PREMIERS ENDORSE A REPORT AT THE COUNCIL OF THE FEDERATION – A health care innovation group Co-chaired by Premiers Brad Wall and Robert Ghiz was established by the Council of the Federation in January 2012 and presented their report to the Council on July 26^th as reported by the National Post. The report made recommendations that require voluntary acceptance by the provinces once they have an opportunity to review and determine how the recommendations can be implemented in a particular province. “The report contains 12 recommendations on how provinces and territories can deliver better care, save dollars and find more value in the $130-billion health-care system.” A major recommendation is for provinces to agree on a bulk buying mechanism for 3 – 5 generic drugs. “Other voluntary measures recommended by the report include: adopting common treatment guidelines for heart disease and diabetes (including harmonized guidelines for prevention and screening); sharing information to help trim labour costs and reduce competition in hiring health professionals such as doctors and nurses; and implementing team-based care to prevent patients from jumping from one provider to another.” See the report at: http://www.councilofthefederation.ca/pdfs/Health%20Innovation%20Report-E-WEB.pdf

MILLENNIUM VILAGES

Social policy reform on a global scale is not what normally comes to mind when social workers think about social reform. However the principles of the United Nations Millennium Project have application to poverty reduction and elimination in our own local communities that experience poverty. Albeit poverty is not a serious as found in countries like Africa where a project known as the Millennium Villages Project has been launched since the beginning of the decade, hence the attachment of the name “millennium” to the effort.

Social workers who believe strongly that social development and social justice are part of their profession’s mandate are naturally drawn to projects that have the potential to alleviate poverty wherever it exists. The wider community these days is slowly adopting the social work basic premise that has guided social work practitioners for decades. That is, change can only be effectively accomplished when people are fully engaged in their own rehabilitation.

This principle has been applied in many local projects when social workers work in the community development and social justice areas of their profession. Social workers who work with their individual clientele on a one-on-one basis apply this principle as well in their practice. Often, we lament that, in many cases, it is the “system” that is interfering with people inhibiting them from attaining their full potential. So the principle of engaging people in the work of solving their own problems with some guidance from outside themselves has been time tested.

Millennium Development Goals - Taking this principle to a higher level is the approach of the Millennium Project which was commissioned by the United Nations Secretary-General in 2002 to develop practicable, concrete, measurable targets for countries to raise their people out of poverty. The Millennium Development Goals (MDG’s) were approved by the United Nations to reverse the grinding poverty, hunger and disease affecting billions of people in the poorest nations of the world.

The eight goals which contain specific targets are listed below:

·       Eradicate extreme poverty and hunger

·       Achieve universal primary education

·       Promote gender equality and empower women

·       Reduce child mortality

·       Improve maternal health

·       Combat HIV/AIDS, malaria, and other diseases

·       Ensure environmental sustainability

·       Develop a global partnership for development (i.e., good governance, availability of new technologies, drugs, debt reduction, productive work for youth, etc.)

In 2005, the independent advisory body headed by Professor Jeffrey Sachs, special advisor to the UN Secretary-General and Director of the Earth Institute at Columbia University, presented its final recommendations to the Secretary-General in a report, Investing in Development: A Practical Plan to Achieve the Millennium Development Goals.

Millennium Villages Project (MVP) - The outcome of the advisory body’s recommendations was the Millennium Villages project and is based on a single powerful idea: impoverished villages can transform themselves and meet the Millennium Development Goals if they are empowered with proven, powerful, practical technologies. By investing in health, food production, education, access to clean water, and essential infrastructure, these community-led interventions will enable impoverished villages to escape extreme poverty, something that currently confines over 1 billion people worldwide.

The Millennium Village Project, a large, experimental intervention which aims to spark local economic development in fourteen village clusters across Africa and show that “people in the poorest regions of rural Africa can lift themselves out of extreme poverty in five years’ time”

The Millennium Village Project, a model for fighting poverty at the village level, is trying to show how a few simple reforms, seven in all, can substantially improve lives and provide livelihoods. These are: fertiliser and seed to improve food yield; anti-malarial bed nets; improved water sources; diversification from staple into cash crops; a school feeding programme; deworming for all; and the introduction of new technologies, such as energy-saving stoves and mobile phones.

