Naureen Aqueel

hajj

Source: Creative Commons

Published on AltMuslim on September 11, 2016

I was 27 years old and I was writing my will. I was apologizing to friends and family if I had ever done anything to hurt them. I was thinking over my life.

It was an eerie feeling as I imagined the possibility of dying and never returning to my apartment. To my bed. To my books. To the fridge that still had some food in it that I hadn’t found the time to give away or discard.

I wondered how it would be if I died and someone came to my apartment and saw the rotting food – which would have rotted by then – in my fridge. I was angry at my husband for leaving tiny specks of hair from his freshly trimmed beard and head scattered across the bathroom sink and tub.

What if we didn’t come back and someone else came and saw this mess? I thought as I wiped it away frantically.

We were leaving in a couple of hours and my mind was in a state of frenzy. I was excited, I was scared. I felt spiritual, I felt emotional. I couldn’t figure it out. And I didn’t have the time to.

My husband and I were embarking on the once in a lifetime journey of the Hajj or the pilgrimage to Mecca. We were both students and we were making this journey in the middle of the fall semester in 2013. That meant we had a lot of stuff to deal with and wind up prior to leaving, some things we just hadn’t been able to get to – like the food in the fridge or the clothes we had contemplated taking, but decided not to, strewn over the couch.

Hajj is religious obligation that Muslims who are financially and physically capable must fulfill at least once in a lifetime. Because of the dangers and difficulties involved in the journey, the Hajj has always been a powerful reminder of death. In the past, people would set out not knowing if they would ever return home. Over the years, although the difficulties of travel and scarcity of resources to cater to the pilgrims have eased, there have still been a number of deaths in accidents and disease outbreaks each year.

It is for this reason that pilgrims are taught to make preparations for death prior to their departure. This involves repaying all debts or making arrangements for them to be paid, writing a will and apologizing to friends and family for any wrongs you have done.

And so, I did all of that. I was excited to be making this journey. To be visiting the birthplace of my faith. To be getting the chance to pray at a place where Allah has promised He answers every prayer. And to be one of the close to two million people who had been blessed with the opportunity to make this journey that year. I was elated. But that eerie feeling still gnawed at my heart at various points in the journey. I was scared when I was squeezed in a crowd of massive proportions when making the circumambulation of the Ka’aba, the black cubicle structure Muslims around the world turn towards in prayer five times a day. I was frightened when people started yelling and pushing when we were in a queue to enter the Grand Mosque on the Friday right before the major Hajj rituals began. The horror stories of people being trampled and crushed in stampedes that we had heard and read came crashing back to me.

At these moments of chaos and confusion, I also felt my concentration in prayer affected. I wished it could be easier to get inside the Grand Mosque and closer to the Ka’aba without having to deal with the unruliness of the crowds. I wished for a peaceful moment of reflective prayer right in front of the Ka’aba.

But as the days progressed and I became a little more used to the crowds and the confusion, I gained a perspective that I felt was missing when I had left home and when I arrived in Mecca.

Patience – that is the most important thing you must practice in the Hajj, our guide had said. In each preparatory lecture and each talk he gave us there, patience was always mentioned.

The Hajj is unique in that it is a journey where Muslims set out for soul-searching, seeking forgiveness and to be connected to God, not to a secluded area, but to a place where close to two million people converge. I wouldn’t say I ever got completely used to the crowds, the fear and the chaos, but as I sat in the Grand Mosque one morning in front of the Ka’aba seeing the hundreds and hundreds of people, of different colours and different nationalities all moving in circular motion around the Ka’aba, all part of a system – as if in an orbit, I felt a peace in my heart. Perhaps that is what it was all about. To find that inner peace, that concentration and that connection despite all the chaos, confusion and uncertainty. To find that spiritual zenith in the midst of our busy, bustling lives. To understand that everything is part of a greater plan, a system set by God. To come out stronger at the end of it all. And I raised my hands in prayer.

