Status of Women Committee on May 10th, 2010

[Bridget Lynch]

Yes.

You asked how we can achieve MDG 5 with this as an issue. We have to be very careful here. There are women who don't have access to basic maternal, newborn, and sexual reproductive health care, and in Canada we risk having this discussion turn completely to one of abortion.

We have to be careful that we don't get sidelined into this trap. We have to be very strategic as women. We need essential health care delivered at the household and community levels so that women and their newborns and children are not dying. The discussion on abortion needs to happen as well, but we can't forsake one for the other.

[The Vice-Chair, Conservative, Cathy McLeod]

Thank you.

Ms. Brown is next, please.

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

Thank you very much, Madam Chair.

I think it's very important that we set the record straight here and say that there are many places where abortion is illegal. The Republic of Congo is one of those countries. Canada must respect the sovereignty of these nations, and if other discussions need to go on, that's for another debate.

Canada has chosen to take a leadership position on the issue of child and mother health because we know that as a millennium development goal it has received the least recognition and the least amount of money has been put toward it. So Canada is taking a leadership role on this. It's a very complex and difficult issue, but we know that we have services, we have expertise, and we can make a difference.

I want to refer you to an article that was in today's Globe and Mail. I understand that Bob Geldof and Bono were given the opportunity to be editors-in-chief for a day, given their long interest in Africa, which I think is quite remarkable, and they're outlining some of the things that are really changing in Africa. They talk about a growing middle class. “Africans are subscribing to mobile phones at an astounding pace, an increase from 54 million to 350 million, or 550 per cent”, and it goes on to say afterwards that this alone is changing how Africa is responding to different areas. It talks about merchants and farmers texting to find out latest market prices. It talks about “Africans can now find out when a medical professional might be available, saving an hours-long walk to town.” So we're seeing some considerable differences.

I pose my question to Ms. Lynch, if I may.

I happened to spend some time last year in Bangladesh. I was introduced there to women in the villages. Sasthya Sabika is the term they use for them, but essentially it's the women who were being given the basic training to become midwives and to give basic medical care. You talked about the need for 350,000 more midwives internationally, I think.

What do we need to do to encourage young people to engage in this? Are there opportunities for men in this field? Do we call them mid-husbands? I don't know. What recommendations can you or your association make to the Canadian government to ensure that we put the incentives forward for young people to choose this as a profession?

I know that for years Canadian women used to have to go overseas to get their midwifery licences, particularly to Scotland, I think, where there was a very excellent course. But how do we create exposure for this profession, and encourage that, because we know Canada has expertise in this area?

[Bridget Lynch]

We do thank you for your question. It's a very important question: how do we move forward?

As we speak today, there's no global standard for midwifery education. What this means is that various countries have invented programs to educate midwives. The International Confederation of Midwives, along with the World Health Organization, as we speak, has a global task force that is developing an international standard for midwifery education for governments to use as reference points for educating midwives. This will allow governments to also create a career path for midwifery. In too many countries midwives have an 18-month training period, a two-year training period, and there's no opportunity to complete an undergraduate degree program and go on into master's, post-graduate work, etc., to get into policy development and research.

Upholding and supporting the development of education programs as a way to build a midwifery workforce globally is one of the most fundamental and essential pieces of work that Canada can contribute to in terms of its actual contribution to workforce development. The other is to help countries develop regulations and standards of practice for not only midwives... In many countries, such as Haiti, there are no regulations and standards of practice for any health care profession in that country.

In terms of Bangladesh, I was there as well. When you have the community health workers who are being trained to attend normal childbirth, they must be supervised and trained by a cadre of midwives. That cadre is missing right now, so the countries are developing tens of thousands of community health workers, doing normal birth, but they're not paying attention to who is supervising and training them over the long term.

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

Is that expertise Canada can assist with?

[Bridget Lynch]

Absolutely.

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

Do we have people at that level who could create the education and the curriculum?

[Bridget Lynch]

The Canadian midwifery education program is being used as one of the stellar models for midwifery education globally.

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

You talked earlier about the continuum of care they provide. You're talking about helping them learn about nutrition and clean water--that was one of the problems we observed in Bangladesh.

[Bridget Lynch]

Yes. Midwives work from the household through to the hospital setting. So that's the most vulnerable service delivery area. That's where the midwifery competencies really have the highest advantage in providing antenatal care, intrapartum care, making sure women have clean water, making sure there's good nutrition, and getting involved at that community health level. That's where midwifery services work.

What we want is that a midwife is a midwife is a midwife. Whether they're male or female—and there are many countries that have male midwives—in Bangladesh, Argentina, or Canada, we need to have a global understanding that they've been educated to the same level, that they are regulated, and that they have standards of practice at the same level.

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

If I have time, Madam Chair, could I just pose a question to Ms. Fontaine?

You spoke about breastfeeding and encouraging women to breastfeed because it is the most appropriate way to nurture a child. However, one of my observations when I was in Bangladesh was that three, four, and five crops were being taken off the same piece of land without any nutrients going back into the soil. So the value of the nutrients is limited. And what we're saying, as the Canadian opportunity or contribution--

[The Vice-Chair, Conservative, Cathy McLeod]

She didn't leave you any time for an answer.

