the fate of the people they encountered. But seeing them within myself is less pleasant. We cannot know now how many missionaries were aware of their role in the larger political projects that European trading empires envisaged for Turtle Island. Imperial powers established these seemingly unhostile presences knowing they could win them economic favours, as a key strategy in building this seemingly cooperative system, offering markets and protection (military and otherwise) to Indigenous nations while relying on their labour and goods. Some workers within this system, including spiritual and physical carers, may have been so involved in the immediacy of their work to be oblivious to its political ramifications. Others were certainly aware of the earthly and heavenly rewards that came with being good footsoldiers of empire. In contrast, for many Indigenous peoples, these new institutions may have represented a means of survival. As trading relationships rapidly shifted around them, with ecological instability and military aggression threatening livelihoods, tools to help future generations navigate this new, alien order lay firmly in the hands of colonists. At least at the very early stages of colonization, Indigenous parents may have decided, reluctantly or enthusiastically, that it was best to let their children engage with these new systems of education and care.

Am I simply a continuation of this history? Even before I started this work, I was by no means naïve. Pushed to Canada through intergenerational displacement caused by the ravages of colonialism, I already knew its dynamics of co-optation and collaboration well. My father was part of the post-Independence exodus from an India set up by its former colonial masters to stumble in its sovereignty—colonial masters whose first concerns for local health in 19th century India centred on institutions for sex workers so syphilis would not wipe out British troops stationed there to protect economic interests.[5] The machinations of a more modern petro-imperialism led to my own displacement, from the Middle East where my father had sought survival, to colonial Canada today.

Emerging from that past, how do I as a caregiver grapple with the colonial baggage of the work I do? When four Indigenous leaders publish an op-ed about health, noting immigration has dealt a huge blow to Indigenous well-being, they do not differentiate between European settlers two centuries ago from me now.[6] The North remains the frontier of the Canadian state’s pioneer imagination, a restive Indigenous hinterland that needs control just as it needs care, where a vast reservoir of resources awaits extraction. Am I a footsoldier of empire, like those who coaxed once-autonomous Indigenous nations into the sphere of influence of a foreign power? As someone who personally recognizes the implications of that history, how do I, the once-colonized, engage in this reality of colonialism?

One wintry afternoon a few years after my arrival, an Inuit panhandler on the streets of downtown Montréal scowled as I passed. “The white man came and brought immigrants with him,” he growled. I was not surprised, more embarrassed that it had taken so long for someone to state out loud the discomfort that rippled beneath the surface of my reconciliation with the British Crown, 55 years after my father was liberated from being its subject.

It is possible that in a desperate quest to belong, I belong to a tradition of those brought here to do the work of stealing land. We are not new. African-American soldiers in the 19th century who decided to assist the deeply racist state’s efforts to settle the frontier became known as the Buffalo Soldiers. The role allowed people to believe in the continued illusion of social advancement, hopeful even despite Lincoln’s assassination in the wake of the Civil War. But the Buffalo Soldiers remained expendable troops, their institutionalized second-class citizenship unchanged as they became collateral damage in the state’s aggressive expansionist goals for the elimination of Indigenous title to land.

But unlike the Buffalo Soldiers, I have not been relegated to the margins of imperial endeavour. Across the ocean, within a century of their union with England, Scots held prominent positions in the work of making the British Empire, disproportionately represented in the bureaucracy and in the professional class, including medicine. James Esdaile, who eventually became the chief physician of the Bengal colony, was a Scottish physician who expanded his work in the practice of Mesmerism, a pseudoscientific procedure of cure through hypnotism. He developed this method through experimentation on Indians, and the actual physical labour of the process was often also carried out by Indian assistants.[7] The controversial Scottish missionary John Philips in South Africa was both lauded for his attempts to protect Indigenous peoples from settler encroachment, and criticized that he only did so through the terms of the church and the regulation of people’s lives under British law. Philips once wrote that he recognized how the backward Celtic people of Scotland advanced quickly upon exposure to the “modern civilization” of England and hoped that Africans would see the same evolutionary process.[8]

Contemporary scholars have been trying to understand this role of the colonized in the colonizer’s world. Findlay describes how the Union of 1707 between Scotland and England, although allowing for some national institutions to be preserved, essentially oversaw the expansion of England into its peripheral countries.[9] Thereafter, in order to have the class aspirations of their peers across Europe, Scots had no choice but to express it through the ambitions of the English state, erasing Scottish identity in the mid-19th century. Only as decolonization took hold of the world, with the particularly potent example in the independence of Ireland, did Scotland begin once more to assess alternatives of being tied to England, acutely aware, however, of having profited from their participation in the imperial enterprise.

