Separate Beds: A History of Indian Hospitals in Canada, I920s-i980s by Maureen K. Lux (review)

Health care for Indigenous people in Canada, compared to that of non-Indigenous Canadians, is vastly different, both in services and the outcomes. Federal responsibility and delivery of First Nation health services have failed to achieve equal health status as First Nations people suffer from extremely high rates of diabetes and chronic disease. Today's health failures are not created in a vacuum but, rather, find their roots in the past, and, accordingly, constructive and effective solutions must bring together the past and future. Maureen Lux has provided a much-needed roadmap that explores the history of segregated health care in Canada.

In 2014, Lux wrote a seminal book on colonized and segregated health care: Medicine That Walks: Disease, Medicine and Canadian Plains Native People, 1880–1940. Her research provided an important base study of Indigenous health care in the nineteenth and twentieth centuries on the Canadian Prairies. Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s is a logical evolution of ideas in Medicine That Walks that not only provides important linkages to her past work but also takes the discussion to a new and heightened critical examination of what were historically referred to as Indian hospitals. The book is an important study on segregated health care in Canada.

The 1946 opening of the Charles Camsell Indian Hospital in Edmonton provided hope and promise that modern health care would be provided to all and was a sparkly reminder that Canada proudly was fulfilling treaty promises made to First Nations. The stark reality proved to be different. As an alternative for federally funded beds in community hospitals, the Charles Camsell Indian Hospital only provided about half the funding that other non-Indigenous people would receive for their health care on a per diem rate. Twenty-two hospitals were opened by 1960. The care was substandard, and it was clear that the purpose was to protect the non-Indigenous population from the ill health of the Indigenous population.

The system of Indian Hospitals Policy in Canada set the standard for failure and stemmed from a set of false assumptions: that Indigenous people were inherently unhealthy and inferior, that they were therefore biologically predetermined to vanish, and that their traditional cultures caused them to pursue harmful lifestyles. Indian hospitals were judged against the perceived inadequate homes on reserves. It did not matter how poor the conditions were in the hospitals; the bureaucrats believed that the patients were better off in hospital than in their own homes. Similar justification was used for the removal of children from their homes and forcing them into residential school institutions. Lux poignantly traces personal stories of the Indigenous patient and tuberculosis. Medical experiments were common, and patients often spent years on bed rest or undergoing painful treatments.

This work is critical to understanding why the health care status of Indigenous people in Canada today is so poor. By understanding the colonial history behind health care, the Canadian public may begin to understand racism and discrimination in Canada and its insidious effects. This is an important book because it draws on the experiences of patients and the staff who worked in the health care system and shows its similarities to the Indian policy in Canada that kept the Indigenous population in a separate residential school system that perpetrated physical and sexual abuse. Is it any wonder the health care system for Canada's Indigenous population is in such dire straits today? Lux has delivered a book that captures the life and failures of Indian hospitals. For all those working in health care, this is a must read.