the medicine chest clause

the unfulfilled legacy of treaty 6
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treaty 6: important background information

August 23, 1876: treaty 6 was formalized, negotiations and signings occurred at Fort Carlton, Fort Pitt, and Battle River. 

who was there?

Representatives of the Carlton Cree included Chiefs Ahtahkakoop (Star Blanket), and Mistawasis (Big Child). Chief Beardy of the Willow Cree/Sauteaux of Duck Lake signed 5 days later, despite voicing concerns regarding the terms.

Pound Maker, not a chief at the time, is known for his presence and vocal dissent of the treaty creation: "This is our land, it isn't a piece of pemmican to be cut off and given in little pieces back to us". 

Present at the Fort Pitt signing in September were a mix of First Nations Leaders. Under Christian influence: Chiefs Weekaskookwasayin (Sweet Grass), Kehiwin, Pakan, and Little Hunter. Non-Christian representatives included Cut Arm of frog Lake, Thunder Companion, and White Fish. 

Representing the British Crown included: Alexander Morris (lieutenant governor of the NW Territories), and treaty commissioners James McKay (a Manitoban Metis politician, interpreter), and WJ Christie (representative of the HBC). 

Peter Erasmus was hired by both parties: as interpreter for the First Nations, and as treaty commissioner. The Crown also engaged the interpretation skills of Peter Ballendine. 

who was not there?

Several leaders were not present for the initial Fort Carlton and Fort Pitt signing, but signed subsequent adhesions at later dates. They include, but are not limited to: Chiefs Mistahimaskwa (Big Bear), Minahikosis (Little Pine), and Lucky Man. Some of these chiefs were not given adequate notice of initial treaty negotiations, we can only speculate why. 

The existing list of First Nations representatives present at treaty 6 signings tend to be incomplete and inconsistent.

Important to note is that Dakota and Lakota nations were not included in treaty 6 and have long been denied their treaty rights as they were not considered "Aboriginal peoples of Canada". The Canadian Government apologized for this at Whitecap Dakota Nation in 2024. 

why did the Crown want treaty 6?

The Crown and Canadian government were motivated to acquire land. This would expand Western settlements and agriculture, and economically benefit them via the expansion of railroads and telegraph lines.

They were also motivated by fear of armed conflict. Just two months before treaty 6 was signed, the Sioux won against the American Army at the battle of Little Big Horn. In 1873, PM MacDonald created the NWMP (now RCMP) to pacify the West and "assist in negotiations with Indians". 

At no point in treaty negotiations was it made clear that signing the treaty would include land cessation  or surrender. Reserves were sold as places to "protect" First Nations from being crowded out by settlers. 

why did First Nations leaders want treaty 6?

It is theorized that First Nation leaders signed largely due to desperation and resignation. The bison had been intentionally wiped from the prairies - in combination with intentional food ration mismanagement by the government many people were starving. Furs, sold to the HBC were declining in price. Relatively new diseases like smallpox and TB were rampant in communities with little immunity. 

Chief Big Bear is known for resisting signing treaty 6 until years later when it was clear the bison population would not recover. At the initial Fort Pitt negotiations, he is known to have said: "I dread the rope to be about my neck". Not out of fear of hanging, but fear that the treaties would imprison First Nations' rights and freedoms. 

Chief Sweet Grass, in referring to the decline of bison and fear for future generations: "... use your utmost to help me and help my children so that they may prosper... It is for that reason I give you my hand."

Many chiefs viewed the treaties as agreements made in good faith that would protect current and future generations by providing them with education, protection, and healthcare. History continues to determine these projections. 
read the treaty 6 transcript here learn more here

what is the medicine chest clause?

The Chiefs saw the massive toll famine and disease epidemics took on their people. They observed Western doctors travelling with chests of medicine and supplies to treat the sick, and wanted the same protection and care for First Nations people. The Crown's written compromise was to supply a chest of medicines and medical supplies at the Indian Agent's house on each reserve. Additionally the famine and pestilence clause promised that the Crown would provide assistance to treaty nations "overtaken by any pestilence, or by a general famine." 

Lieutenant Governor Morris, promised at Fort Carlton: "What I trust and hope we will do is not for today or tomorrow only; what I promise, and what I believe and hope you will take, is to last as long as that sun shines and yonder river flows".  As such, many interpret the clause to represent health coverage and support into perpetuity. 

