These are the first official probes launched by the Office of the Canadian Ombudsperson for Responsible Enterprise (CORE), which was set up in 2019 to hold Canadian garment, mining, and oil and gas companies that operate outside Canada accountable for possible human rights abuses.  

The investigations are based on complaints filed by a coalition of 28 civil organizations, led by the Uyghur Rights Advocacy Project, in June 2022. CORE says it received a total of 13 “admissible complaints” about the overseas operations of Canadian companies, and it has committed to releasing initial assessments on the remaining 11 “in the coming weeks.”.  

“These are very serious issues that have been brought to our attention,” Sheri Meyerhoffer, CORE ombudsperson, said this week.  

“Canadian companies are expected to respect Canadian standards for human rights and environmental protection when they work outside of Canada.” 

Other corporate watchdogs are already warning of the serious limitations of CORE’s ability to get to the truth, something they have been calling on the federal government to change.  

In 2022, the Office of the UN High Commissioner for Human Rights found far-reaching and arbitrary human rights abuses imposed on Uyghurs and other predominantly Muslim communities living in Xinjiang, an autonomous region of China located in the northwest of the country.  

Nike is accused of having supply relationships with Chinese companies identified as using or benefiting from the use of Uyghur forced labour, while Dynasty Gold is accused of benefiting from the use of Uyghur forced labour at a mine in China in which it holds a majority interest.  

In both cases, mediation is not an option, CORE said in a press release.  

In the case of Nike Canada, the complainants zero in on six manufacturing companies with which the sport apparel company is alleged to have relationships or supply chains. The complainants cite findings by the Australian Strategic Policy Institute (ASPI) about factories that employ Uyghur workers who attended “vocational training” or “patriotic education” or “reeducation” classes and include in their evidence bills of lading that show that Nike Canada imported shipments from some of the Chinese companies. The complainants also provide the findings of an investigation by Sheffield Hallam University into the laundering of cotton from the region, detailed in CORE’s Initial Assessment Report, which was released this week.  

In a separate report, CORE looks at allegations of forced labour at Dynasty Gold’s Hatu mine, located in northwest Xinjiang, near Uyghur “detention” or “reeducation” centres. Among the evidence cited by the complainants are public statements by the mine acknowledging that Uyghurs are part of their workforce. “Dynasty Gold’s response to the complaint is that it does not have operational control over the mine and that these allegations arose after it left the region,” CORE noted in its press release. “The Complainants claim that while it is possible that XNF and its subsidiary Western Gold have had operational control of the Hatu mine, this does not remove the responsibility from DYG to ensure that forced labour is not present in its mining operations abroad.”  

Nike Canada responded to CORE by directing it to a response it had previously made to the 2020 ASPI report in which it denied having working relationships with three of the companies listed. It said that a fourth company no longer has employees from the Xinjiang region.  

“Our ongoing diligence has not found evidence of employment of Uyghurs, or other ethnic minorities from the [Xinjiang Uyghur Autonomous Region], elsewhere in our supply chain in China,” it said in a statement. “Nike takes very seriously any reports about forced labor and we have been engaging with multi-stakeholder working groups to assess collective solutions that will help preserve the integrity of our global supply chains,” the company said.  

[This] is a warning sign to other Canadian companies to review their business practices and investigate their supply chains for products tainted with forced labour.

 

– Uyghur Rights Advocacy Project

In its assessment report, CORE identified “conflicts” in the available information – noting, for example, that Nike claims that the bills of lading for one factory in question are from Vietnam, not Xinjiang – but added “the complex nature of garment supply chains” means that “more information is required to consider whether Nike’s [human rights due diligence] is consistent with the robust due diligence required by a high-risk context such as Xinjiang.” 

Organizations such as Above Ground NGO, which is fighting for accountability from Canadian companies operating abroad, say they are encouraged by the CORE’s announcements, while still concerned about its hamstrung investigative powers.  

“The office lacks the power to properly investigate wrongdoing; it still can’t compel witness testimony or force companies to share evidence,” the Canadian Network on Corporate Accountability wrote on Twitter. 

In a statement, the Uyghur Rights Advocacy Project applauded the investigations, noting that they could have legal ramifications, in the form of recommendations from the ombudsperson regarding trade measures, or the withdrawal of government support of companies.  

“CORE’s announcement is a warning sign to other Canadian companies to review their business practices and investigate their supply chains for products tainted with forced labour,” it said.  

In a press release, Meyerhoffer said she launched the investigations to “get the facts” and recommend appropriate actions.  

“It is our mission to resolve human rights complaints in a fair and unbiased manner in order to help those impacted and to strengthen the responsible business practices of the companies involved.”  

The post Canada’s corporate watchdog finally goes after alleged human rights abuses abroad appeared first on Corporate Knights.

But that veil of deniability was pierced in September when the United Nations High Commissioner for Human Rights released a painstaking report that identified thousands of acts of cruelty and violence in Xinjiang, including the “arbitrary and discriminatory detention” of up to a million people. Such acts, the analysis said, were enabled by a lax legal system that allows petty functionaries to label almost any nonconforming behaviour “extremist.”  

The report was welcomed by activists who feel the Uyghur cause has been soft-pedalled by world leaders. And it caused a commotion in Canada, as advocates pushed the Liberal government to punish China for crimes against humanity. “Canada has yet to prevent even a single shipment of products tainted by Uyghur forced labour from entering Canada,” said Mehmet Tohti, the executive director of Toronto-based Uyghur Rights Advocacy Project (URAP), in a statement for “Uyghur Action Day.” “As a result, Canada has become a dumping ground for such products.” 

For her part, Minister of Foreign Affairs Mélanie Joly offered her government’s “grave concern with the ongoing gross and systemic human rights violations in Xinjiang.”  

In March 2021, parliamentarians voted 266–0 to declare China’s Xinjiang actions “genocide.” But the resolution wasn’t binding, and every cabinet member abstained – presumably, to avoid offending our second-largest trading partner. Prime Minister Justin Trudeau described the word genocide as “extremely loaded.”  

Standing up to China can be costly. In 2018, after Canada complied with a U.S. request to arrest Huawei executive Meng Wanzhou on fraud charges, China didn’t just respond by arbitrarily detaining two Canadians. It also imposed restrictions on Canadian canola seed exports that have cost oilseed farmers $1 billion a year. 

But with Canada buying three times more goods and services from China than it sells, Clive Ansley, an immigration and human-rights lawyer who advises URAP, believes Canada has less to lose than China does from any hiccup in trade.  

