More than 2,000 people from across Quebec marched through the streets of Trois-Rivières Wednesday afternoon as the coroner's inquiry into Joyce Echaquan's death came to a close.
Echaquan, a 37-year-old Atikamekw mother of seven from Manawan, Que., died last Sept. 28, moments after she live streamed hospital staff insulting her. Her death sparked outrage and calls for justice across Quebec — calls that were repeated by those at the march.
"Joyce will always live in my heart and those of my children," Echaquan's husband, Carol Dubé, said at the rally.
"Despite all our sad stories, and despite it all, we need to fill ourselves with hope … together we can change things."
Andrea Ottawa, who attended the march, said she felt it was especially important for her to voice support for Echaquan because she, too, deals with systemic racism at work on a regular basis. Ottawa is a nurse and says she often feels her patients treat her differently because she is an Indigenous woman.
"I think it's very important to every woman to be here, present, even from far," she said.
Isabel Napess drove all the way from Ekuanitshit on Quebec's North Shore to attend the march — a journey that took more than 24 hours.
"All natives, I'm sure, they've lived discrimination at least one time in their lives," said Napess. "We just endure that, we never show it, so now I think it's time to stand up and say enough is enough."
'Never again,' says coroner
As the inquiry wrapped up, Quebec Coroner Géhane Kamel promised that Joyce Echaquan's death will not have been in vain.
"To your children, Mr. Dubé, you will need to tell them that the small revolution of reconciliation started because of their mother," she said, turning to Dubé.
"To Joyce, wherever you may be, know that my report will not be complacent. It will be honest and I hope it will be the foundation of a social pact that will help us to say: 'Never again.'"
The lawyer representing the family, Patrick Martin-Ménard, as well as lawyer Rainbow Miller, who represents Quebec Native Women, called on everyone listening to remember Echaquan not just as a victim of a tragedy, but as a person.
"She was a woman who really loved her family," said Miller. "Precious to both her family and her community."
Martin-Ménard said the past few weeks were difficult and emotional for the family, and he said the process was only made harder as they heard conflicting testimony from health-care staff who were there that day, at the Centre hospitalier régional de Lanaudière in Joliette, Que.
"It's a relief for the family to come to an end of a process that was very hard, very emotional," said Martin-Ménard. "Now, it's in the hands of the coroner."
Still, he said the inquiry was able to provide them with some answers into the causes of Echaquan's death.
Last week, expert testimony revealed that Echaquan died of pulmonary edema and could have been saved had she been monitored more closely.
"We learned of a significant gap at the medical level, at the level of the the nurses, of the management of the emergency room," said Martin-Ménard.
"We also learned, in a much larger sense, that systemic racism is a problem in our health-care system that we need to address."
Systemic racism led to Echaquan's death, lawyer says
Several experts who delivered recommendations at the inquiry in recent days called for cultural sensitivity training and changes to the province's health-care system to address systemic racism, and particularly address issues of discrimination against Indigenous women.
Several also stressed the importance of adopting Joyce's Principle — a series of measures drafted by the Atikamekw community to ensure equitable access to health care for Indigenous patients.
But the province has refused so far to accept the full document because of its mention of systemic racism, which Premier François Legault has repeatedly denied exists in Quebec.
WATCH | Joyce Echaquan inquiry concludes:
In his closing remarks Wednesday, lawyer Jean-François Arteau, representing the Atikamekw council of Manawan, repeated that systemic racism was a major factor in Echaquan's death.
Earlier in the inquiry, health-care workers who treated Echaquan the day she died testified they had assumed she had an addiction to medication and was suffering from withdrawal.
"It is based on a stigma, a bias," said Arteau. "This is systemic racism."
Arteau said this false assumption led them to pay less attention to her symptoms and to leave her unsupervised, ultimately leading to her death.
"If her name had been Jocelyne Tremblay, she would still be alive today … but her name was Joyce Echaquan."
Though provincial police determined no criminal charges should be laid in the case, Arteau said he's not so sure about that and would like them to revisit the file.
The new CEO of the Lanaudière health board, Maryse Poupart, told the inquiry this week that more will be done to improve communication and delegation of roles within the hospital, which the inquiry highlighted as areas of concern.
More Atikamekw employees are already being hired at the hospital, she said, to create a safer space for patients who visit. Guy Niquay, who is Atikamekw from Manawan, has also taken on his new role as deputy CEO.
Poupart also said she is working with Paul-Emile Ottawa, the chief of the Manawan Atikamekw Council, to build a new relationship.
Over the next 30 days, Kamel will receive the final written statements from the lawyers representing everyone involved in the inquiry, after which she will submit a report detailing recommendations of her own.