TROIS-RIVIÈRES, Que. — Hundreds of people gathered outside the courthouse where the coroner's inquest into the death of Joyce Echaquan ended Wednesday, hopeful that her death leads to concrete changes for Indigenous patients in Quebec's health network.
Shortly after the hearings closed in Trois-Rivières, Que., halfway between Montreal and Quebec City, a crowd estimated by police at more than 1,000 marched through the streets chanting "Justice for Joyce."
As the marchers — many wearing purple, Echaquan's favourite colour — reached the courthouse, many of them took turns hugging her husband, Carol Dubé. Then, they all observed a moment of silence.
"I can feel how strong the energy is today," Dubé told them.
Since May 13, coroner Géhane Kamel has been leading hearings into the death last September of Echaquan, a 37-year-old Atikamekw mother of seven. The public learned about Echaquan's mistreatment after the Indigenous patient livestreamed herself with her cellphone at a hospital in Joliette, Que., about 75 kilometres northeast of Montreal.
A nurse and an orderly were heard on the Facebook Live stream making derogatory comments toward her shortly before she died. The video was widely shared online and sparked indignation across the country.
Kamel promised on Wednesday after the hearings concluded that her final recommendations would be "honest" and form the foundation of a social pact that will "never again" permit another Indigenous patient to be treated with such indignity.
The inquest heard that Echaquan had died of excess fluid in the lungs, likely caused by heart failure. However, the hearings also heard that doctors had wrongly diagnosed her as suffering from opioid withdrawal when she arrived complaining of severe stomach pains.
Health-care workers testified that Echaquan wasn't properly supervised at the hospital and her condition wasn't taken seriously. One doctor told the hearings that she could have been saved had hospital staff reacted more quickly.
Constant Awashish, grand chief of the Atikamekw Nation, said the crowd was a big boost to morale after several difficult weeks of testimony.
"I think it’s an awakening," he said Wednesday. "I think people are interested in what happened to her, and what happened to First Nations. Tragically, she helped Indigenous people get the awareness we need so people can understand what we are going through and what is systemic racism."
Echaquan's family and leaders in her community of Manawan, Que., located about 250 kilometres north of Montreal, told the hearings that Quebec's government and institutions should adopt Joyce's Principle — a set of measures drafted by the Atikamekw community to ensure equitable access to health care for Indigenous patients.
The document describes Quebec's health system as being imbued with systemic racism. Premier François Legault and his government have refused to fully adopt the principle because of its reference to systemic racism, which they deny exists in Quebec.
Sipi Flamand, vice-chief of the Manawan band council and organizer of the march, said Joyce's Principle extends beyond his community. Flamand said events will continue this summer with an eye on seeing it adopted in the fall.
"Justice for Joyce is justice for all Indigenous people in the health system," he said. "It’s important for the government to recognize what happened with Joyce."
Ghislain Picard, chief of the Assembly of First Nations of Quebec-Labrador, said that with the provincial legislature sitting for the summer, it's important to ensure the issue doesn't die.
"We have to give meaning to her sacrifice," Picard, who took part in the march, said in an interview Wednesday. "We have a responsibility to carry her message that things have to change."
Back at the inquiry, lawyers representing several parties taking part in the hearings made final arguments to Kamel, who is tasked with drafting recommendations to avoid a similar death.
A lawyer representing the regional health board governing the Joliette hospital said the institution recognizes there is bias and discrimination among staff toward Indigenous patients — whether it's conscious or not — and that it is ready to change the situation.
The lawyer representing the Atikamekw nation and the band council in Echaquan's community said the numerous failings in the treatment she received were related to systemic racism in the health-care system. Jean-François Arteau decried a lack of accountability and said the hearings provided evidence that Echaquan was ignored by staff.
Arteau said she would still be alive if she weren't Indigenous.
Patrick Martin-Ménard, lawyer for the Echaquan family, told the inquiry it was important to remember Echaquan as more than someone seen suffering in a widely circulated video.
“She was devoted to her family and had all sort of plans,” Martin-Ménard said. “She had her life before her, and I think it’s important to see Ms. Echaquan from this vantage point and not simply as a patient.”
In a closing message, Kamel thanked those who participated in the inquiry and addressed Echaquan's family, in particular Dubé, who had given a statement on Tuesday asking how he would explain his mother's death to his children.
Kamel said: "To your children, you will have to tell them the small revolution of reconciliation started with their mother."
This report by The Canadian Press was first published June 2, 2021.
Virginie Ann and Sidhartha Banerjee, The Canadian Press