Structures of Indifference by McCallum and Perry, University of Manitoba Press, 2018

In September of 2008 Brian Sinclair, a first nation’s man who, earlier in life, had lost both his legs to frostbite, wheeled himself into the emergency room of Winnipeg’s Health Science Centre. He had an infection that was easily treatable. Sinclair was a soft spoken man, hard to understand and had some cognitive challenges. Although Sinclair had difficulties with addiction in his past, at that point in his life he was clean of substance abuse, had a place to call home, did a great deal of volunteer work for a non-profit organization and had about five thousand in savings in the bank.

Sinclair spent the next day and a half sitting in the emergency room without being seen by a single member of the hospital’s medical staff, including the nurses responsible for triaging patients during that time period. His condition worsened and he died in his wheel chair before anyone noticed him at all.

An inquest was held that found a ‘perfect storm’ of unusual circumstances but couldn’t find any fault with the staff at the hospital. The inquest rejected the possibility that race and profiling had any bearing on the outcome despite evidence that indicated those ignoring Sinclair dismissed him in a number of ways: he was one of those aboriginal homeless people looking for a warm place, he was one of those native guys that are high/intoxicated and looking for a place to sleep it off, or even asking why he didn’t make a fuss or say something when he wasn’t seen by a nurse – as though he was ultimately at fault. Indeed, the Chief Medical Examiner opined that, in the same circumstances, even Snow White would have died. The inquest eventually made recommendations regarding triage policies and systems.

McCallum and Perry have quite a different conclusion. They assert that aboriginal people have to contend with historical structures in health care that are staffed by people who have never questioned their ‘settler colonial’ attitudes or the racism that is deeply rooted in settler colonial history. McCallum and Perry argue that health care in Canada for aboriginal peoples continues to be a far different experience than it is for non-aboriginals.

Using Brian Sinclair as an example, this is a book that examines the roots of the problem, identifying the historic events and attitudes that designed structures to the detriment of first nations’ peoples. It helps explain why Canadians often have such a hard time identifying the racism that occurs frequently in our society. It also throws light on why first nations’ peoples have disastrous experiences in accessing health care.

As a primer on the historical issues and attitudes of settler colonialism and its treatment of native people, this book is quite informative. Its weakness lies in its lack of passion, constantly referring to ‘structures of indifference’ when ‘indifference’ is hardly the operative word when describing some of the dismaying acts of racism encountered by native peoples in Canada, both historically and in the present day. The authors contend that mainstream Canadians are unable to see the racism in cases such as Sinclair’s but their focus on ‘structures of indifference’ lessens the personal tragedy that would make the case more compelling.

In point of fact, after reading ‘Structures of Indifference’, I remembered an old offering by the late ‘Vancouver Sun’ political/editorial cartoonist, Len Norris. With one small change to the Norris cartoon, it would make the point much better than do McCallum & Perry. Imagine a large corporate room with a well-dressed fat white fellow sitting behind a huge desk. In front of the desk is standing a rather sad looking first nation’s person holding his hat. The caption underneath has the fat guy saying, “I’m sorry, we have a policy of not hiring aboriginals because we don’t have a racial problem in Canada.” Exactly.

TL:DR – They say that one picture is worth a thousand words. Norris proves the point.



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