Millennium Village Projects must be financed from outside until they become self-sustaining. To finance the Millennium Village Projects, developed countries aspiring to permanent seats on the UN Security Council, are encouraged to fulfill their commitment to provide 0.7 percent of their GNP to the Official Development Assistance (ODA) by 2015 as part of their leadership responsibilities (the 0.7% target was first affirmed by UN member states in a 1970 General Assembly and reaffirmed by select country groups in 2002, 2005 and 2010). In many low-income countries, and practically all least developed countries, domestic resources alone are not enough to meet the Goals. The process of funding and implementing a Millennium Village is a shared effort between the Official Development Assistance from rich countries, the receiving country, private sector donations and the villages themselves as well as in-kind contributions.

The MVP is an experiment to demonstrate that the Millennium Goals can be achieved by the target year 2015. The experiment may need to continue past 2015 for some villages but eventually will decrease until the village ends its dependency on outside aid and becomes self-sustaining. The data collected so far indicate significant progress is being made and villages are achieving sustainability.  This project differs in several ways from other development programs that have been offered: (a) Progress is tied to the millennium goals and are measurable; (b) It focuses on participatory community decision-making; (c) The initiative uses improved science-based technologies and techniques that have only recently become available; and (d) initiative is linked to national–level processes to ensure that the success can be continued and enhanced by country governments.

Although there has been some criticism (Moyo, 2009) of giving financial aid to African countries as creating dependence and leading to nowhere, the attempt by the Millennium Village project is to tie financial aid to defined measurable goals which, when reached, lead to independence and sustainability.

In 2004, SauriSauri has dropped by at least 50% since the distribution of free bed nets. Food yield has more than doubled and villagers say that everyone can now find at least a little to eat. A school feeding programme, whereby farmers give a portion of their harvest to the village schools, has had a dramatic effect. Children stay in school longer and, with a bowl of maize and beans in their belly, are able to concentrate. Since school feeding began, Sauri has risen from 108th to 2nd in district exam results, out of 253 schools.

Almost two years into its five-year boost, there are signs of economic activity in Sauri as well. Several shops have opened. A few people have purchased mobile phones, one or two have managed to invest in dairy cows, and many more are diversifying into cash crops”. (The Economist, 2006)

In addition to applying the Millennium Goals to the millennium villages in the poorest nations of the world, a broader application of the Millennium Goals can be applied to the elimination of poverty wherever poverty exists. Best practises in seven investment and policy areas are necessary to achieve the MDG’s:( http://www.unmillenniumproject.org/index.htm)

·       Rural development: increasing food output and incomes – Requires soil improvement and resulting incomes of small holder farmers and their families. Need – fertilizers, increase rural access to transport, information and communications, safe drinking water, sanitation, modern energy, and reliable water for agriculture and agriculture-related small and medium-size enterprises, all done in an environmentally sustainable manner.

·       Urban development: promoting jobs, upgrading slums, and developing alternatives to new slum formation - A central focus should be to strengthen the operational capacity of local governments, nongovernmental organizations (NGOs), women's organizations, and other civil society groups, and to include them in the formulation of relevant national policies.

·       Health systems: ensuring universal access to essential services - Practical investments and policies for a functioning health system include training and retaining competent, motivated health workers, strengthening management systems, providing adequate supplies of essential drugs, and building clinics and laboratory facilities. Eliminating user fees for essential health services, -improving -community health education, promoting behavior change, and involving communities in decision-making and service delivery are also critical measures.

·       Education: ensuring universal primary, expanded post primary, and expanded higher education - Governments should ensure that every child, boy or girl, completes basic schooling of good quality, that a substantial proportion also completes post primary education, and that a significant number are enrolled in tertiary education by 2015.

·       Gender equality: investing to overcome pervasive gender bias - They should also address systemic challenges such as protection of sexual and reproductive health and rights (including access to information and family planning services), equal access to economic assets such as land and housing, increased primary school completion and expanded access to post primary education for girls, equal labor market opportunities, freedom from violence, and increased representation at all levels of governance.

·       Environment: investing in improved resource management - Examples of direct investments in environmental management are replanting forests, treating wastewater, curbing chemical pollution, and conserving critical ecosystems. Well-designed sector strategies, including agriculture and infrastructure services, can use strategic impact assessments to minimize negative environmental trade-offs. The removal of environmentally damaging subsidies can further improve environmental management.

·       Science, technology, and innovation: building national capacities - Sustainable MDG-based strategies require the buildup of indigenous institutions and skills to advance science, technology, and innovation. Practical measures to increase a country's scientific capacity include creating science advisory bodies to the national government, expanding science and engineering faculties in universities and polytechnics, strengthening development and entrepreneurial focus in science and technology curricula, promoting business opportunities in science and technology, and promoting infrastructure development as a technology learning process.

