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RIDR - Standing Committee

Human Rights

 

Proceeding of the Standing Senate Committee on
Human Rights

Issue No. 41 - Evidence - Meeting of April 10, 2019


OTTAWA, Wednesday, April 10, 2019

The Standing Senate Committee on Human Rights met this day at 11:30 a.m. to examine and monitor issues relating to human rights and, inter alia, to review the machinery of government dealing with Canada’s international and national human rights obligations (topic: forced and coerced sterilization of persons in Canada).

[English]

Barbara Reynolds, Clerk of the Committee: Honourable senators, as clerk of your committee, it is my duty to inform you of the unavoidable absence of the chair and deputy chairs, and to preside over the election of an acting chair. I am ready to receive a motion to that effect.

Senator Boyer: I would like to make a motion to nominate Senator Pate as chair.

Ms. Reynolds: Thank you. Are there any other nominations?

It is moved by the Honourable Senator Boyer that the Honourable Senator Pate do take the chair of this committee. Is it your pleasure, honourable senators, to adopt the motion?

Hon. Senators: Agreed.

Ms. Reynolds: I declare the motion carried. I invite the Honourable Senator Pate to take the chair.

Senator Kim Pate (Acting Chair) in the chair.

The Acting Chair: Good morning and welcome. I would like to begin, in the spirit of reconciliation, by acknowledging that we are meeting on the unceded, unsurrendered ancestral territory and traditional lands of the Algonquin Anishinaabeg peoples. We thank them for welcoming us on to their territory.

My name is Kim Pate from Ontario. I now invite my fellow senators to introduce themselves.

Senator Boyer: Yvonne Boyer, Ontario.

Senator LaBoucane-Benson: Patti LaBoucane-Benson, Treaty 6 territory, Alberta.

[Translation]

Senator Moncion: Senator Lucie Moncion from Ontario.

[English]

Senator Wells: David Wells, Newfoundland and Labrador.

The Acting Chair: Today, under the committee’s general order of reference, we are studying the forced and coerced sterilization of persons in Canada, particularly Indigenous women. With the limited time before the end of the 42nd Parliament, our committee is launching a preliminary investigatory study to uncover the scope of the problem and identify other people who may have been affected. We expect to release a short report with recommendations for future study.

I now call upon Francyne Joe, president of Native Women’s Association of Canada.

Francyne Joe, President, Native Women’s Association of Canada: Wey-tk and good morning Madame Chair, senators and fellow colleagues. My name is Francyne Joe. I am a member of the Shackan First Nation, located just south of Merritt, British Columbia, and I am president of the Native Women’s Association of Canada. I also acknowledge that we are gathered on the unceded and unsurrendered traditional territory of the Algonquin Anishinaabeg people, and I use she and her pronouns.

Since 1974, the Native Women’s Association of Canada has represented the collective voices of Indigenous women, girls and gender diverse people of First Nations, on and off reserve, both status and non-status, disenfranchised, Metis and Inuit. Through research, policy, programs and practice, we actively work to raise the national and international profile of many issues specific to Indigenous women.

Before moving any further with this testimony, I wish to make it clear that the Native Women’s Association will not tolerate attempts to make this issue a partisan issue. The fact that in 2019 we are discussing a serious human rights violation committed against Indigenous women and girls is everyone’s problem.

The forced and coerced sterilization of Indigenous women and girls is an extremely serious violation of not only human rights and medical ethics but of personal safety and security of Indigenous women and girls. It is also a direct violation of reproductive rights.

According to the United Nations Population Fund, reproductive rights are a significant component of human rights. Canada’s Charter of Rights and Freedoms prohibits discrimination based on race, sex and ethnic origins, among other things, and further guarantees the right to life, liberty and security. International covenants and conventions to which Canada is a signatory require Canada, in its provision publicly funded health services, not to discriminate against Indigenous women and not to subject them to treatment that is cruel, degrading or torturous.

In 2018, the United Nations Committee Against Torture stated clearly that forced and coerced sterilization is an act of torture, yet this practice continues within a country that claims to be a champion of human rights.

Historically, forced sterilization was routinely inflicted on Indigenous women in Canada. It was, in fact, permissible by law. This issue was brought up in the House of Commons in 1976, well after most eugenics legislation in the provinces were repealed. At that time there were still high levels of sterilization procedures performed on Indigenous women in “Indian hospitals,” as well as high levels of sterilization of Inuit women in the North. Remarkably, Canada chose not to take action then. There is no excuse for Canada to fail to act now.

Anyone who is even remotely familiar with the Geneva Convention will understand that this practice is genocide. Indigenous women and girls need assurances that this racist practice will not continue in the future and that it will be safe for Indigenous women and girls to enter hospitals in this country without fear that their reproductive rights will be completely ignored.

We recommend developing, funding and implementing an accountability mechanism or mechanisms within hospitals in order to ensure that practitioners are held accountable for obtaining consent in these often unnecessary medical procedures. NWAC recommends that both provincial and federal medical regulatory authorities work with governments to identify and approve sterilization surgery policies and procedures; obtaining free, prior and informed consent; and anti-racism training for medical practitioners. Further, NWAC recommends that annual reports must be generated from medical regulatory authorities to identify the number of Indigenous women sterilized in order to monitor trends and identify practices regionally and nationally.

What has occurred in Canada is nothing short of a crime. Canada must now do anything and everything in its power to address this crime. For this reason, NWAC calls on the Government of Canada and its law enforcement to begin criminal investigations into the widespread forced and coerced sterilization of Indigenous women and girls, as recommended by the Inter-American Commission on Human Rights, as well as by the United Nations Committee Against Torture, and to prosecute offenders.

If the provisions of the Criminal Code are not enough, on their own, to outlaw these heinous crimes, Canada must follow the recommendations of the Inter-American Commission on Human Rights and the United Nations Committee Against Torture and amend the Criminal Code to explicitly criminalize forced and coerced sterilization.

The direction forward as we see it is relatively simple. Whatever we can do to ensure the forced and coerced sterilization does not happen to one more woman in Canada we must do. Thank you very much for your time, your consideration and your concern.

The Acting Chair: Thank you very much.

Melanie Omeniho, President of the Women of the Métis Nation, the floor is yours.

Melanie Omeniho, President, Women of the Métis Nation: I want to begin by thanking the committee for the invitation to come here and be part of this process. Les Femmes Michif Otipemisiwak is our real name is. It means: “the Metis women who own themselves.” Today, we are here to discuss the violation of human rights and how to rectify those violations for all Indigenous women, including Metis women.

Forced and coerced sterilization of Indigenous women and girls has been condemned by the United Nations Committee Against Torture. The committee recommended that Canada take immediate action to end this practice. Since the media started reporting on this issue back in November, over 100 women have been brought forward to report their experience with forced or coerced sterilization. We need to work to find justice for these women and others who aren’t even aware they have been involved in forced or coerced sterilization.

We need to work with our communities to establish how widespread this policy is and how it has impacted our communities and our young people. Canada has a colonial history of violence against Metis women. The discrimination of Metis women is created and reinforced through government policies and practices. I would actually identify that some human rights issues, which Metis women have faced, are even in the fact that many government agencies, organizations and policies don’t let Metis women represent themselves. They don’t let them come to speak for themselves or have other groups speak on their behalf.

