It’s every parent’s nightmare when their child falls seriously ill or has been injured. When a child needs emergency care in Nunavik, the northernmost Arctic region of the province of Quebec, Canada, the ambulance comes in the form of an airplane, and the child is whisked away from their parents and flown to a facility, two hours south. Parents are directed to a commercial flight, hopefully the next day, if they want to be with their children.
Three pediatricians from Montreal Children’s Hospital sent a four-page letter to the Quebec Ministry of Health and Social Services in December, calling for an end to the practice of barring parents from the Far North on medical evacuation flights. A month later, two of those physicians — Saleem Razack, head of the hospital’s pediatric intensive care unit, and Samir Shaheen-Hussain — began speaking to the press, calling the practice discriminatory and inhumane.
The hospital plane, called “the Challenger,” brings patients from remote regions such as Nunavik and the Cree Territory on James Bay to the only appropriate facilities, located in the south of the province. It is equipped with an incubator and three gurneys but, according to provincial policy, no place for a family member.
It’s a practice that Inuit and First Nations communities, as well as medical professionals, have long decried. In the event of an emergency, there is no one to hold a sick child’s hand and comfort them, or to provide important health information to medical personnel. And, even though they are in their Native land, Inuktitut or Cree translation is not required, because they’re not one of Canada’s two “official languages” — English or French.
The policy is even more traumatic as it recalls Canada’s “residential schools” and other programs that removed Indigenous children from their homes and communities, cutting them off from their culture, breaking their spirit and the hearts of their parents. In fact, the overt mission of the schools was to put an end to Indigenous culture by separating children from their parents, denying them the right to speak their Native language and learn, practice and transmit their customs to future generations. The schools were also poorly maintained and disease-ridden, rife with physical, psychological and sexual abuse. The last federal residential school did not close until 1996.
Quebec health minister Gaétan Barrette asserts that the official policy to separate parents from children during northern medical evacuations puts “security foremost…. The security of the child or other patient being transported could be compromised if an incident were to occur on board.”
Speaking to the Montreal Gazette, Kuujjuaq Mayor Tunu Napartuk replies, “Having a parent on a medevac plane would ease an already stressful situation, not add to it.” Resignedly, he adds, “We’ve accepted it because that’s how it’s always been done.”
Minister Barrette argues that the province pays for later commercial flights, though many reply that it’s hard to get on those planes, and they experience many delays and cancellations. Barrette also claims that space on the airlifts must be reserved in case the plane needs to pick up other passengers.
But Joanie Tremblay-Pouliot, a doctor in Puvirnituq, refutes the minister’s assertion. “Except in the case of having several unstable patients on board, there is always an extra seat available for a child’s family member.”
She continues, “It seems barbaric to us, on the one hand, to separate a parent from their child when the latter is in serious condition, and on the other, to leave the children, who only speak Inuktitut, unaccompanied and alone in an emergency room in Montreal.”
Johanne Morel, a doctor at Montreal Children’s Hospital who worked in the far north in the 1990s, recalls an incident from that time. A 2-year-old had been mauled in the face by a dog and needed to be evacuated. “The mother was distraught. She ran along the runway after the plane that was carrying her daughter away.”
Hannah Tooktoo Koneak relates how she had to board a commercial flight one day after giving birth in Kuujjuaq to follow her baby, who had already been airlifted to Montreal due to the lack of a working breathing machine in the area. Despite the obvious horror of such an experience, she goes on to point out the real problem: the lack of necessary medical care in the north. “Why do we even need to send our sick to Montreal? It happened in the past to Inuit with [tuberculosis]. Something has to change!”
Under Federal policy during an epidemic of tuberculosis in Canada in the ’40s and ’50s, wholesale evacuation of infected northern people ripped families and communities apart. Lack of record-keeping and communication prevented many from finding their way home.
Shaheen-Hussain is also critical of allowing multiple stops on emergency flights, asserting, “It’s completely inhuman to send them alone and, on top of that, to protract their arrival.”
Putting it bluntly, the doctor concluded, “This is another example of Indigenous kids paying the price for draconian governmental policy. No other population would be expected to make do with such undignified and unsafe health care conditions.”
Other provinces do not deny boarding to parents in the case of a child’s medical emergency. In fact, Saskatchewan insists upon it unless physically impossible, because providers are not able to obtain consent for procedures without a parent present. But the Quebec government remains adamant that there is no room on the plane, and that the policy will not change.
Referring to the newest Challenger, which was delivered in 2014, Barrette said, “If you’re asking me if today we have any plans to break down or reconfigure the plane, the answer would be no.”