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April

30Apr

New funding will support food security programs throughout B.C.

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With a $3-million grant from the B.C. government, the Victoria Foundation will improve access to fresh, nutritious, affordable food for thousands of people who regularly experience food insecurity.

“Connecting more people to healthy food will make a huge difference in the lives of so many families,” said Shane Simpson, Minister of Social Development and Poverty Reduction. “This is a perfect example of how we can all work together to reduce poverty and make life better for British Columbians.”

From the $3-million provincial contribution:

  • Up to $2 million will be used to help purchase the Mustard Seed’s Food Security Distribution Centre, which is a hub to redistribute food across south Vancouver Island and home to the region’s Food Rescue Project. The building has been leased since 2017, and the purchase will provide long-term stability for the program.
  • The remaining funding will be used to offer grants to organizations in B.C. for food security projects that can help low-income individuals and families.

“The Victoria Foundation and Mustard Seed are partners in a far-reaching network of businesses, non-profits and community volunteers working together to tackle food insecurity in a sustainable way,” said Simpson. “Our government is proud to support these efforts and help them grow to reach every person who needs support.”

Food insecurity occurs when people do not have reliable and regular access to quality, healthy, culturally appropriate, affordable food. It affects the health of approximately 50,000 people in the capital region and around half a million people provincewide.

Through the new Food Security Provincial Initiatives Fund, the Victoria Foundation will work with local non-profits throughout B.C. to identify community-specific needs and create food security projects that support health and wellness. More details on the fund will be available in late June 2019.

“Food security is central to the well-being of people, which makes it a priority for our region and the Province,” said Sandra Richardson, CEO, Victoria Foundation. “The new Food Security Provincial Initiatives Fund will help us build and support other programs like the Food Rescue Project, because better food creates healthier individuals, families and communities.”

The Food Rescue Project operates in collaboration with more than 50 member organizations of the Food Share Network, an informal group of local non-profits, First Nations, school districts and organizations working toward a food-secure region. The Mustard Seed recovers about 1,815 kilograms (4,000 pounds) of fresh food daily from local grocery stores and redistributes it to network members, who in turn help feed 35,000 food insecure people in the capital region annually. The centre is the key piece in a food distribution network that decreases food insecurity and connects people with social service programs.

“The distribution centre will secure a permanent location for a food hub for the capital region,” said Derek Pace, executive director, Mustard Seed Street Church. “Purchasing the building gives us the stability we need to continue growing the network of donors who provide food each week and to continue to support and participate in the Food Share Network made up of those groups who distribute food to people in their communities. In addition to helping ensure that the Food Rescue Project remains sustainable, the centre will enable the community’s larger vision for food security, growing programs in food literacy, employment, environmental sustainability and the local food systems.”

The Victoria Foundation is actively working to find other donors to support the Mustard Seed’s purchase of the Food Security Distribution Centre and the Food Security Provincial Initiatives Fund. Vancity has already committed $200,000 to support the purchase.

Learn More:

TogetherBC, B.C.’s first poverty reduction strategy:
https://www2.gov.bc.ca/gov/content/governments/about-the-bc-government/poverty-reduction-strategy

The Victoria Foundation’s food security initiatives:
https://victoriafoundation.bc.ca/food-rescue-project/

The Mustard Seed Street Church’s Food Rescue Project:
http://mustardseed.ca/food-rescue/

A backgrounder follows.


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29Apr

Canada warnings about meds should be more consistent with other countries: UBC prof

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FILE – In this Friday, July 8, 2016 file photo, a prescription is filled at a pharmacy in Sacramento, Calif. On Friday, May 11 2018, Trump is scheduled to give his first speech on how his administration will seek to lower drug prices. (AP Photo/Rich Pedroncelli, File) ORG XMIT: NY766


Rich Pedroncelli / AP

VANCOUVER — Health Canada needs to be more consistent with three other countries when it comes to issuing warnings about the safety risks of certain medications, especially if the jurisdictions with similar demographics have already advised patients taking the same drugs, a University of British Columbia professor says.

Barbara Mintzes, the lead investigator of a new study published Monday, said that between 2007 and 2016, Health Canada issued safety warnings for only 50 per cent of drug-safety issues identified in the United States, Australia and the United Kingdom.

She joined researchers in analyzing 1,441 advisories over that period and found regulators in all four countries were only consistent in the decision to warn their populations 10 per cent of the time regarding issues with the same medication.

Compared with the other countries, Health Canada issued advisories for only 317 of 635 drug-risk issues, or nearly 50 per cent of the drug-risk issues identified by the U.S. Food and Drug Administration, the U.K. Medicines and Healthcare products Regulatory Agency and Australia’s Therapeutic Goods Administration, the study said.

The study was published in JAMA Internal Medicine, published by the American Medical Association, and also involves researchers from York University in Toronto and the University of Sydney in Australia.