It has been a long history of these policies and practices that have institutionalized racism toward Metis women and girls and gender diverse people. While the current government is working toward reconciliation, many discriminatory policies and practices still exist today. The circumstances surrounding forced and coerced sterilization of Metis women are discriminatory. This is an act of genocide against our Metis communities, and we think urgent action is needed.

Tubal ligation permanently prevents women from having babies naturally in their futures. Many times it’s not irreversible, as people were led to believe. This has profound consequences for Metis women, their mental and physical well-being, and their families’ and their communities’ well-being. In some of the cases where Metis women have come forward, women are being sterilized despite expressly denying consent, while other women are unduly pressured by child and family service agencies and threatened with the taking away of their parental rights, and others are simply not asked at all.

Tubal ligation is unnecessary in most cases and has other health implications, including bleeding from a skin incision or inside the abdomen, infections or damage to other organs inside the abdomen. There are side effects from the anaesthesia, ectopic pregnancies and incomplete closing of fallopian tubes. Furthermore, they are high risks for women that have a history of pelvic or abdominal surgery, including obesity and diabetes. Metis populations are more likely to experience obesity and diabetes, putting Metis women at a higher risk of complications when undergoing tubal ligation procedures.

Involuntary sterilization is often based on presumptions and stereotypes and/or misinformation about Metis women. This leads to disproportionate impact on Metis women generally, but also the most vulnerable Metis women including those living in poverty with HIV, women with disabilities and gender diverse women such as trans, two-spirit and intersex women. Doctors are performing these sterilizations while the women are in labour, or immediately after in postpartum, when women are physically and emotionally exhausted, still under the influence of anaesthetics and medications related to giving birth, and cannot really give informed consent in these conditions.

A forced sterilization is one performed without women’s free, prior, full and informed consent. International human rights law has clearly established that forced sterilization violates multiple human rights and is an act of gender-based violence. The United Nations and the member states have called upon Canada to ensure that all allegations of forced or coerced sterilization are impartially investigated, that the persons responsible are held accountable, and that adequate redress is provided to the victims.

Additionally, Canada has been called upon to adopt legislation and policy measures to prevent and criminalize forced or coerced sterilization of women, particularly by clearly defining the requirements of free, prior and informed consent with regard to sterilization, and by raising awareness among Indigenous women and medical personnel of those requirements.

Canada has begun to take steps to investigate reports of forced and coerced sterilization, but we have yet to see persons being held accountable for these procedures. There has been little or no redress for the victims. Canada has also taken significant steps to start raising awareness about sterilization and the requirement of free, prior and informed consent, but they have openly stated that they do not intend to criminalize these practices.

Les Femmes Michif Otipemisiwak recognizes Metis women’s rights to make informed choices about their bodies according to their own values. Metis women have the right to consider all options and need to be given time to make an informed decision. Metis women have a right to have all of the risks and benefits associated with medical procedures explained in a way they understand. Metis women have the right to refuse tubal ligation, and their decision must be respected unconditionally. Metis women have the right to lead the way in healing from forced sterilization and finding solutions to end this violation of our human rights. Before this became a media issue in November, I would like to tell you that even in past years there were class action lawsuits where Metis women, because of what they believed to be their mental status, were forcibly sterilized. We need to see that end.

Les Femmes Michif Otipemisiwak would like to see further research and data collection on forced or coerced sterilization procedures in Canada, with a focus on disaggregated data collection and dissemination. More research is necessary around the implications to health care, child and family services and justice systems, with the introduction of legislation to protect Metis women’s rights to informed consent in their health care. If research proves that criminalization is the appropriate responses to these human rights violations, our organization will recommend that Canada takes steps to introduce measures to criminalize the practice of forced and coerced sterilization.

I would like to make a last recommendation. We had a policy session a few weeks ago, and young people who are generally impacted by this issue came along. Even though many of the young women felt bad and horrible about their experiences, what happened to them and the consequences of those choices later on, they had no idea it was something that violated their own human rights. We need to ensure that young people know what are their human rights and are able to take forward with them a position that says, “No, I am not going to put up with this.”

The Acting Chair: Thank you very much.

We will now hear from Anne Curley, Vice President of Pauktuutit Inuit Women of Canada.

Anne Curley, Vice President, Pauktuutit Inuit Women of Canada: Good morning, members of the Senate, chair, guests and staff. My name is Anne Curley, previously identified as E5-2184. I am pleased to be here with you today on behalf of President Rebecca Kudloo.

Pauktuutit was incorporated in 1984. It is the national representative organization of Inuit women. Improving the health and overall well-being of Inuit women and their families is a top priority for Pauktuutit. This includes promoting Inuit women’s access to reproductive health services, including education, screening, testing, treatment, as well as midwifery, prenatal and postnatal care.

The issues of forced sterilization and informed consent haven’t been a priority for Inuit women over other daily survival such as being sure we can feed our children. As a people, we are still dealing with the effects of residential schools, forced relocations, and epidemics of illness like tuberculosis. On a daily basis, we must try to deal with overcrowded and inadequate housing and the highest rates of violence and suicide in the country. The lasting impacts of colonization are reflected in the glaring reality that our lifespan is the lowest among Indigenous people in Canada. Until systems change and circumstances improve, we don’t have freedom of choice.

We are at a different starting point on this issue. Our needs and experiences are unique and unlike those of First Nations and Metis women. These are very difficult and sensitive conversations. We have some information from the early 1970s about forced sterilizations at that time, but we have to remember that most of those women are now gone and unable to tell us what happened. I can only tell you what I know. If there is a national conversation about these issues, we must be present to speak for ourselves. We don’t know what is the current situation, and we need to be the ones to start having these conversations in the best way possible.

We are here today to talk about human rights. Before the 1940s, we must remember that we lived on the land. Traditional childbirth practices were central to our way of life and important in keeping our communities together. We were first taken advantage of by outsiders, including explorers, whalers and fur traders such as, for example, Hudson’s Bay Company. Then the clergy came. We were moved to villages in the 1950s with promises of education, health care and housing. Then we were ruled by outside authorities such as the RCMP, clergy, teachers and nurses.

As Inuit, we are very non-confrontational by nature and we feared those authorities. We just did what we were told. Some of that attitude continues today. There is generally a low awareness of our individual rights as citizens of Canada. We are just starting to realize that we have basic rights as patients, such as the right to ask for a second opinion.

Our population is approximately 65,000. We mainly live in 51 small, remote and fly-in communities spread across Inuit Nunangat. Most of our communities only have health centres staffed by nurses who rotate in and out of our communities. Most of us do not have family doctors. We are not able to build trusting relationships with our health care providers. We constantly repeat our medical history every time we meet someone new.

Our lack of access to health services includes a lack of access to early testing and diagnosis. Far too often we are diagnosed at a late stage of disease when it is too late for potentially life-saving treatment. If we are met with a bad attitude when we ask questions, we often then shut down and that is the end of the communication. One result of this breakdown can be the lack of informed consent from patients.

