I continue to make my way through the pile of books that has accumulated in my office and have just finished reading Clearing the Plains: Disease, Politics of Starvation, and the Loss of Aboriginal Life (University of Regina Press, 2013) by James Daschuk.  Its message is shocking; the scholarship meticulous; and it is definitely one for the personal libraries of all Canadians who care about the history and future of First Nations people. This volume has won multiple awards and was named the "Book of the Year" by the Globe and Mail, Quill and Quire, the Writer's Trust, and booksellers across the country.

Daschuk examines the ecological, economic, and political forces that shaped the medical histories of First Nations people in western Canada from the first arrival of the Europeans through 1891.  He identifies two phases in indigenous health.  The first was the period of introduced acute contagious diseases that swept through otherwise healthy populations, resulting in unprecedented mortality to affected communities. Differences in population density, geographical location and mobility, frequency of contact with outsiders, and access to imported goods led to variable impacts across the region. The second period came in the latter half of the 19th century with the territorial expansion of the Canadian state, the demise of bison herds, and changes in the power dynamics between First Nations and the Canadian state. Treaties relocated First Nations people to impoverished reserves and prevented them from leaving to provide for themselves and their families.  Federal government food aid was insufficient, unhealthy, erratic and  used as a method of control.  Years of substandard diet made men, women and children susceptible to new waves of disease including influenza, measles, scarlet fever, whooping cough, venereal diseases, and TB.  Daschuk shows that the decline of First Nations health was the direct result of economic and cultural suppression and he asserts that there is a disconnect between the view that Canadians have of themselves as world leaders in social welfare, health care, and economic development and the realities of life on many reserves where even the basics such as clean drinking water are unavailable.

This is a powerful publication with a timely message that bridging the gap between First Nations communities and the rest of Canada requires us to confront the reality that First Nations are systematically disadvantaged in policy and practice.