Episode 3: How Does History Teach Us About Structural Racism?

10 Dec 2020

Dr. Mary Jane McCallum is assistant professor in the History Department at the University of Winnipeg, Canada Research Chair in Indigenous People, History, and Archives and a member of the Munsee-Delaware Nation. Throughout her academic career, McCallum has focused heavily on research related to twentieth century histories of health; documenting the impacts of Canada’s colonial healthcare system on Indigenous persons. McCallum argues we need to look to history in order to better understand present day forms of structural racism.

On this episode, we ask the research question: “How does history help us to think about structural racism?” 

Disclaimer: This episode may contain subject matter that may be disturbing to some listeners.

MARY JANE MCCALLUM: …Like in the city I like going from here or from further upstream. You are with the stream, which is great so you don’t have to paddle if you are not in a big hurry.

KENT DAVIES: That’s Dr. Mary Jane McCallum, assistant professor in the History Department at the University of Winnipeg, Canada Research Chair in Indigenous People, History, and Archives and a member of the Munsee-Delaware Nation. In the summer months McCallum enjoys canoeing either on a lake in the Whiteshell or down the Red River here in Winnipeg.

MARY JANE MCCALLUM: It’s a fast river and it helps if you’re going to go in one place and come out another place. [Laughs] Like if you have two cars to pick up the… Yeah. So, it’s just a real cool way of seeing that part of the city and the north of the city. It looks completely different from a canoe. So, it’s kind of cool.

KENT DAVIES:  After classes resume in the fall, McCallum will be back at the University of Winnipeg or more likely working from home; continuing her research even as public health restrictions due to covid-19 create challenges for researchers trying to gain access to archival material. McCallum studies archival records, material evidence, and oral histories in order to understand the historical experiences of Indigenous peoples. Throughout her academic career, McCallum has focused heavily on research related to twentieth century histories of health. While Canada’s medical system is often praised for providing universal health care, McCallum argues what is often left out of the discourse is how its services have affected Indigenous communities. Through her research, McCallum has been addressing the systemic racism that has long been part of Canada’s healthcare system.

MARY JANE MCCALLUM: We can apply our knowledge of the history of the places that we live to understand how those structures become part of our hospitals and how that kind of functions and grows and how we still live with it today.

KENT DAVIES: On this episode the research question is…….

MARY JANE MCCALLUM: How does history help us to think about structural racism?

KENT DAVIES: From the University of Winnipeg Oral History Centre, you are listening to Research Question.  Amplifying the impact of discovery from the researchers of the University of Winnipeg.

The recent incident involving Joyce Echaquan, a Atikamekw woman who recorded a nurses’ racist comments about her as she lay dying in a Quebec hospital bed is just one of the latest in a long line of incidents highlighting the failure of the Canadian health care system to address systemic racism.[i] The incident has drawn comparisons to the death of Brian Sinclair, whose story was told in Structures of Indifference: A Life and Death in a Canadian City, a work authored by McCallum and Dr. Adele Perry.[ii] Sinclair a middle-aged, non-Status Anishinaabeg resident of Winnipeg died from an easily treatable infection in a Winnipeg emergency room after being untreated and unattended to for the period of thirty-four hours. McCallum maintains both Echaquan and Sinclair’s deaths reflect a particular pattern of racism and indifference born out of colonial structures.[iii] As with Sinclair’s case, there is an inquiry scheduled into Echaquan’s death but McCallum cautions that some inquiries can be limited in their impact, and often shift blame to the patient instead of the failure to deliver care. Structures of Indifference outlines that the inquiry into Sinclair’s death, and the subsequent 2014 report omitted any consideration of underlying factors, including racism and systemic discrimination.

MARY JANE MCCALLUM: What I’ve learned about structural racism in healthcare especially with that study on Brian Sinclair is that we can think through this historically to help us understand the answers to these questions when the official answer is not satisfactory.

KENT DAVIES: For McCallum, it is the absence of historical reflection about the impacts of colonialism and lack of Indigenous history in general that initially prompted her to think critically about different forms of structuralized racism.

