Foreign Affairs Committee on June 2nd, 2014

[The Chair, Conservative, Dean Allison]

Thank you very much. That's all the time we have for the first round.

We're going to move over to Ms. Brown, for seven minutes, please.

[Lois Brown, Conservative, Newmarket—Aurora, ON]

Thank you very much, Mr. Chair.

It's very good to have you here with us, Dr. Singer. We spoke last week at the MNCH conference.

Patricia, I also had a great chance to chat with you there, and it was great to have your interventions and participation in that.

I have fundamentally two questions, but I hope all of you can speak to them.

Maybe on the first one, Dr. Singer, I would like you to talk a little bit more about the other innovations to which you referred. I had the chance to see many of those last week, and they were tremendous innovations for saving and protecting children. It goes along with our integrated approach on vaccines and immunization and good nutrition.

There is another issue, and, Ms. Buchholz, this comes out of your comment that there needs to be accurate data on child domestic labourers. The whole issue of appropriate data is one of the fundamental things we need to have on civic registration so that we know who it is we want to protect.

I wonder if there is conversation among you as well as information for the committee on those two issues.

[Dr. Peter Singer]

Great. Thank you very much. I appreciate the opportunity.

Truly, one of the learnings was that the concrete examples of simple innovations that are low cost, and that have a big impact, really did resonate with the participants at the conference, and I think they resonated with Canadians.

My favourite scene happened when we were asked to show some of these innovations that are supported by Canada to the secretary-general and to the head of WHO. There were four of them that we took. My favourite picture shows this windup fetal heart monitor, which is like a windup radio. You don't need batteries. You can use it to monitor the state of the fetus during delivery. Dr. Chan, the director-general of WHO, took this out of the hand of the innovator and was sticking it against Ban Ki-moon's heart. There is a wonderful picture, that I tweeted, with Ban Ki-moon laughing and Dr. Chan poking him with this fetal heart monitor.

That's an example of one; it's an innovator at SickKids who is testing that electronic fetal heart monitor.

One of the other ones we had there was the Odon device, which is like a little balloon that goes over the head of the baby to help deliver the baby in the case of a delayed labour. This is a very interesting innovation. It was developed by an Argentinian car mechanic. You might have seen the story on the front page of The New York Times. He was looking at a YouTube video about how to take a wine cork out of a wine bottle. They did it with a balloon. He woke up at night and he said, “Oh, I have an app for that.”

We're very privileged to support it along with our partners; the Gates foundation, USAID, Norway, and the U.K. We supported a proof of concept through WHO and the proof of concept worked. Now, the large Fortune 500 company, Becton Dickinson, which has developed affordable innovations before, such as safety syringes, and put them in the developing world, has picked this up, has invested significantly more funds, and is carrying it forward.

It's a good example of sustainable innovation and public and private finance working together to get these innovations into the field.

In summary, I think I'll pause here to make sure we have enough time, but some examples of innovations, which was your question, include chlorhexidine, the lucky iron fish, the Odon device, and the fetal heart monitor. One of the favourites was iron-fortified tea. The person who did fortified salt is doing a proof of concept, through the saving lives at birth initiative, to try and put iron into tea.

There were a dozen of them. I won't mention them all, but those are four or five. They were very much the focus of everybody. Picture that photograph of Dr. Chan poking the secretary-general with the fetal heart monitor and you'll see the extent to which it was able to engage people. These are simple, affordable innovations with very good impact.

I think that is what is engaging Canadians. It is what engaged the participants at that wonderful summit that we both attended. It really showed Canada's leadership in women and children's health and in innovation.

[Lois Brown, Conservative, Newmarket—Aurora, ON]

Thank you.

Ms. Buchholz, could you talk a little bit about the registration initiatives and what needs to be done there?

[Christine Buchholz]

What do you mean by registration initiatives, specifically?

[Lois Brown, Conservative, Newmarket—Aurora, ON]

Well, I think one of the problems that we have globally is that there are many children who are born and who we have no information about. We have children who exist in many countries.... We really don't know the numbers or whether or not they're in school.

