Mothers of two Indigenous men who died of medical conditions while in Thunder Bay police custody told a coroner's inquest Tuesday about the pain of losing their children to possibly preventable causes.

Ina Kakekayash occasionally wiped her eyes with tissues as she spoke about her son, Donald Mamakwa, at an inquest exploring the circumstances of his August 2014 death and the July 2017 death of her brother, Roland McKay.

Neither man was assessed by a doctor or nurse before they died of medical illnesses while being held at Thunder Bay Police Services headquarters. They had been arrested for suspicion of public intoxication.

Mamakwa's mother told the inquest jury that the lack of medical attention paid to her 44-year-old son, who was diabetic and had experienced homelessness for years, was particularly painful and she questions if he would have been helped at a hospital.

"Knowing that he died in jail was the most painful part," Kakekayash said through an interpreter from the hearing room in Thunder Bay, Ont.

"We wouldn’t be sitting in this place today if he had been taken to the hospital first, not in the jail."

Sarah Jane McKay also testified through an interpreter about the death of her 50-year-old son, who had been in Thunder Bay for a medical appointment when he died.

She said her son, the youngest of eight children from Kitchenuhmaykoosib Inninuwug First Nation, was "easy-going" and helpful, and she was not aware of him having trouble with police before the day he died. He kept her company, helped with chores and McKay said she is still grieving his loss.

"He was a very kind man," she said. "I really miss my son."

The inquest is expected to hear from an expert who will speak about Indigenous people's experiences with racism and interactions with the health system, and look at how racism and bias may have affected first responders' interactions with the two men.

Inquest counsel Peter Keen opened the first day of the inquest by telling the jury that they can expect to hear evidence that both Mamakwa and Roland McKay could have survived if they had been taken to a hospital.

In Mamakwa's case, Keen said testimony is expected that the man had a 97 per cent chance of surviving if he had been taken to hospital instead of the jail cell where he died on Aug. 3, 2014, from complications related to diabetes and sepsis.

Keen outlined other evidence expected in Mamakwa's case, including that he told paramedics that he was taking medication, but they wrote down that he was not.

On Tuesday, the inquest played video footage for the jury that showed police bringing Mamakwa into custody.

In one video, Mamakwa was breathing heavily and appeared to need assistance walking, sitting down and removing his shoes, though he was verbally responsive when officers asked him questions. The jury also heard audio of a 911 call of a man "passed out" on the steps of a church that led to Mamakwa's arrest, and video from the cell block when a constable found him unresponsive.

Inquest counsel also shared the transcript of an interview with a man who had been in a cell near Mamakwa. Stewart Gagnon told investigators that Mamakwa asked him for water and appeared unwell, but he was unable to help him.

The inquest heard that Mamakwa, a father of six, grew up in Kasabonika Lake First Nation with four sisters and enjoyed playing guitar, baseball and hockey as a youth.

Rachel Mamakwa, Donald Mamakwa's sister, said she believed her brother began using alcohol to cope with his emotions after his father died and he was separated from his children when he moved to Thunder Bay.

The inquest heard that he was diagnosed with diabetes in the 1990s and did not have a family doctor. He first experienced homelessness around 2011, his mother said, but kept in regular contact with his family.

His sister testified about how she and another sister drove around Thunder Bay searching for Mamakwa after they learned through the media that a man his age had died in police custody.

She eventually confirmed her brother had died after the sisters went to police headquarters and asked if he was the person who died in custody.

"I really hope that this never happens again, or if it does happen again make sure you notify the family before the media, because it hurts. It hurts just to find out ourselves," she said.

Sarah Jane McKay said she learned of her son’s death through a phone call from a doctor very early in the morning, asking her to come to "wherever he was at that time." She said she was “startled” and confused by the call, given the late hour and the fact that she was alone at home, and tried to explain that she could not immediately travel from the fly-in community.

Denise Tait, Roland McKay’s niece, testified that an aunt called her to help identify her uncle’s body. The loss of her uncle has deeply affected her family, she said.

"We’re a tight-knit family and I know that his sisters still grieve for him,” she said.

The inquest is a joint one because of similarities in the cases, Keen said.

Both men had been consuming alcohol, both interacted with EMS and police, both died in Thunder Bay police custody and had opportunities for survival that weren't met, the inquest heard.

Both were Indigenous and had a family connection, Keen added. He stressed to the jury the importance of setting aside bias and having an open mind when hearing evidence.

"Truth and reconciliation are fitting words for an inquest of this nature," said Keen.

Rachel Mamakwa told the inquest her family loved her brother and he deserved respect from police.

"He could have been alive today," she said. "I'm just really sad that he had to die alone in a very dark place."

This report by The Canadian Press was first published Oct. 11, 2022.