In September 2020, Joyce Echaquan, an indigenous woman, died in the Joliette hospital, while its staff insulted her with racist comments. Now, we’ve learned her case is far from the only one. Le Devoir met with more than twenty indigneous people across more than ten communities across Quebec to hear their stories about the discrimation they met while seeking healthcare. In this projet, we delve into three of these stories, portraying the long roads they faced, travelling from their remote communities to hospitals, only to receive discriminatory care.
This visualization project, which is part of a larger investigation into racism against indigineous people in Quebec health care, allows readers to understand the difficulties of access to large hospitals for indigineous people who live in the communities.
The publication of this series of articles caused quite a stir at the Salon Bleu, where Quebec’s elected representatives sit. Questioned from all sides by the opposition, the Minister of Indigenous Affairs, Ian Lafrenière, maintained that he was going to tackle these “cases of racism”, which he described as “unacceptable”, “shocking” and “ disturbing”.
Opposition parties also proposed the adoption of a motion to “take note of the disturbing testimonies of Indigenous people who have experienced racism in the Quebec health system” and to document the complaints of Indigenous people in the Quebec public health network in order to have a better idea of the extent of the phenomenon. This motion was initially refused by the government of François Legault, but he finally opened the door to this idea a few weeks later.
This project pressured the Legault government to recognize “systemic racism” and made healthcare safer for indigineous people.
First, we conducted interviews with indigneous people who reported being discriminated against while seeking healthcare. Through these twenty plus interviews, we showed that each story is not an isolated incident, but is rather an instance of a larger, systemic issue within the healthcare system. Throughout these stories, some patterns emerged that we wanted to represent in a visual article to bring them to life. We noticed that in many of these cases, patients had to travel long distances to get to the hospital where they would then receive inadequate care. We wanted to highlight these multiple dimensions we found that restricted indigneous people’s access to healthcare – they received discrimination from hospital staff, as well as having to travel long distances to the hospital.
For our visual article, we selected three stories in particular where the distance traveled by the patient was especially large. We decided to illustrate these stories in a scrollytelling format, where with each scroll, the cost in distance and time to the patient is accumulated at the bottom of the screen, while a map illustrates the large distance from the patient’s community to their hospital.
To illustrate this distance, we created a geojson file containing the shortest route the patient could have taken on their journey to the hospital. Using Mapquest, we reverse geocoded the geographic position of each patient’s stops (sometimes there were multiple) on their journey to healthcare. We then used Mapbox’s API to get the fastest path they could have taken, which sometimes accumulated to hundreds of kilometers and hours.
We then saved these paths to a geojson file, which we visualized in the article with Mapbox. We incremented the counter gradually at the bottom of the page using D3.js. We think these techniques makes the reader feel the length of the journey.
What was the hardest part of this project?
This project was especially challenging because of the lack of data on this issue. At the time of this report, despite efforts by the Public Inquiry Commission on relations between Indigenous Peoples and by certain public services (ex : Viens Commission), Quebec hospitals did not count complaints filed by Indigenous people. Hospitals portrayed such stories as isolated incidents, and attempting to find their documentation on these cases was impossible. The burden of documentation was on the people who have been discriminated against, who may have incentives to avoid going public with their story.
Journalists Jessica Nadeau and Marie-Michèle Sioui persuaded over twenty indigneous patients all across the province to come forward with their stories. Only thanks to their expert understanding of these communities was this issue able to come to light.
On the visual side, it is excessively difficult to create a visualization article without data to represent. These stories, and their similarities, allowed us to quantify come of the costs tied to this form of discrimination, in terms of kilometers and hours lost by the patients. We were then able to visualize these costs on our interactive map, to shed light on the importance of this problem.
What can others learn from this project?
Our lesson is that, even if a problem is poorly documented, using data journalism may be a good road to approach it. Only by looking at these issues from a data-driven lens can we realize that there may be a lack of good data on a topic. This data is important because it helps support recurring or systemic issues with facts, which legitimizes them. It is important to not abandon a data journalism project for lack of data, because it may often be possible to construct our own datasets, through web scraping, research, fieldwork (in our case), etc.
It also teaches us that data is not only numbers, but that there are also humans behind it. In our efforts behind the project, speaking to over twenty indigenous people made us understand their perspectives better than any dataset ever could. Whenever data represents people, we should make a point to speak to them directly. It helps us understand as more than just a data point, but as a human. Only by doing so can we come to a better understanding of the issue and better present it to the world.