Health Canada issues warnings on its website, and Mintzes said it also sends letters to doctors who prescribe the drugs.


Dr. Barbara Mintzes is shown in a handout photo.

Danny Abriel /

THE CANADIAN PRESS

“Some of the safety warnings are put out by Health Canada, together with the manufacturer, and that will come as an individually sent letter to each doctor within a specialty or … a broader set of all doctors who are practising in Canada,” said Mintzes, who is an affiliate associate professor at UBC’s School of Population and Public Health.

She said that in January 2013, Health Canada issued a warning about commonly prescribed cholesterol-lowering drugs, or statins, being linked to an increased risk of diabetes among patients already at risk for the disease.

However, the warning was issued a year after the United States and Australia informed patients about the drugs following large studies showing an association with diabetes, she said.

“Why did Health Canada wait another year after these warnings occurred in the U.S. and Australia?” asked Mintzes, who is also an associate professor at the University of Sydney.

The department said it regularly liaises with key international counterparts including the U.S., Australia and the European Union to determine if there are any emerging safety concerns. Once it becomes aware of any potential issues, an assessment is done to determine if a similar risk is warranted in Canada.

“Timing and content of risk communications can differ across jurisdictions for a number of reasons including, for example, how a product is used in Canada,” it said in a statement.

Health Canada should be more transparent about the information on which it bases its warnings, especially because clinical-trial data that were previously confidential have been publicly made available for some time following a similar stance in the European Union, Mintzes said.

“We could do more as a country to have more services available to people who are using medicines, with a user-friendly website that provides information to the public so they can just look up their drug fairly easily.”

Pharmacies in Canada are also inconsistent in providing patients with written information about drugs and possible adverse reactions, Mintzes added.

“We should have a legislated right to always having approved patient information provided to us every time we have a prescription dispensed.”

A study in 2013 by the Canadian Institute for Health Information said up to a quarter of patients who visit emergency rooms due to adverse reactions are admitted to hospital and that seniors at greater risk for such effects.

Antibiotics are among the most common drugs associated with adverse drug reactions, which are known to be associated with factors such as the number of drugs a patient is taking, the study said.


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29Apr

School board to vote tonight on fate of French immersion at Kitsilano school

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The fate of the French immersion program at Henry Hudson Elementary School will be decided at a Vancouver School Board meeting tonight. 

Trustees will vote on a motion to phase out the program, which would make this year’s kindergarten class the last to accept enrolment.

Many parents are worried about losing the French immersion program. 

“It’s been very stressful for families and our children,” said Josh Paterson, a parent on the school’s advisory council. 

“Some parents have had to think carefully about whether or not they should be looking at other schools, which threatens the existing program here and creates a stress in their life,” Paterson said.

Parent Josh Paterson said the kids at Hudson don’t want to be torn from their school or lose their French immersion program. (Radio-Canada)

The phase-out was one of several options recommended in a recent report to deal with the school being over capacity. There is not enough classroom space to accommodate the English program as well as French immersion. 

There are many families that get turned away every year.– Glyn Lewis, Canadian Parents for French

Adrian Keough, director of instruction for the VSB, said under the School Act of B.C., the board must provide education in English as a priority.

“We’re are at a point now where we cannot continue to enrol French immersion, and accept all of the English students who want to take the English program in that school,” Keough said. 

“We’ve taken away the staff room, we’ve taken away computer rooms, we’ve added portables. All trying to mitigate the situation,” he said. 

Keough said the school board remains committed to French immersion and added about 100 seats across the district last year. 

High demand for French immersion

Glyn Lewis, B.C.’s executive director of Canadian Parents for French, said accessibility of French immersion is already a major issue, especially in downtown Vancouver and Kitsilano.

“To cut a French immersion program in a neighbourhood, in a part of the city where there’s already very long wait lists, makes no sense,” Lewis said. 

“There are many families that get turned away every year,” he said. 

Originally, the report recommended moving the seats to Lord Strathcona Elementary School in Vancouver’s Downtown Eastside. 

However, feedback indicated that “very few” parents at Hudson would choose to enrol their children at Strathcona as an alternative due to an additional 25 to 35 minute commute.

Parent Joanne Garrie hopes her youngest daughter will be able to attend French immersion at Henry Hudson school, alongside her two older daughters. (Radio-Canada)

Joanne Garrie has two daughters who attend Hudson in French immersion. She hopes her youngest daughter can do the same. 

She said providing a place to learn French is important to her and her family, and they’ve built their community around the program and it’s current location. 

“My daughter, who started French in Grade 1, she says, ‘I found my passion, this is where I love learning is in French.’ I can’t take that away from her now. That would be very destructive,” Garrie said.  

The school board meeting begins at 7 p.m. PT. 


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28Apr

Visually impaired youth face 70% unemployment — and this group wants to change that

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Not many people notice that Duncan Simmons has a vision impairment. 

