Running head: Book Review 1

Book Review

Mary Jane McCallum and Adele Perry, Structures of Indifference: An Indigenous Life and

Death in a Canadian City (2018)

Name

Institutional Affiliation
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Introduction

Mary Jane McCallum and Adele Perry’ s ‘Structures of Indifference’ is a book that

examines a Canadian city’s indigenous life and death to reveal the ongoing colonialism and its

history in the country. The book uses the story of Brian Sinclair to bring out the life and death of

the indigenous people in the city. According to the authors, Brian Sinclair is a middle-aged

Anishinaabe resident of Winnipeg who is a non-status middle-aged man who arrived in a

downtown hospital for emergency in September 2008. Brian Sinclair was left unattended and

untreated in the hospital for a period of over thirty-four hours, and later died from a disease

infection that was easily treatable due to negligence and unwillingness of employees. The

authors, Mary Jane McCallum and Adele Perry present ways in their book in which Brian

Sinclair who was ignored and erased, came and represented a diffuse, singular, and a

dehumanized notion that largely represents how indigenous communities are ignored in the city,

the city’s decline, and modernity. The story of Brian Sinclair and his experiences in the city of

Winnipeg in this book’s representation tells its audience ways ordinary indigeneity experiences

and restores a complex humanity that is denied to the community as they interact with the legal

and health systems of Canada, before and after the death of Brian Sinclair. Therefore, the authors

focus on the treatment and the experiences of indigenous people in Canada’s settler spaces in the

colonial society and ways through which the country’s legal system perceives indigenous

groups’ deaths through deliberate omission of influential mitigation factors such as structural

indifference, racism, and colonialism.

Critical Analysis

Mary Jane McCallum and Adele Perry’ s book ‘Structures of Indifference’ has 192 pages

starting with an introduction, three key chapters (including ‘the City,’ the Hospital,’ and ‘Brian
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Sinclair’), and a conclusion. The introduction which is titled ‘Thirty-Four Hours’ puts into

situation the life and death of Brian Sinclair in the pretext of historical and ongoing colonialism.

In this section, Mary Jane McCallum and Adele Perry examine the 34 hours that lead to the death

of Brian Sinclair by giving a timeline of events that occurred from the very time he arrived in the

hospital emergency department at 2:53 p.m. on 19 th September 2008 to the moment he was

determined to have died at 12:51 a.m. on 21 st September, 2008. In Chapter 1 of the book, the

authors give a detailed analysis of the Winnipeg, Manitoba’s history from pre-settler era to the

modern day. The chapter starts by giving a historical analysis of Cree and Anishinaabeg

ancestral lands on which Winnipeg is currently situated on, before giving a review on the rise of

the settler colonialism in the eighteenth and nineteenth centuries. Furthermore, a geographical

segregation of the Metis and the Indigenous people is given while recounting the process of

urbanization that moved people to Winnipeg urban areas, giving rise to racism and

discrimination.

In chapter 2, the authors describe Winnipeg Health Sciences Center (HSC), the place

where Brian Sinclair went to seek medical attention when he fell ill, that he did not receive

causing his ultimate demise. While reviewing the occurrences, Mary Jane McCallum and Adele

Perry believed that it is only by understanding the historical context and experiences of

indigenous communities in the area, will they understand the events that took place in the

hospital. Therefore, it is in this chapter that the authors gave a clear analysis of the historical

accounts and experiences of the evolution of the health system and the legal system that are

racially aggregated in Manitoba. They concluded that settler colonials receive the latest modern

medicine while excluding indigenous people systematically to receive substandard medical care.

In chapter three of the book, the authors focus on Brian Sinclair, sharing his story, live overview,
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and demonstrated the level of segregation, racism, and intolerance that the hospital staff

exercised towards him. Many hospital staffers applied stereotypes that made them believe Brian

Sinclair was not sick but only intoxicated. This perception is supported by Browne et al. (2016,

p. 3) stated, the “colonizing image of the ‘drunk Indian’ is one of the most harmful stereotypes

operating in health care settings.” The assumptions and stereotypes are dangerous and harmful to

people who require emergency medical treatment as they demonstrate dangerous racism in the

society. Finally, the book concludes by giving an account of a 10-year reflection since the death

of Brian Sinclair and how injustices continue in the Canadian hospitals, jails, courtrooms, and

schools among others.

Book Critique

Strengths of the Book

The way Mary Jane McCallum and Adele Perry have taken a place-based historical

approach that is grounded in the lens of anti-colonialism to bring into context the life and death

of Brian Sinclair shows some of the distinctive strengths of the book. The historical background

of the authors is a strength in this book as it reveals the detail and depth of their compelling

analysis. For instance, when examining the hospital’s history, Mary Jane McCallum and Adele

Perry went back to the initial land transfers including its tittle deed, thus proving that the

hospital’s existence depended on the transfer of land from the indigenous society. Furthermore,

the authors used their historical knowledge to examine the colonial history of workers in the

hospital including nurses, doctors, and military personnel among others. Also, the fact that the

authors included supporting visual arts such as maps and images gives the audience the ability to

orient the hospital. Also, readers are able to use the authors’ place-based historical approach to

realize events and histories that could not have been clear. The authors wrote “When we separate
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the history of people like Brian Sinclair and institutions like the HSC and cities like Winnipeg

from the wider history of the dispossession of Indigenous people and land, we radically

misunderstand and underestimate the context…the structures…that shape our lived experiences”

(Mary & Perry, 2018, p. 14). Therefore, the authors have managed to bring together political,

economic, and social environments that describe the tragic death of Brian Sinclair and the poor

condition of health and legal systems surrounding the First People.

