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How do you do justice to Joyce Echaquan?
A “Justice for Joyce” scarf is hung in front of the agora of the Joliette hospital.
9/30/2021

How do you do justice to Joyce Echaquan?

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Note de transparence

“My mother left me a war, and her voice to fight it, but what I really want today is my mom's smile,” says Joyce Echaquan's eldest daughter. The mother of the Atikamekw family died at the Lanaudière Hospital Center, under a shower of racist insults.

“Justice for Joyce! exclaimed the mother's children the day after she died last year. A year later, Joyce Echaquan's family is still asking for justice. While the community of Manawan wants to build bridges to prevent such a tragedy from happening again, they say they are running up against walls.

“There is going to be a lot of work to do to achieve this forgiveness”

Carol Dubé, Diane Echaquan, Solange Dubé and Marie-Wasianna Echaquan Dubé speak out in front of the Joliette hospital, one year after the death of Joyce Echaquan.
Photo: Julien Forest

A year later, to the day, Joyce Echaquan's family went to the room where they spent the last moments of her life. The wound is still alive for the husband of the deceased, Carol Dubé. “Words cannot describe the condition we have been in for the past few days.

This is the saddest date ever. We all need to remember what happened here on this date last year. We all saw the last moments of my dear wife, Joyce, on social networks,” he said during the commemorative ceremony held in front of the Lanaudière Hospital Center. The widower wants the death of his spouse to open the door to systemic changes.

“The door she opened is too important, she cannot have died in vain,” says Carol Dubé. He addressed the crowd gathered in front of the Joliette hospital. “I saw voices being raised against systemic racism. We now have a shared mission to make a difference. I hope that together we will find the strength we need. It seems so important to me that it was a woman, my Joyce, who gave us the courage to build a more just society. I am confident that, with humility, we can move forward together on the path of healing and reconciliation.”

Marie-Wasianna Echaquan Dubé arrived at the hospital a few minutes after watching The Facebook video filmed by his mother before he passed away. It was through the intermediary of the family's spokesperson, Solange Dubé, that she spoke out a year later.

“I don't want to talk, I want to scream. I would like not to be afraid, I would like the world to understand the pain I am going through. The lack is so great, the emptiness so cruel, its end was so unfair. I don't want to be here, I want to be with family, I want my mother to still be with us, I want peace,” she reports.

Karine Echaquan sings a song for her cousin, Joyce Echaquan in front of the Agora of the Joliette Hospital
Photo: Lela Savic

Beyond racist insults, a system that kills

While the nurse and the worker who made the insults have often been pointed at, Carol Dubé has often publicly stated that systemic racism is what killed her wife. But how did systemic racism kill Joyce? “The video shows two minutes of what happened, but there are much broader and more important things to consider in this context,” says Patrick Martin-Ménard, a medical liability lawyer who represents the patient. For him, an entire system has failed. He feels that Joyce Echaquan's symptoms, pain, and complaints have never been taken seriously by the medical staff.

“A label was attached to it”, explains Me Martin-Ménard. Ms. Echaquan had been experiencing severe stomach pain for several months. Despite several consultations, she had not obtained a diagnosis. “We quickly came to the point of prescribing narcotics and morphine to relieve the pain”, says the lawyer. This merry-go-round continued over numerous visits. On the evening of September 27, after a trip of several hours in an ambulance, Ms. Echaquan was determined to find the cause of her pain. “Quickly, she was referred to as a drug addict who was in withdrawal and looking for narcotics,” reports the lawyer.

The message circulates among hospital staff and is distorted when it reaches the health care teams. “It was this information that determined how she was treated by the two people we hear in the video: the nurse and the worker. It's based essentially on prejudice.” During her fatal hospital visit, Ms. Echaquan had a heart failure that ultimately led to her death because she was not treated by the staff at her bedside.

Her family and friends are asking for these behaviors to stop and for the non-native population to be sensitive to the stereotypes they maintain about Indigenous people. “Prejudices are not just the rude things that were said by the nurse and the worker in the video.

There are much more subtle things that are deeply rooted in people's minds and that need to be deconstructed,” believes the lawyer. Stories of racism, contemptuous and condescending attitudes, stereotypes about indigenous and vulnerable people, Ms. Martin-Ménard hears all the time. “What Ms. Echaquan has documented is one case among others.

This is not an isolated case, a rotten apple, a racist nurse in the system. It reflects a system-wide mentality and way of doing things,” he says. According to him, it is difficult to deal with the problem when the government refuses to recognize systemic racism, a racism that persists in the health system, to the point of having cost Joyce Echaquan her life.

Justice for Joyce: who are we protecting?

“The nurse's lawyer we hear the most on the video was painting a portrait of a dangerous Atikamekw community, from which hospital staff needed to be protected. But the only person who was in danger and who died was Joyce,” says a relative of the Echaquan Dubé family, who prefers to remain anonymous. The family lawyer denounces the lack of transparency in the hospital. “What I find shocking from the family's point of view is to see that all of Ms. Echaquan's medical records, very precise details of her private life, have ended up in the public square and have been reported in the media. On the hospital side, we have wall-to-wall witness protection,” notes Me Martin-Ménard.

