October 2, 2014 Leave a comment
September 30, 2014
To: Canadian Association of Midwives Board of Directors and Membership
Re: Support for Stephen Harper and the Conservative Party of Canada
Dear CAM Board Members,
I am writing to express my concern over the public support expressed by the Canadian Association of Midwives and CAM President Joanna Norman Nemrava for the federal Conservative position on maternal, infant, and child health and apparent lack of critical perspectives from CAM on the policies of the Conservative Party of Canada and the Department of Foreign Affairs, Trade, and Development.
On September 23, 2014, the President of CAM posted on her facebook profile: “Joanna Norman Nemrava As CAM President, I am headed to the UN General Assembly at the invite of our Prime Minister, regarding maternal newborn health issues and the PMs address to the UN Assembly….”. Following this posting, the CAM President then went on to post this September 22nd article from the Globe and Mail: Harper to focus on maternal, child health at United Nations. This follows on the May 29, 2014 letter available on the CAM website addressed to Stephen Harper from Joanna Nemrava on behalf of CAM to “applaud” the continuation of funding for maternal, infant, and child health and invites “further discussions on how midwives can contribute to saving the lives of mothers and babies.”
I am gravely concerned that CAM accompanied the Prime Minister to the UN for his speech. I am also concerned that there is a lack of critical voice of the federal Conservative Party policies on development. This trip has the appearance of condoning right-wing policies of the Conservatives that are harmful to women, children and their communities. Millions of Indigenous women on Turtle Island and across the globe find themselves in the path of the aggressive and destructive mining and extractive practices of Canadian-based corporations. The health of poor women is profoundly impacted by economic austerity and Conservative neoliberal economic policies such as the failure to act on a national childcare program and instead institute an insubstantial and regressive child-care benefit voucher-system. Women are affected by escalating climate change, food insecurity, occupation, and war. Having CAM leadership accompany the Prime Minister and publicizing this on the CAM website sends a message that as a collective we are supportive of the Prime Minister’s approach to maternal and newborn health devoid of a structural analysis of how the Muskoka Initiative or other funding initiatives of the Federal government not only fail to address the conditions which underlie health inequities but might actually exacerbate these inequities in the long-term.
International aid is not a politically-neutral or benign process. Indeed, many question the decision to fold the Canadian International Development Agency into the Department of Foreign Affairs, Trade, and Development, in line with the United States. A policy statement from the Department of Foreign Affairs, Trade, and Development reads “[a]s the linkages between our foreign policy, development and trade objectives continue to grow, the opportunity to leverage each of these grows at equal pace”. Not to say that CIDA was completely unproblematic, but many of the CIDA-funded projects struggled to advance women’s economic and social rights, as well as women’s reproductive rights. The loss of an arm’s length organization to oversee federal development funding has facilitated an environment which is completely intolerant of reproductive freedom and legal, safe, and accessible abortion services. Family planning for the Conservative Party of Canada excludes women’s right to safe and accessible abortion services. The World Health Organization estimates that 13% of maternal deaths stem from unsafe abortion practices. Political agendas now directly influence international aid funding and eliminate funding potential for any programs which are morally and politically unpalatable to the Tories and their financial backers.
The conflation of foreign policy and trade objectives with international development in practice also means that aid is used to leverage Canada’s economic and geopolitical objectives. The priority countries for Canadian international development say more about Canada’s economic and geopolitical interests than about the needs of the world’s poor. In countries such as the Philippines, Congo, Colombia, Peru, Honduras, and Burma Canada has significant economic interests, particularly in the mining sector. Other priority areas, such as Afghanistan and Haiti have suffered from direct Canadian military intervention and development projects are explicitly used to prop up unpopular governments imposed in the process of foreign invasion. Similarly the aid directed to the Palestinian West Bank is entirely focused on strengthening police forces to safeguard Israel’s security, while Palestinians continue to suffer under illegal occupation.
Around the world Canada advocates for the privatization of health care and health care systems through its participation in multilateral institutions like the IMF and WTO. In Africa and Latin America, Canada is aggressively pursuing Foreign Investment Protection Acts (FIPAs) that force poor countries to pay Canadian corporations damages when their mining activities are interrupted or halted by popular resistance. These and similar economic policies create the gross structural inequities that contribute directly to fact that 29,000 children die of poverty every day. Even if Canada’s intervention into maternal and newborn health were unproblematic, it can’t be simply lauded in isolation from the whole context of Canadian foreign policy, including foreign aid policy which is perpetuating and exacerbating a massive global wealth and health gap.
It is strategic for Stephen Harper to paint his leadership with a veneer of concern for human rights and social justice. I am saddened and extremely worried that it appears as if the Canadian Association of Midwives is lending credibility to this veneer at this critical junction for human rights, the well-being of women and families, and the future of the planet. Development aid, trade relations, foreign investment, and military intervention are increasingly united in an undemocratic and non-transparent behind-closed-doors environment to exclude the growing voices of dissent, including those voices from the very regions being discussed and negotiated.
