“Medicine on a Global Scale”: Interview with Maureen Lux
- Traduction(s) :
- « Médecine à l’échelle du monde » : Entretien avec Maureen Lux [fr]
Notes de l’auteur
The “Medicine on a Global Scale” series of interviews features researchers from a variety of backgrounds, with the aim of highlighting current works into the global history of medicine and health from the fifteenth century to the present day. By combining different points of view, it opens a window on to the questions, perspectives and debates that are currently driving this dynamic field, which is itself globalised. In order to provide access to the widest possible readership, all the interviews are published both in French and English.
Texte intégral
1Maureen Lux is Professor of History at Brock University in Ontario, Canada, where she teaches Canadian history, the history of Indigenous-government relations, and the social history of medicine.
Martin Robert (MR): What led you to research the history of relations between Indigenous peoples and the government in Canada through the history of medicine?
- 1 William H. McNeill, Plagues and Peoples, New York, Anchor Books, 1976.
- 2 Alfred W. Crosby, Ecological Imperialism: The Biological Expansion of Europe, 900–-1900, Cambridge, (...)
- 3 Maureen Lux, Medicine that Walks: Disease, Medicine, and Canadian Plains Native People, 1880-1940,
Maureen Lux (ML): I grew up in the city of Saskatoon, in the province of Saskatchewan, on the Canadian prairies. This is the homeland of the Cree, the Assiniboine and the Anishinaabe Indigenous nations. Their contact with Europeans, including fur traders, began in the seventeenth century.In 1989, I wrote my master’s thesis on the Spanish flu epidemic (1918-1920). At the time, I found it very difficult to find secondary work on the health of Indigenous communities in Western Canada. For my doctoral research, I wanted to look at the impact of disease on Indigenous communities more broadly. There are historical works on the history of disease and Indigenous peoples in America, such as William H. McNeill’s Plagues and Peoples (1976)1 or Alfred W. Crosby’s Ecological Imperialism: The Biological Expansion of Europe, 900-1900 (1986),2 but the prevailing view is that pathogens were introduced by Europeans, who unwittingly spread death and disease to Indigenous communities that had no immunity and collapsed as a result. This view also suggests that the Indigenous gods were abandoned because they were unable to protect the people who believed in them, leading the Indigenous survivors to adopt the Christian God. This argument struck me as fundamentally flawed, because it essentially takes an individual immune response to infection and applies it to whole societies. It also ignores–or at least downplays–the military, economic and political invasions that accompanied the colonisers and their pathogens. It basically concludes that the collapse of Indigenous societies was a shame, but essentially inevitable.The records I studied do reveal the role of disease in the history of Indigenous peoples after they came into contact with Europeans. However, the diseases I found were most prevalent among them were not raging epidemics like smallpox, but the grinding diseases of poverty, like tuberculosis, gastrointestinal diseases and hunger.That research became my first book, Medicine that Walks: Disease, Medicine, and Canadian Plains Native People, 1880-1940 (2001).3 The title comes from a speech delivered by an Assiniboine chief when his people were forced into an area without adequate shelter, water or food. That winter more than a hundred of them, men, women and children, died of exposure, disease and malnutrition. A government doctor was sent and offered them cod liver oil, but no food. The chief told him they did not want his government medicine. What they wanted was ‘medicine that walks,’ meaning cattle for food, because his people’s diet had been based on hunting bison or buffalo on the prairies. In other words, contrary to the prevailing view, I was able to show that the health problems of Indigenous peoples in Canada had less to do with infectious diseases at the time of their first contact with Europeans than it did with the poverty-related diseases associated with the colonisation of the interior of the territory since the end of the nineteenth century.
MR: Could you tell us more about your chronological choices and what they mean in the Canadian context?
- 4 Maureen Lux, Separate Beds: A History of Indian Hospitals in Canada, 1920s–1980s, Toronto, Universi (...)