·       Interdependence of investment clusters - Each investment cluster depends on the others and most interventions have effects on several Goals. For example, reducing gender inequality is essential for reducing hunger, containing HIV/AIDS, promoting environmental sustainability, upgrading slums, and reducing child and infant mortality. Reaching the Millennium Development Goals thus depends on ambitious action across many sectors.

Designing a national strategy to achieve the Goals can be accomplished even in the poorest countries if there are intensive efforts from all parties to:

·       improve governance,

·       actively engage and empower civil society,

·       promote entrepreneurship and the private sector,

·       mobilize domestic resources,

·       substantially increase aid to countries that need it to support MDG-based priority investments, and

·       Make suitable policy reforms at the global level, such as those in trade.

Can social workers in Canada benefit from the Millennium Village approach to poverty reduction and elimination? How can the Millennium Goals approach be applied to urban and rural poverty in Canada?  Are the Millennium Goals universal enough to give guidance to social workers who work in the community development field of social work?

WILL WE REALLY PROTECT MEDICARE

Will we really protect Medicare? We not only need to protect Medicare but also find ways to enhance it and make it sustainable. Adrienne Silnicki, Council of Canadians, reporting in the  Halifax Chronicle Herald on March 14, 2012 states that this may not be possible if the federal government does not take on its leadership responsibilities. A statement made by Prime Minister Harper recently that health care is a "provincial responsibility" is not true because the federal and provincial governments both have responsibilities "to play in protecting and strengthening universal health care". What is required is leadership from the federal government to ensure that the funding is maintained through the Canada Health Transfer and that the provinces follow the principles of the health act namely: public administration; universality; portability; comprehensiveness; and accessibility. These principles, if maintained, protect universal health care for Canadians.

Ms. Silnicki concludes: "We need a federal government that can look at the best science-based practices being implemented in provinces and territories and tie funding to encourage other provinces and territories to adopt these practices. We need a federal government that can act as a single-purchaser and negotiate with drug companies and save us $10.7 billion a year by implementing a universal pharmacare plan. And we need a federal government that is committed to strengthening the Canada Health Act and bring it into the 21st century with innovations such as team-based practices and better management of chronic care patients by expanding home care, community care and long-term care".

See the article at: http://thechronicleherald.ca/opinion/73368-spur-provinces-be-innovation-incubators

 

GLOBAL AGENDA FOR SOCIAL WORK AND SOCIAL DEVELOPMENT

During the World Social Work Day on March 20, 2012 a GLOBAL SOCIAL AGENDA will be presented to the United Nations, other world organizations and national governments. The joint project between International Federation of Social Workers (IFSW); International Council on Social Welfare (ICSW); and the International Association of Schools of Social Work (IASSW/AIETS) began in 2010 and will be the subject of the Joint World Conference in July 2012 in Stockholm Sweden with theme: “Social Work and Social Development: Action and Impact”. Agenda themes are: Social and Economic inequalities within countries and between regions; Dignity and worth of the person; Environmental Sustainability; and Importance of human relationships.

The conference wants to determine how “the Agenda might impact on the conditions of people and demonstrate how actions in the social work and social development community can contribute to an enduring physical environment and sustainable social development”.

Visible signs to look for in the future will be: Human Rights and Social Equality (How can social work and social policies contribute in the endeavour to respect, protect and fulfil human rights?) Environmental Change and Sustainable Social Development (How does climate change affect social work and social development?)  and Global Social Transformation and Social Action (How can social work and social policy actions contribute to the fulfilment of migrants’ rights and to bridging transnational relations – as consequence of border-crossing migration?)

Read more about this exciting conference at: http://www.swsd-stockholm-2012.org/Default.aspx

Early Childhood Education (ECE): A Component of the Education System

Our existing programs for intervention and prevention of serious deviant behaviour culminate in increased crime, uncontrollable behaviour, trouble accepting authority and general disrespect for others has called for new analyses and solutions. In Nova Scotia for example, crime by youth is higher than the national average (Statistics Canada). The programs we have to address the situation are haphazard and expensive and have not focussed on the root causes of behaviour but rather the presenting problems. Adults or youth need to be seen as out of control before programs are developed and put in place to address them.

This is not to say that the existing programs should be discarded because no immediate positive results can be seen. There are always two stages when attacking current social problems: (a) address the immediate presenting problem and try to change behaviour so that the individual can lead a more productive and positive lifestyle, and (b) determine the root systemic causes of the problem and devise programs that will prevent the problem from occurring in the first place.