Inuit have the highest birth rate in the country. Our population is young and continues to grow. Traditionally, the whole family was there to welcome the birth of a child into the family. The imposition of the western medical model has displaced and undermined our traditional culture of midwifery and childbirth. For example, in my community of Hall Beach, all women are sent to distant hospitals for childbirth for a lengthy period of time. It feels like having your baby at home would be breaking the law. This policy has had serious social and cultural consequences. We want to bridge the best of our traditional cultural ways and western medicine. Pauktuutit has been active in lobbying with Inuit women for community-based childbirth. It has also documented traditional midwifery practices to help save the knowledge of elders before it disappears.

There is a lot we do not know. We have heard stories and have anecdotal information around the forced sterilization of Inuit women. In addition to those stories and the need to understand their impact on our women, we have long called for attention to the disregard of Inuit women’s rights as well as the lack of basic access to culturally safe and competent care. These two issues cannot be addressed in isolation.

Because we are at the beginning of talking about this highly sensitive issue, this work must be led by Inuit women for Inuit women. We need to better understand what has happened and what is happening now so we can ensure a future where our daughters and granddaughters understand their rights as patients and their rights to free, prior, and informed consent. Factors such as lack of infrastructure, racism, stigma, discrimination, access and cultural competency need to be addressed together with the education of Inuit women about our reproductive and health care rights. To improve our women’s reproductive health rights, it is necessary to recognize that it is the responsibility of all health care providers to ensure free, prior and informed consent for and from Inuit women as well as a provision of and access to safe and culturally appropriate care. This includes appropriately trained medical interpreters.

In closing, as I mentioned, we are at a different starting point around what we know about the issue of forced sterilization of Inuit women. We know that the gaps in access to health care services and health status for Inuit women are real, common and persistent. If we were asked to pick a priority, we would choose midwifery in our communities. We want to chart a better path forward for our young women and girls. To do this, we need to develop a coordinated strategy in partnership with the Government of Canada and others to achieve the same quality of life as other women in Canada.

Qujannamiik. Thank you.

The Acting Chair: Thank you very much. I open the floor to questions.

Senator Boyer: I thank all of you for coming here today and for sharing your knowledge with us. I also thank the women who are with you for support and the women who are watching us and with us in spirit today.

My three or four part question is for you, Vice President Curley. First of all, you introduced yourself as E5-2184. I would like you to explain that, please. How does that impact on the intersectionality of the importance of health care, sterilization of Inuit women, housing and everything else you are dealing with in the North?

Ms. Curley: Before 1984, we were tagged with a number. Until 1974, we didn’t have a surname. We were identified by the government with a dog tag. That’s how much Inuit seem to be controlled by others. I mentioned that we are always in agreement with what we are told, even if we don’t really understand what the other person is saying. Our first language is Inuktitut. Our second language in some cases is English. Otherwise we are unilingual. We have some interpreters, but because of a lack of training conversation with another person may be misinterpreted. That has had a big impact on how our women have been treated in the past.

There is a lot of overcrowding within our communities. A family of three would be living in a two-bedroom house, so one family in that household may be living in the laundry room. That causes a lot of stress and has a big impact on violence, suicide and all that. There’s a big lack of housing. A lot of young people are seeking housing and therefore thinking that if they have more children, they have more chance of getting a house. They just continue on building the young population. With child tax, they will be getting more if they have more children, not knowing or understanding the consequences it may have with the high cost of living up North and trying to provide for a family.

Senator Boyer: You mentioned about the language and the diskless system being examples of how sometimes the Inuit would just go along with it. I know the statistics say that in the 1970s, 26 per cent of all the women in Igloolik had been sterilized. I am wondering about people who are going to the South and having their babies. Are they having Caesarean sections? Are they coming back sterilized? Is that something you have heard?

Ms. Curley: Yes, it’s an ongoing thing. When the mothers-to-be go out, they are now escorted by the spouses. They have to leave home for at least a month. If there are complications, they are sent down south. If they have children, they leave your children behind for at least three months.

Who are they leaving their children with? It’s usually the grandparents who have to look after the children. Otherwise, with the lack of housing, some young people are looking to house-sit. They may be leaving their children with somebody they may not know and putting their kids in vulnerable situations.

I don’t know if I am answering your question, but I will tell a story about a lady. I witnessed two nurses telling the mother-to-be that they would not look after her if she was having her baby. They would not allow her to be at home during her delivery because of the risk of her losing too much blood and dying. They didn’t want to be liable for it. Therefore, that lady had to look for somebody with some experience within the community to help her with the delivery of her baby. There were no complications. It was a successful delivery, but she was forced to have a hysterectomy shortly after she had her baby.

Senator Boyer: I have one quick supplementary question. We have heard that the government is putting together a working group on this subject right now. I suggested that it was important to get the voices of the women who have been sterilized.

You specifically said in your speech that it was very important for Inuit women to have a voice, to speak for themselves and to have nobody speaking for them. Would you suggest that an Inuit woman’s voice, Metis voice and a First Nations voice be on that committee?

Ms. Curley: Yes, I would make that recommendation. We have similar experiences but we have our differences, language being an example. We try to keep our language ongoing, but in some areas we’re losing it. That’s part of our culture. We have to keep our culture and we need to have our teachers, the elders. That’s why I think it’s very important to have midwifery in each community.

Senator Boyer: Would the other two like to comment on being part of the committee?

Ms. Omeniho: If we’re going to deal with human rights issues, it is imperative that Metis speak for Metis, Inuit speak for Inuit and First Nations speak for First Nations. I would be remiss in coming here and trying to convince anybody that I had enough knowledge, understanding and experience to be able to represent either First Nations or Inuit people. We have to represent ourselves.

I would support having Inuit, Metis and First Nations on the committee.

Ms. Joe: Similarly, I would concur. We need to bring the survivors to the table to support one another. When we bring them to the table, we need to make sure we’re providing them with necessary supports, financially in reparation, culturally and emotionally, because we’re retraumatizing them. It’s not just a matter of bringing these women together to discuss how we’re going to fix it, but we need to be continually respectful of what they’ve gone through.

Senator Boyer: In a culturally appropriate manner. Thank you very much.

Senator Wells: Thank you, panel, for being here. I would also like to see at the witness table those who have performed these procedures without permission from the women. I think that would be instructive as well.

I thank you for your presentations and for your advocacy on this topic. I absolutely agree with the question of informed consent. I’d like to hone in on that for a couple of minutes and a couple of questions. I’ll open it to the panel.

What conditions would you like to see that would constitute informed consent? First of all, I am shocked that it’s done. I am shocked that it’s done without the woman in some cases being fully informed of what’s happening. I understand there’s a request to have it done sometimes. I imagine it could be in some circumstances considered normal procedure. What would be some of the conditions you would like to see around informed consent? Would it be a time lag after childbirth or a trusted third party? What are some of the things you’d like to see?

Ms. Joe: There are three important elements that the Native Women’s Association would like to see. First one would be the capacity to consent. Second would be full disclosure of the risks and benefits of the operation, including the permanency of the procedure. Third would be to be giving the individual time to consider the information.

