Thursday, February 5, 2015

Support home care workers

While the Ontario government cuts hospitals and downloads care onto the community, and Community Care Access Centre CEOs give themselves hefty pay hikes, both have forced frontline health workers onto cold picket lines to fight a wage freeze.

Cutting and privatizing healthcare
For years the Ontario Liberals have cut healthcare and closed hospitals, including five planned hospital closures in Niagara. According to the Ontario Health Coalition, “For the last seven consecutive Ontario budgets, public hospitals have faced real dollar cuts to global budgets. Ontario now funds its hospitals at among the lowest rates in Canada.”

Health professionals who work at Community Care Access Centres (CCACs)—including registered nurses and nurse practioners, physiotherapists, occupational, respiratory and speech therapists, and social workers—provide essential care to patients recently discharged from hospital, those with chronic health problems, and those with end of life care. Ontario Nurses’ Association (ONA) president Linda Haslam-Stroud’s own parents depend on CCAC workers, and as she said, “It was only because of these care co-ordinators (that they could live at home).”

These services should allow people the flexibility and independence to access care from home, but governments are cynically using home care to justify cuts and privatization. As Natalie Mehra from the Ontario Health Coalition explained, “The story from the Ministry of Health has been that the cuts to hospital care and the downloading of ever more acute and complex hospital patients is not a cut—it is ‘transformation.’ This is utter nonsense. Not only is it a cut. It is the systematic dismantling of vital hospital services that are never replaced in home care. And it is the privatization of vital hospital services to private clinics that undermine single-tier Medicare.”

CCACs show what happens when you privatize healthcare. As Bob Hepburn outlined in the Toronto Star a year ago, “First, executive salaries at Community Care Access Centres, which govern home care in Ontario, have skyrocketed while low-paid workers who actually deliver services to patients haven’t seen their incomes rise in a decade — and in many cases have actually suffered significant drops. Second, the 14 CCACs are now using tax dollars meant for patient care to pay for lobbying firms that advise the CCACs on how to ‘sell’ their message to politicians at Queen’s Park. Third, barely 40 to 50 cents of every tax dollar earmarked for home care actually reaches the health-care professionals who deliver services to patients. Stunningly, the rest goes to executive salaries, rent, administrative costs, care coordination and corporate profits. Fourth, a reign of fear and intimidation imposed by CCAC bureaucrats has effectively shut up critics of the system, especially those employed by private companies that have contracts with CCACs to provide the workers who actually deliver services to patients.”

Downloading services into the home also transfers care to unpaid domestic labour, disproportionately affecting women. Now the CEOs who awarded themselves massive pay hikes are trying to impose yet another pay freeze on home care workers—also disproportionately women—while the Liberal government turns their back on patients.

Braving the cold against a wage freeze
But 3,000 members of the Ontario Nurses’ Association (ONA) have gone on strike at 9 of 14 CCACs across the province. After a two year pay freeze, all they are asking for is a 1.4% increase—the same as that received by the 57,000 registered nurses working in hospitals, long-term care and public health.

While home care workers are braving the cold against a wage freeze, the CEOs are basking in the sun—like Richard Joly, CEO of the North East CCAC, who gave himself a 48% pay hike (from $176,000 to $260,000), and according to ONA is currently on vacation in Mexico. As Haslam-Stroud said, "While we are there for you in your homes, schools and communities, the CEOs are continuing to award themselves hefty increases, in most cases, and jetting off to Mexico during a crisis in home care. The public should be angry and this government should be taking action."

Scabs don’t heal
Instead of respecting home care workers and paying them a fair raise, CCACs are putting patients at risk by using untrained replacement workers. As Haslam-Stroud explained, "Information has been received from inside the South West CCAC that accounting staff and HR are doing this work. It is totally inappropriate for our patients to have their wounds assessed by accounting and HR staff. The referrals for registered nurses to assess wounds should come from a doctor, the family members of home patients and long-term care facilities. The Ontario Ministry of Health and Long-Term Care should be taking immediate steps to address this unacceptable practice and get back to the negotiating table with a reasonable offer for our essential nurses and health care providers."