How many of us reap benefits from participation in Canada now? I am not alone from far and wide. Loretta is one of the nurses I encounter in my travels across nursing stations in Northern Canada. She was far from her birthplace of Trinidad, though she still manages to bring enough spices back to make hot stews in the middle of the icebound, dark winter. She was also known for her obsession with stray dogs. This particular aspect of her reputation advances far to the south of her, with many telling of her little apartment with its overpowering odour, people trying to outdo others with their census of how many canines they have seen inside at one time.

Loretta is a character, but not unique in her function. Federally-run nursing stations exist in every small Indigenous community in Canada, no matter how isolated. They are staffed by nurses often on rotations of up to two months, but many will return repeatedly to communities they know well. They assess and evaluate patients, and often make diagnostic and treatment decisions based on protocols and algorithms in place, work that extends beyond the scope of a nurse’s practice in southern parts of Canada. If they require further support, they call for a doctor over the phone, who makes plans for transfer and further assessment as necessary.

I meet many nurses like Loretta, from Colombia, Madagascar, and beyond, part of Canada’s long tradition of importing migrant labour for healthcare. The first medical school in the country in Montréal was established by Scottish-trained doctors.[10] And when homegrown physicians in Saskatchewan went on strike against the Douglas initiative to publicly fund people’s care in hospitals, the province flew in replacement physicians from the National Health Service in the United Kingdom. Even then, outsiders were required to push state policy forward.[11]

Canadian healthcare, as elsewhere in the Global North, has long relied on migrant labour. Most notably, the Philippines has been a primary source of caring labourers for the affluent classes around the globe across a vast spectrum of work—from domestic workers to nurses. Medicine itself, as the dominant profession in the hierarchy of care, is more strictly controlled for migrants. Its full privileges are only accessible after an exacting, gruelling waiting period of retraining, in which the profession mobilizes a soupçon of racism to strictly control the supply of its skills, thereby enhancing its own stature and value. Nevertheless, about one quarter of Canada’s physicians today are foreign-trained, just slightly above the general proportion of immigrants in the country. This ratio of immigrant doctors is not unlike many other countries in the world such as Australia, Norway, or Switzerland.[12]

The actual distribution of these physicians, however, is more enlightening than crude statistics alone. Many provinces will accept foreign-trained physicians to complete their Canadian credentialing on the condition that these doctors remain in an underserved rural or northern area to practice thereafter. Surveys have shown that, consistent with these programmes, there is a disproportionate number of international medical graduates outside of urban Canada.[13] For many years, the prairies were home to many South African doctors, who were required to work in rural areas as part of their licensure agreement with Saskatchewan. In 2014, I covered the practice of a doctor on vacation in a small agricultural town in that province where all six of the town’s doctors were South African.[14]

What does it mean to rely on Trinidadians, Indians, South Africans, and Filipinos in Canada’s outposts of health? Poaching health professionals from the Global South to staff the edges of state control may serve a redistributive function, as individuals are pushed out by economic suffocation at home. But the labour immigrant healthworkers provide to the Canadian state arguably continues the colonial paradigm in the fractious borderlands between Indigenous territory and settler country. Resonating with Walia’s exploration of migrant labour in an era of border imperialism, even the work of conquest is outsourced, relegated to those who scrabble precariously to find a toehold of belonging in the ice.[15] On my first rotation in the North as a medical student in a mining town 300 miles from Montréal, I remember being struck by how the only people of colour I saw were at the hospital, never outside of it. Our world as immigrants seemed related only to work—why else would we be there, in that windswept community far from home, in the wilds of the boreal forest? Who else would be sent, except those who are desperate to escape their own post-colonial nightmares, to do the backbreaking work of stealing a country?

We might be tempted to suggest that medicine cannot be complicit with the colonization process: it is a purely dispassionate field of scientific advancement; it has no evident political agenda to fulfill; it did not openly dispossess families in the excruciating experiment of the residential schools; it did not attempt to take control of a land’s resources by assimilation of the people who defended it; it did not deliberately try to beat out traditions. Surely health professionals are more likely to be motivated by a concern for empirically poor health outcomes.

