All Canadian children suffered very high mortality before the twentieth century. From the early 1900s onward the Residential Schools were in the forefront of the battle to reduce childhood mortality, and were pioneers in several measures that helped achieve that end.

In 1600, when Europeans began arriving in North America, the First Nations population of what is now Canada was roughly 200,000. By 1900 it had dropped to under 100,000.¹  Despite a higher birth rate than the white population, that population continued to decline until after the First World War.² Since that time it has risen steadily until it is now over 1.8 million.³ The greatest killer everywhere by far in the nineteenth and early twentieth centuries was tuberculosis. First Nations people were also devastated by the decline in the fur trade at the end of the eighteenth century, and by the virtual disappearance of the buffalo herds from the western plains in the late nineteenth. These changes, which caused extreme poverty, starvation and general immiseration among the plains Indians, are the principal explanation of the steady population decline of First Nations people at that time.

In 1907 Dr Peter Bryce, the Chief Medical Officer in the Department of Indian Affairs, issued a scathing indictment of the residential schools for deplorable sanitary conditions, and abysmal ventilation which, he said, were contributing to the unchecked spread of TB. He had a point: the Residential Schools, poorly constructed and badly ventilated for the most part, were swarming with infection in the early 1900s. They mostly did not refuse admission to children suffering from contagious diseases, tuberculosis in particular. Had they denied admission to such children, they would have had virtually no students, since almost all First Nation children were bearers of the tubercule bacillus at some stage of development.

However, the Federal Government and the school administrators took Dr Bryce’s words to heart. They began significant increases in funding, and remodelled many schools  to improve ventilation and personal hygiene. Over the following fifteen years thirty residential schools were built or remodelled to the new healthier standards.  At the largest school, on the Kamloops reserve, a large septic tank was also installed for sewage treatment purposes.⁴

It must be emphasized that overwhelmingly it was children from the reserves who brought tuberculosis into the schools, not the other way around. ‘In no instance was a child awaiting admission to school [in 1909] found free from tuberculosis; hence it was plain that infection was got in the home primarily’ [emphasis added], wrote Dr Bryce. He blamed this on the crowded and unsanitary conditions on the reserves.⁵ In addition, it has been determined that almost every aboriginal baby at the age of one was infected with TB.⁶ Obviously, infants under the age of five could not have contracted tuberculosis at a residential school, since they had not yet attended one. Furthermore, TB was far deadlier on the reserves than it was in the schools. In the 1940s the mortality rate in the schools was only one-fifth what it was among the First Nations overall.⁷

This drastically lower mortality was no accident. We know that before 1940 at least one school took the precaution of arranging lung X-rays for all its students at the local hospital.⁸  Elsewhere steps were also taken to eliminate bovine tuberculosis from the herds that supplied milk to the schools. Medical inspectors were appointed for each province to visit the schools. A number of hospitals and sanatoria were built on the reserves. Dr George Adami, Professor of Pathology at McGill University, who worked with Bryce in combating childhood TB, wrote to the Deputy Minister, ‘… 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.’⁹ In 1933 Dr George Ferguson launched an experimental trial with the new BCG [Bacillus-Calmette-Guérin] vaccine. To demonstrate his conviction that this would benefit, not harm, indigenous people, Dr Ferguson first vaccinated his own six children. His programme at Fort Qu’Appelle, Saskatchewan was a remarkable success. There was an 80 per cent. reduction in active cases of TB among the school children who were vaccinated, while there were no deaths.¹⁰

All these achievements were ultimately overshadowed by the introduction of streptomycin, a specific drug for the tubercle bacillus. This was the first of some ten drugs that were to have overwhelming effectiveness in treating tuberculosis. From 1944 onwards, among both First Nations People and the Canadian population at large the incidence of TB plummeted.¹¹

Overall TB mortality among First Nations people fell by 92 per cent. in the 25 years between 1930 and 1955.¹² Research buried in volume 2 of the History published by the TRC tells us that from 1943 to 1950, the average annual TB death rate for the First Nations population overall was about 520 per 100,000^.13 During the decade of the 1940s, the average annual TB death rate in the residential schools was around 100 deaths per 100,000, less than one-fifth the rate in the overall First Nations population.¹⁴  To this day their mortality rate remains much higher than the mortality rate among the rest of the Canadian population. Long after the last Residential School closed its doors for good, the rate of tuberculosis among First Nations people is a shocking forty times higher than among the rest of the country’s population.¹⁵

As with tuberculosis, the Residential Schools can  boast a favourable record in the great Spanish Inflluenza epidemic that struck the world in 1918-19.  In the schools for which we have precise information the death rate in the Residential Schools was one-third below the rate for all First Nations people.¹⁶ So much for the myth of the Residential Schools as primary sources of infection.

Trachoma is not a disease that is heard much of these days, but in the early part of the last century, it was ‘a most serious health problem’, because it could often end in blindness among children.  A number of residential schools pioneered in the treatment of trachoma, with the result that the 1935 Report of the Department of Indian Affairs announced that ‘the number of acute cases in the schools has greatly diminished’. By 1939 the incidence of trachoma among Residential School students was down 50 per cent. Sulfanilamide treatment, which began at the end of the 1930s soon practically eliminated the disease.¹⁷

Throughout the twentieth century, as they battled against the ravages of disease among their students, the leaders of the residential schools, and their overseers in the Federal Government were motivated by a desire to help the children achieve a healthier, happier life. At the beginning of the century Hayter Reed, Deputy Superintendent of Indian Affairs wrote that the objective of the government’s policies was ‘gain in general health, in physical growth, in freedom from sickness and deaths and in school attainments.’ Dr Lafferty, who with Dr Peter Bryce had been appointed to examine the incidence of tuberculosis among children in select residential schools, echoed this sentiment: ‘all our regulations are designed to obtain healthy pupils’.¹⁸ A few decades later Dr D.A. Stewart argued that the number one reason for stepping up the fight against TB in First Nations communities was because ‘we took and occupied his country, but especially because we brought him the disease’.¹⁹