Breaking down the barriers Indigenous people face in Canada’s health-care system

September 18, 2019

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Disclaimer: This article was published over six months ago. Some information may not be current.

At the age of 40, Samaria Cardinal found herself homeless and alone, living under a bridge in Calgary, calculating miseries endured and all the hopeless days ahead. 

Her father had experienced extreme trauma growing up in Alberta’s residential schools and he’d passed that damage on to his daughter in many ways. Samaria had run away from home and lost herself in drug addiction. Years of interaction with the medical and mental health systems had failed her. She’d been diagnosed as bipolar and locked up in mental health wards. She’d been administered shock treatments and overmedicated on so many antipsychotic drugs she wound up with severe tardive dyskinesia, a condition that causes uncontrollable jerky movements of the face and body. 

On that day, the sum of all those sad experiences brought her to a crossroads. 

“I was sitting on a mattress, dirty and soaked with urine, and I had no coat, and it was freezing,” Cardinal recalls. “And I thought I’m not living anymore, my life has been destroyed. Nobody can help me so I might as well end it right now.” 

Cardinal hesitates there, drawing a long ragged breath at the memory.  

“But something gave me the strength to live. And I chose to live.” 

Some 20 years later Cardinal seems a world away from that sorrowful half-life. She’s proud of her Métis heritage, happy and confident, back at university, with her own place and her own business. And she’s an outspoken advocate for breaking down the barriers Indigenous people face in Canada’s health-care system. 

“I really feel my Indigenous heritage played a big part in how I was treated and misdiagnosed by the health care system,” Cardinal says. “Because we are not understood by mainstream society and we are not understood by many doctors and nurses and people involved in the health care system. They don’t understand what we’ve been through as a people, and they don’t understand how it has affected us. Plus there are judgements.” 

Cardinal saw that again first-hand recently while riding on the C-train in Calgary when an Indigenous man suffered a seizure and slid off his seat onto the floor. All around him the business commuters paid no heed, assuming it was just another “drunk Indian.” A furious Cardinal had to more or less shame the people in that crowded car into action to get the man the medical help he needed. 

“I personally believe many people have to connect more with Indigenous people. Learn the real history of Canada and North America, learn what these people have gone through, and try and understand where they are at the current time. And as a non-Indigenous person, look at the myths out there. Try to educate yourself and try to understand another culture.” 

Twenty years ago Cardinal picked herself up from beneath that bridge, went to a friend’s house and appealed for help. A man from her past, someone who loved her, re-entered her life and gave her some much-needed support. Her daughter stood by her as well. Gradually, Cardinal came to realize that her long-time pattern of care was simply not working for her. She started resisting the idea of simply taking more and more pills. She found support and improvement with other holistic approaches and counselling. 

She eventually broke with her old medical team and started up with a new psychiatrist, who was far less quick to prescribe medications. Over two years, she weaned herself off all the drugs and came to see herself as something other than a lifelong victim. 

“If I had not fired that medical team I would still be living in Calgary housing. I would be taking so many medications that I wouldn’t be able to function. I would be living a life where I was a burden on society, unhappy, a victim, lost, not going anywhere, just basically existing.” 

Asked what single piece of advice she’d like to give to health-care practitioners, Cardinal draws back on her own early diagnosis as bipolar, one she questions today. 

“Be very careful with the label that you’re putting on an individual, especially a mental health care diagnosis. Because with that diagnosis, comes a lot. People are judging you wherever you go so be really careful when you’re dispensing that.” 

Cardinal says she has been encouraged by recent moves toward more culturally appropriate care for Indigenous patients in Canadian hospitals, including access to Indigenous Elders. 

“Having Elders involved in the health care system, working in hospitals in liaison with all the health-care professionals is very important, because they can be an advocate. They dispense wisdom, they dispense experience and they can be the intermediary between the health care system and the Indigenous patient involved. It’s very important to have them there and I have started seeing instances of that in Calgary, which is really nice and it’s a real big step from the way things used to be,” Cardinal says. 

“Also many Indigenous people are not Urban Indigenous, they live on reserves. So they’re coming far away to a place they’re not comfortable in, with a lot of people that don’t know them, so having somebody there like an Elder makes them feel better, provides them with a sense of safety…” 

As part of her healing odyssey, Cardinal has found great satisfaction in working through a difficult reconciliation with her father, Douglas Cardinal, one of Canada’s best-known architects. 

“He was always very focused on his career and I stayed away from him because of the trauma that I experienced when I was quite young,” she says. “I’ve only got back with my father in the last couple of years when I was off all of the medications and I started doing a lot of personal work on myself to deal with my trauma that was involved." 

“The reason why I connected back with my father is because many people have seen the growth that I’ve experienced in my life and that I’m actually almost a totally different person off of all of those drugs and now that I’ve found strength in myself. And I’m expecting people to not look at my past and judge me any more, to see me as I am sitting right here now in this moment, and I thought how can I expect people to do that for me when I cannot do that for my father…  

“Years ago I would not have had the strength to do that. I was still so affected and feeling the victim in my life but now I’m not a victim anymore. I’m an empowered, resilient and strong human being and after I made that connection again I realized he wasn’t the person he was either.” 

Cardinal joined Patients for Patient Safety Canada because she wanted an opportunity to tell her story. She sees the organization as a place where people can give voice to experiences that many professionals in the health care system need to hear.