Can you talk about those initiatives? You talked about it specifically with registration, or the need for accurate data, with child domestic labourers in Haiti. Who needs to collect that data? What do we need to do? We can't manage what we don't know.

[Christine Buchholz]

Right. I think I can address that from a couple of different angles.

I previously mentioned that we have 72% of the children in our program passing national grade level exams. We have child advocates who have followed up with all of these children, ensured that they have birth certificates, and obtained the birth certificates in the situations where they don't have them. There are some national registry programs in Haiti. We needed that registration in order for the children to participate in the national level exams.

The study, that I mentioned, is a collaboration with UNICEF and ILO. For 10 months, they are going to be following 16,000 families. The last study, that I know of, that measured the prevalence of children in restavek, by community, was a Pan American Development Foundation study from 2009.

In terms of other forms of measuring impact, that's something that we are working on and not only with our programs. One of the attractive features of this serial radio drama program that we are doing in partnership with Population Media Center based in Vermont, in the U.S.... They have done a great job. Before they roll out programming in Latin America, or in Africa, they do a baseline study and measure attitudes toward issues. After they've run the programming, they check in with institutions that would be affected by this type of programming. They measure the shifts in attitude and the access to services that are then available on those topics.

[The Chair, Conservative, Dean Allison]

Thank you. That's all the time we have.

We're going to move to complete the first round to Mr. Garneau, for seven minutes, please.

[Marc Garneau, Liberal, Westmount—Ville-Marie, QC]

Thank you, Mr. Chair.

First of all, thank you to all four of you for being here and speaking about the work that you do, and informing us. Thank you for doing that work.

My questions are to seek a bit more clarification. I'll start with Ms. Buchholz.

When you talked about restavek, in the case of Haiti it sounded as though you were telling me that legislation is in place in Haiti to protect against child slavery and trafficking, but it's not enforced. It doesn't seem to be respected. Did I understand that correctly?

[Christine Buchholz]

Partially.

There is no comprehensive human trafficking legislation, so there is nothing that addresses all forms of trafficking specifically. However, there are some child labour laws in place, and those are not enforced.

[Marc Garneau, Liberal, Westmount—Ville-Marie, QC]

Okay, thank you.

Ms. Erb, you talked about the protection of children from violence. I think we can all relate to the need to do that.

You spoke at a fairly general level, and I'd like to better understand the work of Save the Children. I need a specific example, if you will. Choose any developing country where you work, and give me an example of how your work, your interface with the local population, is an example of how you're helping to reduce the incidence of violence.

[Patricia Erb]

I will choose two very quick examples.

One is in areas of emergency. When emergencies happen, children have specific protection needs. For example, with the Syrian conflict, the war, children arrive in the neighbouring countries. They are in camps or in communities that are receiving them, and their normal life has left. That new situation makes for many potential possibilities of violence, even in the case of girls' early marriage. It is something that parents maybe see as a good thing, so it happens more than it would happen normally.

Save the Children spends time doing registration of children in those situations. As Lois said before, what you don't know, what you don't see, you can't fix. It's very important to have the numbers and then create the programs through child-friendly spaces or through schools that protect. We have a lot of that type of work.

In the case, for example, of children who are involved in the sex trade, in Latin America, I'm thinking of a very strong example where Save the Children is working at the system level. There are programs for those particular girls and some boys who have gone into the sex trade, who we are working to try to get into more protective situations. We're also working with a community trying to.... There are studies, for example, on who the users are. If we can create a culture that has no tolerance for this, we can also ensure that we have a more preventive and systemic way of working at it.

So those would be two examples.

[Marc Garneau, Liberal, Westmount—Ville-Marie, QC]

Thank you.

Dr. Singer, you talked about saving brains. I'm a big subscriber to those first thousand days as well. Your focus was on things such as nutrition and getting vaccinated and nurturing. I couldn't help but think that some of that would apply in Canada as well, but we're talking about the developing world.

