What Does Your Orange Shirt Mean?
Taking responsibility for Every Child Matters
“Life’s most persistent and urgent question is, ‘What are you doing for others?’” – Martin Luther King Jr.
Last week, Canada observed what may be our most important national holiday: the National Day for Truth and Reconciliation. For many, it is simply Orange Shirt Day. It is a day born from a story—Phyllis Webstad’s story. When she was a child, preparing for her first day at a residential school, her grandmother bought her a new orange shirt. On arrival, it was taken from her, along with nearly everything else—her clothes, her family, her language, her dignity. At my institution last week, I watched my colleagues—academics, university and hospital administrators—don an orange shirt, hopefully to honour the survivors of residential schools, Phyllis and her message. They stood solemnly as drummers sang, as Elders offered teachings, as survivors recounted their pain. On the surface, it reflected progress. However the depth of that progress and our commitment to honor the message on the shirt is as thin as the fabric on which they are printed.
Responsibility Beyond Symbols
What does an orange shirt mean? Beyond the atrocities of residential schools, the movement is about responsibility. The Truth and Reconciliation Commission (TRC) released its Calls to Action a decade ago: a roadmap for dismantling the structures that continue to marginalize and harm Indigenous peoples.
For health professionals, six of these calls (#18–24) are explicit: address inequities in health outcomes, ensure Indigenous-led systems, and provide culturally safe care. They are not abstract; they are urgent.
And yet, what have we done with this responsibility in the past decade? In short, very little.
The Persistence of Inequities
In 2020, a landmark report on First Nations children in Manitoba and studies from the Manitoba Centre for Health Policy revealed dark staggering truths about our society: First Nations children in Manitoba face diabetes, substance use disorders, and mental health conditions at 5-7 times the rate of their peers. Suicide attempts are 8-10 times higher. Life expectancy: three years shorter. Premature mortality: three times higher.
These numbers are not historical relics from “Canada’s dark history”. They are today’s reality. TRC Call to Action #19 demanded frequent reporting and solutions to close these gaps. A decade later, the indicators remain unchanged. Thousands of orange shirts parading through campuses and Indigenous symbolism everywhere, but the numbers are stagnant. Why?
Racism by Another Name
Racism is not always shouted. Sometimes it whispers. It can be overt, structural, or—in health care—insidious neglect and apathy.
The In Plain Sight report from British Columbia supported by First Nations Health Authority, First Nations Health Council and Métis Nation BC, documented that two-thirds of Indigenous patients experience racism in health care settings. Accordingly, they are also 2–3 times more likely to leave hospitals without care. Physicians and nurses, meanwhile, often deny racism exists or insist it is negligible. The dissonance is embarrassing: patients describe humiliation and neglect, while institutions congratulate themselves for land acknowledgements and symbolic gestures. All while wearing an orange shirt.
Let us be clear: wearing an orange shirt will not prevent a child’s suicide. It will not stop an Indigenous patient from being neglected to death in a hospital corridor or child from dying in jurisdictional limbo away from their family, community, culture. Symbols are not solutions.
What Responsibility Demands
The orange shirt, then, must be more than fabric. It must be a pledge. A pledge towards taking responsibility for every child in our care, in our community, in our country. To wear an orange shirt without action is to perpetuate the very apathy that sustains inequity. It’s time Canada moves “beyond shame, sorrow and apologies”.
So what actions can we take responsibility for in the next 12 months, before wearing that orange shirt again?
Acknowledge Historical and Contemporary Truths about Canada
Recognize that inequities are not accidental—they are the legacy of colonization and the persistence of racism.
Support Indigenous-Led Systems
Support health systems governed by Indigenous health professionals, Elders, and Knowledge Keepers. Governance must be self-determined or shared, not symbolic. Do not uphold current complacency towards self determined health care systems for Indigenous peoples.
Enroll in Anti-Racism Training
Enroll in training designed by Indigenous leaders to dismantle biases and racist beliefs ingrained in medical and academic cultures. When done properly they improve culturally safe care and reduce biases.
Commit Yourself to Accountability and Measurement
Demand and participate in annual, public reporting of inequities in health outcomes, as TRC Call to Action #19 requires. If the next report shows no progress, the failure belongs to us all.
Understand and engage in protocols to uphold Indigenous data sovereignty.
Foster Cultural Safety in Practice
Create spaces in hospitals for ceremony and healing. Engage in the recruit and retention of Indigenous leaders to senior positions. Protect whistleblowers who speak against racism. Speak out against colleagues that are apathetic in the face of racism.
Take Personal Responsibility
Ask yourself: What will I do this year so that when I wear an orange shirt next September, I can say that I have lived its meaning?
A Final Reflection
In 1963, Martin Luther King Jr. asked: What are you doing for others?
Let your answer not be silence, symbols, or apathy. If Every Child truly Matters, then every shirt we wear must be heavy with the weight of our collective responsibility to make that reality.