But medicine’s history in Canada reads as a force of colonization, rather than as an abstract, benign force. A review of the establishment of hospitals across the country, as a proxy history for the expansion of modern medicine, is quite telling. After Québec, the first hospital in Newfoundland was a military institution established in 1662 by the British.[16] The Toronto General Hospital too was founded by the British army as a small shed during the War of 1812, before becoming more established later that decade.[17] And while the Grey Nuns of Montréal established the first hospitals in western Canada at St. Boniface (1871) and Île à la Crosse (1873), they were quickly followed by hospitals established by the North West Mounted Police in Fort Walsh and Fort Qu’Appelle.[18] In British Columbia, the Royal Hospital in Victoria was established in response to the population boom from the gold rush.[19] Similarly, the First Whitehorse General Hospital opened in 1901 in the wake of the Klondike rush.[20] A history of missionaries, the military, and miners, medicine in Canada cannot be understood without understanding colonization: serving those who claimed people, those who claimed resources, and those who claimed land.

But this history began even prior to the establishment of hospitals. When pre-contact economies were disrupted by colonial shifts in ecology and in social power, access to land for traditional means was compromised and living conditions deteriorated rapidly. The ensuing compromise of shelter and nutritional standards for Indigenous peoples were key factors causing tuberculosis to take hold. Residential schools further compounded the spread of the infection. When colonial medicine finally began to confront this epidemic, it did so with systemic racism—responding only because of fears of settler contagion if the plague continued unabated in Indigenous populations.[21] With little other recourse available to confront the rapid decline in health outcomes, Indigenous negotiators of Treaty 6 demanded the inclusion of what has become known as “the medicine chest clause.”[22] Subsequent treaties often included this clause, if only verbally, whereby Indian agents were supposed to keep a supply of medicines for the reserve.

But in so doing, medicine married its fate to the colonial agenda. The establishment of Indian hospitals, that separated settlers from the colonized for care, were part of the tradition of de facto apartheid. Perhaps the sanitaria, like schools before them and like prisons today, were also used to alienate people from the land through institutionalization, leaving its resources available for further exploitation by invaders. The use of public health concerns as an excuse to police people has a rich tradition, and the state will police those it always finds most threatening, on whatever pretence. This fact does not minimize the danger tuberculosis continues to pose: to this day, Nunavut’s tuberculosis rates are 11 times the national average, and more reflective of developing countries than rates in the south of Canada. But consciousness of the scourge in Inuit territory only emerged in the 1950s, conveniently around the time when the Arctic became a strategic battleground in the Cold War.

Not unlike the way American medicine profited from African-American subjugation, evidence also exists that Canadian medicine profited from experimentation on Indigenous peoples. Careers were built on the extraction of data from individual bodies, often without the individual’s knowledge or consent. Ian Mosby recounts studies done in the field of nutrition, the most known of which was done in the community in which I, 70 years later, now work most regularly. The James Bay Study of 1947-1948 in Attawapiskat and Rupert’s House (now Waskaganish) was considered the most seminal study of malnutrition in Indigenous populations, which had become particularly endemic in the region in the 1920s with the collapse of beaver populations, with entire generations in families succumbing to starvation.[23] The study brought renown to the authors, but little changed to transform the underlying conditions that led to malnutrition as a result.[24] Similarly, I wonder how much of Canadian expertise in thoracics emerged from the tuberculosis sanatoria, or Canadian gynaecological knowledge from denying Indigenous women reproductive health agency through forced sterilization procedures?

Beyond colonization actively leading to ill-health, Maureen Lux recounts how colonial authorities undermined autonomous Indigenous responses. The Siksika hospital—managed by an Indigenous nation well into 20th century Canada—was eventually shut down by the collusion between a medical profession and a federal government threatened by its presence, all under the guise of an expanding welfare state.[25] In addition, colonial medicine decimated traditional healing systems. Although there have been many efforts to keep it alive, the erosion through lack of use—and the active disregard for empirical knowledge that evolved over centuries—has had dire consequences. Any attempts to build a syncretic tradition between Indigenous and Western healing traditions do not seem to have survived into formal curricula in Canadian medical schools.

