Volume 103, Issue 7 Thursday, October 17, 2013
EDITORIAL: Let’s talk about colour Page 19
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The McGill Daily
Thursday, October 17, 2013
Mayoral candidates hold French-language debate
03 NEWS
Mayoral candidates debate at McGill Climate Justice talk criticizes Enbridge pipeline
3
Infrastructure, Charter of Values discussed
Divestment movement gathers momentum at Concordia
Philippe Dumais | News Writer
McGill loses battle to deny ATI requests Low attendance at SSMU General Assembly
08 COMMENTARY
The racism of defining what foods are ‘healthy’ What does medical transition mean for trans* people?
10
FEATURES
A journey and lesson on Indigenous struggles
The Healthcare Issue
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SCI+TECH
The rise of mobile health This week in research Exploring internet addiction
14 HEALTH & ED The healing power of music Inaccessibility of healthcare for trans* patients
16 SPORTS
The battle against advanced stats
17
CULTURE
The Daily reviews Margaret Sanger via the funny pages
19
EDITORIAL
The ongoing progress of anti-racism
20 COMPENDIUM! SHMU Council accidentally moves motion of self-impeachment
Camille Chabrol | The McGill Daily
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round 200 students, journalists, and citizens gathered on October 9 at Redpath Hall to hear what mayoral candidates Mélanie Joly, Richard Bergeron, Denis Coderre and Marcel Côté had to propose for the next four years. The four, considered the main contenders for the mayorship, answered questions in French from the public in a debate moderated by Radio-Canada’s Patrice Roy. This debate, the first to be broadcast in French for this election, allowed candidates to contrast their ideas a month in advance of the municipal election, set to take place on November 3. Among the issues debated, the proposed Quebec Charter of Values held a consensus among the candidates, as all four were strongly opposed to it. “The Charter, as presented, tarnishes the image of Montreal as an international city,” said Côté. Bergeron agreed and emphasized the division that the Charter could create between Montreal and rural Quebec. However, only Joly and Coderre explicitly raised the possibility of a legal battle against it. Candidates talk infrastructure The question on public transit and infrastructure brought out the differences between the candidates and their approaches. Bergeron proposed the construction of 10 to 15 kilometres of tramways and wanted to
speed up various construction sites by the Quebec government. “130 kilometres of BRT [bus rapid transit] is 8 times cheaper than Mr. Bergeron’s proposal and 40 times cheaper than the same distance on trams. This is our great project to unify Western and Eastern remote areas,” replied Joly, who favors rapid transit buses. BRT is a system that includes reserved traffic lanes and a high frequency of buses along the routes. Montreal offered one BRT line until 2002, when it was done away with. Coderre suggested that the solution to public transit debates needed to be discussed with suburban cities such as Laval or Brossard. Côté addressed the reliability of existing infrastructure and called for realistic expectations concerning deadlines for existing projects. ‘Revival’ of Montreal also a major topic When questioned on how to revive Montreal, all the candidates’ responses – except for Bergeron’s – focused on ethics. Côté – who is running his campaign on targeting corruption at city hall – proposed a code of ethics and stronger promotion of integrity within the administration, as well as the nomination of someone to control public expenditures. Joly challenged Coderre on the topic of transparency and ethics in municipal politics. She cited New York City’s Mayor Michael Bloomberg as an example of enhancing trans-
parency and asserted that there was “no need for an inspector general like Mr. Coderre proposes.” In the past, Coderre has proposed the creation of the role of inspector general, an individual who would target corruption within the government, especially in light of the recent Charbonneau Commission. His proposal also favoured the expertise within the administration, rather than sub-contracting out the position. “There is an inspector general in New York,” said Coderre in response to Joly’s comment. Unlike the other three candidates, Bergeron’s top priority was to stop the family exodus toward the suburbs, an issue addressed later on in the debate. As an urbanist, Bergeron insisted on the careful planning of new developments “to avoid a repetition of what happened in Griffintown.” Côté and Bergeron agreed to improve existing programs subsidizing access to property for families. Coderre specifically targeted programs that would help families purchase their first property on the basis that it can “apply to new constructions as well as existing households.” Joly proposed a Land Tax Transfer break for families and reiterated that the “BRT would allow the creation of new neighbourhoods dedicated to families.” The candidates will face off once again in an English-language debate on October 22, which will also be hosted at McGill.
The McGill Daily
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News
Thursday, October 17, 2013
Climate Justice panelists talk Enbridge Line 9 Safety, environmental racism discussed Mark Tartamella | The McGill Daily
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n October 10, CKUT 90.3FM and the McGill Sustainability Projects Fund hosted the second installment of “Under the Weather,” a monthly series focusing on climate change. This month’s panel focused on Line 9, a pipeline owned by Enbridge Inc. that runs across Ontario and Quebec. The panel came a day before National Energy Board hearings on Enbridge’s proposal to reverse and expand the flow of Line 9 wrapped up in Montreal. Line 9 was originally built in 1976 and flowed eastward to Montreal, but was reversed in 1998 to flow westward. It was built to transport traditional crude oil, but
the proposed reversal will include the transportation of bitumen from the Alberta oil sands. “[Bitumen] is already even more corrosive than traditional oil [and] the superheated pipeline system used to transport it makes it unconventional,” said Cameron Fenton, Director of the Canadian Youth Climate Coalition. Fenton also pointed out the allegedly elevated cancer rates in citizens living near the pipeline. Reports have found that Line 9 is prone to spills, a fact that Amanda Lickers, a member of the Onondaga nation, the Haudenosaunee Confederacy, and an organizer at SwampLine 9 – a project that aims
Khoa Doan | The McGill Daily to stop the construction of Line 9 – is an act of “genocide and climate change” against Indigenous people. The pipeline is primarily constructed within and around Indigenous lands in Canada. Cindy Spoon, campaign director for the Texas Tar Sands Blockade against the Keystone XL Pipeline, offered similar concerns, arguing that pipelines “disproportionately affect people of colour.” Spoon explained that companies reach out to poorer communities in order to achieve what she called a “facade of consent” in order to legally seize communities’ property to build pipelines. These communities are less likely to resist such actions, said Spoon. She also designated the actions of Canadian and American oil companies – toward Indigenous people and minorities, respectively – as environmental racism. According to Fenton, the environmental impacts of the pipeline will be immense – a statement that the panelists agreed on. “It could hold upwards of 400 gigatons of recoverable carbon, which is almost the planet’s entire carbon budget,” Fenton stated, adding that this was over 25 times Canada’s carbon budget. “[Enbridge’s pipelines] have already spilled and broken over 800 times over the past decade, which comes out to about ten spills per month.”
Fenton also raised concerns about the nature of bitumen spills. “There is actually no proven way to clean up a bitumen spill, especially in a body of water.” The panel discussion shifted from condemning the pipeline to condemning the oil and tar sands in general, and how energy is acquired in a capitalist society. According to the panelists, the current method simply secures too much profit to be changed. “Oil and everything that is supported by oil is so ingrained in our lives that we don’t realize all the ways that we pay for it,” said Melissa Fundira, a McGill student and programmer at CKUT. “When we keep saying that oil is just more convenient, I think we are disconnected from the fact that we’re all here to increase our well-being, but oil is not it.” Another student, Marie Dageville, was optimistic, stating, “We can come together and find a solution [but] it is just a matter of making that first step.” Lickers said that mobilization was the way to divest from oil usage. “Direct action costs them money, and the more expensive we make it for them, the closer we get to winning.” The panel was also broadcast on CKUT. The next event of the series will be held on November 14.
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News
Thursday, October 17, 2013
Tar Sands Reality Check Tour kicks off at Concordia
Divest groups pressure universities to stop investing in fossil fuels Joelle Dahm and William Mazurek | News Writers
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n October 9, the Concordia Student Union and Divest McGill hosted the first stop of the Canada-wide Tar Sands Reality Check Tour. The event, organized by Fossil Free Canada, brought together different personalities from the environmental movement against tar sands and fossil fuels, who recapped their progress and considered further action. Fossil Free Canada is a partnership between 350.org and the Canadian Youth Climate Coalition that urges “universities, religious institutions, city and state governments, and other institutions that serve the public good” to divest from companies involved in the extraction of fossil fuels, such as oil or coal. Cameron Fenton from the Canadian Youth Climate Coalition started the event with a brief history of the movement against tar sands, and discussed the relevance of the growing divestment movement. “The fundamental goal of this is not simply stopping pollution – it’s achieving justice, and building a more just and sustainable world,” Fenton noted during his speech. The Tar Sands Reality Check Tour took place during the same week as National Energy Board hearings concerning the Enbridge Line 9 pipeline. Enbridge wants to increase the line’s capacity from 240,000 to 300,000 barrels per day, and reverse the flow from westbound to eastbound. If reversed, the pipeline would carry crude oil from the tar sands in Alberta to refineries in Quebec. The proposed reversal of Line 9 has sparked a backlash from environmental groups and concerned citizens, especially over a potential for spills. A report published earlier this year by pipeline safety expert Richard Kuprewicz concluded that there was a “high risk” of Line 9 rupturing due to a combination of cracking and corrosion. According to the Toronto Star, Enbridge’s current response time to spills is between 90 minutes and 4 hours, meaning that the municipalities along the pipeline would most likely be responsible for emergency clean-up. “Any pipeline that comes out of the tar sands allows for the tar sands to be expanded. It is an imperative that we block each and every pipeline. [Line 9] is not the biggest one, but it’s the one that’s coming through here, so it’s our job to stop it,” said Curtis Murphy, a member of Divest McGill, in an interview with The Daily. Divest McGill, one of the hosts of the Tour stop in Montreal, is 1 of 14 university
on air Friday Morning After show from 7 to 9am online at mcgilldaily.com/ podcast
Robert Smith | The McGill Daily divestment groups in Canada. Although concentrated mainly in North America, there are over 300 divestment groups on campuses worldwide. One of the speakers, former McGill student and activist Audrey Yank, underlined the importance of students and young people in the movement. “Our generation is in an interesting situation. We’re already facing [environmental] change, but we are young enough to actually be involved in it too, to fight it. And it’s not everybody that is in this position. It’s an opportunity for our generation to make this change.” Anthony Garoufalis-Auger, one of the speakers, and an organizer at Divest Concordia – the newest divest group on Canadian campuses – spoke about strategies for the divestment movement to attract more supporters. “One step that the divestment movement at Concordia is taking is talking to different student associations, actively [...] trying to get the General Assemblies – if there are General Assemblies – to talk about our movement,” he said. “If we can get student associations to talk about this, we can get a lot of people to start getting involved.” Fenton also emphasized the influence of student activism in the divestment movement. “Last year, a campaign to get campuses to divest from fossil fuel started off in the U.S. and took off faster than anything I’ve ever seen. [...] This is happening in so many different places in so many different ways, that we
have this new front that we want to pursue.” In May 2013, Divest McGill presented a petition with 1,300 signatures to McGill’s Board of Governors (BoG), asking McGill to divest from companies that profit from the extraction of fossil fuels or tar sands, as well as the “North for All” plan (formerly known as Plan Nord). McGill currently invests in a total of 645 publicly-traded companies, of which 35 are involved with fossil fuels, while 14 extract crude oil from tar sands. The stocks and bonds from these companies comprise about 2.5 per cent of McGill’s endowment, according to Divest McGill organizers, which is valued at over $1 billion. The petition was rejected after the Committee to Advise on Matters of Social Responsibility – a body that steers University investment toward socially responsible options – recommended against divestment. Lily Schwarzbaum, one of the organizers of the Tour stop and an organizer with Fossil Free Canada, remained optimistic about the future of divestment at McGill. “When there is so much visibility and momentum around this idea, I think that the McGill administration will see that there is not even an option about whether or not we should take climate change seriously for the future of our students and our community,” she told The Daily. Divest McGill continues to pressure McGill to stop investing in fossil fuel industries,
according to members. “Where there is money, there is power,” Murphy said. “[The divestment movement] fundamentally is trying to redistribute power, because there is a lot of power in the hands of some industries and politicians and not enough power in the hands of ordinary people, like students and Indigenous communities. We need to empower those communities because they have not only the skills and the capacity to change things, but the motivation to do so.” Heather Milton-Lightening, the codirector of the Indigenous Tar Sands campaign in Alberta, and one of the speakers at the event, agreed that there is a fundamental power imbalance when it comes to fossil fuels. “All the environmental legislation, all the changes in Canada were pushed by petroleum producers. That says a lot. That says that the petroleum producers and the people that have money run our country,” MiltonLightening said. “That is why I really appreciate divestment campaigns and students critically thinking about where the money is.” “Because at the end of the day, here in Canada, a lot of our strategies need to change. We need to think about who has the money, who’s really controlling the government here in Canada, and who has the ability to give us what we want. And what we want is a new livelihood, a new vision, a new paradigm to move forward.”
The McGill Daily Radio! Coverage of first assembly for McGill’s Feminist publication by Alice Kayitalire Fiction piece by Nicolas Corroon Preview for Congress of Black Writers and Artists
The McGill Daily
News
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Thursday, October 17, 2013
McGill’s request to limit access to information denied Commission rules against “unprecedented” legal request Molly Korab | The McGill Daily
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a st week, Quebec’s Commission d’accès à l’information dealt a major setback to McGill in its ongoing battle against information access, with the Commission deciding that McGill does not have the authority to deny future access to information (ATI) requests at its discretion. That power can be solely exercised by the Commission, although McGill’s request, if approved, would have delegated the Commission’s power to University administrators. McGill’s lawyers, in a pre-trial hearing in September, requested the power for McGill administrators to deny future ATI requests from a specified list of individuals or anyone who could be connected to those on the list, as well as those who fall under a specified list of categories. The categories included “persons associated to McGilliLeaked” or “persons that could reasonably be linked to such requestors,” and requests that show characteristics such as being “overly broad,” “frivolous,” “target[ing] trivial documents and information,” or “associated to one or more categories of documents and information published on McGilliLeaked.” ATIs are a means of legally obtaining otherwise unavailable information – such as administrative documents – from public bodies like McGill. In Quebec, if a public body declines to grant ATI requests, the Commission acts as an administrative tribunal to mediate negotiations and make decisions. In this week’s decision, dated October 7, the Commission stated in French, “The Commission cannot delegate to the University the power to decide in its place which demands meet its criteria and which it can ignore.”
The decision also denied a last-minute amendment from McGill that would have required certain respondents to obtain authorization from the Commission before requesting ATIs from McGill in the future. The Commission’s decision rested upon the grounds that granting the University’s request would represent an “illegal” delegation of its powers to a third party, according to a press release sent out by Kevin Paul, a McGill student and one of the respondents. “[It] would involve passing judgment on requests which have not yet come under the Commission’s jurisdiction.” “The motion was clearly an abuse of power on McGill’s part, or an attempt at an abuse of power,” Mona Luxion, a former columnist for The Daily and one of the respondents, told The Daily. “They basically wanted to have the law rewritten to suit their needs.” The request, in fact, was one that would be legally unprecedented if it had been approved, as the respondents’ lawyer made clear during the hearing in September. The Commission’s decision is the latest in an ongoing case between McGill and several respondents who submitted ATIs to the University dating back to November 2011. In lieu of divulging the information requested in the ATIs – which pertained to categories such as University fossil fuel investments, alleged military research at the university, and administrative finances – McGill sought an exemption from the requests, calling them “abusive because of their systematic character.” “It’s really disappointing to see an institution that’s supposedly committed to sharing knowledge and educated debate about issues trying to keep people away from information that would help us have a conversa-
Robert Smith | The McGill Daily tion about what’s going on,” said Luxion. “I can’t say I’m surprised.” Stephen Strople, Secretary-General of the University, would not respond to questions beyond a single statement, due to the fact that McGill does not typically comment on matters before tribunals or courts. “We are disappointed by today’s ruling and we are considering our options regarding an appeal. This ruling does not resolve the issues,” he wrote in an email to the press. “We are, however, encouraged by the fact that both sides remain interested in seeking a mediated settlement.” The sections of McGill’s motion that revolve around the outstanding ATI requests currently remain in litigation. If
mediation does not work, then the case will go to trial.
A longer version of this article originally appeared online on October 11, 2013.
For more on access to information requests, see this week’s “HowTo” from The Daily’s radio section, with an update on McGill’s ATI case and a step-by-step guide to filing your own ATI. www.mcgilldaily.com/podcast
SSMU General Assembly fails to meet quorum once again Student body unable to take stance on Charter of Values Lauria Galbraith | News Writer
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he first Students’ Society of McGill University (SSMU) General Assembly (GA) of the academic year failed to meet quorum, a common pattern for GAs in the past few years. With 52 students in attendance at the peak of the GA, SSMU was unable to pass a proposed motion in opposition to the Quebec Charter of Values or approve a revised SSMU Constitution. Quorum for a GA is defined as 100 undergraduate students from four separate faculties, with no more than half from a single faculty. If quorum is not met – as so happened – the assembly becomes a Consultative Forum. Votes are no longer binding, but act as ‘recommendations,’ and any motions passed are sent to the next session of SSMU’s Legislative Council. However, the lack of quorum proved a unique challenge, as it was impossible to approve the nominations to the SSMU Board of Directors (BoD), or to greenlight an auditing firm for the 2013-14 fiscal year. Both of these approvals were tabled until the next GA. According to SSMU President Katie
Larson, the lack of a BoD will not affect SSMU policy presently; however, Larson conceded, “It’s truly a problem for future situations that may arise, when we’ll legally need the Board to pass decisions.” New SSMU Constitution A motion to amend the SSMU Constitution – to be more legal under Quebec’s laws, according to Larson – was proposed at the GA, but not without confusion. Clause 28.1 in the old Constitution states, “A general assembly may establish, amend or rescind any policy of any society except [...] this constitution.” According to Larson in an e-mail to The Daily, the Constitution was brought to the GA as the next best option because of the current lack of a legally acting BoD. In addition, although the motion initially resolved for online ratification, Larson said that the SSMU Executive “realized after we submitted the motion to the GA that the clause asking the GA to approve and replace was out of order.”
The motion was amended to reflect a need for a referendum. Because of the lack of quorum, the vote that passed the motion was only a suggestion, and the motion was passed along to Legislative Council. Proposed opposition to Quebec’s Charter of Values The second motion of the GA resolved that SSMU adopt an official stance in opposition to the proposed Quebec Charter of Values, which VP University Affairs Joey Shea, one of the movers, called “completely discriminatory legislation.” The motion initially resolved for SSMU to send a letter against the Charter to Premier Pauline Marois, McGill Principal Suzanne Fortier, and multiple media outlets, in addition to creating a committee to campaign against it. “Although [the Charter] is technically an external matter, it is something that will stand to directly affect students at McGill,” said Arts Senator Claire Stewart-Kanigan, who helped draft the motion.