This is perhaps related a little to my colleague's question. You didn't talk about the cognitive side. Is it simply because there's enough of a challenge on the nutrition and the vaccine side? Or is that also something that is done? I know it's a lot in terms of an additional component, but I'd like to hear your thoughts on that.

[Dr. Peter Singer]

Thank you.

I think the best way to think about it is that you have risk factors and interventions, and then you have outcomes and results. There are many risk factors and interventions, but I like to boil it down into three categories: first, the biological stuff, which is nutrition, immunization, toxins, etc.; second, the cognitive stimulation, actually singing, playing, and reading to children, and also treating maternal depression, so the parent interacts with the child; and third, the conflict, abuse, and neglect.

Those are the three categories of the interventions and risk factors. I think we have to stay agnostic, because you'll get different risk factors in different jurisdictions. Being well nourished doesn't help, if you're a child soldier. One of the real niches of the saving brains initiative is that we are really the only global program that's agnostic to risk factors.

On the other side, you have the results. There you have the cognitive measure you referred to, which is mostly the child's ability to regulate herself, because it's a frontal lobe phenomenon. It's not purely intelligence, and that's why any of those risk factors, when you deal with them or when you protect a child's brain during that critical period, from the key risk factors that are operating, lead to better social soft skills in business, more self-regulation, which prevents criminality, and the evidence also shows that those risk factors lead to depression and non-communicable disease.

I think the fantastic thing, though, is that the very same simple innovations and interventions in those risk factors, that save lives during that critical period—that's the focus of Canada's leadership—also save brains. That's why I talk about it as the double dividend. We really simply need to account for that huge benefit. I think the effect of those risk factors is in the tens to hundreds of billions of dollars, actually, on the world economy. We simply don't have an accounting for it yet, but we're working on that at Grand Challenges Canada.

[The Chair, Conservative, Dean Allison]

Thank you very much.

That ends our first round, and we'll start a second round for five minutes each. I'll start with Ms. Grewal, please, for five minutes.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

Thank you, Mr. Chair.

My question goes to Dr. Singer.

Dr. Singer, one of the many problems facing young girls in developing countries is the threat of child marriages. They often result in early pregnancies with health complications, so in your opinion what is the most detrimental aspect of child marriage to a young girl's health, and what is the best way to intervene?

[Dr. Peter Singer]

That's a fantastic question, and here's another area where Canada has stepped forward, introducing the UN resolution on early and forced child marriage.

The most detrimental effect on a young girl is that she dies, and this is a tragedy. This is about young children being forced into marriage, becoming pregnant early, and having babies at such an early age that the body is not ready for it, simply the size of the pelvis. For example, the labour gets obstructed, there's no access to Caesarean section, and the girl and the baby die. To my way of thinking, there's no greater deprivation of human rights than the right to life.

To answer your question, then, that is the worst outcome of early, forced, child marriage, and it creates a cycle that really leads to the root cause of many of the maternal and some of the child deaths in the developing world. I heard some evidence that a significant minority of the maternal deaths can actually be attributed to young pregnancies, many of which are related to child marriage.

I think that was your first question. You had a second one.

[Nina Grewal, Conservative, Fleetwood—Port Kells, BC]

Yes, the second one.... Unfortunately, sexual exploitation of young girls is a problem in many developing countries, with trafficking and genital mutilation rampant throughout these countries. What solutions would you propose to help prevent these issues in young girls' lives?

[Dr. Peter Singer]

Obviously, one needs to move toward innovative solutions here. Just to take a concrete example, I'd like to point out that many of the innovations here are social innovations.

There's a group working in West Africa—initially on female genital mutilation, more recently on child development, and I think also on child marriage—called Tostan. They've come to realize that there are deeply rooted cultural issues here about all of the things we talked about. They engage community leaders. They get them to publicly renounce these practices and just change the local cultural norms. That itself is a form of social innovation, to take that particular approach.

