“Doctors pour drugs of which they know very little, into diseases of which they know less, into patients of which they know nothing,” said Dr. Tak Mak, quoting the seventeenth century French playwright Molière. Mak’s quote echoed the sentiments of his fellow speakers at “The Changing Face of Health care in Canada,” an afternoon of speeches and dialogues put on, this past Thursday, by student group The Stethoscope.
Six people with “Dr.” in front of their names from several corners of the medical community were invited to talk about community health. Altogether they made one thing clear: good Canadian health care depends not just on drugs and equipment, but also on good “community health care.”
The first to speak was Dr. Caroline Bennett-formerly a practicing MD and now MP for the St Paul’s riding in midtown Toronto; she is also Canada’s current minister of state for Public Health. She spoke about how the Canadian public health care system has to re-learn some of the listening skills that she had to learn as a doctor. MDs must listen to others in the community to achieve better overall public health for this country, she said.
“You really have to know what people who aren’t doctors know,” Minister Bennett said. “It was the pharmacists that first realized there was a problem at Walkerton because of increased sales of particular drugs.”
She used this as an example of the multidisciplinary action that needs to be taken to identify and tackle community health problems.
Bennett also spoke about the multiculturalism that is necessary in Canada’s community health. She explained, “Canada’s food guide does not reflect the people who have never had dairy in their diet in this country.”
Bennett was appointed to this new cabinet position created by Paul Martin just after he became prime minister in December 2003. Although she does take her position very seriously, she admitted, “Everyone knows I wouldn’t have had my job if it wasn’t for SARS.”
Dr. Paul Caulford was on the frontlines of SARS during the summer of 2003. He works at the Scarborough Hospital and at the Volunteer Uninsured Immigrant and Refugee Clinic.
He criticized the lack of integration that exists in community healthcare in Canada. “Within one week at the clinic where three doctors got SARS, [Toronto] Public Health had not informed the other doctors in the clinic how to decontaminate the office,” he explained.
Caulford said that SARS was just a flashpoint for what can happen and what will happen in the future if we don’t get our community system in shape. “The next wave of avian flu is on a plane somewhere.”
He said that with the GTA accepting 48 per cent of immigrants coming into Canada, and Scarborough absorbing many of those refugees, Scarborough is the defining community for Canada’s future. At his refugee clinic he receives 7,000 uninsured patients each year. The statistics at his clinic are worth noting: 19 per cent of patients are pregnant, 65 per cent are women, and 90 per cent meet the criteria for homelessness.
His solutions went back to Bennett’s point about multi-disciplinary action. He says we need to have a geographic information systems (GIS) specialist lay out a map of where low birth rates are in the community; then lay over top of that a map of where low income levels are in the community; and then lay over where industrial smokestacks are. He said that this will help us see the origins of some health problems and allow us to begin to solve it preventatively, instead of everything ending up in the clinic.
Medical anthropologist Dr. Richard B. Lee brought another perspective to this issue. He has worked in Africa on the AIDS epidemic. “Within AIDS research there are many people working on the macro-level but we decided to work on the micro-level.”
He mentioned that 95 per cent of the children 15 and under in areas where he has worked are HIV-negative. It is up to community health workers to educate these children on the importance of restraint and condoms for the future of their country.
Last was Dr. Mak, who spoke about cutting-edge new “sharp-shooter” cancer treatments that kill cancer cells without hurting the regular functioning cells of the patients.