Status of Women Committee on May 12th, 2010

[Christina Dendys]

That's roughly the fair share estimate in terms of the G8 calculation of the $30 billion over five years. It's also a number that we thought was realistic in terms of where new investment could go.

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

And in terms of the caregivers that you talked about, the lay caregivers trained in Ethiopia, was it just around the most common illnesses, or did they have any training for assisting in childbirth?

[Christina Dendys]

They did have training in that as well. They actually got a year's training in terms of leading causes of death, not only actually among children but also in TB/HIV, and in sanitation and hygiene promotion. They got supplementary and additional training in being available as a skilled birth attendant, not a doctor but a skilled birth attendant, to address maternal health and be able to monitor and track pregnancies and deliveries.

[The Chair, Liberal, Hedy Fry]

Thank you.

Now we move to Ms. Mathyssen, for the NDP.

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

Thank you, Madam Chair.

Thank you for being here. I appreciate your expertise.

I'm going to start with a couple of question for Madam Dendys, but I do want to talk to everyone.

Globally, the leading cause of death among women of reproductive age is HIV/AIDS. By the end of 2008, women comprised about half the adults living with HIV/AIDS, and in sub-Saharan African, women and girls account for six out of every 10 people living with HIV.

Could you tell us the impact of HIV on maternal mortality, or the implications generally for the G8 initiative and beyond? I wonder, too, what role Canada has to play and can play in addressing this crisis.

[Christina Dendys]

Thank you for that question, actually. It's a very good one.

HIV remains a significant crisis on this planet, yet it feels as though people are getting a bit tired of talking about it, which is too bad.

From the studies I've seen, there are indications that women who are pregnant with HIV are seven times more likely to die than women who are not. So HIV remains a critical issue in terms of women, but also in terms of the global toll of deaths and illness.

I think there's a significant opportunity. I think we're kind of looking at the G8, but we need to look beyond that in terms of Canada's role. The MDG summit is coming up in September. There are other dominoes in line and things that we need to address leading up to that.

I was actually at a session hosted just this week that talked about Canada's contribution to the international microbicides initiative and also to the international AIDS vaccine initiative, and that contribution has stalled. I think there is some interest there in looking into that, because that contribution has dimmed.

But also, the Global Fund to Fight AIDS, Tuberculosis and Malaria is up for replenishment in the fall. About half the people who have HIV in Africa who have, they suggest, been diagnosed and are on antiretrovirals...about half of those are due to the Global Fund support. So this is a critical year for the Global Fund in October. Just looking past the G8, to October, we should be thinking about our Global Fund investments as well.

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

Okay. And then, of course, there's the transmission from mother to child.

[Christina Dendys]

Yes, also there's the transmission from parent to child, which is absolutely and completely avoidable. It kills about half a million children every year, I think, and is very easily and cheaply avoidable, if we get moms on ARVs and give the appropriate drugs around delivery.

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

I want to talk about the kind of aid that Canada provides. In budget 2005—I'm very proud of this—the NDP was able to change $4.6 billion in planned corporate tax cuts into affordable housing, education, public transit, and $500 million for international aid.

Now we hear from the government in the current budget that the plan is to flatline aid overall past 2011. It seems to me that this goes against any previous commitments we've made. We talk a good game, but we haven't delivered.

I wonder what your thoughts are in this regard.

[Christina Dendys]

I think the decision to flatline aid past this year is unfortunate, obviously, because I work in this area and I think we can no longer think about what happens “over there” as something that simply happens over there. We live in an interconnected globe. What happens in Africa or happens in rural areas of Mexico, where H1N1 started, matters here. It's a world with decreasing borders and certainly no solid foundations between countries.

So I think it's unfortunate that there was a decision to flatline aid. I hope, and again this is a longer issue for the committee, that in terms of Canada's role beyond the G8 we should be working to reverse that decision.

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

Thank you.

Ms. Snowdon, I was quite interested in the discussion about having a comprehensive plan in terms of the G8. I want to read a quotation from Maureen McTeer. She was at the committee on May 5. She said:

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”...

That would seem to me to be the reality we're talking about in terms of this G8/G20 initiative. These are the kinds of lives we want to impact.

