Kris grew up in Prince Albert, SK, and moved to Saskatoon in 1990. He’s a doctor who specializes in infectious disease, which gives him a unique perspective on Saskatchewan medical care, racism and the HIV crisis in rural Indigenous communities.
“In Saskatchewan, we’re so under-resourced,” he said. “There absolutely was a huge need for people to treat HIV because the ID department was completely under-staffed. At one point there was about six full-time employees here in the province, and Edmonton had twenty-five.”
One of the first things Kris talked about was his experiences with racism in rural Saskatchewan, particularly as he grew up in Prince Albert. Prince Albert, known as PA by its locals, is the third-largest city in the province and the last major centre in the north.
(As an aside, Prince Albert was incorporated as a town in 1885 after the Prince Albert Volunteers militia fought alongside the North-West Mounted Police against the Gabriel Dumont’s Métis forces at the Battle of Duck Lake during the North-West Rebellion—which I learned about in my article about Louis Riel. Racism has old roots.)
“I think growing up in Prince Albert, where, you know, in many ways it is the epicentre of bad race relations in Saskatchewan. I grew up right in the midst of a racist culture, the non-Indigenous people of Prince Albert.”
“We played their kids, they were in residential school; we played them in soccer, and our coaches told us to, you know, get out there and get those Indians. It was just so casually caustic.”
“And at some point in my life,” he added, “I was part of it. But eventually I started to realize that it was wrong. So I think as I grew older, and in university, you learn about the history and you visualize what that disruption must have been like. And you try to imagine the future of our country and our province, and you think, well, I don’t know what will really change meaningfully in time, but I need to be part of something positive related to that.”
I like that quote as a glimpse of a relatively young, privileged man recognizing the oppression that was part of his upbringing, owning it and committing to doing better. We don’t get to choose where we begin, but we do choose where we go. That’s what Kris did.
The only criticism I have is that education about colonialism and racism began in university. That was my experience as well. Things are changing, though.
“My daughter is growing up with an awareness of the richness of Indigenous culture but also the harsh realities in our history. That has not been rewritten to sort of hide the shame. That’s a huge improvement. Her generation is growing up with a very different impression of what that is all about.”
“That’s helpful,” he added.
“What isn’t helpful is that the poverty in those communities is extreme, and that the population growth is extreme, and the money is not keeping up with that. It’s an absolute…there’s no future in that. And there’s no plan to address it. You can’t help but think the idea is to just let it fall apart.”
Kris spent the last ten years offering clinics and working with patients in rural Saskatchewan communities, including a number of reserves. His description of res culture wasn’t universal, but it had the same concerns that I heard from First Nation chiefs and Elders in different parts of the country.
“The reality is, for so many young people in these communities, there is nothing to do. So what are you going to do? I mean, kid with lots of things to do do drugs and alcohol. If there’s nothing to do, you’re going to do it. Then you add in that there has been so much destruction of their families and multigenerational trauma and violence and neglect, so the kids grow up hurting. And they want to kill that pain. So it is that pain, but it is also boredom.”
“It’s heavy. So then when you look at the population growth, Saskatchewan actually is a young province, and it’s largely in the Indigenous community. So [those youth are] the future of our province.”
From there, Kris began describing the HIV crisis currrently facing First Nations in Saskatchewan.
“What is going on with those communities, with more than double the incidents of HIV infection in Saskatchewan—and rates in some of those communities which are on par with communities in the developing world, you know, three hundred cases per hundred thousand versus the national average which would be about six.”
Let me repeat that. Three hundred, compared to six. Fifty times higher.
Kris made it really clear, with the simple logistics of a frontlines worker. “There is an opportunity here. You can go in there, you can educate people, you can create an infrastrucutre, you can treat people and by treating people, you can prevent transmission. You could contain the epidemic, much like they did fairly successfully in the Downtown Eastside of Vancouver.”
That coordinate, effective response has never happened.
“I think we’ve had some gains,” said Kris, “but when you consider not just the humanitarian aspect of it, but the actual health economic cost of not preventing HIV transmission, when every new case is a million dollars—five hundred thousand dollars in drugs, five hundred thousand dollars in doctor visits, et cetera—there’s economic benefit there. It’s a humanitarian necessity. And they don’t do it? How do you explain that?”
“How do you explain that?”
“You can blame the government,” Kris continued, “but we just had an election, and the opposition struggled to gain traction on anything. Did they bring up this issue? No. Why? It’s toxic.”
“HIV is toxic, because it’s an Indigenous problem, among the marginalized component of the Indigenous community. So they could have brought it up, but the people of Saskatchewan don’t care."
