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Fighting for a Hand to Hold: Confronting Medical Colonialism against Indigenous Children in Canada (Volume 97)

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Launched by healthcare providers in January 2018, the #aHand2Hold campaign confronted the Quebec government's practice of separating children from their families during medical evacuation airlifts, which disproportionately affected remote and northern Indigenous communities. Pediatric emergency physician Samir Shaheen-Hussain's captivating narrative of this successful campaign, which garnered unprecedented public attention and media coverage, seeks to answer lingering questions about why such a cruel practice remained in place for so long. In doing so it serves as an indispensable case study of contemporary medical colonialism in Quebec. Fighting for a Hand to Hold exposes the medical establishment's role in the displacement, colonization, and genocide of Indigenous peoples in Canada. Through meticulously gathered government documentation, historical scholarship, media reports, public inquiries, and personal testimonies, Shaheen-Hussain connects the draconian medevac practice with often-disregarded crimes and medical violence inflicted specifically on Indigenous children. This devastating history and ongoing medical colonialism prevent Indigenous communities from attaining internationally recognized measures of health and social well-being because of the pervasive, systemic anti-Indigenous racism that persists in the Canadian public health care system - and in settler society at large. Shaheen-Hussain's unique perspective combines his experience as a frontline pediatrician with his long-standing involvement in anti-authoritarian social justice movements. Sparked by the indifference and callousness of those in power, this book draws on the innovative work of Indigenous scholars and activists to conclude that a broader decolonization struggle calling for reparations, land reclamation, and self-determination for Indigenous peoples is critical to achieve reconciliation in Canada.

360 pages, Hardcover

Published September 23, 2020

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Samir Shaheen-Hussain

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Displaying 1 - 12 of 12 reviews
Profile Image for Loutella.
9 reviews1 follower
October 13, 2025
Oh la belle assurance du début de l'année! Quelle idée de commencer mon défi lecture par un essai de plus de 400 pages! Moi qui voulais faire mon smatte avec une lecture intelligente, me voilà servi :)

« Plus aucun enfant » est un essai sur l'histoire du système médical canadien et de sa relation difficile avec les autochtones. Écrit par un médecin pédiatre de McGill (le texte original est en anglais), le récit prend comme point de départ la campagne « Tiens ma main » lancée en 2018 par des membres du personnel de la santé au Québec. Cette campagne dénonçait la pratique qui interdisait jusqu'à tout récemment aux parents d'enfants autochtones du nord du Québec d'accompagner leur enfant malade dans l'avion le transportant dans un hôpital. Arrivant à l'hôpital seul, ne parlant souvent pas la langue, ces enfants étaient évidemment effrayés. En l'absence d'un parent pour communiquer avec l'enfant, pour raconter l'historique médical de l'enfant, pour donner le consentement sur les soins à prodiguer, ces enfants recevaient des soins non seulement inférieurs, mais étaient carrément victimes de violence médicale. Comment une telle pratique pouvait-elle subsister au Québec en 2018?

L'auteur raconte d'abord l'histoire de cette campagne, pour ensuite la placer dans un contexte historique plus large: l'histoire des pensionnats et du colonialisme canadien évidemment, mais plus précisément du rôle que les professionnels de la santé ont joué dans ce colonialisme. Un rôle, on le découvre, plutôt actif! La médecine canadienne a un long historique de pensées et de pratiques profondément racistes, qui sont bien ancrées et dont on ressent encore aujourd'hui les effets. Déni de soins, instrumentalisation de la crise de la tuberculose qui touchait (et touche encore) de manière disproportionnée les autochtones, expériences de toutes sortes sur les enfants dans les pensionnats... on comprend mieux ensuite les enjeux actuels, dont le cas récent de Joyce Echaquan. Saviez-vous que les dentistes des pensionnats arrachaient les dents des enfants autochtones à froid, sans aucun analgésique, préférant se les mettre dans les poches pour leur pratique personnelle? Un exemple parmi les dizaines présentés dans ce livre de la déshumanisation des autochtones. Considérés comme des sous-humains, on les soigne mal ou pas du tout, on cherche à les déplacer, voire à carrément les éliminer. Un aspect particulièrement important et utile du livre est d'ailleurs sa démonstration sans équivoque du génocide dont ont été victimes les peuples autochtones au Canada, point par point. On vole les terres et les ressources de ces peuples, pour ensuite tenter de les éliminer, physiquement et culturellement. Des années plus tard, on refuse de les soigner alors même que ce sont leurs ressources et leur territoire qui ont fait la richesse du pays.

