From the moment she was admitted to the hospital in Joliette, Que., Joyce Echaquan started filming her interactions with staff.
It was an impulse, friends and family say, driven by long-held concerns about the way Indigenous people are treated at the hospital 70 kilometres north of Montreal.
Ultimately, two days after she walked in with stomach pains, she would broadcast her final pleas for help, capturing insulting and foul language directed at her by attending staff.
Sebastien Moar, Echaquan’s cousin, said she had several health problems, and felt she didn’t receive adequate care at the hospital.
“She always said, at the hospital, they never did anything. They just made sure she wasn’t hurting. She always had appointments and she said the nurses seemed fed up with her,” Moar said.
Echaquan used her phone, Moar said, to make sure her experience was documented.
“She was able to communicate what was happening and what had already happened.”
Her mistrust in the health services provided at the Joliette hospital, the Centre hospitalier de Lanaudière, is widespread in Echaquan’s Atikamekw community of Manawan, 180 kilometres further north.
It was flagged as a problem in the Viens commission, a provincial inquiry into the discrimination faced by Indigenous people.
One year after the Sept. 30, 2019 release of the report, Paul-Émile Ottawa, chief of Conseil des Atikamekw de Manawan, said he has started advising people to seek services elsewhere, for example Trois-Rivières or La Tuque, where signs in the hospitals are translated in Atikamekw.
“The racism problems at [the Joliette] hospital did not start yesterday,” he said Wednesday.
“Even during the commission we came to devote a whole week to listen to the testimonies of the people of Manawan who suffered discrimination in this hospital.”
According to the Grand Chief of the Atikamekw First Nation, Constant Awashish, people are hesitant to file complaints because they distrust the system.
With no clear directives coming from the Quebec government following numerous recommendations and reports that have identified systemic racism, including the Viens commision, Awashish wants change.
“We’re in 2020. I think we need the government to step up on this and we need them to work on mitigation,” he said.
WATCH | Video captured in hospital contains disturbing images and sounds:
Mistrust in Manawan
For Alexia Nequado, who is also from Manawan, the death of her friend Joyce Echaquan was all too familiar.
Like Joyce, Nequado said she was admitted to the Joliette hospital two years ago with stomach pain.
Lying on a hospital gurney, Nequado said a nurse came to check on her. When she explained she was still in pain despite the dilaudid injection she had received, the nurse went to fetch a syringe of morphine.
Nequado, who was wearing a bracelet that indicated she was allergic to the drug, passed out.
“When I came to, the nurse told me I was an idiot for not telling her I was allergic,” Nequado said Wednesday.
“I didn’t feel safe and I felt awful for being treated that way.”
Nequado said she filed a complaint to the hospital, but when she followed up later she was told it had not been reported to management.
Alland Flamand, a witness at the Viens commission who is also from Manawan, said he’s avoided going back to the hospital after trying and failing to get treated for an undiagnosed back problem.
Over six months, he said he went five times and each time was told nothing was wrong then given pain medication and told to rest. He was often asked, he recalled, if he was on drugs.
At one point, Flamand said, he saw a white man at the hospital for his own back problem being treated with a degree of respect he had not been given.
“It showed me clearly that there was racism there,” he said Wednesday.
After half a year of hardly being able to stand up, let alone walk, Flamand finally went to the hospital in Trois-Rivieres where he was taken in for emergency surgery for a herniated disc.
“I could have been in her place,” Flammand said of Echaquan.
The local health authority, the Centre intégré de santé et de services sociaux de Lanaudière, did not return a request for comment Wednesday about those incidents.
Health authority promises to work with Manawan
Earlier, Daniel Castonguay, the executive director of the health authority, said he was “shocked and disappointed” to hear the language captured on video coming from one of his staff members.
But he denied there is systemic discrimination at the Joliette Hospital against Atikamekw patients.
“We receive complaints from people from all backgrounds, and those complaints are taken very seriously,” Castonguay said.
“But to say that residents from Manawan are systematically treated this way? No, that’s not true.”
Castonguay said staff have to follow a cultural awareness training program. He wants to replace that with a working committee in collaboration with Atikamekw communities.
“The goal of that partnership is to ensure people feel safe, no matter where they are from.”
With pressure mounting on provincial authorities, Echaquan’s death is now the subject of three investigations: a coroner’s inquest, an investigation by the local health authority into her treatment and broader investigation by the same organization into practices at the hospital.
One of the nurses involved has been fired.
WATCH | Carol Dubé, Joyce Echaquan’s partner, calls for change:
Sylvie D’Amours, Quebec’s minister responsible for Indigenous Affairs, said that whatever the outcome of the investigation, what was captured on video was “totally unacceptable and must be denounced loud and clear.”
“This shows that, unfortunately, there is still racism in Quebec, in particular against Indigenous communities,” she said Wednesday. She also said that 51 of the 142 recommendations from the Viens report have an action plan.
But she too, like Premier François Legault, has continued to deny systemic racism is a problem in the province.