“Labbayk Allaahumma labbayk, labbayka laa shareeka laka labbayk. Inna al-hamd wa’l-ni’mata laka wa’l-mulk, laa shareeka lak

(Here I am, O Allah, here I am. Here I am, You have no partner, here I am. Verily all praise and blessings are Yours, and all sovereignty, You have no partner)

I would miss being there when I went back home.

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baby

Published in the Ottawa Citizen, August 16, 2014.

Mother-to-be Rhiannon Andrews ignored the slight cramp in her belly as she was preparing for bed. A week past her due date and expecting her first child, she awoke the next morning to a similar sensation, but carried on with her day. Heeding the advice of her midwife and doula, the 33-year-old relied on relaxation techniques as her labour pains began.

The next day, she felt a tightening of her uterus, but visited a golf exhibition with her husband followed by a two-hour walk along Dow’s Lake with her mom. By that time, the sharp pains were coming about every 30 minutes.

At bedtime, her contractions were 10 minutes apart, yet she fell into a peaceful sleep after listening to relaxation tapes and visualizing scenes of nature, colours and rainbows.

The next morning, her labour pains were intensifying so she rocked on a birthing ball to ride them out and did breathing exercises. At 9 a.m., she took a nap, again using relaxation tapes to lull her asleep.

For a woman in labour — especially a first-time mom — Andrews was remarkably calm and credits the relaxation techniques she learned in a hypnobirthing class she took with her doula Pia Anderson. Andrews is one of a number of women seeking greater control over childbirth and managing their pain.

For many new parents, hypnobirthing offers the potential of a drug-free way to manage the discomforts of labour.

The use of hypnosis in labour is generating a buzz with about 60 certified hypnobirthing instructors in Ontario and four in Ottawa. In Canada, hypnobirthing training has been offered since 2004, while courses are now available in 46 countries.

“I knew I needed to equip myself with whatever was out there in order to ensure that I had the birth I wanted — a peaceful, calm experience that I was in control of,” says Andrews, who had always wanted a natural childbirth, believing that having an epidural or drugs, with their potentially unpleasant side effects, was more frightening.

When she became pregnant, she chose a midwife for prenatal care instead of an obstetrician because she wanted to play an active role in the choices she made during her pregnancy and opted to deliver at a hospital with her midwife. Her midwife referred her to Anderson, who is also a certified hypnobirthing instructor.

Hypnobirthing maintains that birth is a normal, natural part of life and shouldn’t be feared. It teaches techniques in self-hypnosis, breathing, relaxation, fear release and visualization to help women and their partners achieve comfortable births.

When she was in labour with her son, Andrews focused on “breathing down through her body, instead of out” and she visualized walking in the park with a green balloon and her dog when it was a puppy. There was no forced pushing and she gave birth on her knees, catching her son before handing him over to the midwife.

“Madoc was a beautiful, healthy, alert baby,” says Andrews, who was initially skeptical about hypnosis. But as she learned more, she became a believer. Hypnosis was nothing like what she saw on television and describes it as more of a meditation and relaxation technique.

“I run marathons and like when you are preparing to run a marathon, you train for it. What I liked about hypnobirthing was it’s training for labour and delivery,” she says. “It’s conditioning your mind and your body for birth.”

Practitioners teach parents that being relaxed and breathing properly is vital to allowing oxygen to flow to the muscles, uterus and baby.

Being relaxed also allows the body’s natural endorphins to kick in and makes a gentler experience possible,  says Lisa Keeley, a hypnobirthing instructor in Ottawa for the last three years. Keeley started teaching after her traumatic first birth and a much calmer second birth, which she had using hypnobirthing techniques.

Evidence suggests hypnosis is effective in childbirth, as well as other medical procedures where it has been used as an alternative for patients allergic to medical anesthesia or drugs. Studies in mainstream medical journals have also shown that women using hypnosis preparation for childbirth have required fewer epidurals and interventions than women who did not.

