Jane Thomas

How colonial medical policies are linked to health inequities that persist in First Nations a century later.

Tuberculosis, once a leading cause of death in Europe and North America, was understood to be preventable and even curable by the early twentieth century. Yet despite growing knowledge about the disease and interventions that would slow its spread, tuberculosis deaths among First Nations in Canada remained staggeringly high. Government policies rooted in colonialism exacerbated a tuberculosis epidemic. Wilful Neglect explores the devastating consequences of the Department of Indian Affairs’ failed responses to tuberculosis among First Nations in Canada from 1867 to 1945. Even when medical treatment for tuberculosis became widely available, and despite the codification of the federal government’s obligations in treaties and other legislation, the basic health needs of First Nations remained unmet. The government instead prioritized an assimilationist agenda, including the placement of Indigenous children in residential schools, which became hotbeds for the spread of the infection. Drawing on the department’s own annual reports, memoranda, and budgets over more than seventy years, Jane Thomas traces key moments, decisions, and individuals involved in shaping federal health policy, laying bare the repercusions of racializing a disease. Health policies developed by colonial governments without the involvement of First Nations have always failed. Wilful Neglect demonstrates a direct link between the federal government’s historical health policies and the disparities that continue into the present.

Reviews
“Wilful Neglect is a compelling national case study of the federal government’s complicity in the deaths of thousands of First Nations individuals during the tuberculosis epidemics of the nineteenth and twentieth centuries.” - Hugh Shewell, Carleton University

Educator Information
Table of Contents
Figures and Table • ix
Foreword • xi
Shawn Batise
Acknowledgments • xv
Abbreviations • xxi

Introduction • 3

1 “The promises we have to make to you are not for today only but for tomorrow”: Setting Precedent Through Legislation, Treaties, and Government Practice, 1867–1883 • 25

2 “There is a ready compliance on their part with regulations”: Assimilation at All Costs Through Civilizing, Christianizing, and Sanitizing the Infected, 1884–1903 • 47

3 “We are giving the best attention we can to the medical needs of the Indians”: Dr Peter Bryce’s anti-TB Crusade, 1904–1913 • 70

4 “We have been trying to get off rather cheaply”: Treatment of “Indian Tuberculosis,” 1914–1928 • 109

5 “The activities of the medical branch cannot fairly be judged by the visible results”: Vaccine Trials, Pilot Projects, and a New Medical Services Branch, 1929–1937 • 139

6 “A comprehensive and progressive program is long overdue”: New Funding and Treatment Facilities, 1938–1945 • 172

Conclusion: If Preventable, Why Not Prevented? • 193

Afterword • 199

Appendix A: Individuals Responsible for the Department of Indian Affairs (1867–1945) • 202
Appendix B: Department of Indian Affairs Medical Expenses (1868–1904) • 206
Appendix C: Timeline of United Church Mission Hospitals Opened in Canada • 208
Appendix D: Canadian Tuberculosis Association Expenses (1902–1945) • 210
Appendix E: Department of Indian Affairs Medical Expenses (1905–1945) • 212
Notes • 217
Bibliography • 271
Index • 289

Additional Information
318 pages | 6" x 9" | Paperback