Medicine Representative David Benrimoh also voiced his dissent, saying that he had talked to at least two people in his faculty who would be directly affected by this law. “[This Charter] is intended to alienate people, it is intended to make people want to leave Quebec […] it’s not a Quebec for everybody, it’s a Quebec for certain people,” said Benrimoh. “This is racism, this is xenophobia, this is ridiculous. It is a stupid, ridiculous law.” “Even if we could [opt out], having this law on the books is a slight to every [value] we hold dear,” he added. Shea explained that although McGill can opt out of the proposed law as it currently stands, neither SSMU nor the SSMU daycare would be exempted. The motion was divided, so the external resolved clauses – such as the letterwriting campaign – were not included in the motion passed along to council, as they could only be passed by a GA and not by a Consultative Forum.
Commentary
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The McGill Daily
Thursday, October 17, 2013
The racism in healthy food
Why we need to stop telling others what to eat Aaron Vansintjan A Bite of Food Justice
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tuff goes in, and if your body is working properly, less stuff comes out. If too much bad food goes in and you don’t exercise, you gain weight. If you eat good food and you do more exercise, you get healthier. That’s a pretty common line of logic. It’s also the basic argument of North America’s number one food guru, Michael Pollan. In a 2009 New York Times article, “Big food vs. big insurance,” Pollan links cheap bad food to the obesity ‘epidemic.’ The problem? That ‘bad’ food (like corn, potatoes, and wheat) is subsidized, making it cheaper, and people are eating too much of it, which has led to a rise in obesity. The solution? Stop subsidizing, and educate people to “vote with their fork” by buying locally and organically. It turns out that this line of reasoning is totally false. It is also elitist, classist, racist, and fat-phobic. But before debunking Pollan, I want to put the discussion of food and health in a different context. *** Anna Pringle is a student and food activist in Montreal. “Right now,” says Pringle, “one of the things I’ve been working on with other people is accessibility. How can we work on the idea of having healthy food for all, rather than healthy food being defined by very expensive organic food not for everyone? I don’t really know how much good moralizing is going to do for people when they just can’t afford to go to health food stores.” Pringle is involved with the Food For All campaign, which works to improve access to food in Montreal, particularly undocumented migrants. In this work, she directly sees how food activism and racism can intersect. “If you want to start changing people’s health,” says Pringle, “you might want to be aware how that might be a racist act.” Why is it racist to say what food is healthy and what food isn’t? For one, this presupposes that the food from one culture is more ‘nutritious’ than that of another. Two clear examples: Canada’s Food Guide and the U.S. Department of Agriculture’s Food Pyramid. In both, dairy is seen as cornerstone food group, despite findings that in the U.S., 70 per cent of African Americans, 74 per cent of Indigenous Americans, 90
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The perspective of a kippah-wearer Suncor and The Walrus host conference on Canadian energy
Alice Shen | The McGill Daily per cent of Asian Americans, and 53 per cent of Mexican Americans are lactose intolerant. On the flip side, high-calcium foods traditional to some of these cultures (for example, collard greens) are not included. Food racism happens when certain foods are excluded in favour of the dominant (white) culture’s idea of good food. Secondly, health itself is racialized. As Pringle says, it involves “saying that a certain type of body is better than other types of bodies.” Ideas of health often presume a certain type of body. This doesn’t take into account how other cultures see health, nor does it acknowledge that the dominant idea of a ‘healthy body’ in North American media is most often thin and white. Healthy bodies shouldn’t be defined by what they look like. *** Julie Guthman, writer and professor at UC Santa Cruz, takes aim at Pollan’s simplistic argument in her 2011 book, Weighing in: Obesity, Food Justice, and the Limits of Capitalism. Guthman completely destroys the idea that the obesity epidemic is caused by eating too much bad food. First of all, she shows that it’s not just governmental subsidies that make for cheap food. Cheap food is driven by cheap labour. In the U.S., food was able to be cheap firstly by stealing ‘cheap’ land from natives, then, by importing ‘cheap’ slave labour, and later still, by importing Europeans to do ‘cheap’ labour in return for the promise of their own land (also stolen), and now by making use of ‘cheap’ migrant labour from south of the highly-securitized U.S. border. Fast food is cheap because it went to great lengths to destroy unions, taking away employees’ bargaining power, pushing wages as low as
possible. What makes for cheaper food? The exploitation of people already in precarious situations. Then it’s fed back to those of us who can’t afford otherwise, further exacerbating reliance on a destructive food system. Second, an obesity ‘epidemic’ simply isn’t caused by too many people eating too much. As Guthman says, “The evidence is just not there that people eat more calories than they did a generation ago or that different socioeconomic groups eat different amounts of calories.” Guthman points to research that instead implicates epigenetics, toxins in food packaging, and environmental toxins as factors that may have caused a rise in the average body-mass index. The energy balance model, where more highenergy food has a direct, causal link to more obese people, just doesn’t hold up. Third, there’s a big problem when we link size to health. The problem is what Guthman calls co-production: when scientific assumptions actually become the variables. For example, most studies evaluating causes of obesity only measure variables that are assumed to cause obesity: the number of gyms in an area, the number of ‘healthy’ grocery stores, the number of fast food stores. In other words, people think fatness is the problem, and then try to prove it by seeking factors they assume cause fatness. This is not just a chicken-or-egg problem, it’s fat-phobia. It seems that people are more interested in proving why fat people are eating too much than actually examining what environmental factors affect people negatively. Guthman argues that we need to go beyond shaming fat bodies. She turns to fat activists to show how this can be done. “Health at every size” is the most well-known slogan of the fat acceptance movement. This movement aims to
battle the stigma against fat bodies. The slogan strikes at the heart of the mistaken assumption that weight and health are intrinsically linked. One issue with the slogan, however, is that it still prioritizes health over weight. Everyone should be respected, regardless of how healthy or unhealthy they seem to be. *** What should the food movement’s slogan be? It shouldn’t be Pollan’s “vote with your fork,” that’s for sure. This excludes those who can’t vote, from lack of time, money, or privilege. It also shouldn’t be “good food for all,” as this takes for granted that it’s even possible to define what good food is, requires someone to judge what food is good, and what food everyone should be eating. I can’t really think of an appropriate slogan for a food movement. Maybe this whole sloganeering thing is not for me. I ask my friends, Grace and Micah, sitting by me as I type late into the night, what they think. “Eat to live!” Grace shouts, punching their fist in the air, mouth full of salad. “I like it. It keeps it real. That’s why we eat,” says Micah. I like it too. It’s about affirming people’s choices and people’s struggles, while emphasizing how the food we eat can be harmful, not because it makes us bigger, but because some can choose and some cannot. A Bite of Food Justice is a column discussing inequity in the food system while critiquing contemporary ideals of sustainability. Aaron Vansintjan can be reached at foodjustice@ mcgilldaily.com.
Commentary
The McGill Daily
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Thursday, October 17, 2013
What defines a medical transition?
The despotism of Standards of Care for trans* health Gabrielle Polce | Commentary Writer
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transition means starting as one gender and moving toward another. The narrative is like that of travelling from one country to the next, except there are only two countries and you’re solely responsible for that travel. This ‘travelling’ assumption is based on the idea that there are only two genders: male and female. To categorize one genital surgery as belonging to a group of people who are ‘targeting’ one gender is to make an essential connection between certain forms of genitalia and certain forms of expression and life. This insidious connection is a persistent issue in the SoC. Suffice it to say that the categorization of surgeries into ‘FtM’ or ‘MtF’ undermines many possible identities. Being genderqueer, two-spirited, or even simply wanting to have a body that is not the specific collection of penis-testosterone-pecs or vagina-estrogenbreasts are just a few of the possibilities that the phrasing in the SoC undermines. One might want to make a distinction between being transgender, genderqueer, or nonconforming, and being transsexual, in that being transsexual entails having the medical symptom of gender dysphoria. As such, many procedures are understood as belonging to transsexuals in that they attempt to remove the symptom. Distinguishing transsexuals from other forms of nonnormative gender is not a solution. What usually happens is that the procedures that are deemed to belong to transsexuals are seen as unessential to folks who do not belong in this category, but would still benefit from such procedures. This is grounded in the very problematic pathologization of transsexual folk which stigmatizes them while simultaneously undermining the plight of those who do not meet the troublesome criteria. More importantly, to make such a distinction is to encourage dissent among people who could have fruitful discussion and could share experiences as people who do not conform to assumptions about gender. Being misnamed, having difficulty using public restrooms, and having trouble coming out to important people in one’s life are just a few examples of experiences that genderqueer, nonconforming, transgender, and transsexual folk can share and might discuss for the betterment of each other’s lives All of the requirements are interest- personally and politically. Making that dising and say something about the kind of tinction also gives the impression that one person the SoC assumes will want genital cannot be more than one of these categories, surgery. The first thing of note is how the and it shuts off discussion between people SoC describe the surgeries themselves: who are constantly reminded that their be“metoidioplasty or phalloplasty in FtM [Fe- ing different is problematic. Let us conclude with a look at the last remale-to-Male] patients,” and “vaginoplasty in MtF [Male-to-Female] patients.” What quirement for genital surgery: “12 continumakes this problematic is that the surgeries ous months of living in a gender role that is are separated according to whether one is congruent with the patient’s identity.” Set‘FtM’ or ‘MtF’. Already, this flies in the face ting aside the arbitrariness of 12 months, the of many possible identities that someone language points to yet another problematic might have. To classify someone as ‘female- assumption about trans* folk and gender in to-male’ or vice versa is to assume that general. The individual has to live in congruhen talking about trans* individuals and their transitions, there are many details one can get caught up in. Within transition itself, many complications are easily overlooked. One of the complicated issues that often comes up is the question of whether transition ought to be considered a social process or a medical one. It’s unclear why a medical process isn’t also social, and what the difference is between the two. What is clear is that classifying transition as either social or medical has very profound effects on how we come to view transition, with positives and negatives in both categories. Viewing transition as a medical process is a very powerful thing; it allows us to legally offer benefits to those who can meet the criteria put forward. In order to make transition a medical process, however, these criteria must be clearly defined. Like all categories, this requires that we make some exclusions. To get a clearer picture of transition as a medical process as well as the kinds of exclusions made, let’s take a look at the World Professional Association for Transgender Health Standards of Care (SoC). Specifically, I want to look at the requirements for genital surgery, a process that, in mainstream media, seems to define much of what it means for someone to transition. My hope is that these requirements will illustrate the kind of person one has to be in order to go through medical transition, as well as the assumptions made about that person. This will highlight what kinds of people or what aspects of individuals are left out of the discussion.
In order to make transition a medical process, however, these criteria must be clearly defined. Like all categories, this requires that we make some exclusions.
Alice Shen | The McGill Daily ence with their identity – note the possessive. An identity is understood to be something one has, instead of something one is. There are two assumptions here: that someone’s identity is fixed or permanent, and that they are somehow responsible for their identity. Both of these are myths that are problematic for anyone who does not conform to them, because the language one must speak in, in order to be heard, is usually a language that implies this conception of identity. I will not argue here that gender identity is something that cannot be permanent by definition. What I will argue against is the second part: people are not responsible for their own identities. Being a man or a woman is not something that everyone accidentally invents and yet, reading the SoC’s justification for its 12 month requirement, one can’t help but feel that the whole point of the requirement is to ask the individual: are you sure? To say that living in a gender role for a year allows for “a range of experience” or helps people “adjust” to their new role is
to view them as the cause of the problem. If you decide to set strict barriers for procedures that are helpful to a wide range of people, you ignore the years of experience that led them to seek help in the first place, in favour of controlling those certain products and services. This does two things. It gives the impression that if someone does not complete those 12 months, or get the referrals, or jump through the right hoops, then they didn’t want it enough. This also allows you to be the final arbiter of whether or not they succeed. This despotism is the paradox that is essential for the gate-keeper model to work the way it does in enforcing certain conceptions of what a gendered human being is. Quotes are from the SoC’s seventh edition as it appears in the International Journal of Transgenderism, vol. 13, 2011. Gabrielle Polce is a U4 Philosophy Honours student. To get in touch, email commentary@mcgilldaily.com.
Features
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The McGill Daily
Thursday, October 17, 2013
“ OF MOOSE ANTLERS AND TRANSNATIONAL INDIGENOUS ALLIANCES Differences and similarities in Canadian and Panamanian Indigenous struggles Sean Phipps | Features Writer Illustration by Alice Shen
So what are you hoping to see up North?” I ask Celestino as we make our way along Highway 167, through the dark, boreal night to Oujé-Bougoumou. Celestino pauses and then smiles. He turns to me with a grin. “I want to find the other moose horn. I need to complete the set.” We laugh for a bit and then try to get some sleep. Our destination is still several hours away. *** Celestino already has one moose antler and apparently it’s quite a hit in Panama’s NgöbeBuglé, the Comarca where Celestino Mariano Gallardo makes his home. The Comarca is the autonomous province and traditional homeland of the Ngöbe, Panama’s largest and most politically active Indigenous group. Celestino is one of their leaders and last year he came to Canada as part of an ongoing research exchange between various Canadian professors and Indigenous groups from across the continent. While he was here, he met with Algonquin activists from the communities of Barriere Lake to discuss the shared experiences of government betrayal and resource conflicts between their two peoples. As a parting gift he was given a moose antler. But Celestino had trouble holding on to the moose antler in the beginning. “I had such a hard time getting it back,” he told me. “The customs official in Mexico tried to confiscate it. He had no idea what it was, what animal it was, but figured it was probably illegal. He had to go through a whole book to see if moose were banned before he let me keep it.” Back home in the Comarca, Celestino’s moose antler sits in his house in a place of pride among various other objects from his travels: an Iroquois flag, an Aymara wiphala – an emblem representing the native peoples of the Andes – and a poster of Bolivia’s first Indigenous president Evo Morales. All of which are testament to a growing movement: Indigenous peoples across the Americas, North and South, have begun to share knowledge,
to share stories of resistance. Celestino’s moose antler is not just an odd gift; it is a symbol of Indigenous solidarity. “We don’t have animals like this in Panama, the people of the Comarca look at this antler and they have no idea what this creature looks like. That’s why I want a picture of the moose as well. I really want to see one.” I smile and nod, but then remember stories of moose running across highways and smashing little cars like ours to bits. I want to see a moose too, but perhaps not quite yet. *** Celestino is back in Canada to deliver a speech at a conference about Indigenous people’s environmental governance and alternative development. His speech looks at the way in which the Ngöbe people’s traditional way of electing leaders has been manipulated and undermined by a neoliberal government keen to exploit the Comarca’s ample mineral and hydrological reserves. Since the 1960s the Ngöbe people have been locked in a fierce battle with the Panamanian government to prevent the development of mining and hydroelectric projects in their territory. In 2012, the Ngöbe captured international attention by staging a two-week blockade of the Pan-American Highway – the country’s main artery – to protest the granting of new mining concessions. Despite the government’s brutal repression (two Ngöbe were killed and many more wounded when riot police stormed the barricades), a partial victory was attained and mining development halted for the time being, but the threat still remains. Celestino, a traditional Ngöbe leader and lifelong activist (he helped found a coffee pickers’ union at the tender age of 18), was, of course, heavily involved. So why are we going to Oujé-Bougoumou? Or first of all, where is Oujé-Bougoumou? A Cree town of population 700, nine hours north of Montreal can often escape the attention of the (Continued on Page 11)
THE HEALTHCARE PULLOUT
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Healthcare
THE HEALTHCARE ISSUE W
e are launching this special issue – both in print, and online with a special microsite – on the topic of healthcare. The accessibility of healthcare is more relevant now than ever. It has dominated public conversation over the past few months – from the implementation of the Affordable Care Act in the United States to the recent media attention, both on campus and elsewhere, surrounding the availability of mental health services here at McGill. Accessibility to healthcare is one of the most vital aspects of a free and just society, yet care still remains inaccessible to many. Marginalized groups such as immigrants and rural populations, among many others, still face significant hurdles when accessing care. The healthcare system is also one of the most vulnerable in terms of predation from corporate forces. From the rise of powerful pharmaceutical companies to the valuebased way that we think about medicine, the system has, in many ways, lost sight of its very base: the core, basic necessity of healthcare as a human right. In this issue, we hope to bring to light some of the most important aspects of healthcare on campus and across the country – whether they’re overlooked or widely-talked about. Privatization, sexual healthcare on campus, the pernicious ideas underlying how we think about ‘health’ – these are a few issues touched upon within the next few pages. We hope that this issue can provide a launching pad for a conversation about healthcare on campus: most importantly, what students demand in their healthcare system, and the absolute necessity of keeping those in power accountable.
In this issue... 3 On-campus sexual health resources Mental health at McGill 4 King Pharma 5 New curriculum, old problems
6 Colliding with McGill’s healthcare system
10 What’s privatization (and why should you care)?
8 Co-opting the word ‘health’
11 Comparing healthcare plans at McGill
9 Living with an invisible disability
12 Healthcare, straight from the horse’s mouth
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Healthcare
Don’t be silly, wrap your willy
Navigating sexual health resources on campus Emma Noradounkian and Rochelle Guillou
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affected by sexual assault. Their services are free and open to all during their walk-in hours or through their helpline at (514) 398-8500. B-27, Shatner Building, 3480 McTavish.