Simmons, 19, can see relatively well during the day. But when it’s dark, he’s virtually blind.

“At nighttime it’s like I’m walking around with sunglasses on. Everything is really dark,” Simmons said. 

He was one of two dozen young adults who gathered Sunday at Fighting Blindness Canada’s Young Leaders Summit in Vancouver. The event aims to help blind youth overcome hurdles finding work in a market dominated by screens.

Facing stigma

Canadians with vision impairments face 70 per cent unemployment rates.  

Event co-chair Patrick Losier, 27, said it can be tricky for visually impaired youth to determine the appropriate time to disclose their disability to a potential employer. 

“There’s a stigma with people with vision loss that they’re not capable of certain things,” said Losier, who has low vision and light sensitivity. 

Once job candidates have disclosed, they then have to ask for accommodation, Losier said, and figure out when they need to ask for help. 

Public perception

Blind paralympian Donovan Tildesley was the event’s keynote speaker.

Tildesley says blind and vision-impaired youth need to stay positive and advocate for themselves.

Blind paralympian Donovan Tildesley says visually impaired youth can be an asset in the workplace. (Jon Hernandez/CBC)

“I think the challenge with vision impairment is public perception,” he said. “Employers don’t know what a blind or visually impaired person needs, or how to make things accessible.”

Tildesley says people who are blind or visually impaired are used to overcoming challenges and can be an asset to any workplace. 


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28Apr

Surgery delays deepen over compliance letters B.C. government has forced on surgeons

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Dr. Amin Javer and his team perform sinus surgery on a patient at False Creek Surgery Centre in Vancouver. That is where Mr. Justice John Steeves had his sinus surgery under a contract with Vancouver Coastal Health. But the provincial government has severed contracts between health authorities and clinics that allow patients to pay for their expedited surgeries.


Arlen Redekop / PNG

Patients are waiting even longer for operations like sinus or breast reconstruction because of the latest government crackdown on private clinics and the surgeons working in them, according to affidavits filed in court.

Sinus surgeon Amin Javer says he can’t even begin to make a dent in the number of patients waiting. That’s because he only gets four operating room days at St. Paul’s Hospital a month, allowing him to handle just 12 to 16 cases monthly.

He also operated on patients at False Creek Surgical Centre. But last fall, the government ordered Vancouver Coastal Health to end its contracts with False Creek because the centre was also taking money from patients who were paying the clinic’s facility fees to get expedited surgery.

Javer was the sinus surgeon who operated on the judge in the continuing constitutional trial launched by Dr. Brian Day. The judge would not be able to get that sinus surgery today because False Creek can no longer do business with the government. Yet False Creek is the only private clinic in B.C. with the sophisticated equipment Javer needs to do delicate sinus surgeries.

Not only can Javer no longer perform publicly funded operations at False Creek, but he’s also doing fewer at St. Paul’s because, as the hospital struggles to deal with growing waiting lists, his operating room days have been cut to eight hours from 10.

He has about 300 patients on a pre-surgical wait-list and another 220 waiting for surgery. “It will take me about four years to get through my current surgical wait-list.”

He used to tell patients they’d get their surgery in 2.5 years. Now Javer, the head of the St. Paul’s Sinus Centre and co-director of ear, nose and throat research at UBC, says he has to tell them the waiting time has gone up to four years.

“There’s no outsourcing at all, so the wait-list at the hospital continues to grow. And there’s no extra time being given to surgeons at public hospitals. All that extra operating room time we were promised hasn’t happened,” he said.

Dr. Nancy Van Laeken, a plastic surgeon who performs breast reconstructive surgery on breast cancer patients, said in her affidavit that the government did not increase operating room time in public hospitals enough to compensate for the private clinic crackdown. That means that fewer surgeries are being done in B.C., she said.

Van Laeken said she has privileges to work at five hospitals but only gets four operating room days in total each month. She is willing to do surgeries 10 days a month, but can’t get more time.

“Because of the limited OR time in the public hospitals, the wait times for surgery … in the public system are very long. For example, many of my patients wait (up to) 48 months for breast reconstruction surgery,” she said in her affidavit, noting that is 42 months longer than the target.

For years, health authorities have paid several private clinics to help because of backlogs of scheduled surgeries. But most private clinics also take patients willing to pay out of pocket for expedited surgery. The NDP government argues it is illegal for clinics and doctors to take money from patients for operations covered by medicare and the government is determined to stamp out the practice.

Last fall, the government introduced so-called compliance letters. Surgeons who do any work at private clinics that have contracts with health authorities must sign statements promising they will not do medically necessary work in both the public and private systems. If they refuse, they are banned from doing publicly funded operations at those private clinics that have contracts with health authorities.

If private clinics don’t agree to the same conditions, they won’t get contracts from health authorities or could have their contracts cancelled.