Rather than informed consent, which really is a practice that protects medical individuals, we want to see informed choice. We see informed choice as a way of providing a decision-making process for women that relies on a full, whole conversation in a non-urgent and non-authoritative environment. Then they know exactly what they’re deciding on without any pressures. It’s their choice.

Senator Wells: Any of the other panellists?

Ms. Omeniho: I’d like to say that for us informed consent is making sure that every individual clearly understands the good, bad and indifferent implications of the decisions they make. We’d like to ensure that informed consent doesn’t have issues related to child welfare or poverty as reasons or cause to have various procedures done.

Many of these things are not life-threatening decisions or urgent decisions. We do understand there are medically necessary procedures that must be done at times but often that isn’t the case in the examples we’ve been engaged with. In a non-Indigenous society and world, women are very often discouraged at a young age from trying to do any permanent procedures that will affect their reproductive health. In our communities it’s the opposite of that. We need to have the same opportunities afforded to young women in our communities so they understand the long-term effects of the decisions they’re making. We have seen instances where those decisions have been taken out of their hands and consent hasn’t been there. The social workers, doctors, nurses and other medical professionals are making those decisions and choices for them. They just have to live with the consequences of that later.

That was part of what we had talked about too. We need to create advocacies within hospitals to help people understand the things that are going on, the choices that are being made, and the decisions they are making, based on the information they have. It could be the creation of available brochures or literature for people who have to make these choices. They should not have to make those choices in dire conditions where they feel that there is some urgent issue unless it’s a medical one.

Ms. Curley: One of the problems we’re having, even right now, is with the lack of trained interpreters. The younger generation is lacking the ability to speak English. Some people can understand English but they have difficulty speaking it. Some understand a bit of it but are too ashamed to ask for an interpreter, so they try to communicate with a non-Inuktitut speaking person. That’s why it’s very important. Some young people are being forced to have abortions because the doctor is saying there may be complications with the babies.

I’ve talked to an individual who said she was being forced to have an abortion. According to our culture, it is not our belief to have an abortion. In our religion, having an abortion is murdering a person, a human being. Therefore, she refused to have an abortion, and that child was born healthy. He is still living and healthy.

Senator Wells: It’s unsettling to hear the stories. We heard some last week as well. You mentioned the language disconnect. I imagine there’s also a cultural disconnect. At one time I lived in a small Inuit-Metis community of fewer than 300 people. I saw clearly the cultural disconnect as a White person from southern Canada.

What other supports could provincial, federal or even hospital boards provide that would help to overcome some of these linguistic, cultural and other disconnects? Medical procedures are difficult enough for a layperson to understand, but for one who doesn’t speak or understand the language it is even more so. What are other supports that could be put in place as part of the advocacy?

The Acting Chair: Senator Wells, do you mind if I add something to your question?

Senator Wells: Not at all. Anything that makes my questions better, I am happy to hear.

The Acting Chair: Perhaps you could also add what are the differences in terms of power imbalances when you have a professional. You have the language and cultural barriers, but what if someone is institutionalized in a prison or a mental health facility, in poverty and those sorts of things. Could you add those too?

Also, what recommendations would you have to make it more accessible, so that you would be more certain that someone be able to give informed consent?

Senator Wells: You changed my question.

The Acting Chair: I am sorry, I didn’t mean to change your question.

Senator Wells: I’m kidding.

Ms. Joe: I can address Senator Wells’ question first. It has been since 2015 when the TRC released its Calls to Action. We specifically see Call to Action, paragraph 19:

We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, . . . .

Paragraph 20 reads:

In order to address the jurisdictional disputes concerning Aboriginal people who do not reside on reserves, we call upon the federal government to recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples.

Then there are paragraphs 21, 22 and 23, but it’s paragraph 24 that I really wanted to address:

We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.

The best time to make change is with people in schools. When you look at the medical centres that are in urban area that don’t always have interactions with Indigenous people, there’s a disconnect when graduates go out into the communities to deal with our women and our families. We need to ensure they also understand that they’re as accountable to us as we all are. We need to hold them accountable.

Whenever I go to see my doctor, I place a lot of trust in my doctor. If my doctor says I need to have something done, I rarely go for a second opinion. If I am in the situation where I am delivering a child, I would believe what I am told. I would believe my doctor. If I were told afterward that the procedure wasn’t necessary, I would go through quite the grieving process. Who do you blame at that time? Indigenous people have a lack of trust in institutions, policing institutions and judicial institutions. We need to overcome that. If we see these Calls to Action being implemented, we can start true reconciliation.

In regard to the power imbalance, we don’t have the numbers, do we, for how many incarcerated women may have been subjected to this? That’s an area we need to look into. I hope that has answered the Senator Wells’ question.

Ms. Omeniho: I would like to add that there are examples in the past, maybe not specifically around forced sterilization but between our various Indigenous communities and health care professionals, of advocates or allies being brought into various medical institutions to help people be informed and to understand their rights. Maybe we need to make that an example of how they should be working with the Indigenous community. It is very true that independently each one of our cultures is different.

Often issues will come up in a medical context that may have us making choices between medical processes and our cultural beliefs. If we had people to help us float through some of the issues in the various institutions and acute care facilities, we would have a better understanding of how to make informed decisions as to our well-being and what is in our best interests. That’s part of what we need to do.

When it comes to barriers like incarceration, poverty and all those things, they are part of why we’re asking that there be research and work done. There is not enough data and understanding of just how much this is affected. It falls in line with what we experienced with the Sixties Scoop, where women were often pushed into positions of giving away their children or some of their children because of issues around poverty, or they were threatened that all of their children would be taken out of their care. This is along those very same lines. We have a lot of work to do. In our experience and in the experiences of the women we have talked with, child welfare is often engaged in putting the pressure on our communities to make these decisions. It isn’t always health care.

Another thing I’d like to raise, which hasn’t been talked about much, is that a lot of times our young population is experiencing a variety of mental health issues that make them sometimes make unrealistic decisions. If they’re struggling with bipolar or addiction issues, how do they make healthy choices for themselves? They’re not in a place where they can make those decisions in a healthy way. We need to help support and find ways for them to make choices that will make them well again and to keep them balanced so they are able to make informed decision making.

Ms. Curley: It’s good that the ladies going on maternity leave are being escorted by their spouses, but the government is using a lot of funding to do that. In our region of Iqaluit, there’s a big lack of available accommodation. With spouses being sent along with the pregnant ladies, some empty beds are not being used because there are two beds in a room and another patient can’t be there. It’s husband and wife in one bedroom, and they don’t want a stranger to be in the same room.

If there would be midwifery in each community, that would be a good investment. It would build local community capacity, instead of using up all this funding to have patients travel out of the community and risk damaging their children by leaving them behind. A good investment in midwifery in each community would be a lot better.

It is not so much the lack of not knowing or being able to speak English. There’s ongoing racism within the health system. An instance was documented in a file about a lady who had to go to Montreal every three months. It was documented in her file that she had travelled in January, which never happened. It is happening, and we need to address the health inequities and racism within the health care system.