So far, only the U.S. has dared accuse China of genocide. If Ottawa joined Washington in confronting China, Ansley thinks other Western allies might jolt into action. China doesn’t want a showdown with North America and Europe, he says: “Courage is a great thing, and I would love to see the Canadian government take a stand.” 

The post Is Canada a dumping ground for products made with Xinjiang forced labour? appeared first on Corporate Knights.

To put these costs in perspective, they are roughly double the total economic value of the global food system.

Feeding eight billion people healthy, sustainable food by 2030 is a monumental challenge. Yet transforming food systems that inflict tens of trillions of dollars in health and environmental damages is essential for realizing human rights.

Industrial food production is a major driver of the planetary environmental emergency. Food systems are responsible for 21 to 37% of global greenhouse gas emissions, 70% of water use and 80% of the pollution causing eutrophication and marine dead zones.

Agriculture and aquaculture are major threats for 85% of the species identified as threatened with extinction. Deforestation – mainly expanding agricultural land to produce beef, soy and palm oil – is responsible for 30% of the infectious diseases that spill over into humans from wildlife and livestock, raising the risk of pandemics.

Environmental problems are exacerbated by food loss and waste, as an estimated 30% of all food produced is never eaten.

Skyrocketing impacts

Driven by increasing wealth, population growth and the rising dominance of input-intensive industrial agriculture, the negative environmental impacts of food systems are skyrocketing. Since 1960, synthetic fertilizer use jumped more than 800%. Meat production leapt more than 500%. Unhealthy diets are estimated to be the world’s most significant risk factor for disease, contributing to more than 10 million premature deaths annually.

Enough food is produced annually to provide adequate nutrition for everyone, but a large portion is fed to livestock, wasted or used to manufacture non-food products such as biofuels.

Two billion people lack adequate access to safe, nutritious and sufficient food, including 700 to 800 million suffering from daily hunger. Paradoxically, more than two billion people are overweight or obese.

Diets in high- and middle-income countries include excessive animal protein and a growing share of ultra-processed, nutrient-poor foods. Unhealthy diets contribute to obesity, diabetes and a smorgasbord of non-communicable diseases.

The environmental impacts and unhealthy diets associated with industrial food systems interfere with the enjoyment of a wide range of human rights, including the rights to life, health, water, food, a healthy environment, development, an adequate standard of living, cultural rights, the rights of the child and Indigenous rights.

Rights and obligations

To prevent negative impacts on human rights and the environment, governments should apply a rights-based approach to all food-related laws, regulations, policies and actions. A rights-based approach should focus on the right to food and the right to a healthy environment. This approach would clarify the obligations of governments and the responsibilities of businesses; catalyze ambitious actions; prioritize progress for the poorest, most vulnerable and marginalized communities; and include people in designing and implementing solutions.

Not all food systems contribute equally to environmental degradation and human rights violations. There is a vast diversity of production practices and an even wider range of diets. The use of water, pesticides, synthetic fertilizers, antibiotics and other inputs, as well as associated levels of pollution and environmental damage, varies extensively by type of food and production method. Meat and dairy generally use the most land and have the largest environmental impacts per calorie produced. Agroecology – a holistic approach to food systems that integrates ecological principles with social equity – offers more healthy and sustainable practices.

Experts have called for transformative changes to food systems to achieve just, healthy and sustainable outcomes. The International Assessment of Agricultural Knowledge, Science and Technology for Development stated that “the way the world grows its food will have to change radically to better serve the poor and hungry if the world is to cope with a growing population and climate change while avoiding social breakdown and environmental collapse.”

Not an option

The good news is that there are proven solutions available to reduce greenhouse gas emissions; enhance carbon sinks; reduce air and water pollution; alleviate water scarcity; decrease the use of pesticides, fertilizers and antibiotics; restore soil health; safeguard biological diversity; and decrease the risks of zoonotic diseases. Many solutions offer multiple benefits – for example, reducing pesticide use is good for soil, biodiversity and human health.

While the foregoing changes are necessary, they are not sufficient. Fulfilling the rights to food and a healthy environment also requires reducing inequalities, promoting healthy and sustainable diets, cutting food loss and waste, and transforming governance to be more participatory, preventive and precautionary.

Economic reforms are also imperative. More than US$600 billion in food-related subsidies that undermine sustainability should be repurposed to support smallholders (farms less than two hectares), agroecology and innovation; implement sustainable production practices; end over-fishing; and restore damaged ecosystems.

Prioritizing the rights to food and a healthy environment offers a clear path toward just and sustainable food systems. It is not an option for governments; it is an obligation.

David R. Boyd is the UN Special Rapporteur on human rights and environment, as well as an associate professor of law, policy and sustainability at the University of British Columbia.

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

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You’d be wrong.

A new study of 200 of the world’s biggest brands found that fewer than half of them show any signs of meeting the United Nations’ 2011 Guiding Principles on Business and Human Rights.

Conducted by the UK non-profit Corporate Human Rights Benchmark (CHRB), the study mainly surveys companies in apparel, food and drink, resource extraction and technology manufacturing – the four industries considered most susceptible to compromising workers’ rights. The key finding: one in four companies received a score of 10% or less for their efforts to support human rights, activities that range from mere transparency on human-rights issues to establishing effective grievance mechanisms and holding board directors accountable for human-rights issues.

With an estimated 25 million people today working as forced labour, business clearly has to work harder to expunge its supply chains of people and organizations that consider human rights an optional frill.

The survey results look only slightly better when you distinguish between the performance of 100 companies being studied for the third time and 100 new companies added to the survey this year. The 100 original firms, knowing they’re under scrutiny, showed real progress, moving from an average score of 18% in 2017 to almost 32% in 2019. But the new 100 companies posted an average score of just 17%.

“In aggregate, the 200 companies are painting a distressing picture,” noted CHRB chair Steve Waygood. “That one quarter of companies score less than 10%, and a full half of companies fail to meet any of the five basic criteria for human-rights due diligence, should alarm governments and investors.”

Danone, Diageo, Heineken, Kellogg and Pepsi are among the companies that showed the most improvement since 2017. The laggards, with the lowest scores overall, include Costco, Phillips 66, Western Digital, Broadcom, Lindt chocolate, Monster Beverage and Canadian firms Loblaw and Alimentation Couche-Tard.

Most companies will likely continue to underplay human rights until they’re forced to change, whether by public exposure or by increasing pressure from activists, shareholders, investors and governments.

The post Companies get failing score on human rights appeared first on Corporate Knights.

In the newsrooms and watering holes of Phnom Penh, the two expressions were read as a telling contrast between “nice guy who’s trying” and “Nobel Peace Prize winner.” If these two Southeast Asian reformers represented the best hopes for their troubled countries, most would have put their money on Suu Kyi and Burma. Cambodia was just three years removed from a historic United Nations-sponsored election, but it was already sliding into what one scholar notably described as a “vaguely communist free-market state with a relatively authoritarian coalition ruling over a superficial democracy.”