Meanwhile the Liberal government—who created this crisis in the first place by cutting hospitals and encouraging privatization—is pretending nothing’s wrong. Ontario Health Minister Eric Hoskins claimed that “CCACs have developed contingency plans and are working with all of their partners to ensure patients continue to receive the care they need." The mainstream media are dutifully playing along, with headline likeOntario health workers strike could cause hospital backlogs,” blaming the chronic hospital backlog created by government cuts on a few days of home care workers fighting back.

Patients above profits
We need to support home care workers as part of putting patients above profits. We need to reverse hospital cuts that are downloading services, and where there is a need for homecare it shouldn’t be contracted out to for-profit corporations but provided by nurses and personal support workers—who  are well paid for the vital services they provide. As Margaret Marcotte, a labour relations officer for ONA in Windsor, said on the picket line, “My appeal is this: call the CEOs of your CCAC, call your MPPs, call your local LHINs and demand they get back to the table and negotiate a fair deal.”

Join a picket line—for more information visit ONA.


Monday, January 26, 2015

Makayla, cancer and colonialism

The tragic death of Makayla Sault—who died of leukemia after stopping chemotherapy—has triggered a backlash. “First Nations parents can now doom their sick children,” warned the Toronto Star. “Dying, because her parents were likely weak and uninformed, possibly misled, and our institutions could not find the backbone to protect this child,” wrote an infuriated doctor in the Ottawa Citizen. “Just how aboriginal rights should matter to any of this in the first place is something that beggars belief,” exclaimed the National Post. What beggers belief is the way in which these remarks ignore and reinforce colonialism.

Cancer, colonialism and capitalism
Makayla died from cancer, an invasive and destructive disease that colonizes the body and extracts its life force without its consent. This is what Canada has done to Indigenous peoples. As Indigenous academic Leanne Betasamosake Simpson explained, “Colonialism and capitalism are based on extracting and assimilating. My land is seen as a resource. My relatives in the plant and animal worlds are seen as resources. My culture and knowledge is a resource. My body is a resource and my children are a resource because they are the potential to grow, maintain, and uphold the extraction-assimilation system. The act of extraction removes all of the relationships that give whatever is being extracted meaning. Extracting is taking. Actually, extracting is stealing—it is taking without consent, without thought, care or even knowledge of the impacts that extraction has on the other living things in that environment. That’s always been a part of colonialism and conquest. Colonialism has always extracted the indigenous—extraction of indigenous knowledge, indigenous women, indigenous peoples.”

As a consequence of living in a system that treats people and the planet as mere resources, regardless of the toxic consequences, we're in the midst of a cancer epidemicwith half of all people in Canada developing some form of cancer. This has been normalized (blamed on our genes or the natural aging process) or blamed on individual "lifestyle choices" like smoking. But much of the cancer epidemic is rooted in the economy that contaminates the earth, water, air and food on which we depend. The pollution of Indigenous territory from the tar sands has led to high cancer rates in Fort Chipewyan, and the carcinogenic economy also affects those on whose labour it depends. 

As the Unifor Prevent Cancer Campaign explains, "Workers in certain carcinogenic-laden industries are contracting cancer at rates well beyond those experienced by the general population. At last 60 different occupations have been identified as posing an increased cancer risk. Studies show that the auto industry is producing laryngeal, stomach and colorectal cancers along with its cars. The steel industry is producing lung cancer along with its metal products. Miners experience respiratory cancers at rates many times higher than the expected levels in the general population. Electrical workers are suffering increased rates of brain cancer and leukaemia. Aluminum smelter workers are contracting bladder cancer. Dry cleaners have a elevated rates of digestif tract cancers. Firefighters contract brain and blood-related cancers at many times the expected levels. Women in the plastics and rubber industry are at greater risk of uterine and possibly breast cancer. The list goes on...Why do we hear so much about the dangers of tobacco but so little about the other 23 lung carcinogens? The reason is that tobacco is claimed to be a 'lifestyle' choice, so industry and the medical profession can blame the victims. The other 23 known causes of lung cancer are related to industry. They can be prevented and removed from our workplaces and our environment."