SACOMSS Located in the basement of the Shatner building, the Sexual Assault Centre of the McGill Students’ Society, a volunteer-based organization run by students dedicated to the direct support of sexual assault survivors, welcomes those who seek answers to questions concerning sexual assault, sexual health, and gender issues. They also carry a wide selection of books dealing with such questions, and a database of resources on support groups, therapists, organizations, and medical and legal services for those directly or indirectly
The Shag Shop The Shag Shop is one of the only sexual health centres on a university campus in Canada run by student services. Run by Healthy McGill – whose mandate involves harm reduction, sexpositivity, inclusivity, and a holistic approach to well-being – the Shag Shop offers students both resources and advice about sexual health. The Shag Shop offers items such as 24 different types of condoms, lubricant, and toys. They also sell low-cost pregnancy tests and alternative menstrual products. The Shag Shop is accessible to students of any identity or background. The only downside is their limited opening hours, because of their location with-
here are a variety of accessible on- and off-campus sexual health resources for McGill students, ranging from services that provide information on questions and issues related to sexual health, to those providing direct care.
in the clinic in the Brown Building. Opening hours are Monday to Friday, 12 p.m. to 4 p.m. Suite 3312, Brown Building, 3600 McTavish. Student Health clinic Located next to the Shag Shop in the Brown Building, the McGill walk-in clinic attends to students in need of prescription renewals, STI and pregnancy testing, contraceptive counselling, and other sexual health matters. Meetings are by appointment from 8:30 a.m. to 4:00 p.m., open seven days a week. Visitors will have to pay upon their arrival at the clinic, unless they show their valid McGill ID card and either their provincial health care card or the McGill Blue Cross health insurance card. To make an appointment, students can call on the 15th of the month to make an appointment for the next month: (514) 398-6017. However, if the clinic has reached its capacity, they can access a number of off-campus
clinics in Montreal, some of which might require those with out-of-province or international student insurance to pay cash. Suite 3300, Brown Building, 3600 McTavish. Department of Psychology The Department of Psychology at the McGill University Health Centre, located on the second floor of the Allan Memorial Institute, also offers off-campus sexual health-oriented services to McGill students, now covered by other sources of medicare. They include assessment, treatment, and consultation for sexual problems, and sex and couple therapy. Those wanting help with such issues should contact (514) 934-1934 ext. 34284, or email sexandcoupletherapy@gmail.com to make an appointment during the day or evening, Monday through Friday. Second floor, 1025 des Pins.
Moving toward a different model of mental health Students, alternative groups fill in the gaps left by the University Diana Kwon, Nina Jaffe-Geffner and Dana Wray
M
ental health issues are a growing concern on college campuses. A 2013 study of Canadian post-secondary institutions by the American College Health Association found that 26 per cent of students experienced depression to the point of being unable to function within the last year, and 6 per cent had at one point seriously considered suicide. The high stress university environment can give rise to anxiety and a wide variety of mental health concerns, making the development of accessible services that meet the needs of students utterly important. At McGill, both Mental Health and Counselling Services – funded through the Student Services budget – find it hard to keep up with the demand. Dr. Robert Franck, Director of Mental Health Services, told The Daily that last year, the average wait time for a first appointment at Mental Health Services was two weeks, while the wait time for a therapy appointment was close to a month. Counselling Services also comes with looming wait times. Last year, wait times ranged between two to six weeks, with higher wait times for follow-up appointments than for intake. However, as Director of Counselling Services Dr. Vera Romano told The Daily, unlike Mental Health Services, Counselling Services focuses on an ecological model, which involves collaborations with community groups and a more holistic approach to well-being. In addition to traditional appointments, Counselling Services offers meditation workshops, a self-help library, an upcoming cognitivebehavioural therapy program, and other non-traditional workshops. They also liaise with student mental health groups, providing, for example, a support group for floor fellows and other students who help their peers. “We need to be much more collaborative in understanding that people experience
Sarina Gupta | The McGill Daily wellness and lack of wellness very differently,” said Romano. The Inclusive Mental Health Collective is one recent initiative to build a community of individuals with shared experiences (which include, but are not limited to: psychiatric diagnoses, mental and emotional distress, and extreme states) who can speak openly and work collaboratively to promote their personal empowerment and well-being. The hope for such groups is not to replace traditional mental health services, but to provide an alternate means through which individuals can address their needs. Students have continued taking active measures to improve the services and the culture surrounding mental health on campus. This year, the first annual Students in Mind Conference was held on October 5, a first step in establishing a dialogue about mental health among students on campus. The conference touched
on issues such as self-care and peer support, among others. One new student-supported service, which will be available to students starting December 2013, is the Peer Support Network (PSN). According to its website, the PSN aims “to foster a community of positive mental health, to help students understand emotional well-being, and to reduce the stigma around the subject.” The PSN will rely on student volunteers, called Peer Supporters, who will focus on making a safe-space for drop-in discussion rather than making diagnoses. Amy Tang, a member of PSN, told The Daily that events earlier in the fall, including the implementation and subsequent cancellation of a $20 registration fee for Mental Health and Counselling Services, encouraged students to get involved. “If [the institutions] on campus aren’t achieving the results or aren’t meeting the needs
of [students], then people look for more grassroots initiatives,” Tang said. Student politicians have begun to get the ball rolling as well. At the first Students’ Society of McGill University (SSMU) Legislative Council meeting, the SSMU executive created an ad hoc committee on mental health. The committee is comprised of members of various mental health groups on campus and students who sit on the advisory committees of Mental Health and Counselling Services. Although its end-goal is to create a policy on mental health, according to SSMU VP University Affairs, Joey Shea, the committee could also help connect the various, often disparate, groups on campus. When asked why she felt there was a need for the committee and a new policy, Shea said, “I think it’s definitely [...] because [Mental Health and Counselling Services] are so overstretched and students are on wait-lists for four months at a time [...] Now there are students who are coming and filling [...] the resource gap and the [service] gap.” The administration has also heard the rumblings of discontent from students on campus. According to Shea, Vice Provost (Student Life and Learning) Ollivier Dyens – whose portfolio includes Student Services, under which both Mental Health and Counselling Services fall – is convening a working group on mental health. On November 19, a joint meeting of Senate and the Board of Governors will also discuss a renewed focus on mental health at McGill. “I think that all the talk that has been happening amongst the students is starting to influence McGill [and the administration] a little bit,” asserted Shea. Check
online
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WEB com for a video on ecological mental health.
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All about Big Pharma
Healthcare
A look at the pharmaceutical industry and how it influences McGill’s Health Clinics Anqi Zhang and Evan Dent
Robert Smith | The McGill Daily
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he pharmaceutical industry is one of Canada’s biggest money-makers and has widespread impacts on the population. As producers of prescription medication, the industry has a direct impact on population health and patient care. As a result of this, the industry has come under scrutiny in the past for a variety of issues, including ethics of clinical trials and financial accessibility. It has also come under scrutiny for its direct lobbying of, and influence on, health care providers, especially primary care physicians, through individuals who have come to be known as ‘drug reps.’ The pharmaceutical industry is an important part of the Canadian – and Quebec – economy. In 2012, the Canadian Generic Pharmaceutical Association reported a total of $22.1 billion in revenue from brand name and generic drugs combined. Rx&D: Canada’s Research-Based Pharmaceutical Companies’ publication Saving Lives – Transforming Care, noted that the pharmaceutical industry added $3 billion in jobs to the Canadian economy in 2012. Of this amount, Quebec jobs make up $1.2 billion, with over 5,000 people employed; these numbers are second in Canada to Ontario. The influence of drug representatives ‘Drug reps,’ more formally known as pharmaceutical sales representatives, are the direct contact between pharmaceutical companies and those who have the power to write prescriptions: doctors. These drug reps
provide information to medical professionals about newly available drugs and offer free drug samples for doctors to pass to patients for trial use. As a result, drug reps have a large impact on pharmaceutical sales and how often one brand of a given drug is prescribed over another brand’s version. A 2007 study published in PLOS Medicine found that doctors who write the most prescriptions receive most of their information from drug reps as opposed to journal articles. The proximity and influence that drug reps have to doctors, and the ‘selling’ inherent in the nature of their job, allow for the possibility of gifts and bribes. In response to this, many research groups, associations of pharmaceutical companies, and healthcare providers have proposed guidelines for pharmaceutical representative-physician interactions. For example, Rx&D, an association of Canadian pharmaceutical companies, has a Code of Ethical Practices in place to guide interactions between pharmaceutical companies and healthcare providers. In the United States, the influence of drug reps on prescriptions has caused substantial concern. As a result, drug reps’ access to doctors has become restricted in many areas of medicine. In recent years, they have experienced increasing difficulty getting time with oncologists. Since the late 1980s, the Federal Drug Administration and the U.S. government have been passing laws restricting pharmaceutical representative gifts and donations to
physicians as well as overall access. ThedaCare, a Wisconsin healthcare system, stopped distributing free samples earlier this fall, and does not allow drug reps to make in-clinic visits. In Canada, a recent survey of medical students at the University of Western Ontario revealed that 81 per cent of the 374 respondents thought that pharmaceutical representatives were interested in profit primarily, though their intentions were generally good. However, the survey also indicated that a number students were not opposed to receiving gifts from representatives if they were ‘educational,’ which shows that many may not be fully aware of the impact these gifts can have. This sort of relationship with representatives – wary of the profit drive, but still believing in the benefits of pharmaceutical companies – is mirrored by McGill’s own Health Clinic. Drug representatives and McGill McGill’s Health Clinic and Big Pharma – a term referring to the world’s largest pharmaceutical companies – have a fairly standard relationship. Big Pharma tries to sell their drugs to the McGill Health Clinic, and the Clinic considers drugs that are applicable to their patient base – the most popular being vaccinations and birth control medication. Vendors who try to exclusively sell the Clinic drugs designed for issues outside the normal scope of the McGill student population (such as heart disease) are barred from continuing
to pitch to the Clinic. In the past couple of years, McGill’s physicians have been asked to cut down on the frequency of their discussions with reps regarding new drugs. In an interview last year, Dr. Pierre-Paul Tellier, Director of Student Health Services, said that it had happened twice in the recent past. Some physicians take meetings with pharmaceutical reps, and others do not; the choice is made on a doctor-by-doctor basis. Most meetings with reps are taken by the administration of the Clinic, who decide whether to pass on information to the doctors. In essence, the McGill Health Clinic will take meetings with any rep who has an applicable drug, but bans reps who are not selling useful drugs to the clinic, and haven’t formed a special or exclusive relationship with any major company. Both the McGill Health Clinic and Mental Health Services sometimes distribute samples obtained in part from drug reps. At Mental Health Services, they are used only in cases of financial need. Oftentimes, the Health Clinic prescribes generic drugs (not associated with Big Pharma) because they are cheaper. Big Pharma’s influence on doctors across North America is a worrying trend, but one that governments and doctors themselves are taking notice of and acting upon. McGill’s relationship with representatives at the moment is admirable, and will hopefully continue.
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Healthcare
McGill’s medical school makeover New curriculum aims to resolve persistent problems Anvita Kulkarni
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his fall, incoming medical students are being taught under the McGill Faculty of Medicine’s revised medical MD, CM degrees (MDCM) curriculum. This major revision in the structure and themes of medical education was influenced in part by recent advocacy from the Association of Faculties of Medicine in Canada (AFMC) for education reform. “The last major change to the curriculum was in 1994. So it was a long time ago,” said Robert Primavesi, McGill’s Associate Dean of Medical Education and Student Affairs. The ten AFMC recommendations for the MD curriculum call for reform in multiple sectors, including confronting the so-called “hidden curriculum,” building upon the scientific basis of medicine, cultivating a sensitivity to individual and societal needs, and encouraging discussion on public health and prevention. How is this all being implemented into McGill’s new curriculum? “All of those are actually themes [in] the curriculum and we’re actually implementing it longitudinally. We’ve tried to be more integrative so that what’s being taught is linked [together],” said Primavesi. For example, regarding changes in the teaching of basic science, Dr. Terence Hébert from McGill’s Department of Pharmacology & Therapeutics explained, “They would get, in the old years, an introduction to cellular and molecular biology, an introduction to the respiratory and circulatory system [...] an introduction to this and to that. At the end of their two years, they would finally come and learn pathology and pharmacology. So what’s different about the new curriculum is that, as they learn about all of those systems, they get pathology and pharmacology at the same time.” “I think it helps with retention. You don’t want physicians who have such a minimal command of basic science that every drug company marketing scheme that they see will be evaluated uncritically,” said Hébert. But other AFMC recommendations, such as confronting the hidden curriculum and cultivating physician sensitivity, demonstrate the more implicit problems in medical education. “I think the hidden curriculum is the curriculum that we model, unknowingly sometimes. And I suppose that it refers to a gap between what we teach and what we say, and what we do as a profession,” said family physician Dr. Sally Mahood. “We all believe that we should be what we call ‘patient-centred,’ meaning making the patient the centre of what goes on in care,” she said. “But in actual fact, much of the healthcare system is not structured for the benefit of patients, but structured for the benefit of the people who are working in the system, and in a fairly hierarchical way, with physicians pretty close to the top of that hierarchy.” Jos Porter, the Health Services Coordinator from Montreal clinic Head & Hands, added, “[Clinical environments] are not always
David Zheng | The McGill Daily very approachable spaces. If you’re a queer youth, for example, and you go to a clinic […] and your doctor starts talking about birth control or something that makes assumptions about sexuality and doesn’t pertain to [you], it can be a very alienating experience. It can make it very difficult to want to share what’s going on in your life with your doctor. It can often make people feel judged.” In regard to how these problems are tackled by the McGill’s new curriculum, Primavesi said, “We want to make sure that not all of the cases that are presented are [like] ‘husband and wife with two kids.’ We want to make sure that there’s a spectrum of diversity within the regular case presentations. So maybe someone who’s paraplegic in a wheelchair may have asthma, for instance.” “The other part about addressing the needs of society is widening the admissions precept. So we’re doing a lot of outreach – in terms of underrepresented populations, including rural and lower socioeconomic groups,” Primavesi continued. Mahood agreed, “We pick people who are young, who are academic stars, who often have very little experience of life other than to be, you know, relatively privileged young people. So it’s no surprise that it’s very difficult for those people to come through an intense course of professional training and socialization and [they] come out with – perhaps – no empathy, no understanding of marginalized populations, and what their barriers to good
healthcare, or good access, are.” “I also think that the lack of empathy and patient-centredness that we see in our learners has to do with the stress that’s put on them to perform. [...] If that’s the pressure on you, then patient-centredness isn’t valued and a mark of 99 [per cent] is. What we evaluate in our students is what they’re going to learn to model.” In regards to evaluation techniques in the new curriculum at McGill, Hébert stated, “In large classes, one of the main tools we have to evaluate is, unfortunately, the multiplechoice question. But the new curriculum has a series of exercises built into it – or will have built into it, because we’re still working on them – called reflection and evaluation weeks, where we’ll have the opportunity of [choosing] different modalities to evaluate students’ progress. So there’s the possibility of longitudinal testing.” More external factors, such as pressures on the healthcare system as a whole, also add a layer of difficulty to the teaching of medical education. “You can’t spend a morning where there’s 30 or 40 patients at the ward, where everyone has to be seen to discuss every little detail in people’s lives,” said Dr. Pierre-Paul Tellier, McGill’s director of Student Health. “Much of the teaching goes on when you are doing clinical work in hospitals, where you are overwhelmed by the number of people you have to see.” Other universities across Canada, such as
“Patient-centredness isn’t valued and a mark of 99 [per cent] is. What we evaluate in our students is what they’re going to learn to model.” Dr. Sally Mahood the University of British Columbia and Memorial University, are also in the midst of implementing revised medical curricula in light of the AFMC recommendations. Moving forward from the recent implementations, Primavesi commented, “We have to monitor what we’re doing this year. We get feedback from the students, so we do have focus groups at the end of every block.” However, Mahood advised taking these developments with a grain of salt. “I think that the problems are very stubborn, and I still see them every day, all day. [...] I think things are improving slowly, but we have a very long way to go.”
Healthcare
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Experiences with McGill’s Mental Health Services The Daily reached out to the McGill student population through listservs and social media, soliciting personal testimonies of experiences with different healthcare services at McGill. Almost all the testimonies submitted related experiences with McGill’s Mental Health Services, perhaps indicating a need for the University to recognize the need to change their approach to student mental well-being.
I I
’ve been a McGill student for over three years, and never once had to visit a hospital in Montreal. My medical experience in Quebec was limited to McGill Health Services Clinic – and it was overwhelmingly negative. Over the years I’d contracted some nasty, crippling coughs, and each time I sought relief it was the same: hours of waiting for a drop-in appointment, resulting in nothing but advice to “rest.” Sure, I once got a birth control prescription, but the necessary appointment took a month’s foresight. One day, I got into a more serious accident and immediately went to a nearby hospital’s emergency room. After a few hours and some awkward explanation in hackneyed French, I was stitched up. I thought everything would be okay, but after two days of serious pain I decided, begrudgingly, to head to the clinic. This time, I thought I had a real problem that would be taken seriously. I waited with a smug sense of superiority, knowing that the sniffling students in the waiting room were just wasting their time. Three hours later, I saw a doctor who … referred me to another emergency room! She said I could have x-rays taken there, but that they would take days to process. So, I re-started the waiting process at a new hospital (five hours) before I was diagnosed properly and scheduled for surgery the next day. The clinic, to me, faces a paradox: common time-sensitive conditions aren’t seriously treated, but serious ones are better treated elsewhere, with a higher calibre medical capacity. I realize now that I kept going back because of its affiliation with McGill, which was convenient to me as an outsider. And while familiarity is nice – I don’t want to repeat my alienating experience at the first hospital – I now know better. In Quebec, you’re going to wait wherever you seek medical care. Best to head straight to a (good) hospital’s emergency room and get to the bottom of it.
’ve signed my name onto the McGill Mental Health waitlist four different times over my degree at McGill, and not once have I seen them. The first three times was because they never got back to me. The last time, after three weeks, I was finally called but couldn’t find a time that worked for me among the time slots that they offered, and so they said they would have to call again in the next few weeks when more time slots opened up. By the time that they called me again, it was the end of the semester, and I was leaving for the summer. These experiences have prompted me to go to Counselling Services instead. By and large, their waiting times are much shorter (I’ve usually been able to see someone within one or two weeks). Through my experience in Counselling, one thing that I’ve learned is that we as seekers of support should feel empowered to seek a counsellor that fits our needs. I’m a second-generation FilipinaCanadian from a lower-middle class background. This has impacted my mental health needs, and has prompted me to seek a person of colour (PoC) counsellor. Even though I’ve yet to see a PoC counsellor because of scheduling conflicts, I’m happy to now know they exist! Being upfront with what you do and don’t need in a counsellor, and changing counsellors when your relationship with them doesn’t feel ‘right,’ is important, and since I’ve been doing this, it has saved me pain and energy. Because I hadn’t done counselling prior to McGill, I didn’t know what feeling ‘supported’ in the way that I wanted to meant. But in retrospect, I can say that, until recently, most of my counselling experiences were quite unsatisfactory, and I would leave feeling [uneasy]. This has somewhat changed since I’ve changed counsellors, and become more aware of what I want in counselling and articulated these things to the front desk (i.e. “schedule me with a PoC counsellor), and the counsellor herself (i.e. “I’m not just looking for all-the-time-affirmation, but for support in thinking through my thoughts). I’m definitely ‘happier’ at counselling since I’ve starting voicing my needs more. That being said, there are many valid reasons for which people cannot and do not communicate their mental health needs, at least in the normalized ways we have come to understand communication. I would not like to perpetuate the myth that the quality and quantity of support that an individual receives is, or should be, commensurate to one’s efforts in communicating one’s need for support. We have to collectively learn how to create a culture where people feel comfortable communicating their needs, where we understand that people communicate needs in different ways, and in which we understand how to actively to listen to these needs in different ways.