ML: I focus on the period beginning with the signing of treaties between the Canadian government and Indigenous communities. When Canada became a nation in 1867, it consisted mainly of the eastern part of what is now Canada (the current provinces of New Brunswick, Nova Scotia, Quebec and Ontario). The west and the north were still owned by the Hudson’s Bay Company, a British fur trading company. In 1870, Canada purchased what was known as Rupert’s Land from the Hudson’s Bay Company. It was eager to establish a measure of sovereignty in the west before the Americans decided to move north and settle on that territory. It was also part of Canada’s efforts to emulate the United States by expanding across the continent to create a transcontinental nation. The vehicle for this Canadian westward expansion was the signing of treaties between the Crown–that is, Canada’s federal government acting on behalf of the British monarch–and the Indigenous peoples. To put it bluntly, Canada began negotiating treaties with Indigenous peoples across the West because it simply could not afford to go to war with them. Treaties were seen as less costly than the United States’ approach of waging constant war against its own Indigenous population. Between 1871 and 1921, eleven treaties were signed, numbered from 1 to 11, and hence became known as the ‘Numbered Treaties.’ In return for agreeing to share the land with settlers, the Indigenous peoples were given support to make the transition to a new way of life based on farming rather than hunting, as well as annuities of $5. That annuity is still being paid, and it is still $5.The treaties formed the basis of the relationship between Indigenous peoples and the federal government of Canada. Moreover, the federal government adopted the ‘Indian Act’ in 1876, which is a comprehensive piece of legislation that defines what an ‘Indian’ is, who they can marry and where they can live. It certainly was not negotiated. It was imposed upon Indigenous populations in an effort to control and isolate them in favour of settlement by immigrants, who were essentially coming from Britain, America and Europe. The Indigenous peoples were increasingly confined to small areas of land called reserves (in Canada) or reservations (in the United States).It is against this background of settler colonisation and nation-building that I see the emergence of poverty-related diseases among Indigenous peoples linked to these new living conditions. To bureaucrats and doctors in Canada, these diseases proved that Indigenous peoples were unfit for what they called civilisation, and that they were a dying race. This led to the idea that little could be done to help them, and indeed little was done. At the same time, Indigenous spiritual leaders were criminalised for their practice. I followed this story up to the 1940s, when the government had begun to provide some resources for healthcare in the form of what were called Indian hospitals. I had never heard of these hospitals before. Once I started researching, any optimism I had about them quickly faded. This became my next book Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s (2016).4These hospitals were racially segregated, the kind of institutions that most Canadians probably associate with the history of the United States, not Canadian history. They grew out of a changing medical discourse. Where Indigenous peoples were once seen as a dying race, by the 1940s they were increasingly being characterised as a disease threat to the rest of the Canadian population. At that time, Indigenous peoples were an increasing presence in towns and cities, especially in the wake of their significant support for the war effort. The perception that they were somehow soaked in tuberculosis created the idea that they were a threat to the health of Canadians. At the same time, Canadians in general began to demand and to pay for better hospital care. Millions of public dollars were spent to build new hospitals that relied on paying patients. In this context, hospital administrators were reluctant to offend middle-class sensibilities by having Indigenous patients in the next bed. This is why the government ran segregated so-called Indian hospitals in borrowed buildings or redundant military facilities. Hence we can say that segregated institutions were not a phenomenon specific to the United States. They existed in Canada as well.
Guillaume Linte (GL): How would you define your research?
ML: I would define my research as the history of the relations between the Indigenous peoples, the federal government and the settler population in Canada. I do not see myself as studying Indigenous history as such, because I frankly do not possess the necessary cultural and linguistic skills, but I can read the archival record and establish this relationship around medicine and healthcare. This is a history of the intersections of race, medicine and public policy in twentieth-century Canada, which was often a perilous place for Indigenous peoples. By the mid-twentieth century, the role and voice of organised medicine and its ability to influence and actually write public policy when it came to Indigenous peoples was unprecedented. This social authority of medicine was rooted in values of humanitarian concern and benevolence for Indigenous peoples, and yet, the health disparities continued, and indeed widened. For instance, Indian hospitals treated people made ill by poverty and appalling living conditions, only to return them to those same conditions. This patriarchal kind of medical benevolence and the physician bureaucrats I study–and, of course, they were all men, and a surprisingly small number of men–created this vertical approach to healthcare that did little to deal with overcrowded housing, contaminated water supplies and general poverty.My work is very much based on the archival record, with some work with oral history. I see myself as trying to revise much of the historiography of health and medicine in Canada, or at least attempting to integrate the history of Indigenous/settler relations into this field. For instance, I was really struck by how few people in Canada had ever heard of Indian hospitals. The reaction of archivists, librarians, other historians and so on was usually that we did not have racially segregated healthcare in Canada. The dominant narrative when it comes to healthcare in twentieth-century Canada is the so-called ‘road to Medicare,’ which is a celebratory story of the path from public financing for community hospitals, to national hospital insurance, to national healthcare insurance, or what we call in Canada ‘Medicare,’ in the late 1960s. It is a very progressive story, and Canadians are immensely proud of it. But there is nothing in this progressive story that would explain the seemingly intractable health disparities in not all but very many Indigenous communities. When one talks with Indigenous communities, however, it becomes clear that they have a deep familiarity with the history of Indian hospitals. I did not have to go far to find people who had spent time in these hospitals, or had friends or relatives that were either patients or workers there, or both. Working with the documents and trying to tell this story of Indian hospitals, I understood how these two enduring narratives, which are usually told as separate and unrelated stories, are in fact intimately linked. In other words, the isolation and segregation of Indigenous peoples in Indian hospitals were central to the dominant project of modernising healthcare for non-Indigenous Canadians.Certainly, my work also benefits from the insights of international scholars of colonialism and race like Warwick Anderson or Alison Bashford, as well as American scholars of medicine and Indigenous peoples like David S. Jones and Christian W. McMillen. I have not done any explicitly comparative work so far, but the Australian situation in particular seems to be comparable to the Canadian one insofar as it involves a white colonial settler society.