Colonial medicine
Colonization has included medical arguments and institutions. As the physician and philosopher Frantz Fanon wrote in A Dying Colonialism, “The fact is that the colonization, having been built on military conquest and the police system, sought a justification for its existence and the legitimization of its persistence in its works. Reduced, in the name of truth and reason, to saying ‘yes’ to certain innovations of the occupier, the colonized perceived that he thus became the prisoner of the entire system, and that the French medical service in Algeria could not be separated from French colonialism in Algeria.” The same is true in Canada. As Laurie Meijer Drees writes in Healing Stories: Stories from Canada’s Indian Hospitals, “As early as 1914, sections of the Indian Act allowed the government to apprehend patients by force if they did not seek medical treatment.” This forced treatment denied traditional medicine and included segregated facilities (“Indian hospitals”) that medically experimented on Indigenous people. The same happened in residential schools that stole Indigenous children from their communities—a practice that continues today through other means.

The denial of traditional knowledge included imposing a highly restricted view of healthcare (“Western medicine”) that reduces health to an isolated individual and pharmaceutical intervention—ignoring social, economic, environmental and cultural factors that determine health and the accessibility and effectiveness of pharmaceuticals. There’s nothing inherently Western about this biological reductionism. In his 1845 work Conditions of the Working Class in England, Friedrich Engels outlined a social model of health, and called diseases “the necessary consequence of the present neglect and oppression of the poorer classes.” But a biological reductionist view came to dominate capitalist healthcare—undermining the potential of its own treatments, by ignoring broader factors that shape people’s susceptibility to illness and their potential to access and benefit from medication. Profit-driven pharmaceutical corporations dominate healthcare, creating skepticism and reinforcing a market in equally profit-driven “alternative” medicine like the Florida clinic that treated Makayla.

Right to refuse, and right to access
Given the legacy of colonialism it’s not surprising there might be suspicion towards hospital treatment—especially when accompanied by threats of apprehension, in order to enforce such a difficult regimen as chemotherapy (despite its effectiveness in treating leukemia). We might disagree with the choice to stop chemotherapy, though Makayla did brave it for nearly three months before stopping it (contrary to media headlines that she simply refused it). But as the courts found, “(Makayla’s mother’s) decision to pursue traditional medicine for her daughter is her aboriginal right. Further, such a right cannot be qualified as a right only if it is proven to work by employing the western medical paradigm. To do so would be to leave open the opportunity to perpetually erode aboriginal rights.”

Despite media claims, “Indigenous rights vs Western medicine” is a false dichotomy. While Makayla died after stopping treatment, there are far more Indigenous people who die from being denied access to treatment and prevention—and this sparks far less fury from the mainstream media. “Racism can doom sick patients,” could have been the headline after Brian Sinclair died in a Winnipeg ER, denied treatment for 34 hours. “Our institutions could not find the backbone to protect this community,” could be written about the Ontario government’s refusal to support the community of Grassy Narrows against mercury poisoning. “Cancer rates in Fort Chipewyan beggar belief,” should be included in every discussion of the tar sands.

If we’re concerned about private clinics profiting from dubious claims and treatments, then the response should not be to blame Indigenous families who chose that option. Instead we need to strengthen public healthcare, including creating a national pharmacare program and stopping Harper’s $36 billion cut to health care (and the federal government's denial of chemotherapy to refugees).

Decolonizing medicine
Thanks to Indigenous sovereignty and solidarity movements there are growing attempts to decolonize medicine. As Brantford physician Chris Keefer wrote last spring in the Two Row Times, “By behaving in a manner consistent with a colonial master’s mentality, McMaster Children’s Hospital and members of the medical team have very unfortunately created a lack of trust and a break in the therapeutic bond between the medical team and the family. Threats of apprehension of Onkwehon:we children, the dis-respect of elders in family meetings, and denigrating remarks about traditional medicines have no place in a respectful two row relationship. Such actions, comments and behaviours extinguish the opportunity to build trust with the family, trust that is necessary to encourage the family to pursue a very difficult two year treatment plan marked by severe and even life threatening side effects. As a medical doctor trained within Canadian society with no experience of traditional Onkwehon:we medicines, I am not sure that the family is making the right choice by refusing chemotherapy. However it is not my right as a member of Canadian society to impose my will upon Onkwehon:we people.”