To this day, the presence of the federal government looms large in routine healthcare decisions. While most settlers would never think twice about going to the doctor without an accompanying family member, it has traditionally required tortuous negotiations with bureaucrats at Non-Insured Health Benefits to win an escort for a specialist’s appointment in city hospitals for on-reserve Indigenous peoples. But more importantly, the system for on-reserve health, which falls under federal jurisdiction, remains infuriatingly under-resourced for the sicknesses that being forced into settlement has wrought. Health workers function far from the tools we would otherwise expect to use in our jobs as modern-day professionals, confronting logistical challenges to get X-rays or blood tests. Yet, with alternate systems of care disrupted, people have come to rely on us though aware that, betrayed by the interference and the neglect of foreign institutions, they are being underserved. Decades-long presence of medicine on Indigenous territories notwithstanding, health outcomes for Indigenous peoples continue to lag considerably behind the Canadian average.

This fraught relationship between medicine and colonialism is not unique. Frantz Fanon’s nuanced exploration of the colonized in a colonial medical system reverberates today, with the attitudes he ascribes to French physicians in Algeria sometimes painfully echoed in the commentary of contemporary Canadian colleagues.[26] Nested within this history, I reflect on what my daily work done with the best intentions of care means. Against whose standards am I monitoring children during routine developmental examinations, and why? Why do I need to reduce insulin prescriptions when people are out living a traditional lifestyle on the land? Why does contemporary psychiatric care simply cycle people through periods of institutionalization only to send them back into communities whose deep dispossession would make the sanest people sick? Why do so many women have to leave their home to give birth? All of these clinical algorithms which have a real impact on the way people live their lives are the result of the colonizing process, decided in large part by the federal government, implemented by health care practitioners such as myself. What do I do with the reality that I am also there to make it easier for the occasional mining executive or forestry worker to do their work as I staunch wounds inflicted upon them by the land? Considering the history of dispossession etched into my own consciousness, why am I participating within it?

For a child of the desert, ice can seem like a very familiar landscape. Squinting against brightness. The endless bleakness of the horizon. Extreme temperatures burning on the skin. The smallness of my presence against the immensity of the landscape. For those of us who escape post-colonial dystopias of border skirmishes and imperialist wars, economies shuddering under failing cash crops and exploding populations competing for too little, consolidating another empire through our work is another means of aspiring for other futures for ourselves, no matter that they be extractive economies built on sand or snow. But in subscribing to Canada as a place of personal advancement, do we legitimize its expansionist project? What does it mean to me whose family has resisted the implications of Anglo-American extractive imperialism? Can the work of trying to address the ill health that dispossession has caused be enough of a counterbalance to this slow, creeping claim to land, consolidating empire’s hold?

For me as a health provider and health activist, the primacy of restoring access to decent and equitable medical services for Indigenous nations is paramount. But as a migrant born of colonialism myself, how this work is done is critical. Rather than participate unquestioningly in institutions that remain wedded to the Indian Act, how do we move towards more liberatory care? How do we work in solidarity with Indigenous healers to reclaim knowledge that has been lost? How do we stop pathologizing coping mechanisms for the distress of colonialism? How do we transform a system that continues to remove people from their communities in order to access complete, comprehensive care?

These questions are not theoretical musings, but actual day-to-day decisions that have an impact on the way patients with whom I work experience their sickness and their health. As I strive to develop an ethical clinical practice in the spirit of anti-colonialism, I consider how migrant healthworkers on Indigenous lands can build a praxis of engagement with contemporary colonial land grabs from our position within the global order. How do we build a community of co-conspirators not only to staunch the wounds of dispossession, but to dismantle the weapons that cause the injury, wielded as they are by a foe common to both Indigenous peoples and immigrants? Few movements have comprehensively worked in solidarity with Indigenous peoples confronting medical colonialism in Canada today. Perhaps all of us struggling against it in our respective isolations should come together to do this work.

The tasks are many. We should be making space for Indigenous carers: not only those within formal systems such as Indigenous physicians and physiotherapists, nurses and nutritionists, but also those outside of it. This process can be uncomfortable, resulting in alliances with evangelical priests or land-based healers that can be personally or professionally uneasy. But rather than co-opting them into the colonial system, I suspect learning to coexist across autonomous disciplines will ultimately be freeing for all. We can build solidarity with the informal caregivers in the family—those who stay at home to look after youth in distress or elders who can no longer leave their beds. We can support those who are trying to reclaim the pharmacopeia whose knowledge has been lost. As a physician who works with the goal of relinquishing my power over the lives of people, I find that reinforcing these relationships is the doorway to a more liberated health system.
More immediately, addressing the health demands of the Truth and Reconciliation Commission allows us room to explore these issues more substantively.[27] Those who work within formal medical settings should ask if Indigenous healers would consider building syncretic traditions of caring with us, not only because they may make patients feel safer, but because we ourselves might learn from them, and learn how to practice better healing ourselves.