You have to imagine me listening in silence as Kris directed the conversation back to Prince Albert. His perspective on both Indigenous and non-Indigenous communities’ experiences and beliefs was utterly eye-opening.
“Because I grew up in Prince Albert, I understand—in a sense, although I think it’s wrong, but I do understand—where they’re coming from.” He cleared his throat. “Freezing. Drowning. Car accidents. Murders. Suicides. Overdoses. This is what happens constantly in Indigenous community, in the reserve. This is normal. My patients lose someone close to them every three months, every four months. It’s devastating. These are people in communities where each other are their greatest treasures. The bottom falls out of their world every time this happens. That’s their reality, that is partly why they have a hard time getting on their feet.”
“To the people of Prince Albert, per se, when you say that people are dying of HIV as well, it doesn’t register. It’s just another problem. This is just one more thing. And what a cynical, working-class Prince Albert person is saying, is, my taxes are going to that community and gets consumed in the leadership class of that community, while the people around them live in squalor. They don’t care, I don’t care.”
Again, to reiterate that Kris wasn’t saying he agreed with them. He was describing the racism that he knew was alive and well in the foundation of Saskatchewan and Canada’s democracies.
“That’s what they see,” he finished. “I think we all seek the evidence which confirms the biases we already have.” He described the Harper government’s 2014 First Nations Financial Transparency Act, which compelled First Nations to disclose their annual financial reports, and the self-fulfilling racism that was part of that. “So is that working-class guy from PA, is he justified in saying that? I’ve seen examples of that and I’ve seen situations that are not like that. But this is where that apathy comes from.”
“Desensitization to this really harsh reality that we’ve grown up as just seeing as normal, and a sense of helplessness that more money is not the solution.”
Kris also described opposition that he had heard from the Indigenous communities themselves. Offering a voice from their perspective, he said: “If we don’t fix this community, we’re never going to get to this problem. So we don’t need you doctors telling us that you just need to come in here and treat people. You need to heal our community first.”
“And I think, okay, but I’m standing here outside a burning house, okay, and I’ve got a hose, and I’m asking you to turn it on and get a couple more people with hoses, because I can save those people that are in that house that’s burning. And you want to build a park? I’m having a hard time with that. It’s not like that park doesn’t need to be built, but right now we need to put out this fire.”
Maybe that description spoke to me because the burning-house imagery reminded me of Jonathan Cunningham’s analogy for the Black Lives Matter movement. Maybe it spoke to me because I imagined Kris desperately trying to save more lives as an epidemic unfolded just beyond his reach.
He knew he didn’t have perfect relations with every community or community member he worked with, and he understood as best he could where they were coming from, naming the systemic widespread discrimination against Indigenous people that he had seen in the medical community and the politics of Saskatchewan.
“I don’t have answers,” he said simply. “I think about it all the time.”
I think that speaks to the complexity of trying to do the right thing. Often justice gets made out to be black and white, when really there’s a thousand shades of grey, government bureacracy, privilege and neocolonialism in between. That’s part of why I value this conversation with Kris. It’s not easy, and it’s not clear.
The one thing that does seem to be clear is lives being lost.
Kris described the AIDS crisis of the 1980s. For me, that’s history, but for Kris it was completely part of his work today. “I’m colleagues with people that worked through that period, where every single one of their patients died a miserable death. And they fought to have access to experimental medications that didn’t work. The gay community had strong community advocates in Vancouver. Business people. Architects. So they had a voice, and they were able to rally the city around the cause.”
“Julio Montaner relentlessly lobbied the government that he could save money and save lives by being aggressive and sort of leading many ideas in the world, and went into the Downtown Eastside—where they had the worst injection drug problem in Canada for sure, and arguably North America—and had a dramatic impact on incidents through this concept of treatment as prevention.”
“That’s the frustrating thing. You know, they were through their peak by the mid-90s, seeing their numbers coming down. And here it wasn’t until the early 2000s that our number started to go up. Peaking in 2009 at about 200 cases, then it started to go down, and now it’s going back up again. We’re headed back to 200.”
“You would think we could learn from them,” said Kris, and his was emphatic, not bitter. “Maybe we could skip this eight-year lag between realizing there’s a problem and having an impact if we just implement what they did. We are making progress now but we are eight years into our high, high numbers.”
“Every community we go to, we find more. And our government is still in denial about it.”
His voice became softer, almost wistful, and I wondered if he was counting lives or remembering the words of his childhood soccer coach. Fifty times the national average. Get those Indians.
“Race determines so much in North America.”