Canada can actually stimulate ideas like that—I just used that concrete example—see which ones work best, and scale them. I also know that this is an area, again, where Save the Children, which is such a fantastic group, has a lot of experience. I'm sure our colleagues from Save the Children will have some great ideas about solutions as well.

I just want to highlight the role of innovation, the simple innovations, and we're blessed in Canada to have a group of 70 organizations working together right from the innovation and idea generation end through to the implementation and programming end. Save the Children would be a fantastic example and that's a real asset that we have.

If I may, I'd like to invite Patricia to also comment on the second part of your question because it's such a fantastic group and we work so closely together.

[Will Postma]

Maybe I'll just respond on behalf of Patricia. I'm right here with her—thanks, Peter and everyone.

Some of the best innovations are just working with local facilitators and local partners. We've seen this in, say, Burkina Faso, where we work with networks of bus drivers or truck drivers to spot children who may be at risk of trafficking outside of their countries and far from their communities.

In Somalia, in a recent project supported by the Government of Canada on early and forced child marriage, it was really critical to work with religious leaders, Islamic leaders, and as Peter was saying, have them publicly take stands against early and forced child marriage. That way we can work with them, and then when our project comes to an end, they will still be there to denounce this practice. But not just denounce it but also help girls find other choices that are going to be good for them.

Many of our innovations on the social side connect to the economic side, so that girls, as they grow up, also have economic choices. They learn market skills, they learn budgeting skills that will give them other choices, and they can discuss those with their families in the evenings, and come back to class the next day and learn more.

Some of these key innovations are right there in the community. Save the Children, in our work, has really learned to work with them and value how important those innovations are for the long term.

[The Chair, Conservative, Dean Allison]

Thank you. That's all the time we have.

Madame Laverdière, you have five minutes.

[Hélène Laverdière, NDP, Laurier—Sainte-Marie, QC]

Thank you very much, Mr. Chair.

Dr. Singer, you spoke about social innovation. As a sociologist, I always find this interesting. It reminds me of a story that happened in Senegal. We trained women who had been performing female genital mutilation so that they could become midwives. It was a way of giving those women a new profession. And it worked very well.

Thank you for the example that you gave.

For Save the Children, I'd like to have your views as well. We all know we're going toward the post-MDG; we're developing the post-MDG agenda. I'd like to know what you would like to see in the post-2015 agenda regarding children, and particularly, children in situations of conflict and/or violence against children, as well as children and girls' rights.

I know it's a very broad question, but if you would like to comment.

[Patricia Erb]

Yes, many organizations are happy with some of the achievements that we have had up to now with the MDG goals, particularly with maternal-infant results, but as we now position ourselves for the post-MDG, some issues are starting to become more important. One of them is the issue of poverty and the “hardest to reach”. So, on education or health, we've improved the numbers, but now the numbers that we have to improve fall in areas that are much harder to reach, so it has to be a more focused, and sometimes different, kind of approach because we won't be able to reach and change those numbers with the same methodologies that we're achieving right now. What we did maybe was good with a mainstream methodology, but now it might be more indigenous people, or it might be those who are, exactly as you said, affected by conflict, those who are suffering emergencies, who are not getting the benefits.

For us, the post-MDG agenda sees the issue of poverty and the issue of “hard to reach” as much more important ones for us to be able to achieve with the new numbers that we all are committing to achieve.

[Hélène Laverdière, NDP, Laurier—Sainte-Marie, QC]

Thank you.

During your presentation—and I'm just jumping from one issue to the other, but there is just so much to discuss—you talked about migration and trafficking in West Africa, and what some people saw as trafficking is now more described as migration. I think it's all a matter of understanding the context in which things happen, and sometimes when we look at it from here in Canada we don't always understand the context. Can you comment on that? Is it often your experience that you come with some views on some things, but once you see the context, that view may change?

[The Chair, Conservative, Dean Allison]

You have about a minute to do that, Mr. Postma.