At present (2025), we are almost 150 years past treaty 6 signing.

how the clause fell short

key ways Indigenous healthcare has not been protected in treaty 6 and beyond 
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tuberculosis

TB decimated the prairies in the 1920s. Major risk factors for acquiring TB were malnutrition and overcrowding. First Nation's food rations were inconsistent, and varying in quality. Sometimes food was stockpiled until spoilage, deemed "the absolute minimum to sustain life". Overcrowding became common on reserves, where folks had to stay to maintain Indian status. Housing provided was scarce.

It is estimated that one third of indigenous communities died of TB within the 1920s. 

1928: Pasqua First Nation elders from Qu'Apelle Valley travelled to Ottawa and petitioned the government to honour the clause, as Indigenous people were being denied treatment at community hospitals.

As of 2019 Statistics, Indigenous individuals are 300x more likely to acquire TB, and represent 20% of all TB cases across Canada
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indian hospitals

In response primarily to rising TB rates within Indigenous populations, the federal government of canada created TB sanatoriums. Many became Indian Hospitals, as Indigenous people were mislabeled "reckless and irresponsible", and should be "legally separated from the non-indigenous population".

In 1936 Fort Qu'Apelle Indian Hospital was mainly used as a TB sanatorium. Evidence shows that children were controlled with bed restraints, non-consensual leg-plasters. Non-consensual TB vaccine trials were performed on infants. 

In 1953 it became a criminal offence for Indigenous people to refuse to see a doctor, refuse to go to an Indian Hospital, or leave a hospital prior to discharge. The RCMP could arrest, charge, jail, or forcibly hospitalize individuals. 

Former patients of these hospitals filed a class action lawsuit against the federal government. This statement disclosed the government operated 29 Indian Hospitals between 1945-1981.
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medicare

The Medical Care Act was passed by the federal government in 1966. This became the foundation of the 1984 Canada Health Act: establishing universal and comprehensive medically necessary care.

However, with growing evidence of their inefficacy and unethical practices, Indian Hospitals started to quietly close in the 1960s. Assuming provinces would now manage healthcare for all residents, the federal government deemed their responsibility fulfilled by providing provinces with funding, but limited guidance or structure. 

There are many ways healthcare for Indigenous peoples has thus fallen through the cracks. Federal funding went towards building clinics on reserves, but not for physicians working at them. Other critical elements of care were disregarded: access to pharmacies, affordable nutritious groceries, high quality seasonal housing, prioritizing mental/spiritual health, and transportation.
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present-day

Today, the health data speaks for itself. Intergenerational trauma, a marked legacy of the Residential School System, has resulted due to physical, mental, emotional, psychological, and spiritual harms. The disproportionate rates are known: of PTSD, suicide, incarceration, child apprehension, and numerous diseases. 

Data from the covid-19 pandemic now shows that the First Nations mortality rate was 4.5x higher than non-Indigenous individuals. Living on reserve or in unsuitable/crowded housing doubled this risk. The Maskwacis Cree declared a state of emergency in 2020, invoking the medicine chest and famine & pestilence clauses. 

In 2008, Brian Sinclair died after waiting 34+h in an ER. Jordan River Anderson, of Jordan's Principle, died at 15 years old due to provincial and federal governments disputing his healthcare coverage. In 2020 Joyce Echequan died in hospital after sharing the discriminatory and inadequate treatment she received. 
separate beds (m. lux) clearing the plains (j. daschuk)

how the clause is working

moving forward, how are we doing better?
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TRC

The 2015 Truth and Reconciliation Commission of Canada released its Calls to Action. 

September, 2024 the Saskatchewan Health Authority reaffirmed its commitment to honouring the Calls to Action. Their commitment pledged to prioritize Traditional Knowledge Keeper input on organizational change, increased anti-racism and cultural safety training, to increase Indigenous representation working within the health authority (including improved retention and advancement opportunities), and to build and foster closer community partnerships. 

The Canadian Medical Association formally apologized for the experiences of Indigenous people in Canada's health system in 2024. 
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language

Language as a tie to culture has been shown to both protect against and improve health disparities. This applies to individuals and communities.  