Senator LaBoucane-Benson: I have two questions, one from me and one from Senator Bernard.

The first from me is around prevalence. It occurs to me that every one of your very important leaders has indicated that within your membership young women and other women often don’t even understand that they have been coerced into sterilization or that their human rights have been trampled on.

To do research could retraumatize people, as President Joe mentioned, but in your opinion what do you think the prevalence of sterilization in your membership? If you had to guess or if you had to tell us, of people living, maybe, how many women do you think have suffered this?

Ms. Omeniho: You’re right. We don’t have a lot of data to assist us, and we never will. We had this conversation a couple of weeks ago. We were in a room of about 70 Metis women, and I will tell you that close to a third of them have been affected or impacted by these kinds of issues. They didn’t understand it until we started the conversation to explain what it was we were presenting and what we had been dealing with.

When we asked them if they would want to come forward to talk about their experiences, in many instances they don’t want to because they’re ashamed. They’re ashamed that they’ve changed/ On our culture, it’s a part of who we are. Kinship ties are really important, so they don’t want to be identifying themselves as people who have been exposed to having their human rights violated. Not all of them felt that way, but I will say the majority of them did.

For us to be able to say what is the prevalence of this, we’re really not sure. I am not so sure the ones who had happen would be willing to tell. It would be hard to figure out those statistics.

Ms. Joe: We know there has been at least a hundred. As my colleague said, sometimes our people don’t understand what are their rights. If you don’t know what are your rights, that is a breach also. It’s not their fault. The legal system is very confusing.

Indigenous people have had a traumatic history. Since the government hasn’t made changes to respect them and their rights, unfortunately they accept this is something that will continue to happen to them. We’ve seen this in the residential schools. I believe all, except my youngest aunt, have attended residential schools. She did not attend only because she was institutionalized for Down syndrome.

It’s a sad situation for our elders to expect that they will not be listened to. As Melanie Omeniho mentioned, you feel like you’ve done something wrong. You’ve been shamed, and you don’t want to report it a policing system that doesn’t always believe you. As this discussion is happening, slowly our Indigenous women are saying, “Hey, I think this is wrong. I think something happened to me.” I hope they’ll come out more so in the next little while.

Ms. Curley: I can only say that the majority of our Inuit population would ask you what are human rights. There’s really no knowledge about human rights. Like I said earlier, there’s a lack of understanding communications between the two of us, but there’s also the lack of understanding our rights.

Senator LaBoucane-Benson: I understand if you don’t want to answer this question. In my research around historic trauma and about violence that women have experienced, it seems to me that talking about coerced sterilization would bring up and intersect with sexual violence if a woman has experienced that. I wonder if anybody would like to talk about that. If there’s to be an inquiry into coerced sterilization, maybe you could give us some ideas about how to go forward because I think those two items will come up together in many situations.

Ms. Joe: You’re right. I’ll ask my technical person, Virginia Lomax, to answer because it is a little distressing for me. It is for her too, but she has a legal mind.

Ms. Omeniho: I want to say that I agree with you that this is a part of the issues we’ve dealt with when it comes to sexual violations of Indigenous and Metis women.

It all fits within the same premise of how we deal with things within our communities even today. People don’t talk about being sexually violated. We are still not a part of the Me Too society. We are not talking about these things. Quite frankly, the women in our communities are not even dealing with the issues of violations by medical professionals within their own processes. If they have experienced abuse within a doctor’s appointment or within some other process that has exposed them to being sexually violated within a doctor’s care, they are not dealing with those things.

They don’t talk about them. Much like this issue, they have a shame base within them that somehow they did something wrong and it’s their fault. They take responsibility for these things. It’s better not to talk and not to tell people because it makes them feel like they have taken a lesser place and that they should have been smarter and better than that.

I don’t know outside of my own Metis community, but I know within my Metis community women often take responsibility for what goes wrong. They feel, if they would have done something different or if they would have acted differently, it would have changed the outcome. That’s a lot of what they talk about.

I believe the two are hand in hand. If there ever is an inquiry into this matter, they will find that a lot of people who have similar violations will be a part of these conversations.

Virginia Lomax, Legal Counsel, Native Women’s Association of Canada: Thank you, Senator LaBoucane-Benson, for this question because it’s important for our institutions to recognize the impacts that trauma has on survivors and on the people who would be required to give evidence in these types of situations.

Speaking from the perspective of the justice system, you asked about ideas of how to go forward. Something more people need to be advocating for is the employment of trauma-informed processes within the justice system, not simply from a perspective of victims’ rights, but also from a perspective of the harm that retraumatizing victims can do to the evidence that is presented.

We can’t necessarily speak specifically to the histories of sexual assault with particular victims, as that’s not within our knowledge right now. An idea for moving forward would be to ensure that the trauma-informed perspectives and rights of victims who will be providing evidence, or for victims who will be participating in research studies at legislative or Senate levels, are respected in a way that is not simply meaningful but possibly also enforceable.

Ms. Curley: I can’t really speak to this.

Senator Moncion: For me, a new page is being turned. I knew that it existed, but not at this level.

What kinds of programs do you have available now to inform and educate little girls and little boys from the youngest age in your different communities on their behaviour and their rights? Where do we start? Does anything exist right now? What can we do to avoid any of this continuing?

I don’t know of any programs that exist. You did speak of some solutions, such as having midwives in the communities for childbirth. What kind of education do we give on the system and on how it works? Does anything exists?

Ms. Omeniho: I’d like to tell you that my experience with the education system in itself seriously lacks in the area of being able to educate people on their human rights. I believe some work has been done in the past on trying to create opportunities to make people more aware of their human rights. It has been very little and very patchy, here and there. Maybe there needs to be a stronger concerted effort to get the information out to our communities, whether it is mine or others, to start educating some of our youngest beings in understanding their human rights and when their human rights are being violated. Whether you are looking in criminal justice, health care or children’s services, you don’t have to look very far. The violation of our community’s human rights is exponentially higher than anywhere else in the world.

Nobody wants to talk about things like the racism or the systemic discrimination that exists within all of these various institutionalized processes. We need to deal with that. I fully support doing something to help understand our human rights, in terms of our own culture and community. If I go back to my community and start talking about section 35 rights, they all seem to know what that is but do not understand what are their individual rights. There is very little understanding, knowledge or information being shared to help them understand exactly how they, as individuals, need to be able to protect themselves from some of the systems that exist.

Ms. Curley: There is really no education available within small communities. I don’t know about the larger communities. I can only speak on the experience I have and what I have seen. There is really no education on this topic. There are some available pamphlets. You can google or go to the Pauktuutit web page.

There is a gap around sexual health education and healthy relationships. Living in a small community, although you can google it, there are always Internet connection problems. If you are trying to download something it can take maybe a week with poor connections, if you can even download it. There is some information out there, but we just can’t grasp onto it.

There are some pamphlets, but they are in English. Where is the Inuktitut versions of them? Some of them are in Inuktitut, yes, but it may be in a different dialect. We can’t understand the other dialect in some cases. It is not in all cases, but in some cases.