Burma, on the other hand, still seemed to have a political future worth looking forward to (even if it was under the name Myanmar), and the unexploited economic potential to back it. Suu Kyi’s infallible, principled resistance to the thuggish junta made her country a cause célèbre and appeared certain, even then, to put it on track for better things.

Just two years ago, that promise finally felt within sight. Isolated and aging, Burma’s military leadership had begun implementing its “roadmap to democracy,” with reformer Thein Sein emerging as the first civilian president in decades. Suu Kyi and other dissidents were released; she won a seat in parliament and toured foreign capitals in a blaze of publicity and optimism. Ordinary Burmese gained impressive new freedoms and the doors were thrown open to liberalization, investment, currency regulation and the end of foreign sanctions.

To hear their stories told this way, these two countries appear to have emerged from economic and social ruin in very different shape. But while Burma still has prosperous potential, it’s treading perilously close to Cambodia’s path – cronyism, corruption, land grabs, social and environmental exploitation. In the short time since the easing of foreign sanctions and Suu Kyi’s triumphant foreign tour in 2012, elements of “reformed” Burma have begun to resemble that ugly characterization of its neighbour. It may yet end up taking the wrong path unless its foreign partners, including Canadian investors and political leaders, show the resolve to demand better.

Land grab

If a single word can be used to sum up what’s animating the economic and political transitions of both Cambodia and Burma, it is “land.” Cambodians and now Burmese have emerged from their isolation with severely underdeveloped economies and labour forces that will require generations to rebuild, but the value of their underdeveloped land, and what can be extracted from it, is real and immediate.

The paranoid Khmer Rouge shattered the lives and livelihoods of millions of Cambodians, but its experiments in agrarian socialism had the effect of a perverse form of environmental conservation. Burmese military rule left a larger footprint – black-market logging, destructive gem mining and a cavalier attitude toward delicate ecosystems – but much of the country’s prime land emerged underexploited due to sanctions, civil war and the sleepy pace of its ox-cart economy. The sudden embrace of open markets, growth and resource exploitation has inevitably created Wild West conditions in the rush to exploit these two Far Eastern “frontier” states, along with tiny Laos.

Despite years of advocacy by international NGOs, illegal timber exports continue to significantly erode the forest cover of all three countries to feed the needs of neighbouring Thailand and China. In past decades, this trade fuelled civil conflict; today, it largely benefits Burma’s powerful military and business elites, working with the regional rubber firms that have been sweeping across Southeast Asia, acquiring land for plantations to feed global demand.

Resource extraction, which was a tricky business for Western firms in Burma under the watchful eyes of sanctions and Western public opinion, is proceeding apace, with all that entails. Gems and precious metals continue to leave a particularly dirty stain. Working conditions have been widely deplored and the infamous Letpadaung copper mine has tripped up many of those involved in the project – from former Canadian partner firm Ivanhoe, which remains locally reviled, to Suu Kyi, who headed an official committee that allowed the project to proceed against the wishes of local villagers.

Meanwhile, Burma’s government is pushing ahead with a panoply of energy projects, auctioning off oil and natural gas rights to multinational firms and advancing plans for dozens of new hydroelectric dam projects. For a country with chronic power shortages, this should be a no-brainer, but most of the new capacity is for export and the environmental and social costs of the infrastructure have been exorbitant.

Next Cambodia?

Consider the massive Myitsone Dam project at the headwaters of the Irrawaddy River, intended to generate up to 6,000 megawatts of power, most of it for the Chinese province of Yunnan. Thousands of Burmese were forcibly relocated and experts warned of widespread environmental and cultural destruction before the government suspended the project, citing local sentiment. With the government under intense Chinese pressure, it would hardly be a surprise if construction resumes following next year’s elections.

With weak regulations and enforcement practices, immense environmental and human consequences are already evident elsewhere in Burma. Villagers, farmers and remote tribes with traditional land claims, but no formal title, have been forcibly relocated or marginalized with little compensation or sympathy, and the country’s vaunted biodiversity is under threat due to habitat loss and the trade in endangered species. Black-market logging has been reorganized and legitimized through Rangoon-area ports, which observers believe allows for the “laundering” of logs illegally cut in disputed or ethnic-conflict areas – one of the issues fuelling conflict between the government and ethnic minority groups. Even the feel-good tourism industry, which has developed at breakneck speed, has brought unexpected costs, including environmental damage and overdevelopment at Inle Lake, a world-renowned tourist attraction even in the bad old days.

There are many similarities to Cambodia, where land grabbing, forced relocation, exploitative work conditions, corruption and ethnic strife are familiar parts of the landscape.

Burma “stands at a crossroads,” says Ali Hines, a campaigner with British-based environmental NGO Global Witness, which has done high-profile work in both countries for years. “Either it can continue down the path of its neighbours – whose limp efforts at reform do little to mask a de facto policy of land grabbing and cronyism – or it can use its natural resources to drive the sort of equitable national development that is needed to set the counter on a more stable, more sustainable course.”

Getting it right

For Canadians who have or want a stake in Burma, these trend lines should be cause for concern.

Will nascent reforms, such as transparency in oil and gas contracts, be strengthened and enforced, or allowed to wither on the vine? Will effective legislation be passed to properly and fairly establish land title and regulate its use and sale? Will pervasive cronyism and corruption be allowed to flourish? Will consultation and popular will play a greater role in weighing the fate of mega-projects like the Myitsone Dam? Will restrictions on Suu Kyi’s path to the presidency, currently blocked by junta-era legislation, be lifted – or have her principles and promise merely been co-opted by a junta with a friendlier face?

The answers to these and other questions are not yet certain. But this is where the outside world Burma has been courting – including Canadian investors, political leaders and even the public – can make a difference.

Like the leaders of many emerging quasi-democracies, Burma’s government, military and oligarchs are walking a fine line with their foreign suitors. In essence, they say: In order to make money with you, we will undertake an amount of reform that satisfies your business and political requirements.

So how badly do we want to make money with Burma? And what amount of reform will satisfy our standards? These are the international community’s bargaining chips.

In Cambodia, where reform has gone so badly off the rails, growth has been high but the amount of money to be made was still relatively small (its economy is defined by agriculture, tourism and low-cost labour). But international standards for reform were similarly low. The defining issue for Cambodia’s foreign suitors was justice for victims of the Khmer Rouge regime, responsibility for which was tangled in regional rivalries and Cold War politics. Prime Minister Hun Sen, in power for nearly 30 years, has a singular talent for delay and obfuscation, and the Khmer Rouge tribunal process has been dispensing justice in a slow trickle for more than 15 years now – just fast enough to keep foreign aid and investment on the hook.