Healthcare
D
uring my first week at McGill, the Mental Health clinic and other such support systems were advertised as being highly accessible and available to all. As a new college student dealing with remnants of anorexia and anxiety, I tried to reach out to the Mental Health Clinic as early as possible. However, not only did it take me over a month to get a spot on the waiting list, but I waited another two weeks to actually get an appointment that lasted five minutes. I was then told that the next available appointment to see a cognitive behavioural therapist would be in over two months and that my only other option would be to see a therapist outside of McGill. I was also advised to contact the Eating Disorder program, which has a ridiculously impractical schedule and an outrageous cancellation fee. I wouldn’t say that I’m dissatisfied by the employees I’ve communicated with, as they were all very professional. Unfortunately, I cannot say the same for McGill’s Mental Health system itself. It would almost be better if McGill stopped promoting its clinic as the go-to place for mental instabilities. It’s lucky that I’m much better now than a couple years ago, because McGill Mental Health would probably not have been able to provide me with the pressing help I needed then.
7
I
wanted to access McGill Mental Services in the middle of first year to receive treatment for depression, which I was diagnosed with in high school. I was able to get an appointment with a psychiatrist after about three weeks, which wasn’t too long of a wait, considering the wait-times of the public sector. I met a few times with that psychiatrist, who didn’t provide much interest in collaborating with my psychiatrist at home in terms of ongoing treatment, but was helpful in some regards. Since I had also received cognitive behavioural therapy during high school, I put my name on the list for psychological services shortly after, hoping for a more constructive experience and treatment through therapy, which has been proven to be just as effective as medications which are commonly the treatment prescribed through psychiatrists. I’m now in the middle of my third year and haven’t heard back about an appointment. I depend solely on visits home to my psychiatrist in order to keep up treatment. Perhaps I could have been more persistent or proactive about obtaining an appointment with a psychologist; my name could have just been lost along the way. My case was not an emergency, so I didn’t probe into it further. Nonetheless, I essentially could not access the services I needed at McGill to continue the treatment for my chronic condition. I don’t think that someone who’s dealing with a mental illness – or any illness for that matter – should have to constantly fight for their right to be treated, or second-guess the importance of their concerns.
tion
ra illust
I I
f there is one thing I learned from McGill Mental Health it’s not to share anything that could be used against you with the therapists who work there. Even with those you trust. When I first went to Mental Health Service to deal with what I suspected was depression I met with a patient, understanding, and non-judgmental therapist – let’s call her Liz. I felt that I could trust her, and I disclosed information about my occasional drug use to her. I felt that disclosure would better allow her to help me. A few months later I started experiencing mental health issues again, and wanted to withdraw from one of my classes past the add/drop deadline. I went to McGill Mental Health to see if I could get a note recommending that I withdraw from my class. I came in for a drop-in appointment and met with a therapist I had never met with before – let’s call him John. When I explained my situation to John, he was extremely judgmental. He insinuated that if I was having a tough time at school it was my own fault for using drugs, and that because I had said I used drugs, I could not possibly have a legitimate reason for wanting to withdraw from a class. He claimed that I must be using drugs more frequently than what I had told Liz. He also claimed that withdrawing from a class would not solve my problems, yet he did not give me any advice about alternatives. It seemed like he wanted to get me out of his office as quickly as possible while being as hurtful as possible. Needless to say, I never received a note recommending that I withdraw from my class. What was so horrifying about the situation was not that John refused to give me a withdrawal note, but that he used information that was on my record, information that I had told Liz, who I trusted, against me. He also used that information to make me feel bad about myself. I later complained about this man to another therapist working at McGill Mental Health and her reaction was that I couldn’t expect a therapist who I did not see for a full session to be understanding. Yeah, I guess that would just be too much to ask from a mental health professional. Although there are good therapists at McGill Mental Health, there are also terrible ones. I now deeply regret telling certain things to Liz because that information is now available to incompetent therapists. I feel that I can never go back to McGill Mental Health because of that. It is extremely problematic that our mental health service hires therapists who will use personal information against students rather than to help them.
han
era C H y b
went to see someone at McGill Mental Health for my clinical depression two years ago. As far as I can remember, I came in for an emergency appointment because I needed a doctor’s note, and they saw me the same day. The psychiatrist who saw me scheduled me for a regular appointment two weeks later. I had one-hour sessions with a therapist intern, but they didn’t help me much so I asked for the possibility of medication, and they reassigned me to a psychiatrist who prescribed anti-depressants for me. She wasn’t very interested in providing the extended talk therapy aspect, which I think is a function of how overbooked McGill Mental Health is, so I’d only go for brief appointments to update my prescription. Once I found the right anti-depressant, my depression lifted, which was fantastic and literally life-changing. However, the other emotional and mental problems in my life didn’t go away. Things like mental fogginess, forgetfulness, inability to concentrate, a poor sleep schedule – all symptoms that my psychiatrist attributed to my depression – remained even after my mood lifted. So my psychiatrist suggested that I see someone else at McGill Mental Health who had a lot of experience with treating attention deficit hyperactivity disorder (ADHD). This new doctor totally rearranged my life again when he facilitated my official ADHD diagnosis at the Office for Students with Disabilities (OSD) the following semester, and gave me a ten-week, one-on-one cognitive behavioural therapy course for my ADHD. The six-hour psychometric diagnostic test normally costs something ridiculous like $1,500, I believe, but OSD administered it for free. After that, I got registered with the OSD and another psychiatrist at McGill Mental Health prescribes my ADHD medication now. I got passed off to McGill Counselling Service for talk therapy to resolve residual emotional issues I couldn’t really address at McGill Mental Health. I still see my psychiatrist there for renewals and alterations to my prescriptions every few months. I don’t know if I would have gotten the help I needed if it weren’t for McGill Mental Health, because it costs so much money to see a private psychiatrist. So, overall my experience with McGill Mental Health was very positive. It was accessible for me, waiting times were short, and I got what I needed from them. My problems still haven’t been fully resolved, but I’m dealing with that through the OSD and McGill Counselling Service now. However, from what I’ve seen of friends and acquaintances using McGill Mental Health’s services, the accessibility can vary widely. I was very fortunate that all of these things came together as they did. I think the biggest factor is how well you advocate for yourself, the timing of when you schedule your appointments, and how serious your condition appears. When I went to my very first emergency appointment with them, I started crying and talking about the severe derealization I was experiencing, as well as my suicidal thoughts. The student health clinics’ limited resources mean that they have to do significant triaging, and they evidently thought my case was quite serious. My friend, who I’d say was suffering a comparable amount of emotional turmoil, went to an emergency drop-in appointment and didn’t get the same priority I got – I assume because she didn’t show the same kind of visible distress or vocalize her experiences as strongly.
8
Healthcare
Co-opting the word ‘health’ Alexander Calderone, Gelila Bedada And Zoey Tung
ercise Overdosing on exon you can give your e of the best things
Regular exercise is u with an emoenergy, provides yo ur yo t os ll bo lps he body. It ular diseases, as we combat cardiovasc lps he s d ha an ise t, lif erc l tiona betes. Ex s such as type II dia ly us ero ng da be as manage condition t can physical benefits, bu many mental and constitutes a suppos at wh th wi on ssi se ob s ty’ cie so by warped e. edly ‘healthy ’ figur than the suggested ercise much more Individuals who ex ly restricting their ca lf hours while severe ise erc ex as on weekly two and a ha ssi ofe pr fied by the medical ty, loric intake are classi way stems from socie in rta ce a k loo to e ur ess d pr pe e op Th . sh ics oto bulim lmed by Ph constantly overwhe me ito ep e th as as individuals are ped up usly thin models prop images and dangero ecially when chanesp ty, cie so r ou of cts tru ns co e Th ty. of beau e a misinterpretaam media, encourag tre ins ma ms, h ug ro th neled In real medical ter rd healthy means. le ab is it ich wh tion of what the wo in nism condition of an orga tuna ich wh on health refers to the iti fin de and sustain itself, a to properly function t. igh we low ly us ero rally excludes a dang lethal combination over-exercising is a Barely eating and uired in order ential nutrients req ess e th of le op pe s that deprive s even more devs a tragedy to see. It’ It’ s. ve sel iem th in to susta auty ideal pushes ind that a restrictive be r ve co dis to ng ati ast bodies this way. viduals to treat their
‘Thinspiration’
Juice cleanses
Liquid cleanses are an extreme recent focus on fad diet made popular by a raw or organic food intake. M brands offer cl ost juice cleans eanses lasting e from 24 to 72 brands offer cl hours and som eanses that last e up to of the cleanse, cl five days. For th eansers are com e duration mitted to only dr of juices contai inking a variety ning just enough fat and calories The intensity of to sustain them the cleanses is de . termined by thei by the amount r duration and of ‘green juices ’ included. The to green vegeta green juice refe bles such a cele rs ry, kale, cucumbe maine lettuce. Th r, parsley, and ro e recommendatio ns are that you times a day, and juice five to six keep a ratio of 80 per cent vegeta cent fruits for ea bles and 20 per ch juice. A serv ing of juice has and when nuts 70 to 200 calorie such as cashew s, s are included 300 calories. Ord this can climb ering a juice clea to nse package can from $45 to $80 cost anywhere a day. One of the reas ons offered in support of juic weight loss. Ac e cleanses is cording to Hea lth Canada, an tween the ages average male be of 19 and 30 sh ould have a da between 2500 ily caloric inta to 3000. The re ke co m mended daily in males is betwee n 1900 to 2350. take for feA juicing diet on to 1800 calories ly provides 1200 a day, and is an unsustainable an method of weigh d unbalanced t loss. Supporters of ju ice cleanses also toxins out of th allege that it cl e body. However eanses the , the intestines ability to self-cl ? ts en m le actually have th pp su ea e n; os ot th he ed rw ne e ise , generations be been lost withou noon, and Do you really fore us would ha rning, in the after t the invention of mo e th in ve em th e rm juice cleanses. In fibre found in ce You can tak by the body to perfo fact, insoluble lery, whole grai Vitamins, required ns, and root ve These h. ea alt sil he y of before going to bed. do te th sta ge e a jo ta to b. ble skins can ial W nt at se er es e is ar another principa s, essential detox the inte metabolic processe l element that he stines. In the w d K, which are all an E, D, lps to C, B, A, orst-case scenar iencies, such will actually need include vitamins ios, when the bo from vitamin defic he lp ng lti de su to re dy s xi se fy ea ide in g chemical toxi als that accumul ts that prov to prevent dis ns or heavy met ate, there are m e are also supplemen er Th ts. ke ric ail ed d av ic e an al protocols crea for these circum as scurvy t of these ar ted uniquely stances. a-3 fatty acids. Mos eg om at as th ch ts su es ts gg en su nutri research m. However, recent lar able in capsule for ired through a regu qu ac be all vitamins trigfor le sib on not only can these sp re be lements may even diet, but some supp gering diseases. ing scare tactics in are notorious for us Vitamin companies r Elaine Scarry renowned professo o, ag ars ye y an M . In one chapter, advertising. ting Representation sis Re led tit ok bo a published at is carried by medionishing message th ast an s odibe scr de y Scarr consume a certain pr if you choose not to ch mu ed inc nv co cal advertisements: ies have ve to be ill. Compan causare ey th ts, uct, then you deser en lem glecting to take supp of society that by ne h. reing their own ill healt According to many posite may be true. op e y ma , rly ula reg But in fact, th en supplements, tak id ac ty fat g a-3 eg lon e wn to it, th searchers, om er. When it comes do nc ca e tat mos co pr d to an d be linke are unknown, of these compounds ts term effects of many o taking supplemen int le op on scaring pe panies largely rely . more harm than good that may actually do
A quick Tumblr, Pinterest, or Instagram search will reveal the distressing glamourization of ‘thinspiration’. Here, you’ll find community dietary support through trending images and video montages of slender women, ranging from naturally slim to gaunt with visibly protruding bones. Skinny does not necessarily equate to healthy, but the ‘thinspo’ sensation would have you think so. ‘Thinspo’ culture romanticizes anorexia, undermining body positivity by advertising messages such as, “You can be THAT girl. The only thing stopping you is yourself.” One of the glorified fad diets that has accompanied this phenomenon is the Anorexia Boot Camp Diet, or the ABC diet. Over a span of 50 days, dieters are expected to follow an extreme, low-calorie, pro-anorexia diet. Proponents of the diet say the body’s metabolism is tricked by consuming a variable number of calories. However, the health benefits of consuming 500 calories a day are dubious at best. The ABC diet is not advised by dieticians, since the recommended minimum daily calorie intake of calories is about 1000 calories. Fad diets that promise to encourage health and fitness, such as the ABC diet, often promote short-term weight loss, usually with no concern for long-term weight maintenance or any real health benefits. The long list of side effects should be enough to make anyone reconsider such harsh nutritional deprivation. The risk of muscle mass loss and osteoporosis is very high. Deficiency of necessary vitamins leads to the possibility of low blood sugar, dizziness, malnutrition, fatigue, sensitivity to cold temperatures, and depression. Yet, the most alarming consequence of ‘thinspo’ is the chance that the weight loss fixation never ceases, the calorie counting does not end, and the “Nothing tastes as good as skinny feels” mantra will perpetuate itself. In antagonizing the individual, motivation to get fit breeds through self-hate, ultimately creating a gateway for more serious eating disorders.
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Healthcare
Invisible disabilities Joelle Dahm and Mark Tartamella
W
hen people think of the word “disability,” they often immediately relate it to a person with visible physical disabilities, for example someone who uses a wheelchair. What about people with disabilities that aren’t immediately visible? Invisible disabilities present a lot of challenges to the affected people – challenges that are often neglected. Some students with invisible disabilities might be marginalized and stigmatized due to the ableist fear attached to the word disability. “In some morbid, terrible way, I sometimes feel like I’m not disabled enough. Symptoms of my special needs are assumed to be the shortcomings of a ‘normal’ person. It is assumed to be some type of intentional inferiority rather than biological conditioning,” Z.J. Kauffman, a student at McGill, wrote in a personal narrative for The Daily on struggling with having an invisible disability. At McGill, the Office for Students with Disabilities (OSD) accommodates students who experience barriers at the university, be it through visible or invisible disabilities. “In the past we’ve been traditionally providing individualized accommodations for each and every single student,” Tanja Beck, Access Services Advisor at the OSD, told The Daily in an interview. “We still do that, but we would like to move away from that model [so that we are] able to include more students in the general classroom setting, and students no longer have to disclose their disability if they do not want to.” The term ‘invisible disability’ encompasses a broad variety of things, such as physical illnesses like Crohn’s disease, fibromyalgia, arthritis, endometriosis, ulcerative colitis, diabetes, lupus, et cetera. It also includes mental disabilities such as anxiety and depression. An invisible disability can also be a matter of someone with a hearing disorder not sporting a visible hearing aid, for example. Of the 1,500 students registered with the OSD, 85 per cent have invisible disabilities, the most common being mental health issues. “There is a lot of anxiety, but also depression, and we do see an increasing number of students with schizophrenia, bipolar disorder, and borderline personality disorder,” said Beck. In 2009, the organization InvisAbilities was started by Julie Harmgardt, a student at Queen’s University. According to the organization’s website, InvisAbilities was founded primarily to “promote awareness, education and support of young adults living with hidden, chronic illness” as well as to “break down societal misconceptions associated with invisible illness.” In 2011, a chapter was formed at McGill, although
it is inactive this year due to former leaders having time conflicts. Alexandra Tighe was the former cochair of McGill InvisAbilities, and suffers from Ehlers-Danlos Syndrome, an extremely rare connective tissue disorder that causes loose joints, chronic pain, and other problems. “I feel as if I face a lot of the same issues that all people with invisible chronic illnesses have to deal with,” Tighe told The Daily. “It can be very difficult to explain to people that, while you may look perfectly fine on the outside, you are actually in poor health or suffering. It’s really difficult for people to wrap their head around that conflicting image.” Beck told The Daily she believes that the rising number of mental health issues is caused by the university environment. “McGill is a very high pressure environment [...] At the same time a lot of students are away from home for the first time, and they have to organize their life themselves and start being responsible for themselves.” During her time at McGill, Diana Di Zazzo, a former student, experienced anxiety related to the high-pressure environment at McGill. “The anxiety did build up and I would not necessarily get panic attacks but I would miss sleep, and I would have these harsh shivers in my spine every once in a while that also did not help my sleep,” Di Zazzo wrote in a personal narrative for The Daily in this issue. However, apart from her friends, Di Zazzo struggled with finding a support system. “Were there available resources at McGill for me? If there were, I did not even know about them. I never was offered help in the sense of coping with school life. It was more what parties or groups were available to join, which I never felt I had time for,” she wrote. According to Tighe, it seems like there are more invisible disabilities than the past “simply because we are more aware of [the] various disorders […] and there are better techniques for diagnosis,” said Tighe. However, sometimes students don’t understand that they have a disorder, and are therefore less likely to seek help, Tighe said. Students with invisible disabilities in day-to-day life often face questions from misunderstanding peers – “Why are they taking the elevator up one floor? They’re fine!” – but there can also be conflicts with professors. “Many chronic disorders can have unpredictable flare-ups or complications that may require students to delay submitting assignments or midterms,” explained Tighe. Although the OSD is there for student assistance, “much of the advocacy is [students’ own] responsibility […] and it
Alice Shen | The McGill Daily can be challenging to explain to a professor how, even though you look put together and healthy, you are not doing well.” Beck stated that the OSD realizes this is a problem, and tries to make classrooms and the academic environment more accessible for everyone. “We are working with faculty on implementing universal design for learning. We take a barrier approach, where we see which barriers exist in the learning environment for students and how we can reduce them,” she said. Beck also gave the example of notesharing, one of the OSD’s services. The OSD pays students to take notes in classes, which are then shared with students who register with the OSD. “You have so many different learning styles in the classroom [... so there are problems] not only for
students registered with the OSD but [... students] who speak English as a second language, or students with anxiety [...] or in general students with general attention problems. They can all benefit from [the note-taking] without needing to go through the office.” Ultimately, Beck said, “It would be good if we could start to acknowledge the fact that the student population is so diverse, that they come from so many different backgrounds, and that by integrating simple tools you can make learning much more accessible and [...] equitable.”
