OTTAWA—After the second girl killed herself, Dr. Mike Kirlew was beset once again with the temptation to leave. But then, as always when things in Wapekeka get tough, the people there gave him the reason to stay.

It was early January and the First Nation in northwestern Ontario was in the throes of a suicide crisis, the likes of which have periodically erupted in the area’s indigenous communities for decades. Two 12-year-old girls, Jolynn Winter and Chantell Fox, had killed themselves in the same week, prompting fears of a suicide pact among the nation’s youth.

They were Kirlew’s patients. He knew them and their families, and the enormous grief in the community — coupled with his own rage that the medical system had failed these girls — implanted Kirlew with the thought of leaving the north for the relative calm and superior funding of the provincial health-care regime in a southern city.

It was a simple comment from someone who lives there that inspired him to remain: “We’re down now, but we’re going to be up again.”

Kirlew was blown away.

“In the height of that sadness, you’re looking at ‘We’re going to be up again?’ Imagine,” he said, speaking over the phone from Sioux Lookout, where he works for the First Nations health authority that sends doctors to remote northern communities. He spends one week a month in Wapekeka, about 420 kilometres north of his home in Sioux Lookout.

“That infectious resilience, that show of quiet strength through the face of adversity, is incredibly powerful — and transferable,” Kirlew said.

It has kept him working there for 10 years now.

The 36-year-old is known in Wapekeka as “Dr. Shakehand,” for his habit of shaking everyone’s hand, said band manager Joshua Frogg. But in recent months, the community’s long-time doctor has also emerged as a strident advocate for better health care for Canada’s indigenous peoples, fighting for what he argues is a “moral obligation” to bring in much-needed resources.

Last spring, he forcefully testified before a parliamentary committee on aboriginal health care, describing the lack of basic supplies like painkillers and asthma medication for children in far-flung northern communities. He penned a letter last year to the federal health minister, Jane Philpott, to bemoan the barriers to receiving travel funding for indigenous patients who may need to be airlifted in a medical emergency.

And in January, he sternly addressed a room of journalists after the Wapekeka suicides, at times trembling and raising his voice as he pounded a table with his forefinger and denounced the underfunding of indigenous health care that persists, he argued, in light of Canada’s racist colonial legacy.

“The health-care system on reserves is far inferior to what other people get — period,” he said. “This is taking children’s lives.”

Outcries of injustice have rung out for years from those that argue the federal government woefully underfunds indigenous health care, leading to race-based discrepancies in the quality of medical services available to First Nations people — especially in remote communities like Wapekeka — and everyone else who isn’t indigenous.

“That’s really where the advocacy fire starts to burn,” Kirlew said, describing how he has seen children without asthma medication struggle to breathe, and others wail with broken bones because he doesn’t have the provisions to numb their pain.

“What makes you angry is that, unless you change the system, this is going to be an unfortunate narrative that’s going to repeat itself,” he said.

“You’re triaging people based on race to an inferior system … That’s what makes you angry.”

Kirlew was born in Ottawa to Jamaican immigrant parents, and grew up in the capital with a younger sister. He said his parents were socially conscious and progressive, and pushed their children to assume similar views. “There’s no question about it. And they always wanted to ensure that we fought for rights and ensure that the world is a good place for everyone.”

After completing his undergraduate degree in biochemistry, Kirlew enrolled in medical school at the University of Ottawa. Upon graduation, Kirlew wound up deciding to work in Sioux Lookout after another placement unexpectedly fell through. He was open to the experience, but never expected to stay for long.

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Ten years later, he still lives there with his wife, Yolaine, and their three children. He now teaches at the Northern Ontario School of Medicine, where he produces regular educational podcasts.

Part of what has kept him in Sioux Lookout is his philosophy that a doctor’s job — especially in the context of what he sees as an underfunded and neglected health system — isn’t limited to the confines of medical care. He also has a duty to push for better resources for his patients, Kirlew said.

“It’s also looking at the advocacy side as it relates to the system, or bringing about system change in systems that are unjust and unfair,” he explained. “The medical community has a unique role to play in that fight for social justice.”

Charlie Angus, MP from northwestern Ontario for the New Democratic Party, said it’s rare to see a health practitioner stick out their neck and criticize the government like Kirlew has.

“Doctors don’t want to rock the boat because they’re worried it will affect their patient care, but Dr. Kirlew has been fearless in speaking out because he’s seen the children dying on his watch,” Angus said.

“Having a whistleblower like Dr. Kirlew, he needs to be protected and he needs to be supported and he needs to be listened to.”

Frogg, the Wapekeka band manager, lost his niece Chantell Fox to suicide in the most recent crisis. Like Angus, he said he’s glad to have Kirlew pushing for change.

“I think (we need) more people like him, for doctors to voice their opinion, to make people understand that there is something wrong,” Frogg said.

“He knows the system, he’s aware of the shortfalls.”

That, for Kirlew, is the goal: spreading the word that something is wrong and unjust, and then pushing for it to be addressed. And even though it’s sometimes hard, and dispiriting, and so seemingly futile and tragic that there’s a temptation to just leave, Kirlew said his work and the people he cares for end up bringing him to the same conclusion.

He’s not going anywhere.

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