A/HRC/54/31/Add.2 in Québec,54 among others. In many of the cases reported, women did not provide consent and the procedure was performed without the patient’s knowledge, or consent was not informed owing to the absence of complete or correct information, and/or consent was obtained without the presence of an interpreter. As demonstrated by the case of Ms. Echaquan, Indigenous women and girls experience differential and discriminatory treatment in hospitals, including stereotypes that they are unable to care for children. 55 81. The symptoms of the chronic underfunding of health services for Indigenous Peoples and the structural discrimination in the delivery of medical treatment is evidenced by disproportionately low physical and mental health outcomes. Indigenous Peoples experience the highest rates of tuberculosis, AIDS and other communicable diseases, mental health issues and other chronic health conditions. Suicide rates remain high among Indigenous Peoples across Canada, despite implementation of the National Aboriginal Youth Suicide Prevention Strategy. Suicide rates among Indigenous youth are higher than those among nonIndigenous youth. For example, among males aged 15 to 24 years, suicide rates are 7 times higher for First Nations and 30 times higher for Inuit than among non-Indigenous males of the same age.56 82. Indigenous languages are the repository of collective knowledge, history and memory. Languages encapsulate uniquely Indigenous ways of thinking and being. Indigenous children and youth were forbidden from speaking their language in residential schools and some were punished for it. The United Nations Educational, Scientific and Cultural Organization indicates that 75 per cent of Indigenous languages in Canada are in danger of disappearing. 57 83. Among Inuit of Canada, the vast majority speak their Indigenous languages, yet those are not the official language in all of Inuit Nunangat, the Inuit homeland, and Inuit are not offered education in their languages. In 2021, the Special Rapporteur raised the issue in a communication to Canada detailing the persistent challenges faced by the Inuit of Nunavut in receiving essential public services in their language in the education, health-care and criminal justice systems.58 84. Indigenous Peoples in Québec expressed concern over recent legislative changes affecting language of instruction that could cause Indigenous children and youth to drop out of school. In May 2022, the Québec National Assembly adopted an Act on respecting French as the official and common language of Québec. One aim of the Act is to reinforce French instruction at all levels of education without any exemption for those whose first language is neither French nor English, such as Indigenous Peoples. It reinforces the province’s Charter of the French Language, which does not apply to First Nations. Despite this, the Act requires Indigenous high school and college students to take courses in French. The imposition of French language requirements for graduation may affect efforts to increase educational success among Indigenous students in Québec. 85. The Government of Canada has taken some positive steps on the preservation of Indigenous languages through the implementation of the Indigenous Languages Act (2019) and the creation of the Office of the Commissioner of Indigenous Languages. Long-term and dedicated funding is required for operationalization and implementation of the Act, in order to increase the number of language learners and speakers, to support the preservation, revitalization, normalization and fluency of Indigenous languages, and to ensure that such actions are centred on the principle of Indigenous control. 54 55 56 57 58 16 First Nations of Québec and Labrador Health and Social Services, Free and Informed Consent and Imposed Sterilizations among First Nations and Inuit Women in Québec. The practice of issuing birth alerts to notify the government when an Indigenous woman gave birth was only discontinued in the past few years. See also A/HRC/41/42/Add.1, para. 60 – the Saskatoon Health Region apologized to Indigenous women who had been subjected to forced sterilization, and said that “racism exists within our health care system and we, as leaders, acknowledge this”. See https://www150.statcan.gc.ca/n1/pub/99-011-x/99-011-x2019001-eng.htm . See also CCPR/C/CAN/CO/6, para. 19. See communication CAN 3/2021. Available at https://spcommreports.ohchr.org/TMResultsBase/DownLoadPublicCommunicationFile?gId=26480. GE.23-13374