Open Letter To the Public Health Association of British Columbia

To the Public Health Association of British Columbia (PHABC) Board of Directors,

We are writing to express our concern regarding the PHABC’s promotion of partnerships with the business sector at the conference “Shared prosperity for health and well-being: A collaborative dialogue between business and public health” on December 4-5, 2014.

Although the stated mission of these partnerships is “creating the conditions for health and well-being for all”[1], it is well-documented that markets are incapable of providing health services equitably across and within communities and do not serve the interests of those who cannot afford to pay. Julian Tudor Hart describes this as the inverse care law, where those with the greatest healthcare needs often receive the least adequate healthcare. In 1971, he wrote that, “the market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.”[2] Over 40 years later his words are more urgent than ever.

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De-funding and privatization of public services have only intensified in the face of neoliberal policies, particularly in health. The private sector cannot fill these service gaps, and detracts from the responsibility of governments to provide public services in our right to health. Similarly, corporate projects of “social responsibility” are part of a growing arena of philanthro-capitalism where health is viewed as a profit-making and corporate investment opportunity.

Partnerships between the health and business sectors are fundamental contradictions: while our primary responsibility in health is to improve the health of our community, the primary aim of business is to serve shareholders in the accumulation of profit. Health care is not a commodity to be bought and sold, and we need only to look to the pharmaceutical industry to see that diseases of the poor receive little attention and monopoly over products (and services) inflates prices to unaffordable levels.

To improve health for all, we need to engage in concrete actions on the social and structural determinants of health[3]. The highly unequal distribution of power and wealth under capitalism are the main drivers of health inequities, which result in differential access to the resources that affect health, such as housing, income, and education. There can never be shared prosperity between health and business, as economic growth and wealth creation occurs at the expense of the politically and economically marginalized. This is particularly salient in British Columbia, where resource extraction is causing innumerable harms to the health of our communities and the environment. We only further entrench health inequities when our prosperity is gained at the expense of others. We can only improve the health of our communities when we work to increase their control and decision-making over their health care, resources, and their lives.

Image from Warrior Publications
Image from Warrior Publications

As health workers, researchers, and students, we urge the PHABC reconsider its direction in seeking partnerships in the private sector and to engage in critical dialogue on meaningful actions towards health equity.

Sincerely,

The Alliance for People’s Health

Jannie Wing-sea Leung, MSc
Leah Diana, RN
Azar Mehrabadi, PhD
Thomas Warren
Martha Roberts, RM, MSc(c)

Endorsed by:

People’s Health Movement – Canada

We invite individuals and organizations to endorse this letter. Action toward equity and justice is urgent. If you or your organization would like to endorse this letter, please contact us at allianceforpeopleshealth@gmail.com

[1] http://phabc.org/files/PHABC_2014_Call_for_Abstracts.pdf
[2] Hart JT. The inverse care law. The Lancet. 1971;297(7696): 405-412.
[3] World Health Organization (WHO). Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva (CH): WHO; 2008.

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Release Dr. GN Saibaba Immediately and Unconditionally!

Release Dr. GN Saibaba Immediately and Unconditionally!
Statement of the Alliance for Peoples Health
The Alliance for Peoples Health, a grassroots organization of progressive health workers, condemns the assault and abduction of Dr. Saibaba by Indian state police on May 9th, and call for his immediate and unconditional release.
Dr. Saibaba is a professor at Delhi University and is known for his outstanding work in solidarity with movements of the most oppressed sectors of Indian society: Dalit people, Adivasi people, women, and the poor, all of  whom have faced intensified oppression and exploitation under Indian capitalism.
Despite its democratic and public character, Dr. Saibaba’s organization, the Revolutionary Democratic Front has been targeted violently by Indian police, military and paramilitary forces.  This tagging of activists as ‘maoist’, justifying violent repression, has become a major tactic of the Indian state in its attempt to silence, marginalize and liquidate those who organize and struggle for social, economic and environmental justice.
As health activists we are very concerned about Dr. Saibaba’s health and well being while in detention.  As health workers who choose to side with the excluded, the exploited and the oppressed we add our voice to many others around the world who are calling for Dr. Saibaba’s immediate and unconditional release!
Alliance for Peoples Health
Vancouver – Unceded Coast Salish Territories, Canada
May 13, 2014
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International Women’s Day 2013

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Women at the Forefront of Emancipation: Resisting Structural Violence and Exploitation!