There are only a few private clinics that have agreed to the terms, including View Royal Surgical Centre in Victoria and the ASC Vancouver Surgical Centre.

Javer and Van Laeken are among a group of surgeons who want B.C. Supreme Court Justice Janet Winteringham to issue an injunction to stop the province’s latest stab at clinics until the end of the Day trial, which is being heard by Justice John Steeves. Winteringham has reserved her decision.

The government’s unwavering approach doesn’t end there.

“Doctors who work at Cambie have received warnings from health authority executives that they may lose their surgical privileges in public hospitals if they continue to treat patients wishing to be treated quickly and privately at our facility,” said Day, co-owner of the Cambie Surgery Centre.

Rob Grant, a lawyer for Day, the Cambie Surgeries Corporation and other plaintiffs, calls the government’s actions “authoritarian” and counter-productive because surgeons get a limited amount of time — often only a day a week — in hospital operating rooms. Private clinics have, for over 20 years, allowed surgeons to use their excess capacity to help more patients, he said.

According to the government, the new contracting out policy has not hurt patients and “more scheduled surgeries are in fact being performed.” In the Vancouver Coastal Health region, however, the latest figures show about a third of patients who were waiting for surgery in the last nine months of 2018 were waiting for more than 26 weeks — triple the target numbers. While  86.4 per cent of scheduled operations were completed within 26 weeks, the target is more than 95 per cent.

In Fraser Health, the latest report also shows targets not being met.

[email protected]edia.com

Twitter: @MedicineMatters




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28Apr

‘I had to crawl’: Amputee seeks damages after United Airlines and airport security seize scooter batteries

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Stearn Hodge says he will never forget the humiliation of having to drag his body across a hotel room floor during what was supposed to be a vacation celebrating his 43rd wedding anniversary — because a security agent at the Calgary International Airport and United Airlines confiscated the batteries he needed to operate a portable scooter.

“Having to crawl across the floor in front of my wife is the most humiliating thing that I can think of,” said Hodge. “It unmasks how real my disability is … I haven’t been the same since.”

The 68-year-old retired contractor from Kelowna, B.C., lost his left arm and right leg in a 1984 workplace accident. He now relies on a portable scooter powered by lithium batteries.

But on a trip to Tulsa, Okla., on Feb. 26, 2017, an agent with the Canadian Air Transport Security Authority (CATSA) and a United Airlines official told Hodge to remove the $2,000 battery from his scooter and fly without it, as well as his spare battery.

In making the demand, both employees cited safety concerns.

Stearn Hodge shows how he had to crawl when he didn’t have his mobility scooter:

Stearn Hodge demonstrates how he was forced to crawl on his holidays, after United Airlines and an airport security agent seized the batteries needed for his portable scooter. 3:18

Lithium-ion batteries are a potential fire hazard, but global standards issued by the International Air Transport Association (IATA) allow people with disabilities to travel with compact lithium batteries for medical devices in carry-on luggage.

Hodge said no one from CATSA or United Airlines would listen to him or read IATA documents he had printed out, showing his batteries are permitted on board if an airline gives prior approval. Hodge had received that permission.

“They’re taking my legs — and not only that, my dignity,” said Hodge. 

He can only wear a prosthetic leg for a short period due to discomfort and risk of infection, he said.

A few months earlier, Hodge almost had his batteries seized on a WestJet flight. But “seconds” before takeoff — and after he suffered a panic attack — Hodge was granted permission to take them on board.

He has now hired a lawyer and is fighting to have his case heard before the Canadian Human Rights Commission.

A spokesperson for an Ottawa-based disability rights organization says it’s “frustrating” that Canada’s airline industry seems to ignore hard-won protections for people with disabilities.

“It’s been a long fight to make sure that mobility devices — or any device used to accommodate a person with a disability — can be carried on [a plane],” said Terrance Green, of the Council of Canadians with Disabilities.

“When security can — even with regulations in place — seize what otherwise should be able to go onto the aircraft, that leaves people with disabilities very vulnerable.”

‘Get a wheelchair’

When the CATSA agent seized his batteries in Calgary, the employee suggested it wasn’t a big deal, Hodge said.

“I still remember the CATSA agent saying, ‘Well, you could get a wheelchair.’ How’s a one-armed guy going to run a wheelchair?” asked Hodge. “How am I going to go down a ramp and brake with one hand? But that shouldn’t even have to come up.”

Hodge’s wife had recently undergone cancer treatment, which affected her spine, and she couldn’t push a wheelchair for her husband.

Hodge said he asked for an agent from United Airlines to come to the security checkpoint, as he had called the airline earlier and was assured it was OK to bring his battery and a spare on board.

Stearn Hodge, seen with his wife, Jan, says he has been hassled about his batteries at the airport more than a dozen times over the past two years. (Gary Moore/CBC)

But the United Airlines employee that arrived sided with the security agent.

