“Separate Beds: A History of Indian Hospitals in Canada” 1920s-1980s

Author: Lux, Maureen K. (2016) Toronto: University of Toronto Press

Book Review by Dr. Paula Cook

InSeparate Beds, Dr. Maureen Lux, a Canadian historian and academic, traces the history of medical care provided to the First Nations in Canada.

Lux provides a comprehensive look of the racially segregated health care system, which has plagued Canada since the first treaties were signed. Non-Indigenous Canadians and politicians are often so proud of Canada's progressive medical history and its evolution from a hardscrabble provincial plan to the definition of national health that embraced all – however most if not all, are unaware of the other 20th Century healthcare story in Canada: The First Nations’ healthcare system that embodies intractable and enduring health disparities in most Indigenous communities and impact First Nations people that live on and off the reserve. This second history is conspicuously absent from average Canadian's consciousness and while the Canadian government has attempted to put forth the public perception of its’ efforts benevolent “humanitarian efforts” toward the First Nations.

Lux details how even the earliest Canadian policies and efforts to provide First Nations health care services were grossly inadequate, discriminatory, and arbitrary. From the 1860s to the 1940s First Nations health care on reserve was provided by missionaries, under direction of the Indian agents. These missionaries addressed many of the First Nations' healthcare needs striving to deliver the same dismal level of service provided in residential schools. Under the racist and illegal pass system, First Nations were prevented from leaving their reserves without written permission from the Indian agent. Further Indian agents controlled when and which First Nations people could access health care off reserve.

Later in the 1940s Canada opened Indian Hospitals in response to the rampant Tuberculosis (“TB”) crisis on First Nations reserves. Provincial governments barred First Nations people from admission and access to provincially operated TB sanatoriums. Indian Hospitals were operated by the government's Indian Health Service (IHS), and the standard of care was dismal. Treatment was arbitrary and punitive. Conditions were dire and substandard care was the norm. Lux details in her book how medical personnel who worked at these hospitals typically could not find jobs anywhere else because of their inadequate skills, reckless treatment practises and cavalier attitudes. Abuses were common. Children were placed in plaster casts for the purpose to immobilized them in bed and prevent them from running away. Surgeons operated on patients with little or no anesthesia, one doctor claiming his skills were so great that the patent did not need anesthesia, despite the fact he was removing the patient's lung and three ribs.

Continued on the following page

Continued from the previous page

In 1953 the Indian Act was amended to criminalize illness in First Nations' people and allowed for the RCMP to arrest those who were ill but refused treated at Indian Hospitals. Indian Hospitals developed close relationships with medical schools and universities, providing test subjects (patients) for medical experimentation. Various pharmaceuticals, chemical interventions (chemical warfare chemicals) and medical procedures were researched in these hospitals. Lux substantiated all these findings with archival records from the Canadian Department of Indian Affairs, and the Department of the National Health and Welfare, newspaper archives, published primary documents, oral interviews and a profusion of secondary sources and academic writings.

It is important to understand how the hundred plus years of marginalization, being blamed and criminalized for illnesses, (many caused by the factors put in place by the repressive Indian Act), the propaganda promoting Canadian' "humanitarian" care of the First Nations people, (which was neither humanitarian or in the best interests of the First Nations people) and the government's active promotion of the idea that First Nation people were a public health hazard to the rest of Canada, influences healthcare today.

Lux’s book was published in 2016 and therefore does not consider the Jordan’s Principal and the efforts of Cindy Blackstock and the First Nations Child and Family Caring Society’s decades long efforts at the Human Rights Tribunal and Federal Court for access to non-discriminatory health care for First Nations children.

Dr. Lux, being an academic, scholar and Canadian history professor from Brock University, used extremely reliable and credible sources to support the information in this book. She heavily relied on the Canadian government's own words from the archival documents, legislation, and newspaper reports from the time. Because the book is so well referenced and substantiated official government documents of the time, this book is a valuable addition to one's personal library. As Dr. Lux stated in a talk in 2016 to a medical school, "Separate Beds may be the catalyst for Canadians to understand our history of racially segregated care, so Canadians can begin to see how our privilege came at such a terrible cost."

Reference: Lux, Maureen K. (2016). Separate Beds : A History of Indian Hospitals in Canada, 1920s-1980s. Toronto: University of Toronto Press.

Addendum: On November 15, 2021, the Winnipeg Free Press reported on a University of Winnipeg archivist who has developed a tool to help find Indigenous patients who were sent to tuberculous hospitals and never returned home.