Ms. Joe: Off the top of my head, I could not recall a program. In looking at my own background, the first time I learned about human rights was when I was studying human resources management.

This is something we need to introduce to our communities. I learned best as a child when I was able to discuss with my family, my teachers and my friends. Because I was studying human resource management, my children know their rights in the labour market. They don’t know their rights as Canadians though.

I was quite impressed when I went to the United Nations and saw a children’s book on UNDRIP. I had to grab it for my niece and nephew. Why isn’t it standardized in our school system? I have heard of programs, but they are not consistent across the country or the province or territory.

I have heard of navigator programs in hospitals, and I am leaning toward advocacy supports in the hospitals so that Indigenous families and Indigenous women can feel they are not alone when they have to make this sort of decision. I believe this is something we need to start looking at. These individuals, these community members, these Indigenous people, must understand what these women are going through. They must be very culturally involved, and they must understand the trauma these women are going through.

Senator Boyer: The last panel we had told us of a young woman who came forward in December 2018 who was sterilized against her will in a Saskatchewan hospital. I find that shocking in light of everything that has been in the newspaper, in light of the United Nations’ call, and in light of the class action lawsuit. We still have it happening. Some people calling for criminalization. Some people are asking for criminalization and adding something into the criminal code as a way forward.

Do you believe this would solve this systemic issue, particularly because of Indigenous people’s mistrust of the justice system? Do you have any other legislative recommendations that might address this problem?

The last part of the question is: The RCMP made a statement a week or so ago saying that nobody has really complained about this issue. They don’t have any records of it. We had a witness last week that said that a client had complained.

If we could get some comments on that, I would appreciate it.

Ms. Omeniho: In relation to the RCMP, we report missing and murdered Indigenous women, and we see where that got us. They tell us that they don’t have any complaints. That doesn’t give me a lot of confidence in the fact that they have taken those complaints seriously. If some woman went in to complain to the RCMP about feeling like they have been coerced or forced into some medical procedure, I suspect the RCMP would clearly say, “This is outside of our mandate. You have to go somewhere else and report these things.”

We sit with some of the medical professionals on a committee that the federal government started in November. My shock was that nobody knew about it. I mean we knew about it. Nobody asked us, but we have known about it for a long time. Through our experiences within our communities and our families, we knew that people were being coerced into having tubal ligation or having early hysterectomies.

Like I said, I don’t know who would ever come forward, but there are even young women in our communities at the ages of 22 and 23 that have had complete hysterectomies that were not medically necessary. They were not given any other options to address their health issues. That’s the first thing. We know of young women that went in to have some procedure done and came out sterilized. Our shock was that nobody else seemed to know about it until the UN raised it as an issue. That is what I would tell you.

Do I think that criminalization will solve it? No, I don’t. I am not saying people that have blatantly forced people into things like sterilization shouldn’t be held accountable, but do I really think the justice system in this country will start putting doctors, nurses and social workers into the prison system? No, I don’t.

If we were to start looking at ways of building legislation, we should build legislation and policies that will help health care institutions to take these matters more seriously and change how they do business. That’s my approach, rather than trying to figure out a way to get the justice system to put all the doctors in jail.

Ms. Joe: I agree. There is a relationship that Indigenous people don’t have with the RCMP. In our large country of Canada, it’s not always the RCMP you might go to. You might be going to provincial policing organizations or municipal policing organizations. They don’t have a shared database, and they don’t always believe that this is a crime. I don’t think the patients or the individuals understand that this is a crime against them. Is it sexual assault? Is it aggravated assault? We need to have more education surrounding this area.

In regard to the criminalization and legislation, I am going to pass it over to Virginia Lomax.

Ms. Lomax: The recommendation for specific criminalization of forced sterilization comes from international human rights bodies. They made these recommendations to other countries that have had this issue occurring as well.

Speaking in the Canadian context, a legal analysis might see that the act of forced sterilization could fall under another provision of the code; but that will not necessarily be what a member of the public sees. A member of the public might not say, “Oh, I have been subjected to a surgery against my full, prior and informed consent. This must be aggravated assault.” That’s not necessarily the perception of the justice system that everybody will have. One benefit of specific criminalization is to mark this as a crime so that everyone knows that the act of sterilizing someone without their full, free, prior and informed consent is in fact a criminal act. That could go a long way, but it must be zealously enforced.

Simply adding something to the Criminal Code, in and of itself, will not achieve a level of deterrence unless people know that there will be penalties. If it does become an aspect of the Criminal Code, the police would need to be taking it seriously. As we have mentioned before, maybe the RCMP doesn’t have reports; but there are a lot of reasons why there might not be reports on record. The testimony from the National Inquiry into Missing and Murdered Indigenous Women and Girls might point to some of the reasons why there aren’t reports on record. That’s also not speaking for municipal and provincial police systems where these reports may have been made as well.

To come back to the issue of whether this would solve the problem, murder is a crime and that has not solved the problem of missing and murdered Indigenous women in this country. It’s clear to me that this is a much larger systemic issue. Criminalization will only be a small piece of the puzzle. Every moving part of the system that creates these injustices must be informed in a way that will prevent, not simply react.

As far as other legislative initiatives, we can speak to Bill S-215. If forced sterilization were to become a crime, it would be helpful considering the history of colonial violence and genocide against Indigenous people in this country. The fact that this crime would have occurred against an Indigenous woman would be an aggravating factor in sentencing that would at least somewhat adequately address the much larger issue in the context of a history of colonial violence and genocide.

Ms. Curley: I am in agreement with my colleagues. Of course there are no records at the RCMP. We are now realizing and understanding human rights. Some of them are just hearing about it. Who are the RCMP to believe? Will be the doctors or the individual? Most likely it will be the health system. It’s documented. What the doctors or the nurses say to you is true according to what you believe, so therefore you agree to whatever they say you should do.

The language barrier is a big problem. There is a big difference between the words “may” or “shall.” If the nurse tells you that you can, if you want to, or you should, you may misinterpret either one. You may be signing a consent form without reading it. If you can read it, maybe you will, but most likely you will not be able to read the document. If it has medical terminology in the contents of that consent form, even a White person wouldn’t be able to understand the terminology. I wouldn’t. I don’t know what the solution would be.

Senator Boyer: Thank you for your thoughtful responses on that question.

The Acting Chair: I have a question arising from the question that Senator Boyer put. There is a fair bit of evidence in the criminal context that deterrence and denunciation are less effective than promoting a positive aspect. If people are encouraged to a different standard, they may rise to it.

Would the ability of doctors, nurses and social workers, being licensed, having to show an understanding of these issues be something that either of your organizations would find useful? Before someone can be licensed, there is some information about issues like sterilization of Indigenous women, violence against women and the disproportional impact. Would that be an area where there might be an interest? If so, what recommendations would you make?

Ms. Joe: Education needs to happen across the board from the medical communities in federal and provincial institutions. It can’t happen just once in your career. You need to continually address what’s happening because our history is changing and getting better, hopefully.

The situation that has popped up in December of last year is abominable. The conversation is happening now, and we need to address it. I think licensing, because you have to renew your licence, is a good area to consider for education in these issues.

