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Not a Genocide : Part 1: Disease and Nutrition

This article was originally published in Quillette as a single article. It has been edited for republication as a series of articles here.  

The movement to describe Canada’s system of Indian Residential Schools as a “genocide” has been gaining momentum since the late twentieth century. That momentum became stronger in 2021, when it was claimed that the unmarked graves of hundreds of Indigenous children who’d attended these schools had been found using ground-penetrating radar. While none of those claimed graves have yet been found, the social panic that followed the initial announcements has not fully abated.

In 2022, Canadian MPs unanimously voted for a parliamentary motion that described the schools as genocidal. Even the Pope has now used the word “genocide” to describe the schools and the larger project of assimilation they stood for—a notable development given that the Catholic Church ran almost 50% of these government-funded institutions during their period of operation, from the 1870s until 1997.

Indeed, the word genocide is now thrown around so casually in regard to the approximately 150,000 Indigenous students who attended Residential Schools, that it’s easy to forget how recently this allegation became popularized. In 1996, Canada’s Royal Commission on Aboriginal Peoples indicted Residential Schools for the “horrors” committed under their watch, leading the Department of Indian and Northern Affairs (as it was then named) to issue a statement to the effect that residential schools were guilty of creating a “tragic legacy.” The word “genocide” was not used.

Even in 2015, when Beverley McLachlan, then Chief Justice of the Supreme Court of Canada, weighed in on Residential Schools, she described their mission to assimilate Indigenous children as “cultural” genocide; rather than genocide, full stop. This language was echoed that same year in a summary volume published in 2015 by Canada’s Truth and Reconciliation Commission, which reported that for over a century, the government’s central aim had been to “cause Aboriginal peoples to cease to exist … which can best be described as ‘cultural genocide.’”

Over the last eight years, the qualifier “cultural” has fallen away. And it is now seen as heretical to challenge the claim that Canada’s Residential School system qualifies as a true genocide in the sense of the Holocaust, Holodomor, or Rwandan Genocide—despite the fact that such a classification remains questionable under international law. Indeed, some Canadian activists claim that even debating the applicability of the word “genocide” to the Residential School system is, itself, a “tool of genocide.”

Nevertheless, that is what I intend to do in the essay that follows.

Canada’s system of Residential Schools was founded by the government of Sir John A. Macdonald, the country’s first prime minister. The fortunes of Indians (as most Indigenous people were then described) were in decline, partly because the fur trade—which for many years had been profitable to white traders and Indigenous trappers alike—was no longer economically viable. A second factor was the decline of the buffalo hunt. By the middle of the nineteenth, the herds were thinning out. And in the spring of 1879, for reasons that have never been fully explained, the buffalo did not return to the western plains at all. Many found themselves in desperate straits, and there seemed a real possibility that the affected Indigenous communities would fade out completely.

Part of the Canadian government’s response to this crisis was the establishment of day schools and boarding schools that would offer Indigenous children an education that would prepare them to become “productive” workers (as the government would have defined the term) in the modern industrial society that Canada was then becoming. However, school attendance would not become universally mandatory until 1920.

The objective was unabashedly assimilationist, which is why it is now described by modern observers as racist, or even genocidal. But at the time, it was viewed as progressive. The hunting, trapping, and fishing that sustained many Indigenous communities seemed to be completely doomed. And it was believed that a new way of life based on agriculture, mining, and industry would offer a more promising future for a majority of the peoples we now call First Nations, Métis, and Inuit.

Macdonald’s government, which would remain in power for much of the latter nineteenth century, following Canada’s creation in 1867, was not unsympathetic to the needs of Indigenous people. In 1870, it responded to Louis Riel’s demand for a province for the Métis and other Indigenous peoples of the west by creating the Province of Manitoba and providing for its entry into Confederation. Macdonald ensured that the new province was provided with federal subsidies and strong representation in the federal parliament.

