Mr. Speaker, I am pleased to speak today on the opposition motion. Even though some on the other side feel this is about politics, it is actually about the lives of women and children.
The science is clear. The facts are clear. The statistics are horrific.
I have delivered probably 2,000 babies as a family physician, and I have seen one maternal mortality in my lifetime. It is a day I will never forget. We had every possible modern medicine technology there in the room to try to save this woman's life and she died anyway.
I have seen many babies die. To this day, I feel that every single one of those babies had a family, had grandparents, and that experience changed the lives of those families forever.
Once as a medical student in the Caribbean, I saw a woman arrive with a temperature of 104°, chills and rigors, septic from the effects of an illegal abortion.
We actually have to get on with this file. It is one woman dying every minute of every day. In my lifetime I saw one maternal death, but in Sierra Leone 2,000 women die in every 100,000 births. That is two per hundred. This is unacceptable and we have to do better.
However, we also have to do better here in Canada where, because of the gap in health status of our aboriginal peoples, we still are not doing well enough on the world standard. We still are losing 5.2 babies per 100,000 when even Cuba was able to reach the goal of 4.8 per 100,000 in the last year.
The report, “Adding it up: The Benefits of Investing in Sexual and Reproductive Health Care” by the Allan Guttmacher Institute and the UNFPA states that sexual and reproductive ill health account for one-third of the global burden of disease among women of reproductive age and one-fifth of the burden of disease among the population overall. It says that HIV-AIDS accounts for 6% of the global disease burden. It says that the need for sexual and reproductive health services, and thus the potential benefit of meeting the need, is greatest among the poorest women, men and children in the world's lowest-income countries.
We know that satisfying the unmet need for contraceptive services in developing countries would avert 52 million unintended pregnancies annually, which in turn would save more than 1.5 million lives and prevent 505,000 children from losing their mothers.
A woman cannot die from complications arising during pregnancy and childbirth if she is not pregnant, and we know the children do not do well when their mother is dead.
Yet by refusing to fund programs that respect women's reproductive rights, including contraception and all aspects of reproductive health services, the government is allowing its ideological differences to get in the way of good health and gender equity.
The Mexico City policy was created in 1984 by the Reagan administration. This later became known as the global gag rule and was a policy of the United States government that barred any foreign organization receiving U.S. foreign assistance from using its own funds or funds from other donors to perform abortions, advocate for the liberalization or decriminalization of abortion in laws and policies, or provide information, make referrals or counsel women on the procedure, even in countries where abortion was legal.
The Mexico City policy was announced as a new restriction at the international conference on population development in Mexico City in 1984 by the Reagan administration. This policy was in place until 1993 when, as his first act in office, President Bill Clinton overturned it. Yet on January 22, 2001, President George Bush issued a presidential memorandum reinstating the Mexico City policy. It was his first act as president. On January 23, 2009, President Barrack Obama overturned this policy once again.
According to the Center for Health and Gender Equity, approximately 500,000 women die from pregnancy-related causes each year, and according to the United Nations Population Fund, 74,000 women die every year from unsafe abortions.
They go on to say that an estimated 201 million women have an unmet need for family planning. The highest unmet need is in sub-Saharan Africa where one in four married women wants to limit or space her births but does not have access to the services to do so.
This lack of access to family planning results in 80 million unintended pregnancies a year. They go on to say that of the 80 million unintended pregnancies each year, 60% end in abortion.
The problem was that the global gag rule tied the hands of the trained reproductive health providers, because family planning organizations receiving U.S. funds could neither perform abortions for their clients nor advise women on where to seek the procedure.
As a result, women were not able to turn to trained doctors or nurses for safe medical care. They were left to find their own care, which often meant an unsafe, illicit abortion. Globally, 16 women die every hour from unsafe abortions.