So I'm wondering how including this issue of transportation safety in the package is going to make a substantive difference when we consider this reality.

[Dr. Anne Snowdon]

I think the issue again goes back to engaging the key stakeholders in the countries we hope to be offering some aid and assistance and expertise to. The scenario you describe—for example, that culturally the women wouldn't leave the village, perhaps, without the permission, for lack of a better way to say it, of their spouse—really speaks to the issue of one size not fitting all. You have to engage the key stakeholders, the community leaders in the systems you're trying to have an impact on. I think we should use that as a guiding principle, rather than coming in with a very western view of health and health care delivery and health values. It's something you need to be aware of. You need to be thinking about engaging those people who are going to receive your care in planning how that care might be delivered.

I don't have expertise in maternal health—I'm a pediatric nurse—so I can't offer you an opinion or expertise in that area. In my experiences, when I work with injury prevention, I engage children. I ask them how they see themselves as being safe in a vehicle, and they tell me. That becomes a basis for how I teach families—children, mothers, parents—about how to stay safe in a vehicle. That kind of principle has been very successful. I would suggest it could perhaps be considered in the much broader system.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Ms. Mathyssen.

We're going to go into the second round. The second round is a five-minute round, with the same system: five minutes for questions and answers.

We will begin with Ms. Simson for the Liberals.

[Michelle Simson, Liberal, Scarborough Southwest, ON]

Thank you, Chair.

I'd like to thank all the witnesses for very interesting presentations.

I want to start by addressing something my colleague Ms. McLeod said. It was about shifting the dialogue, first and foremost.

The Prime Minister shifted the dialogue by becoming selective about what he was going to honour. The G8 declaration, signed by our Prime Minister in Italy, included a full range of reproductive interventions that, quite frankly, included family planning and abortions. It's this document that forms the basis of this year's G8 initiative, not a WHO definition.

So my question is this. Given that you all mentioned that you support a comprehensive approach, wouldn't you agree that this is now maybe becoming a menu-like approach, based on what our government would like to do, and would contradict this consensus on a comprehensive approach, and in doing so would drastically reduce its effectiveness?

[The Chair, Liberal, Hedy Fry]

We'll begin with Ms. McWilliam.

[Cicely McWilliam]

To be honest, I actually will choose to stay silent on that, in large part because there is a reason why we as a group, and Save the Children in particular, in our brief focused on community health workers. It's that we really felt that this was where the need is.

It's not that we don't support the notion of a comprehensive approach. We're a member of the Partnership for Maternal, Newborn and Child Health, and as a member we have certainly endorsed their overall mission statement.

But from the point of view of the work that we do, what we see—

[Michelle Simson, Liberal, Scarborough Southwest, ON]

Yes, you did testify that your organization doesn't offer any abortion services.

[Cicely McWilliam]

Right, but beyond just the services we provide, I'm talking about what we see on the ground and the fact that roughly 85% of the women who are dying are dying not because of or related to abortion.

Those are all reasons why we felt it was important to focus on providing skilled attendants—

[Michelle Simson, Liberal, Scarborough Southwest, ON]

You mean they're not dying as a result of a lack of access to abortion?

[Cicely McWilliam]

No, no, 85% are dying through lack of access to skilled birth attendants and because of sepsis, etc.

[Michelle Simson, Liberal, Scarborough Southwest, ON]

I don't mean to cut you off, but this is a five-minute round, so I want to give the other witnesses an opportunity.

[Cicely McWilliam]

Fair enough. But that's why I sort of stayed silent, on balance.

[The Chair, Liberal, Hedy Fry]

Ms. Dendys.

[Christina Dendys]

I actually didn't think you stayed silent. I thought it was a good answer.

We focused on Canada's value-add being front line workers because we thought that's where we could have tremendous impact for the very poorest people where they live.

But in terms of a comprehensive approach, what I heard coming out of the development ministers meeting was that under the G8 initiative as a whole, countries will have an opportunity to invest where they feel they can have the most impact, based on their skills and their capacity, and that Canada's approach would be focused on contraception and other ranges of opportunities, but not necessarily abortion.

[Dr. Anne Snowdon]

I have nothing further to add.