Race used to determine medical treatment

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Seventy years ago, about 30 kilometres outside of The Pas, Clearwater Lake Indian Hospital was experiencing a large turnover in patients. The annual provincial tuberculosis X-ray survey used to screen, identify and remove First Nations people with active and contagious tuberculosis had returned.

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Opinion

Hey there, time traveller!
This article was published 08/10/2016 (2190 days ago), so information in it may no longer be current.

Seventy years ago, about 30 kilometres outside of The Pas, Clearwater Lake Indian Hospital was experiencing a large turnover in patients. The annual provincial tuberculosis X-ray survey used to screen, identify and remove First Nations people with active and contagious tuberculosis had returned.

Managed by the Sanatorium Board of Manitoba for the federal government, Clearwater Lake had been operating as an Indian hospital and had experienced considerable setbacks over its first year.

Initially built in 1943 as a U.S. Army field hospital, the Canadian government purchased Clearwater Lake and repurposed it in 1945 as an Indian hospital after the war. But the wooden, barrack-like structure had been built hastily and was meant to be temporary, and when it was used as a permanent hospital problems arose, including poor ventilation, unsanitary flooring, an unsafe heating system and inadequate electrical power.

By 1947, there was considerable overcrowding at the hospital. Beds were far too close, and staff were unable to adequately segregate infectious patients. In the first few years of operation, there was a nursing, domestic and specialized staff shortage, insufficient staff housing and no ambulance and unreliable modes of patient transportation. The hospital needed surgical equipment and lighting. For patients, Clearwater Lake was far from an ideal place for healing.

Researching the history of Clearwater Lake is part of a larger project that seeks to document indigenous histories of TB in Manitoba. There are three areas of inquiry: “Indian Clinics” or X-ray surveys of reserves, northern communities and Indian schools; TB treatment in sanatoriums and other institutions; and education and rehabilitation programs offered to recovering TB patients.

The first of the key findings is medical knowledge and practice in 20th-century Manitoba was thoroughly invested in the idea that race determined whether and how often one became sick and, therefore, should also determine medical treatment.

In the records we are looking at, race and racially segregated treatment is ever-present. There were “Indian and Eskimo TB Surveys” conducted specifically at First Nations and under different conditions than other TB surveys; there were “Indian Sanatoriums,” and there were programs of “Indian Rehabilitation” distinct from those directed to the main sanatorium population.

Second, “Indian” TB management occurred without consultation with or involvement of indigenous people, in spite of being developed distinctly only for indigenous people.

Third, between 1930 and 1970, the approach to “Indian” TB treatment changed significantly. Treatment was largely withheld from indigenous people until the early 1940s. In that decade and through the 1950s, very limited and stingy concessions were made, but by the 1960s, rigorous indigenous TB surveillance and treatment were enforced.

This shift reflects an increased interest in “Indian health” in Manitoba; it also coincides with the decline of the disease among non-indigenous Manitobans. More examination of this era is necessary.

Treatment of indigenous patients was more economical and sometimes also outdated. Into the late 1960s, TB specialists argued for long-term sanatorium stays for indigenous people even while shorter stays and outpatient drug therapy had been recommended for other citizens of the province for at least a decade.

Fourth, oral-history research has revealed patients faced considerable hardships due to their isolation and long stays in sanatoriums. Hospitals were often located at a significant distance, and few families could afford the time and funds to visit; communication between patients and families was very limited. Consequences of removal included loss of language and difficulties adjusting back to family and community life upon return. A particularly devastating impact was the emotional distance between parents and children that resulted.

The indigenous history of tuberculosis in Manitoba is an important context for understanding ongoing inequities and racism indigenous people experience in the provision of health care today. This project seeks to document this past so it is not forgotten and to inform efforts to improve health care today. For more on the project, see: indigenoustbhistories.wordpress.com

If you are an indigenous person who either underwent treatment for TB or worked in a sanatorium in Manitoba between 1930 and 1970 and would like to be interviewed about your experience, contact Mary Jane Logan McCallum at m.mccallum@uwinnipeg.ca or Scott de Groot at scottdegroot@gmail.com.

Mary Jane Logan McCallum, PhD, is an associate professor in the department of history at the University of Winnipeg.

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