Statement by the International Women’s Day Organizing Committee 2013

On March 8th International Women’s Day we raise our fists in solidarity with women struggling for emancipation and we stand united in defense of women’s rights, for genuine liberation for all women.

Women resist colonial occupation!
Today we rally on unceded Coast Salish territory; the traditional territories of the Squamish, Musqueam and Tsleil-Waututh peoples. Indigenous women bear a great burden of colonial occupation and yet across the globe it is Indigenous women who keep the fires of resistance burning in the face of displacement, ethnic cleansing, and genocidal attacks on Indigenous culture, history and traditions.

Indigenous women have never been idle! Palestinian women assert their right to return to the lands from which they were expelled by the Israeli colonial settler state. In India, Adivasi women struggle to protect their ancestral territories despite extreme state violence.

Women resist imperialist plunder of the land and natural resources!
Women lead pivotal struggles for environmental and economic justice in opposition to mining and extractive industries, tar sands, fracking fields, oil and gas pipelines, mono-crop agribusiness, and imperialist military aggression which leads to the destruction and poisoning of the earth.

Former Filipina political prisoner Angie Ipong spent 6 years in prison for joining peasant and Indigenous communities in their land struggles. Freda Huson and women of the Unist’ot’en clan of the Wet’suwet’en are defying pipelines and development aggression on their territories. Wahu Kaara and millions of women across Africa are fighting displacement, development aggression and colonial debt exploitation. These brave women inspire us to protect the Earth and our future generations!

Women resist capitalist exploitation!
Women’s reproductive labour continues to form the basis of capitalist profit as women provide privatized labour in the home and are segregated into ‘women’s work’ such as teaching, nursing, food service, and household management. Women’s work is devalued, and despite decades of struggle, women in Canada continue to be paid only 70% or less of what men earn. In Canada women comprise the vast majority of migrant workers from Asia, forced to migrate by neoliberal economic policies, providing deskilled and cheap labour, privatized health care, and modern-day domestic slavery to the Canadian middle and upper classes.

Migrant women in Canada face a triple-burden of racism, exploitation, and patriarchal violence, and yet women are on the frontlines of struggles against austerity and in defense of public services such as healthcare, daycare and public education. Migrant, immigrant and undocumented women workers,
often excluded from the mainstream union movement, defend and assert their rights through community organizations against great odds.

Women resist patriarchal violence!
There are over 600 missing and murdered Aboriginal women and girls in Canada. For decades women’s organizations have known that the police are integrated in a patriarchal justice system which fails to address violence against women, and in fact, forms a part of the problem. Prostitution, trafficking, and the sexual commodification of women is exploitation and violence against women for the purposes of capitalist accumulation, colonial control, and patriarchal power. It is time to decriminalize women in the sex trade and demand an end to the buying and selling of women! Male violence in the family, including in social justice movements, reinforces patriarchy and gives men individual power over women. It is time to hold men accountable for their sexist attacks against women.

We fight for all women to be free from male violence and sexual exploitation. We stand in solidarity with women who resist religious institutions, ideologies, and practices that suppress and govern women’s lives in all aspects: political, economic, and social limitations placed on women by reactionary theocratic regimes. Hands off women’s bodies and lives!

In India tens of thousands took to the streets in militant protests following the rape of women on a public bus, women political prisoners in Iran recently went on hunger strike to resist torture and degrading and inhumane conditions imposed by the Islamic regime, and in Canada Indigenous women lead the struggle for justice for their murdered and missing sisters, daughters, mothers and aunties.

Women Rising for Emancipation and Justice!
Women around the world are at the forefront of struggles for emancipation that ultimately seek to end capitalism, patriarchy, exploitation, and greed. We struggle to build a society based on collaboration, cooperation, self-determination, the fulfillment of human potential, and the survival of our planet.