Determining the root causes and devising preventive programs is a far more cost effective way to address social problems in the long term. This is the approach made recently by the study, Early Years Study 3: Making Decisions, Taking Action[1] (2011) which was presented to a large audience at the Westin Nova Scotian on February 9^th. Two of the authors of the study were present during the presentation: Hon. Margaret Norrie McCain, founder and chairperson of the Margaret and Wallace McCain Family Foundation, which published the study, and former Lt. Governor of New Brunswick, and Kerry McCuaig a researcher in the area of early childhood policy at the University of Toronto. She was also involved with the “Early Years Study 2: Putting Science into Action (2007)”.

Early Years Study 3 transfers the results of scientific enquiry into the realm of innovative social policy and offers suggestions for immediate and concrete action.  The key suggestion in the study is the creation of a solid platform for addressing services for the development of early childhood education which should be the provincial education system. The idea is that our schools are the best place to offer programs for 2 – 5 years olds. “Good quality early childhood education supports children’s physical, social, emotional and cognitive growth, providing a smart start for school life. If organized to allow parents to work or upgrade their skills, it has been shown to reduce family poverty and contribute to healthier communities”.

The provincial education system provides the best platform from which to promote and build early childhood education programs. A comprehensive early childhood education program for 2-5 year olds can be launched from our publically funded schools. The infrastructure is already there so there is no need to start from scratch to build a new program. “By broadening education’s mandate to include younger children, we can bridge the gap between parental leave and formal schooling. Schools can become community centres for families, with supports and programs from pregnancy onward”.

Communities that have integrated programs for preschoolers focussing on education, social development, positive social behaviour, greater independence and self-regulation, show more positive results than communities with non-integrated programs. Another advantage in the “all-in-one”concept is the effect it has on parents. “Researchers have also found that parents whose children attend programs that are integrated into their school are much less anxious than their neighbours whose children are in the regular jumbled system”. Parental stress is a major cause preventing parents from responding appropriately to their children and “…researchers have connected chronic parent stress to the poor academic record of their children”.

Major changes are needed not tinkering around the edges with the existing system. We must be ready to ensure that all children have the opportunities to enter the school system ready to learn and to mature as responsible and successful adults. Let’s advocate for the changes that will ensure that our children truly come first.

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[1]  McCain, M.N., Mustard, J.F., & McQuaig, K. (2011). Early Years 3: Making Decisions, Taking Action. Toronto: Margaret and Wallace McCain Family Foundation.

Can a village raise a child?

The case of a 16 year old youth now before the Youth Court after a long list of serious difficulties in the home and the community may finally be coming to a conclusion. Unfortunately the conclusion may not be satisfactory to those involved. The youth, who cannot be named because the matter is currently before the court, has never been named because he has been the subject of first, custody proceedings and now criminal proceedings. His offences include robbery, arson and driving without a licence as well as longstanding behavioural problems in the home and community. As reported by the CBC, Judge Jamie Campbell said he had a "sense of helplessness" when it came time to sentence the boy.

It’s no wonder that there is confusion as to what should be done to help this boy. He has been in numerous facilities from an early age when his grandparents (guardians) asked the Nova Scotia Department of Community Services to intervene in 2009. He was placed in several institutions and group facilities and foster homes not only on this province but also other parts of the country that had well known programs for difficult youth. His behaviour even included defying court-imposed restrictions numerous times. It was obvious that the grandparents as well as the court system and the services available in the community were not effective in changing this boy’s behaviour.

How this situation is being portrayed in the media and the youth’s existing behaviour exemplifies how difficult it is for available programs to adapt to individual situations. Most programs developed in the community think about services and programs as being set up to serve numbers of children and youth. In fact, children and youth are referred to these programs with very difficult behaviour for which a specific specialized program may not be appropriate. As the community develops these programs we end up with an array of programs and services which cannot serve all children and youth referred to them. This is simply because there will always be a child who will not fit the program. The community is then left with the dilemma of finding a program that is appropriate for the child or youth.

The next thing that happens is for the family and the community to blame the system for not responding to their specific needs. The system has great difficulty to plan for services not knowing well in advance what the treatment requirements will be for a future behaviour problem. However, the public expects that the system can and should respond to their particular need whenever it arises. The system responds and tries to develop services that are flexible enough to accommodate a wide variety of presenting problems. Yet this approach does not allow for extreme behavioural situations.  