Ms. Lomax: I would like to add when I say that criminalization might be one piece of the puzzle. Another piece will be getting the involvement of the medical regulatory authorities who have oversight over doctors.

Because there are power dynamics at play if a woman is told by her doctor that this is what you need to do. Maybe she sees a consent form and thinks it will be protecting her, but it’s actually protecting the doctor. It’s a situation where power dynamics will not necessarily play into positive outcomes for people even if criminalization is enforced.

Proactive responses to this issue rather than reactive ones will be extremely important because what we need to be focusing on is ensuring that it does not happen to another woman, rather than when it does happen we can put doctors in jail.

Ms. Omeniho: I support the fact that we need to change the curriculum within most of the medical field so there is a better understanding of some of the issues with the cultural diversity of Canada. I don’t think this only impacts us as Metis women or even if we say Indigenous. There is enough cultural diversity in the country that medical professionals need to understand the programming and the practices of the various things they will be a part of. I agree that the regulatory system most medical professionals fall under is key in being engaged in building regulations so people don’t get away.

Rather than criminalizing doctors, the thought that they will lose their medical practice will be a lot more significant if they violate people’s human rights. I also support what Francyne Joe said. It can’t be that you have all the knowledge and understanding if you take a four-hour course at some point in your career. It has to be an ongoing in-servicing that helps them build and understand who we are historically, what cultural genocide has been about, the effects and impacts on us of the historical trauma we have faced, and why we are where we are. Those things will go a long way to helping to understand how to work with us.

Ms. Curley: It’s good that we are starting to see some Inuit practising as doctors or nurses, but the number is very low right now. It’s very important that whoever is going up North should have some knowledge, education and understanding of our culture and our attitude. We have an attitude of agreeing with whatever the authority may be saying to you.

There is a big lack of understanding on both sides. It would be important that licensing is in place and that there is an understanding of our culture and needs.

The Acting Chair: My apologies for cutting in. Many of your stories reminded me of earlier in my career. A young man who was unilingual Inuk had a psychological assessment. We had to establish that it was impossible he had been properly assessed because he couldn’t speak the language even though he was nodding throughout. Thank you for raising that issue.

Senator Boyer: If the committee decides to study this matter further, what are some aspects that we should be sure to look at? Do you have recommendations on that? Are there gaps in the current literature we should be looking at? How important is it to hear from the women and their families who have been involved?

Ms. Omeniho: I want to tell you that there are obviously gaps. I don’t know what research project can be done to fill in all of the gaps. What kinds of literature exist even now? In the work we have done up until this point, even working within the professional medical committee, very little or none truly exist.

If there were any further investigation into it, it’s absolutely imperative to understand the stories of the people who have been impacted. It’s also imperative those stories are what leads us on a path of trying to change everything that has resulted in our being in this situation even from the onset.

I would like to see compensation for the people. There is no real compensation, but at least there should be an acknowledgment of the trauma they have experienced as a result of forced sterilization. I don’t necessarily say that it has to be money, but at some point there should be some engagement or acknowledgment of what has happened to these women and how it has affected and changed their lives.

Ms. Joe: I agree with my colleague. As mentioned earlier, there needs to be a reparation fund for the victims or the survivors and their families. I prefer to call them “survivors.” In regard to further research, I would like to bring together those survivors to co-develop any future programs, any services, any legislation.

We also have to talk to the medical regulatory authorities and delve into what are the processes that are allowing this to happen. Obviously we need to incorporate this culturally relevant education.

There is a growing number of Indigenous people going into the medical field. I think that’s a resource we need to tap into. I’ve had many good conversations with Dr. Evan Adams back in B.C., and he has a very good relationship with communities. Having that kind of resource to discuss where we go from now would be quite practical.

Finally, I want to get the opinions of witnesses out there who have seen this. It’s very difficult, as we’ve mentioned, to use your voice to question something you feel inside might be wrong. You do have that power struggle again if a doctor or someone with a higher authority is saying that this is what they’re going to do. I’ve done it myself. I’ve seen something wrong, and I didn’t use my voice to move forward. We need to provide a safe environment for people to bring ideas to the table that will prevent this from continuing to happen.

Ms. Curley: I am in agreement with my colleagues. There needs to be education on both sides. This is very new to us. We need to have education on what are human rights. Unless you understand what are human rights, you think whatever the doctor did to you was right, that there was nothing wrong with it.

There should be more investigation on whether the consent form being signed is understood by the individual who is signing it.

Senator Boyer: Would you say that there should be some unification on what consent means? Would that be something that would be useful in this discussion?

Ms. Curley: I think it would be, yes. Normally, or if it’s not all the time, a consent form is in English. Some Inuit people can’t read English. They can only read syllabics. Even if they are able to speak English, they may not be able to read the contents of that consent form. Whatever the nurse or the doctor says, you believe and therefore sign the consent form. Maybe the doctor or the nurse is just summarizing the contents of that consent form, so you may not be picking up some parts of that information that you’re signing for.

Senator Boyer: There are essential elements that should be looked at, then.

Ms. Curley: Yes, I believe so.

Senator Boyer: Thank you very much.

Senator LaBoucane-Benson: I have one more question. I wasn’t sure if I should deal further with the very interesting and important idea of a trauma-informed inquiry. Back in my old life, I did a lot of trauma-informed legal education for Indigenous communities, as Melanie Omeniho knows.

For example, there is a law in Alberta that says every woman has the right to be safe. Every Albertan has a right to be safe, but we know that Indigenous women are often not safe and experience domestic violence at a higher rate. In working on the legal education pieces, we realized that one of the outcomes of historic trauma is not only hopelessness, helplessness and powerlessness, but also a feeling of lack of self-worth. Oftentimes women do not access the laws in Canada because they don’t feel worthy of being protected by that law.

I wonder if anybody would like to speak on what a trauma-informed inquiry look like. I am grateful to Senator Boyer for her work in bringing this forward. Certainly that’s what Senator Boyer has been thinking about. Do you have any recommendations to us about what a trauma-informed inquiry would look like?

Ms. Lomax: If I may, the first step of a trauma-informed inquiry would be to ensure that a public inquiry process would actually be something that the victims would want. If it’s a top-down approach where a government or some sort of public entity is saying that it will now do an inquiry on the issue, there needs to be an absolute confirmation that this is something the victims want and are willing to participate in.

Ms. Curley: It should also be understood by everyone that we are very forgiving. We don’t want to go back to the past. Even if you were traumatized or were treated the way you didn’t want to be treated, you just want to forget about it and leave it in the past.

Therefore, I would strongly recommend that some education be provided to Indigenous people so that there is a good understanding of what is out there, what you’re looking at, and what are your hopes.

Ms. Omeniho: When it comes to a trauma-informed inquiry, Les Femmes Michif Otipemisiwak is working on a Metis toolkit around trauma-informed work. We recognize the struggle that exists. Our experience with the National Inquiry into Missing and Murdered Indigenous Women was trauma based rather than trauma informed. We recognized the work that we needed to do to help our communities overcome their experiences.

