An exploration of anti-Indigenous systemic racism in Canadian health care, medical violence inflicted upon Indigenous children, and the medical establishment’s role in colonial genocide.
Launched by healthcare providers in January 2018, the #aHand2Hold campaign confronted the Quebec government’s practice of separating children from their families during medical evacuation airlifts, which disproportionately affected remote and northern Indigenous communities. Pediatric emergency physician Samir Shaheen-Hussain’s captivating narrative of this successful campaign, which garnered unprecedented public attention and media coverage, seeks to answer lingering questions about why such a cruel practice remained in place for so long. By focusing on the structural drivers of the social determinants of health, this book serves as an indispensable case study of contemporary medical colonialism in Quebec, and demonstrates that inequalities in health care follow the fault lines of societal injustices.
Fighting for A Hand to Hold exposes the Canadian medical establishment’s role in the displacement, colonization, and genocide of Indigenous Peoples — colonial genocide. Through meticulously gathered government documentation, historical scholarship, media reports, public inquiries, and personal testimonies, Shaheen-Hussain connects the draconian medevac practice with often-disregarded crimes committed against and medical violence inflicted upon Indigenous children across the country for more than a century and a half: fomented smallpox epidemics and avoidable tuberculosis deaths; experiments and abuse in residential schools, Indian Hospitals, reserves, and communities; forced sterilization; child abduction and disappearances. This devastating history and ongoing medical colonialism prevent Indigenous communities from attaining internationally recognized measures of health and social well-being because of a pervasive culture of systemic anti-Indigenous racism that persists in the Canadian public health care system— and in capitalist settler society at large.
Shaheen-Hussain’s unique perspective combines his experience as a frontline pediatrician with his long-standing involvement in anti-authoritarian social justice movements. Sparked by the indifference and callousness of those in power, this book draws on the innovative work of Indigenous scholars and activists to conclude that a broader decolonization struggle calling for reparations, restitution (including land reclamation), and self-determination for Indigenous Peoples is critical to achieve reconciliation in Canada.
Fighting for A Hand to Hold is part of McGill-Queen’s University Press’s Indigenous and Northern Series.
All author royalties from sales of this book will be redirected to groups and initiatives that support Indigenous self-determination, and that are concerned with the health and wellness of Indigenous children and youth: Eagle Spirit Science Futures camp, First Nations Child and Family Caring Society, Groundswell Community Justice Trust Fund, Minnie’s Hope Social Pediatric Centre, Mohawk Language Custodian Association, and Native Women’s Shelter of Montreal. Proceeds from hand sales at public events will go to Indigenous land-defence initiatives and resurgence movements. Lux Éditeur will publish a French translation of the book in early 2021.
Table of Contents
Foreword, by Cindy Blackstock
Preface and Acknowledgments
A Note to Readers
PART 1: Above All, Do No Harm
Chapter 1: Medevac Airlifts in Quebec and the Non-Accompaniment Rule
Chapter 2: The #aHand2Hold Campaign: Confronting a System
PART 2: Structural Fault Lines in Health Care
Chapter 3: Social Determinants of Health: Equality, Equity, and Limitations
Chapter 4: Recognizing Systemic Racism: A Social Justice Approach
Chapter 5: Medical Culture and the Myth of Meritocracy
PART 3: Medical Colonialism and Indigenous Children
Chapter 6: A Little Matter of Genocide: Canada and the United Nations Convention
Chapter 7: From the Smallpox War of Extermination to Tuberculosis Deaths in Residential Schools
Chapter 8: Experimental Laboratories: Malnutrition, Starvation, and the BCG Vaccine
Chapter 9: Cruel Treatment: Indian Hospitals, Sanatoria, and Skin Grafting
Chapter 10: Gendered Violence: Forced Sterilization and Coercive Contraception
Chapter 11: Breaking Up Families: Child Welfare Services, Mass Evacuations, and Medical Disappearances
Chapter 12: Oral Histories and the Narrative of Genocide
PART 4: The Structural Determinants of Health and Decolonizing Our Future
Chapter 13: Capitalism and the Cost of Caring
Chapter 14: History Matters: Colonialism, Land, and Indigenous Self-Determination
Chapter 15: Decolonizing Health Care: Reparations before Reconciliation
Afterword, by Katsi’tsakwas Ellen Gabriel
What People Are Saying
