The two greatest affronts to human rights in Canada are, I believe, the treatment of the Canadian First Nations and the lack of subsidized housing for the homeless. The latest development in the former case is the exclusion of Assembly of First Nations representatives from the First Ministers' conference on health care. The following is an opinion piece by Matthew Coon Come, National Chief of the Assembly of First Nations. It appeared in Tuesday's edition of The Globe and Mail. I suggest my fellow Canadians take this to heart:

Mr. Chrétien, you've deliberately excluded the First Nations

By MATTHEW COON COME


Tuesday, February 4, 2003 – Page A17


Across Canada from coast to coast to coast, First Nations peoples are trapped in a cycle of ill health, inferior health care, lower life expectancy, poverty, lack of resources and despair.

Our peoples have extraordinarily high rates of disease, substance abuse and suicide. As Health Canada reiterated in 2000, "Canada's aboriginal people, as a group, are the most disadvantaged and have the poorest overall health status." Pick any health indicator -- rates of infant mortality, postnatal mortality, hospitalization, AIDS and TB infection: First Nations peoples' rates are many, many times higher than most Canadians take for granted. Our life expectancy remains six or so years lower than other Canadians, a terrible cost of millions of lost potential years of life.

Hundreds of reserve communities lack any resident physicians; often they're served only by one or two nurses in primitive nursing stations. By contrast, neighbouring non-native towns, some with smaller populations than the reserves, have fully equipped health centres or hospitals. Because our communities lack rudimentary care, Ottawa spends millions of dollars annually evacuating our people by air, away from families and support systems, for treatment in major centres for minor conditions.

Today, the Prime Minister and the premiers meet to forge a new agreement on health care. Aboriginal leaders were not invited to attend this conference. The people who need to benefit the most from health-care reform in Canada are being shut out. Commenting on this exclusion, Shirley Douglas, chair of the Canadian Health Coalition, warned: "If they're not at the table, who is going to discuss the lamentable, tragic, and well-documented circumstances of aboriginal health care?"

I recently told Prime Minister Jean Chrétien and Health Minister Anne McLellan that First Nations must be directly involved in the discussions, decisions, development and delivery of health services to and for our peoples, on and off reserve in Canada. When health services are "done" for us, they fail. When they are delivered in partnership with us, with resources, facilities and commitment, they succeed. First Nations need the authority, resources and jurisdiction to design and deliver health-care systems based on our needs, our respective cultures and our rights.

Aboriginal health is constitutionally a federal responsibility. The Prime Minister and federal Minister of Health do not need the consent of the premiers in order address First Nations health and health-care issues. The federal government has extraordinary administrative and developmental know-how and capacity -- it's the government of a G8 state. It also has massive surpluses, and broad public support for solutions to the gross social disparities facing aboriginal peoples.

The Prime Minister recently said that since today's meeting was "a first minister's conference," only first ministers would be there. With respect, Mr. Chrétien, this excuse is fatuous. If there are no seats at the table for aboriginal leaders, that's because -- in keeping with tired, colonial and discredited past conceptions of Canadian federalism -- you deliberately set the table to exclude us.

The only message I can draw from our exclusion is that -- as in past days when our fundamental interests and rights were decided in our absence, in rooms of state, in elections, in Parliament and before the Privy Council -- the intention is to shortchange and discriminate against us once more.

Our tragic health and social conditions have become Canada's shame. The Prime Minister of Canada has an opportunity to do something. Because our peoples' future, and our peoples' children's future, depend upon it, I will be in Ottawa, ready to attend and participate constructively. Recent history has shown that when we have participated fully in national processes, extraordinary progress has been made.

Sadly, it appears that the Prime Minister and his provincial and territorial colleagues have decided not to let me take part on behalf of all First Nations. I can only hope from the outside that they will meaningfully include Canada's First Peoples in any new health accord. But based on past First Nations experience, I'm not counting on it.