Status of Women Committee on May 12th, 2010

[The Chair, Liberal, Hedy Fry]

Thank you.

That ends Ms. Neville's round.

Now we go to the Bloc Québécois and Madame Deschamps.

[Johanne Deschamps, Bloc, Laurentides—Labelle, QC]

Thank you, Madam Chair.

Welcome. I am going to speak to you in French.

It is interesting to see from your presentations what each of your organizations is doing to improve health.

I have a question for Ms. Fuselli, Ms. Snowdon and perhaps also Ms. McWilliam, because I may not have grasped in what context you work. At Save the Children Canada, do you work here Canada? Do you work with partners internationally?

[Cicely McWilliam]

C'est international.

[Johanne Deschamps, Bloc, Laurentides—Labelle, QC]

Ms. Snowdon and Ms. Fuselli, do you work in Canada, or do you have expertise that you export internationally?

[The Chair, Liberal, Hedy Fry]

I'll begin with Ms. Fuselli.

[Pamela Fuselli]

Safe Kids Canada is part of a global movement called Safe Kids Worldwide. Our mandate is to address injuries in Canada itself, but we certainly work within the global context with our partners that have Safe Kids organizations in countries such as Germany, New Zealand, Uganda, Vietnam, Mexico, and Brazil. We come together face to face once a year, but we communicate more often than that, to share ideas and exchange opinions and solutions to issues. And certainly we build on the work of others working in other countries, taking pieces of information and successes that can be used in our own.

More recently, Safe Kids Canada is partnering with the Canadian Public Health Association in applying for a European Union grant to help support and build capacity in four countries: Uganda, South Africa, Tanzania, and Romania. So our mandate is specifically Canada but we do have outreach in terms of the international community.

[Cicely McWilliam]

As I said earlier, at Save the Children Canada we have some projects in Canada, but the majority of the work we do is overseas. We're in 120 countries.

[The Chair, Liberal, Hedy Fry]

Ms. Deschamps, you may continue.

[Johanne Deschamps, Bloc, Laurentides—Labelle, QC]

I asked Ms. Snowdon the question.

[Dr. Anne Snowdon]

Merci beaucoup.

My work is predominantly in Canada; however, I have worked with the World Health Organization around the training of health professionals and the looming shortage of nurses, particularly. For example, in 2020 the U.S. will be short one million nurses, and whenever a large, economically developed country is short of nurses, it tends to recruit from many other countries, developing countries being one of them.

So we do face a tremendous challenge in our delivery system of children's and women's health intervention programs around the health professional capacity. And further to my earlier comments, that's where collaboration among countries will become very central to manage that shortage of health workers.

[Johanne Deschamps, Bloc, Laurentides—Labelle, QC]

For several sessions, we on the Standing Committee on the Status of Women have been holding discussions. The Standing Committee on Foreign Affairs and International Development has been doing the same thing. We have been meeting with civil society organizations to discuss major priorities.

The fifth millennium development goal is said to be the one on which the least progress has been made in developing countries. On the eve of the G8 meeting that will be held in Canada in June, we are trying to show, through the testimony of our guests who come to share their expertise with us, that 2015 is not very far away. It is just five years from now. Most of the people who have come here are calling on Canada and other donor countries to increase their aid envelope by 50% to achieve the goals countries have set for themselves. Representatives of the Global Fund to Fight AIDS, Tuberculosis and Malaria came to tell the Standing Committee on Foreign Affairs and International Development this week. Canada made a commitment in 1995 that it reiterated in 2000 and again in 2009 in L'Aquila, Italy. Today, the Canadian government is working to honour that commitment and has made it a priority.

I feel that all measures and all initiatives are good. But in countries with high infant and maternal mortality, I wonder what can be done in the way of prevention. Earlier, Ms. Fuselli talked about bike helmets and car seats. I went to Uganda last year and visited refugee camps. What impact can Safe Kids Canada have in Uganda, for example, Ms. Fuselli?

[The Chair, Liberal, Hedy Fry]

Madam Fuselli, there's only one more minute left in this round, so perhaps you could be brief.

[Pamela Fuselli]

The leading cause of death worldwide is motor vehicle collisions. But certainly in the developing and middle-income countries, that needs to be looked at under the broader umbrella of road traffic safety, in terms of pedestrians interacting with traffic, cyclists, as well as motor vehicles. While the leading cause of death may be the same in Canada as it is in Uganda, in Uganda the focus is more in terms of pedestrian safety.