  • We stand in solidarity with all women who struggle for emancipation!
  • Hands off women’s bodies and women’s lives!
  • Justice for all missing and murdered women!
  • Resist the plunder of our lands!
  • Long Live International Solidarity!

Host organizations:
ILPS-Canada
Iranian Left Alliance-Vancouver
Alliance for People’s Health
Canada Philippines Solidarity for Human Rights
Iranian Centre for Peace, Freedom and Social Justice
Migrante BC
International Federation of Iranian Refugees and Immigrants (IFIRI)

Cuts to Interim Federal Health, Forced Migration, and Imperialist Globalization

This talk was given by APH organizer Martha Roberts at this recent event organized by No One Is Illegal

Greetings from the Alliance for People’s Health.  I’d like to start by applauding No One Is Illegal for hosting this timely round table and raising the level of the conversation on migration and repression.  I’d like to thank you for asking me to speak today to share our perspective on the cuts to interim federal health and the consequences of imperialism on the people’s health.

1.      Impacts on Health

I work as a Registered Midwife in Vancouver providing prenatal, intra-partum, and postpartum care to new moms and babies until 6 weeks of age.  In plain language, I look after pregnant mamas and deliver babies.

Following the cuts to the IFHP prenatal care coverage for refugees will depend on if their country of origin is listed as a Designated Country of Origin (DCO); the list of DCOs is not yet public.  Prenatal care for women not from DCOs will continue to be covered.  If they are from a DCO (European countries, some speculation re: Mexico and Latin America) prenatal, intra-partum, and postpartum care will not be covered.  Medications will not be covered to any refugee, unless the diagnosed health condition poses a risk to Canadians.  Pregnant women suffering from gestational diabetes, preeclampsia, hypo or hyper-thyroid, or other serious disorders of pregnancy will not have coverage for their medications[i].

On February 27, 2012, the CBC ran a story “Mom without medicare gives birth in hotel: Immigration backlog left pregnant wife of Canadian without status”[ii].  This story caused a flurry of discussion amongst midwives and maternity care providers about caring for women without medical insurance, the potential risks involved for moms and babies, and the high possibility of poor outcomes which have a devastating impact on both care providers and parents.   Women who must self-pay for prenatal care book late into care, are far more likely to decline screening and diagnostic tests, and are forced to balance financial risk with risk of undiagnosed and untreated complications for themselves and their babies.  The mom in the CBC story was a healthy white woman of Scottish descent from a relatively privileged background; what of those whose stories aren`t told?  We know as maternity care providers and in my personal experience as a midwife, working class, marginalized, and racialized women experience poorer birth outcomes, including but not limited to higher rates of hypertension, premature birth, and low birth weight babies.  It is only a matter of time before the impacts of these cuts begin to be realized on a generation of babies born without proper health care.

The cuts to Interim Federal Health are reinforcing and expanding a three-tiered system of health care in Canada.  The first tier is those who can afford privately funded supplemental care over and above what is provided by MSP; the second tier is those who are limited to what the public insurance system will cover; the third tier is those who are denied access to public insurance and segregated as non-deserving; left to fend for themselves in a convoluted maze of bureaucracy, negotiating scraps of piecemeal care.  As immigration requirements continue to tighten, this third-tier will continue to expand.

2.      The Health Sector Response – Petty Bourgeois Politics

Actions from physicians, nurses, midwives, and medical students have been inspiring and at times courageous as they confront Minister Kenney and other Conservative Cabinet Ministers to demand a stop to the IFHP cuts.  As an anti-imperialist and international solidarity activist I am moved by the actions of the professional health sector, which historically has been predominantly a reactionary force.

As a true reflection of its petty bourgeois class position, the Society of Obstetricians and Gynecologists of Canada issued a statement on June 4th supporting the Conservative decision to cut the IFHP, recognizing that “spending from the public purse in support of health services is reaching crisis proportions” and that “products and services must be dispensed in a fair and equitable manner that is consistent with what Canadian tax payers are currently entitled to”[iii].