Consequently, a three-week trip that was supposed to be a celebration with his wife resulted in Hodge spending much of his vacation confined to his bed.

To perform basic personal hygiene, he was forced to drag himself across the hotel room floor to the bathroom.

“An anniversary is supposed to be all about remembering how you fell in love … and keeping that magic alive,” said Hodge. “And those things were denied. I’m crawling across the floor and it is pathetic.”

United apologizes

A United Airlines spokesperson told Go Public that it couldn’t comment on Hodge’s experience, as he wants his case heard by the Canadian Human Rights Commission.

In an email sent to Hodge by the airline, complaint resolution official Tatricia Orija wrote that “it appears we were in violation of federal disability requirements,” offering both Hodge and his wife an $800 travel certificate.

She also apologized for the “inconvenience.”

“Inconvenience is when it rains on your holiday,” said Hodge. “This was a … life-changing moment for me and my wife.”

WestJet offers travel credit

Three months before the United incident, on Nov. 27, 2016, Hodge had also run into battery problems while travelling to Cancun, Mexico.

In that case, a WestJet employee initially told him he could take the batteries in a carry-on, but when he got to the security checkpoint, a CATSA agent said the batteries had to be in checked luggage.

“According to federal airline law, that’s the worst place you want to put them,” said Hodge. “Because if a problem develops with those batteries, they don’t know where they are and they’re only going to find out about it when it’s too late.”

Lithium-ion batteries are a potential fire hazard, but are permitted as carry-on for passengers with disabilities who require them to power medical devices. (Gary Moore/CBC)

Minutes before his departure, a WestJet employee was able to confirm that the batteries could go on the plane.

In an email to Hodge, WestJet spokesperson Morgan Bell wrote: “While I cannot change your past experience, I would like to offer you a $350 future travel credit as a goodwill gesture.”

WestJet said it couldn’t answer questions from Go Public, as Hodge has named the airline in the case he wants heard.

CATSA also wouldn’t address questions from Go Public, citing Hodge’s complaint.

The agency did provide Hodge with a transcript of a recorded call with client service agent Justine Drouin, who apologizes to Hodge and says “all of the screening officers will undergo a briefing.”

The Canadian Air Transport Security Authority, in charge of security screening at airports across the country, told Hodge that it would update standard operating procedures to ensure all agents are briefed on batteries permitted on board flights. (Jonathan Hayward/Canadian Press)

‘It’s like playing Russian roulette’

Hodge and his wife travel at least once or twice a year and say the only place they run into trouble with his scooter batteries is in Canada.

“I have flown through Europe, the United States and Mexico since 2015 with these batteries and have never been detained or harassed because of them. It is only in Canada that I have been relentlessly detained,” said Hodge. 

He estimates it’s happened more than a dozen times in the past two years, saying it now triggers severe anxiety.

“When I go through the checkpoint, I’m starting to vibrate now. I don’t know what I’m going to get. It’s like playing Russian roulette.”

‘An assault on a person’s dignity’

Green, of the Council of Canadians with Disabilities, said while he’s pleased there are protections in place for people with disabilities who are travelling, those protections need to be enforced.

“This is an assault on a person’s dignity,” said Green, noting his organization has been fighting over transportation issues for four decades.

“In 1979, the government of the day said, ‘Yes, we will make our transportation system accessible,'” he said. “Here we are … 40 years later and the same barriers are there in transportation for Canadians with disabilities.”

Terrance Green, of the Council of Canadians with Disabilities, pictured here with his seeing-eye dog, says the airline industry needs to respect protections in place for people with disabilities. (Jean-Francois Benoit/CBC)

Green, who is visually impaired, said he has had security agents question the battery in his laptop, which allows it to “talk” when it is turned on. He said he receives “a lot of emails and telephone calls” from people with disabilities who have been hassled at the airport.

“It happens very, very frequently,” said Green. “You put in complaints, the first thing that happens is the airlines deny.”

Complaints to transportation agency

Go Public asked the Canadian Transportation Agency, which regulates air, rail and marine travel, how often people have filed disability-related complaints over the past three years.

A spokesperson said the agency has received 583 accessibility complaints related to air travel during that time — with fewer than one per cent related to batteries. And those numbers have steadily increased since 2016.

The majority of complaints are from passengers who have had expensive mobility devices — scooters and wheelchairs — damaged during loading and unloading.  

Hearing in Federal Court

Last September, the Canadian Human Rights Commission referred Hodge’s complaint to the Canadian Transportation Agency. However, the agency has no power to award general damages beyond out-of-pocket expenses. 

On May 9, Hodge’s lawyer, John Burns, will ask a Federal Court judge to compel the commission to hear the case.

“It’s a failure of the Canadian Human Rights Commission to grant access to the remedy that the statute provides,” said Burns.

The Canadian Human Rights Act allows for up to $20,000 in damages for each count of pain and suffering, and up to another $20,000 if the discrimination is “willful or reckless.”

