A coroner's inquest into the death of Kevin Mamakwa, a 27-year-old Indigenous man, has shed light on the systemic issues plaguing correctional health care in Canada. Mamakwa, a member of Kingfisher Lake First Nation, died on June 2, 2020, while incarcerated at the Thunder Bay Jail.

The $30 million heritage conundrum

The Thunder Bay Jail, a provincially-owned heritage property, is a complex puzzle for those seeking to reform its outdated facilities. Designated by the City of Thunder Bay in 2009, the jail's heritage status complicates renovations aimed at addressing overcrowding or adding programming space. Any changes require Ministry of Infrastructure approval and must preserve heritage features, leaving the jail with a capacity of 462 beds.

The inquest has highlighted the ongoing challenges in correctional health care, with Dr. Leonora Regenstreif, an adjunct assistant clinic professor at McMaster University, testifying about opioid withdrawal symptoms. She explained that withdrawal from suboxone, which contains bupprenorphine, typically becomes severe three to five days after the last dose and can last for weeks.

Kevin Mamakwa had received four doses of suboxone from a pharmacy on May 14, 2020 , which would have run out by May 18. He was remanded into custody on May 28, 2020 , and died days later. It is unclear whether he consumed any substances between the pharmacy visit and his incarceration .

A systemic failure to save lives

The inquest has exposed the harsh realities of correctional health care in Canada. when Dr. Regenstreif started working in correctional settings in 2017, there was significaant stigma around suboxone and forced withdrawal was common. Inmates did not receive equivalent care compared to those in the community. Policy changes have since been made to improve access to opioid agonist therapy in correctional facilities, offering hope for better future care.

Thunder Bay Jail superintendent Rylan Forrest described the facility's intake process and relevant policies.. He acknowledged operational challenges during the early COVID-19 pandemic in 2020. Since Kevin Mamakwa's death, modifications have been made to sight lines and security cameras to improve surveillance. However, installing emergency call buttons within cells is beyond his scope.

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The inquest is expected to hear more about a proposed new complex later in the proceedings. The jury is tasked with determining the circumstances of Kevin Mamakwa's death and making recommendations to prevent similar tragedies. His family and community are seeking accountability and systemic reforms to ensure that incarcerated individuals receive appropriate medical care, particularly for opioid dependence.

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Reporter Sarah Law, who covered the testimony, noted that the inquest highlights the ongoing challenges in correctional health care and the importance of implementing the recommended changes to protect inmates' lives .

The inquest continues, with the jury tasked with determining the circumstances of Kevin Mamakwa's death and making recommendations to prevent similar tragedies. His family and community are seeking accountability and systemic reforms to ensure that incarcerated individuals receive appropriate medical care, particularly for opioid dependence.