Hold my Hand

On a snowy Wednesday afternoon, my class was fortunate enough to have two guest lecturers Jennifer and Yousra from the Access Alliance Community Health Centre. Having never volunteered or worked at a community health centre before, I was amazed at the range of services this centre offers to newcomers to Canada from all over the world. Having grown up in a suburb or “bubble” north of Toronto, I was unaware that these comprehensive services were even available. As Jennifer and Yousra spoke passionately about the diversity of care they provide and the community cooking programs they run, the value and significance of the social determinants of health began to come to life. Seeing the complexity of the patient case studies, I realized that being a community dietitian involves so much more than simply telling people what to eat.  I was reminded of what I had learned four years ago in FNP 100 about how dietitians must be able to take on multiple roles or “wear different hats” in different situations. Jennifer used the example of how she had once spent her entire session with someone teaching them how to use a can opener for the very first time. Teaching newcomers about Canadian food practices and practical cooking skills can empower them to experiment with new foods and not feel like they are outsiders in a foreign environment. To me, social inclusion is one of the most important aspects of overall health and one of the key ways in which we can bridge social inequities. Community kitchen cooking programs (such as the one offered as Access Alliance) reflects one of the ways that we can break down social and cultural barriers to help build social support networks and equality in the community.

In seminar, my group was talking about the difference between an educational and charitable model of health promotion. In first and second year of the program I volunteered at the Community Food Room, a student run food bank funded by the Daily Bread Food Bank at Ryerson University. The students who use the food room are incredibly thankful that this is service available to them and would often explain to me how much they appreciated my time and dedication to being there. Since the students were roughly my age, I could directly relate to them and understand the emotional barriers they had to overcome to resort to using the food room for their essential needs. However, even with the introduction of collectivist organizations such as community kitchens, there is still a stigma attached to using food banks. Despite their sincere gratitude to having this service available on campus, it was clear that some students felt ashamed to be using the food room, often coming alone or making their friends wait outside. For more information about the Community Food Room see http://www.foodroom.ca/.

As I reflect on the lessons I have learned from this week, all I keep thinking is...how would our society be different if these essential services did not exist?

Acheiving Global Impact at the Expense of Our Own

I am writing in response to the article "Shaping the future of health promotion: Priorities for action". This article written by the International Union for Health Promotion and Education (IUHPE) outlines the need to promote global health between and within countries around the world. In sticking with Medicare's Canadian values (fairness, equity, compassion and solidarity) health promotion must move beyond the health care system and focus more on the social determinants of health to enable people to take control of their health. The Ottawa Charter for Health Promotion has laid a solid foundation for the mobilization of health promotion, however new challenges and changing demographics create the need for health care reform and revitalization, in Canada and around the world. " As we move into the 21st century, health promotion researchers, practitioners and policy-makers must build on what has been learnt about effective health promotion in different parts of the world, putting widely into practice what works to ensure that all countries and regions fully implement the ambitions of the Ottawa Charter".

Despite these efforts of bridging health inequalities, the University Health Network in downtown Toronto has issued a $75 million five-year agreement with the Kuwaiti government to provide cancer treatment to their citizens at the Princess Margaret Hosptial. This bold plan highlights the underlying issue of Canadian hospitals: with limited public funds, hospital are now seeking new ways to generate revenue at a time when patients are waiting longer than ever for health care services. The details of this initiative were published in last week's Globe and Mail which drew the attention of some very angry reader's. "Our hospitals are jam packed. Specialists are limited and waiting lists for care are still far too long. No one should be able to buy their way to better treatment". To me, this undertaking goes against Medicare's values, particularly fairness and equity for all. How are we supposed to take care of our own citizens if patients in third world countries are the priority? To me, it all comes down to the lack of funding and limited resources given to health care.See http://www.theglobeandmail.com/news/national/ontario/ontario-hospitals-deal-with-kuwait-sparks-fears-of-queue-jumping/article1889648/ for the full article on this developing story.

Building on my section's seminar discussion, it is clear that there is a critical need for preventative health services in the community. Health services such as dental care, eye care and psychology are all privatized and therefore prevent people from getting the care they need, solely because they simply cannot afford it. In order to move forward with health care reform, policy makers must look beyond the health care system and focus in on the social determinants of health and the underlying causes of illness and disease. The changing demographics of our population pose additional challenges to current policy which must be adressed immediately to help alleviate the burden on the health care system.

See the link for a short video clip published in November 2010:
http://www.theglobeandmail.com/news/national/time-to-lead/healthcare/video-debates-part-1-can-private-clinics-fix-public-health-care/article1795031/