The Canadian Medical Association Journal has taken the same progressive approach. In their article “Caring for Aboriginal patients requires trust and respect, not courtrooms,” Lisa Richardson of the UofT Office of Indigenous Medical Education and magazine deputy editor Matthew Stanbrook write: “Media coverage has fueled a narrative of polarized paradigms that is unhelpful and misleading, implying false choices. Medical science poses no inherent conflict with Aboriginal ways of thinking. Medical science is not specific to a single culture, but is shared by Aboriginal and non-Aboriginal people alike. Most Aboriginal people seek care from health professionals—but nearly half also use traditional medicines. Aboriginal healing traditions are deeply valued ancestral practices that emphasize plant-based medicines, culture and ceremony, multiple dimensions of health (physical, mental, emotional and spiritual), and relationships between healer, patient, community and environment. These beliefs create expectations that Aboriginal patients bring to their health encounters; these must be respected. Doing so is not political correctness—it is patient-centered care…For the state to remove a child from her parents and enforce medical treatment would pose serious, possibly lifelong, repercussions for any family, but such action holds a unique horror for Aboriginal people given the legacy of residential schools. To make medical treatment acceptable to our Aboriginal patients, the health care system must earn their trust by delivering respect.”

At the same time we can learn from Indigenous teachings to broaden our conception of health and healthcare. As the National Aboriginal Health Organization explains, health indicators include not only individual lifestyle behaviours like smoking and physical activity, but also health knowledge, personal resources, health services (both access to physicians and Aboriginal representation in health professions), physical environment, and social and economic environment. Rather than blaming a family for their tragedy, we should be collectively working to improve these determinants of health, so that we can treat and prevent cancer and replace the cancerous system driving it with one that respects people and the planet. As the Six Nations of the Grand River and the Mississaugas of the New Credit explained “We sincerely hope that this decision is part of an emerging era of healing and reconciliation between Canada and our nations. We hope that our children and generations to come will no longer experience the mistrust, misunderstanding, and mistreatment by the Canadian government that have been our daily reality for over 200 years.”

Friday, January 9, 2015

10 crimes of John A Macdonald

Rather than a celebration of the “father of Confederation,” the 200th birthday of John A Macdonald on January 11 provides an opportunity to remember the history of Canada’s first Crime Minister—and the ongoing movements undoing his legacy.

On January 11 there will be state-sponsored glorifications of John A Macdonald across Canada, but also Indigenous-led teach-ins about his real legacy. Wilfred Laurier said that “the life of Sir John A Macdonald…is the history of Canada,” and it’s true: John A Macdonald shows us that Canada is built on colonialism and oppression, driven by capitalist expansion, and armed with state violence.

Obviously he was not singularly responsible for these policies, many of which began before or continued after him. But as Prime Minister for nearly two decades (1867-73 and 1878-91) he presided over these policies. His defenders, like biographer Richard Gwyn, claim that “to describe Macdonald as ‘a racist’ is pure, and smug, ‘presentism,’ or the judging of the past by the standards of the present.” But this assumes the past was universally reactionary and the present universally progressive—which ignores the resistance to his policies at the time, and ongoing movements against his continued legacy.

1. Founded Canada on stolen land
John A Macdonald is called the “father of Confederation” for signing the British North America Act of 1867 that created Canada. But this “accomplishment” created a colonial settler state built on the colonial oppression of Indigenous peoples, and the national oppression of the Québecois. Two years later Macdonald bought “Rupert’s Land,” nearly a quarter of the continent, from the Hudson’s Bay Company, without consultation of its population. As Macdonald admitted, “All these poor people know is that Canada has bought the country from the Hudson's Bay Company and that they are handed over like a flock of sheep to us.” But the history of Canada is also the history of resistance, from the 1869 and 1885 rebellions during Macdonald time, to Idle No More today.

2. Criminalized abortion
Canada imported British anti-abortion laws under Macdonald  who claimed that abortion “saps the very life blood of the nation.” This law lasted a century, sapping the very life of thousands of women. The law was liberalized in 1969 but it took a mass movement to defeat it in 1988, a movement that continues.

