Evidence of meeting #68 for Veterans Affairs in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was survey.
A video is available from Parliament.
4:35 p.m.
Liberal
Wilson Miao Liberal Richmond Centre, BC
Thank you for sharing that.
What can we do to influence how women veterans should be treated? If you—
4:35 p.m.
Researcher, As an Individual
How would this influence women veterans?
Imagine showing up at your doctor with a problem that you think is a problem. Again, urinary incontinence is a great example. They say that everyone has it. For you, it's like, “Okay, I guess I have to wear a diaper to work because I run, I have to go in trenches and I carry a rucksack”, which exacerbates pelvic dysfunction. Then you say that you have back pain and it wasn't there before your pregnancy. Again, the medic says that everyone has back pain.
Eventually, to what end...? Do you just keep going back and being told that your experience doesn't matter, that they're not going to be able to help you because everyone has it, so deal with it? Do you just keep being dismissed and feeling invalidated in your experience?
If I had to go to work every day and I was peeing myself every day, I wouldn't really want to be there either. I don't know if anyone else feels that way, but.... If there are alternatives and supports that exist for civilians, why can't I have access to that?
4:35 p.m.
Liberal
Wilson Miao Liberal Richmond Centre, BC
In your opinion, what is research lacking in order to better help our women veterans right now, especially when they're medically released?
4:35 p.m.
Researcher, As an Individual
There's actually very little on Canadians. Right now, typically there are a few things. Veterans Affairs uses a different classification system for diagnosing than the international classification of disease, which is what's used by our health care system in Canada and also in the CAF. That alone makes it challenging when we're talking about any issue, regardless of whether it's women's health-related or not.
When we get into women's health definitions, we're working with a medical system that doesn't have women's health-specific training. Then it's being interpreted by someone who works at VAC who doesn't have a health background, and they're using a different definitions classification. Even with that alone, before we even start researching, there are existing definitions that we need to line up. Then we need to understand what is actually happening with our females in the military, and also the RCMP. They're actually not the same. Their job demands are quite different. The supports that they have access to are quite different.
We need to understand what injuries are happening and what physical health conditions exist for both military and RCMP. Then we can build systems to support that.
4:40 p.m.
Liberal
The Chair Liberal Emmanuel Dubourg
Thank you very much.
Thank you, Mr. Miao.
Now I turn the floor over to Luc Desilets for the next six minutes.
4:40 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
Thank you, Mr. Chair.
Good afternoon, colleagues.
Thanks to our guests.
Ms. Edwards, I've been here for four years. For some time now, we've been hearing about problems involving equipment for women, but what you're saying beggars belief. You're telling us that women are undergoing mastectomies. Is that a frequent occurrence? Is it recent? When did it start?
4:40 p.m.
Researcher, As an Individual
Because we haven't been asking these questions and we haven't been tracking these, I can't give you a number. However, I do know a number—those are just the people I've spoken with, but I'm one person—who have had this surgery so that they can do their job.
We don't ask about breast injuries in basic training. We don't ask about breast injuries when we go to our medic. In sport we do or we have started to. The bruising and the ischemia, or the lack of blood flow to the area that actually causes tissue death, are way more common than you would think. Maybe if you put on one of these vests you would understand.
I can't give you numbers, but it's alarmingly common among the people I support. Again, I'm just one person. I've only lived in Ontario and New Brunswick. I've only supported the bases there.
4:40 p.m.
Researcher, As an Individual
Isn't it disappointing that we're allowing females to surgically alter their body to fit into a piece of kit when we actually have female-specific alternatives on the market? Other nations are buying them.
I'm passionate about it, obviously, but it doesn't make sense. Imagine going to work and having to wear women's pants, made for females. You get the largest size, yet it still doesn't fit really well. Would we accept you altering your anatomy for that? But that's what we do.
4:40 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
I'm astounded. I never thought the equipment problem could be that acute.
You say there are solutions. What are people thinking? My understanding is that it might involve adjusting vests. Is that happening? Is the department working on it?
4:40 p.m.
Researcher, As an Individual
We have a team that is tasked to this. They are taking a female-inclusive approach. I'm not real sure what that means, but they are not looking at female-specific vests. We don't have female-specific rucksacks either.
In a female frame, the shoulders are narrower than a males, so their straps should be narrower. Right now the rucksacks that we have available are designed for a male frame, so they will sit wider. Imagine having to wear 80 pounds on your back in a position that isn't ideal for you. It pushes your head forward, so you get additional stress on your cervical spine.
Then you have the ballistic vest, which is not designed to accommodate breasts. Usually it doesn't fit. They'll only have mediums when you're an extra small, but you're a “small target”—a quote that actually came from what was told to one of my friends. She was on deployment in an active combat zone, and they didn't have ballistic plates for her that fit. She was told, “It's a good thing you're a small target.”