Read the personal narratives of students living with invisible disabilities online at mcgilldaily.com.
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Healthcare
PRIVATIZATION B
roadly, privatization is the process by which an industry originally run by the state is transferred to one, or many, privately owned entities. From an economic and political standpoint, the main argument for privatization involves the estimated increases in efficiency that result from private ownership. This increase in efficiency is thought to come from the greater importance private owners tend to place on profit maximization through cutting costs. Additionally, by opening an industry to the free market, companies will begin to compete with one another – and, as the theory goes: the more competition, the lower the prices. Like any other commodity, this logic is often applied to healthcare. By and large Canadians take pride in our health care system. A 2009 poll by Nanos Research found 86.2 per cent of Canadians sur-
Z.J. Kauffman & Nathalie O’Neill
veyed supported or strongly supported “public solutions to make our public health care stronger,” and, in the same year, a Strategic Counsel survey found 91 per cent of Canadians believed their healthcare system was better than the American system. Public healthcare in Canada is designed to ensure that all citizens of the country have reasonable access to insured health services on a prepaid basis, without direct charges at the point of service. The belief underpinning this policy is the simple normative claim that, as a Canadian citizen, one has the right to a basic level of healthcare, and no one should be faced with the choice between bankruptcy or death. There is a conviction that healthcare is not ‘just like any other commodity,’ and that when sick patients are looking at products and prices, their behaviour cannot be expected to be
Many of Canada’s healthcare services tend to fall under the purview of private healthcare plans. Most of these private plans are offered by employers or unions, and Canadians who do not qualify for a private plan may be eligible for supplemental public coverage (in Quebec, the Public Prescription Drug Insurance Plan). Different plans cover different drugs, and plans tend to vary to a high degree from province to province. Many insurers only reimburse 60 per cent of the total price of prescription drugs, dental services, and optometry. Recently, skyrocketing drug prices have led private healthcare providers to doubt whether they can continue providing coverage. Some groups, such as the political party Québec Solidaire, have made it part of their platform to use governmental leveraging power to force pharmaceutical companies to lower their prices.
One of the most prominent examples of privatization in Canada is the proliferation of private clinical services. Defenders of private clinics argue that the public system is mismanaged and sluggish. They believe that patients should have the right to pay their way to faster health care. Private clinics charge patients for medical equipment, facilities, and support staff, as well as diagnostic services (such as MRIs and CT scans). The two-tier system championed by a number of Canadians is actually a significant threat to public health care: as well-off patients flock to private clinics, they take away their power to improve public clinics and demand the lowering of taxes.
similar to that of voluntary buyers and sellers in a free market. Lastly, there are concerns that privatized healthcare leads to political protection for insurance corporations. In today’s world, the question of privatization seems all the more poignant. Many assume that almost all Canadians’ healthcare spending happens through the public system. In fact, over $56 billion was spent on private healthcare services in 2010, and over the past decade private spending has constituted approximately a third of all healthcare expenditures in Canada. Quebec has seen significant growth in private, for-profit clinics. Such clinics operate on the premise that those willing to ‘cough up’ the money can avoid longer wait times – a premise that pushes the system closer to basing accessibility on wealth rather than need. Students, in particular, feel the brunt of
limited accessibility since students tend to be a transient and vulnerable population. Students typically work with fewer financial resources, but often resort to seeking out services in private clinics due to longer wait times at university or public institutions. For instance, McGill’s Student Health Services clinic requires students to call at 8 a.m. on the 15th of each month to schedule an appointment for the next month. That phone call, based on anecdotal stories, can often last an hour. That inaccessibility often translates into the use of outside services in order to obtain essential medical care. Privatization affects us all, but in our vulnerable position as students, we must be vigilant in ensuring that the system works to accommodate all based on need rather than wealth, or other similar circumstances.
Under the Canadian public healthcare system, only hospital care and doctor visits are covered. Everything else, including optometry, dentistry, drugs, ambulance services, and chiropractic services, is driven by market forces. In fact, only about 70 per cent of Canadian health expenditures are publicly funded; the rest are either paid for out-of-pocket or through private health care. While 40 per cent of Canadians are covered under a private health care plan, they are rarely fully reimbursed. In addition, the public healthcare institutions of hospitals and clinics are also affected by privatization.
Public-private partnership (PPP) hospitals are another salient example of market forces merging with public health care. PPP hospitals are funded by outside capital. Private interests provide the funding, and sometimes the expertise, to build a new hospital (for instance, the scandal-ridden Montreal University Health Centre), which is then leased to the government. Governments are attracted to PPPs because it means delaying payments, but these hospitals actually end up costing the government about 16 per cent more in the long run.
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Healthcare
Comparison of student health care plans Jordan Venton-Rublee, Hillary Pasternak and Rachel Nam
OUT-OF-PROVINCE
OR
QUEBEC STUDENTS
SSMU
As a student paying out-of-province or Quebec graduate tuition fees, you are automatically eligible to be a part of the Post-Graduate Students’ Society (PGSS) healthcare plan. Very similar to the plan offered by SSMU, the plan covers students for everything from vision to travel, as well as tuition insurance in the case of health issues. The full cost, included in your student fees as long as you do not opt out, is $401.45, charged once in the fall semester.
As a student paying out-of-province or Quebec undergraduate tuition fees, you are automatically eligible to be a part of the Students’ Society of McGill University (SSMU) healthcare plan. The “I Have a Plan” plan, which is provided by the ASEQ insurance company, acts as a supplement to your existing provincial health care plan. This plan covers students for everything from vision to travel, as well as tuition insurance in the case of health issues. The full cost, included in your student fees (as long as you do not opt out), is $220, charged once in the fall semester. The cost breaks down to $100 for health and $120 for dental coverage. Note: If you choose to opt out because you are covered under your parents’ or your workplace’s healthcare plan, you are not covered under the SSMU plan. Additionally, students belonging to the School of Continuing Education are not covered.
Health
Dental
Health coverage for “I Have a Plan” covers everything from prescriptions to X-rays, and health practitioners – including naturopaths, osteopaths, and registered dieticians – to home nurses. “I Have a Plan” will also cover 100 per cent of vaccination costs, 100 per cent of medical equipment costs – including wheelchairs, crutches and hearing aids – and up to $250 for ambulance trips. Tuition insurance in the case of a medical emergency is also included in this category, for up to 100 per cent of costs - as long as the costs do not exceed $10,000.
The dental plan is extensive, covering up to 60 per cent for procedures like fillings and root canals, and up to 70 per cent for lesser, more routine procedures, such as exams, extractions, and cleanings. Additionally, dental accidents are covered by the plan, but only for repair and replacement of natural teeth and within 12 months of the accident.
What isn’t covered: Ultrasounds for monitoring illness and pregnancies. If the health practitioner is not listed on the “I Have a Plan” website, they will not be covered by the plan either. Watch the fine print: 100 per cent of vaccinations are covered – but only up to $300 per year.
Vision Vision is covered less than other parts of the plan, but coverage includes one eye exam a year, eyeglasses, contacts, and laser eye surgery. Students are covered much more extensively under the “Vision Network,” a list of off-campus providers that are covered. What isn’t covered: Any additional checkups after the first year, as well as any eyeglasses and contacts over $75. Watch the fine print: Laser eye surgery is covered up to $150 a year, although if you go to one of the Lasik MD locations you get an additional $200 to put toward surgery. Additionally if you use the “Vision Network” you can get additional discounts, such as discounts off eye exams and an additional $75 off prescription eyeglasses.
PGSS
What isn’t covered: Procedures like crowns, posts, and bridges – although if you go to one of the “Dental Network” clinics, which are off-campus clinics that give students additional coverage, you are able to get a 20 per cent discount. Watch the fine print: Some procedures – like cleanings – are only covered once a year. Other procedures, like a complete exam, are only covered every year and a half.
Travel You are covered for up to 120 days of travel, for multiple trips taken within that period. Coverage includes hospital trips, physician visits, and emergency treatment for injury and illness with up to 5 million per incident. You are also covered for $1,500 in the case of a trip cancellation due to medical emergency, and $5,000 for trip interruption due to injury or illness. What isn’t covered: If you or your dependent is 65 or over, you are not covered under travel insurance. Did you know: If you are going on a McGill exchange or internship, you can extend your travel insurance while abroad with proof of a letter of acceptance. You are then insured for up to 120 days after your exchange ends – so don’t jump on the travel insurance offered by your bank unless you have to.
Health
Dental
Similar to the undergraduate plan, the PGSS plan covers 100 per cent of vaccinations – but only up to $50 per year. Also covered under the category of health are prescription drugs, up to 90 per cent of costs per year.
The plan covers 50 to 65 per cent of total dental costs, similar to the undergraduate plan. If you use the “Dental Network,” you can be covered up to an additional 30 per cent on some services.
Vision
Travel
The vision portion of the plan covers one eye exam a year, up to $30 a year. For additional information, see the SSMU vision section.
For travel insurance under the PGSS plan, see the SSMU travel section.
INTERNATIONAL STUDENTS The McGill Senate requires all international students (full-time, part-time, exchange, special, and visiting) to be registered under the McGill International Health Insurance Plan – even if a student is covered under a separate private plan. The plan follows a yearly contract with each contract year, starting on September 1 and ending on August 31. The plan provides four sub-categories of coverage: basic health benefits, supplementary health benefits, accidental dismemberment, and repatriation. For a higher rate, dependents and spouses can also be covered under a student’s plan. The basic coverage: The plan allows for up to $150,000 of basic coverage per person per year. These benefits include hospitalization, physicians’ fees, diagnostic tests, maternal care, dental care (accidental), medical evaluation, and vision care. Up to $15,000 can be reimbursed for supplemental benefits like flu shots, routine vaccinations, local ambulances, and physiotherapy. What isn’t covered: Pre-existing conditions that will incur more than $10,000 in charges, charges for treatments related to aesthetic purposes, organ transplants, drugs and medical treatment not deemed a “medical necessity.”
Health What is covered: Expenses for treatment at a hospital not including hospitalization, psychiatrists, and some diagnostic tests (e.g. MRIs). Maternal care – including ultrasounds, prenatal care, delivery, and abortion, is also covered – along with prescription drugs and professional treatment by physiotherapists, osteopaths, chiropractors, and dietitian-nutritionists. Local ambulance services are also covered. What isn’t covered: Cosmetic procedures, health specialists not mentioned in the plan, injuries or charges resulting from insurrection, war, or participation in a riot, and any self-inflicted damage, committed “while sane or insane,” are not covered either. Additionally, organ transplants, diagnostic tests for screening, and hospitalization for elective purposes are not covered. Watch the fine print: In cases of accidental dismemberment, coverage can only be given if the injury is solely caused by an external, violent, and accidental event. In addition, for preexisting conditions, charges related directly or indirectly are only payable up to a lifetime maximum of $10,000. Pre-authorization requests are required for some hospitalizations,
if planned. Psychiatrists are only covered when referred by a general practitioner or Mental Health Service. Coverage for maternal care also
Vision What is covered: One vision test per year, to a maximum of $40 per year. What isn’t covered: contact lenses.
Eyeglasses
and
Dental What is covered: Dental care following an accident, with no maximum limit, or dental care which requires hospitalization, with a limit of $1,000 per year. Undergraduate students are covered by the SSMU dental plan, and graduate students by the PGSS plan – as long as they start in the fall semester. What isn’t covered: See the SSMU or PGSS dental plans.
Travel Coverage outside of Canada is only provided in emergencies, up to a maximum of $2,000 per day.
Healthcare
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Canadian healthcare, privatization, and equality of access The Daily sits down with Antonia Maioni
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ast week, The Daily sat down with Antonia Maioni, associate professor of political science at McGill and Director of the McGill Institute for the Study of Canada, to talk about Canadian healthcare policy. Maioni touched on comparisons between American and Canadian healthcare, equality of care in Canada, and efforts to privatize the Canadian system.
– we’re talking about care for elective surgery or for certain kinds of things that may not be [at the] top of the urgency chart. The political and legal ramifications have pushed wait times to the forefront of our conversation. MD: So it’s more a political reason, rather than something that’s really pressing? AM: Well, it depends on whom you talk to.
The McGill Daily (MD): How has healthcare policy changed over time in Canada? Antonia Maioni (AM): We still have the healthcare system that has been in place for several decades. That is to say, the healthcare system that provides universal coverage and first-dollar payment so that people don’t have to pay at the point of service. We pay for our healthcare system with general revenues so it’s universal and comprehensive and in the main we have pretty much the same kind of healthcare system that we’ve had. What’s changed over time is that we’re now perceiving that there are bigger gaps in coverage and access to care, particularly in terms of wait times for consultation with specialists and for non-urgent surgery. We’ve seen how in effect the share of what people pay outside of the public system, for things like pharmaceutical care, has also increased over time. And thirdly, what we’ve seen is a sort of ebb and flow in the amount of money that the federal government has made available to the provinces to help them pay [for] providing healthcare services for their populations. MD: You mentioned waiting times earlier; do you think this is still the biggest issue af-
“I would say there is a bit of a ricochet effect, specifically in terms of the way the Canadian healthcare system is vilified in the U.S.”
“It’s not a floodgate, but there is a pressure that is there in the system, and people will vote with their feet to take advantage of what’s out there.” fecting healthcare in Canada? AM: It’s certainly a top-of-the-mind issue because it’s something you can point to in thinking about what needs to be improved. Part of that new money that I was talking about was intended to help the provinces address the wait times issue. The reason is that politicians like to be able to point to something that’s happened, or something that you can see, because investing in healthcare is always a long-term gain. If you invest in something like [wait] times, though, you can actually see evidence. The wait time for x has gone down, or the wait time for y has gone down, so that’s one of the motives – it’s political. But the other motivation has been legal. We now have a court decision on wait times that points out that governments may not be doing their duty in allowing people to wait too long for certain kinds of services even if they’re not urgent. When we’re talking about wait times, we’re not talking about urgent care
To wait for a procedure depends on the acuteness of the case and how long you’re waiting; it also depends on whether it means a deterioration in someone’s overall health. Nothing can be instantaneous, but the question about wait times is: what’s the evidence-driven, parameter benchmark for a proper wait time? That’s what the provinces have tried to work with in terms of putting a lot of attention not only on elective surgery, but also things like oncology and cardiology, and to have these benchmarks in place and to try to meet them as ways of actually delivering effective care. MD: Could you comment on alleged efforts to privatize the Canadian healthcare system? AM: There’s been more scope for privatization, I would say, in the past decade. Part of it has been the fact that there are certain things that are [not] covered by provincial health plans, and so necessarily you have to pay for them some other way. The rise, for example, in pharmaceutical costs means that people are paying more than they would have two decades ago. Also, a lot of the procedures that people might have been hospitalized for two decades ago are now being treated by pharmaceutical procedures. In that sense, if you don’t have pharmaceutical coverage that means you’re relying more on the private system. That’s on the one hand. On the other hand there has been a tendency to look for alternatives for the kinds of things that are clogging up a lot of the waiting. The push on diagnostic testing, for example, has led people to perhaps be more willing to go to private alternatives that will do diagnostic testing for them for a fee. And the same thing for elective surgeries. It’s not a floodgate, but there is a pressure that is there in the system, and people, in a sense, will vote with their feet to take advantage of what’s out there, which may drive the demand for these kinds of services as well. MD: Do you see any convergence with what’s happening in the United States and the Canadian healthcare system? AM: That’s an interesting question. With Obamacare locking in some of the el-
Robert Smith | The McGill Daily ements of the private system in the U.S., I don’t think we’re going to see national health insurance in the U.S. anytime soon. Whether it’s true that there’s a sort of an impact from the U.S. to Canada, I would say there is a bit of a ricochet effect, specifically in terms of the way the Canadian healthcare system is vilified in the U.S.. This has an impact on the way people view the Canadian system, it’s a sort of self-confidence thing – people wonder if it’s really that bad and start asking what are the real gaps in the system. The other thing is that people measure their healthcare system not against the [British] or European systems but against the American system. The latest medical technology, the way things are treated, the heavy influence of how we think about pharmaceuticals, et cetera. I wouldn’t say we’re going towards a convergence, but there are certainly elements at play that put Canada in the North American sphere in terms of talking about healthcare. I think there’s more of a conversation in terms of what we have as alternatives in Canada today than there was two decades ago. Part of that has been this observation of what’s going on in the U.S. and the push towards types of care that are more immediate, that are unequal in terms of their access and do depend on whether you can pay for it or not. MD: I’m glad you brought up equality in terms of healthcare provision. Is there equality of access in Canada? AM: On paper yes, but it depends on how you define equality of access. If you say that equality of access means that need trumps the ability to pay, then I would say you could make the argument that there is equality of access. That’s the way triage happens in a hospital, for example; that’s the way physicians are supposed to work with their patients. There’s no extra-billing, you can’t charge one patient more than you would another, you’re not allowed to impose a user fee – all these kinds of things point towards equal access.