“The memories of the Inuit children I attended as a young interpreter at the Montreal Children’s Hospital came flooding back to me, the sad face of a child looking up at me. Nurses informed me that he was not speaking, but I immediately recognized the fear in his face, in his eyes. As soon as I spoke to him in Inuktitut, he looked at me in disbelief, but in the next moment his tears began to roll and I could only sound out the Inuit sound of love, ‘mmph’, and to tell him it will be alright, and that his mom or a relative would be arriving soon. I felt for that child, and as he began to relax and open up, we had a lovely conversation in Inuktitut. He did not feel so alone in this strange place he had just been deposited on, as if he was cargo. To this day, I still feel for him. Throughout all these years, we all have been made to believe that this is how things should work. It was one of those things we stayed quiet about for decades. But no longer. We Inuit, we are a people. We love our children. Fighting For A Hand To Hold — Confronting Medical Colonialism Against Indigenous Children in Canada, helps us understand the issues of colonization in the medical system that has vexed us as Indigenous peoples. Today, we Inuit are working to bring our health back to our communities. Healthy communities and families mean self-governance to us and the de-colonization process will happen.” Lisa Qiluqqi Koperqualuk, M.A., vice-president international affairs, Inuit Circumpolar Council Canada
“In Fighting for a Hand to Hold: Confronting Medical Colonialism against Indigenous Children in Canada, Samir Shaheen-Hussain addresses different aspects of the healthcare system offered to indigenous people, always stressing that this is a field strongly marked by colonial power relations, historically perpetuated by the Canadian state. Starting from a harsh critique of the current health policies dispensed to indigenous children and their families, the book takes us to a profound reflection on how medical colonialism and systemic racism perpetuate themselves, and how movements for sovereignty and decolonial thinking are key pieces in changing diverse paradigms. The book shows that important changes in the health system offered to indigenous peoples have not yet been executed, which prevents an effective transformation of the healthcare system. This mismatch between the discourses and the reality is in tune with the maintenance of the colonial posture in relation to indigenous peoples is still in force in the Canadian State. While grounded firmly in the academic literature, the author uses language that will be easily accessible to a general audience and will incite the reader to engage in a profound examination of Canada’s history and its relationship with Indigenous peoples. A moving and necessary book. A must-read for all who are interested in one of the most macabre faces of medical colonialism: its genocidal and eugenicist face.” Quebec Native Women (Femmes Autochtones du Québec)
“Heartbroken. This is how I feel after reading Fighting for a Hand to Hold. It hurts to read about children suffering. Shaheen-Hussain’s book does not relieve that pain. Yet his words hold the potential to help us create broader healing, if his insights are heeded.” John Borrows, Canada Research Chair in indigenous Law, University of Victoria Law School
“A sick child is transported by plane to a hospital 1000 kilometres away alone and without a parent to accompany the child, a state practice without pity. No parent can read this and not feel a sharp pain yet so many managed to defend the practice even when the mothers of the children who died alone en route publicly grieved that they were never able to give comfort to their dying children. This is the racial terror that was aimed at Indigenous peoples in the province of Quebec. This book tells the story of the fight to change what so clearly springs from the annihilative impulse at the heart of settler colonialism. What can we learn from this book about the struggle to abolish the practice? This practice was no mere discriminatory residue of an old colonial system long gone. Instead it is a telling sign of an ongoing settler colonialism, one deeply structured to “disappear Indians” and to declare Indigenous lives as worth less than white ones. Samir Shaheen-Hussain’s clear-eyed account reminds us that we can change but not until we recognize this ugly truth.” Sherene H. Razack, Distinguished Professor and Penny Kanner Endowed Chair in Gender Studies, UCLA. Author of Dying From Improvement: Inquests and Inquiries into Indigenous Deaths in Custody
“In Fighting For A Hand To Hold – Confronting Medical Colonialism Against Indigenous Children in Canada physician Samir Shaheen-Hussain exposes the social, cultural, and historical structures that allow medical colonialism to hide in plain sight as it harms generations of Indigenous children and their families. It is an unflinching analysis that should be required reading in every medical school in the country.” Maureen Lux. Professor and Chair, History Department, Brock University; author of Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s