Like many other government projects—then and now—the Residential Schools were underfunded. And one reason why the actual operation of the schools was outsourced to Christian priests, nuns, and ministers was that this sort of devolution helped save money. Moreover, the early buildings were generally constructed on the cheap, badly heated, and poorly ventilated. In many schools, the students shivered during cold winter nights, and transmitted infections to one another in overcrowded classrooms. These included influenza, pneumonia, smallpox, whooping cough, diphtheria, and especially (as discussed below) tuberculosis.

But while all of this is true, the context was that, until well into the twentieth century, all Canadian children suffered what we would now consider to be shockingly high mortality rates. As discussed in more detail below, the death rates for Indigenous children tended to be much higher than for non-Indigenous children. But from the early 1900s onward, as Canadians’ understanding of public health became more advanced, Residential School administrators began embracing measures to reduce childhood mortality—in some cases, even pioneering new policies that had not yet been widely adopted elsewhere.

When Europeans first began arriving in North America, the Indigenous population of what is now Canada was at least 200,000, according to the best available academic estimates. (Some argue that it was much higher.) By the early 1900s, it had dropped to about 100,000. Despite many Indigenous communities having, on average, a higher birth rate than their non-Indigenous counterparts, the Indigenous population didn’t begin to rebound until after the First World War. (Since that time, it has risen steadily, and now stands at about 2-million.)

Canadians reporting Indigenous ancestry, by census year

The greatest infectious killer of all in Canada during this period was tuberculosis (TB)—especially in Indigenous communities. Even as late as 1957, when the overall Canadian death rate for tuberculosis had fallen to just seven per 100,000, the death rate for the category then described as “Registered Indians” was still 42 per 100,000—six times higher. For the Inuit, in Canada’s far north, it was even higher: 179 per 100,000, or about twenty-five times the national rate. These facts surely constitute a stain on Canada’s national conscience.

Residential Schools were swarming with TB, as they generally did not refuse admission to children suffering from any contagious disease (though administrators did subject students to health checks, so they might at least monitor their ailments). Had schools enforced such a requirement, they would have had few students, since large numbers of First Nations children had been exposed to mycobacterium tuberculosis at some stage in their development.

A graph tracking Residential-School death rates published in the Truth and Reconciliation report

While critics of Canada’s policies during this period will rightly note that such facts serve to indict the socioeconomic conditions of the Indigenous communities from which Residential Schools students originated, it was generally the case that children from the reserves brought tuberculosis into the schools, and not the other way around. “In no instance was a child awaiting admission to school found free from tuberculosis; hence it was plain that infection was got in the home primarily,” wrote Dr. Peter Bryce in his 1907 Report on the Indian Schools of Manitoba and the Northwest Territories. He blamed this fact on the crowded and unsanitary conditions on Indigenous reserves, where TB was far deadlier than in schools, in large part thanks to the federal government’s neglect.

A graph tracking Residential-School deaths attributable to illness, published in the Truth and Reconciliation Commission’s Report

Dr. Bryce, then Chief Medical Officer in the Department of Indian Affairs, had issued a scathing indictment of the Residential Schools’ deplorable sanitary conditions, which, he concluded, were contributing to the unchecked spread of TB. Applying their (often scandalously limited) resources, many school administrators and government officials took his words to heart and upgraded their schools so as to improve ventilation and hygiene more generally. For example, the largest school in the entire national system, on the Kamloops reserve in British Columbia, installed a large septic tank for sewage-treatment purposes—an important undertaking by the standards of the day.

One of many tables contained in a 1907 report written by Dr. Peter Bryce, detailing information pertaining to Residential Schools he had inspected

Over the following fifteen years, about 30 Residential Schools were built or remodelled to the new, healthier standards. This is reflected in the data. Mortality from TB in Residential Schools fell from about 900 per 100,000 in 1907 to fewer than 100 per 100,000 in 1921, a more than nine-fold decline.

At the beginning of the school year in 1938, the Blue Quills Residential School in Alberta took the precaution of arranging lung X-rays for all its students. A school report from the period records that one Dr. Davison “came to the School to give the skin test to the newcomers. He said that the four girls at the hospital, being treated for T. B., will soon be able to come back to school.”