Bar set low

There is no similar defining issue to distract the international community in Burma. But the amount of money to be made is much higher than it was in Cambodia. The Burmese economy is already twice that size, with a much richer resource base and four times the population. And Burma’s sanctions-era business partners (Thailand and China, notably) set a very low bar for reform. Can Western firms with checkered records of their own, such as Canadian resource companies, be counted on to raise it?

“Canadians and Canadian companies are urged to remain vigilant and ensure that they engage with individuals and companies of the highest ethical standard … it remains the responsibility of individual companies to ensure their activities are within legal parameters and beyond reproach with respect to integrity,” Foreign Affairs Minister John Baird and International Trade Minister Ed Fast advised in 2012, as Canada announced its intention to open an embassy in Burma.

To that end, international money has largely been concentrated in high-profile industries such as oil and gas, tourism and telecommunications – foreign investments “are largely contracted on the basis of intentional standards where transparency is not a problem,” says Derek Tonkin, a former British diplomat who now serves as an adviser to investment firm Bagan Capital.

But sustained change will take time and commitment by both investors and governments. Before they make their money, Burma’s new foreign partners need to demand more: clear, fair rules for foreign investment and domestic politics; the disavowal of cronyism and corruption, official and unofficial; consideration of social and environmental impacts of potential investment projects; incorporation of best practices and corporate social responsibility; understanding and accommodation of local context, culture and relationships.

Although some (including Burmese-Canadian democracy advocate Tin Maung Htoo) have argued that the threat of sanctions should be maintained, it’s clear that Burma is now open for business. Economic opportunities abound and Canadians can no longer be expected to stay out on principle or nervousness at dealing with what remains an unsavoury regime. But as they engage, they need to keep pushing back. They could start by asking what kind of Burma they want to deal with in the future: another Cambodia, or something better?

Guy Nicholson is deputy comment editor at The Globe and Mail. He was foreign editor and managing editor of The Cambodia Daily in Phnom Penh from 1996 to 1999. 

The post Is Burma the new Cambodia? appeared first on Corporate Knights.

“We are experts in mining, we are not experts in community development,” says Valerie Pascale, Manager, Corporate Social Responsibility at Goldcorp Inc. So, the company relies on organizations that have experience with development to help it resolve challenges, she said.

And since NGOs and extractive companies do not have a long history of working together, the Devonshire Initiative (DI) is hosting a discussion forum where non-governmental organizations and mining companies can smooth out their differences and make sure they are creating lasting benefits for communities.

Having a social license to operate, which means getting the support of a community to do business, is becoming increasingly important for successful mining operations, says Andrew Crane, director at the Centre of Excellence in Responsible Business at Schulich School of Business.

Unfortunately, getting a social license is not as straightforward as getting a legal license. “You may have met all the legal hurdles, but the community can pose all kinds of obstacles to mining operations,” said Crane.

Companies have adopted a number of strategies to try to address their social license problem, including showing citizens how much money they have paid host governments for access to their resources.

The Mining Association of Canada and the Prospectors and Developers Association of Canada (PDAC) teamed up with transparency organizations last January to write a set of recommendations that would make it mandatory for extractive companies listed on Canadian stock exchanges to disclose how much they pay governments for each of their projects.

As Corporate Knights reported earlier this week, the details of such a rule are hard to nail down, and companies are still trying to boost their reputations on the ground by working with NGOs on community projects.

But, Stephen Brown, a professor of political science at the University of Ottawa, says simple partnerships between companies and NGOs are not enough. When development programs are run separately from the mine’s day-to-day operations, the projects become incentives for the community to welcome the mining company, rather than a mechanism for real change because they do not improve the company’s business practices or respect local rights, he says.

Instead, a well thought out partnership with shared objectives is needed to have a positive impact, says Alanna Rondi, Executive Director of DI.

Part of DI’s mandate is to create a space where mining companies and NGOs can learn from past partnerships and anticipate challenges that might arise during the project, she says.

“There is a recognition that mining companies and NGOs working together is complex and it’s not the type of partnership you enter into lightly,” she adds.

“Mining folks tend to be engineers and science-oriented, and NGO folks tend to be people-oriented and those don’t always match in terms of conversation,” says Harry Kits, Senior Advisor, Corporate Engagement at World Vision. “So it’s important to be clear on the development outcome you are trying to achieve.”

While there is potential for the private sector to play a constructive role in development, its methods and practices are still in the experimental phase, says Kits.

“The key thing is to understand what the development outcomes are and try to ensure that the overall impact…is positive,” he says. “The first thing is the people you are trying to support.”

The post Mining companies need therapy appeared first on Corporate Knights.

In September last year, some 300 workers died in a garment factory fire in Pakistan, many because they were trapped behind locked emergency exits. Six months later, another 1,100 seamstresses were crushed to death when an eight-storey building collapsed in Bangladesh, despite warnings it was unsafe.

As the multi-trillion-dollar textile industry struggled to respond to these tragedies, the much smaller global toy industry was able to call on a resource no other consumer product industry can match.

In short order, big toy brands and retail members of the International Council of Toy Industries (ICTI) were able to tap into a one-of-a-kind database they have built over the past decade known as the ICTI CARE (Caring, Awareness, Responsible, Ethical) Process (ICP).

The trove of data, which includes wage rates, hours worked, worker age and 200 or so other metrics at thousands of toy factories, allowed big toy buyers to rapidly identify manufacturers located in the areas affected by the recent labour disasters for focused follow-up. Within weeks, industry executives started to develop and roll out tougher rules to all of the factories in the ICP network, guiding inspectors to enforce stricter requirements for fire escapes and building integrity.

The quick response was made possible by a combination of ICP’s carefully cultivated industry collaboration together with a recent decision to port its unique database onto a web-based platform provided by Enablon, a supply-chain software service provider founded in 2000.

“Not long ago, this sort of information was considered proprietary. A single factory might have two dozen clients, but they didn’t want to talk to one another, for fear of competitive disclosure” says Philippe Tesler, co-founder and CEO of Enablon North America.

A combination of factors has rewritten these habits. There’s a growing recognition that risks can be lowered and costs minimized through collaboration. “Reporting has gone from a defensive response to a more proactive process,” says Tesler.

Back in 2002, the toy industry was facing a series of relatively small-scale labour mishaps at overseas factories. “Pressure was building from retailers, from consumers, NGOs [non-governmental organizations] and investors to boost regulation,” recalls Christian Ewert, president and CEO of the ICTI CARE Foundation, which oversees the supply chain program.