GL: How do your research and teaching interact with each other and with the work of health professionals?
ML: I teach at Brock University, which is essentially an undergraduate university without a medical school. Many of my students are pursuing a History degree and will go on to MA and PhD programmes, but many of them are studying to become teachers. I try to use my research to provide them with a broad base of understanding of the history of Indigenous/settlers relations because the curriculum for children in elementary and high schools in Canada does not spend much time on Indigenous peoples. I don’t have that much contact with medical students, but I am very often asked to address healthcare professionals and different associations to provide a historical perspective on healthcare in Canada. Many Indigenous patients do not trust healthcare professionals because they have deep memories in their families and communities about healthcare in the past. Therefore, a historical understanding is valuable for the professionals who work with Indigenous patients and communities.For example, during the COVID pandemic, once vaccines became available, Indigenous communities were prioritised to receive the vaccine first, or nearly first, and much of the discussion in the media was that Indigenous peoples were particularly vulnerable. This was not the case at all, because nobody was immune to COVID, but it goes back to that same notion of non-immune Indigenous people. Moreover, because of ongoing colonisation in Canada, very few Indigenous communities have any sort of medical infrastructure. There would be nowhere for people to go to quarantine. Ultimately, the COVID vaccine rollout in Indigenous communities was incredibly successful because it was managed by the communities themselves. They were the ones who decided who should receive the vaccine, and when and where. In this way, I think COVID helped some Canadians understand that allowing Indigenous peoples to make decisions on the type and pace of healthcare for themselves works far better than telling them what to do.
- 5 Maureen Lux et Erika Dyck, Challenging Choices. Canada’s Population Control in the 1970s, Montreal: (...)
Shiori Nosaka (SN): What was the starting point for your most recent book, Challenging Choices. Canada’s Population Control in the 1970s (2020)5 co-authored with historian Erika Dyck?
- 6 Justin Trudeau resigned as Prime Minister of Canada on 6 January 2025. This interview was conducted (...)
ML: Erika Dyck came to me with the idea for this book. We took as our starting point a 1967 statement by the then-Prime Minister of Canada, Pierre Trudeau (the father of the current Prime Minister Justin Trudeau6), who was a Liberal party federal politician. Pierre Trudeau stated that ‘there is no place for the state in the bedrooms of the nation.’ At the time, his government was liberalising the Criminal Code by decriminalising abortion, birth control and homosexuality. We were interested in the wake of this legislation in the 1970s. The fact is that the state took even more interest in the bedrooms of several groups of the Canadian population in the post-liberalisation context. We identified four representative groups: Indigenous women, mentally and physically disabled people, pregnant teenagers and men–we thought we would bring men seeking vasectomies into the picture. Whereas the story often goes that this era was one of social liberalisation, we found in these groups in particular that the power structures and hierarchies around class, gender and race were actually reinforced.The 1970s witnessed great fears of the so-called ‘population bomb,’ as stressed in biologist and demographer Paul R. Ehrlich’s book The Population Bomb (1968). This was a neo-Malthusian fear based on the idea that the Earth’s population was exceeding its food supply. This rhetoric equated poverty with overcrowding because it assumed that the poorest parts of the population were not able to control their own fertility and therefore needed help and advice to help them do so. We discovered that this discourse came to be applied quite seamlessly to Indigenous communities in Canada, although the notion that Canada could in any sense be overcrowded is quite bizarre. We have a very small population and a very large land mass. But that did not disrupt the narrative when it was applied to Indigenous peoples, and the family planning discourse came to the fore with the notion that Indigenous women should control their fertility to control their poverty and thereby avoid illness. As the author Matthew Connelly asks in his book Fatal Misconception (2008), who is doing the planning in family planning? The state’s interest in controlling the fertility of Indigenous women led to many incidents of sterilisation without consent or knowledge.