MARY JANE MCCALLUM: It’s funny when you think about when you come to consciousness about this stuff, right? And I think for me it wasn’t really until I went to university when I started to think about these things. And really, I became a part of the McMaster First Nations student association and started to think critically about what I was learning in my undergraduate degree. How Indigenous history had really no place in the history department there. It’s a different kind of place. Southwestern Ontario has a very different history; has a very different history of the presence of the Indigenous people.

KENT DAVIES: McCallum, a member of the Munsee-Delaware Nation grew up just north of Barrie Ontario.

MARY JANE MCCALLUM: I am a band member of the Munsee-Delaware Nation. It’s one of two Delaware First Nations in Canada. Both are located along the Thames River in southwestern Ontario. It’s a small first nation of about a hundred and fifty people. That’s been the population since my band settled there in about the 1790s. So, they were refugees from the United States looking for a sort of safe place to live after having you know survived multiple sessions of violent dispossession. Originally the Munsees lived in the area of eastern North America around New York State and over hundreds of years had been dispossessed a number of times and moved westward and other people like me who end up like you know in places like Winnipeg. 

One of the ways I kind of think about this past is to remember when my mom having kind of interjected in one of my teachers lessons which was to teach us some weird song about how, “I’m glad I’m not an Eskimo,” kind of thing. Which was you know, “we eat raw meat,” you know, “they dance around and live in ice” and that kind of thing. And she sort of said, “you know, you have students in your class who come from an Indigenous background,” and this was unacceptable. It sort of made her unpopular and increased her kind of visibility in our community probably as well. So, that was kind of our upbringing at least until High school. I had a few Native friends in high school. Barrie was a very white place when my brother and I grew up there.

KENT DAVIES: After high school, McCallum attended McMaster University joining the First Nations Students Association.

MARY JANE MCCALLUM: This was the central and only real push to formal spheres of the University. And you know Mac is really big and so the kind of impact of that voice tended to be outside of the student lounge pretty small. Compared to my experience of working at the University of Winnipeg now in the 2000s where you have a pretty solid and consistent history of Indigenous participation on campus that has actually had an impact on the way that things work on campus.

KENT DAVIES: It is important to note that McCallum’s academic career could have been a lot different as she was deeply interested in researching a different historical period altogether.

MARY JANE MCCALLUM: I was interested in medieval history when I was doing my undergraduate degree and still am. I actually applied to go to school in Montreal for medieval history. And I took a year off and went to Europe and I kind of got sick of the wealth of the Church over there. I kept thinking about how that wealth was derived from imperialism and from our ancestors. And I was like…I couldn’t do it.

I read an essay by John Milloy about Indian policy and I think that was kind of the hook into Indian policy for me.[iv] Also, I’d experienced going through the process of applying for Indian status after 1985. Which had been lost in my family since my grandmother had married a non-Indian and in spite of our strong connection to the community and certainly her connection throughout her life this was something that didn’t really play into my identity very much I knew who I was but certainly my access to the community for sure. And so it was something that I was…you know? This stuff about the British Imperil government and the Canadian government kind of taking this on, this is real. And it really has this reality in my life and in the way that I relate to my community. So yeah, I just… I think probably I emailed him and said, tell me about Trent. 

I didn’t know what I was going to study. I knew I was going to study Indigenous colonial relations. And over time we kind of came up with a topic and it was reading for that topic which had to do with Indigenous women’s history that I came across Adele Perry’s article, “Fair Ones of a Purer Caste,” which was about female immigration in B.C. and I was like, “Oh wow that’s super smart right?”[v] And I just wanted to talk about it and think about it all the time and then I think John introduced us online or something or I emailed her or something and came out here to Winnipeg in February. [Laughs] The funny thing in academia is the assumption that you move eastward for your graduate degrees right? You go to Toronto or you go to Ontario for those and I was doing the opposite of what the trend was at the time. But I have not regretted it. This was by far and may still be the best place to study Indigenous history in Canada.