Restrictive government laws on abortion often force the practice underground, as the centre said, contributing to the morbidity and mortality rates associated with unsafe abortion. Instead of fostering civil society participation in government and promoting democratic values, they felt that the global gag rule undermined rights, such as the freedom of speech and assembly rights that Americans enjoy, by prohibiting international organizations from working with their governments.
What was worse was that the global gag rule also prohibited organizations that provide information and services related to abortion from receiving U.S. contraceptive supplies, such as female and male condoms, birth control pills, intrauterine devices and other medically effective methods of contraception. As a result, services providers either had to comply with the policy or forgo the much-needed family planning.
We are hugely concerned on this side that should the government go forward with its plan, where it believes it can restrict or cherry-pick parts of a family-planning approach, we will again end up with the effect of the gag rule.
While immunization, access to clean water, better nutrition and improved training for health-care workers are all important to the health and safety of women and girls, addressing the real issues underlying poor maternal and infant health requires that the full gamut of options be made available to promote education, family planning and gender equality. Anything less is a mere band-aid solution.
The Partnership for Maternal, Newborn and Child Health has produced an excellent consensus document. Their aim is “every pregnancy wanted, every birth safe, every newborn and child healthy”. They have a plan that will save the lives of more than 10 million women and children by 2015.
How will it be accomplished? The consensus document could not be clearer. It calls for political leadership and effective health systems that deliver a package of high-quality interventions in key areas along the whole continuum of care.
Effective health systems are necessary to target the most disadvantaged, and to prevent, treat, manage, assess and evaluate all aspects having an impact on maternal health, as well as on those living with HIV-AIDS or STDs.
I wish to thank Janet Hatcher Roberts, the executive director of the Canadian Society for International Health, for her incredible work in advocating the strengthening of national health systems in every developing country.
It is important to say how this plan would be delivered through a strong, well-funded health system, with trained appropriate and paid health professionals. The continuum of care must include: comprehensive family planning; skilled care for women and newborns during and after pregnancy, including antenatal care; quality care at birth; emergency care for complications; post-natal care and essential newborn care; safe abortion services when abortion is legal; and improved child nutrition, and prevention and treatment of major childhood diseases. These are all explicit in the partnership document in terms of its plan.
It also stress that barriers to access must be removed, and skilled and motivated health workers be in the right place at the right time. Accountability at all levels must be ensured for credible results.
I would like to commend Dr. Dorothy Shaw, Canada's spokesperson for Partnership for Maternal and Child Health for the G8-G20 and her excellent work on this initiative. I implore the Government of Canada to take her advice and put forward at the G8 table the full spectrum of the plan and the consensus document put forward by the partnership.
Action Canada for Population and Development, under the leadership of its excellent executive director, Katherine McDonald, has written an extensive call to action, asking the Prime Minister to assure that he will not change Canada's long-standing tradition of recognizing women's reproductive rights and access to contraception as part of his maternal health initiative at the G8.
ACPD has explicitly called on the Prime Minister to work with Canada's G8 partners to ensure that sexual and reproductive health and rights, particularly access to family planning, including contraception, will be part of the G8 maternal and child health initiative.
ACPD also stresses accountability, and I am pleased that the government has stressed that accountability be a focus of this year's G8. At last year's G8 in Italy, the heads of government agreed that maternal and child health was one of the world's most pressing global problems. They committed to accelerating progress on maternal health, including through sexual and reproductive health care and services, and voluntary family planning. The Prime Minister promised last year; the Prime Minister must deliver this year.
ACPD is calling on Canada's G8 partners to build on, not backtrack, previous commitments. Sexual reproductive health and rights, especially access to family planning, including contraception, must be part of the initiative.
Therefore, in order to be accountable, the government must honour its own commitment at last year's G8 to accelerate the progress on combating maternal and child mortality, including through sexual and reproductive health and family planning.
We know that dividing the G8 is not leadership. It is not leadership for Canada to say, “We will do this and the other members of the G8 can do the ones that we do not want to do because of our socially conservative ideology”.