If there is to be a trauma-informed inquiry, I really recommend that the commissioners or other individuals have some training and background. They should not be appointed and put into a position where they don’t really understand trauma informed.

Retraumatizing, as was alluded to in the first process, people who are actually victims, without their consent and without their understanding, only help us to continue to traumatize them a little further. This is not for the purposes of making them better or healing them, but for the purposes of our undying need to always hear the stories.

I support and encourage that the work be done, but to be really done in a trauma-informed way so that we don’t revictimize people anymore. That would be my advice on this point.

Ms. Joe: When we’re looking at a possible inquiry, let’s not forget our sisters who are incarcerated, in institutions and homeless. There’s a reason behind the obvious ones, and we need to also provide them with continued supports afterward.

The Acting Chair: To pick up on that point, on April 3 the witnesses did recommend a national inquiry. I appreciate that you’ve made some comments about that. On behalf of all of us, we appreciate that input.

If you support a national inquiry, what kind of scope would you like to see? How would you like to see it developed? How would you see involving women from your various communities in that process? How would you conduct it? Would you presume it to start in camera? Some of those sorts of issues come to mind.

Linked to that, you’ve mentioned the reluctance of people to report to the police. I think you’ve alluded to or have talked about, in different contexts, how reluctant sometimes people are to go back to the medical profession. Would you also include how you would involve the various pieces?

How would you involve doctors? How would you ensure the safety of people who have already experienced sterilization? I mentioned earlier the scope and the involvement of other parties: people who are incarcerated, people living on the street, and that sort of thing.

Ms. Omeniho: First, if you are to do a national inquiry, you need to educate yourself around the pitfalls of the current inquiry. A national inquiry would engage every province and territory, as well as the federal government. That has its challenges. We’re still dealing with some of that as of now.

How do you get the community engaged and involved? All you have to do is ask and give them the supports they need. There need supports for people in trauma-informed process to help the survivors of this particular issue. We need to ensure those are in place and readily available to the women who are coming forward.

In an inquiry process, one of the issues is that we all come from our own place in life with our own experiences. It is imperative that we understand the medical professional experiences and why we’re on such different sides of the spectrum. It would be important that they be a part of an inquiry. The only way we will build solutions is by doing them collectively.

It’s easy for us to gather a roomful of women who have been impacted in some situation and say, “Okay, this is what we need.” If we don’t understand the challenges that exist, if we’re not working with things like language barriers and medical technology barriers that exist for us, we can’t make good decisions.

An inquiry would have to be inclusive of everyone, but I recommend and suggest that it be trauma informed and really trauma informed this time so that we are not revictimizing people.

We need to make it so it isn’t a “them and us” kind of thing. It isn’t about us attacking the doctors or medical professionals. This is about us trying to find strong solutions to go forward.

Ms. Curley: Like Melanie Omeniho said, it’s only a matter of asking. We are very welcoming. We lack resources at times. I wanted to add that.

Ms. Lomax: Determining the scope of an inquiry would need to be done by centring the voices of the victims. I don’t want to assume that voice right now. If this is something the victims want and if they are involved in determining the scope, extensive work would need to be done to ensure we draft a robust terms of reference. It would clearly set out the scope, the rights of the victims throughout the process, and the supports available to them.

Further, we would need to ensure that adequate time would be given to that inquiry. We can’t fool ourselves into thinking that 200 years of colonial violence and genocide can be undone within the convenient span of a parliamentary term.

Ms. Joe: Addressing that these women aren’t wrong is a great first step. Something happened to them, and they have rights we need to respect. We need to ensure the medical profession understands that they need to change. They need to incorporate culturally relevant training at the school level and at the licensing level. The government also needs to understand that when they commit to something like this, we can start to trust them again.

I don’t want to hear that these doctors didn’t mean to do something. It was done. You breached someone’s reproductive rights, and they cannot get back what they’ve lost. Physically, possibly, but emotionally, no.

Bring back the stakeholders, put these women front and centre and respect them. As Virginia Lomax mentioned, give enough time for this. We’ve learned quite a bit from the national inquiry. We’ve learned quite a bit from the Truth and Reconciliation Commission. Let’s now move forward so that we can build the trust and relationship we need for our sisters and for our future generations.

Senator Boyer: In light of the fact that in December 2018 a woman was sterilized in Saskatchewan after all of this, I think we’re failing miserably at this moment in time. This is not stopping, even with everything that we’re doing and all the media. The hospitals are up in arms, but it’s not stopping. What do we do? Do you have any ideas?

Ms. Omeniho: We have a long way to go to inform and educate people. In the limited work we’ve done on this issue since December, we’ve had a lot of aggressive defensiveness coming from medical professionals at this point. A lot of work needs to be done to build the bridge between medical professionals and the ongoing issues in our community. Somehow we need to find a way. That is what we’ve talked about.

We need to find a way to educate our young women in our communities that they have a right to say no to this. Regardless of their decision, people can’t go around and threaten to take away their children. They can’t threaten to throw them off social assistance because they don’t have the financial means to care for themselves. They can’t threaten them to be involved in any other process that will make them vulnerable. That’s not acceptable anymore.

We need to keep educating our young people. I don’t think it will happen overnight. I am grateful for the fact that it’s more open. It really isn’t in the media that much. Average Joe Canadian has no idea what we’re talking about. I would beg to say that I have not seen a lot of media attention around this issue. I guess that is why I was surprised to hear that everybody was shocked it was happening. We knew it was happening. We assumed everybody else knew that these things were going on, that people were being pushed into making decisions about their own sexual well-being without proper process.

It’s not just this issue. As Anne Curley raised, there are consent forms in the medical field on all kinds of issues. You would need a lawyer and a medical professional to interpret things like the right to life and the right to resuscitate. Those complex things are slapped down in front of you when you’re in the middle of a medical crisis. How do you know what is the decision?

Even from my own personal experiences, I know that decisions get made. Then you question yourself. Did we do the wrong thing? Was it the right thing to do? There’s nobody there to guide you and explain what is the best decision. You sign it because you’re told to sign it, not because you’re informed about what’s happening.

We need to change that. I don’t know if that’s just in our Indigenous community, but those are our experiences. Consent forms are legal documents, and we don’t even understand the context of the documents. That would be my input. Hopefully, things will change. I don’t know how fast they will change.

I am glad that we’re at least having a conversation, though. That wasn’t happening before.

Ms. Joe: What we need to do is treat this issue as seriously as it is. I hate to say it, but when there’s a fund that recognizes Canada has done wrong and that survivors have remedies, tension is brought to the situation. We need to start investigating these allegations now. Let’s not wait. This education needs to take place, but survivors need to know that if they bring up the subject matter it will be dealt with quickly.

We need to set up advocacy offices for Indigenous people in the hospitals. We need to allow women to have a choice to use midwifery services or doula services in their own communities. We need to pass Bill C-262. Once we understand that these are inherent rights of Indigenous people, those are the starts we can do now so that this issue can be addressed for the seriousness that it is.

The Acting Chair: Thank you very much, and thank you to all of our witnesses for joining us today.

(The committee adjourned.)

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