If you’re talking about equal access as having the wherewithal to know where to go for certain services, in terms of being informed, perhaps not. If you’re talking about equal access in terms of geography, then we have a long way to go, but we have a country with a number of remote populations, and it’s unbelievably complex to be able to service every population equally in Canada. MD: Are you saying that the system should work on paper, and that if it doesn’t work it has more to do with people not knowing what’s available to them? AM: I think we have a healthcare system that needs to do a lot of work on what they call ‘medical home’ in the U.S., on the idea of access points. Equal access means that money should not be the issue if you want to access the healthcare system, which means
“Political and legal ramifications have pushed wait times to the forefront of our conversation.” that if you or I go to the emergency waiting room, it’s not going to matter that I’m earning more money than you are, what matters is the severity of the condition. That’s what equal access means on paper, but we know that access is dependent on a lot of other things besides that. One of them is the fact that we need to streamline our system, which is happening now with primary care reform, and to understand the stepwise nature of how healthcare works. With the [British system] for example, everyone has a medical home, everyone has a physician that they’re rostered with, and that physician makes the decisions about where they go for care. In the UK case, for example, money follows the patient, and that has an impact on how hospitals are financed. That’s not the way that hospitals are financed in Canada. -compiled by Emmet Livingstone
The McGill Daily
Features wider world. Now we are heading to Oujé-Bougoumou, one of the ten Cree communities of Northern Quebec. Celestino has been invited to visit the new Cree cultural institute there and to meet with members of the community to share stories of struggle, of the land and of the fight to preserve that which makes and maintains them as Indigenous. And so the five of us – Celestino, myself, my professor, and two other students – set off. We’re all a bit sleepy, what with only having arrived in the town at 3 a.m., as we join Gaston Cooper, a Cree artist and photographer, for lunch in Oujé’s one restaurant. Luckily the conversation and the coffee soon liven us up. “What’s to eat?” Celestino asks. “Well,” I say, translating the menu, “there’s goose soup, salad, trout, oh, and moose stew.” Celestino’s eyes light up. “I’ll have that then.” I explain Celestino’s interest in moose to Gaston, and one of the people who works at the cultural center. “He knows about moose!” Gaston says in surprise. And so, Celestino begins telling Gaston about his antler, and about how he really wants to see a moose. And Gaston replies by telling him everything he knows about the animal, where to find them, their behaviour, their mating, and how to hunt them. “The Cree are a hunting people,” Gaston explains to Celestino. “Even today most people in the community get most of their food from hunting.” Gaston explains to Celestino the ways in which the Cree still share the animals they hunt. “I’ll go out and shoot a bull moose and by the time it’s dressed and butchered I’ll only have a small bag of meat left, I’ll have given the rest all away. But that’s okay because I know others will do the same for me. You don’t even need to barter with people, sharing is expected. It’s part of the culture.” “The Ngöbe too used to hunt a lot,” Celestino replies. “Now there aren’t that many animals left. People have hunted them too much, people have forgotten the respect they used to have for them.” Celestino then begins to explain to Gaston the way in which overhunting was prevented. Every animal, he explains, has a cacique, or a chief. A chief of the deer, a chief of the tapirs and so on. This cacique would protect the other animals of his species and punish hunters who took too much. Celestino told us the story of story of a hunter who liked to hunt conejo pintado (lowland paca, a large rodent). “All the time he would go to the same spot and hunt conejo pintado. One night, he went to where he had set a trap up in the mountains, and all of a sudden he saw the eyes of a conejo pintado glowing in the dark. He shot and the eyes grew dim and fell. The hunter then got up and went over to pick up the body but there was nothing there, no blood or anything. All of a sudden he heard a laugh behind him and he was so scared he ran all the way home. It was the cacique of the conejo pintado playing a joke on him for taking too much.” Gaston explained to Celestino how there exists a similar concept in Cree culture as well as a belief that all animal populations rise and fall in 100-year cycles, natural limits that must be respected. The two men conclude that when it comes to hunting and the environment, their two peoples are very similar. The only big difference they can see is that with the Ngöbe only the men hunt, while the women stay home. “We could, never do that,” Gaston says. “It’s so cold here, we need the women to come with us to keep us warm!” While the Ngöbe and Cree experiences with
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Thursday, October 17, 2013 hunting may be quite similar, their experiences with government-imposed natural resource development have been very different. The Ngöbe have fought long and hard to resist all such projects on their territory, but the Cree approach has been more heavily focused on conciliation and negotiation. In 1975 the Cree signed the James Bay Northern Quebec Agreement, a modern treaty that ceded portions of Cree territory for hydroelectric development in exchange for recognition of Cree self-government and a very generous revenue sharing scheme. The consensus among most scholars is that the Cree did very well for themselves. Certainly compared to most Indigenous peoples in Canada, the Cree of northern Quebec have a level of political power and material well-being that is far higher than the average. Oujé-Bougoumou itself, with its well kept new houses and beautiful pine and glass cultural centre is certainly not what most Canadians would imagine when they think of life in Indigenous communities. There is then a slight feeling of awkwardness when Celestino meets in the main hall of the cultural centre with the former chief of Oujé, Abel Bosum, a man whose community has benefited so much (at least on paper) from projects his compatriot has spent his life working to oppose. Abel is quick to point out though that the James Bay Northern Quebec Agreement itself was hardly a gift from the government, but the result of the long struggle of the Cree people. “The [Quebec] government didn’t consult us [about the hydro project]. We had to fight to be included. The government wanted to use the James Bay Agreement to destroy Cree rights but the leadership has used it to wield influence instead.” Abel goes on to describe projects that the Cree have successfully halted, such as the massive Hydro-Québec expansion on the Great Whale River, which they, in conjunction with Inuit activists, were able to stop in the 1990s. “There is a story,” Celestino says, “of this time the Devil made a mill to crush sugar cane. “It was only when he was done that he realized the mill was in the shape of a cross and ran away screaming.” “It was the same thing when the government of Panama created the Comarca,” he said, “it appears to be the same thing with your people and this agreement.” Abel agrees but the fact remains that many Cree find themselves employed as part of the region’s extractive economy, with the new Goldcorp mine in Wemindji employing practically the whole community. The mine in Malarctic is also a major employer of Cree in the region. As the meeting ends Celestino offers Abel a word of warning: “The government offering development in exchange for natural resource exploitation is like a man who offers to help a sick woman only if she agrees to sleep with him.” As far as Celestino is concerned, Indigenous peoples should not be forced to accept natural resource projects if they want government assistance. “The government, whether here or in Panama, has a duty to help Indigenous peoples regardless as part of the debt owed to them from the pillage of Indigenous peoples, from Chile to Canada.” *** As we make our way down the steel steps back to the car I ask Katherine, one of the other students on the trip, what she felt looking at a new gold mine in Malarctic owned by Montreal-based mining company Osisko. “It made me sick,” she replies, “physically sick.”
Malarctic is a small town of about 6,000 people, a few kilometres west of Val-d’Or, the centre of what has been a major gold and copper mining district since the 1930s. At the far end of Malarctic is a pretty little church and right behind it a long embankment, like some prehistoric moraine, hovering above the town. On the other side is the 1.44 km² square pit of Osisko’s Malarctic mine. It is a huge operation; in fact, it is the largest open pit gold mine in Canada. Enormous dump trucks bring ore from deep within the pit, moving up toward the horizon. There is an endless chatter of drills and the dull thud of distant dynamite. Celestino surveys the scene bellow; “sulia” he says, the Ngöbe word for cockroach and for white settler, as he points at the trucks that scuttle insect-like around the mine. Later in the car, I ask jokingly whether the visit changed his opinion about mining. “The mine convinced me of nothing,” he replies. “I have seen mines before in Panama, I’ve heard about ones in other countries. We have a clear idea about the social and environmental effects of mining, of the health effects of an abandoned mine, of the contamination. We have clear information about the impacts over time. Now the company may say, ‘look the mine right next to a town and there’s no contamination, there is no sickness.’ This doesn’t convince me however, the mine is only three years old; the environmental impacts and the contamination often take much longer to appear.” “Also,” he says smiling, “This company says the mine is bringing benefits to the town but the mining museum we tried to go to wasn’t even free! It’s ridiculous!” *** Alongside moose and mining there was another reason we came to Oujé: to see the new cultural centre that has been built here. The centre hopes to preserve the memories, the histories, and the artifacts of the Cree. Since its opening, the members of the centre have sought to document all they can, to preserve and breathe new life into those traditions that persist, and to remember and revive those that have been lost. To do so, they have conducted interviews with elders across the Cree territory and gathered recordings to digitize and preserve. It is extremely difficult; we are told some of the recordings are so old they are often destroyed as they are played one last time. Through their work, and the work of archaeologists such as David Denton and Dario Izaguirre, a richer and more complete history begins to emerge, a history that colonization has neglected or tried to erase, but that stubbornly survives. The centre’s Cree language expert Kevin Brosseau proudly told us that about 95 per cent of Crees still speak their native language and the old traditions of hunting and living off the land still remain. That being said, many in the community still feel the pressures from settler society, and especially worry about how to ensure these traditions are passed onto the next generation. According to Gaston, they need to make the culture seem relevant to the youth, as he tells us about the ways videos, apps, music, and plays have all been used to capture the youth’s attention. Ultimately, though, it’s the culture itself that’s the real attraction. As we leave the centre Celestino thanks Gaston and the rest. “The work you are doing helps all Indigenous peoples, I feel as if you are doing work for my people.” “When you’re a child you’re always interested in the culture,” Harold tells me, while show-
ing me how to make a moose call out of birch bark. “Then when you’re a teenager you leave it for a while, but you always come back.” Harold, a lifelong Oujé resident who we met at the cultural centre, is one of these returnees, who has recently set about trying to revive the art of basket- and, hopefully one day, canoe-making out of birch bark in the community. The tour of the centre is over and there are now about 15 of us sitting outside: people who work at the cultural centre, friends, family, kids, dogs, chatting and laughing, waiting for the trout to smoke in the smoke house. Four hours ago we cut and cleaned it and soon it should be done. The late afternoon sun shines low over Lake Opemisca, the scraggy pines along its shore bristle in the wind. The entire air of the town is still and at peace. I understand why people love the land so much here. The fish is done now. It’s smoky and delicious and tastes great with bear grease. More people show up and they eat and share stories as 1990s R&B plays on the generator-powered radio. When I get back to Montreal my jacket still smells of smoked trout and I can’t bring myself to wash it. In our last night in Oujé-Bougoumou, Dorothy Stewart, a Wemindji resident visiting for a conference at the cultural centre tells Celestino about the Cree walking out ceremony, in which a child is not allowed to set foot on Mother Earth until they are one year old. “Until that time,” says Dorothy, “they just observe, experience the world around them. Then at one they set foot on the earth. The boys dress as hunters and using a toy gun kill their first goose. This way they can know the importance of hunting and a relation with their land.” Celestino tells Dorothy about the importance of keeping these kinds of traditions alive, how in the Comarca many of the rituals surrounding children and childbirth are beginning to die out. Then, so as not to be in her debt, as he says, he tells her of a story about his culture. He tells her of his dream. “With my son,” he says, “I had a dream before he was born. I had a dream about an AK-47 and that the river beside my house overflowed and the sky filled with dark clouds and rained. I dreamed this every night. Thinking about the grandfathers, about their knowledge, I knew if you dreamed this it was because the child would have some sort of power but you would have to take care of it. And so I wasn’t surprised when the child was born, it was born with two teeth.” *** Celestino is a man, it would appear, of many dreams. On the road home he tells me a few of them. He dreams of a day in which Ngöbe students from the Comarca can come to Oujé-Bougoumou and learn how to preserve the culture, to learn about archaeology so they can come back and prevent the government from stealing their history and instead keep it and protect it as the Cree have done. He dreams of Cree students coming to the Comarca to study and learn and live with them. He dreams of a Comarca free of mining and hydroelectric exploitation, of the multinational corporations, the great monsters ¬ as he calls them – that control the Earth. He dreams of all these things and wishes to live to see them all come true. “Anything else?” I ask. “Yes, I need to come back again,” he says smiling. “Why’s that?” “I need to come back because I never got the other antler for the moose!”
Sci+Tech
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The McGill Daily
Thursday, October 17, 2013
Making health mobile
How technology is changing individuals’ approach to healthcare
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he mobile phone is closer and closer to becoming a universal device. Banking, media, and communication are now on our mobile devices. One can envision a near future where our lives could fit into our back pocket. Mobile health (mHealth) refers to health applications (apps) on mobile devices. In an age where healthcare costs are increasing and accessibility is decreasing, mHealth provides an avenue through which the growing needs of the population might be met. Though this emerging technology holds much potential, there are still issues that must be addressed. Internet-based healthcare services for self-diagnosis and advice have been around for a while. Websites such as WebMD provide the tools for online self-diagnosis and direct individuals to see a nurse, doctor, or go to the emergency room if needed. mHealth technology has the ability to empower individuals to take care of their own health and well-being. According to Shivani Goyal, a researcher at the Centre for Global eHealth Innovation in Toronto, there are two major approaches to mobile technology. One is to help people engage in preventative health by using mobile phones to track, assess, and change bad behaviours. The other is to help people manage longterm conditions requiring medication or careful monitoring. “Mobile health is changing the model of current healthcare. It’s enabling patients to be informed about their own medical information,” Goyal told The Daily. The Centre for Global eHealth Innovation has developed a number of mHealth applications. These mobile self-management applications include “bant” for individuals with diabetes
Diana Kwon | The McGill Daily to collect and track their blood glucose levels, and “breathe” for people with asthma to engage in their own treatment plans. Another mobile technology application is medical screening. Dr. Nitika Pant Pai, a professor in the Department of Medicine at McGill University, has developed an HIV self-screening smartphone application. “The patients want access to quality care, they want to be seen quickly, and they want confidentiality,” explained Pai. Before developing the HIV screening app, Pai scouted the field for existing apps and found that many had not been tested or tailored to patients. This provided her main motivation to develop the technology herself. One of the biggest concerns for existing mHealth technologies is quality control. Currently, there are over 17,000 mHealth applications available to download on app stores, but only a small volume of those have gone through proper evidence-based testing. “People have to be cognizant of the fact that there are a mixture of people who are making these apps. I would caution people going onto the app store to do research to see where the apps are coming from, who is designing them, and read reviews about their functions,” Shivani told The Daily. Though the Food and Drug Administration in the United States has made moves to properly test and approve mobile apps used for health procedures such as screening, testing, and providing direct diagnoses, no such regulatory body exists in Canada. “As far as mHealth approval is concerned, I’m not aware that regulations are in place,” said Pai. “The [technology] is so novel that people don’t know where to place these things. People don’t know [its] potential,
K.P. | Illustrator people are skeptical, and on some levels, it’s [an] ‘anti-health system.’” Pai described mHealth as a disruptive technology, in the sense that it provides services that can overlap with those provided by existing healthcare institutions. “Healthcare systems are politicized, have many stakeholders involved, and are very hard to change,” Pai reflected. As the technology is relatively new, there has not been enough time to develop fast and effective testing strategies for these applications. Currently, those that are being tested are going through the traditional clinical trials model, which can take three to four years – which, in the world of tech, is extremely slow.
Not only does the testing happen at a slow pace, but medical institutions are generally late to adapt new technology. “Healthcare systems take a lot of time to change and adapt a new technology. The reason is that there is a business model in place. There is the healthcare system and the business of the health system. When you introduce a new technology, you are introducing a new technology to the business,” Pai told The Daily. The emerging field of mHealth technology is hoping to fill the gaps in the current healthcare system while being complementary to it. Though challenges remain, this technology will hopefully provide one way for people to take control of their own health.
The dirt on dirt
A look at soil ecology research at McGill
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oil ecology is a relatively young field, having emerged in North America in the mid-1990s. The rising demands for enough food to sustain the swelling global population has given increasing importance to research in this field. Joann Whalen, a professor in the Department of Natural Resource Sciences, and her lab at McGill’s Macdonald campus, is concerned with soil ecology and, in particular, the study of nutrients in fertilizers. Many current fertilizers release compounds such as carbon dioxide (CO2), nitrous oxide (N2O), and methane (CH4) – otherwise known as greenhouse gases – into the environment. In large amounts, these greenhouse gases are harmful to the climate and cause ozone depletion. Large amounts of nutrients like nitrogen and phosphorus find their way into runoff from agricultural land masses and
Sivakami Mylvaganam | Sci+Tech Writer have been associated with eutrophication, the process where excess nutrients in water bodies stimulate excessive plant growth. Eutrophication has many ecological consequences, including toxic effects on the environment and decreased biodiversity. Efficiency is of special concern when looking at nitrogen fertilizers. Soil systems tend to be leaky in their retention of nitrogen. Therefore, tools that enable the prediction of nitrogen release by the soil nutrient cycle would be useful in determining when, and how much, nitrogen fertilizer is needed for crops with high nitrogen demands, lowering costs as well as environmental risk. By addressing these questions, the Whalen lab is seeking to reduce the amount of nutrients released into waterways and the atmosphere, while increasing their effi-
ciency by finding a comprehensive solution to the drawbacks of current fertilizers. In addition to investigating nutrient cycling in soil cycles, the lab also studies soil microbiology. While examining the reason certain soil environments are more prone to losing nitrogen than others, the Whalen lab has found that manure and inorganic sources are cycled through the soil biomass quite rapidly. This has resulted in a very significant amount of nitrogen runoff, and nitrogen loss to the atmosphere. The lab also utilizes the earthworm to study nutrient cycles. Earthworms create a habitat suited to microbial nitrifiers (microorganisms that oxidize an ammonia compound in nitrates and nitrites) and denitrifiers (microorganisms that convert nitrogen oxides such as nitrous oxide to molecular nitrogen). This is valuable because
testing the nutrient flux of an area provides more practically useful information for developing precise farming and land management techniques than testing nitrogen composition in isolation. The lab also looks at a number of other soil-related environmental issues such as the toxicity of nanoparticles and the economic benefits of temperate tree-based intercropping systems. With their research, the Whalen lab hopes to find ways to make fertilizers more economically and environmentally efficient.
Science blurbs What’s happening in science at McGill.