Practitioners acknowledge that not all pregnancies are uncomplicated and low risk. But even women having caesarean births have successfully used the method. When contacted, obstetricians from the Ottawa Hospital and the Queensway-Carleton Hospital declined to comment on the topic.

But practising the techniques is essential. “Practising is important because hypnosis is compounding, so the more you do it, the deeper you go, the quicker you go,” says Anderson, who has been a hypnobirthing coach since 2005 and doula for the past 11 years.

Andrews’ experience with hypnobirthing was so positive, she decided to use it again during the birth of her second son. This time, her labour was even shorter and smoother. While she admits that both of her birthing experiences were intense, she was able to do them drug-free.

“It’s almost like a marathon,” she says. “When you think you can’t go on any further, that’s when it’s about over.”

Nadine Miville, 32, of Gatineau teaches natural labour techniques and credits hypnobirthing with helping allay fears associated with the birth of her first child. She had a calm and relaxed home birth the second time and felt completely in control.

“Because in the end, you are the only person who can do it,” says Miville. “There’s no one who is going to get you through it except for yourself.”

It may just be time to say goodbye to steaming cups of coffee late at night and products piled neatly on shelves in the grocery stores in Fort McMurray, a booming town nestled near the boreal forest that covers the Athabasca oil sands in Alberta.

The federal government’s changes to the Temporary Foreign Worker Program are forcing businesses to cut down their operations, negatively impacting the growing city, says Nick Sanders, president of the Fort McMurray Chamber of Commerce.

“We don’t want to go back to 2006 and 2007 where all the food was piled in the aisles in the grocery store and there was no one to put it on the shelves,” he says, also mentioning how the local Tim Hortons is eliminating its night shift and cancelling plans for a new location at the airport due to staffing problems. “We just want what every other Albertan and every other Canadian has and that is food on the shelves and customer service that is reasonable.”

More than five months after the government announced changes to the Temporary Foreign Worker program, businesses and business groups across the country are complaining that the negative effects of the reforms are already starting to manifest themselves. Some businesses have also reduced their hours after not being able to hire the Canadians that they need, says Monique Moreau, director of national affairs at the Canadian Federation of Independent Businesses (CFIB).

“Crocodile tears.”

That is how Gil McGowan, president of the Alberta Federation of Labour describes the complaints by businesses.

“There is no company that shut down their operations, there is no evidence anywhere,” he says. “This is just overheated rhetoric from employers who have been addicted to the temporary foreign worker program and addicted to using cheap labour. Just like with any other addict when you cut off their drug of choice they will complain but they are likely to recover.”

McGowan says the changes have had a positive effect and that he has heard from Canadian workers who say they are finding it easier to find work since the changes have been put into place.

The reforms created an uproar among business groups when they were first introduced in June this year. Labour groups and some experts, on the other hand, have welcomed them saying that they would allow for more jobs for Canadians.

But tensions are rising as the effects of the government’s changes are starting to kick in.

Earlier this year, Employment Minister Jason Kenney announced in June that the government was phasing out the temporary foreign workers program in low-wage jobs by putting a 10 per cent cap on the number of low-wage temporary foreign workers employers can hire per work site by 2016. The cap will be phased in gradually starting at 30 per cent, then 20 per cent in 2015 and 10 per cent in 2016. Other reforms made at the same time included an increase in the number of inspections of the program, an increase in application fees for each worker requested; fines of up to $100,000 for employers who abuse the program; and reducing the amount of time a temporary foreign worker can be employed in Canada to two years, down from four. The changes were made after reports of widespread abuse of the program by employers who were either exploiting the workers or displacing Canadians by hiring labour from abroad.

Fees for applying to hire a temporary foreign worker have gone up from $275 to $1000. For small businesses, that is a substantial amount to pay regardless of whether or not they get an approval, says Moreau whose organization represents 19,000 businesses of which less than 10 per cent use the temporary foreign worker program. Moreau says the organization has received calls from members from across the country who are concerned that they would be at a risk of closing down their businesses because of the caps.