Instead, the industry group pushed for self-regulation and established the ICP, a framework in which toymakers would share and compare information towards the end of “ensuring safe and humane workplace environments for toy factory workers worldwide,” says Ewert.

Notably, the ICP was established as a standalone not-for-profit, overseen by a board that includes NGO and civil-sector experts, and on which active toy industry executives are in a minority.

Streamlining inspection efforts has been a central priority from the beginning. When Ewert started in the toy industry in the 1990s, he worked with a manufacturer that faced 64 audits per year, each asking for similar information. “I’d much rather have seen those auditors inspecting 64 different factories, rather than the same factory 64 times,” he says.

The move to Enablon’s platform has helped transform this process from a cumbersome paper chase into a more scalable, easier to use and fast-evolving technology. On a factory floor in China, auditors and factories can input data wirelessly. On the other side of the planet, ICP members can log in and tweak standards on the fly, and do deep data analysis across the factories they are working with.

Today, the system tracks data on roughly 2,500 factories that employ some one million workers. Most are based in China, home to a vast majority of the world’s toymakers. Just 1,600 factories are currently certified as meeting ICP’s criteria. New factories join each year, but year to year about 13 per cent lose their approved status.

The most frequent causes for such a loss? A lack of transparency about whether workers are paid correctly or companies are demanding too many hours of work, says Ewert. Picking up such malpractice early can nip bigger problems in the bud, lowering the risk to corporate reputation.

“Companies don’t want to be named and shamed,” says David Metcalfe, CEO of Verdantix, an independent analyst firm focused on energy, environment and sustainability issues.

Over time, Metcalfe adds, the best employee health and safety plans can evolve to do more than protect workers. They can also proactively improve supply chain operations by identifying potential trouble spots, focusing corrective responses and avoiding the cost and hassle of switching factories following a crisis.

ICP, for example, goes beyond simply tracking auditors’ reports. It reaches out to workers directly. Factories are required to post a hotline to which workers can anonymously phone in problems. The organization receives up to 350 such calls per month. When the software detects a spike in calls from a given factory, ICTI CARE can increase its training efforts with both staff and management, before a crisis breaks.

And if early action doesn’t work, the threat of being de-certified is a potent motivator, says Ewert. After all, it’s not a single buyer pulling out, but the entire ICP network. Ewert is confident the transparency will continue to grow as technology advances.

“Workers can call us today,” he says. “In time, they’ll be able to send pictures of dangerous conditions too,” as smart phones emerge as another tool to help the industry identify and repair risks before they become tragedies.

Click here to view our complete Tech Savvy series.

The post Tech savvy: toys appeared first on Corporate Knights.

Having made our way through Lagos’ dingy airport, we were transferred by van to a hostel. As night fell we drove through a seemingly never-ending street market, a sea of Nigerians selling every conceivable thing out of baskets balanced on their heads, carts and mobile stalls. It was my first taste of the so-called Third World. I had never seen humanity on that scale and it was overwhelming.

Living in the West, the population explosion that has taken place in the last century reaches us in the form of numbers. Lagos, 10 million people when I visited it, is now home to 21 million. By 2100, the United Nations expects Nigeria at an estimated 914 million to be the world’s second-largest country after India and before China. The UN’s most recent projection envisions the world population in 2100 at 10.9 billion. That’s the medium variant; the high variant projects 16.6 billion, the lower 8.3 billion, depending on fertility rates, over which demographers bicker endlessly.

It all seems pretty abstract. But as the world’s population, currently at 7.2 billion, continues to grow, we’re becoming more aware of its impact: climate disruption, plant and animal species extinction, land degradation, ocean acidification, the spread of toxic compounds, increased susceptibility to infectious diseases, groundwater depletion and resource wars. It’s a depressing litany for which history offers little consolation; we’re not talking about the rise and fall of a regional civilization, like the Mayan or Egyptian, but the potential collapse of a global one.

Humans are good at denial. We’re also good at blaming others. And as British environmentalist and occasional Corporate Knights contributor George Monbiot points out, the rich white Western men that dominate the population control conversation are more inclined to blast the breeding habits of far-away brown people than to acknowledge the impact of their own overconsumption. The uncomfortable fact is that I, with my trans-Atlantic, first-worldly existence, will have consumed a whole lot more of the world’s resources in the last 20 years than probably all the yam vendors on that street market combined. In fact, Paul Murtaugh, statistical ecologist at Oregon State University, estimates that an American born today will produce a carbon footprint 86 times that of a Nigerian down the generations.

This fact can’t be taken to condone population growth in the developing world, providing it remains poor. Population-curbing support to the developing world is indeed worthwhile but it won’t solve the problem of overpopulation, let alone begin to address the arguably more egregious one of overconsumption. Begging the question of what, if anything, will.

Humankind is not grappling with this problem for the first time. Ever since populations began blossoming in the Industrial Revolution, cautionary voices have been raised. Writing in 1798, Reverend Thomas Malthus predicted that with human numbers increasing exponentially and food supply growing arithmetically, mankind was headed for a catastrophic crunch. Being a man of the cloth, Malthus’ recommendations were of a moral nature – abstinence and delayed marriage – but his morality did not extend to the poor or “defective” whose reproduction he thought should be forcibly prevented. Otherwise and less desirably, Malthus believed that war, disease or starvation would take care of the overpopulation problem.

While the Malthusian catastrophe was averted by advances in agriculture and birth control and his thinking subsequently roundly denounced for its pessimism and inhumanity, the notion that the unwashed masses threaten the well-being of the rich has proven remarkably tenacious. And his basic tenet, that human population will ultimately outstrip global resources, has gained currency with time. During the postwar boom of the last century as the world’s population growth peaked, reaching a 2.2 per cent annual increase in 1963, the World Bank, UN and major American philanthropic foundations made population control in the Third World top priority, more or less deaf to calls that what was needed as much as contraception was development aid aimed at reducing poverty and child mortality and improvements in women’s health and education. Soon developing countries were taking matters into their own hands. When Indira Gandhi declared a state of emergency in 1975, her son and advisor Sanjay implemented a sterilization program – initially voluntary and then forced – in which over eight million Indian men are said to have been snipped. In 1978, China introduced its one-child policy, which was only eliminated fully last month. It was credited by the Chinese government with having prevented the births of 400 million people.