The McGill Daily
Sci+Tech
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Thursday, October 17, 2013
More internet, please
The problem of internet addiction Faisal Naqib | Sci+Tech Writer
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he internet has become an integral part of our lives and has made tasks that used to require hours to accomplish achievable at the click of a finger. However, the internet is also a major source of distraction. For most people, the distractions don’t outweigh the increases in productivity gained by the internet. But for some, internet gaming and media outlets become sources of addiction that bring their productivity, and their lives in general, to a complete stop. Comparing internet usage between different demographic groups can be difficult because study designs differ in their definitions of what constitutes internet usage. A study by the Kaiser Family Foundation, a non-profit private research group, found that in 2009, Americans between the ages of 8 and 18 spent an average of 7.5 hours a day consuming media content, which included computers, televisions, and video games. The heaviest users spent an astonishing 16 hours a day consuming media. Internet usage was also found to differ across countries. On average, American teens were online for 7 hours a week while a South Korean government study found that teens there spend 23 hours a week playing video games. Spending extensive amounts of time on the internet can have severe health and social effects. One internet addict described a fiveweek gaming binge in an interview with The Mirror. He never left his apartment, let pizza boxes and garbage pile up, and completely ignored his friends, family, and studies. These stories are starting to become commonplace: a study conducted at Stanford University estimated that around 1 in 8 Americans suffer from internet addiction. Internet-addicted users experience repetitive, intrusive urges to use the internet despite functional impairment or subsequent distress. Internet addiction is currently not believed to be an isolated disorder, but rather, is associated with other mental health problems including social phobia and depression, and some researchers draw a link to obsessive-compulsive disorders. A longitudinal study conducted in China, where internet addiction is recognized by the government as a public health concern, has found an intensifying feedback loop where prior mental health problems predispose people to internet addiction, which then exacerbates mental health
Haidon Dong | Illustrator problems. While internet usage continues to increase, the treatment options for addicts are slow to catch up. Internet addiction is not currently recognized by the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Instead, it is listed as a condition requiring further study. The opponents to including internet addiction as a mental health disorder cite inconsistency in its definition as a disease and blame poorly designed research studies that obscure the facts. Exclusion from the DSM not only reduces recognition of internet addiction but also the likelihood that insurance companies will pay for its treatment, which can be expensive. Clinics offering rehab-like facilities for internet addicts have opened, but costs are steep. Treatment at reSTART, a popular rehab facility based in Washington state, can be upwards of $14,000 for a 45 day stay. The
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centre offers cognitive behavioural therapy, group counselling, and recreational activities that all seem to involve physical activity. However, some clinicians believe that internet addiction cannot exist on its own and shouldn’t be treated as such. Dr. Bruce Ballon, director of the internet addiction program at Toronto’s Centre for Addiction and Mental Health, told the Toronto Star that he searches for underlying diseases, such as depression or post-traumatic stress disorder, which he believes are the root cause of internet addiction. While Canadian and American psychiatrists are still debating the definition and best treatment for internet addiction, their South Korean and Chinese counterparts are moving ahead with nationwide policies. After a string of heart failure-related deaths in internet cafés, and one gamingrelated murder, South Korea has invested in training over 1,000 counsellors to treat
internet addiction. China has passed laws that discourage more than three hours of daily video gaming. The law requires online gaming operators to install a ‘game fatigue system.’ The system allows three hours of regular play and only half the points earned for the next two hours. After five hours, no points are awarded and a pop-up appears every 15 minutes warning the gamer of their unhealthy behaviour. Some parents have decided to take matters into their own hands. As reported in the online news site TG Daily, one father, fed up with his son’s addiction to World of Warcraft, hired virtual assassins to kill his son’s character with the hope that it would dissuade him from gaming. As the internet continues to increase its presence in our lives, more research is needed to determine root causes, effective treatments, and optimal public health policy.
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The McGill Daily
Thursday, October 17, 2013
Taking advantage of good vibes Realizing the healing power of music Diana Kwon | The McGill Daily
Alice Shen| The McGill Daily
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hen Thomas* entered the shortterm assessment centre for children where Debbie Carroll was working as a music therapist, he was emotionally distressed. He had been removed from a second foster home due to his aggressive and threatening nature and was unable to contain or control his emotions. Carroll was initially at a loss. Thomas refused to engage in playing any instruments, and would not respond to any therapy. After multiple failed attempts, Carroll decided to go to the local library, where she discovered a Persian lullaby titled “Bird Without Nest.” When she played this song at a therapy session, Thomas had an immediate response. For the first time in four months, he paused – and turned to look at the record turning around and around. His whole body relaxed and a smile slowly crept onto his face. He opened his mouth to utter his first word since entering the centre: “Again.” Carroll is one of the many practicing music therapists in Montreal. Music therapists are trained to utilize the therapeutic qualities of music and musical elements to restore, preserve, and improve individuals’ well-being in the physical, emotional, and social domains. From neonatal care to mental health, music therapy’s applications are incredibly wide-ranging and can help people across all age groups with any level of musical aptitude. Though documentation of music’s healing power has existed for thousands of years, formal training for music therapy only began after the Second World War. It was realized at the time that music could alleviate pain and some of the psychological symptoms of brain injuries and shell shock in soldiers (known today as post-traumatic stress disorder). As a result of this breakthrough, musicians were
recruited into military hospitals in order to provide this new form of treatment. It was soon recognized that a system was needed to train these musicians to assess and establish treatment goals, giving birth to professional music therapy programs. “[Music therapists use] the aspects of music that are inherently therapeutic … [Music] can be relaxing or stimulating, can mirror emotions, and allow us to reflect [on] how we feel,” Carroll told The Daily. Music therapy tries to improve an individual’s quality of life by using music’s ability to reflect the whole range of human emotions, allow nonverbal communication, and foster social interactions through shared musical experiences. In today’s healthcare system, the go-to response for mental health issues is often drug prescription. This model has been criticized in the field of psychiatry, where piling prescriptions and diagnoses can become an endless loop. Sandi Curtis, a professor of music therapy at Concordia University, is hopeful for music therapy’s future integration into the medical institution. While music therapy would not act as replacement for current types of medical care, the hope is to reach an understanding of the roles of each profession. “There is some research that shows that in certain circumstances, music is more cost effective in comparison to some medication – and free of the side effects,” described Curtis. “We have a lot to teach people about the human condition. We need to work with people as human beings and understand what they bring as individuals rather than [giving them] pills.” In some areas such as palliative care, music is being used in lieu of medications. Collins reflected on her time working in pal-
liative care, where patients whose medication was no longer helping them would be referred to her in order to be treated with music therapy. “Clearly, there is more than just the pain [to take into account]. There is the patient’s response – the fear of dying and family difficulties that come with having a life-threatening illness,” reflected Curtis. Pascal Comeau, a music therapist at the Montreal Children’s Hospital (MCH), uses music to help children of all ages. Comeau recalls an incident with a 19-month-old child, who, despite all efforts made by hospital staff, would not stop crying. The staff did not want to medicate the child, and decided to call on Comeau to alleviate that child’s anxiety using music. Comeau used a drum to match the level of anxiety the child was feeling. Within 30 seconds of the drumming, the infant had stopped crying. An important principle of music therapy involves reaching the emotional level of the person in question. By matching that, it allows the person to feel supported and heard at the level of their experience. Similarly to Thomas’ case, it is often a specific piece or type of music that can help an individual out of their distress or anxiety. Though music therapy has recently gained momentum in the public spotlight, a number of misconceptions still surround it. “It’s part of our mandate [at the MCH] to tell people about music therapy. Even staff who have been here for many years don’t fully understand,” Comeau told The Daily. A common misconception is that music therapy is about listening to recreational music. However, this is not the case – a huge portion of a music therapist’s work involves trying to actively engage individuals in music.
An integral part of music therapy is the relationship between music, the individual, and the therapist. Music therapy is not simply about the individual and the music. “We all more or less intuitively know that music moves us – but music therapists have the [skills and training] to take this a huge step further […] to handle it and control it,” explained Curtis. “As much as music can move us tremendously emotionally [and] open a door for growth, it can also open a door for danger if the person is not prepared for what will come out of it.” Because music has the power to unleash very strong emotional responses, without the proper training to be able to handle these effects, using music as therapy might not be a good thing. An ongoing challenge for music therapy is that there are still a number of individuals using music as treatment without being properly trained. “Music can be used for good, but it can also be used to create a barrier between oneself and the world. We need to be vigilant in how to bring out the healthy and positive aspects of a person,” Carroll explained to The Daily. In Thomas’ case, it was later found that his mother was of Iranian descent, and the song was almost able to reflect the act of his mother nurturing and caring for him. After his experience with the lullaby, Thomas experienced a dramatic change in the unit. He would sing and hum that song, and after a few weeks, finally started to speak to the staff about the feelings of being abandoned by his mother. The song, for Thomas, marked the beginning of a healing journey. *Name has been changed
The McGill Daily
Health&Ed
15
Thursday, October 17, 2013
(Non)universal healthcare
Institutional discrimination of trans* people within the system Dana Wray | The McGill Daily
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lthough rhetoric surrounding the Canadian healthcare system focuses on its accessibility and affordability for large swathes of the population, patients from the trans* community are actively left out. Trans* people face a myriad of challenges and barriers: harassment in everyday life, a lack of legal recognition, and problems with accessing even the most basic healthcare. Although there is a disturbing lack of studies on systemic barriers facing trans* people in Canada, the statistics that are available are bleak. An Ontario-based study by the Centre for Addiction and Mental Health found that over half of the trans* people surveyed lived on less than $15,000 per year. A U.S. study published in 2010 found that 28 per cent of respondents postponed medical care when sick or injured because of discrimination, while 19 per cent noted that they were refused medical care because of their gender non-conforming status. J.R.**, a non-binary-gendered person, told The Daily that the postponement of medical care because of discrimination within the system is a real problem in Canada as well. “I know too many people who are resistant or fearful of trying to navigate medical institutions at all because they know that something could easily come up that makes their potential healthcare provider stop seeing them as worthwhile, or [even] human.” A common complaint from trans* patients is misgendering – calling somebody by a name other than their preferred name, or using the incorrect gender pronouns. According to J.R., they often have problems with receptionists who don’t know which pronouns or name to use. Gabrielle Bouchard, trans* advocacy coordinator at the Centre for Gender Advocacy, agreed that what could be perceived as small
Alice Shen | The McGill Daily mistakes can stress out and disempower patients. “[As a trans* patient] you know that the very place that is supposed to make you feel better will treat you like a thing to be displayed, [and] judged,” said Bouchard. Other times, invasive questions that often have nothing to do with the health problem in question can make the system unsafe for patients. “If you go in for [pneumonia], what genitals you have is irrelevant to the problem at hand,” said Bouchard. “There is no correlation between your genitals and any given treatment for [your] lungs, right?” The acceptance of a person’s identity is also a barrier that faces trans* people in the healthcare system. “Trans* people might not have legal recognition of the identity that they live in their everyday lives,” Bouchard explained, pointing out that the discrepancy of name or legal gender with preferred name and preferred pronouns can result in problematic situations. “Or [their] identity might not fit with what is perceived as ‘normal’ by the healthcare system and personnel.” For J.R., that could lead to health problems – trans* patients sometimes have different health risks than what their medical forms might suggest, especially when taking hormones. “If I have to request information or help from a medical professional who assumes that because there’s an ‘F’ on my medical forms that I have only a ‘woman’s’ set of risk factors to consider, that leaves out a large swatch of issues that need to be taken into account.” This kind of respect for identities is crucial, Bouchard argued. “Staff and physicians have to understand that it does not matter if they agree with trans* realities or not – they have a job to do and that job is to help people.” A recent CBC article entitled “Transgender people face strife at the doctor’s office”
ostensibly covered the issues that trans* patients face in the healthcare system, but had many problems of its own. Bouchard disagreed with how the article shifted the onus for respectful and safe care onto the patients themselves, rather than the healthcare system. “We’re talking about a systemic problem here [...] The problem must be addressed by the system with the help of organizations and people who are in a position to give them good information, not a patient who’s been mistreated in a healthcare setting.” While many healthcare systems have room to grow, some have begun to implement concrete change. The Canadian Professional Association for Transgender Health, formed in 2007, aims to set voluntary guidelines for healthcare along with other professions. In Toronto, Mount Sinai Hospital implemented a Gender Identity Policy that aims to create a safer healthcare environment for trans*, intersex, and two-spirit patients. The policy was an “active approach to ensure equitable treatment,” according to Marilyn Kanee, Director of Diversity & Human Rights at Mount Sinai Hospital. The policy’s implementation in 2012 came after community consultations were conducted in 2008 with several marginalized communities, as well as a decision by the Ontario Human Rights Commission in 2012 to protect gender identity and gender expression under the Human Rights Code. The policy educates staff on trans* issues and lays out rules for treating trans* patients. It addresses using preferred pronouns and names, placing trans* patients in gendersegregated rooms according to their identification, and so forth. According to Kanee, the policy has already made a difference at Mount Sinai. “Sometimes [positive changes are] ‘small’
things like ensuring everyone uses the correct name or pronoun, or a group of nurses reading the policy to decide where is the appropriate and safest room for a transitioning patient,” Kanee explained. However, neither Kanee nor Bouchard knew of any hospitals in Montreal with similar policies protecting the rights of trans* patients. A number of grassroots organizations based in Montreal do exist to help trans* people find safe healthcare. The Centre for Gender Advocacy offers resources and referrals for trans* people, and also offers workshops for healthcare professionals on trans* issues. Action Santé Tranvesti(e)s et Transsexuel(le)s du Québec (ASTTEQ), also known as Quebec Trans Health Action, advocates for improved access to healthcare through mobilization, education, and so forth. Project 10, a trans* support group for youth and the greater community, maintains a database of trans*-friendly healthcare professionals. There are many more grassroots organizations that can’t fit into a single article, but for the most part, they haven’t been able to penetrate the higher levels of the healthcare system in Canada. Overall, Bouchard, Kanee, and J.R. all agreed that healthcare providers need to work hard on creating trans*-friendly spaces. “It shouldn’t be up to the patient to try to figure out who is going to be judgmental, mislead or misinform you based on your gender expression, identity, or your race, class, or sexuality,” said J.R. “It’s not the responsibility of trans* people to educate the people who are supposed to take care of them. Basic personal safety and dignity shouldn’t have to be a major consideration in seeking help, the way it is for many trans* people.” **Name has been changed
Sports
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The McGill Daily
Thursday, October 17, 2013
The backlash against knowledge
Fans and sportswriters against advanced stats Evan Dent | The McGill Daily
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efore the internet, and before anyone could have a blog, the kings of sports journalism were newspaper columnists. These were the guys (and I say guys because a large majority of them were, and continue to be, men) who knew sports better than anyone else. They were eventually joined by television personalities, who were like the old columnists, except for the fact that many of them once professionally played the sport they covered. Then came the blogger movement. With the advent of the internet, anyone could have a voice in the debate, and a good portion of the ‘blogosphere’ was either familiar with advanced stats, or actively creating new algorithms to better understand the game. ‘Advanced’ or sabermetric stats have been around since the late 1970s in baseball, and since then have continued to grow, though the last 15 years or so have seen an explosion in new, computer-driven statistics across all sports. Today, there are still some great columnists and analysts, and there are still some terrible ones, all amid the new blog-heavy sports media landscape. The worst are the ones who fall into simplified narratives, who mythologize intangible things – ‘heart,’ ‘grittiness,’ ‘toughness,’ ‘clutchness,’ and ‘hard work’ being the most popular – and value them above talent. The worst columnists’ favourite guy on the team was the undersized, usually white player who succeeded through hard work and perseverance, because that was the best story. At the same time, new writers have found new avenues for looking at the game – and, increasingly, seen that the tropes of the traditional sports writer were wrong. That ‘clutchness’ is more random than an actual ability; that the hardest-working player can sometimes be the worst player on the team.
Haidan Dong | Illustrator So, inevitably, we’ve reached a point where a ludicrous dichotomy has sprung up: blogger, advanced statistics nerds versus the old guard sportswriters who just know the game better. And it is an insufferable battle. It seems like every week, without fail, someone will start a debate about ‘advanced’ statistics. It usually comes in the form of a tweet or a column that decries those nerds who use newer statistics and ignore the beloved clichés of ‘heart’ or grittiness. I’ll use a recent example in the hockey world: Gord Miller, of Total Sports Network, tweeted Tuesday morning that “[s]ome analyze NHL [National Hockey League] teams using ‘advanced’ stats like Corsi #’s. I prefer the Bill Parcells approach: you are what the standings say you are.” A little background: Corsi is a stat that counts the number of shot attempts (including blocked shots or shots that miss the net) by either team, with the idea being that if you shoot the puck more than the other team, then you possess the puck more than the other team, and have a better chance of winning. Repeated studies have shown that positive Corsi numbers highly correlate with winning percentages, and that playoff performance is also highly correlated with good possession statistics. Bill Parcells, mentioned in the tweet, was a football coach in the 1990s and 2000s, so Miller’s choice of cross sport comparison is weird. Basically, he’s saying that good old wins and losses are a better indicator of team ability than those newfangled stats. Miller’s tweet – and, basically, his ideology on what makes a good hockey team – completely ignores the fact that a team can be outplayed and still win through some lucky bounces. It’s a simplified way of looking at the game – team gets win, therefore team is good – and it’s the most reductive
way to discuss sports. But these are the kind of people who are making a career off of opposing new statistics.They’ve become the meathead jocks of the journalism world, decrying the ‘nerd’ bloggers who live in their mothers’ basements looking at a spreadsheet instead of the game, or who deny their beloved traits of stick-to-it-ness, their easy narratives. Another trend of stat-denying is by fans or writers focused on teams that are winning in spite of statistical trends that predict that they should be worse, or that they will eventually fall to Earth. If their team keeps winning in spite of the statistics, these people use that to dismiss stats entirely. It’s a logical fallacy – if one thing is wrong, even one time, then it can never be trusted. Bill Barnwell, a football writer for Grantland, is one of the most widely read stats-focused writers. For the past two years, he has predicted that certain teams will do worse than the year before because their lucky streaks will end, and statistical benefits for the team will regress toward the average the next year. Barnwell basically becomes public enemy number one for these teams’ fans, who refuse to believe that their team will do worse. This year, Barnwell predicted that the Indianapolis Colts would do worse than last year. The Colts have started the season well, and I’ve seen one Colts fan on Twitter tell Barnwell that this start should make him reconsider the very idea of statistical regression. Again: one prediction is off (and, even then, there’s a whole season left to go, in which the Colts could still regress), so ‘advanced’ statistics are fundamentally wrong. In hockey, there’s the continuing case of the Toronto Maple Leafs, who made the playoffs last year despite terrible possession numbers, and have started this season well
with the same terrible possession numbers. There’s a whole cadre of Toronto media outlets and fans that have vehemently denounced ‘advanced’ statistics just because they say that their team is getting lucky, and will eventually fall to Earth. For instance, on Tuesday, as the Maple Leafs were getting hugely outshot but still holding a slim lead, Globe and Mail columnist David Shoalts tweeted that he could hear “geeks’ heads exploding all over their spreadsheets” and, after that, that the “Actuary Army had [him] in their crosshairs,” providing yet another example of the complete dismissal of advanced statistics based on one event – even before the whole season has played out. The only thing missing from that tweet was the sound of a bespectacled dork being shoved into a locker by your least favourite person from high school. I can’t help but get the feeling that these are simply reactions to a threat; that statistics are getting better and better at predicting performance and showing us newer and more interesting ways of looking at the game than the old guard can. It’s their innate knowledge being pitted against stats, with the narratives and received knowledge of the traditional crowd under attack by new statistic-driven discoveries. That’s not to say that analysis of sports should only be based on ‘advanced’ statistics – there are certainly things that can’t be measured entirely by statistics – but to deny them outright is just plain dumb, an act of willful ignorance. As these stats become more and more entrenched, they have become increasingly accepted by the sports fan and journalist community; we can only hope that in a decade or so, we won’t have dumb, influential people plugging their ears to things that can only improve their knowledge of sports.