“It sends a very clear message to the airlines and everybody else involved,” said Burns. “People with disabilities should be taken seriously. You don’t take away somebody’s legs and then describe it as an inconvenience. No, this is an injury.”

Lawyer John Burns has filed a judicial review to have Hodge’s case heard by the Canadian Human Rights Commission. (Submitted by John Burns)

‘Human rights violations cannot go unchallenged’

Hodge is optimistic he’ll eventually have his day before the Canadian Human Rights Commission.

It’s a pricey endeavour. In order to cover legal costs, he’s had to put up for sale a cherished Corvette he has worked on for years. But it’s a fight he says he has to have — not just for himself, but for so many others with disabilities.

“The thing I would love more than the compensation,” said Hodge, “is the [legal] decision that someone can go to and say, ‘You did it here, you can do it for me.'”

Submit your story ideas

Go Public is an investigative news segment on CBC-TV, radio and the web.

We tell your stories and hold the powers that be accountable.

We want to hear from people across the country with stories you want to make public.

Submit your story ideas at GoPublic@cbc.ca.

Follow @CBCGoPublic on Twitter


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26Apr

Kelowna man wants people to help him learn to walk again after recent amputation

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Ralph Zaiser first noticed something wasn’t right with his leg last year, when it became red and inflamed and it hurt to walk.

The 50-year-old from Kelowna, B.C., went to see doctors and learned he had several blood clots in arteries and veins in his upper and lower right leg.

Initial surgery to remove the clots and restore circulation was unsuccessful, according to Zaiser — and four days later he underwent surgery that amputated his leg below the knee.

“You’re shattered,” he said. “You have so many emotions that go through your mind, like, ‘why me?,’ denial and utter disbelief.”

Ralph Zaiser is learning how to be mobile on his new prosthetic leg and is now able to run errands around the city and cut his front lawn. (Brady Strachan/CBC)

After two months of healing, Zaiser started to use a series of prosthetics, along with crutches.

He spent afternoons at the local shopping centre walking and resting as he learned to use a prosthetic leg — and that’s when the idea hit him.

“Why don’t I get a bunch of people to join me in this walk?” he said.

On Saturday, Zaiser plans to walk for an hour around the corridors of the Orchard Park Shopping Centre and is inviting the community to join him.

“I want to create some awareness, and [a] good way to do that might be to create a spectacle of some sort, because if you do that, all of a sudden people will be like, ‘What is this all about?’ and maybe they will start asking some questions.”

Zaiser chose a date in April to coincide with Limb Loss Awareness month and started sharing his story through videos posted to social media about being a recent amputee and the challenges and triumphs he’s experienced as he learns to accept his disability and work toward greater mobility.

That experience has been very rewarding, and eye-opening, he said.

“There are so many disabled people in this town that I’ve started taking note of and before I was a lot like everybody else and didn’t notice these people.”

He is inviting both physically disabled people and the able-bodied to join him in his awareness walk.

A positive attitude and a support network

Steve Ziehr, president of the Amputee Coalition of B.C. Society applauded Zaiser’s effort seeking out people to help him on his journey back to mobility.

Most amputees go through a grieving process when they lose a limb, Ziehr said, adding it can be a difficult road for them to reach acceptance.

“The more positivity you have and the more people you have around you to help, it sounds trite but it’s so true, the easier it’s going to be on you,” Ziehr said.

Zaiser is asking anyone interested in participating to meet him at the shopping centre food court this Saturday at 10 a.m.




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25Apr

Last member of Vancouver baseball team that fought racism helps unveil new stamp

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BURNABY, B.C. – A new Canada Post stamp honours an amateur Japanese-Canadian baseball team that used sport to battle racism and discrimination.

The Vancouver Asahi formed in 1914 and thrilled fans in the city until 1941 when it was disbanded during the Second World War as Canada interned more than 20,000 people, most of them Canadians of Japanese descent.

Canada Post says the stamp recognizes more than the well-known story of the Asahi players, who used a strategy they dubbed “brain ball” to beat bigger, more powerful teams by relying on bunts, base stealing and squeeze plays.

The stamp also honours the Asahi commitment to honourable, fair play to oppose overt racism and fear that was common in Canada during the first half of the 20th century and resulted in the forced internment of Japanese-Canadians.

Kaye Kaminishi – a third baseman and, at 97, the last surviving member of the Vancouver Asahi – helped unveil the stamp Wednesday night at a ceremony in Burnaby, B.C.

The stamp displays 11 Asahi players from the 1940 team, including Kaminishi, who appears in the back row, second from left.

Carla Qualtrough, minister of Public Services and Procurement and Accessibility, who is responsible for Canada Post, attended the unveiling and says Canada’s internment policy during the Second World War remains one of the most tragic events in Canadian history.