Furthermore, while there are significant strides towards self-governance in health in many contexts—I work most frequently within one of the most autonomous Indigenous health authorities in the country—it remains largely within the framework of Canadian customs, laws, regulations and authorities: the federal government remains the policeman and the judge, the teacher and the social worker, and yes, the doctor and the nurse too. While contemporary structures do have benefits—we cannot fall into the trap of pristine pre-colonial romanticism—healthcare is still populated not only by people from far away, but driven by a logic that is imposed from outside even if the reins are handed over to community members. Supporting local efforts where they exist for self-government in health should be part of a movement for anti-colonial medicine too.

Additionally, rather than measuring the deficiencies in the health of Indigenous nations, Stime, Laliberté, and Waters argue that we should be measuring the failures of the settler state that cause ill-health.[28] Engaging in broader conversations outside of medicine that focus on revolutionizing the relationship between the colonized and the colonizer is critical as well. Participating in work to protect the land is important not only for those of us dedicated to anti-colonialism, but also for those who work for health, knowing so much of illness is determined in the environments in which we live well before arriving at the clinic.

Those of us with diasporic ties to movements that have done the work of anti-colonialism for generations have perspectives that may be useful as we navigate the complicated role of being sometimes-outsider, and sometimes-not. We bring knowledge of the history of what modern medicine has done to our own peoples—women subjugated to service colonizing military personnel, hospitals made to build the careers of those who study our diseases but not to cure them, medical knowledge decimated, ceremonies that heal our pain banned. We know the damage that has been done to our psyches with the belief that white is right, and West is best. But our presence can be a bridge between the experiences of the theft of land and the theft of labour, whose perpetrators are the same. If we approach our work in this sense of solidarity, of tending the wounds that these dispossessions have inflicted, then we can heal a wider epidemic. One of the most intriguing realms to explore solidarity health work between immigrant and Indigenous peoples in Canada might be on the conversation around diabetes, which is considered to be a high-risk pathology for everyone except people of northern European descent: Indigenous peoples, Latinos, South Asians, Middle Easterners, Africans, Southeast Asians. Can we as racialized peoples build on our common struggles to understand this pathology that we all intriguingly share, just as we do the experience of being colonized by economic systems originating in northern Europe? Can we ask together what it means if the pathology is not so much our physiologies, we the majority of the world’s peoples, but the psychologies that colonized us?

In all of this work, we should also remind ourselves that sometimes presence is not the answer; stepping back from our own impulse to intervene, calling our own power to account—as settlers and as professionals—is also necessary. We should never relent in questioning who is the problem, what is the disease, and where is the cure—including ourselves in that critical gaze. As careworkers—nannies and nurses, physiotherapists and physicians—we need to remember that although we work in service of the most therapeutic work of all, the journey from oppression to liberation, healing is not ours alone to make.