Culture
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The McGill Daily
Thursday, October 17, 2013
The Daily reviews
Darkside, Lazer Kitty, Blue Sky Black Death, The This Many Boyfriends Club
Darkside – PSYCHIC Matador / Other People After a rather forgettable three-song EP, producer Nicolas Jaar and guitarist Dave Harrington team up once again for their debut album, Psychic. The journey into Harrington and Jaar’s ambient world begins with “Golden Arrow.” Its slow, varied build, lasting a total of 11 minutes, may not be a casual listener’s favourite song, but its importance to the album as a whole is immeasurable. Not only does “Golden Arrow” act as an apt introduction to the atmospheric album, it also gives insight as to where Jaar is heading as an artist. Harrington’s experimental guitar riffs, jumping back and forth from bouncy to mellow, complement Jaar’s organ-like production, creating a perfectly full and haunting sound. The album hits other high points with “Heart” and “Paper Trails,” both featuring a mix of soft, feel-good guitar licks with airy vocals and synth. Shortly after, the album loses its momentum. “Freak Go Home” is similar to “Golden Arrow,” although it lacks a sense of direction. To be fair, there are brief redeeming moments within the song, but, as a whole, it doesn’t keep up with the rest of the album. In fact, it’s not until the very end that Psychic proves itself to be one of the strongest albums released this year, tying up all loose ends with its poppy, echoing beats. The song “Metatron” concludes listeners’ short visit into the duo’s minds in a nicely satisfying way. Psychic takes listeners on a journey, one that is sometimes lively and sometimes dark and unpleasant; as Jaar puts it, “the project’s called Darkside for a reason.” Psychic attempts to pack so much into a short time, triggering conflicting emotional responses within a single song, which may leave some feeling a little disoriented. This album may not please all first-time listeners, but for those who give it a chance, it’s an experience worth having. -Christian Favreau
Lazer Kitty – MOONS Unsound America
Blue Sky Black Death – GLACIERS Fake Four
The This Many Boyfriends Club – DIE OR GET RICH TRYING
Described as a Seattle “experimentalimprovisational-space-rock trio who make soundtracks for the cosmos,” Lazer Kitty’s newest album Moons is nothing short of ethereal. The trio’s soundscape, inventive and textured, illustrates a cosmic sound infused with full bodied swells of synth punctuated with a crashing wash of cymbals. Transporting listeners into the dark caverns of space, Moons feels like floating in zero gravity as breathtaking nebula swirl before your eyes. The album, sound-packed with a crossfire of synth waves, puncturing drums, and heavy bass, is designed for the fantastical mind. Although initially alienating, Moons grows increasingly more mesmerizing with each listen. The rippling instrumentals are mysterious and hypnotic, the abstract synth noises wander and rove, but not without intent. From beginning to end, Moons offers a kaleidoscopic eccentricity. Opening with “Hyperion,” the extraterrestrial vibes launch into a funky melody – an eight minute escape into a galaxy far, far away. Guiding us into a lyricless space odyssey, track melts into track. “Dino Wipeout,” as the title suggests, has an ominous vibe, the guitar sombre but ending on a calming note. The celestial mood combines a progressive rock rhythm that tinges “Pilgrimage” with indie psychedelic undertones and strikes a mystical groove in “Titan.” But, with other tracks on Moons, the band has deviated far from anything resembling a straightforward song, which leaves tracks like “Luna” and “Io” resembling something of a thought experiment. This album is most certainly for the audacious but earth-bound listener, with moments of cohesion, but leaves more to be desired in terms of substance. The music doesn’t demand our attention, but it is these unfocused elements of Moons that make for perfect background, catering to a crowd that can appreciate the intangible yet abstract quality.
Glaciers’ first track, “I” (Blue Sky Black Death is anything but creative with its track titles), plunges listeners right into its own world with a slightly cheesy 1980ssoundtrack-gone-dark sound. Sporadic vocals and echoing sound effects make Glaciers sound, like its cover art looks, eerily intriguing. At times beautifully engaging, Glaciers is an album with highs and lows, a compelling musical exploration that fails to reach as far as it could. Blue Sky Black Death, hailing from Seattle, Washington, is a production duo composed of Kingston Maguire and Ian Taggart, better known, respectively, as Kingston and Young God. The duo is known for their unique artistic process, mixing live instrumentation and sampling to create a multigenre, layered sound. Glaciers, their fourth album, has a musical fluidity reminiscent of Montreal-based art rock band Braids and electronic legend Burial, an intricate bubbly pop meets ambient dubstep. The duo provides soothing ambient instrumentals, with echoing vocals that can be a touch overdone, like on “II.” “IV” features vocals bordering on the lackluster and repetitive, but redeems itself with textured instrumental layering – pretty much as pop as ambient electronic music can get. With only one of its five tracks under ten minutes, Glaciers lives up to the immersive goal of ambient music, sometimes to the point where a listener might actually forget they’re listening to anything distinctive. Only in “III” does Glaciers’ much-heralded hip hop sound truly take centre stage, giving the track a stronger rhythmic backbone. In fact, “III” is the album’s strongest track, combining the rest of the album’s light ethereal instrumentals with a solid bassline and vocal hip hop touches. Turning up the hip hop influence a notch higher would have given Glaciers the chance to flourish that much more as an explorative electronic album. As it is, Glaciers risks falling through its shaky foundation.
Whatever happened to reverb? The alt-rock music of the 1980s and 1990s was dripping in the stuff. Sometimes it was used to dreamy and decadent effect by shoegaze and dream pop acts like My Bloody Valentine, sometimes to create avalanches of sonic aggression (see every grunge act ever). These days, listeners looking for layers of swirling fuzz to swaddle their ears generally steer toward the electronic end of the Pitchfork spectrum, where echoing, distorted synths are thick on the ground. But there are those that prefer their drone old school, originating from guitar strings rather than computer keys. For this particular flavour of music geek, we have The This Many Boyfriends Club (Cas Kaplan, Andrew Miller, Lara Oundjian, Veronica Danger Winslow-Danger, and Evan Magoni, among them two McGill alumni and one current student), who clearly seek to revive the ancient age of reverb. The early 1990s indie-rock scene is writ large across their new EP Die or Get Rich Trying, in the intertwined boy-girl vocals, the burbling rumble of the bass, the alternating roar and jangle of the guitars. This is especially evident in the endearingly cluttered quality of This Many’s arrangements – everything seems to overlap a bit, as if each instrumental track is racing the others to a song’s finish line. At times, it seems that the band’s musical intake is entirely limited to the years between 1988 and 1992. While This Many’s focus could be called narrow, there’s no questioning the fact that they know their little corner of the pop music universe exceptionally well. They’ve nailed the Pixies’ stop-start dynamics on opener “Alright,” and “The Swan” is essentially a slightly shouty My Bloody Valentine track with a bit of chugging guitar on the verses for texture. They manage to effectively straddle the reverb divide, using noise to channel punkish angst and ambient melody. Get Rich Trying clocks in at a skimpy 10:41 for five tracks, and it’s unlikely to garner a terribly wide audience. But anyone looking for alt rock nostalgia is going to find just the shot of adrenaline they need.
-Gelila Bedada
-Nathalie O’Neill
-Hillary Pasternak
The McGill Daily
18
Culture
Thursday. October 17, 2013
Comics and controversy
New graphic novel re-evaluates Margaret Sanger’s life Rory Williamson | Culture Writer
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I have super powers!” thinks a young Margaret Sanger a short way into Peter Bagge’s new graphic novel, Woman Rebel: The Margaret Sanger Story. This sequence, in which Sanger is cautioned at school for misusing her powers of persuasion, is a thoroughly convincing demonstration of the fitness of these two seemingly unlikely bedfellows that are the author and his protagonist. Sanger is a divisive figure: on the one hand, she’s the pioneering birth rights activist who set up the first birth control clinic in the United States and spearheaded what was to become Planned Parenthood; on the other, a raging racist and proponent of eugenics. With this in mind, she might seem an unlikely subject for the man behind darkly humorous 1990s cult comic series Hate. However, the jarring quality of seeing Sanger rendered in Bagge’s exaggerated, comic style of illustration is one of the work’s greatest strengths. Her energy and devotion to her cause seem at once to be aligned with the superhuman, while remaining within a comic context that deflates and humanizes her claims to grandeur.
a bit curious. This complexity seems related to the surprising success of this medium for biographical depiction. In Bagge’s world of agape mouths and elasticated faces, Sanger becomes what in biography she must be: a partly fictionalized figure. His comic style is so removed from realism that it seems to tacitly acknowledge the impossibility of a definitive, ‘factual’ biography. Woman Rebel might allow us to step to the side of traditional biography, openly acknowledging that every account of a historical figure’s life is a manufactured fiction on the part of the writer, though no less valuable for it. Sanger emerges from Woman Rebel as a character in a ‘story’ of her life, one neither to be wholly praised nor buried, but rather a figure with whom we can identify and about whom we can debate. Bagge’s medium proves particularly apt for his purpose due to the enormous range it allows. Indeed, the energy with which the work ranges across time and location can make it difficult to follow, even if that
The jarring quality of seeing Sanger rendered in Bagge’s exaggerated, comic style of illustration is one of the work’s greatest strengths.
Woman Rebel might allow us to step to the side of traditional biography, openly acknowledging that every account of a historical figure’s life is a manufactured fiction on the part of the writer, though no less valuable for it.
Bagge’s distance from the conventional biography also helps to mark one of his primary motivations: shifting the focus in evaluating Sanger from some of her controversial views to a holistic appreciation of her complex life and work. His whistlestop narrative, ranging across all of Sanger’s long life, allows Bagge to provide key biographical and historical context for her views and activism: for instance, an early segment effectively dramatizes the illegality of mere discussion of contraception between doctor and patient. Bagge glazes over Sanger’s oft-cited, disturbing comments concerning eugenics and race, arguing that she needs to be understood in the context of her time, when such views, though hardly mainstream, were far more commonplace amongst intellectuals. There’s no doubt that context is key when understanding the views of a historical figure, but downplaying their significance in order to create an image more palatable for modern day evaluation results in an incomplete picture. Within the novel itself, Bagge doesn’t flinch from the less laudable aspects of
Courtesy of Drawn and Quarterly Sanger’s life, such as the time she addressed the Ku Klux Klan about birth control. But in the extensive and informative prose notes section that follows the graphic novel, Bagge seems determined to vindicate Sanger as a historical figure. This section provides ample demonstration of the depth of Bagge’s research and his clear, though not unqualified, affection for his subject. Still, he’s got a clear agenda: “If one types the name Margaret Sanger into an internet search engine, most of the results that appear loudly proclaim her guilty of the worst thought crimes imaginable in our life and times.” Here, he provides an unsourced list of hyperbolized epiphets including “genocidal maniac,” “fascist,” and “the inventor
of abortion.” “None of this is even remotely true,” Bagge writes, “and it is largely the result of a deliberate effort by opponents of abortion to slander the founder of Planned Parenthood…” Bagge has something of a point (Sanger’s racism, for example, did not stop her from opening a clinic in Harlem), but his admiration for her is in need of a bit more qualification. His view of the woman herself is nuanced: through an array of subtle asides and an affecting look at the toll her activism took on her personal life, it becomes clear that Sanger’s achievements were driven by her stubbornness and egotism as well as by her passionate conviction. This makes his willingness to excuse her views in the name of historical context
is occasionally a part of what makes Woman Rebel informative and entertaining in equal measure. Credit for the latter must go largely to Sanger, whose life provides Bagge with material ranging from free love to stints in prison to a brilliant anecdote in which she pisses in front of Havelock Ellis. For all its interest and complexity, Woman Rebel is foremost a hell of a lot of fun; which makes it even more worrying how Bagge glazes over Sanger’s less laudable accomplishments and views. Woman Rebel’s accessibility and the idiosyncrasy of its genre allows for a modern exploration of a divisive figure deeply rooted in history.
Editorial
volume 103 number 7
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E.k. Chan | The McGill Daily
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here is an absence of discussion on issues of race on campus, in the greater community, and within society at large. The lack of discussion is not limited to white people, but extends into communities of people of colour as well. Many groups at McGill organize events to engage students and members of the university in discussions about race, the most recent being Culture Shock, a week-long initiative co-organized by SSMU and the Quebec Public Interest Research Group (QPIRG) at McGill that aims to start conversations about immigrants, refugees, Indigenous people, and communities of colour. On a day-to-day social level, students of colour experience racism in the form of microaggressions by other members of the university community, including other people of colour. This can be as simple as being asked, “Where are you really from?” a question based on the assumption that a person of colour cannot be ‘from’ Canada. It also extends to associating the identity of a person with their apparent ethnicity without first asking for their personal identification. The power of an event series such as Culture Shock is that it works from within the McGill community to raise consciousness about issues of race. However, larger student organizations such as SSMU and PGSS should strive further to facilitate discourse among their members, and should actively support the independent student groups that are already doing so. The conversation regarding race starts at the social level, and can extend to the institutional level.
Only 14.2 per cent of McGill staff self-identified as a visible minority and 23.7 per cent as an ethnic minority, according to a 2010 report conducted by the Equity Subcommittee on Race and Ethnic Relations. The way our curriculums are written and taught, and the minimal racialized make-up of our faculty and non-academic staff show a lack of representation of diversity. For example, the Social Equity and Diversity Education Office, which seeks to bring attention to questions of race and equity on campus, receives low levels of University funding, reflecting the lack of interest in including alternative narratives at an institutional level. Avoiding individual instances of racism and simply being ‘politically correct’ is not enough to eradicate racism in our community, because the society we are integrated into and the culture we are socialized into is inherently racist. But this can change. Being anti-racist is a process – one where we, as a community, can actively extricate ourselves from a system that silences and devalues the voices of people of colour. We must take care to listen to and legitimize all experiences of marginalization, and to challenge the microaggressions that happen day-to-day rather than letting them go unnoticed. Workshops and other facilitated discussions are a first step, but the conversation should not end there, because racism persists outside those discussions, and it must be challenged wherever it occurs. —The McGill Daily Editorial Board
Errata In the article "AUS Council talks student engagement" (October 7, News, page 3) The Daily stated that Council discussed the proposed restructuring of the Leacock building. In fact, Council discussed the creation of a third floor reception area in Leacock, though no formal motion was passed. The Daily regrets the error. 3480 McTavish St., Rm. B-26 Montreal, QC H3A 1X9 phone 514.398.6790 fax 514.398.8318 advertising & general manager Boris Shedov sales representative Letty Matteo ad layout & design Geneviève Robert
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Amina Batyreva, Jacqueline Brandon, Théo Bourgery, Hera Chan, Lola Duffort, Benjamin Elgie, Camille Gris Roy, Boris Shedov, Samantha Shier, Anqi Zhang All contents © 2013 Daily Publications Society. All rights reserved. The content of this newspaper is the responsibility of The McGill Daily and does not necessarily represent the views of McGill University. Products or companies advertised in this newspaper are not necessarily endorsed by Daily staff. Printed by Imprimerie Transcontinental Transmag. Anjou, Quebec. ISSN 1192-4608.
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Compendium!
20
The McGill Daily
Thursday, October 17, 2013
Lies, half-truths, and exotic yet strangely endearing animals
SHMU Council accidentally motions to impeach themselves Motion amended during GA, but was a “close call” E.k. EK | The McGall Weekly
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he Students’ Headquarters of McGall University (SHMU) held its semesterly General Assembly (GA) last week. This GA, like all before it, fell on the same day as “some midterms I totally have to study all afternoon for,” according to many campus activists who voiced their entirely genuine intention to attend, if not for all the work they had to do. “Sorry, I would totally go,” several said, “because it’s important for students to engage in campus politics, but… you know…” As a result of the unfortunate timing, this GA was unable to meet its measly quorum and was unable to approve nominations for representatives to the Board of Delegators (BoD). The BoD normally has responsibilities such as brief contemplation of legal matters related to SHMU, shrugging nonchalantly as they evaluate whether they would rather go have lunch at Shmert’s Bar, and voting to table items on their agenda until later meetings. The lack of a BoD may drastically affect the operations of SHMU this semester. As SHMU President Karp Larping admitted at the GA, “We have a lot of things that need tabling and delegation to sub-committees and sub-sub-committees. I’m not sure how well we’re going to get by.” “There’s already something of a backlog of things to be passed on to slightly more competent working groups, et cetera,” Larping continued. “We have a lot of work ahead of us.” The two motions proposed were both moved by SHMU Executive Council members, the first being a “Motion to ostensibly, but not practically or actively, oppose any obviously fascist legislations,” and the second being a “Motion to amend SHMU Council membership policy.” Motion to oppose legislation that is definitely fascist Discussion of the first motion was largely straightforward, though there was some pointed critique from the Farts Representative to SHMU, Charles Schmance, regarding the use of “too many adverbs” in the motion and its many long-winded clauses. A handful of the sparse SHMU members in
A SHMU Council hopeful fills out some of the requisite paperwork attendance delivered brief speeches about the “definite badness” of fascism, and were met with serious nods of agreement. “I know at least two people who would be directly affected by fascism enacted by law,” said Anne Gee, U3 Brain Thinky Problems student. “We need to show our fellow SHMU members that we stand alongside them in a fundamental distaste for fascism. We need to do this with words and actions. Well, maybe not actions. But we definitely need to say it.” Gee then looked around at the attendees over the top of her glasses, as though daring anyone to challenge her. None did so. A collective pat on the back was self-administered to all attendees for their show of ideological bravery. New SHMU Council membership policy The second motion, however, was met
with more contention and confusion, as it proposed a fundamental change to the selection process of SHMU Council members. The proposed policy was drafted by “some people who are definitely familiar with laws,” according to Larping. However, it came to light on the day of the GA that certain clauses of the motion could be interpreted in such a way that the current SHMU Executive would be immediately relieved of their duties, namely the clause that reads, “Resolved, if this motion is ratified at the General Assembly, all current SHMU Council Executive members will be replaced with various large, slowmoving mammals, effective immediately.” Larping spoke carefully at the GA when recommending an amendment. “I think it was largely just a technical oversight on our part. [...] We realized after we submitted the motion that the clause could be misinter-
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E.k. EK | The McGall Weekly preted somewhat. It’s easy to understand, as it’s a little vague.” Larping would not comment on why it was included in the motion moved by the executives themselves in the first place. The motion was amended to propose that the executives would only be replaced by large mammals in case of impeachment by SHMU members. The modified motion was passed by roughly 85 per cent of attendees. Larping expressed relief on behalf of all the SHMU executives. “I’m glad SHMU members seem to understand it was just an honest mistake.” “Damn,” one attendee remarked, as the GA wrapped up and leftover bagels were descended upon like a flock of vultures to fresh carrion. “I really feel like SHMU could be going places if a couple pandas were running the show.”