Status of Women Committee on May 5th, 2010

[Dr. Sharon Camp]

I think we need to focus on where there is agreement. Family planning is not controversial. Although I would love to see leadership from Canada on the issue of reproductive rights and access to safe abortion, certainly we can agree that behind every abortion is an unintended pregnancy. We can prevent those. While we will never completely reduce the need for abortion, we can bring it down very substantially if we meet women's need for modern contraception.

I continue to be embarrassed that my own country, the United States, does not in fact, even under our new government, provide support for safe abortion services. But I'm happy to say that most of the European donors, who are involved in this maternal mortality initiative, do support access to safe abortion. The British are very committed to it. The Danish government has made it the focus of their health programs this year. The Norwegians, the Swedes, virtually all of those who have been in the forefront of the leadership on maternal mortality have also supported access to safe abortion as one piece of the effort to reduce maternal deaths. But let's concentrate on where there is agreement, which is about family planning.

[The Chair, Liberal, Hedy Fry]

Excuse me, I'm going to have to ask that you shorten your answers, please, because we have now gone overtime on this. However, I will give Ms. McDonald an opportunity to say something, and Ms. McTeer. But please be as brief as you can. We've gone well over the time limit.

[Katherine McDonald]

Okay. I'll try to be as brief as possible.

I would echo my colleagues, but I would also talk again about the Maputo plan of action. Here is a card setting out the key elements of it. They say the key elements of sexual and reproductive health are adolescent sexual and reproductive health, maternal health and newborn care, abortion and post-abortion care, family planning, and sexually transmitted infections, including HIV/AIDS.

So that's what Africa is asking the world to support. This is what they want, and I think we have a responsibility of privileged people in the global north of providing aid in accordance with the needs, desires, wants, and expectations of African leaders.

[The Chair, Liberal, Hedy Fry]

Ms. McTeer.

[Maureen McTeer]

I am going to say two things, very quickly. I think that Canada historically has demonstrated leadership in the area of women's equality, women's rights and the health of women. This is a position that was established and developed and cultivated over a number of years. If this really marks the beginning of a change in our priorities with regard to international development, we need a public debate. We cannot just sweep everything away, off the table with one swift movement. We have to mandate a commission of inquiry or have this question put before Parliament. Before we reject everything we have to know why we are doing it and ensure that this is what we want to do. And you are the ones, parliamentarians, who have this responsibility.

Once again, if we are just going to reject in one fell swoop the principles of equality, our promises and our legal responsibility regarding women's equality and the rights of women, we cannot accept that this be done from one day to the next because it happens to be what one individual wishes or one government wishes.

These are principles Canada has always been proud of and for which we have been recognized internationally. We have to protect them, promote them and implement them. I completely agree with Sharon on the fact that it is absolutely essential that we move forward. We cannot slip back. We are women, and there are men also who have wives, partners, daughters, mothers, etc. We are talking about their lives; we have to move forward. We could talk about this indefinitely, but we absolutely have to accept the fact that we have the moral responsibility to move forward with this.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

We now move to Ms. Brown. Are you both sharing?

Ms. Brown first and then Ms. McLeod, from the Conservatives.

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

Thank you very much, and thank you to our witnesses for being here. I certainly enjoyed your presentations.

Ms. Camp, you made a comment in one of your last answers that I think we need to focus on, and that is the areas of agreement. I think that is very important for this discussion because we are talking about women's lives. I've been to Bangladesh, I've been to Africa, I've seen the circumstances, and I understand that we are talking about some catastrophic conditions that women are living in. I have a heart of compassion when I see these women and children and the beggar babies that are on the streets of Bangladesh. It is heart wrenching for everyone.

I think what we are seeing here is that Canada is taking a leadership role. We are recognized on the international stage, first of all for the security and safety of our financial institutions, and that has given Canada credibility in many, many other areas. We are able to take a stand, and stand proud. I am proud to be a Canadian and to know that we are being recognized for these things in the world. I think this has given us the opportunity to take leadership in other areas.