Notes

1 Dictionary of Canadian Biography, “Denis Jamet,” http://www.biographi.ca/en/bio/jamet_denis_1E.html.
2 See Bonita Lawrence, “Rewriting Histories of the Land,” in Race, Space, and the Law: Unmapping a White Settler Society, ed. Sherene Razack (Toronto: Between the Lines, 2002), 29.
3 See Sylvio Leblond, “History of the Hotel-Dieu de Québec,” Canadian Medical Association Journal 60 (1949): 74-80.
4 Domenico Ribatti, “William Harvey and the discovery of the circulation of the blood,” Journal of Angiogenes Research 1 (2009): 3.
5 R. Basu Roy, “Sexually Transmitted Diseases and the Raj,” Sexually Transmitted Infections 74 (1998): 20-26.
6 Jean-Victor Wittenberg, Michael Dean, Cindy Blackstock, and Isadore Day, “First Nations Health Crisis is a Canadian Problem,” Toronto Star, October 8, 2015. https://www.thestar.com/opinion/commentary/2015/10/08/first-nations-health-crisis-is-a-canadian-problem.html.
7 See Chapter 11 in Sudip Bhattacharya, Unseen Enemy: The English, Disease, and Medicine in Colonial Bengali, 1617-1847 (Newcastle upon Tyne: Cambridge Scholars Publishing, 2014).
8 See Chapter 4 in Tilman Dedering, Hate the Old and Follow the New: Khoekhoe and missionaries in early nineteenth-century Namibia (Stuttgart: Franz Steiner Verlag, 1997).
9 Richard J. Findlay, “National Identity, Union, and Empire, c. 1850-1970,” in Scotland and the British Empire, eds. John M. Mackenzie and T.M. Devine (Oxford: Oxford University Press, 2011).
10 FJ Shepherd, “The First Medical School in Canada,” Canadian Medical Association Journal, 15(4) (1925):418- 425.
11 A review of the struggle in Saskatchewan to establish public health insurance can be seen in part one of the 1983 NFB series “Bitter Medicine,” entitled “The Birth of Medicare,” https://www.nfb.ca/film/bitter_medicine_part_one_the_birth_of_medicare/.
12 OECD.Stat, “Health workforce migration: Migration of doctors,” http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT.
13 Canadian Medical Association, “Rural and Urban Practices—Where they differ and where they don’t,” Physician Data Centre Bulletin, https://www.cma.ca/Assets/assets-library/document/en/advocacy/42-Rural-Urban-e.pdf.
14 You can read about other health professionals of recent immigrant stock in Indigenous territories in profiles found in Canadian mainstream medium such as the following: https://www.thestar.com/news/canada/2017/03/05/mike-kirlew-the-doctor-advocate-fighting-for-better-indigenous-health-care.html, or http://www.cbc.ca/2017/why-i-stayed-in-iqaluit-after-moving-there-by-accident-1.3882547.
15 Harsha Walia, Undoing Border Imperialism (Oakland: AK Press, 2013).
16 Heritage Newfoundland and Labrador, “Health,” http://www.heritage.nf.ca/articles/society/health.php.
17 Lost Rivers, “Toronto General Hospital,” http://www.lostrivers.ca/content/points/torontogeneralhospital.html, some discrepancies with the history found at University Health Network, “Toronto General History,” http://www.uhn.ca/corporate/AboutUHN/OurHistory/Pages/toronto_general_history.aspx.
18 The Encyclopedia of Saskatchewan, “Hospitals,” http://esask.uregina.ca/entry/hospitals.html.
19 Vancouver Island Health Authority, “Royal Jubilee Hospital Archives,” http://www.viha.ca/NR/rdonlyres/279A6321-6F94-42FB-ABA4-957D7B54B842/0/history_of_rjh_2012_final.pdf.
20 Yukon Hospital Corporation, “Historical Timeline,” https://yukonhospitals.ca/yukon-hospital-corporation/news-events/timeline.
21 Maureen Lux, “Care for the ‘Racially Careless’: Indian Hospitals in the Canadian West 1920s-1950s,” Canadian Historical Review 91(3) (2010): 407-434.
22 A full discussion of the medicine chest clause and associated rights to health for Indigenous peoples can be found at this 2003 discussion paper published by the National Aboriginal Health Organization in Ottawa and the Native Law Centre at the University of Saskatchewan in Saskatoon: http://www.naho.ca/documents/naho/english/publications/DP_rights.pdf.
23 See Chapter 1, S. Marshall and the Cree Regional Authority, Healing Ourselves, Helping Ourselves (Val d’Or: Cree Regional Authority, 1989).
24 Ian Mosby, “Administering Colonial Science: Nutrition Research and Human Biomedical Experimentation in Aboriginal Communities and Residential Schools, 1942–1952,” Histoire sociale/Social history 46(91) (2013): 145-172.
25 Maureen Lux, “We Demand ‘Unconditional Surrender’: Making and unmaking the Blackfoot Hospital, 1890s to 1950s,” Social History of Medicine 25(3) (2012): 665-684.
26 See Chapter 4, Frantz Fanon, L’an V de la révolution algérienne (Paris: Éditions Maspero, 1959).
27 Seven of the TRC’s 94 Calls to Action directly deal with health. You can read them here: http://www.trc.ca/websites/trcinstitution/File/2015/Findings/Calls_to_Action_English2.pdf.
28 B. Stime, N. Laliberte, and S. Waters, “Surveillance and the Settler State: Monitoring structures that impede well-being,” presentation at the Indigenous Health Conference, Mississauga, May 2016.