“We think this is a result of a few bad apples who were misusing and abusing the program and of course, all of our workers support penalizing those individuals,” she says. “Regrettably however, the industry is now suffering as a whole because of those individuals.”

These views are shared by Laxman Chouhan who owns an Indian restaurant in Toronto called Bombay on the Lake and used to hire a chef from India but currently has a permanent resident working as a chef. He says the caps are harmful for businesses and that the temporary foreign worker program is essential for businesses like his as it is very difficult to find labour with the specialized skills needed for the job.

Dave Kaiser, president and CEO of the Alberta Hotel and Lodging Association says its member hotels in resort areas like Banff and Jasper and rural and resource based communities like Fort McMurray and Cold Lake have been impacted significantly as access to the program has been restricted. Positions that have taken the greatest hit are for those who clean hotel rooms, change the linen and wipe the bathroom floors.

Moreau says this labour shortage exists throughout the country not just in the west. “For whatever reason Canadians have decided it’s menial work and they don’t want to do it,” she says.

Businesses have also complained that the policy changes made by the government are informed by flawed data about the number of temporary foreign workers companies are employing. The Conservative government is also beefing up its blacklist of employers who have broken temporary foreign worker program rules and provincial labour laws, leading to a fear among businesses that flawed data may lead to businesses erroneously ending up on the blacklist, having a “devastating” effect on operations.

Moreover, businesses decry the challenges with labour mobility in the country. In areas with low unemployment like Alberta, labour mobility challenges often leave employers with little option but to turn to temporary foreign workers.

“There are people from Ontario or somewhere else that are interested but once they find out where the job is yes they turn it down,” says Kaiser. “It’s easy for an economist to stand back and look at a spreadsheet and say we’ve got X number of unemployed people in this province and X number of jobs over here but in reality it’s not easy to just take those folks and move them all where the jobs are. That isn’t happening.”

However, McGowan says the labour market is a market like any other and in order for it to work price signals need to be sent. The problem with the temporary foreign worker program is that it was short circuiting market signals by allowing employers to access a large and growing pool of cheap labour from abroad as opposed to responding to the labour market by increasing wages and sending price signals to Canadians who might be looking for jobs, he says.

“These employers cannot legitimately say that there is a labour shortage unless they have actually increased wages but the evidence is clear that in many cases they haven’t done that,” says McGowan.

Critics of the Temporary Foreign Worker program say the program was not like it is today until before the Stephen Harper government. Under the Harper government, the low-skilled workers stream was introduced and many of the problems began. The opposition has also criticized the government for not properly enforcing the rules.

“It’s hard to say what impact the changes have had because a lot of the changes just seem to be there on paper,” says Jinny Sims, official NDP critic for employment and social development. “So every time the government gets caught in doing something wrong or the employers, the government makes a little tweak. But really does that fix the problem? No.”

The reforms to the temporary foreign worker program are affecting some regions more than others as is clear from the complaints from employers and business groups in provinces like Alberta. Business groups like the Fort McMurray Chambers of Commerce have called for a localized approach in regions of high unemployment that have trouble attracting labour.

On the other hand, critics of the program say the unemployment threshold that the government set for allowing the hiring of temporary foreign workers in regions where unemployment is below 6 per cent does not reflect the high levels of unemployment in First Nations reserves. Experts also say that problems with the quality of Canada’s labour market data make it impossible to know the level of the labour shortage in the market.

Dominique Gross who wrote the C.D. Howe Institute report on the temporary foreign worker program said in an interview that the changes the government made to the program were a bit too simple to fix the problems with the program. She said that the biggest problem is the lack of information about the labour market. According to her, the solution is for the government to work on obtaining this information about the labour market.

“So as long as there is no clear information about that, it is going to be very difficult to have an efficient temporary foreign worker program.”