I was initially drawn to Kris’ story just because of the awareness angle. I did not know HIV was still a crisis in Canada. I did not know that it was affecting prodominantly Indigenous communities. Period. But Kris’ story had a lot more to it. He took on roots of racism, he acknowledged the struggles of colonial poverty, he connected the history of the AIDS epidemic to the lives being lost today. Holding those kinds of histories and experiences isn’t easy. It wasn’t easy for the gay community in 1983, and it’s not easy today.
But it matters. It matters because lives are at stake.
Scientific consensus is that HIV treatment has become effective enough to make the disease untransmittable. That means HIV/AIDS can be eradicated. Literally. But for this to work, people need to know their HIV status, and people who are HIV-positive need to have access to care.
Laurie Edmiston, executive director of CATIE, wrote literally an hour ago that Canada is falling behind on both of these measures. She says it’s time for Canada’s leaders and policy-makers to step up—and according to Kris’ beliefs about democracy, that means it’s time for every single one of us to step up.
So make this an issue. Now.
If you’ve heard about ACT UP and TAG and wondered what you would have done if you could have been there, fighting for those defenceless men and women dying in the 1980s, stop wondering and start looking at yourself now. This crisis is happening now.
There’s countless pieces of writing about the AIDS epidemic that will break your heart and have broken mine, so I’m going to conclude with a poem that I’ve read most recently: The Worrying by Paul Monette. Paul Monette’s husband, Roger Horowitz, died of AIDS-related complications in 1985. Monette died of AIDS-related complications in 1995. This poem was published in Love Alone: Eighteen Elegies for Rog, an anthology that written for his husband that captured ‘the enormity of a loss that ravaged a generation.’
“ate me alive day and night these land mines
all over like the toy bombs dropped on the
Afghans little Bozo jack-in-the-boxes
that blow your hands off 3 A.M. I’d go
around the house with a rag of ammonia
wiping wiping crazed as a housewife on Let’s
Make a Deal the deal being PLEASE DON’T MAKE
HIM SICK AGAIN faucets doorknobs the phone
every lethal thing a person grips and leaves
his prints on scrubbed my hands till my fingers
cracked washed apples ten times ten no salad but
iceberg and shuck the outer two thirds someone
we knew was brain dead from sushi so stick
to meatloaf creamed corn spuds whatever we
could cook to death DO NOT USE THE D WORD
EVEN IN JEST when you started craving deli
I heaved a sigh because salami was so de-
germed with its lovely nitrates to hell with
cholesterol that’t for people way way over
the hill or up the hill not us in the vale
of borrowed time yet I was so far more gone
than you nuts in fact ruinous as a supermom
with a kid in a bubble who can’t play and ten
years later can’t work can’t kiss can’t laugh
but his room’s still clean every cough every
bump would nothing ever be nothing again
cramming you with zinc and Haagen-Dasz so wild
to fatten you up I couldn’t keep track of
what medicine what old wives’ but see
THERE WAS NO MEDICINE only me and to
circle the wagons and the island the last of our
magic spoon by spoon nap by nap till we
healed you as April heals drinking the sun
I was Prospero of the spell of day-by-day
and all of this just the house worry peanuts
to what’s out there and you with the dagger at
your jugular struggling back to work jotting
your calendar two months ahead penciling
clients husbanding husbanding inching back
and me agape with the day’s demises who
was swollen who gone mad ringing you on
the hour how are you compared to ten noon
one come home and have blintzes petrified
you’d step in an elevator with some hacking
CPA the whole world ought to be masked
please I can’t even speak of the hospital fear
fists bone white the first day of an assault
huddled by your bed like an old crone empty-
eyed in a Greek square black on black the waiting
for tests the chamber of horrors in my head
my rags and vitamins dumb as leeches how did
the meningitis get in where did I slip up
what didn’t I scour I’d have swathed the city
in gauze to cushion you no man who hasn’t
watched his cruelest worry come true in a room
with no door can ever know what doesn’t
die because they lie who say it’s over
Rog it hasn’t stopped at all are you okay
does it hurt what can I do still still I
think if I worry enough I’ll keep you near
the night before Thanksgiving I had this
panic to buy the plot on either side of us
so we won’t be cramped that yard of extra grass
would let us breathe THIS IS CRAZY RIGHT but
Thanksgiving morning I went the grave two over
beside you was six feet deep ready for the next
murdered dream so see the thread was real
why not worry worry is like the prayer is like
God if you have none they all forget there’s
the other side too twelve years and not once
to fret WHO WILL EVER LOVE ME that was
the heaven at the back of time but we had it
here now black on black I wander frantic
never done with worrying but it’s mine it’s
a cure that’s not in the books are you easy
my stolen pal what do you need is it
sleep like sleep you want a pillow a cool
drink oh my one safe place there must be
something just say what it is and it’s yours