Demonstrating leadership on this maternal and child health has been one that you know of. The MDG goals have had the least attention. Nobody wanted to touch it. No money or little money was put toward it, so at a time when many other countries are cutting back on their foreign aid, Canada has actually increased our budget. Half a billion dollars is going forward in foreign aid. I think that is substantial when we see what is going on around the world. We've chosen a basket of initiatives in which we know that Canada has expertise.

I read from the millennium development goals put out by UNICEF, where it says “Access to skilled care during pregnancy, childbirth and the first month after delivery is key to solving these women's problems--and those of their children.” That's talking from...you know, the majority of deaths and disabilities are preventable, being mainly due to insufficient care during pregnancy and delivery.

Then I was doing some research on the World Health Organization's report. According to the World Health Organization, trained skilled attendants who are able to prevent, detect, and manage obstetric complications as well as provide equipment, drugs, and other supplies, are the single most important factor in preventing maternal deaths. So where Canada has made the decision to put this money into a basket of initiatives, like the EU has done, and saying we are really good at providing clean water and sanitation, those are the areas where we feel we are going to do some real good in the world and have real impact.

I've probably used up my time. I should turn the questions over to Ms. McLeod.

[The Chair, Liberal, Hedy Fry]

Well, there are only four minutes left, so if you expect answers, Ms. McLeod and Ms. Brown, you'd better make sure you get your questions in as quickly as possible.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

First of all, I really appreciate the comments around ultimately needing a comprehensive primary care system. I think that's absolutely critical.

What I really want is an on-the-ground perspective. We talk about emergency obstetrical services being important; how do the 68 countries we're looking at distribute emergency obstetrical services? Are they hundreds of miles away from the majority of the population? Can anyone comment on that? It's probably a very complicated question.

[Maureen McTeer]

It depends on the country. We sometimes forget that one of the reasons we can play a leadership role is that we share similar geographies with many of these countries. Some of the technologies we've developed in telemedicine are an example, and how we deal with rural communities or northern communities provides valuable lessons on how we can contribute as well.

Your question is very well taken, because in addition to that, there's very little infrastructure in terms of roads. One of the realities is that you need to have skilled attendants in the community, because they can then make a decision that this person is going to have trouble with her delivery, and if there is no facility in the village or the town, where most of the women will be, she will have to go away. That, in and of itself, is okay, except that if you have to pay when you get there, and you have to be buried in your village, you're not going to go, if in fact you have to pay.

When we talk of being integrated and putting everything together, it's because the issues are so large, but we know how to deal with them at the local level. Maybe you can enlighten us from your own personal experience, but I really do think it's absolutely essential to realize that each country is different. Some countries use the lakes as a method of transportation, or women will be on the backs of bicycles for 30 miles, in labour, trying to get somewhere. It's a bit late then.

Why don't they go earlier? Perhaps it's because they have no money or perhaps they have no one to babysit their kids. Perhaps their husband says “No, you're not allowed to leave the village”, or “I'm not going to pay”, or “I'm not going to get rid of my best cow”, or “I'll marry somebody else”.

These are all elements of their decision-making. That's why an integrated approach, as opposed to a one-off, is so important.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I hope to get one--

[The Chair, Liberal, Hedy Fry]

Mr. Fox indicated that he wanted to answer your question as well.

[Robert Fox]

I want to emphasize that in many cases we're really talking about midwives. In my personal experience, I was outnumbered 40 to one by health professionals at the birth of my son. Our vision of what birth entails tends to be a little more high-end or high-tech than what we're talking about here.

I draw your attention to one of the charts in the documentation we have. It shows that Niger has a handful of midwives and 14,000 women who are dying every year in childbirth; Sri Lanka has 10,000 midwives and a handful of women who are dying every year. These aren't high-tech solutions; these are integrated, low-scale, and highly labour-intensive solutions, in many cases, but those are the investments that have a huge impact. That's why we want to ensure that the money we're putting into health care systems goes to health care services and not to the accountants following the money trail.

[The Chair, Liberal, Hedy Fry]

Thank you.

That's seven minutes. I'm sorry, Cathy.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Excuse me. How many minutes did the Bloc have earlier?