3. Criminalized homosexuality
Canada also imported British laws against homosexuality—which was punishable by death during Macdonald's first two years in office. Though this was dropped, the homophobic persecution continued. As his justice minister said in 1890, explaining an amendment to the Criminal Code,”The third section of the Bill contains a penalty for gross acts of immorality committed in reference to a male person…The maximum penalty of two years imprisonment is, I think, entirely inadequate.” The criminalization of homosexuality also lasted a century, and it was a mass movement—from Stonewall in the US, to protests against the Bathhouse raids in Toronto—that launched the gay liberation movement.

4. Used of starvation as a weapon
As a tactic of colonial expansion, Macdonald used starvation as a weapon against Indigenous peoples. As James Dascuk documented in Clearing the Plains: Politics, Starvation, and the Loss of Aboriginal Life, “For years, government officials withheld food from aboriginal people until they moved to their appointed reserves, forcing them to trade freedom for rations. Once on reserves, food placed in ration houses was withheld for so long that much of it rotted while the people it was intended to feed fell into a decades-long cycle of malnutrition, suppressed immunity and sickness from tuberculosis and other diseases. Thousands died.”

This tactic continues, as Mi’kmaq lawyer and activist Pamela Palmater explained: “Can you think of any Prime Minister, President or World Leader that would withhold food, water, or health care as a bullying tactic to force its citizens into compliance with a new government law, policy or scheme? Can you ever imagine this happening in Canada? I don't think most of us could.
Yet, this is exactly what is happening with Harper's implementation of the illegal C-27. Minister of Aboriginal Affairs Bernard Valcourt has threatened to cut off funds for food, water and health care if First Nations do not get in line and abide by this new legislationdespite the fact that it was imposed without legal consultation and is now being legally challenged. How many First Nations children will have to die for Harper to sit down and work this out with First Nations?”

5. Created a repressive police
In response to the Red River Resistance of 1869, Macdonald sent a military force, saying “These impulsive half breeds have got spoilt by their émeute, and must be kept down by a strong hand until they are swamped by the influx of settlers.” Macdonald institutionalized this repressive force in 1873 with the creation of the North West Mounted Police—the precursor of the RCMP—that crushed the North West Rebellion of 1885. As Métis academic and activist Howard Adams wrote in his 1975 work Prison of Grass: Canada from a Native Point of View, “According to popular explanation, the Mounted Police force was established to prevent whiskey traders from buying Indian furs, which the Hudson’s Bay Company claimed as its exclusive right. However, it is not just a coincidence that the Mounted Police were established during the development of Indian reserves to ensure the ‘success’ of he treaty negotiations with the Indians and ‘help’ relocate Indians and halfbreeds to their reserves and colonies…The Indians, who had lived in the area for thousands of years without police, saw no reason for the establishment of a force in the Northwest since there was no serious disorder or lawlessness in the country. To the native people, this military force was similar to the federal troops who had invaded Fort Garry in 1870. The Mounties were not ambassadors of goodwill or uniformed men sent to protect Indians; they were the colonizer’s occupational forces and hence the oppressors of Indians and Métis.”

These policies continue—from the disregard for missing and murdered Indigenous women, to the criminalization of dissent. As Indigenous activist Clayton Thomas-Muller explained to APTN regarding the RCMP’s surveillance of him and others: “We are challenging the most powerful corporate entities on the planet. What we have on our side is endless human resources. We have the power of our ancestors and traditions fueling us. We are intimately aware of the domestic surveillance that is happening as well as the agenda to criminalize Indigenous dissent.”