Published in the Ottawa Citizen, June 15, 2013.

2013-06-22 13.31.14

For the Ottawa dragon boats that glide through the placid waters of the Rideau River each summer, the beginning was modest. The festival that attracts 190 teams, about 5,000 paddlers, more than 85,000 spectators and top entertainment acts began at a small meeting in Mont Tremblant, Que., in the fall of 1993.

When the small group of Hong Kong Canada Business Association directors discussed the idea in their annual retreat in the Laurentian Mountains, they had no drummers beating their drums to motivate them, nor thousands of fans that now cheer on the paddlers each year.

They had no idea that the suggestion by Gordon Huston, then manager of the Hong Kong Bank of Canada, to have a dragon boat festival similar to Toronto and Vancouver in Ottawa would one day turn out to become the largest in North America.

Frank Ling, who was the founding president of the Hong Kong Canada Business Association, agreed to take the idea forward. Ling, now 76, became chair of the festival and is credited as a founder along with Warren Creates and Mike Chambers who were present at the meeting.

It wasn’t until the next year that the festival saw the light of day: 28 teams, around 540 paddlers and about 200 spectators met at the Rideau Canoe Club on July 23, 1994.

The race course along the Rideau River was set to 640 metres, a distance chosen to replicate the international competition in Hong Kong. Sleek, long wooden dragon boats painted to look like the texture of a dragon’s skin with the beast’s head and tail at either end were rented from Toronto.

The boats sliced through the waters of the Rideau River, with each boat’s 20 paddlers striving in unison to be the first to reach the finish line.

“We went from zero teams, zero money, zero sponsors to having our first ever event,” recalls Creates who succeeded Ling as chair.

“And we broke even — we raised enough money to pull it off successfully.”

Ottawa became the third Canadian city to start the dragon boat racing festival that day. From a one-day event in 1994, the race has grown to become a four-day multicultural sports and arts festival billed as one of Ottawa’s top annual tourist attractions.

To accommodate the growing number of participants, the festival moved from its original site at the Rideau Canoe Club to Mooney’s Bay, on the other side of the Rideau River.

The races now end at Mooney’s Bay, starting 100, 200 and 500 metres upriver.

Dragon boat racing can trace its origins in Chinese culture back 2,400 years. It began as a fertility rite to ensure bountiful crops and ward off misfortune, with the dragon as the symbol of worship.

Ling recalls that the first day of the festival was fraught by bad weather. “It was thunderstorm, lightning,” he reminisces. “One of the boats even turned over, but we survived.”

Heather Jarrett, who has been a paddler and team leader with the festival since 1994, says the weather that day was the worst the dragon boat races have ever experienced. She recalls how two of her team members did not show up that day assuming that the races would be cancelled because of the bad weather.

“Their absence necessitated finding spare paddlers from among friends and family who had come to cheer us on — this established a precedent for the next few years, and some of the team’s fans became anxious about attending, for fear that they might end up wielding a paddle or drumming!”

In its early days, the festival was called the National Capital Dragon Boat Race Festival. It then became the Nortel Networks Dragon Boat Festival and is now called the Tim Horton’s Ottawa Dragon Boat Festival after its title sponsor.

Music and free concerts have been some of the festival’s most prominent attractions over the years, including Spirit of the West, David Usher, Steven Page, 54-40 and Bedouin Soundclash.

This year Sloan, Raine Maida, Born Ruffians, Sam Roberts Band, The Balconies, Great Lake Swimmers and Autumns will rock two stages. There is a children’s section, as well as a Ferris wheel and carousel.

On June 20, there will be a 20th anniversary gala on the beach with a Tiki theme, featuring festive music, fire dancers and area chefs with culinary samplings for guests.

“I think they have really found out how to get families involved,” says Michael Sulyha, a team leader and paddler who has been with the festival since 2006. “There are a lot of activities for children and big-name entertainment acts. It’s become much more attractive to not just people who want to come and watch the competition. There’s something for everybody over there.”