The majority of health professional associations are standing up in defense of refugee rights to access to health care, and I agree with the three basic tenants of their arguments:

1. Spending and budgetary constraints: that cuts will not be a cost savings but will off-load federal spending onto the provinces as more and more folks show up in emergency rooms and health conditions are exacerbated by lack of timely care;

2. Helpless and deserving recipients: that refugees deserve our help as Canadians; here I quote from the Huffington Post, “Dr. Mark Tyndall, a physician in Ottawa, says these “unfair and unethical” cuts would reflect poorly on Canada, by “taking the most disadvantaged and traumatized human beings on Earth and telling them we have been too generous for too long.””[iv]

3. Moral obligations under international law: references to Canadian obligations as a signatory on the Universal Declaration of Human Rights and the legal, moral obligations of states to provide equally for all.

I don’t dispute any one of these popular positions.  What troubles me as an anti-imperialist are the narrow confines of the discussion, reflecting the petty bourgeois class interests of the health professionals, which, unfortunately, based on my personal experiences of discussion in the community of midwives, can be boiled down to whether or not the health care provider gets paid for the work they do.

3.      The Right to Rebel – A Working Class Response

It’s time to blow up these three narrow positions and take a more comprehensive anti-imperialist approach to defending the rights of all migrants, whether refugee claimants, economic migrants, or undocumented workers.  As the health sector, it’s time to oppose war, occupation, and unjust trade as the roots of forced migration, and take a stand on the side not just of more obligations, but of justice.

The health sector needs an anti-capitalist approach.  Let’s broaden the discussion of budgetary constraint and spending and examine the entire federal budget.  Why are we trapped in a discussion of health care spending?  The federal government’s Canada Health Transfer is 29 billion for 2012-2013[v], while Department of National Defence spending has reached $22.5-billion[vi].  The projected cost savings through cuts to the Interim Federal Health Program over the next five years is $100 million or 20 million annually[vii].  And yet on June 8th the Canadian Armed Forces announced a 708.7 million dollar contract to purchase 500 Tactical Armoured Patrol Vehicles (TAPV)[viii].  Further, the Department of Energy and Natural Resources has committed millions in tax credits to support the expansion of the mining and extractive industries which plunder Third World and indigenous territories, and Export Development Canada continues to mitigate financial risk for overseas exploration.

If we’re to move beyond a losing reformist struggle we’ve got to move beyond the arguments of the capitalist states and advance our own positions.

The health sector must stand against national oppression.  It’s time for the health sector to drop the language of “deserving” and stand up against Canadian foreign and military policy; we’re culpable in forced migration.  Canada continues to sign trade agreements with Israel and support the Israeli apartheid.  Canada continues to expand ‘investment defense’; defending capitalist profits at the expense of oppressed nations and peoples.  As a NATO member, the Canadian military is responsible for oppressive occupations and imperialist wars of aggression: currently Canadian Forces are leading Operation Artemis in the Arabian Sea, Operation Attention in Afghanistan, and Operation Calumet in the Sinai Peninsula in Egypt as three examples[ix].  In the recent past Canadian Forces have engaged in operations in Haiti; Canada spent 347 million dollars and engaged in 733 bombing sorties above the North African nation of Libya[x]; and contributed to the training of repressive and murderous counter-insurgency forces in the Philippines.

Now is the time for the health sector to stand up for women`s rights and against patriarchy.   Migrant women have a long history of exploitation under Canadian temporary foreign worker programs.  It is women who will pick up the slack from cuts to health care insurance programs; it is women who bear the greatest economic burden of forced migration, and who bear the greatest burden of reproductive and caring labour.

I`d like to close by stating again that I applaud the professional associations and progressive health workers for standing up for the rights of migrants to access publicly insured health care in Canada.

Let’s build people’s institutions to care for those who lack access to public health insurance; democratic people’s institutions that address the structural as well as the social determinants of health!

Let’s stand in solidarity with the people’s legitimate right to self-defense and movements for national and social liberation!

At the Alliance for People`s Health we call on health workers to take that struggle one step further and hold the Canadian State accountable for the creation of unjust conditions which force migration, and for the exploitation of migrants in Canada.