On the anniversary of Joyce Echaquan's death, the verdict was in for Paule Rocray, the nurse who uttered racist insults against patience. She was expunged from the profession for one year after being convicted of two counts. In the eyes of Me Martin-Ménard, this is a lenient sentence.

“It is believed that the disciplinary council could have gone much further and brought a lot more accusations”, believes the lawyer, who maintains that only the bare minimum was done. Me Martin-Ménard also denounces the fact that the disciplinary council took nearly 10 months before bringing charges. In addition, the Order of Nurses and Nurses of Quebec (OIIQ) did not report that a college candidate for the practice of nursing (CEPI) was working in the emergency room and with Joyce Echaquan at the time of the events, an element revealed by the coroner's investigation. “Ms. Echaquan was under the responsibility of a student, who should never have had an unstable patient under her responsibility,” recalls Me Martinique Echaquan at the time of the events, an element revealed by the coroner's inquest. “Ms. Echaquan was under the responsibility of a student, who should never have had an unstable patient under her responsibility”, recalls Me Martinique under her responsibility. -Ménard, who believes that it is one of the main causes of the patient's death. “She did not detect the signs of heart failure that appeared in Ms. Echaquan. A video, filmed by her daughter Marie-Wasianna Echaquan Dubé, clearly shows Ms. Echaquan in cardiopulmonary arrest.

CEPI is present and tells him that everything is fine. She says that it is only the medication that takes effect.” Although justice is slow, the lawyer hopes that the coroner's report, which is still pending, will not only shed light on the events, but also put in place concrete solutions. “There is certainly something to think about and changes to be made to ensure a better balance between victims and defendants, and for justice to be put in place. be accessible,” he believes.

The dialogue on cultural security

Cultural safety is advocated by many Aboriginal people as a way to correct these dangerous prejudices. According to the concept of cultural safety, aboriginal people have the right to receive health care that respects the identity of the patient. Could this approach be applied in the Quebec health system, starting with the hospital where Joyce lost her life? Asked about this subject, Pascale Lamy, director of institutional affairs and public relations at the Centre Intégré de Santé et de Services Sociaux de Lanaudière (CISSSLAN), indicated that a public communication organized with the leader of the Atikamekw community in Manawan, Mr. Paul-Émile Ottawa, would take place at the beginning of October. This will be an opportunity to address this issue.

“You will have the opportunity to hear the actions that have been put in place in recent months to promote a relationship of trust between members of the Atikamekw community in Manawan and our organization”, we are told, without however specifying the nature of these actions. For Hayley Morris, manager at the Mohawk Council of Kahnawake, cultural safety in the health system is a personal issue.

“For a lot of Aboriginal people, it's really hard to go to a big hospital where they're misunderstood,” she says. The young woman considers herself lucky to have a hospital in the heart of her community, where she feels safe. At Kateri Memorial Hospital, she was immediately reassured by the signs and posters written in Kanien'keha on the walls.

She doesn't have to worry about her loved ones. “It's a modern hospital with the latest facilities, but I see my traditional culture in it,” says the employee at the Kahnawake Mohawk Council. It makes me happy to feel represented and to know that this institution really cares about my health.” Recently, her mother-in-law had to receive health care far from home. “She went to a hospital outside our community and was treated in an atrocious manner,” Ms. Morris said in outrage.

She said that hospital staff refused to grant simple requests. “There were nurses who didn't even want to look at her or talk to her. The only one who was open to offering him help was a racialized nurse,” says the young woman. According to her, the problem lies in the lack of dialogue between indigenous and non-indigenous communities. In passing, she recalls what the health personnel said about Ms. Echaquan.

“I really think that they think that way because of a lack of interactions with indigenous people,” she says. A first step, according to her, would be to offer training that makes health personnel aware of Aboriginal realities.

“We have health issues that stem from alcoholism, trauma, and colonialism. If health care providers are more aware of these realities, they will have greater empathy for their Indigenous patients,” she says. Ms. Morris also suggests that Aboriginal seniors make hospital staff aware of the realities of their communities. She also wanted to see more health resources allocated to indigenous communities, having witnessed the benefits that such initiatives could have. A graduate of Concordia University, she has good memories of the Otsenhákta Student Centre, which offers services to Aboriginal students. “There was an elder you could consult and a room dedicated to traditional medicine,” she recalls. It was reassuring for me to be among my family.” Ms. Morris is constantly educating people about Aboriginal realities and cultures. She believes that institutions also have their part to do to facilitate this dialogue, just like the non-native population.

“Indigenous people can't carry the burden of awareness alone,” she says. Barbara Flamand was a cultural safety liaison officer for the Manawan community at the Joliette Hospital. She was there when Joyce Echaquan died under racist insults from medical staff. Nobody told him that Joyce Echaquan was in the health facility. It was only when the victim's mother, Diane Echaquan, called her to tell her that her daughter was asking for help in a video on Facebook, that she went to the emergency room.