Une lecture qui n'est donc pas nécessairement très légère, mais qui est absolument nécessaire pour comprendre le sort des peuples autochtones de chez nous. Cette semaine même, on cherche à faire passer une loi qui rendra illégales les stérilisations forcées dont sont victimes les femmes autochtones et racisées au Canada, encore aujourd'hui. Le projet de loi est appuyé entre autres par la sénatrice noire Amina Gerba, elle-même une victime de cette pratique.
Profile Image for Scott Neigh.
909 reviews21 followers
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March 11, 2021
Scholarly. Listed as "Indigenous studies" and "health studies", but also contains lots of important history and at least a little attention to social struggle. Focused on the role that the medical establishment has played in genocide and colonization in Canada – that is, medical colonialism. Written by a pediatric emergency physician who practices in Montreal. He was centrally involved in a campaign in 2018 that pushed the province of Quebec to end its practice of preventing caregivers from accompanying sick and injured children on emergency medical evacuation flights from remote, rural, and northern areas of the province to urban hospitals. This practice was traumatic and terrible for all children and parents involved, but had a particularly serious impact on Cree and Inuit people in the northern part of the province. Given this disproportionate harm to Indigenous communities and the context of long histories of forced removal of children from these communities, including under medical pretexts, as part of broader processes of colonization and genocide, Shaheen-Hussain understands this as an instance of medical colonialism.

In this book, he begins from that 2018 campaign to explore medical colonialism in Canada more broadly. The book looks at related ideas to do with health, including those that allow us to understand how powerfully health is shaped by unjust social relations like capitalism, colonialism, and systemic racism, and also at the systemic problems within the culture and social organization of medical professions. The biggest chunk of the book takes up the United Nations Convention on the Prevention and Punishment of the Crime of Genocide and uses it as a framework to offer an exploration of the history of medical colonialism in Canada – including how it has contributed to aspects of colonization that meet every element of the original UN definition of genocide. The book concludes with a discussion of what kinds of change we need to deal with the ongoing realities of medical colonialism in the present, both broader social changes like the return of land to Indigenous nations and space for their full self-determination, and specific changes within the medical system. The book includes a foreword by Cindy Blackstock and an afterword by Ellen Gabriel, both renowned Indigenous activists.

The writing is careful and methodical, and quite accessible and readable for a non-specialist. A very useful introduction to these ideas and issues, and to this history – I certainly learned things, particularly elements of the history. I can also imagine it being a good tool in medical education contexts. Definitely worth reading!

And to be transparent, the book was given to me by the publisher in the run up to an interview I did with the author. I also pitched a proper review to a site that I thought might be interested, but they never bothered getting back to me. Anyway, if you are interested in knowing more about the book and the issues, this link will let you read a bit more about it and also listen to the interview: https://talkingradical.ca/2021/03/02/....
Profile Image for Rose.
145 reviews
December 27, 2020
Fighting for a Hand to Hold should be required reading for every Indigenous course of studies in Canada as well as for history, medical and health programmes. It's a well-researched, honest account by an emergency pediatric physician on the effect of medical colonialism on the health care of Indigenous children in our country. At times, it's a difficult read with the all-too-familiar stories of abuse, mistreatment and neglect of Indigenous children. What's especially disturbing is that these acts took place while children were under medical care. Shaheen-Hussain's research began as an exploration of the Évacuations aéromédicales du Québec (Évaq), a programme that separated children from their caregivers during emergencies when they were transferred by air ambulance from northern communities to hospitals further south. Recognizing that Évaq's non-accompaniment policy was an example of deep-rooted systemic racism and medical colonialism, Shaeen-Hussain and some of his colleagues launched the #aHandToHoldCampaign. In Fighting for a Hand to Hold, Shaeen-Hussain uses this campaign as a case study to explore the truths about how colonial governments have treated Indigenous children and communites and to expose “the medical establishment’s genocidal role in colonization and colonialism.”
Profile Image for Karen Ocana.
81 reviews1 follower
November 26, 2025
Fighting for a Hand to Hold is a remarkable book. Engaged, engaging, carefully researched and clearly on a mission to change the Canadian medical establishment and the powers that be. The initial thrust of Fighting for a Hand to Hold: Confronting Medical Colonialism against Indigenous Children in Canada is the campaign he spearheaded to put an end to Quebec's unwritten policy of not allowing Inuit, Innu and Cree parents to accompany their children on medical aircraft transporting them to receive emergency medical aid at southern hospitals. This book grew out of that political success to become a teaching tool. I can see it being used in medical schools and in Indigenous Studies.