Harper’s government has repeatedly ignored or overridden community concerns for public health and environmental justice for communities impacted by the tar sands or pipeline construction, even from those communities who lay claim as the original inhabitants and traditional protectors of the land as recognized by international law, and even at times by Canada’s own Supreme Court rulings. Despite this growing dissent, the International Energy Agency reports that tar sands production will increase from 1.3 to >4.2 million barrels per day by 2035. The Agency reports that at this level of production they anticipate a “catastrophic increase in global temperature”. There are currently over 80 projects dominated by major transitional corporations such as Shell, Imperial Oil, Chevron, and Suncor, among others. This expansion of oil sands production means further encroachment onto the traditional territories of the Lubicon Cree First Nation, Mikisew Cree First Nation, Duncan Lake First Nation and the Athabasca Chipewyan First Nations (and many more through pipeline construction) despite ongoing dissent within these communities and documented public health and environmental harms which will impact generations to come.
In particular, in 2011 the unceded traditional territory Lubicon Cree experienced one of the large oil pipeline spills in the history of Alberta. Simultaneously the Federal government refuses to acknowledge the sovereign rights of the Lubicon Cree, which in and of itself is a grave human rights violation, and the failure to protect the rights of the Lubicon Cree has been condemned by UN human rights bodies. In addition, Oil Sands Reality Check states “[e]ighty per cent of the traditional territory of the Mikisew Cree and Athabasca Chipewyan First Nations has been rendered inaccessible for most of the year by tar sands development, and the Beaver Lake Cree have documented 20,000 treaty rights violations.”
Further, there is a vast and growing body of literature interrogating the relationship between wealth and health inequities, in particular infant mortality and stillbirth rates which continue to show a relationship with income gradients even in countries undergoing rapid development. Those communities with the greatest wealth inequities are most often those same communities who experience the highest maternal and infant mortality and stillbirth rates. Economic exploitation and widening wealth disparities may lead to increases in infant deaths at a greater rate than increasing development aid can reduce them. Structural conditions of our societies lie at the root of the issues that the Muskoka Initiative claims to want to tackle with development aid while sidestepping any hard discussion or examination of Canada’s role in the exacerbation of these structural inequities.
Harper’s maternal and newborn health strategy is window dressing on an overall economic and foreign policy that is aggressively pushing Canada economic interests, particularly in mining and extractive industries in ways that cause serious environmental and social damage to poor people and communities around the world. Unconditional applause for the funding of the Muskoka Initiative is something I urge CAM members to question. If development aid is directly partnered with international trade and investment, our support for international aid should be accompanied by a hard look at the international and national economic policies and actions of the federal Conservatives.
Increasing the numbers and locations of practicing midwives can only go so far to rectify maternal, infant, and child health inequities. In February of this year The Lancet – University of Oslo Commission on Global Governance for Health stated that “the deep causes of health inequity cannot be diagnosed or remedied with technical solutions, or by the health sector alone, because the causes of health inequity are tied to fairness in the distribution of power and resources”. Importantly the Commission goes on to explain that “construing socially and politically created health inequities as problems of technocratic or medical management depoliticizes social and political ills, and can pave way for magic-bullet solutions that often deal with symptoms rather than causes”. This is important insight into how fundamentally inequitable global decision making processes which ultimately favour the wealthy and the powerful impact global health.
I believe as a professional organization we are currently engaging in this process without sufficient collective discussion or analysis; a process not only of global significance, but one which could determine the future for generations and perhaps even the survival of the planet. I urge CAM to re-consider any suggestion of an organizational relationship with the Conservative Party and to distance ourselves from regressive, exploitative, and fundamentally unjust political and economic positions. It is time to start talking more deeply about democratic processes and economic and social justice. I, for one, would be encouraged to see CAM participating in such a dialogue either through supporting progressive research or striking a social justice committee.
Thank you for your time and for considering my input into this matter.
Martha Roberts, RM
Strathcona Midwifery Collective
MSc Candidate, Faculty of Health Sciences, Simon Fraser University
 http://www.fns.bc.ca/pdf/William_en_%28SCC-2014%29.pdf It is of interest to note that James Anaya, Special Rapporteur on the rights of Indigenous Peoples, focussed on the Canadian Government’s lack of democratic engagement with Indigenous peoples in Canada in his Report to the 27th Session of the Human Rights Council in July, 2014: http://unsr.jamesanaya.org/docs/countries/2014-report-canada-a-hrc-27-52-add-2-en.pdf
 International Energy Agency. (2010). World Energy Outlook 2010. Paris, France: International Energy Agency.
 Readings: http://www.lubiconlakenation.ca/index.php/resources/information-for-the-public/other-readings
 CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. Accessed October 23, 2011, from: http://www.searo.who.int/LinkFiles/SDH_SDH_FinalReport.pdf
 Ottersen, O.P., Dasgupta, J., Bluin, C., Buss, P., Chongsuvivatwong, V., Frenk, J., Fukuda-Parr, S., Gawanas, B.P., Giacaman, R., Gyapong, J., Learning, J., Marmot, M., McNeill, D., Mongella, G.I., Moyo, N., Mogedal, S., Ntsaluba, A., Ooms, G., Bjertness, E., Lie, A.L., Moon, S., Roalkvam, S., Sandberg, K.I. & Sheel, I.B. (2014). The Lancet – University of Oslo Commission on Global Governance for Health: The political origins of health inequity: prospects for change. The Lancet, 383, pp. 630-667.