The extent to which these measures kept the numbers down is debatable. Many, including Karan Singh, India’s health minister under Gandhi, maintain that it was advances in development more than sterilization and abortions that put Indian population growth in check – consider the difference between fertility rates in developed southern states like Kerala (1.6 children born per woman) versus impoverished northern ones like Bihar (3.4). Likewise, demographers of China will point out that fertility rates were already in decline when the one-child policy was introduced, and that with urbanization and poverty reduction, the population was bound to drop.

Not only is their efficacy questionable, such coercive measures cause collateral damage. The selective abortion of girls which has drastically skewed China’s gender balance, the notorious abuse of power by local bureaucrats trying to fill quotas or their own pockets by kidnapping and selling “illegal” children for international adoption – all these offend Western (Christian, human rights, feminist, democratic) sensibilities to the point that even today’s most vehement population control advocates won’t defend them.

India’s health minister maintains it was advances in development more than sterilization and abortions that put Indian population growth in check.

American ecologist Paul Ehrlich, for instance, who in the 1960s supported certain forms of coercion, including suspending food aid to countries deemed “hopeless,” now talks less about adding sterilants to drinking water than about empowering women and reversing wealthy countries’ tax systems so that additional children cost more. A biologist and butterfly specialist at Stanford University, Ehrlich is in no way anti-life. But he fears the worst and, within a generation, his concerns have migrated from the margins to the mainstream.

In his 1968 best-seller The Population Bomb, Ehrlich predicted that global overpopulation was going to cause imminent catastrophe in the form of widespread disease, famine and/or war. His critics don’t tire of reminding him that none of this came to pass. But as with Malthus, Ehrlich’s prognosis was followed by something of a miracle – the Green Revolution – in which agricultural yields and thus food supply were dramatically increased particularly to those parts of the world that needed it most.

But even Norman Borlaug, the so-called father of the Green Revolution, described these gains as “bought time” and took his 1970 Nobel Lecture as an opportunity to warn of the ongoing “magnitude and menace of ‘the Population Monster’.” Today, with 852 million people suffering chronic malnourishment, the vast majority in developing countries, Borlaug’s concerns have been validated.

It’s unlikely that the world is going to be blessed with another miracle. In fact, as Alan Weisman points out in his just-published Countdown: Our Last, Best Hope for a Future on Earth?, the next two billion people are going to have a more devastating impact on the planet than the last two billion did, as we scrape the bottom of various resource barrels. Modern-day cornucopians and free-market environmentalists who claim that technological advances will continue to support unfettered consumption of energy, food and stuff sound like increasingly deranged voices in a rather barren wilderness. Carbon capture, ethanol, genetically modified organisms, space colonization – none of these advances, if that’s what they are, are going to rescue us from ourselves. We are faced with the most inconvenient truth that we might actually have to change our own habits.

Is it too late, or as a paper Ehrlich recently presented to the Royal Society in London cheerily asked: “Can a collapse of global civilization be avoided?” Despite a grim collective assessment of the current state of affairs – Prince Charles calls humankind’s current behaviour an “act of suicide on a grand scale” – Ehrlich and others find reason for hope.

For one thing, population growth rates are steadily dropping. In the last 60 years, women have gone from having an average of 6 to 2.5 children. Population numbers will continue to increase as the postwar bulge works its way through the system, but fertility rates continue to fall. The burgeoning middle classes in China, India and Africa – increasingly educated and urbanized – are having fewer children than their foremothers. And they’re not behaving as badly as we sometimes claim; in 2012, China committed to put a quarter of its land mass under ecosystem protection.

Furthermore, Ehrlich applauds Europe’s negative population growth and calls on wealthy countries to dispense with early retirement and to plan for rather than bemoan their aging populations. “It’s easier for a 70 year old to be economically productive than a 7 year old,” the 81-year old professor said in a recent phone conversation from California, before jumping on a plane to Australia and New Zealand for lectures, conferences and field work.

The biggest challenge, Ehrlich believes, is to wean the economic system off its addiction to growth. Steady-state economic systems have to be designed and, trickier, sold to a consumer-driven public. Ehrlich makes a plea for a culture of “foresight intelligence” which would eclipse short-term selfishness, enabling people to pay a price today for benefits that will accrue to others tomorrow. Too bad that can’t be sprinkled in the drinking water.

According to Sara Parkin, a further challenge is the male domination of the population debate. The former British Green and founder of the sustainability charity Forum for the Future has observed in her careers as both nurse and politician that men simply can’t talk about sex. They prefer calling for “chalk boards and dollar bills” than anything to do with the reproductive act. While for Parkin, the key lies in contraception.

“Look at Cleopatra,” Parkin exclaims. “She saw half an orange and thought womb cup.” Perfectly shaped and acidic to boot.

Parkin would love to debunk the myth that poor women want lots of children. Poor women are acutely aware of mouths to feed; they simply want children that survive to adulthood. She believes that if women have constant access to contraception – not predicated on roads that wash out, refrigeration that fails and spouses that won’t comply, as is still the case in much of the world – global population could be brought down to the UN’s lowest projection trajectory by 2100.

Honking our way through that chaotic Lagosian street market 20 years ago, I remember thinking of my grandmother, who had fretted about my going to Nigeria. For her, the place was a something of a black hole. A fan of Silent Spring author Rachel Carson, she kept a huge garden at her home in the countryside outside of Hamilton, Ontario, where a rainbow sticker on the front door reassured visitors: “You are entering a nuclear-free zone.”

Every generation has its challenges. My grandmother had six children, but none of her 13 grandchildren have had more than three. In fact, most of my cousins, in their 30s and 40s, are childless. And there hasn’t been nuclear war.

No doubt, with enlightened (and maybe a little more female) leadership, global population can be kept under control, too.

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A week before the G20, a conference for the world’s young women took place in downtown Toronto. The G(irls) 20 helped to bring together women representing each of the countries of the Group of 20, plus Malawi, to discuss obstacles facing women across the globe. The women discussed attitudes surrounding menstruation in the developing world, a subject that is now on the radar of many aid agencies and NGOs.

Belinda Stronach, the executive vice-chairman of Magna Corporation and an MP from 2004 to 2008, sponsored the G(irls) 20 through her Belinda Stronach Foundation. “When you give girls a chance to get an education, they can earn more money,” Stronach told the Toronto Star in October. Citing former U.S. Secretary of State Madeleine Albright, she added, “They reinvest 90 per cent of their income back into their families and their communities, versus 30 to 40 per cent of their male counterparts.” However, organizations such as the World Bank and Oxfam believe prevailing attitudes towards menstruation have prevented women from playing a more active role in their communities. In 2005 the World Bank estimated a girl could miss up to 20 per cent of her school year if she doesn’t attend during menstruation.

Studies suggest menstruation is taboo in some cultures, preventing learning and open discussion about the subject. These taboos often require menstruating women to refrain from interacting with their family and community, and from participating in religious ceremonies.

