Response to "Apartheid in Canada".
Bowering, David ; George, Prince
Dear Editor,
As a physician and public health practitioner with 38 years of
experience working and living in Northern British Columbia and the
Yukon, in close proximity to First Nations citizens, I was immediately
drawn to the title of your editorial "Apartheid in Canada".
(1) Finally, I thought, someone in public health who is willing to tell
the inconvenient truth.
Imagine my disappointment on reading your last sentence, which
begins "We do not have apartheid policies in this country ..."
Of course we do! If we take the notion of "apartheid" to mean
legislated structural differences in governance that have the effect of
reducing the opportunities and living standards of one race or ethnic
group with respect to another (which for me is close enough), Canada is
an exemplar of apartheid. Your editorial outlines the outcomes: relative
poverty, poor living conditions, marginalization, etc. You refer to the
well-intentioned efforts of "skilled competent and dedicated
professionals" and suggest that the answers lie in "greater
efforts" and more resources.
Unfortunately, the problems have little or nothing to do with a
lack of either effort or resources. They are intentional, structural and
overwhelming in their effect. I would suggest that jurisdictional
complexity and dysfunction are at least as important determinants of the
health of First Nations people as are poverty and education.
Non-Aboriginal Canadians have access to a system of governance
based on carefully articulated relations between three distinct levels
of government: federal, provincial and municipal. By and large it is
clear to most of us where to go for services and solutions, and by and
large the three levels have learned to stay out of each other's
kitchens. The outcomes of this are reflected in relatively good social,
economic and health conditions for the majority of non-Aboriginal
Canadians.
By contrast, First Nations communities have to survive in a
jurisdictional morass that replaces progress with unending processes,
including "new" ones such as the tripartite agreement in
British Columbia. While the principle of including and engaging First
Nations' representatives in these governance processes is admirable
and important, the structural underpinnings of this are a confusing
substrate of politics and jurisdictional fuzziness involving bands,
treaties, partial treaties, affiliated bands, Nations and others. This
ensures that there is an abundance of talk and almost no tools for
moving forward in a systematic way. When you add in the overlapping
mandates of the federal and provincial/territorial governments, include
health authorities and regional governments and truckloads of
Memorandums of Understanding and Agreements simply to provide basic
services, "tripartheid" instead of "tripartite"
becomes more than just a slip of the tongue.
It seems crystal clear to me after watching variations of the same
scenario for many years that we desperately need to focus on systematic
restructuring along the lines of the Canadian
federal/provincial/municipal model and that, until we do, First Nations
people in our country will have to make do with policies that are
designed to deliver hand sanitizers and band aids in a pinch but that
are completely ineffective if the goal is to address and redress the
systematic inequities First Nations people face every day. We need to
begin by acknowledging apartheid in Canada and working with First
Nations leaders to replace it with something at least as useful and
effective as the system that provides the rest of us with so much.
David Bowering, MD, MHSc
Prince George, BC
REFERENCE
[1.] Paradis G. Apartheid in Canada. (Editor's page) Can J
Public Health 2009;100(4):244.