SN: What do you have in mind for your future work?
ML: I am embarking on a new project about Inuit health and qallunaat medicine. Qallunaat is a word designating outsiders, or non-Inuit people. In the 1950s and 1960s, Inuit patients were relocated from their Arctic homes to southern institutions, especially Indian hospitals. During my research, I was introduced to the archives of these patients. I found that these hospitals were mainly, but not exclusively, used for the treatment of tuberculosis. What is notable is how massive this relocation of people was over the course of a single decade, from 1955 to 1965. It involved nearly half the patient population. The average length of their stay in southern hospitals and sanatoria was two and a half years. At the time, most Canadians were treated as outpatients who took their drugs at home because effective antimicrobials for the treatment of tuberculosis were available. Inuit patients with the same condition, on the contrary, were institutionalised for years.I am particularly researching this treatment’s impact on families and communities in the North. Not only patients but also their families were being relocated in mass numbers. The state was encouraging, if not compelling, their relocation. Thus, their whole lives were fundamentally changed. They were no longer on the land hunting, but were settled in new communities where they could receive health care, education and social services.One of the problems with this research is that much of the archival record is at the National Archives of Canada, which is dealing with a years-long backlog in access to information requests. It has literally been years, and I still do not have access to these records. One database that I do have access to is a fascinating collection of letters written by Inuit patients who were in hospital and were writing to government departments. The Inuit of the eastern Arctic were widely literate in syllabic writing, which was a form of writing that had been introduced by missionaries in the late 1890s. Inuit people would teach it to each other. These letters were therefore written by patients in syllabic writing and addressed to a government agency unfortunately named the ‘Eskimology section,’ which then translated the letters.I have access to nearly 5,000 pages of these translated letters. Patients were writing about their frustration, for example, with being unable to communicate with their own caregivers in hospital. The patients were speaking Inuktitut, and the caregivers were speaking English. None of the hospitals had any translators. Other patients wrote about their fears for their families’ survival while they were away and unable to hunt for them. They questioned the logic of their own incarceration in far removed southern hospitals, especially since they had no control over when they might be released. Women in hospital wrote about their grave concerns for the children they had left behind and their families’ well-being, because there was nobody there to sew the furs for the family’s outfits that helped them survive in the far north. This is a remarkable source we do not generally have in the history of medicine: letters written by patients about their own condition, providing a rare glimpse into the lives of patients and their medical treatments.
Notes
1 William H. McNeill, Plagues and Peoples, New York, Anchor Books, 1976.
2 Alfred W. Crosby, Ecological Imperialism: The Biological Expansion of Europe, 900–-1900, Cambridge, Cambridge University Press, 1986.
3 Maureen Lux, Medicine that Walks: Disease, Medicine, and Canadian Plains Native People, 1880-1940,
Toronto, Toronto University Press, 2001.
4 Maureen Lux, Separate Beds: A History of Indian Hospitals in Canada, 1920s–1980s, Toronto, University of Toronto Press, 2016.
5 Maureen Lux et Erika Dyck, Challenging Choices. Canada’s Population Control in the 1970s, Montreal: McGill-Queen’s University Press, 2020.
6 Justin Trudeau resigned as Prime Minister of Canada on 6 January 2025. This interview was conducted on 26 March 2024.
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Martin Robert, Guillaume Linte et Shiori Nosaka, « “Medicine on a Global Scale”: Interview with Maureen Lux », Histoire, médecine et santé [En ligne], 27 | été 2025, mis en ligne le 17 juin 2025, consulté le 13 mars 2026. URL : http://journals.openedition.org/hms/10035 ; DOI : https://doi.org/10.4000/1479s
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