A fundraising component was introduced in 1996 and the festival has raised about $3 million in charity to date. More than 29 Ottawa charities have benefitted, including the CHEO Foundation, Ottawa Food Bank and the Rideau Valley Conservation Foundation.

According to Sandy Foote, the current chair of the Dragon Boat Foundation that manages the fundraising part of the festival, the event aims to raise $450,000 this year in charity.

Those participating in the festival come from all walks of life. Over the years, the festival has seen teams of teachers, media, bureaucrats, high-tech professionals, lawyers, police, people with disabilities and breast cancer survivors.

Some teams are made up only of family members — at times formed as a tribute to a family member they have lost — while others have a mix of family and friends. For some, the motivation is paddling for a cause, for others it’s good sport. Yet others see it as simply a way to get out there and have some fun.

Another one of the major components of the festival is the flower ceremony held by the breast cancer survivor teams.

During the ceremony, paddlers from the breast cancer survivor teams raise a pink flower above their heads, join hands with paddlers from the other boats and reflect on the lives that have been affected by breast cancer. They then toss the carnations into the water. The ceremony aims to honour all those who have passed away because of breast cancer, give hope to those who are battling the disease and celebrate those who have survived.

Ling is ecstatic by the festival’s growth over the years. “It is a world-class event and the largest festival in the world in terms of attendance.”

The festival attracts teams and spectators from across Canada and the U.S. and has served as an inspiration to other such festivals in the world.

John Brooman, president of the Ottawa Dragon Boat Festival, says Israel’s festival, which began in 2012, traces its genesis back to Ottawa.

“Definitely, there are other festivals that will use Ottawa as a template to try to improve their own.”

Creates thinks the first day of the festival has had a role to play in its growth. In Chinese folklore, rain is seen as a symbol of good luck and he takes it as a sign.

“We got rained on that first day and we have been lucky ever since.”

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Published in The Ward, Nov 27, 2012.

ward-xray

Another osteoporosis drug has been linked to unusual thigh bone fractures in a small number of users, according to an alert issued by Health Canada.

Amgen Canada, the company that produces the drug denosumab under the brand name Prolia, joined with Health Canada in issuing a warning statement last week. Amgen said, however, that instances of the fractures were very rare.

Last year, a warning was issued by Health Canada about an entire class of osteoporosis drugs, known as bisphosphonates, which had been linked to unusual thigh bone fractures in users.

These unusual fractures, which are known as Atypical Femoral Fractures (AFF), can occur with little or no physical impact. They have often been associated with long-term use of certain osteoporosis medications. The fracture is often preceded by thigh or groin pain which may occur several weeks or months before the actual fracture.

“This is new safety information related to unusual thigh bone fractures and the use of Prolia,” Sabrina Paiva, senior manager for product communications at Amgen, told The Ward.

“Cases of AFF have been confirmed in patients receiving Prolia participating in the ongoing open-label extension study of the pivotal phase three fracture trial in postmenopausal osteoporosis,” said Paiva. “These events have occurred very rarely in less than one in every 10,000.”

Health Canada said the study is evaluating the long-term efficacy and safety of Prolia in 4,550 post-menopausal women.

The drug Prolia is used in the treatment of post-menopausal women with osteoporosis who have been found to be at high-risk for fracture. It works by reducing the amount of bone broken down by the body, making bones less likely to break.

Osteoporosis Canada, the national organization working for people who have or are at risk of osteoporosis, said in a statement released last week that while unusual fractures had been seen in people taking bisphosphonates and denosumab for several years, a causal relationship between the use of osteoporosis medications and these fractures had not yet been confirmed. The statement also said that the atypical fractures had been reported without osteoporosis therapy.

Tanya Long, education manager at Osteoporosis Canada, stressed although there has been some instances of these fractures associated with the use of denosumab, “they were very, very rare.”