“This stamp reflects the Asahi’s determination to overcome racism and discrimination through the power of sport,” Qualtrough says in a statement. “Asahi players exhibited integrity, honour and fair play and were shining examples of what it means to be truly Canadian.”

Actor George Takei, known for his role as Mr. Sulu on “Star Trek,” took time off from a local movie shoot to attend the unveiling at Burnaby’s Nikkei centre, a complex celebrating Japanese-Canadian history and culture.


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25Apr

North Vancouver doctor’s painful ambulance ride led to ketamine on board

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Paramedic Specialist Ryan Stefani holds ketamine, shown here ready to be used as a nose spray. In a recent paramedic trial, used intranasally, the drug reduced patient pain significantly. Photo: Courtesy of BCEHS


PNG

Gary Andolfatto spent four hours hobbling nine kilometres on one leg over snowy forest trails, using his bike as a crutch, after breaking his leg four years ago in a cycling mishap.

When Andolfatto, an emergency room doctor at Lions Gate Hospital, was discovered by Lynn Canyon park rangers and loaded into an ambulance, his immediate need was pain control.

Andolfatto was shocked when the paramedic riding in the back with him could only offer nitrous oxide, commonly referred to as laughing gas.

“He told me how frustrating it was that it is all primary care paramedics are permitted to give since they aren’t trained or permitted to inject drugs or give opioids,” said Andolfatto.

“I was ashamed, and felt so humbled that I didn’t realize what their limitations were and how bad it must be for them and their patients in serious pain. It really struck a chord and it gave me the impetus to do something that would be a game changer. Maybe I was meant to break my leg that day.”


Dr. Gary Andolfatto, ketamine researcher and emergency room physician at Lions Gate Hospital.

Some innovators jot down the kernels for good ideas on napkins. While lying on a stretcher, with a broken left femur, Andolfatto conceived a research study that would involve paramedics spraying low doses of ketamine — a non-opioid, but still a controlled substance — into the nostrils of patients.

Unlike opioids like fentanyl, ketamine doesn’t suppress respiration so it is considered much safer.

“With low-dose ketamine, the risk of doing serious harm is zero,” said Andolfatto. “There are many reasons why it makes sense for this to be used more widely in an ambulance setting. On the other hand, laughing gas (delivered through a mask) requires a certain amount of co-operation (inhalation) from patients.”

Laughing gas is also not as effective as ketamine for controlling pain, added Andolfatto.

The research Andolfatto envisioned that day was recently published in the Annals of Emergency Medicine.

Now primary and advanced care paramedics with B.C. Emergency Health Services (BCEHS) are enthusiastically starting to deliver intranasal ketamine. Critical care paramedics with advanced training have been using intravenous ketamine on patients since 2008 but 70 per cent of the more than 4,000 paramedics in B.C. are at the primary care level and not permitted to do so.

The research led by Andolfatto has paved the way for use of a drug that is economical ($10 a dose), effective, safe and delivered quickly without needles, said Joe Acker, director of clinical and professional practice at BCEHS.

But before ketamine can be widely used by paramedics the provincial government will have to change statutes pertaining to the scope of practice of primary care paramedics as it is a controlled substance, said Acker. Health Canada will also have to give its approval.

BCEHS also has some challenging logistical issues to work on to prevent theft of ketamine by patients, paramedics or others. Biometric safes for storage and audits — similar to what hospitals have done to prevent drug diversion — are two of the strategies being implemented. 

“The onus is now on us to do our due diligence,” Acker said, adding that paramedics have for too long been hampered when it comes to relieving pain experienced. In rural areas, such transports may take hours and when paramedics witness such pain, it can be traumatizing, “opening huge moral wounds for paramedics frustrated that they cannot offer more.”

The study involved 120 patients who were transferred by ambulance to Surrey Memorial Hospital between November 2017 and May 2018. Patients were randomized to receive either a ketamine nasal spray or a placebo of saline solution. Those who got ketamine, along with nitrous oxide, reported having a significant reduction in pain after 15 minutes. A majority of patients who got ketamine said they felt dizziness and a feeling of unreality, but their levels of comfort were higher than those who received a placebo spray into the nostrils.

“We now have the science to show us that it can be used effectively and safely by primary care paramedics,” Andolfatto said. “Now it’s time to allow primary care paramedics to start using it and doing the quality assurance piece to ensure it provides a real benefit, is financially feasible and won’t potentially be abused.”

The $26,000 study involved researchers from UBC, Lions Gate Hospital, Surrey Memorial Hospital, and BCEHS. It was funded by the Vancouver Coastal Health Research Institute and the B.C. Emergency Medicine Network.

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Twitter: @MedicineMatters




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25Apr

B.C. soccer player recovering after scary flesh-eating-disease fight

by admin

VICTORIA — Harry Sandhu walked out of Royal Jubilee Hospital on Wednesday a changed man, 24 days after flesh-eating disease left him fighting for life and limb.