KENT DAVIES: It wasn’t until later in her academic career in Winnipeg that McCallum found an interest in medical history discovering the relatively unknown history of Indigenous nurses.

MARY JANE MCCALLUM: I was very interested in the history of medicine and in particular in the colonization of medicine here in North America. And I was reading a lot of that literature in my first and second year of my PHD and I was really getting frustrated with the lack of engagement of Indigenous people as providers of healthcare and medicine. So there was this kind of history at that time where by traders and missionaries brought this knowledge to people and kind of rescued them and you know improved the life and the health of Indigenous people. And I think that idea is probably is still out there and you know we confront it all the time but I started getting interested in the history of Indigenous nurses. And so I started writing about that and then realized that there was this larger history of women’s work that somehow had managed to be completely erased from the territory of women’s labour history, labour history in general and also Indigenous history. The more I kind of looked the more I found right? You know? Go to the archives and look up things about Indigenous women and work and you’d find all kinds of things on domestics. I found information about the federal relocation program that sought to remove people from First Nations reserves to urban areas for permanent kind of relocation and placement in permanent positions. So I just got very, very interested in this. You know the nurses and CHR’s (Community Health Representatives) in particular in the health field but also in that era of the nineteen say late twenties, thirties to the eighties. And this interesting succession of very hard working women who were engaging with a system that by and large they didn’t create but they were trying to improve for their communities.  

KENT DAVIES: Indigenous nurses were virtually non-existent in Canada’s health care system until after WWII when the war caused a shortage and the federal government reluctantly changed their stance allowing Indigenous women to join the nursing profession.

MARY JANE MCCALLUM: After the second world war they did a whole bunch of nurses’ aides programs. Native women were encouraged to go into those programs because they’re short, they’re cheap. The federal government didn’t want to spend a whole lot of money on post-secondary education especially for women. So, there is a rise in the numbers sort of in the fifties and sixties.

KENT DAVIES: This led to the formation of a professional organization representing Indigenous nurses across the country. The Registered Nurses of Canadian Indian Ancestry once formed, pushed for more Indigenous representation in the Canadian healthcare field.[vi] 

MARY JANE MCCALLUM: When they formed that was one of the first things they did was to take stock of the nursing staff in the federal system and to say, “Oh wow, we have this massive under-representation of Indigenous nurses. What are we going to do to address that?  Because we want to have representation among those who have you know power and authority in our communities.” I have to think back when I was reading that as an historian right, an Indigenous person who is in a history department is like… it feels like you’re the only one, right? I know I’m not. I know I’m not the first or anything like that but it was like an inspiration to learn about this professional organization that formed in the seventies and what might Indigenous history look like if we had those same numbers and that same representation and that same leadership in the seventies. It’s a completely different field of work but it is still and interesting question.

KENT DAVIES: Despite gains towards more Indigenous representation in the Canadian health care system, there is still a chronic shortage across the country to this day. According to the 2016 Stat Canada census of ninety thousand plus specialists and general practitioners in Canada, less than one per cent identify as Indigenous.[vii] The underrepresentation of Indigenous healthcare providers is just one of the many issues concerning First Nations relationship to Canada’s healthcare system. The lack of clear government accountability between the provinces and the federal government over who is responsible for providing healthcare services for Indigenous peoples has always been a point of contention to the detriment of the collective health of Indigenous persons in Canada. The Canada Health Act (1984) outlines the responsibilities of provinces and territories for delivering health services. The health of Canadians is a provincial and territorial responsibility while health support for Indigenous people is seen as the federal government’s responsibility as outlined in the Indian Act (1876).[viii]

MARY JANE MCCALLUM: This is a part of a general approach to treaty rights and federal responsibilities that the department of Indian affairs was been working on since the nineteenth century. This larger effort to shrink the population of status Indians and to reduce its responsibility through offloading of services to the province. And so, this has been interpreted by many First Nation’s people as to kind of shirk treaty rights and treaty responsibilities on the part of the federal government but also as an effort to kind of assimilate or integrate First Nations people into the broader Canadian population. Which would completely undermine status and rights as indigenous people, right? The federal government has never recognized a treaty right to healthcare. It rather says that it has a moral obligation to help First Nations people attain the status of other Canadian citizens and until that moment they will play a role and that roll will be ever decreasing, right? In the sixties and seventies that got turned into, “we are going to help people who are poor.” Right? “We are going to help people who are not working full time. So, we will provide that benefit to those people just as we would to anybody else who is unemployed.” And now we still live with this assumption that federal Indian rights are really for those who are impoverished only, right?