Samir Shaheen-Hussain's first book has already reaped literary awards, and well-merited recognition. While it's apparatus is scholarly, it has literary flair. The epigraphs are quotes from Albert Camus, Ursula LeGuin and Cherie Dimaline. Most cultural references are popular and accessible.

The book demonstrates both serious political intent and humility. Shaheen-Hussain gives ample credit for some of his ideas to his mentors and inspirations, notably Cindy Blackstock and Ellen Gabriel, but also Pamela Palmater and many, many voices that have preceded his, calling for systemic change and fighting for indigenous rights in Canada.

Fighting for a Hand to Hold is divided into four parts: i) Above all, do no harm, which deals with the book's motivation and ethical underpinning, and the build-up and execution of the #FightingForAHandToHold campaign to ensure indigenous children are accompanied by a caregiver from their Northern lands to Southern hospitals; ii) Structural fault lines in health care, which shows how Quebec and Canadian society are historically but also currently structured and biased against indigenous peoples; iii) Medical colonialism and indigenous children deals with the heinous history of the Canadian government and medical establishment's overtly hurtful policies and actions against indigenous children (Smallpox, TB). This section provides historical evidence that Canada has indeed violated each of the five conditions that make its actions genocidal in effect, and quite believably genocidal in intent; iv) The structural determinants of health and decolonizing our future argues for the need to put Indigenous People in the driving seat. For the need to value their traditional knowledge and way of doing things. For the need to return their land and dignity.

This is not an easy read. It puts into perspective the events and the effects of state-sanctioned cruelty, i.e. Canada’s racist culture, which has perpetrated so much indigenous suffering for so long. Colonialism is systemic violence. Reading Shaheen-Hussain's book I better understand the historical foundations and ongoing structural inequities of the Quebec and Canadian medical systems which have had such atrocious and devastating effects upon the First Nations whose stolen land has become our land. In fact, it's the first time I could say to myself, without flinching, that I'm a settler Canadian. Sure, I'm first-generation Canadian, but I'm from European stock. I've had an easy ride.

We need to hold hands. Samir Shaheen-Hussain's book holds out both hands and both arms to indigenous children and their families, extends his physician's heart to indigenous people. This is a tribute to the First Nation’s children who have ended up in emergency services at the Montreal Children's Hospital where he works, and to their parents and communities.
Profile Image for Alexis.
487 reviews37 followers
May 2, 2022
There was a lot to learn, and a lot worth learning, in this book, but you can tell that most of the author's writing has been in academia.

Fighting for a Hand to Hold tells the story of the successful campaign to end Quebec's policy of non-accompaniment on remote medical airlifts.

Or, in other words, the government's insistence of airlifting kids, often Indigenous kids, of any age, to hospitals hundreds of kilometres away, alone, without their parents or guardians.

Wait, that can't be right. That's a mistake, right? An oversight? A fluke in a couple of cases?

Quick Google search later: Holy crap. For the love of God, why?!

So this was written by a pediatrician who basically got tired of treating young kids who arrived alone and terrified because their parents were still waiting for a commercial flight down to Montreal to join them. The problems were legion, and honestly not difficult to imagine if you took a hot second to think about it.

Some of the kids were toddlers, and they only spoke Inuktitut. Translators weren't always easily on hand. So on top of being alone and in pain around strangers, they were alone and in pain and around strangers who they couldn't understand and who couldn't understand them.

How was the doctor supposed to reassure or explain what was happening to them? How was the doctor supposed to get information like, "On a scale of one to 10, how bad is your pain?" "Where does it hurt?" "Is the pain aching or sharp?"--all these really basic questions critical to patient comfort and diagnosing the problem.

Because the parents weren't easily accessible, there were real issues with getting parental consent for procedures. There also was no one around to offer medical history. Once again, basic information critical for care.

There were also cases where kids died before the parents could get there. There was no one familiar around to comfort them when that happened.