Looking at the specific countries and the issues that are facing them, we need—as Dr. Snowdon said—not a one-size-fits-all, but to take into consideration what is the most effective approach to reach the highest number of people affected.

[The Chair, Liberal, Hedy Fry]

Thank you. I think we have finished with that round.

We will go to Ms. McLeod, for the Conservatives.

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

Thank you, Madam Chair.

The first thing I have is a comment. Certainly the G8 initiative is comprehensive. I think it's important to recognize that the WHO definition of family planning does not actually include abortion.

I do find it unfortunate that we keep getting sidetracked. We're here talking about child health, and we keep getting sidetracked back into that issue. Really, we don't want to reopen that debate and we don't want to be doing things that divide Canadians, so in regard to the initial comments in terms of the comprehensive plan, it is a comprehensive plan and it's certainly respecting the WHO definition.

From there, I would like to pick up on the topic of childhood injury. I'm actually struggling a little bit. When you go to these developing countries and you see five or six people, a whole family, on scooters, is it at all practical, or is it something that perhaps shouldn't take a prominent role, and we really should be focusing on maternal and child health, focusing on those interventions in these countries?

I guess that would be to both Dr. Snowdon and Pam Fuselli. How do you see that this might be practical in terms of childhood injury prevention in the particular maternal and child initiative with the G8?

[Dr. Anne Snowdon]

For road safety and injury prevention, you really have to look at a systems approach. One of the reasons we focus on car seats in Canada is because we have well-developed road infrastructure and we have very strong public policy to support road safety initiatives and injury prevention in particular.

In developing countries, they often lack road safety infrastructure, road safety policy, and trauma care as well. If you have policies against five people riding on a scooter, then many of the injuries that come with those scooter accidents decline rapidly, as we saw in Canada in 1977 with the seat belt legislation.

It's a complex problem. You need a very comprehensive strategy at the system level to get the policy in place and the road infrastructure issues started to be addressed.

I would advocate a partnership with existing groups, such as the Global Road Safety Partnership, which is affiliated with the Red Cross, because they're in these developing countries looking at each of those major issues.

Again, each country has different issues, but you would really have to address each of those four large levels of the system in order to make the impact.

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

But you are suggesting that it should be part of a plan as we move forward in terms of this maternal and child health initiative.

[Dr. Anne Snowdon]

Absolutely. It would have to be part of what I would see as a comprehensive plan.

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

Pam, could you comment?

[Pamela Fuselli]

I would agree with Dr. Snowdon. It needs to be part of a comprehensive plan because of the high burden that it has in terms of deaths and hospitalizations. Again, the one-size-fits-all approach does not work, but there are certainly similarities across interventions.

One example that has been quite successful is in Vietnam. The SickKids Vietnam group has worked on getting helmets on every child's head and really focusing on what works for that community and what leaders they needed to engage to make this something that was popular and acceptable. Not that this would work for everyone, but they actually engaged in their own helmet production facility so that they could control the style and the standards. They really worked hard at all those different levels in terms of looking at what children needed, how they needed to be protected, how that was going to be enforced, and working at the multiple levels in terms of education, enforcement, and environmental change.

It certainly is not an easy fix and it does take time, but there are some success stories out there that we can look to for guidance.

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

My next question I'll throw out to anyone, because I'm not sure the answer is readily available.

When we talk about the 68 nations that we are looking at in terms of this initiative and we have percentages around mothers dying of hemorrhage and in childbirth, to what degree do we actually know the numbers of children dying of injuries in our targeted countries?

[Dr. Anne Snowdon]

There are significant gaps in the data. Many countries do not have the systems for reporting, so we have best estimates, largely. The World Health Organization is one of the sectors that we look to for those, but it is acknowledged, and in childhood health particularly, that there are substantial gaps in actual numbers. We're at the moment working with best estimates.

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

So we perhaps have more accurate guesses on diarrhea and malaria than we do for injuries. Is that accurate?

[Dr. Anne Snowdon]

I would suggest that if we're not tracking injuries accurately, we're not likely to be able to track some of the other causes of death for children, which really speaks to the need for surveillance systems and using information technologies readily available through cellphones to track on the ground what's happening in these countries and in these communities.

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

My next question is for Ms. Dendys.

You talked about $1.4 billion over five years. How did you come up with that number?