A study by the Forum of African Women Educationalists of Uganda in 2004 found Uganda’s rural population had a poor understanding of menstruation, but men stood out in particular. When asked about menstruation, girls described a culture of silence.

When girls do receive information about menstruation, it is often from unreliable sources. The African Journal of Reproductive Health surveyed 550 secondary school girls in south eastern Nigeria, and found over 90 per cent received information about menstruation from mothers, aunts, or friends. Only 3.3 per cent had discussed the subject with a health professional.

The education system is not much better. Only 0.4 per cent reported discussing the subject with a teacher. This may be due to the fact that female teachers represented only 30 per cent of primary school teachers in West Africa in 2009. In this patriarchal system, female teachers may be afraid or unable to educate children on puberty and bodily functions such as menstruation. A paper published in 2009 by international NGO Wateraid reported a teacher from Lalitpur, Nepal told a girl, “This topic need not be taught; you can self-study at home.”

Because of this lack of education girls are often stigmatized. In conversations held in 2004 by the Sudan Basic Education Project, one girl explained, “We have to ensure that we are very clean before we get back to school. Otherwise boys will tease us publicly, bully, and say nasty things about us. It is so embarrassing that we avoid the embarrassment by staying away from school.”

Working women also suffer similar problems. A study published by the Institute for the Study of Labour in February 2010 found women in China were 10 per cent less likely to participate in wage work if their place of employment lacked access to a clean source of water than if there was a clean source. The authors concluded that this is due to the need to wash used menstrual rags, maintain personal hygiene, and avoid infection.

This lack of facilities has been observed in many developing nations. Wateraid noted in Bangladesh public facilities for women were often non-existent. As a result women rarely washed their rags in clean water and hid them in dark places, which encourages the growth of mould. This has led to vaginal infections and cuts that are hidden and dealt with in silence.

Elizabeth Scharpf, a graduate from Harvard Business School and founder of Sustainable Health Enterprises (SHE), discovered how menstruation affected women lives while working for the World Bank in Mozambique. “This wasn’t just one problem that existed as an anomaly, but actually a global issue,” she says. “[It has] significant costs to education, health, and productivity.” For instance, SHE estimates the lack of menstrual pads could lower Rwanda’s GDP by up to $115 million U.S.

Scharpf explains a pack of ten brand name disposable pads in Rwanda costs approximately $2.25 U.S., while the average monthly salary is around $34 U.S. In other words, a single pack of menstrual pads, not enough to last a period, consumes about 6 per cent of a Rwandan family’s monthly budget. In Nepal, this figure can go up to 10 per cent. This can be a difficult expenditure to justify when many in the household may not understand menstruation.

SHE partnered with North Carolina State University and Massachusetts Institute of Technology to created a low-cost menstrual pad using banana fibres. The pads, for which SHE won the 2010 Curry Stone Design Prize for innovative design, are safer for the environment and less expensive because they are made with locally available, natural materials. SHE’s goal is to empower women by giving them an opportunity to own and operate businesses selling these pads via microfinance loans, training, and partnering with existing local women’s networks. SHE intends to begin manufacturing the pads in Rwanda before the end of 2010.

Scharpf has also created the SHE28 campaign, an advocacy campaign that has helped 5,000 community health workers provide generic menstrual pads at a fraction of the cost, secured an investment of $35,000 from the government of Rwanda to procure pads for the poorest girls, and is working with developing countries to integrate sexual education into their curriculum, and eliminate taxes on pads.

SHE is not the only organization seeing the need to provide women with access to menstrual pads. The Clinton Global Initiative and Proctor and Gamble have pledged $2.8 and $5 million U.S. respectively to help deliver more affordable pads. And Canada has pledged $1.1 billion CDN for maternal and child health initiatives which will include “sanitation” initiatives.

But a new study published in March 2010 by the University of Michigan, the University of Chicago, and Harvard University cautions organizations against just throwing money at the problem. The authors, Emily Oster and Rebecca Thornton, tried to capture the effect providing menstrual cups to school aged girls would have on attendance. Using a randomized sample of 192 students in Nepal they found girls missed only 0.4 days in 180 due to their period regardless of whether they had access to menstrual cups. The study was taken in one of the more developed regions of Nepal but the authors believe the results could be generalized to other developing countries.

Instead, The Center for Global Development, a policy think tank, believes, “Donors must focus (…) on the social barriers in the transition between primary and secondary levels, typically affecting girls ages 10–14.” They found parents were less likely to invest in educating daughters because girls leave home upon marriage and are therefore perceived as an empty investment.

It may be impossible to single out menstruation as the main reason women have been left behind in the developing world. Nicholas Kristof, author of “Half the Sky: Turning Oppression into Opportunity for Women Worldwide”, wrote, “There’s no silver bullet to get more girls in school,” but added, “[providing menstrual pads] may be one of the silver buckshot.” If nothing else, menstrual pads promise to give women in developing countries more confidence to take the opportunities that come their way, regardless of which days in the month those opportunities fall.

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“I was a family physician in rural practice for over 20 years and twice I had individuals who chose to go blind rather than travel to the big city to access an eye specialist,” says Dr. Roger Strasser, founding dean of the Northern Ontario School of Medicine. “So you can hardly say the system is meeting the needs of those patients.”

Those patients were scared of leaving their community, he explains. “If you’ve never been to a big city, it’s really terrifying. People who grow up in rural areas feel comfortable there. They want to access health care [close to home].”

That’s not easy when almost a third of Canadians live in rural areas with access to one tenth of our country’s physicians. The result: rural Canadians have more illnesses and a shorter life expectancy than their urban peers. Specifically, First Nations men and women live seven and five years less, respectively, than other Canadians.

And things are about to get worse. In July 2010, the Canadian Journal of Rural Medicine (CJRM) found one in seven rural physicians are planning to move from their communities within the next two years.

Despite the fact that Canada’s urban population is growing and small towns are disappearing, rural and Aboriginal health care should not fall further through the cracks. Beyond the fact that all Canadians deserve the same access to care, rural Canada generates the country’s fuel and food supply, and as arctic sovereignty issues heat up, access to health care in the far north will be critical to keeping a population settled there.

Before nurse practitioner Renate Bennett’s small forestry community of Caledonia, N.S. banded together eight years ago to build a local health care facility, she was working out of a small trailer without heat or running water. We’re not wealthy, she says, “but people were able to find $100 because they were committed enough to having this building.” Bennett knows some communities are not as fortunate. “Sooner or later, if people can’t access primary health care in a rural community, they’re going to end up in a larger centre.”

