Wilful Neglect

The Federal Response to Tuberculosis among First Nations, 1867–1945

Jane Thomas

• Publisher: McGill-Queen's University Press
• Year: 2025
• eBook ISBN: 9780228026228
• Topic: Medicine
• Subtopic: North American History

Tuberculosis, once a leading cause of death in Europe and North America, was understood to be preventable and even curable by the early twentieth century. Yet despite growing knowledge about the disease and interventions that would slow its spread, tuberculosis deaths among First Nations in Canada remained staggeringly high. Government policies rooted in colonialism exacerbated a tuberculosis epidemic.

Wilful Neglect explores the devastating consequences of the Department of Indian Affairs’ failed responses to tuberculosis among First Nations in Canada from 1867 to 1945. Even when medical treatment for tuberculosis became widely available, and despite the federal government’s obligations being written into treaties and other legislation, the basic health needs of First Nations remained unmet. The government instead prioritized an assimilationist agenda, including the placement of Indigenous children in residential schools, which became hotbeds for the spread of the infection. Drawing on the department’s own annual reports, memoranda, and budgets over more than seventy years, Jane Thomas traces key moments, decisions, and individuals involved in shaping federal health policy, laying bare the consequences of racializing a disease.

Health policies developed by colonial governments without the involvement of First Nations have always failed. Wilful Neglect demonstrates a direct link between the federal government’s historic health policies and the disparities that continue into the present.

Table of contents

• Cover
• Half Title Page
• Series Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Figures and Table
• Foreword
• Acknowledgments
• Abbreviations
• Introduction
• 1 “The promises we have to make to you are not for today only but for tomorrow”: Setting Precedent Through Legislation, Treaties, and Government Practice, 1867–1883
• 2 “There is a ready compliance on their part with regulations”: Assimilation at All Costs Through Civilizing, Christianizing, and Sanitizing the Infected, 1884–1903
• 3 “We are giving the best attention we can to the medical needs of the Indians”: Dr Peter Bryce’s anti-TB Crusade, 1904–1913
• 4 “We have been trying to get off rather cheaply”: Treatment of “Indian Tuberculosis,” 1914–1928
• 5 “The activities of the medical branch cannot fairly be judged by the visible results”: Vaccine Trials, Pilot Projects, and a New Medical Services Branch, 1929–1937
• 6 “A comprehensive and progressive program is long overdue”: New Funding and Treatment Facilities, 1938–1945
• Conclusion: If Preventable, Why Not Prevented?
• Afterword
• Appendix A: Individuals Responsible for the Department of Indian Affairs (1867–1945)
• Appendix B: Department of Indian Affairs Medical Expenses (1868–1904)
• Appendix C: Timeline of United Church Mission Hospitals Opened in Canada
• Appendix D: Canadian Tuberculosis Association Expenses (1902–1945)
• Appendix E: Department of Indian Affairs Medical Expenses (1905–1945)
• Notes
• Bibliography
• Index