The appalling discovery of the remains of 215 children at the Catholic church-run Kamloops residential school has caused a global outcry and a national, long-overdue moment of reckoning at the cultural genocide inflicted on Indigenous Canadians by the federal residential school system. The residential school system was founded by the Government of Canada and Christian churches in 1880 to assimilate Indigenous children into Anglo-Franco-Canadian culture, though the first residential school was opened in Brantford, Ontario in 1831. The residential school system’s mandate was to strip Indigenous Canadians of their culture and history, whitewash them with religious conversion, and indoctrinate them into a Christian white society. Children were taken from their homes and parents, separated from their siblings, barred from speaking their native language or wearing their native dress, and assigned new Christian names. Not only were these new values imposed upon them, but their Indigenous spiritual traditions were disparaged in an effort to “civilize” these innocent children. Prominent Canadian leaders such as John A McDonald, Canada’s first prime minister, and Adolphus Egerton Ryerson, former Chief Superintendent of Education for Upper Canada, championed the residential school system as a way to rid Indigenous children of the “savagery” of their culture. Based on accounts of residential school survivors, meals were abstemious to the point of malnutrition, and daily life was highly controlled. Before the 1960s, children were not routinely sent home on holidays to reunite with their families. Imagine, for a moment, how you would feel if you or your child were a residential school student, enslaved by a system designed to crush your very essence.
On top of the tragedy of the residential school system, it is a tragic and immoral fact that many students suffered physical, emotional, and sexual abuse. Compounding this tragedy, rarely did the government, Church, or police, who had a fiduciary duty to care for these children, provide any protection to an abused child on the rare instance an allegation was brought forth. Proof of the extent of vituperation is in ample testimony of surviving students, and now, forensic evidence with human remains of 215 children at one school alone. One has to wonder why the Canadian medical community provided no effective or affectual leadership to protect the health and wellbeing of Indigenous students in residential schools. Beyond obvious signs of physical abuse, children suffered mental health aliments, and high rates of preventable diseases such as tuberculosis and influenza. It is unacceptable that no one has taken responsibility for the 3,200 apparent deaths (most likely an underestimate) of these children, one-third of which were not properly recorded. Most deaths were preventable, from fire, drowning, other accidents, and malnutrition, suicide, and infectious diseases.
The Truth and Reconciliation Commission of Canada (TRC), founded in 2008, is mandated to tell Canadians the truth of residential schools which 150,000 First Nations, Inuit, and Metis children attended. In 2015, it released 94 calls to action, most of which have not been completed. Following the recent discovery of 215 bodies at the Kamloops Residential School of BC, there is renewed interest in uncovering the truth of how many children died, where they were buried, and their manner of death. Believe it or not, this inhumane system was in use up until 1996, when the last residential school was closed. The brutality of the residential school system is not ancient history; records of death and documentation of grave sites should have been far more meticulous and the cover-up should be a criminal matter before the courts.
What does this crisis have to with us as physicians? Some issues are bigger than hepatology or medicine itself, and as doctors we have a direct bond with our patients and the public we serve. Our position of inherent authority, respect, and trust gives us a unique qualification to address systemic problems that contribute to poor health. For instance, we must step out of our comfort zone to call for gun control, to promote education and other opportunities for our Black citizens, to call out Asian hate, which has become rampant during the COVID pandemic, and, in this instance, to demand that our government prioritizes seeking out the truth of what happened at the residential schools, including finding the remains of other unaccounted – for deceased children. Finally, this tragedy should have us, and the Canadian medical community at large, asking ourselves what we can do to promote the physical and mental wellbeing of Indigenous Canadians, and how we can promote Indigenous Canadians in the health care industry. Within our own field of hepatology, we can consider ways to reach marginalized Indigenous persons afflicted with autoimmune liver disease, alcoholic liver disease, metabolic fatty liver disease, and viral hepatitis. We can work together to find ways to improve linkage to our speciality with the Indigenous community. As Gandhi once said, “The future depends on what you do today.”