[The Chair, Liberal, Hedy Fry]

Actually, I allowed the witnesses to answer. That was the thing. I didn't allow Madame Deschamps to come up with another question. She only asked the one.

I sometimes want to let the witnesses finish their answers. I allowed Ms. McTeer and Mr. Fox, and they went over the time. To allow you to ask another question would not be appropriate, because I didn't let anybody else ask a question.

Thank you. I think we'll go to a third round. We move to Ms. Mathyssen for the NDP.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

Thank you, Madam Chair.

Thank you very much for your testimony. You've added a great deal in terms of scope and depth to this study, and I appreciate it very much.

I want to start with Ms. McDonald, although certainly, please, if you have something to add....

I'm quite fascinated by the Maputo plan of action because one of the things we very often hear is that women have absolutely no control over what happens to them in terms of their reproduction. In some instances, in some countries, they can't determine when or with whom they will have sexual relations, and some of them are very young. The fact that all African nations indicated that abortion was allowed in some circumstances I think suggests that there's some progress or some understanding being made here. I just wondered, in what situations would abortion be allowed. Would it be rape, the mother's life in danger, etc.?

It also seems to me that unless somebody is there on the ground monitoring every single case, if a woman simply needed to have an abortion because there were too many babies to feed, who is going to be there saying, no, you can't have this service?

[Katherine McDonald]

Certainly I did a quick look at the grounds on which abortion is legal in Africa, and in light of the Maputo plan of action. In all countries of Africa, abortion is available to save the life of the woman. In about three-quarters of those countries, it's available to preserve the health of the woman. In about more like half to 60% of the countries, it's available in the case of incest, and it's very similar in the case of rape. Even in some cases it's available for social and economic reasons, and in some cases in the case of fetal impairment or abnormality.

Also, there's another very interesting statistic I actually read in an article by Don Martin, in one of his columns. The WHO shows that despite the fact that abortion is legal in each of those countries, only five out of every 100 abortions in Africa is carried out under safe conditions. We're talking about the inability of those nations, despite the political will at the top, to put in place the infrastructure to provide safe abortions. So we're talking about a real problem.

Related to this, if we are to restrict abortion from Canadian aid policies, we have to remember that in most of those countries where women get sexual and reproductive health care, there's only a one-stop shop. There is only place where they get it, and that is, generally speaking, a family planning clinic. If abortion is legal, contraception fails, and they go back to find our what their options are with respect to possible termination of that pregnancy, the practical issue arises of what do they do if that clinic is receiving Canadian aid? Do they say, no, we have to turn you away because we've got Canadian aid pooled in our funding, or is it a situation where Canadian aid won't be available to that clinic at all? So in fact funding for reproductive health with reduce. That will exacerbate this situation where you only--

[The Chair, Liberal, Hedy Fry]

Excuse me, Ms. McDonald. I would like to ask the responders to please try to be as succinct as you can. Thank you. We've now used up four and a half minutes of Ms. Mathyssen's time.

[Irene Mathyssen, NDP, London—Fanshawe, ON]

It's like holding these people and these clinics at ransom by saying, no, our money isn't going to go for this procedure.

I'm tired of dancing. We've heard the government say they're putting in all this extra money in terms of aid, yet the reality is we promised 0.7% and we're somewhere in the range of 0.32%. Is it time for Canada to just say that we're going to live up to our obligations, we're going to show leadership, we are the host of the G-8 and G-20, and we're going to do 0.7%?

[Katherine McDonald]

Yes.

[Robert Fox]

Certainly it is disappointing that the government has indicated there will be a cap on further increases in aid in future years, because this again speaks to our credibility as host this year. We are far from 0.7%, and we've already indicated we will be making further savings into the future by capping our commitment, at a time in fact when a significant increase is warranted.

[The Chair, Liberal, Hedy Fry]

Thank you.

Ms. McTeer, Ms. Camp, do you have anything to add?

[Dr. Sharon Camp]

I have nothing to add on that last question.

[The Chair, Liberal, Hedy Fry]

All right.

You have one minute.