4:40 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
Will military doctors go so far as to suggest women undergo mastectomies? Does it go that far?
4:45 p.m.
Researcher, As an Individual
It's a medical issue. If you have repeated trauma to your breast and that's the alternative they can give you, eventually, that's the alternative.
4:45 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
That's the solution that a military doctor may suggest.
4:45 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
Wait a minute. Are you saying that the Canadian Armed Forces pays for the operation?
4:45 p.m.
Researcher, As an Individual
You're wondering if medical services are paying for these operations. It's through the CAF health services. They're not paying for it out of pocket, if that's the alternative you're asking about.
4:45 p.m.
Bloc
Luc Desilets Bloc Rivière-des-Mille-Îles, QC
A woman might pay for that kind of operation in some circumstances, but, in this case, it's paid for by the Canadian Forces. I understand.
I find these answers somewhat disturbing. We've previously seen situations in which military doctors didn't enjoy the same status as civilian doctors. We've even heard of cases in which military doctors refused to accept the medical credentials of civilian doctors.
Do you agree? Have you experienced that?
4:45 p.m.
Researcher, As an Individual
I actually have a story. One day in 2016, a member started experiencing mild discomfort in her left rib cage. At first, she didn't think much of it, but she started having shortness of breath, so she followed up and went to MIR. She had severe chest pain. During her intake, the medical staff reviewed.... I'll skip a lot of this.
A few days passed. She started feeling even more ill. Left arm pain and the pain in her chest was more intense. Fast-forward to three days later. At this point, she must have looked like hell. She went up to the counter in tears and said she couldn't breathe. They finally took her seriously and she went for blood work, X-rays and an ultrasound.
Her blood work must have tipped them off or something. They sent her to a Fredericton hospital, where she received a CAT scan and an MRI. She deteriorated overnight, and they told her that if it got worse, to go to the emergency room. She eventually went to the emergency room, where she was immediately admitted to the ICU and they diagnosed her with a pulmonary embolism.
It was her first major experience with the medical care system outside of routine medical checks. To this day, she has minimal faith in the care provided to her by military members.
4:45 p.m.
Liberal
The Chair Liberal Emmanuel Dubourg
Thank you very much.
Thank you, Mr. Desilets.
Now I invite Ms. Blaney for six minutes, please.
4:45 p.m.
NDP
Rachel Blaney NDP North Island—Powell River, BC
Thank you, Chair.
Thank you, everyone, for being here and testifying.
It's heartbreaking to hear again and again how invisible the women who serve us and become veterans are. Today, it's even clearer.
Ms. Edwards, if I could come to you first, you said in your statement that 6.7% of CAF members who were pregnant while serving received specialized physical training, meaning a large number did not. You expressed shock at this. Can you explain why you were shocked? I hope you can tie it into your earlier questioning about peeing yourself.
I'm just wondering if you can clarify this. Are there specific health interventions that could help with this for serving members? How is this documented so that it can be understood when women become veterans?
4:45 p.m.
Researcher, As an Individual
You will probably have to ask me that second part again, but I'll start with the first part: Why was it shocking that only 6.7% received specialized exercise support?
The Canadian guideline for physical activity throughout pregnancy came out, and that was a first in the world. Our physical activity guidelines during pregnancy have been adopted by a number of countries, so since we're leaders, you would expect that it would be adopted by our military, because it just makes sense.
We recommend 150 minutes per week for a pregnant woman to exercise. Fifty per cent didn't have modifications to their PT—they just continued on—and 27.6% stopped their physical training altogether. It's no wonder they are having issues returning to duty afterwards and meeting the physical fitness standard if we're not actually supporting them through pregnancy.
A number of females in Canada—there's a study out of the University of Alberta—are lifting up to 80% of their repetition max. They have, obviously, been training before pregnancy, but they can continue lifting through. The fact that only 6.7% received support is very disappointing, especially when you have a physical employment standard that you have to achieve and when you have a health services assistant that is supposed to support you through this process.
When I was doing this analysis, over 90% wanted support and would have taken support if they had it. To be fair, there are initiatives that have been started to address this issue, but when we're talking about veterans, we can't look at what's happening now. We have to look at the systems that were in place while they were serving and how those systems are affecting their physical health now.
With regard to the urinary incontinence and pelvic floor issues, there are a number of different things we can do. There's pelvic floor physio, which is quite common, and you don't just have to have had a baby to need or benefit from pelvic floor physio. This does treat and greatly reduce the symptoms of pelvic floor dysfunction, whether they be pelvic organ prolapse, fecal incontinence or urinary incontinence. You can do those during pregnancy, and after childbirth, it also assists.
4:50 p.m.
NDP
Rachel Blaney NDP North Island—Powell River, BC
My next part of that question is this: Is that being properly documented so that, when they become veterans, they can claim on that?