KENT DAVIES: Scholars like McCallum and Dr. Maureen Lux, through her work, Separate Beds maintain that Canada’s healthcare system advanced policies of assimilation while neglecting treaty rights and disparaging Indigenous systems of healing.[ix] At a time when Canada was consciously defining and investing in the national health culminating in what would become Medicare, racially segregated hospitals were being instituted across the country.[x] Recently some of these institutions have been the focus of McCallum’s research. The “Indigenous History of Tuberculosis in Manitoba 1930-1970,” project seeks to uncover, explain, and preserve the experiences of Indigenous persons who were treated in Tuberculosis Sanatoriums in Manitoba.[xi]

MARY JANE MCCALLUM: First Nations experience in federally funded hospitals and community hospitals has been… you know? Terrible, right? They are treated like they don’t belong. So, we’re looking specifically at this; the Indian hospitals and at Ninette and their history in Manitoba from nineteen forties to mid nineteen sixties; that process by which the Sanatorium Board of Manitoba basically made decisions over the treatment of healthcare for First Nations and Metis and also Inuit in the nineteen fifties and about their removal from their communities to this community the hospital, right? And then, also decisions about their return to their community about where they might be buried if they lost their life while they were in that institution; their lack of communication with the home communities that has led to a real disconnection for many of those patients, now adults but they would have been children at the time. There is this kind of legacy of a sort of stigma related to that experience probably because of the disconnection of being removed and then a loss of control over decision-making. And like we found in many instances now, that there are community members who know the adults who were in these institutions but had no knowledge that they had been where they had been when they left and they had experienced this. Even family members. So, people had not talked about it or whatever. So, we’re seeing many of the same kinds of things that we saw in residential schools happening to those who were removed to Indian hospitals.  

KENT DAVIES: Unlike Federal Indian hospitals the TB sanatoriums in Manitoba had a different structure. Run by a volunteer board of doctors and public health professionals, the Sanatorium Board of Manitoba received money from the federal government to build and run institutions for the treatment of tuberculosis from the early nineteen hundreds until the nineteen sixties.

MARY JANE MCCALLUM: So instead of the federal government directly running its own Indian hospitals for TB. The San board did. So, they had this special Indian rehabilitation program where by patients who were recovering or who had recovered from TB were encouraged to engage in this quote, unquote, “stepping stone” to modern societies. So, once they recovered they would go into a kind of employment training or education upgrading and then an employment placement officer would find them work in an urban area and then the assumption was that they would move to the city, gain this full employment and then just relocate themselves to the city. There’s a bunch of different assumptions that TB patients were kind of weak that they couldn’t return to reserves because it would be too rigorous for their health and they may relapse to TB but that’s kind of one branch of the explanation. The larger one is that these Sans were an important opportunity for integration of First Nations people into Canadian society. The Indian act has special regulations for Indian health that compliments and augments public health regulations. So, it enables the Indian agent to kind of ensure that people go to hospitals and that they stay there. So, they have the RCMP to kind of ensure anybody who runs away is taken back until the doctors say so. So, they were accelerating this larger drive for integration in the post-war era in Canada.