Thank you

[i] Ontario Association of Midwives public policy analyst email communication, May, 2012

[ii] “Mom without medicare gives birth in hotel: Immigration backlog left pregnant wife of Canadian without status.” By Kathy Tomlinson, CBC News. Posted: Feb 27, 2012 6:58 AM ET: http://www.cbc.ca/news/canada/story/2012/02/24/bc-motelbaby.html

[iii] Society of Obstetricians and Gynecologists of Canada. 4 June, 2012. POSITION STATEMENT: Federal budget cuts to the Interim Federal Health Program.  http://www.sogc.org/documents/medRefugeeHealthBenefitsStatementENG120604.pdf

[iv] Ritika Goel and Naheed Dosani..  No Refuge for Refugees in Health Care.  Posted: 06/11/2012 12:03 pm. http://www.huffingtonpost.ca/ritika-goel/refugee-health-care-canada_b_1579385.html

[vii] Ritika Goel and Naheed Dosani..  No Refuge for Refugees in Health Care.  Posted: 06/11/2012 12:03 pm. http://www.huffingtonpost.ca/ritika-goel/refugee-health-care-canada_b_1579385.html

Women Be Brave, Stand on the Side of Justice!

Today as we rally to celebrate March 8th International Women’s Day, the Alliance for People’s Health salutes the brave and tireless leadership of women at the forefront of liberation movements struggling against US and Canadian-led imperialism across the globe.

Now more than ever it is urgent that we declare our opposition to imperialist globalization; that we decry capitalism as a corrupt and fundamentally unjust system.  It is imperative that we join the progressive forces of the world in commanding a serious consideration of socialism as a viable and a necessary solution.

As oppressed and exploited women, we know that economic exploitation and capitalist patriarchy underpins the crisis women face today.  Capitalism promotes patriarchal policies and practices, thriving on the cheap labour of women.  In Canada women comprise the vast majority of migrant workers from Asia, forced to migrate by neoliberal economic policies increasing the global wealth divide between the imperial north and the global south.  Canadian migrant women form a source of cheap labour, often providing privatized health care and modern-day domestic slavery to the Canadian middle and upper classes.  Migrant women in Canada face a double-burden of racist and profit-driven state and corporate practices designed to extract maximum profits from marginalized women.

Women’s reproductive labour continues to form the basis of capitalist profits. After a life-time of work in the home and raising children and caring for our families, the only compensation working class women receive for our labour are the occasional flowers and chocolates on Mother’s Day.  Are flowers and chocolate enough to compensate for a life-time of struggle?

On top of providing privatized labour in the home, women continue to be segregated into ‘women’s work’, teaching, nursing, preparing food, serving, and managing households.  Our work is devalued, and despite decades of struggle, women in Canada continue to be paid only 70% of what our male counterparts earn.

Our daily lived experiences speak to our economic situation under capitalism:

  • The majority of those who live in poverty in Canada are women and children: one in seven women in Canada lives under the poverty line.
  • Given our role as the providers of under and un-paid reproductive labour, women are far more reliant upon government services, and more deeply impacted by the escalating government cutbacks and slashing of public services such as health care, education, community-based services, childcare, and welfare.  Upwards of 60% of single mother families will be reliant upon welfare at some point.
  • Women are often segregated into public sector jobs such as teaching and nursing, and therefor face a double-impact of privatization and neoliberal globalization. As the conditions of our work continue to worsen, and our relative pay continues to drop, and our jobs are contracted out and privatized, we have fewer social services to fill the gaps.
  • And in the ultimate irony, as women we bear the greatest brunt of the health impacts of poverty, suffering from greater rates of many chronic and infectious diseases, depression, anxiety, and increasing social isolation.

As our daily lives are dominated by capitalism’s need for profits, our communities are increasingly being destroyed.  Environmental injustice abounds: from tar sands, oil pipelines, and mining projects that plunder indigenous territories, to the ever-escalating imperialist drive to wars of aggression, women are the most deeply impacted by imperialist globalization.

The Way Forward:   We are approaching a turning point in history.  As the global Occupy Movement has demonstrated, increasingly people are fed up with the fundamental injustices of capitalist economics!