Blossom Leung from Health Canada’s communications office said that all marketed health products have benefits and risks associated with their use.

“Health Canada continues to monitor the safety profile of health products once they are marketed to ensure that the benefits of the product continue to outweigh the risks,” said Leung in an e-mail to The Ward.

Leung said manufacturers  are also responsible for the continuous assessment of the benefits and risks of their health products.  “The risks of a health product should never be considered in isolation, but instead, the balance between possible risks and potential benefits needs to be taken into account, with benefits always outweighing the risks,” she said.

Leung added that information on adverse reactions, precautions, warnings and contra-indications associated with health products is provided in the product information to keep prescribers and patients informed.

Osteoporosis Canada recommends patients who are taking osteoporosis medications and experiencing symptoms like pain in the thigh or groin to contact their doctors immediately.

Published in The Ward, Nov 27, 2012. 

New federal regulations that aim to give more health-care providers the authority to prescribe narcotics and other controlled substances will not immediately take effect in Ontario because of a provincial law that prohibits this practice.

The federal government announced new regulations last week that allow nurse practitioners, podiatrists and midwives to prescribe certain medications classified as controlled substances, including morphine, codeine, fentanyl and diazepam.

The move is aimed at improving health care service delivery, said Jocelyn Kula, manager of the regulatory policy division for Health Canada’s Office of Controlled Substances.

Health Canada published the regulation covering a “new classes of practitioners” on Nov. 21.

“What they broadly do is to remove any federal impediments to certain classes of health professionals being able to prescribe controlled substances,” Kula said. “But the catch is that in order for one of the classes of health professionals to be able to use their new authority, they need to have the similar authority provided to them at the provincial or territorial level.”

Kula said the new regulations should allow patients to get care and access to drugs in a more timely manner. People will no longer have to go to multiple health-care professionals or jump through various hoops before getting required care or drugs.

Midwives in provinces that allow them to prescribe the listed drugs will also be allowed to provide access to medication for women who choose to have a home birth. They wouldn’t have to wind up in hospital just to access drugs needed to ease labour, Kula said.

Kula said the new regulations came into effect after a series of requests and exchanges from certain provinces and professional health associations, which informed Health Canada that the limits in prescribing authority were disrupting the delivery of health services.

The College of Nurses of Ontario issued a notice to nurse practitioners in the province after Health Canada published the new regulations, alerting the health-care providers that it was still illegal for them to prescribe any controlled substances, including narcotics, under the provincial Nursing Act.

Bill Clarke, a college spokesman, said in an email that all the federal changes have done is to give each province the power to make its own decisions around the prescribing authority of practitioners.

“Now, however, with this change in federal law, the College of Nurses of Ontario has the power to propose changes to the Ontario Ministry of Health around nurse practitioners prescribing of these drugs,” Clarke said.

“The college will work with Ontario’s nurses and stakeholders to develop provincial regulations around this aspect of nurse practitioners’ practice in a manner that supports the public interest and builds confidence in nursing regulation.”

No one was available for comment from the provincial health ministry.

The Canadian Nurses Association called the new regulations a “milestone for nurse practitioners and the patients they care for.”

Nurse practitioners – who are experienced registered nurses with advanced training and education that allows them to make certain medical diagnoses, write some prescriptions and administer some treatments – have often been called vital links that help make the health-care system more efficient.

Although a majority of them work in community health centres and family health teams, they can also be found in emergency departments and long-term care institutions. In the past, moves to expand the powers of nurse practitioners have been hailed as key to preventing overcrowding and speeding the delivery of care.

Last month, British Columbia approved regulation to allow nurse practitioners to admit and discharge patients, becoming the second jurisdiction in Canada, along with Ontario, to allow those powers.

While many in the medical community have welcomed the new regulations, not everyone is excited about this decision. Joanna Binch, a nurse practitioner at the Somerset West Community Health Centre in Ottawa, said that while she has been in situations where she could have prescribed something to a patient, she was happy to have not had the authority to do so, particularly when prescribing narcotics.

