John A. Macdonald
Sir John A. Macdonald was a crucial figure in the development and nation-building of Canada in the early days of Confederation. In terms of Canada’s health system, MacDonald had a critical role in the formation of early Canadian health policy, especially with regard to the Indigenous peoples of Canada. That is, MacDonald severely harmed Indigenous health and well-being through the manipulation of Canada’s health system against Indigenous groups in favour of the interests of white settlers. Most notably, his administration intentionally used starvation as a colonial tool to suppress Indigenous populations and facilitate settlement on Indigenous lands.
One of Macdonald’s most controversial policies involved manipulating the distribution of food and other resources to Indigenous communities on the Canadian prairies in the late 19th century. His government deliberately withheld or severely restricted food rations from Indigenous peoples, which was a tool that they abused to force many Indigenous peoples onto reserves and into compliance with subservience. The Indigenous peoples, who were already severely impacted by the loss of their traditional hunting grounds and the overhunting and resulting decimation of the bison population, experienced profound food insecurity, starvation, and malnutrition as a result. The deliberate use of starvation as a tool to eliminate Indigenous groups was successful for MacDonald in that it ultimately increased the susceptibility of Indigenous Peoples to diseases like tuberculosis, resulting in devastating epidemics and significantly increased mortality rates among Indigenous peoples.
Additionally, Macdonald was heavily involved in the government’s implementation of the policies of segregation with the passing of the Indian Act in 1876, which institutionalized racialized and unequal treatment of Indigenous peoples in health care. Indigenous peoples were denied access to general hospitals and mainstream health services, instead being confined to segregated, underfunded facilities known as Indian hospitals. These Indian hospitals were typically understaffed, under-resourced and poorly equipped, which meant that they offered substandard medical care compared to services provided to white settlers. The mistreatment of Indigenous peoples during Macdonald’s tenure was an example of how the government purposefully engineered health disparities, which contributes to contemporary mistrust toward Canadian government health policies.
Overall, Macdonald’s policies had long-lasting effects on Indigenous communities. That is, the use of starvation as a weapon of colonization and the implementation of segregated health services created systemic disparities and institutional racism that persist within Canada’s health system today. These historical injustices continue to shape challenges to Indigenous health and, more broadly, efforts toward reconciliation.