We noticed in the Minister of International Cooperation's remarks last week that “they”, the G8 leaders, not Canada, will chart the way forward to save the lives of mothers and children. “They” is not good enough. We need Canada to lead by affirming Canada's commitment to providing the full range of reproductive health services and a pledge of financial support befitting the Canadian leadership the Prime Minister has promised.
The Minister of International Cooperation was quoted as saying that she was not closing the door on any options that will save the lives of mothers and children. There is, however, a huge difference between keeping a door open and Canada coming up with a consistent, comprehensive approach to sexual health and reproductive health services.
We have become particularly concerned in the government's ability to present a comprehensive and coherent plan, when we hear its own members spreading false information.
In a recent editorial the member for Saskatoon—Wanuskewin and the member for Saskatoon—Humboldt told readers that there was no evidence to back up claims that proper education, resources and support would reduce maternal deaths and complications in spite of the wide swath of evidence already mentioned in our remarks.
How can we be confident in the government's ability to represent the mothers and children of the developing world, when here in Canada it has launched a systemic assault against women's health?
The four centres of excellence for children's well-being, whose job is to put research into practice in early childhood development, in child welfare, in children with special needs, and in youth engagement, did not have their funding renewed under the government's new program review. The centres of excellence for women's health received informal cuts and are being forced to operate under a new, more narrow and constrained mandate.
The government's new program review uses three criteria: accountability, cost effectiveness and alignment. I find this last criteria particularly worrying. It is a code for any intent of the government to cancel programs that are not aligned with government priorities. It also allows the government to cancel programs that it determines are not aligned with its strict interpretation of federal responsibility; that is, health and health care. We are all concerned that community-based programs may be increasingly at risk.
In leadership the first test is always what is happening at home. We draw the attention, although admirable, of the Prime Minister to the state of the developing countries with issues like potable water and deplorable housing conditions.
We actually want the government to look at home, to the plight of our aboriginal people, where there are 17 people living in one home with no running water, as we learned, on the reserves in Manitoba in June during H1N1.
It is extraordinary that we have to do more at home. It is a national and international embarrassment. We have to begin at home.
The Government of Canada has also refused to provide the International Planned Parenthood Federation with $18 million over three years, funding that is essential if the government truly wants to abide by the Partnership for Maternal, Newborn and Child Health's consensus document, answer ACPD's call for action, and honour Canada's international obligations to meet—not renege on—previous commitments to provide funding for sexual and reproductive health and rights in general.
Effective family planning is a human rights issue. The Convention on the Elimination of All Forms of Discrimination Against Women, to which Canada is a signatory, says countries must ensure access to health services, including those related to family planning.
The 1994 International Conference on Population and Development in Cairo and the United Nations Fourth World Conference on Women in Beijing recognized the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice.
Without this right to make decisions about fertility and family planning, women's capacity to exercise their own civil, political and economic rights is limited. The consequence of their absence has serious implications for women, and may even jeopardize their right to life.
Immediate action is needed. I have said before that it is crucial that politicians do the politics and that scientists do the science, and that the transmission of information from the scientist to the politician be done transparently, with accountability, and without ideology.
I implore the government to listen to the partnership action plan for the G8 and act in terms of what the midwives and the obstetricians, and the professionals have said is an essential, coherent plan, not to cherry-pick the bits that it wants to do.
I would encourage all members of this House, especially my colleagues on the government side, to support this motion, support the millennium development goals four and five, and ensure that Canada builds on its commitments to include the full range of family planning, sexual reproduction and health options, including contraception, as part of the G8 initiative.
The Prime Minister's opinion piece was a beginning. We welcomed it. We now want real leadership in honouring Canada's history in the world, and the government's previous commitments in Italy and at the UN. The government must put forward a real comprehensive plan based on the partnership of the G8 and full access to reproductive care.
The government must put leadership-level dollars on the table. Canadians want Canada to lead. We implore members to support this motion.