Canada passed the Indigenous Languages Act in 2019, leading to its subsequent legislation in 2021. This represents a national promise to preserve, promote, and revitalize Indigenous languages in Canada. 

Organizations like Pewaseskwan (a USask affiliated Indigenous Wellness Research  Group) have initiated language revitalization programs in communities such as Onion Lake Cree Nation. This is one of many communities bringing language and culture revitalization back to their homes.
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birth

Many Indigenous communities require their birthers to leave their homes and support systems in order to birth their babies in urban-centre hospitals. 

Places like Sturgeon Lake First Nation Health Centre have worked hard to bring birthing back to their lands. This includes the reawakening of Indigenous birthing practices, and Indigenous Midwives, trained to keep birthers and babies safe.

Urban hospitals like Jim Pattison Children's Hospital offer in-house Indigenous Birth Support Workers to help expecting families feel safe, informed, and advocated-for. These support workers are publicly funded experts in providing safe and culturally relevant perinatal support care.
landback birth how language impacts health

what can I do?

we are not powerless, especially when we work collectively

keep our public servants accountable

Did you know it is free in Canada to send mail to your Member of Parliament? Click the image above to find your representative.

Below is a downloadable letter template that you can print, personalize, and share. It calls for the federal government to honour treaty promises and the TRC Calls to Action as they relate to Indigenous Health in Canada. 

support language revitalization efforts 

Organizations like the nēhiyawak language experience host workshops, and Cree-immersion summer camps. Click the image above to explore their offerings and support them.

FirstVoices is another organization aimed at Indigenous language revitalization. Though focused on the western coast of turtle island, they have an interactive language map worth exploring (link below). 

support Indigenous-led health projects

There are many Indigenous-led health initiatives worth supporting. One of these includes Moon Time Connections. They support menstruaters across Turtle Island by giving access to menstrual products and education. Click the image above to get involved with, or to support a local chapter. 

support Indigenous health research

Indigenous research does not mean research on or for Indigenous people. It means research by and with Indigenous people. 

Usask's Pewaseskwan (cree for "the sky is clearing") is one of many such research groups. 

Another is the SILR: the Supporting Indigenous Language Revitalization research team, a project led by the University of Alberta.  Click the image above to learn more about, and support their work.
letter to MP FirstVoices language map

different ways to learn

alternative ways to shed light: listen, read, and watch

podcast

The Secret Life of Canada

A CBC podcast, this conversation with Kyle Muzyka explores the history of treaty 6, how it occurred, and why it matters today.  

treaty learning 

Cultural Safety and Respectful Relationships

Published by the National Collaborating Centre for Indigenous Health (2021), this document explains health as treaty right. 

TEDxUManitoba 

Indigenous Knowledge to Close Gaps in Indigenous Health

A talk by Dr. Marcia Anderson-DeCoteau, a Cree-Saulteaux physician working to ground Indigenous health in Indigenous rights and ways of knowing. 

purpose & author

Hi, my name is Avni. I was born on treaty 1 and raised in treaty 6. I am both a product and perpetuator of colonialism. I am actively learning how to dismantle it both internally and externally every day. My intersections include being a queer woman of south asian descent, privileged in education, ability, and a tendency to stop and smell the roses and pine trees. A once-midwife, I am now a medical student, yoga teacher, and respectful disrupter. 

This site is the capstone project for a global health certificate course. I am not of Indigenous descent. I have not been directly impacted by generations of mistreatment by our governing bodies. As a second generation settler, I see it as my responsibility to engage in learning about the land I call home, and her first and ongoing nurturers. 

The purpose of this page is to shed light on the history of treaty 6, and its unique element - the medicine chest clause. I aim to synthesize these teachings and amplify the voices of folks engaging in Indigenous Health work and research.

The additional resources in interview and video format are a testament to the value of oral history and story sharing as an inherently valid way to preserve and share information. The action items demonstrate ways to mobilize our collective power. 

In the spirit of staying accountable and humble on my learning journey, feel free to reach out to me below if there are any inaccuracies or mis-representations you find in the content of this site. In advance, I thank you for your grace.

A special thanks to Dr Jarol Boan, author of "the medicine chest: a physician's journey towards reconciliation", who first sparked my awareness and interest on the topic. 
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