Frieda Prince, social development worker for the Lower Similkameen Indian Band in the Okanagan Valley of B.C., agrees. “All those people in Vancouver, Toronto, and Montreal come from somewhere, usually the smaller communities. When you look at your Downtown Eastside, wherever that is in whatever community you’re in, that’s usually made up of people migrating to the larger centres from [rural] communities.”

Instead of promoting a diaspora from rural to urban centres, Dr. Strasser says the best health care solutions come from the rural communities themselves. “There is a tendency to take models from the city and somehow try to miniaturize them. Worst case scenario, it leads to a collapse of the health service.”

The urban formula for determining where to locate care facilities based on population density is one example of this collapse. When applied to rural communities, facilities are often concentrated in one area, which means surrounding districts have to travel far distances. Instead, Dr. Strasser says planners should look at integrated health services, which mix emergency, short-term, and long-term care beds in the same facility. But that means having versatile practitioners.

“Rural practitioners provide a wider range of services,” says Dr. Strasser. “They carry a higher level of clinical responsibility, in relative professional isolation.”

That isolation presents both challenges and opportunities. With fewer health providers, people get overworked and don’t last very long, says Dr. Michael Jong, Associate Professor with the Northern Family Medicine Education Program (NorFam) at Memorial University. But once there is a “reasonable” number of peers, the broad scope of practice available to doctors means they’ll stay, says the CJRM’s July survey. And there are other exciting benefits.

“[Health providers] live in the community they serve, so they have the opportunity to assist the community as a whole in improving their health,” says Dr. Strasser. “In a small town in rural Australia, the local doctor was so effective in presenting the message of the relationship between red meat, cholesterol, and heart disease the butcher shop started selling fish.”

To achieve such effectiveness, the NorFam program at Memorial trains physicians in rural areas, for rural areas. At the Northern Ontario School of Medicine in Sudbury, first-year students spend four weeks living and learning in Aboriginal communities.

That type of immersion, Dr. Jong says, is the key to successful retention. Dr. Jong came to rural Labrador from Malaysia to practice medicine in the late 1970s and having seen many doctors come and go, he has a deep understanding of the issues with a transient provider population.

“You cannot parachute someone into the community [to help you and] solve your problems. Residents say, ‘You need to be around for at least a couple of years before we trust you.’ Most people hate retelling their medical issues over and over again,” he says.

With programs that expose students to the issues, the fear of working in a rural environment is eliminated. “Most of the doctors here in Labrador were trained here, except the old guys like me.”

And rural and Aboriginal students often prefer staying close to home. The University of Lethbridge has a Support Program for Aboriginal Nursing Students (SPANS) located relatively close to the Blood and Piikani reserves. It prepares and supports First Nations, Métis, and Inuit students throughout the four-year Bachelor of Nursing Program by incorporating mentorship and the wisdom of elders. Before the program there were at most four aboriginal nursing students, and now there are 60, says Dr. Judith Kulig, SPANS’ coordinator.

A varied approach is needed not just for education, but for the doctor-patient relationship.

“We need to allow physicians a multiplicity of ways of dealing with their patients,” says Dr. Diane de Camps Meschino, a staff psychiatrist at Women’s College Hospital. One of her psychiatric patients lives two hours away and has three kids. Despite icy roads in winter, Dr. Meschino can’t treat her by telephone. “A system like that is revolting.”

While Dr. Meschino treats some patients by phone and doesn’t get paid, she criticizes, “How is a system [like] that sustainable?” Increased use of technology would help both patients and other doctors, especially those in remote areas who can’t just go next door to ask their colleague a question.

“While I was on holiday, I had a call from a doctor in a small town in Ontario, and an email from a physician in Newfoundland [looking for specialized expert advice],” she says. “If I can give that kind of information in five minutes to a doctor, it means [neither the doctor nor] the patient has to travel, and the patient gets timely care.”

Some options include telehealth programs, which use video conferencing to connect doctors with each other and with patients. There is also email consultation. In his town of Happy Valley-Goose Bay, Dr. Jong says they are piloting remote-controlled robots for surgeries.

But we need to start with the basics. “Canada has among the lowest rate of electronic health records in primary care in the industrialized world,” says Dr. Danielle Martin, Chair of Canadian Doctors for Medicare. “That’s a real barrier to patient safety,” she says, since documentation of prescriptions, allergies, and other medical history is crucial to proper treatment.

Technology alone won’t solve the problem. A different view of what it means to be healthy, however, will improve health care. The Partners in Community Collaboration (PICC) committee in Kelowna, B.C. help remove barriers to health care for the “disenfranchised” by having frontline staff discuss the specific needs of individuals in their community. While developed for the homeless, the program deals with more than just primary health care, bringing together community partners such as mental health, addiction, employment, and legal services.

Adam Wylie, chair of the PICC committee, explains the social determinants of health with an analogy. If someone has one bee sting, they’ll take care of it. If they have ten bee stings, would you have motivation to treat all of them? No, he says. We have to address multiple issues, because addressing one won’t make a difference. “[Otherwise] the issue or the pain’s still there. It still hurts.”

Dr. Kulig agrees. “If they don’t have a chance for a job or an education, you can tell them all you want about eating properly, but there are too many other things for them to deal with.”

To Dr. Meschino’s mind, Québec is a good example. Québec’s health policy extends beyond core public health functions and deals with “healthy public policies:” adequate income security programs, a good education system, a clean environment, adequate social housing, and community services.

In B.C., the First Nations Leadership Council and the federal and provincial governments have jointly created Tripartite First Nations Health Plan to give First Nations greater control over the design and delivery of their own health care. This represents a first in a patient-centred, collaborative approach to health care. Doug Kelly, Chief of the First Nations Health Council, says chiefs in Manitoba and Ontario are interested in a similar direction.

Unfortunately, the Lower Similkameen Indian Band in B.C. hasn’t seen the benefits of this new system, says Eliza Terbasket, health and social team leader of the Band. While she supports the tripartite concept, “There is a lack of communication. Our community hasn’t been informed. When we start setting up organizations provincially, generally the small bands like ours get the tail end.”

Dr. Strasser says there’s a common expectation the Ministry of Health will do everything without the people being directly involved.

Community collaboration and empowerment is instrumental to increasing access to health in rural and Aboriginal communities. Is Canada’s health care system designed to do this? Most practitioners would say no.

This article has been nominated for a RNAO Award for Excellence in Health-Care Reporting.

The article photo is courtesy of the Frontline Health Story Project, the goal of which is to increase awareness of the innovative ways that practitioners are helping to improve the capacity to serve Canadians facing barriers to healthcare. See more at www.frontlinehealth.ca

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