We can no longer accept an unceasing drive for profits as the fundamental organizing principle of our society.  We must continue to speak out about the experiences of and consequences of capitalism in our lives, and yet we must start to take the necessary steps to build a viable solution to capitalism.

It is not enough to increase women’s access to jobs, higher wages, or pay equity with working class men – we must reject our exploitation as workers!

It is not enough to increase women’s access to capital through such NGO and finance schemes as micro-credit – we must reject our exploitation as producers!  There is no room for the private sector and patriarchal corporations in our future!

It is not enough to talk about policy change at the governmental level, as history shows us that what we fight for today, without concrete structural and fundamental economic change, we will be fighting for tomorrow – we must struggle towards a world beyond partial solutions!

It is time for women to rise up against imperialist wars of aggression, profiteering, and economic exploitation!

From Palestine, to the Philippines, to the unceded Coast Salish territory upon which we stand today, women are at the forefront of liberation struggles that ultimately seek to oust capitalism and replace it with collaboration, cooperation, and a society that values health, the fulfillment of human potential, and the survival of our planet.

Resources:

Alliance for People’s Health: https://aphvan.wordpress.com

International Women’s Alliance: http://internationalwomensalliance.wordpress.com/

International League of People’s Struggle – Canada: http://ilps-canada.ca/

Women’s Poverty in Canada: http://www.criaw-icref.ca/WomenAndPoverty

Asian rural women speak out: Rights, empowerment and liberation: http://iboninternational.org/resources/pages/EDM/67/162

To Premier Christy Clark: the lack of dental care is scary!

This Hallowe’en weekend, the Smile With Dignity dental committee sent a message to our BC premier that the lack of access to dental care is scariest of all. An enthusiastic and vocal group of campaign organizers and supporters (including a contingent from Occupy Vancouver) donned tooth costumes and rallied outside Christy Clark’s constituency office on October 29. Placards and posters declaring “dental care is a human right” and “universal dental care now” highlight the principle demand of the campaign: to have basic preventative and restorative dental services included in the BC Medical Services Plan.

Speakers shared their experiences and frustrations with our broken dental care system, where those without dental insurance must pay out-of-pocket for care – or live with the pain. Richard shared his experiences with his dental plan on income assistance, where inadequate coverage has left him with only 8 teeth remaining in his mouth. Cutbacks to the meager public dental programs leave parents such as Aiyanas struggling with the costs of dental care for his children. The Smile With Dignity committee has been gathering and documenting similar dental experiences from people on the streets (http://smilewithdignity.wordpress.com), and these stories were submitted to Christy Clark so that she can finally hear the voices and needs of our community.

From the large number of passersby who stopped to endorse the campaign that day, dental care is an issue that hit a nerve for many. Our health care system is neither universal nor accessible when only those with private insurance or money can get dental care. As health services fall under provincial jurisdiction, we will continue our escalating campaign and public pressure on Christy Clark, BC Minister of Health Services Michael de Jong, and the BC government to make the change.

To find out more about Smile With Dignity and how you can get involved, visit https://aphvan.wordpress.com/dental-campaign/

The Alliance for People’s Health Congratulates VANDU

APH Organizer Dave Hendry speaking at a VANDU rally

Organizers with the Alliance for People’s Health send our message of congratulations to VANDU members on their recent successes! 

As grassroots organizers, we acknowledge the dedication that it takes to struggle for the rights of working class and marginalized communities, too often overlooked by those who govern our fundamentally unjust society.   Your long battle with the City of Vancouver to address the serious issues of DTES residents is an inspiring example of how when we are united and organized we can change things for the better, one step at a time.

We applaud the lowering of the speed limit on Hastings as a step towards a more pedestrian friendly neighbourhood where people take precedence over private vehicles; we applaud the lengthening of public toilet hours, so that our community members have the dignity they deserve; and we whole-heartedly support the vendors market, creating economic independence for DTES residents.

Communities who face multiple barriers to political, economic, and social inclusion in society can take a lesson from the democratic and inclusive organizing that VANDU has spearheaded in the DTES.

APH organizers will continue to stand in solidarity with VANDU members, and we look forward to more victories in the future.