“Samir Shaheen-Hussain’s Fighting For A Hand to Hold is a searing indictment of medical colonialism in Canada. This must-read book shatters the myth of universal and equitable healthcare as a pillar of this country’s benevolent social democracy and, instead, forcefully exposes the active involvement of the medical system in upholding historic and ongoing settler-colonial power.” Harsha Walia, author of Undoing Border Imperialism
“Fighting for a Hand to Hold denounces with ferocity the utterly inhuman, decades-long practice of separating children from their families during emergency medevacs in northern and remote regions of Quebec. In a precise, compelling, and well-documented narrative, Samir Shaheen-Hussain challenges our collective understanding of systemic racism and social determinants of health applied to Indigenous communities most dependent on medevac airlifts and most impacted by the non-accompaniment rule. An eye-opening, tough, and essential book.” Dr Joanne Liu, pediatric emergency physician and former international president of Doctors Without Borders (Médecins Sans Frontières)
“A necessary and sobering read. Shaheen-Hussain’s text masterfully exposes the ways in which the logics of settler colonialism and genocide are structurally embedded into Canada’s healthcare system. It illuminates how egregious racial violence takes place — in plain sight — under the direction of a publicly-funded institution that is broadly understood, to most Canadians, as a social good. The book, meticulously researched, firmly centers Canada’s medical system as a crucial site for ongoing anti-colonial struggle.” Robyn Maynard, author of Policing Black Lives: State Violence in Canada from slavery to the present
“An astonishing book. It begins with the anguished story of Cree and Inuit children from northern Quebec travelling alone by air, sick or injured, panic-stricken, to hospitals in the south, and becomes one of the most moving, ferocious, historically comprehensive narratives of medical colonialism and indigenous cultural genocide that I have ever read. It’s a stunning piece of work. When I finally put it down, I was gasping … an absolute tour-de-force.” Stephen Lewis, Co-director AIDS-Free World
“Its clever framing, detailed research and frequent critical gems put Fighting for a Hand to Hold in the very good company of a small group of stellar books and articles about Indigenous health issues, all of them manifestos for change. It’s a passionate and informed report from the medical frontlines that exposes some of the social determinants and racial subtexts that prevent us from improving and safe-guarding the lives of Indigenous peoples and other minorities in Canada.” Gary Geddes, author of Medicine Unbundled: A Journey Through the Minefields of Indigenous Health Care
“Shaheen-Hussain argues that genuine reconciliation can’t occur without reparations and restitution. Besides disclosure and acknowledgement of the harm done, this means a genuine demonstration of sorrow and regret, a promise to never do harm again, and action that ensures the harm will not be repeated. This book should be read by anyone who wants to meaningfully enter into reconciliation with Indigenous people.” Marie Wadden, author of Where the Pavement Ends: Canada’s Aboriginal Recovery Movement and the Urgent Need for Reconciliation
About the Author and Contributors
Samir Shaheen-Hussain has been involved in social justice movements – including Indigenous solidarity, anti-police brutality and migrant-justice organizing – for almost two decades. He is a member of the Caring for Social Justice Collective, and has written or co-written several pieces about state violence and health care over the years. He is an assistant professor in the Faculty of Medicine at McGill University and works as a pediatric emergency physician in Tio’tia:ke (Montreal).
Cindy Blackstock, a member of the Gitxsan First Nation, serves as the Executive Director of the First Nations Child and Family Caring Society of Canada and is a professor in the School of Social Work at McGill University. Her interests are culturally based equity, Indigenous child rights and systemic advocacy.
Katsi’tsakwas Ellen Gabriel is a Kanien’kehá:ka human rights and environmental activist-artist. She was chosen by the People of the Longhouse and her community of Kanehsatà:ke to be their spokesperson during the 1990 “Oka” Crisis. For three decades, Ellen has consistently advocated for climate justice and Indigenous Peoples’ self-determination, cultural, and language rights, while opposing violence against Indigenous women.
Related Articles, Op-eds & Interviews
By: Outside The Book
August 25, 2020
We Must Ask Why Medicine Still Puts Racists On A Pedestal
By: Samir Shaheen-Hussain, HuffPost
August 24, 2020
No pedestal for medical pioneer Sir William Osler
By: Samir Shaheen-Hussain, Montreal Gazette
August 10, 2020 (print version of August 11, 2020)
Decolonizing Health Care: Confronting Medical Colonialism against Indigenous Children
By: Samir Shaheen-Hussain, Canadian Paediatric Society
July 14, 2020
Doctor pens book on fight to confront ‘medical colonialism’ in Canada
By: Holly Moore, APTN News
May 21, 2020