What is Indian rehabilitation? Like it was…they’re all racialized; like Indian hospitals, Indian rehabilitation, Indian surveys, Indian TB surveys. So it’s all considered like Indian. What does that mean? Right? And I started thinking about how our ideas about race played a role in the kind of specific healthcare experience of First Nations people in Manitoba and it really infiltrates everything, right? So reading the records of the Sanatorium board of Manitoba has really made very clear the conscious bias not unconscious bias in the healthcare system. Like this is…we like to say now and there are indigenous scholars out there that there is unconscious bias in our healthcare system but I think that people are less willing to talk about the conscious bias. This is the, “I know, I think about Indians this way.” “I know I think Indians deserve to be treated this way.” And that is clear as day in reading these records.

KENT DAVIES: Supporting the archival research are the oral histories of TB patients who McCallum interviewed for the project.

MARY JANE MCCALLUM: So we were interested in talking to people who wanted to talk to us. We were looking specifically for people who had information about the experience about being a patient or an employee at those institutions. What I wanted to do was I wanted to actually read those two types of narratives together. So, somebody recalling an experience in a hospital when they were six and seven years old and when they are now sixty or seventy years old. That is going to be a different kind of record entirely, right? Than at the time, a procedural medical records of doctors or rules and regulations about the running of an Indian hospital kind of thing. So, there are very different types of records of the past but I really wanted to be able to be able to read them together. And especially important for understanding the place of those people in their own communities I think too.

KENT DAVIES: McCallum maintains that government records, documentary evidence, and oral histories all contribute greatly to having a clearer understanding of the historical experiences of Indigenous persons in Canada.

MARY JANE MCCALLUM: You know in those debates what’s more important the voice of Indigenous people or the policy of the government. I think that’s it’s really important to keep your eye on the government and what the government is doing, right? I do not want to lose sight of that when I’m doing this project because for the person who has a disease like tuberculosis… like it’s frightening, right? And you often are left with a kind of feeling of gratitude towards the government for having provided institutions and doctors and medicine and that becomes a kind of narrative of your life and your survival and that’s really important right to have and we have a lot people who see the history of the San board that way. But there’s also evidence of Indigenous people that was created at the time; letters by patients who were Inuit who were in Manitoba hospitals and other hospitals in Canada talking about the oppression of those institutions, talking about the loneliness talking about the depression, and real disconnect from their families and communities. And I want to keep that in mind too, right? You could tell this history so many ways but I do want to keep that history of colonization as part of it.

KENT DAVIES: While some of her work has been delayed due to archive closures caused by the Covid-19 pandemic, McCallum has kept busy reviewing records and data available online. McCallum is now focusing on the next phase of the project. The assessment and digitization of photos from the Manitoba sanatorium board archives.[xii]

MARY JANE MCCALLUM: We had applied earlier this year for a grant to continue the Manitoba indigenous TB photos project which was a project that was initially initiated I guess in the basement of the San board of the Manitoba which is now the Manitoba Lung Association, who had boxes of photos some people had seen them but no Indigenous person had seen them and certainly none of the communities that were most invested in those histories had seen them. And so we had worked with the Manitoba Lung Association as well as the archives to try and make those photos available; in showing those photos, in making copies for communities and also in just continuing the general work of the TB project which has so many angles now but right now we are devoting more attention to deaths and burials, which is to help people try and locate ancestors who were in the institutions and died there and never returned.

KENT DAVIES: For many Canadians Medicare has become a defining icon of our national identity but the narrative of a benevolent universal health care system often lacks a First Nations perspective. This is something McCallum hopes to provide with her most recent article co-authored with Dr. Maureen Lux, “Medicare v Medicine Chest: Court Challenges and Treaty Rights to Healthcare.”[xiii]

MARY JANE MCCALLUM: Maureen Lux says there is two questions in Canadian health history one is questions about this rise of the universal healthcare system, how wonderful that is and the other question is this massive gap in the health standards between you know Indigenous people and non-Indigenous people. And they never get connected. So this was work that kind of came in part of her book on Separate Beds on the Indian hospital system in Canada. Asking these questions about what role does the treaty right to healthcare have in the rise of the Universal healthcare system? And the answer is zero, right? In fact, it’s kind of an erasure of it, treaty rights and we kind of went in and had a closer look at that era. The late sixties and seventies and the resistance on the part of First Nations people to the declining expression of the treaty right to healthcare which is the non-insured health benefits program. This is an insurance company that contracts to the federal government to provide health care of first nations people not with rights but with benefits, right? So, it was really great to work with her on that.