He boarded a ferry to begin his trip to Surrey, where he’ll stay with his parents for the weekend as he continues to recover from his near-death experience.

Until this month, Sandhu, 43, who has played soccer nationally, provincially and professionally, ran about seven kilometres every other day around the Cedar Hill chip trail, lifted weights in a gym and played soccer recreationally.

On March 31, he was playing soccer with the Saanich-based Gorge FC against the Cowichan 49ers for the Tony Grover Masters Cup at Royal Athletic Park in Victoria. An opposing player’s soccer cleat cut open what was already a small abrasion on his right shin.

Sandhu bandaged the bloody wound and kept playing. He has played in India, Honduras, Mexico and never been concerned about sports injuries. “I mean, what’s a cut?” Sandhu said.

He later realized the extent of the bloody gash and sat out the rest of the game. He took a long shower, wrapped his shin in a tensor bandage with ice, watched another game and went to dinner.

He thought no more of it.

In the morning, he woke about 8 to “intense projectile vomiting.” His shin was badly swollen. “I thought what is going on?” said Sandhu. “I tried to stand up and, oh my God, I was screaming at the top of my lungs.”

The pain was excruciating.

He phoned a friend to drive him to hospital.


Harry Sandhu

DARREN STONE /

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Based on the pain and swelling, Sandhu thought he had broken his shin. Infection never entered his mind.

At the hospital, medical staff wasted no time. Sandhu was seen by doctors and whisked into emergency surgery.

Necrotizing fasciitis, commonly called flesh-eating disease, was on a path of destruction, dissolving fat, muscle and tissue from his right shin to his thigh.

If it had been allowed to continue, his vital organs would have been next.

Sandhu said his leg was sliced open to get at the infection.

Dr. Richard Stanwick, Island Health chief medical health officer, said with flesh-eating disease, bacteria enter a break in the skin and produce powerful toxins that help infiltrate tissue, destroying the tissue and decreasing blood flow. The tissue dies.

“At the microscopic level, the toxins being made are the deadly shock troops for the germs, killing the muscle cells, rapidly advancing the continued growth of the bacteria in the dead and dying tissue, causing even further local destruction and more toxin production,” said Stanwick.

If untreated, this lethal combination results in infected muscle dissolving and dying off, said Stanwick.

The disease is rare, but if it takes hold, it has a fatality rate of about 26 per cent.

It moves at such a rapid pace that amputation or cutting away most of the tissue around the infection is often necessary.

“Antibiotics alone are not fast enough or powerful enough to stop the infection, so they have to do emergency surgery,” said Dr. Dee Hoyano, medical health officer for Island Health.

The symptoms include swelling, redness and excruciating pain out of proportion to the size of the wound.

Sandhu said faced with all that was coming at him, he wasn’t the tough soccer player he imagined himself to be.

He was in tears from the pain, in tears over the thought of losing his leg or life, and in tears at the thought he might have left his nine-year-old daughter, Sahana, without a father.

“You bawl your eyes out,” said Sandhu. “ ‘I can’t go,’ I thought, ‘I have a kid’ — that’s what you fight for.”

Sandhu credits the swift and skilled action of infectious-disease specialist Dr. Eric Partlow and plastic surgeon Dr. Jason Gray with not only saving his limb and his life, but preserving the integrity of his right leg.

Sandhu would have three surgeries and now faces months of physiotherapy.

Where the bacteria came from is uncertain.

It could have already been on his skin and just needed a break in the skin to enter his system.

In general, the bacteria are more commonly found on the skin, nose or throat — rather than lurking in dirt or dirty items — and enters a wound, Hoyano said. Why and when it strikes is less understood.

Necrotizing fasciitis is caused by several kinds of bacteria, but more commonly it is a Group A streptococcus, said Hoyano.

Some of these bacteria also cause infections such as strep throat and impetigo. Usually, infections caused by these bacteria are mild.

But in rare cases, they can produce toxins that result in a dangerous infection.

Sandhu calls the near-death experience life-altering. “I didn’t want this to happen to me, but I think coming out of this has changed me for the better.”

He made a lot of hospital-bed pledges — to be more spiritual, coach more, return to Topaz Sikh Temple, volunteer more and educate kids in sport about washing and caring for abrasions.

“When you see death, it changes the way you think.”

He has also been changed by the outpouring of care he’s received from his family, church, soccer and school community.

Health officials advise practising good hygiene and handwashing and paying attention to thoroughly cleaning cuts and scrapes with soapy water and covering them. If after an injury, there is sudden and disproportionate pain, swelling, heat, fever, chills, vomiting and diarrhea, seek immediate emergency medical assistance.

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An online fundraising page has been set up for Sandhu, who is on unpaid leave from his job in education while he recovers.

Click here to read more stories from The Victoria Times Colonist.


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