Such reports come from surviving fragments of Residential School documents—such as old issues of the school newspaper at Blue Quills, the Moccasin Telegram—and so it is impossible to make any kind of definitive generalization about such practices. But certainly, even anecdotal reports such as these are difficult to square with the idea of genocide.

Cover page for a 1948 edition of the Moccasin Telegram

Steps also were taken to eliminate bovine tuberculosis from the herds that supplied milk to the schools. (This was at a time when milk pasteurization, which was not uniformly adopted in Canada until well into the Cold War period, was still seen as an innovation.) Medical inspectors were appointed in each province to visit the Residential Schools, many of whose facilities had been expanded to include hospitals that served local Indigenous reserves.

During this period, some of the medical officials charged with these duties implored the government to provide more personnel and resources to help Residential School students. Dr. George Adami, a Professor of Pathology at McGill University in Montreal who worked with Dr. Bryce in combating childhood TB, wrote, “I can assure you my only motive is a great sympathy for these children, who are the wards of the government and cannot protect themselves from the ravages of this disease.”

Alas, their entreaties often fell on deaf ears in Ottawa, where many bureaucrats and politicians seemed fixated on cutting costs—a state of affairs that Dr. Bryce dramatically denounced in his writings.

An excerpt from The Story of a National Crime, a 1922 book written by Dr. Bryce, (archly) describing the deadly neglect of government actors in respect to conditions at Residential Schools

Certainly, many fewer Residential School students would have perished from disease if governments had provided more resources to administrators and local medical personnel. Nevertheless, new medical technologies did have dramatic positive effects. In 1933, Dr. George Ferguson launched an experimental trial with the then-new Bacillus-Calmette-Guérin (BCG) vaccine. To demonstrate his conviction that this would help prevent the spread of TB among Indigenous people, Dr. Ferguson first vaccinated his own six children. His program at Fort Qu’Appelle, Saskatchewan was a remarkable success, featuring an 80% reduction in active cases of TB among those vaccinated, and no deaths.

All of these achievements were ultimately overshadowed in the 1940s by the introduction of streptomycin, an antibiotic that could effectively treat tuberculosis—the first of many such drugs that eventually would help virtually eliminate tuberculosis in Canada. From the World War II period onward, the incidence of TB plummeted in Canada.

Vaccine pioneer George Ferguson being honoured in 1935 by the Qu’Appelle Valley Natives as Muskeke-O-Kemocan (Great White Physician)

Among Canadian First Nations populations, the incidence of tuberculosis fell by 92% in the quarter century between 1930 and 1955. Research summarized in the History published by the Truth and Reconciliation Commission informs us that from 1943 to 1953, the annual TB death rate for the First Nations population as a whole dropped from 627 per 100,000 to 100 per 100,000. During the same periodthe annual TB-associated death rate in Residential Schools went from about 230 deaths per 100,000 to 20 deaths per 100,000.

These statistics indicate that the rate of TB mortality for Residential School students not only fell sharply in absolute terms following the introduction of these new medications: It also fell in relation to Indigenous TB mortality as a whole. In 1943, the TB mortality rate for First Nations Residential School students was about one third the rate for First Nations overall. By 1953, the corresponding number was about one fifth. And it is worth noting that while the last Residential School closed its doors more than a quarter century ago, the rate of tuberculosis among First Nations people in Canada now remains a shocking forty times higher than among the rest of the country’s population (although, thankfully, deaths from TB are now extremely rare).

A somewhat analogous pattern may be observed in regard to the waves of Spanish Influenza that struck the world in 1918-19. First Nations families were ravaged by the epidemic, which carried off the young(under age 20) more than any other age group. And the mortality rate for these communities was many times higher than in the general Canadian population. (In B.C., for instance, it is known to have been nine times higher.) But in the Residential Schools for which we have precise information, the death rate associated with the Spanish Flu was only about 27% of the rate for First Nations people as a whole.

