Denial of proper dental care ‘may never have happened’

Published November 1, 2000

A different interpretation of the same data suggests conflicting conclusions about the quality of dental care Native children received at school.

AFTER READING Ottawa Experimented on Native Kids (May Journal), and related articles in daily newspapers, I conducted my own research at the National Archives of Canada. I was left with quite different conclusions.

In fact, a plausible case could be made that these children received exceptional dental and nutritional care relative to standards at the time for both Native children who did not attend Indian residential schools and poor non-Native children in Canada. (Between 1900 and 1969, only about 20 per cent of status Indian children attended these schools.)

Studies to determine the effectiveness of fluoride were being undertaken at the same time in several Canadian settings so this work was not an isolated study with status Indian children. The deprival of dental care to residential schools students as described in some letters may have never happened. And the net result of the “experiment” in at least one of the schools (Port Alberni), was increased nutritional care for the children.

For five years I have been wading into the extensive federal government document holdings in the National Archives, first as a staff person with the national office of the United Church from 1992 to 1998, then as a self-employed research consultant to various church organizations facing civil litigation.

The first thing you notice about the available documentation on these nutritional/dental studies is that the record is incomplete. Most significantly, the final report, or even a draft report, on the results of this five-year study (1948-1953) by Dr. L.B. Pett of National Health and Welfare has not been located and may in fact have never been written. As a result every interpretation, including my own, must be tentative.

A memo from Dr. Pett dated Oct. 18, 1948 reports that six residential schools were visited and 824 children examined (to grow to 1,000) for the baseline of the five-year study. Some of the schools were to receive enriched flour, some therapeutic supplements, and some only educational efforts.

Central to your reporter’s conclusions to make the case for deliberate deprival of dental services to residential school students are two letters in 1949 and 1950 from Dr. H.K. Brown, Chief, Dental Health Division, National Health and Welfare to his colleagues in the department.

The two letters confirm that students were getting regular visits by a dentist and all normal dental procedures were not to be stopped for this nutritional study. In fact, other documentation indicates that this study was also an opportunity for increased education of students on the use of toothbrushes and regular dental hygiene.

Dr. Brown’s two letters request withholding specialized dental care such as “sodium fluoride and dental prophylasix” at the six schools involved in the study.

Since the study began in 1948, one wonders why Dr. Brown, who was Dr. Pett’s superior, had to send these letters one and two years after the study started. One explanation could be that the treating dentists assigned by the federal government to its resdential schools were doing the specialized procedures anyway and this was threatening to spoil the nutritional study’s results.

Why was no final report preserved? It may be that it was never written because this study was doomed from the start and thus not completed. Children in residential schools would appear at first glance to have been ideal study participants in a five-year nutritional project, since their diets were controlled in a central kitchen. But there was a great deal of turnover among students. In addition, students went home for summer vacations and many could go home on weekends so their nutrition was not as controlled as might be expected.

In the 1940s and 1950s, fluoride treatment in drinking water or administered during dental treatments was not yet generally accepted as part of regular care. Further, these types of studies on large groups of non-Native children in Canada were being done at the same time, so this was not a case of discriminating against Native children in residential schools. This is clear from documents in the same National Archives files as were researched by your reporter.

The documents indicate that the experimental approach across the six schools chosen for the nutritional project in 1948 included no variations in diet in some (control groups) and increased nutritional intake and education at others.

For the Alberni residential school, the subject of Dr. Brown’s Oct. 3, 1949 letter, the experimental aspect of the study involved doubling the amount of milk intake of the students. The objective at this institution was to: “Double the milk consumption, so that average is clearly above one pint per child per day, using skim or whole dried milk.” The documents show Principal Caldwell at Alberni had to subsequently demand extra money from the Indian Affairs Department to pay for the milk supplements when the promised funds were not in the school’s budget.

The inaccurate impression is left that the principals of these residential schools were granting permission in loco parentis for this experimental program that deprived children of dental care without speaking to parents or guardians first.

Fluoride treatment was not a fully recognized dental procedure at the time and thus nothing was being denied or imposed as a result of Dr. Brown’s instructions in the two letters.

Further, from other federal documentation, it is clear that principals were never given guardianship of the students. Indian Affairs always maintained that it was the guardian of its status Indian wards in residential schools.

Directives were issued by Indian Affairs that medical treatments (as opposed to elective dental procedures) of students must be cleared with the students’ parents unless an emergency arose requiring immediate treatment. These are similar to the provisions in place today if you send a child to camp or boarding school.

There were other accusations of ill treatment on the nutritional front in residential schools that should have been more intensely researched. For example, the withdrawal of enriched flour is cited. In St. Mary’s residential school, enriched flour was introduced and then withdrawn and your reporter leaves the impression that the children were callously treated.

A 1953 document describing the activities of the Department of Health and Welfare, Nutrition Division states: “Evidence has been obtained that the ‘enriched’ flour used in Newfoundland may induce anemia, under some circumstances, presumably due to the added bone meal. This study is continuing.” Stopping the use of enriched flour in this school appears to have been the proper medical and nutritional step once the evidence was in.

Your reporter’s research on these nutritional studies is unsound. Through the article in the Anglican Journal and the mainstream media coverage of this apparent scoop, it has now become everyday journalistic commentary that Indian residential schools were the site of inappropriate nutritional/dental experiments on children.

The detailed research and careful response required to refute these allegations don’t make for great headlines. Imagine reading a story under the banner, Dental Care Superior at Residential Schools. And yet, that would have been more accurate.

John Siebert is a research consultant to several church organizations historically associated with Native residential schools.

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