First Peoples Struggling to Survive

What Kind of Government Is This?

Influenza, First Nations, and federal government policy

Mary-Ellen Kelm

First Nations peoples have their own stories of the 1918 flu, and you will hear some of those in their own words elsewhere on this website. This is a flu story about government, drawn from public archives, that explains much about the relationship between federal officials and institutions and First Nations people – a relationship that medical historian Mary Jane McCallum has characterized as one of segregation, isolation, and trauma.

Margaret Gagnon was just a girl in 1918 when the flu swept through her Lheidli’Tenneh community at Shelley, north of the town of Prince George in central British Columbia. Years later, she could not recall what happened when she got sick, only that it was autumn when she fell ill and that it was spring before she walked again through the village. Then as the snow melted away, and the rivers rose, she saw what was left of her village: a place of cold empty homes. Her family in disarray, Margaret was forced to go to Lejac Residential School, 160 kilometres away at Fraser Lake.[1]

As with other Canadians, the flu devastated families on reserves across Canada. First Nations’ death rates were higher than most: eight times higher than the general population in BC.[2] Yet First Nations had what other people did not: a public health-care system operated by the Department of Indian Affairs. But the role that government played in the lives of Indigenous people made them less likely to receive the care they needed to survive the flu. By considering Margaret’s story, we can see it as a nested narrative, one that makes better sense if we set it into the context of Canada’s relationship with the First Nations.

The federal health-care system for “status Indians” had developed in piecemeal fashion at the end of the 19th century. When Ottawa first undertook this work, at the urging of First Nations leaders, government officials did so to help prevent epidemic diseases, such as smallpox, from breaking out on reserves. Across Western Canada, a system of health care emerged: the federal government paid doctors, nurses, and others to visit reserves to dispense medicine and to vaccinate the inhabitants.[3] In 1905, career civil servant Duncan Campbell Scott – one of the principle architects of the Indian residential school system in Canada – became the chief accountant at the Department of Indian Affairs (DIA). When he reviewed how much money the government was spending on First Nations health care, he wondered why. The federal government, in his opinion, was under no legal obligation to do so. Whatever moral obligation might have existed in the days of treaty-making was now long gone, he argued: smallpox seldom broke out on reserves.

During the decade before the 1918 flu outbreak, Scott slashed the health services budget. He stopped paying departmental doctors by the visit and put them on very low salaries. The best doctors simply dropped out of the service, while others tried to combine reserve work with private medical practice or contract work for a local company. [4] Pulled in many different directions, these doctors were seldom able to make First Nations health care their first priority.

When a disease as widespread as the flu struck in 1918, DIA doctors struggled to meet the needs of reserve residents when their paying patients needed them as well. Margaret Gagnon recalled being told that the DIA doctor never visited from nearby Prince George. He had no time, little energy, and less incentive to travel to Shelley.

If the flu had arrived even 10 years earlier, a doctor would not have had to travel at all to attend to Margaret and her family. Until 1911, the Lheidli-T’enneh community was situated where it had always been – at the confluence of the Fraser and Nechako rivers, right next to the town of Prince George. In 1911, however, the Canadian government amended the Indian Act to force the relocation of any reserve community considered to be too close to a white settlement. The town leaders of Prince George grasped the chance to open up the real estate at that prime location to settlers and, influencing the vote by the Lheidli-T’enneh band councillors by burning their homes, forced them to move to the location known as Shelley, some distance upriver. One of their many justifications for doing so was to protect the town population from rising rates of diseases, particularly tuberculosis, among Indigenous people.[5]

By 1918, the focus and intent of the federal health-care system for First Nations had changed from protecting Indigenous lives to protecting settler lives. It was no longer smallpox that worried government officials, but rather tuberculosis (TB). The tubercle bacillus can infect any part of the body, but it is pulmonary tuberculosis that’s most commonly associated with TB. Spread by droplets when someone coughs, sneezes, or spits, it is highly contagious, especially in overcrowded or unsanitary conditions. By 1918, while still a disease of urban slums, TB infection rates among Canadians were dropping. Yet on Indian reserves and in residential schools, the disease was spreading.[6] 

The problem was clearly known as early as 1909 when Dr. Peter Henderson Bryce, the DIA’s first chief medical health officer, studied the problem. But his recommendations – to improve the health conditions of residential schools, to increase the number of doctors, nurses, and hospital beds available to status Indian patients – went against Scott’s parsimonious tendencies. Scott personally attacked Bryce, called his recommendations naive, and, finally, forced him from office. To Scott’s mind, the solution to the “Indian problem” was assimilation, not government support.[7]

Scott would, however, agree to fund infirmaries in residential schools.[8] The problem was that the residential schools themselves served to spread the disease: these facilities concentrated sick children; weakened them with poor nutrition, overwork, and abuse; infected the healthy with TB that lurked in all the schools; and then sometimes sent the sick home to die, spreading the disease to family and friends who gathered at their bedsides. As families like Margaret’s foundered after the flu, more children were sent to the residential schools, where their mental, spiritual, and physical health would forever be impaired.[9] Margaret spoke little about Lejac, but her classmate, Saik’uz Elder Mary John, remembered it as a place of loneliness and hunger. Lejac itself is gone, but its cemetery remains on the windswept shore of Fraser Lake.[10]

In sum, we can see that Margaret’s story is not a singular tragedy but a systemic one. The federal government consistently made decisions that negatively affected the health of First Nations members even as it administered a health-care system that was purportedly designed for their benefit. In so doing, the federal government allowed influenza to take its toll among First Nations communities and set up conditions in which Indigenous people would continue to suffer high rates of disease for generations to come.


[1] Taped interview with Margaret Gagnon by Mary-Ellen Kelm, September 1993, Prince George, BC.

[2] Library and Archives Canada, National Health and Welfare, RG 29. vol. 853–096.1 May 1919; “Vital Statistics, 1919,” British Columbia, Sessional Papers, 1920. 

[3] Mary-Ellen Kelm, Colonizing Bodies: Aboriginal Health and Healing in British Columbia, 1900–1950. (Vancouver: University of British Columbia Press, 1998), 104-152; James B. Waldram, D. Ann Herring and T. Kue Young, Aboriginal Health in Canada: Historical, Cultural, and Epidemiological Perspectives. 2nd edition. (Toronto: University of Toronto Press, 2006),173-209.

[4] Kelm, Colonizing Bodies, 111.

[5] Frank Leonard, A Thousand Blunders: The Grand Trunk Railway and Northern British Columbia, (Vancouver: University of British Columbia Press, 1996), 175; Frank Peebles, “City’s 100th anniversary built on village’s ashes,” Prince George Citizen, March 17, 2015.

[6] Waldram, Herring and Young, Aboriginal Health, 69.

[7] Kelm, Colonizing Bodies, 112–3

[8] Maureen K. Lux, Separate Beds: A History of Indian Hospitals in Canada, 1920s–1980s. (Toronto: University of Toronto Press, 2016), 23.

[9] Ian Mosby and Tracey Galloway, “‘Hunger Was Never Absent’: How Residential School Diets Shaped Current Patterns of Diabetes among Indigenous Peoples in Canada,” Canadian Medical Association Journal 189, no. 32 (August 14, 2017): E1043–45.

[10] Bridget Moran, Stoney Creek Woman: the Story of Mary John. Vancouver: Arsenal Pulp Press, 1988.