Once the Canadian medical community was properly roused to the project of improving public health in Residential Schools during the interwar period, significant advances also were made against other diseases—such as trachoma, a once common ailment that could cause blindness before the development of an effective sulfanilamide-based treatment in the late 1930s. At the aforementioned Blue Quills school, officials monitored students for symptoms. By one student’s report, one Dr. Walls “came to see how our eyes were. During class, we all went up and it was not long before all our eyes were examined. Dr. Walls was very pleased with the appearance of our eyes.” A 1935 government report indicates that “the number of acute cases of trachoma in the schools has greatly diminished,” while also encouraging officials to remain vigilant:

This does not mean that the disease is nearly conquered. There is a great deal of practically unreachable trachoma among the older people on the reserves. Many of the young children coming into the schools are affected, and undoubtedly some of those whose eyes have been cleared up in school will forget their training and become reinfected after discharge. Their treatment and training in school, however, is bound to be of great value. They will protect themselves better, will recognize the disease in early form in their children and neighbours, submit more readily to treatment, and know how to carry out directions intelligently. The department anticipates a long struggle, but is very hopeful of the final outcome.

The debate about the legacy of Canada’s Residential Schools is sometimes conducted on the assumption that public officials of the nineteenth and early twentieth centuries were completely insensible to the deadly hardships imposed on Indigenous communities by European settlers. But the historical record indicates that, even before World War I, government ministers and medical experts were wrestling with the best way to—as Hayter Reed, Deputy Superintendent of Indian Affairs, put it—promote a “gain in general health, in physical growth, in freedom from sickness and deaths and in school attainments” for those attending Residential Schools.

Archived government correspondence from 1911, indicating a discussion on the best means to address health and nutrition concerns regarding Residential School students

A few decades later, Canadian Medical Association Journal readers were informed that the fight against tuberculosis in First Nations communities was not only a practical imperative, but also a moral one, as settlers were the ones who “took and occupied his [i.e., the Indigenous] country, [and] especially because we brought him the disease.”

As noted above, such admonitions often were ignored by Ottawa politicians. “Despite the growing provincial pressure for action on tuberculosis prevention, in 1937, the federal government imposed another round of cuts on Indian Affairs,” the Truth and Reconciliation Commission reported. In January of that year, “the director of Indian Affairs … instructed all staff that ‘their duty in the immediate future is to keep the cost of medical services at the lowest point consistent with reasonable attention to acute causes of illness and accident. Their services must be restricted to those required for the safety of limb, life, or essential function.’”

This language will appear scandalous to modern readers. And, to repeat the point, it is absolutely true that many Indigenous lives likely would have been saved if the Canadian government had spent more freely on health services for patients, both Residential School students and otherwise. But it is important to remember that millions of other sick Canadians suffered from the same frugal attitudes. Socialized medicine didn’t become a universal feature of Canadian public policy until well into the 1960s—more than three decades after these words were written.

As to the allegations of substandard food and inadequate servings at Residential Schools, many are no doubt true. But again, historical perspective is important. The National Truth and Reconciliation report, for instance, contains a reference to a 1931-era menu at the Gordons Residential School in Saskatchewan as an example of the poor and inadequate diet offered the students. Yet the authors do not mention that Canada was then in the depths of the Great Depression, when families all over the country worried where their next meal would come from. The sample menu referenced by the authors is as follows: “Breakfast—boiled eggs, rolled oats, sugar, and milk, bread, butter, tea, cocoa; dinner [the mid-day meal]—soup, cold roast beef, vegetables, potatoes, bread, rice pudding; supper—beef stew (including vegetables?), bread, butter, jam, tea.” Even if one assumes small portions and an unappetizing presentation, this hardly seems an insufficient diet by Depression-era standards.

A study recently published in the Canadian Journal of Economics found that prior to 1950, children placed in Residential Schools were, indeed, often undernourished—thanks to government underfunding. However, reforms instituted following World War II resulted in often dramatic improvements in students’ health:

We find evidence that, on average, residential schooling increases adult height and the likelihood of a healthy adult body weight for those who attended. These effects are concentrated after the 1950s, when the schools were subject to tighter health regulations and students were selected to attend residential school based partly on their need for medical care that was otherwise unavailable.

Depending on the region of the country, Residential School students born after 1930 experienced an average height increase of up to an inch—an indicator of improved health and living standards.

End of Part 1

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