When Joyce Echaquan, a 37-year-old Indigenous Canadian woman, began experiencing stomach pains, she checked herself into a hospital in Joliette, Quebec. But she did not get the help she needed. Instead, hospital staff told Echaquan she was stupid, only good for sex, and that she would be better off dead.

Screaming and crying out in pain, Echaquan began live-streaming on Facebook. In the video, which has since gone viral, Echaquan says in her native language that she is worried doctors had given her too much morphine, which her family says she was allergic to. “You made some bad choices, my dear,” a hospital staff member can be heard saying in the background. “What are your children going to think, seeing you like this?”

Echaquan died shortly after posting the video online on Sept. 28. Though the autopsy results have not yet been released, Echaquan’s family believes the high dosage of morphine she was administered could have played a part. The hospital has begun an internal review into what happened.

The death of the mother of seven, a member of the Atikamekw Nation in southwestern Quebec, has sparked outrage across Canada after a summer in which protests brought systemic racism against the country’s Indigenous people to center stage.

In June, a dash cam video emerged showing police officers beating Allan Adam, chief of the Athabasca Chipewyan Nation, after stopping his vehicle for expired license plates. The incident sparked nationwide protests calling for reforms to policing, just as the death of George Floyd did in the U.S.

The same month, health workers in British Columbia, the country’s Westernmost province, were accused of allegedly betting on Indigenous patients’ blood alcohol levels, drawing attention to racism in Canada’s state-run healthcare service. Now, Echaquan’s death has given fresh urgency to the anti-racism movement, with protests taking place across the country. 

“I’m convinced that my partner is dead because systemic racism contaminated the Joliette hospital,” Carol Dubé, Echaquan’s partner, said at a news conference on Oct. 2 where it was announced his family would be filing a lawsuit against the hospital. “She spent her final days in agony, surrounded by people who held her in contempt, people who were supposed to protect her.”

Since Echaquan’s video surfaced, the government has launched three investigations, two of which will be conducted by regional health authorities looking into both Echaquan’s case as well as into the practices at the hospital more generally. Both the nurse and the orderly depicted in the video have since been fired.

‘Now we need action.’

Politicians have spoken out about Echaquan’s death, with Prime Minister Justin Trudeau calling it the “worst form of racism.” François Legault, the Quebec Premier apologized to Echaquan’s family but denied systemic racism is an issue in the province. “What happened to Ms. Echaquan is totally unacceptable,” he said at the National Assembly of Quebec, but added, “this does not mean that Quebec is racist.”

But many leaders of Canada’s 1.6 million Indigenous citizens—who for years have listened to politicians across the political spectrum apologize for Canada’s historical and ongoing racism against Indigenous people—said the time for talk was over.

“We’ve had two apologies this year from this premier,” the Atikamekw Nation’s Grand Chief Constant Awashish told Global News, noting that Legault had not been invited to Echaquan’s funeral because of his denial of systemic racism. “Now we need action.” 

For years, evidence has emerged of racism in Canada’s healthcare system. In 2015, a report revealed that racism contributes to poorer health outcomes for Indigenous Canadians. As recently as 2018, Indigenous women across the country have come forward with stories of forced sterilization. Echaquan’s death itself marks a year since a public inquiry revealed that Indigenous people struggle to access government services in Quebec, including health care. 

But many Indigenous people say that despite these reports, too little has been done to address racism in medical services. Indigenous Canadians still have a lower life expectancy and higher rates of chronic diseases than the national average. “Joyce Echaquan’s case does not tell us anything new,” says Mary Jane McCallum, a professor at the University of Winnepeg and Canada Research Chair in Indigenous People, History and Archives. “This case tells us that healthcare racism threatens and terminates Indigenous life.”

The COVID-19 pandemic has further put on display how racism affects Indigenous health. While the federal government has encouraged Canadians to socially distance, wash their hands and get tested if they have symptoms, many Indigenous people have asked how they are supposed to implement these measures when nearly a quarter of Indigenous Canadians live in overcrowded homes and 61 Indigenous Nations have not had access to clean water in at least a year.

“Our health system was built on racial segregation,” McCallum says. “White supremacy and colonialism is in the fabric of our being—it is the air we breathe and the water we drink in Canada.”

Federal and provincial governments claim they are taking action to address systemic racism against Indigenous people. On Sept. 30, members of parliament gathered to mark Orange Shirt Day, a national event created in 2013 to raise awareness about the traumatic impacts of residential schools, where until the mid-1990s Indigenous children were taken away from their communities by the Canadian government and Christian churches and forced to abandon their cultures. 

At the House of Commons, politicians commemorated the survivors of residential schools and also discussed Echaquan. “It is quite simply unacceptable in Canada,” Trudeau said about Echaquan’s death. “We will do our utmost to eliminate racism where it exists.”

But for Echaquan’s family, these are mere platitudes and not enough. “All I’ve gotten are questions and condolences, but no answers,” Dubé said at a meeting recorded by the Aboriginal Peoples Television Network before breaking down in tears as his son consoled him. “I wasn’t even able to tell her I love her.”