“The situation that I run into much more often is that people are requesting narcotics,” Binch said.

“And I often like not being able to prescribe them because I can say, ‘Look, I know you have an addiction or you would like this, but this is not something I can deal with. Let me talk about anything else you would want to talk about.’ And it just changes the priority of the visit. But as I say, I’m sure this is not the case for many nurse practitioners who are in different settings.”

Published in The Ward, Nov 20, 2012. 

2012-11-20 11.47.27

Ottawa has 22 neighbourhoods that have inequitable access to healthy foods, Dr. Elizabeth Kristjansson of the award-winning Ottawa Neighbourhood Study said Tuesday at an event organized by Ottawa Public Health. Kristjansson who was speaking at the Meet, Eat and Learn (M.E.A.L) forum at the Ottawa Public Library said that neighbourhood design and community access to grocery stores can cause a number of potential health issues.

Kristjansson spoke of a consistent link that has been found between poor health and poor access to healthy foods in areas that do not have grocery stores nearby.

“People that live in these areas with poor access to grocery stores are consistently found to have poorer diet, high rates of obesity, higher rates of diabetes and higher rates of cardiovascular diseases,” Kristjansson said.

But Kristjansson pointed out that these were not necessarily true causal relationships. Studies have only revealed a consistent link between poor health and poor access to healthy food, she said.

“Food purchasing patterns have been found to be not only related to price but convenience,” she said. “People shop at the closest places.”

The head of the Ottawa Neighbourhood Study, who is also an associate professor at the University of Ottawa, said that areas that have a “food imbalance,” which she described as a higher ratio of unhealthy things like convenience stores and fast food restaurants to grocery stores, have higher mortality rates. She said the issue posed a complex problem for urban and health planning policy makers.

Kristjansson announced the launch of the Ottawa Neighbourhood Study website that presents food-related data and information on the strengths and challenges for each neighbourhood. Her team won the national prize for collaborative research – a $25,000 award from the Canadian Institutes of Health Research – in September.

The study, which was launched in 2005, brings together the work of contributors from the University of Ottawa, Ottawa Public Health, the City of Ottawa, local community health and resource centres, Carleton University, United Way/Centraide Ottawa, IBM, The Champlain Group and the Ottawa Food Bank.

The study maps and profiles more than 90 neighbourhoods and lists demographics, incomes and other social determinants for them.

“The Ottawa Neighbourhood Study has a great impact on informing public policy and has contributed greatly to better public education at the community level,” Kristjansson said in an earlier statement.

The study identified “food deserts” in various parts of Ottawa where residents have to walk great distances to find a grocery store. Kristjansson said that the findings showed that a lot of the food deserts were concentrated in the downtown area, but that not all lower income areas in the city’s centre face that problem. “A lot of downtown lower-income communities have great access,” she said.

Some other neighbourhoods of concern identified in the study were Bayshore, Greenboro and Carlington.

Other Canadian cities are now considering starting their own versions of the neighbourhood study.

Dr. Isra Levy, a medical officer at Ottawa Public Health, said the data was vital for public policy. “With this new data in hand, Ottawa Public Health and our partners can better address social challenges such as the lack of proper access to healthy food,” Levy said in a statement.

Other organizations working on food insecurity in the city also participated and spoke at the event. Just Food, Ottawa Food Bank, Poverty and Hunger Working Group and the School Breakfast program were some of the organizations that presented updates about their work.

Jamie Hurst, a nutritionist at Ottawa Public Health who was one of the organizers of the event, said the event was a contribution by the organization towards dealing with food insecurity.

“We recognize that food and security, and specifically hungers, are significant issues in our city,” Hurst said. “At the same time we recognize that we cannot solve the problem on our own. It requires a collaborative effort among many, many partners and so we wanted to have the opportunity to bring all of those partners together.”

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