The entire thing turned into a massive social campaign in Quebec, and the policy successfully changed in 2018.

On top of that story, the author uses this book to dig into medical colonialism. Because, if you're an Indigenous parent, having a bunch of people fly your kid away and telling you you can't come has historically not been awesome for you, to put it mildly.

So the author talks about residential schools, including the now infamous nutrition experiments. He talks about conditions friendly to TB, and how kids kept getting put there, despite everyone knowing that TB was rampant.

He also talks about TB evacuations in the north, a policy that meant people (including kids) would disappear to hospitals in the south, and families would have little to no idea where their relatives ended up or how they were doing. Those hospital stays lasted for years and records were so badly kept that, in cases, there were kids that no one knew where they were supposed to go once they got better.

He talks about the collective responsibility of his own profession, in light of that history and the medical profession's culpability in it.

So there was a lot of good content in here.

The main issues came with readability. Most of the analysis and historical parts of this read very much like a textbook. It was all very worthy, but not easily picked up outside the classroom.
Profile Image for J. Joseph.
439 reviews38 followers
May 4, 2025
The instigating event that caused Shaheen-Hussain to write Fighting for a Hand to Hold is the #aHand2Hold campaign in Montreal. This was a public movement led by families and healthcare professionals and focused on ending the Quebec policy of minors being evacuated without their parents during medical emergencies in Canada’s northern communities. This "policy" required children with no English or French language skills be flown hours away from their communities without parents or guardians. This clearly has impact on health and well-being, but also on consent, community trust in medicine, and the long-lasting and continual intentional fracturing of Indigenous community and ways of life. The book is split into several parts and outlines this campaign, Canada’s historical mistreatment of Indigenous people, how Shaheen-Hussain believes all five articles of genocide have been commit in Canada, and finally how to move forward from these events.

If you know anything about the medical system’s treatment of Indigenous people on Turtle Island, you know this will be a rough book to read. It is stuffed full of examples of colonialism, anti-Indigenous racism, and as Shaheen-Hussain (who is a practicing paediatrician in Montreal) presents it, genocide against Indigenous communities and especially against Indigenous children. This is a solid book if you don’t already know about this situation, as he covers the historical and the present-day context for these arguments against governments, the general public's lack of advocacy, and even the medical system he works in daily.

However, from a critical perspective, I do have to say that it would be better to go to and engage with the individual sources he cites instead. Those arguments are clearer and are more thorough with the details. Shaheen-Hussain also has a tendency to claim that he's coining a term, and then later in the same chapter make reference to others who have used the term before. In fact, a lot of how he handles his argumentation feels similar to this - often it feels like you're reading a summary of other reports such as the Truth and Reconciliation Commission's reports. Other elements feel rushed or like too much ground is being squeezed into this book.

So, to summarize: this is an important book with critical information, but it could have been handled much better than it was.
Profile Image for Carmen Petz Wishlow.
25 reviews
November 8, 2023
This is an absolute must read for anyone who is going into or currently working in the medical system. I am unfortunately not surprised on how the Canadian Government treats Indigenous peoples, this was eye opening though and glad I read it. It was recommended for my social work class. It was a hard read but the light needs to be shed on how the medical system in Canada is a detriment of health for Indigenous people.
Profile Image for Kyra Shaver.
33 reviews1 follower
February 15, 2023
I had to read this for university. I wouldn’t have normally picked it , but it was very educational. Would I read it again? No. The information was important although I found it repetitive and dry at times. Simply because I do not find books based around history that interesting. Nothing against the book. Here’s hoping I do well on my test.!
Profile Image for L.
45 reviews
December 29, 2023
Super informative book on the many traumas experienced by the Indigenous community in Canada. I wish the book was a bit more easy to read, as many have pointed out, it was very academic. Nonetheless a great book and I learned a lot from it. My heart goes to all of the Indigenous Peoples, and I will do my best to support and advocate for them in the future.
110 reviews1 follower
March 14, 2022
Tough content to get through.
The first half reminds me of writing like someone's professional application to a position.
The latter half borrows a lot from Karen Stote's incredible work, I would just suggest reading Stote's book instead for framework developing/rethinking.

Profile Image for Kara.
61 reviews4 followers
July 28, 2021
Important subject matter. The writing style is quite academic. This book will likely appeal more to scholars than the general public.
Displaying 1 - 12 of 12 reviews

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