Ms. Mathyssen.

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

Thank you, Madam Chair.

Thank you for being here. Thank you for this expertise.

I have a number of questions.

I want to start with you, Ms. Fontaine, because you've touched on something that I explored at length with my students. It is the whole issue of the multinationals intervening in countries and providing short-term milk products to new mothers, which interfered with their ability to breastfeed. That led to incredible disruption, baby deaths, and all kinds of quite horrendous things.

I know Nestlé was one of the companies that was targeted. There was a 10-year boycott, and they eventually got the message. But you've indicated that it's still going on. Can you describe what is happening and how these multinationals are continuing to operate in a reprehensible way?

[Lorraine Fontaine]

In Quebec we put together a premise on how to support breastfeeding. We have many baby-friendly hospitals in Quebec, and breastfeeding is taking on a kind of new renaissance. Part of the code of commercialization does not allow hospitals to receive gifts from companies that make substitutes for breast milk. So if you can't receive the gift, the companies can't send their ads, and if they can't send their ads, they have to find someplace else. So they find the Internet and all kinds of other ways to get their message out. Of course, they're really good and have lots of money to advertise about that. That's one of the things.

Another example of what's been happening recently is in Haiti. I was at the Coalition for Improving Maternity Services in February, and we had a midwife who worked in Malaysia speak to us about Haiti. She said one of the first things that happened was that Nestlé dropped off their milk and said, “Aren't we good? We're bringing all these substitutes for milk.” But they didn't have clean water and the circumstances under which to sterilize bottles. She told the mothers to give it to their babies if they were walking. It has stuff in it and it isn't all bad, but it's not the kind of milk infants need.

The other issue you raised has to do with the environment. She was telling us about Malaysia and the women there. The rice they were eating 10 years ago had all the nutrients they needed, but now that we have GMOs and things that are denuded of all the nutrients, they have to give vitamin supplements to the mothers in order to allow them to have healthy babies and not hemorrhage after childbirth. So the commercial interests are sort of sneaking in all over the place, and we need to be vigilant.

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

Thank you.

Ms. Jenicek, you made mention of the Bush gag rule, and I think you described the impact of it very well. You called it Bush's other war. Ms. Fontaine, you made reference to it too: Bush's other war, that other agenda.

What hidden agenda are you fearful of?

[Ainsley Jenicek]

That's referring to a document produced by the International Women's Health Coalition. I believe it's called “Bush's Other War”, his war on reproductive and sexual health of women. It has to do with the repealing of all progress made over the last few decades in these areas to advance the rights of women. To emphasize it, 60% of the world's 1.55 billion women of reproductive age live in countries where abortion is broadly legal. That is why there is a reluctance about our government repeating such mistakes.

To come back to the fact that where abortion is illegal within Africa and Latin America, these laws tend to be holdovers of the colonial era, where European colonizers imposed these laws; they have since liberalized their own abortion laws, but these laws continue on in their former colonies. Hopefully that'll give you a sense of that.

Bush's other war is very much connected to the cutting of financing of women's groups domestically at the same time as these abortion services are denied internationally, in preparation for the repeal of abortion rights within the domestic borders.

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

It's cutting funding to women's groups for research, or advocacy, or...?

[Ainsley Jenicek]

Yes. I mean a broad range of activities. There are no specific activities that stand out in my mind. Their document is so thorough that I would be hesitant to try to summarize it here. They have pages and pages of different assaults on women's rights, reproductive and sexual rights, domestically and internationally, on their website.

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

I'd like to have that document.

[Ainsley Jenicek]

Yes, absolutely.

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

I appreciate that very much.

This reference, in terms of this colonial attitude, underscores the Maputo plan. We heard about that in our committee work a few days ago. It does makes sense and it does sort of begin to blend together.

Is there anyone else who would like to comment?

Mr. La Ramée.

[Pierre La Ramée]

I'd like to say a little bit about abortion in Africa and Latin America. It would be a misrepresentation to say that abortion is illegal in Africa and Latin America. The fact is that in the majority of countries in Africa and Latin America it's legal under some circumstances. In countries where it is not legal, the Democratic Republic of the Congo being a case in point, Canada's concern shouldn't be to try to impose its laws or its values on the Democratic Republic of the Congo. Rather, I would hope that Canada would be concerned with rape as a weapon of war and the large number of women who die from unsafe abortion, because in a circumstance where abortion is not legal, this becomes a major contributor to maternal mortality.

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

Ms. Fontaine, you talked about slippage in terms of Canada's child and maternal health and infant deaths. That astounds me. Why on earth are we going backwards in our own country?

[Lorraine Fontaine]

You know what? I'm just going to say it's the threshold of intervention.

[The Vice-Chair, Conservative, Cathy McLeod]

Very good.

We're now onto our next round. It's five minutes each, and we'll start with Mrs. Simson.