6. Expanded capitalism
Macdonald is called a “nation builder” for extending the railroad across the country. But this was intertwined with waging war on the existing Indigenous nations—using the starvation to clear the path for the railroad, and using the railroad to transport the police to crush the 1885 rebellion. The expansion of the railroad itself killed hundreds of workers—primarily Chinese migrant workers—as part of expanding capitalist industry across the country. While the 1872 Toronto strike and the movement for the 9-hour workday pushed Macdonald to pass the Trade Union Act legalizing unions, he followed this with a law criminalizing picketing. Right from its inception, Canadian capitalism exploited workers and fuelled corruption—and Macdonald had to resign in 1873 when the Pacific Scandal exposed his receipt of campaign donations from the owner of the Canadian Pacific Railway. Today the nationalism of “nation building” is used to justify expanding tar sands pipelines across the country—which also undermine Indigenous sovereignty, waste resources on harmful work instead of good green jobs, and rely on complicity between corporations and their government regulators like the National Energy Board.

7. Promoted residential schools
Resuming his role as Prime Minister in 1878, Macdonald continued colonial oppression, expanding residential schools. As he said in 1879: “When the school is on the reserve, the child lives with its parents, who are savages, and though he may learn to read and write, his habits and training mode of thought are Indian. He is simply a savage who can read and write. It has been strongly impressed upon myself, as head of the Department, that Indian children should be withdrawn as much as possible from the parental influence, and the only way to do that would be to put them in central training industrial schools where they will acquire the habits and modes of thought of white men.” Residential schools were Canadian concentration camps, and included torture and medical experiments.

While Harper apologized for residential schools in 2008, his government has blocked the release of documents to the Truth and Reconciliation Commission, while continuing to remove Indigenous children from their communities through underfunding. According to Cindy Blackstock, member of the Gitksan Nation and executive director of the First Nations Child and Family Caring Society of Canada, “The number of First Nations children in care outside their homes today is three times the number of children in residential schools at the height of their operation.”

8. Outlawed the potlatch
Calling for “an iron hand on the shoulders” of Indigenous peoples, Macdonald outlawed the potlatch—because in his words, “It is not possible that Indians can acquire property or can become industrious with any good result while under the influence of this mania.” As the amendment to the Indian Act in 1884 stated, “Every Indian or other person who engages in or assists in celebrating the Indian festival known as the ‘Potlatch’ or in the Indian dance known as the ‘Tamanawas’ is guilty of a misdemeanor, and liable to imprisonment for a term of not more than six nor less than two months in any gaol or other place of confinement; and every Indian or persons who encourages… an Indian to get up such a festival… shall be liable to the same punishment.” But Macdonald failed to extinguish Indigenous traditions and ceremonies, as can be seen from ongoing Indigenous sovereignty movements. 

9. Imposed a racist head tax
Macdonald extended his racism to anyone who did not represent “the Aryan race and Aryan principles.” In compensation for Chinese migrant workers dying to build the railway he’s credited with, MacDonald imposed a head tax and attacked their right to vote. As he said in 1885, “When the Chinaman comes here he intends to return to his own country; he does not bring his family with him; he is a stranger, a sojourner in a strange land, for his own purposes for a while; he has no common interest with us…has no British instincts or British feelings or aspirations, and therefore ought not to have a vote.” (While Macdonald was in office the vote was also denied to Indigenous people, women, people with disabilities, and men without property.) The migrant justice movement continues to challenge modern day head taxes—from the Temporary Foreign Workers Program, to the cuts to refugee health.

10. Executed dissidents
Not content with crushing the 1885 rebellion, Macdonald wanted to make an example of its leaders. He transferred the Métis leader Louis Riel from Winnipeg to Regina to ensure a white Anglophone jury, used the ancient British high treason law that carried the death penalty, and refused to consider a flood of petitions in support of Riel. As Macdonald said, “He shall hang, though every dog in Quebec shall bark in his favour.”  Macdonald also incarcerated Cree Chief Poundmaker, and used a mass execution of Cree warriors as a public spectacle. As Daniel PaulMi'kmaq author of We Were Not the Savageswrote, this was “the largest mass execution in Canadian history. The First Nations People abiding around the area, living in various states of starvation and malnutrition, were forced to watch the executions. The following is what the Father of Confederation had to say about it: 20th of November, 1885: In a letter to the commissioner of the Indian Affairs: ‘The executions of the Indians ought to convince the Red Man that the White Man governs.’”


January 11 is a day to remember Canada’s first Crime Minister, to celebrate the struggles that resisted his policies, and to keep building movements challenging his legacy.