Remote First Nation Health Care focus of upcoming Inquest


The challenges with primary health care provision in remote First Nations will be a key focus of the upcoming Inquest into the death of Ruthann Quequish.

Ms. Quequish died on April 1, 2017, after repeated visits to the Swanson Mekanak Health Centre in Kingfisher Lake First Nation during the week before her death.

The Inquest into Ms. Quequish’s death is scheduled to start on April 2, 2023, in Thunder Bay, Ontario.

In addition to examining the circumstances around Ms. Quequish’s death, it is anticipated that the Inquest will scrutinize the systemic issues involved in providing health care on reserve in remote First Nations. The challenges are stark. Despite significant healthcare needs in the community, healthcare is limited. Doctors are not stationed in the community permanently, leaving weeks-long gaps where nurses as the primary health care providers for community members. Specialized medical and mental health services often require being flown out to urban centres, but access to those services can be restricted unless the primary care providers agree the services are needed.

It is expected the Inquest will hear that more healthcare providers are needed in Kingfisher Lake, just like in many other communities in the north, in addition to the need for enhanced services and more access to specialized care.

Ms. Quequish attended at the Health Centre almost daily in the week leading up to April 1, 2017. On the night of her death, she attended the Health Centre but was discharged to her home. She died in the early hours of the following morning. The immediate cause of death, according to the initial Coroner’s Investigation, was ketoacidosis due to untreated diabetes.

The Inquest jury will be asked to determine what could have been done to help Ms. Quequish in the days leading to her death, in the hopes of creating recommendations that could prevent similar deaths in the future.

Coroner’s Inquests in Ontario have previously examined remote Nursing Stations in the context of emergency services, in the 2018 Inquest into the death of Ina Matawapit of North Caribou Lake First Nation. The 2023 Inquest into the death of Moses Beaver of Nibanamik First Nation also examined some elements of health care in a remote First Nation, from a mental health provision perspective. The 2016 Inquest into the death of Romeo Wesley of Cat Lake First Nation considered how medical professionals and police interacted in the context of a remote First Nation’s nursing station.

It appears that the Inquest into Ms. Quequish’s death will be the first time an Ontario Coroner’s Inquest has examined primary care in a remote First Nation. The Inquest is an opportunity to consider the systemic challenges in the primary health care system on reserve, at a time when many individuals, Nations and organizations are working to transform indigenous health care.

Edwards Bell Jewitt LLP is honoured to represent Kingfisher Lake First Nation and Shibogama First Nations Council at this important Inquest.

Written by Shawn Bell

Edwards Bell Jewitt LLP