RACISM IN HEALTHCARE

Ojibway chief upset at how a First Nation teen with 'massive' wound was treated in Kenora, Ont., hospital's ER

Logan Turner - Yesterday 
cbc.ca


A Kenora, Ont., hospital is investigating after the chief of Ojibways of Onigaming says a 13-year-old from his First Nation was left in the emergency room without immediate care for a "massive" wound, and a nurse told him to bandage it himself.

Jeff Copenace said he was called by the family to go to Lake of the Woods District Hospital (LWDH) on April 25 to advocate for the teen. He said she had tried to harm herself, and she had already been waiting in the ER for more than 30 minutes when he arrived. When he approached the desk to get help, he said, a nurse handed him gauze and tape.

"I was shocked that [the girl] was sitting there with an open wound and not even like a social worker talking to her, anyone rushing to her aid," Copenace told CBC News, adding the girl is now doing well and at home.

"We're a First Nation that remains in a state of emergency for suicides and mental illness. The district hospital is well aware of that."

CBC News has been unable to independently verify exactly what happened at the hospital.

The president of the LWDH, Ray Racette, said they began investigating after seeing Copenace's tweet, which came the same day as the incident, adding they hope to speak with the chief.

The incident comes amidst a nationwide conversation — spurred by the 2020 death of Atikamekw mother Joyce Echaquan — about the impacts of systemic racism toward Indigenous people in the health-care system, as well as hospital staffing shortages across Canada.

It also came just months after a First Nation family said a 32-year-old man died of a brain bleed hours after he was discharged from the same hospital with headache pills.

Wound was 'alarming,' chief says

Copenace said he immediately drove 116 kilometres north to get to the Kenora hospital after the family of the young girl called him, saying she had harmed herself.

The girl and her uncle were in the emergency room with a deep, open cut on her arm, he said.

"It was a massive wound. It was cut straight through the skin … and it was really alarming," Copenace said.

He said that after he asked the ER desk if they planned to bandage her wounds, the nurse told him, "'I'm not going to dress a wound that happened last night and isn't bleeding anymore.'"

"I was panicked," said Copenace. "I asked [the nurse], 'Do you know she's 13? Do you know that she self-harmed?'"

At that point, he said, a second nurse gave him gauze and medical tape, and told him to bandage her wound. It wasn't until he asked for a supervisor that the girl's cut was taken seriously, Copenace said, and then closed with stitches.

When the supervisor came out to speak with him about the incident and the hospital's response, Copenace said she told him there had been no experiences of racism at Lake of the Woods hospital in the 20 years she's worked there.

"If this was a young, white child, the whole hospital would have raced to her," the chief of the Treaty 3 First Nation believes. "They never would have left a young white child with an open wound that required eight stitches."

Copenace repeated concerns about the way systemic and direct racism affect the health care of Indigenous people. Those concerns — which have been documented for decades in government reports, inquiries and royal commissions — include disproportionately longer wait times, minimizing of concerns, inappropriate or no pain management, medical errors and a lack of respect for cultural protocols.

He also emphasized concerns over youth suicide in Indigenous communities. According to Statistics Canada, the rate of suicide among Indigenous people is three times higher than the national average — among Indigenous youth, the disparity is even greater.

"The treatment that we receive from non-Indigenous health-care professionals, police officers, government officials, taxi drivers, the systemic racism that we face is driving this self-harm and it needs to stop."

The connection between systemic racism and poor mental health outcomes, including higher rates of suicidal ideation and self-harm, is well established in academic research and government reports, including most recently the 2020 report "In Plain Sight" on Indigenous-specific racism in B.C. and a 2021 report into 45 mostly Indigenous boys who died by suicide or homicide in Manitoba.

Copenace said his focus last week was ensuring the girl had the proper supports, and now he is preparing to file a complaint with the hospital.

Tweets prompt hospital to open investigation

Racette, the Kenora hospital's president, said early findings from the investigation show that upon arrival to the ER, the patient was triaged, which is the assessment process hospitals use to determine which cases need to be seen most urgently. Based on that assessment, the patient's wound was treated within one hour, and then released within 5½ hours.

"Our staff look at patients based on need, and they do the best that they can for them," Racette said. "There are different things that needed to happen in the process of care … the emergency team, they work as a team and they have lots of patients to see."


© Logan Turner/CBC

Ray Racette, president and chief executive officer of the Lake of the Woods District Hospital, says they are investigating the care provided to the 13-year-old after Copenace tweeted about it.

"We're understaffed. We have a 40 per cent vacancy rate in staffing in [the emergency department], so that in itself is very challenging for staff who are just trying to do the best job they can. But it's going to impact wait times."

Racette said the way hospital officials understand what happened in the emergency room is different from what the chief posted on social media, adding they called the band office and sent an email to Copenace's executive assistant in an attempt to meet with him.

"We would really appreciate meeting with him because we respect him and we want to have an exchange with him," Racette said, adding social media can be "a very blunt instrument" that can harm their reputation and relationship with Indigenous people.

"We're working hard to improve. There's a lot of perceptions on this hospital that go back a long time, and those are hard to change because they're part of the lived history with some people," he acknowledged.

Copenace told CBC News he had not received any messages, but would be reaching out to the hospital to discuss the situation.

History of negative experiences at hospital

Jennifer Dreaver, chief operating officer of the Kenora Chiefs Advisory (KCA), a First Nations health and social services agency that works with nine communities, said she was saddened but not surprised to hear about what Copenace said he experienced at the hospital.

"It's disconcerting for the community, because it just continues to erode trust and faith in the utilization of the Kenora hospital," said Dreaver, from Mistawasis Nehiyawak First Nation in Treaty 6.

Dreaver said she's heard many stories about First Nations people choosing to bypass the Kenora hospital and drive hundreds of additional kilometres to get medical help in Thunder Bay or Winnipeg, adding there is a long history of mistrust between the hospital and surrounding First Nations.

As an agency that advocates for Indigenous patients, the KCA has partnered with the Kenora hospital on a project of "reconciliation through health" that will see the construction of a new facility — the All Nations Hospital — to replace the existing building and improve health care for Indigenous people.

"We do want to work together to validate patients' experiences and make them feel heard, to have transparent processes for people to have their concerns addressed and to have responsiveness on the part of the hospital," said Dreaver.

'A lifetime of work'

Dreaver said the goal is to have a local hospital people can be confident in and is properly resourced, and where staff have training in cultural safety and trauma-informed care.

Work is happening now at the existing facility, including the hiring of more Indigenous staff and patient advocates and improving the complaint process, but it takes time, Dreaver said.

"It's a lifetime of work to build those bridges."

But the change isn't happening soon enough, Copenace said.

"We're still talking in a completely different language from the non-Indigenous health professionals, and our people are suffering."

He fears more Indigenous people will choose to stay home and not seek help, which would lead to higher rates of premature deaths — a link made in the 2020 report in B.C. about Indigenous-specific racism in health care.

"I've got nothing but respect for the medical profession, but I just want to see these racial boundaries broken down and our children served properly."

Kenora Chiefs Advisory Crisis Services: 807-629-7562

This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you're worried about.