KENT DAVIES: McCallum’s research continues to demonstrate how history can help us uncover forms about structuralized racism. By using a variety of historical sources to challenge narratives concerning Canadian intuitions we can begin to recognize how entrenched colonialism is within Canada’s national identity and how the impacts of colonialism continues to affect Indigenous persons. And while McCallum thinks education is a good first step towards meaningful reconciliation, she is adamant that strong action is also needed.

MARY JANE MCCALLUM: We believe that education has this ability to change people’s minds to change the way that people think and to eventually radically improve the conditions of life for Indigenous people and people of colour. We’ve invested kind of in that. One of the problems with education is that it takes a long time for that pay off to happen. As much as I am committed to education, I’m also committed to radical redistribution of wealth. Like now. So that goal of education always has to come with a knowledge that power and money is not equally distributed in our society and that is what is contributing to ill health and racism in our hospitals.

KENT DAVIES: You’ve been listening to Research Question. Research Question is produced by the University of Winnipeg Oral History Centre.

The University of Winnipeg is located on treaty 1 territory. The heartland of the Métis people.

Written and Produced by Kent Davies

Interview with Dr. Mary Jane McCallum

Our Theme music is by Lee Rosevere

For more information on the Indigenous History of Tuberculosis in Manitoba 1930-1970” project go to indigenoustbhistories.wordpress.com

For more on University of Winnipeg research go to uwinnipeg.ca/research

For more info on the University of Winnipeg Oral History Centre and the work that we do go to oralhistorycentre.ca

Thanks for listening. 


[i] Benjamin Shingler, “Investigations launched after Atikamekw woman records Quebec hospital staff uttering slurs before her death,” CBC News, September 29, 2020. Accessed October 9, 2020.

[ii] Mary Jane Logan McCallum and Adele Perry. Structures of indifference: An Indigenous life and death in a Canadian city. (Winnipeg, Canada: Univ. of Manitoba Press, 2018).

[iii] Sarah Petz, “Death of Atikamekw woman in Quebec hospital draws comparisons to death of Brian Sinclair 12 years earlier,” CBC News, October 1, 2020. Accessed October 9, 2020.

[iv] John Milloy, “Indian Act colonialism: A century of dishonour, 1869–1969” (Research Paper for the National Centre for First Nations Governance, 2008).

[v] Adele Perry, “”Fair ones of a purer caste”: white women and colonialism in nineteenth-century British Columbia,” Feminist Studies 23, no. 3 (1997): 501-524.

[vi] Mary Jane Logan McCallum, “The Indigenous Nurses Who Decolonized Health Care,” Briarpatch Magazine, October 7, 2016. Accessed October 8, 2020.

[vii] Quinn Ohler, “Access to Aboriginal doctors a struggle for Indigenous population,” Global News, December 17, 2018. Accessed October 8, 2020.  

[viii] K. Palmer, J. Tepper, and M. Nolan. “Indigenous health services often hampered by legislative confusion.” Healthy Debate, 2017. Accessed October 8, 2020.  

[ix] Lux, Maureen K. Separate beds: A history of Indian hospitals in Canada, 1920s-1980s. (Toronto, Canada: Univ. of Toronto Press, 2016), 5.

[x] Lux, Maureen K. Separate beds: A history of Indian hospitals in Canada, 1920s-1980s. (Toronto, Canada: Univ. of Toronto Press, 2016), 4.

[xi] Indigenous Histories of Tuberculosis in Manitoba, 1930-1970, Accessed October 9, 2020.

[xii]CIHR supports research into history and impact of Indigenous TB,” University of Winnipeg News Centre, Dec 9, 2020. Accessed December 9, 2020.

[xiii]UWinnipeg health historian turns to past to understand present,” University of Winnipeg News Centre, May 7, 2020. Accessed October 7, 2020.