But it was too late when she got there. After waiting for an hour in the emergency room, she was told that the patient had died. A year later, the former liaison officer said she still did not know why she was not called. She thinks that Joyce Echaquan would not have died if she had been there. “I shut myself up for a year, I resigned. I feel guilty,” she said, unable to hold back her tears at the commemorative ceremony.

Awareness at the national level

Today, Joyce Echaquan's family wants the non-native population to be sensitive to the stereotypes that make Aboriginal people dangerous and to the damage that these prejudices cause.

Innu senator Michèle Audette also believes that there is still a lot of awareness-raising work to be done. Also the Commissioner of the National Inquiry into Missing and Murdered Indigenous Women and Girls, Ms. Audette denounces the fact that the media feeds the stereotype of dangerous Aboriginal people, especially in the case of Cindy Gladue, another Aboriginal woman who died in tragic circumstances. “In the media, we never name this Aboriginal woman, who is described as a prostitute, a sex worker, or an Indian, when we name the person who committed the crime against her.

It's a big problem,” said the former president of Quebec Native Women. According to her, it is this type of discourse that fuels the problem.

“We end up normalizing violence against Aboriginal women,” says the senator. However, Ms. Audette is optimistic. Joyce Echaquan's death sparked a public conversation, something she didn't see 10 years ago. She wants this momentum to continue and for Aboriginal people to be able to take their rightful place in all spheres of society. “The media must dare to cover Aboriginal issues to make us known to the general public,” she says. If the government passes a bill, non-native citizens must question it about its impact on Indigenous nations.”

The fight for the recognition of systemic racism and the Joyce Principle

“We talked about creating bridges, and I think the bridges were there, but there were walls that were built on these bridges,” says the Grand Chief of the Atikamekw Nation Council, Contant Awashish. Photo: Julien Forest

To do justice to the mother of the family, the Atikamekw community is asking the government to recognize systemic racism, a difficult fight according to Constant Awashish, Grand Chief of the Council of the Atikamekw Nation. “We are talking about systemic racism, we are talking about something that is difficult to explain, that is difficult to defend often. But Joyce allowed collective awakening. It showed the general population that there were indeed inadequate treatments for First Nations.

That's what she knew how to represent, that's what she was able to demonstrate as a woman. We owe him a lot for the future of our children,” says the Grand Chief. “Every time I think of Joyce, I think of her children, of future generations. I think that the work she has begun is to open the door to collective awareness, both among us and among non-indigenous people. It's what we want. We talked about creating bridges, and I think the bridges were there, but there were walls that were built on these bridges.

Now, we just need to break those walls, the walls of ignorance, the walls of ignorance, the walls of hate, the walls of fear of each other — that's what fuels our separation,” he adds. He believes that more education about Aboriginal realities is needed. The Grand Chief Atikamekw is also asking the Quebec government to “make water in its wine”, to review its position on systemic racism and to make September 28 a national day of remembrance in honor of Joyce Echaquan.

Ms. Echaquan's family also want the provincial government to adopt Joyce's Principle, a request reiterated by the Atikamekw community on September 28. This is linked to a brief submitted by the Council of Atikamekw of Manawan and the Council of the Atikamekw Nation last November. This thesis defends the rights of aboriginal people in Quebec and Canada in terms of health and social services. Presented to the federal and provincial governments, “the Joyce Principle aims to ensure that all Aboriginal people have the right to equitable access, without any discrimination, to all health and social services, as well as the right to enjoy the highest attainable standard of physical, mental, emotional and spiritual health.” It also requires “recognition and respect” for traditional medicines. “I hope that the governments of Quebec and Canada adopt the Joyce Principle so that this terrible event is not in vain, so that her voice sounds the beginning of real changes for all Aboriginal people, so that no one will ever again be a victim of systemic racism,” says Carol Dubé at the beginning of the thesis. At the federal level, the Liberal Party indicated during the campaign that it would fully apply the Joyce Principle. In Quebec, the CAQ announced earlier this year that it did not intend to adopt this Principle.

On Tuesday, September 28, in parliamentary session, the Prime Minister declared that he agreed with the foundations of the Joyce Principle. However, he said he was reluctant to adopt it because of the systemic racism he was referring to. François Legault's party rejected a motion on the cultural security of aboriginal people proposed by the opposition parties. As for the issue of systemic racism, ministers Geneviève Guilbault and Ian Lafrenière refused to answer questions from the media on Tuesday, during the commemoration.

The Salon Bleu was also the scene of a partisan confrontation on this issue. Disappointed with the Legault government's lack of commitment, Indigenous leaders are now looking to Quebecers to commit to ending the systemic racism that killed Joyce Echaquan.

Will they be there?

On video

A song for Joyce by her cousin Karine Echaquan Karine Echaquan remembers

Patrick Martin Ménard, Joyce Echaquan's lawyer, illustrates how her death was a result of systemic racism in the health care sector

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