The way Mary Jane McCallum and Adele Perry have used secondary sources as well as

primary research information to document the existence of discrimination and racism in the

Canadian health and legal systems against indigenous people is another strength of the book.

This analogy is well supported by a number of scholars (including; Boyer, 2017; Allan &

Smylie, 2015; Boyer & Bartlett, 2017; Browne et al., 2011; Browne & Fiske, 2001;Furniss,

1999). According to the First Nations Information Governance Center (2018), 24% of indigenous

people have reported cases of discrimination against them in the last one year. Furthermore, a

survey conducted by Ipsos public affairs affirmed that among 225 health institutions, at least

51% are anti-indigenous and have a history of racism (Richardson & Murphy, 2018).

Another significant strength of the book is the authors’ explicit focus to analyze and

study structural levels of racism, indifferences, and colonial violence against indigenous

societies. Instead of focusing singularly on the actions of hospital staffers who ignored Brian

Sinclair interpersonal racism that resulted to his death, Mary Jane McCallum and Adele Perry

opted to examine structural racism with a broader focus on understanding all indifferences that

influence the lives of the indigenous people on their everyday activities. Although the book

focused primarily on health care, Mary Jane McCallum and Adele Perry opted to cover other

optics affecting the indigenous people including the justice system, child welfare system, and the
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media. As a result, the book raises key points that focus majorly on all broader social issues that

contribute to structural and institutional inequalities in Canada. Their narrative is well researched

and evidence-based to unravel ways settler colonialism and racism continue to penetrate through

the Canadian indigenous societies. Despite the fact that the book is only 192 pages, its content is

resourceful and heavy with significant information on the outlined themes.

Book Weaknesses/Criticism

Although Mary Jane McCallum and Adele Perry described both the city and the hospital,

their work has not shown a detailed life history of Brian Sinclair. Despite having a chapter that

covered Sinclair, it is the shortest chapter in the book that contained shallow information about

him. I clearly agree and appreciate the authors for including this chapter on the victim.

The authors in their research relied on colonial information and records that existed for

centuries available online and in libraries such as newspapers (p. 106), the authors would have

strengthened their research further if they had adopted stories and quotes from interviews that

they had with the family. Furthermore, Mary Jane McCallum and Adele Perry did not give

sustainable applicable recommendations for indigenous policy, research, and practice that will

best move them forward.

Importance of the Book

The book in my opinion has achieved its primary goal of using the Brian Sinclair case,

the effects of colonial settlers and the indifferences o the lives of the First People. The authors

have created attention around the role of racism, history, and colonization to the understanding of

issues such as that of Brian Sinclair facing local communities. This is very important because

understanding the cause of death of Brian Sinclair helps people and communities around to find
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ways that will ensure such scenarios are prevented in future and avoid other indigenous

community members from encountering similar challenges. Since the incidents uncovered in the

Brian Sinclair episode in the book involves failed procedures and policies in the health care as

well as legal system, the broader of issues of discrimination and racisms in Canadian institutions

can be corrected with proper policies and recommendations. This is because despite denials, the

effects of colonial histories are visible within Canada’s systems and work against indigenous

communities.

As a way of fighting racisms and discrimination, the country has adopted and

implemented agencies and institutions that are aimed at addressing racism nationally. This

includes Truth Reconciliation and Commission of Canada which offers anti-racisms training in

institutions such as schools and colleges to help students, nurses, and medical practitioners. This

implicit bias, anti-racism, and cultural safety training has been incorporated in many Canadian

colleges and universities as a way of embracing diversity in the curriculum and professional

development.

All in all, Mary Jane McCallum and Adele Perry’s Structures of Indifference is an

important read that has offered important timely information on indigenous communities’ health

concerns. the book is a valuable and resourceful literature that is insightful to both indigenous

and non-indigenous audience. It gives perspectives to specialists such as future researchers,

scholars, students, public health policy makers, health practitioners, as well as healthcare

administrators and the broader political class or legislatures who are interested to understand the

historical perspectives of Canadian indigenous tribe and the present day structural and

institutional discrimination and racism against them.

More significantly, this book adds knowledge and insight into a broader collection of

literature that are focused on structural racism as its effects on healthcare and the wellbeing of

minority communities.

References

Browne, A. J., Varcoe, C., Lavoie, J., Smye, V., Wong, S. T., Krause, M., Tu, D. Godwin, O.,

Khan, K., & Fridkin, A. (2016). Enhancing health care equity with Indigenous

populations: Evidence-based strategies from an ethnographic study. BMC Health

Services Research, 16(1), 544. https://doi.org/10.1186/s12913-016-1707-9

Mary Jane McCallum and Adele Perry, Structures of Indifference: An Indigenous Life and Death

in a Canadian City (2018)