The prevailing approach over the years has been to remove the responsibility from parents and set up controlled settings where problem behaviour can be modified. It is what society did in the early days to treat mental illness. That is, set up large institutions where mentally ill patients could be placed with the expectation that the patient will be treated hopefully cured and then returned to the community. This was followed by dismantling the large institutions with a preference for small scale facilities such as group homes and supervised apartments where mental illness could be treated in the community. Service planners have learned from the past and now, for some children, the group home solution is being substituted for treatment in the child’s own home supplemented with appropriate services in the community. This presupposes that appropriate services can be made available in each community – a requirement that may be unreasonable or too expensive. The insistence that appropriate services should be available in each community where a difficult problem occurs so that a child or youth can live at home with parents would be difficult to impossible to develop. Its positive aspects are that parents are required to take part in the treatment which they must do in order to responsibility raise their child.  It does not let the parent off the hook by handing over a difficult child or youth to someone else to assume responsibility in their place. Professionals are now insisting that parents take an active part in treatment. Sometimes this means that the parent themselves may need treatment for behaviour that has been transferred to the child or youth. Unfortunately there are other situations where the destructive behaviour of the parent is the cause of the child’s problem. If something cannot be done to correct the parent’s contributing behaviour then a decision needs to be made to treat parent and child separately. This often means that a court has decided that the child must be removed from the home and not the parent because there is no law to force the parent to leave their own home. Courts are reluctant to remove children from their parents and usually is done as a last resort when all else has failed.

So, the prevailing approach to treatment of children and youth is to have a continuum of treatment options available - specialized foster homes, group homes, institutions and parental homes with community support services readily available. There will always be the need to search for specialized programs that exist in other parts of the province or country. No province can have every conceivable program readily available when needed. Unfortunately out-of-province treatment will need to remain an option in rare situations and it is regrettable that such treatment separates parent and child which is a negative factor that needs to be evaluated before placement.

Our government health system has many demands for services and programs for adults as well as children and youth. It does no good to blame one segment of the community or the other. What is needed is a collaborative effort of all interested parties – parents, government and professionals. Often it takes the judicial system to bring all parties together to focus on the needs of a child or youth. This is what seems to have happened in the current case reported in the media. Apparently the latest court hearing was focussed on a new program of the IWK Health Centre called the Halifax Youth Attendance Centre - an individualized treatment day program that allows a youth to return home each evening. Time will tell if it is too late to be effective for this young person and his guardians.

WikiLeaks: Shooting the messenger

One of the best ways to reform social policy whether it is national or international, is for the facts on which it is based to be open and transparent. Policy often comes down from high with very little information for the public to take part in a meaningful debate. Knowledge of all the information that is available is vital for a well-informed public. Attempts to keep information secret only leads to suspicion and distrust of those who are promoting the policy. In our political system almost every day in our legislatures we see the refusal of the government party to provide satisfactory answers to legitimate questions from the opposition parties.


Since 2007 WikiLeaks, a not-for-profit media organization, has been reporting and publishing information for the public to make informed decisions as to what actions they wish to support. What is unique about WikiLeaks is that the organization has developed technologies to enable contributors to send information with impunity to support their news gathering ability. One of the major reasons that prevent whistleblowers from exposing themselves has been the reprisal that they could face from superiors or those who would suppress the information. Often the suppression of information is justified on the basis that it would compromise "national security" another vague term that does not explain how security would be compromised. The United Nations Universal Declaration of Human Rights promotes the ideal that all persons should have the right to freedom of opinion and expression including the right to seek, receive and distribute information and ideas through any media regardless of national boarders.

A familiar tactic by those in authority is to vilify those with opposing views rather than a frank discussion of the facts. It seems to be a juvenile tactic that one might witness during an argument between two children not high-level senior officials. What is required for informed debate is an honest discussion of the known facts or recognition that all the facts may not be known.

Another disturbing tactic is the attempt by those who promote changes in policy to engage in rhetoric that does not discuss the facts but rather speaks in pleasant generalities that no one can oppose. It only encourages others opposing the policy to also speak about it in general terms, which does nothing to clarify the debate.

A headline today from the Associated Press reported, "China ordered hacking of Google – sources". The information attributed by WikiLeaks mentioned a cable about the hijacking attacks against Google was classified as secret. In other words the public would never have learned about these discussions unless the cable had been leaked. Of course the media organization is required to try and confirm the information with the source or state that the information is unverified so that the public can form their opinion or perhaps treat the information with skepticism. If people have all the information verified or not, reasonable people will form reasonable conclusions.

Another media report from the Associated Press, in which a leaked cable by a US Ambassador stated that President Karzai was "an extremely weak man". A statement like this can jeopardize relationships. In this case the US official defended the cable by stating: "We are determined not to allow the reckless actions of WikiLeaks to harm the strong and strategic relationships we have built over many years with many members of the government of Afghanistan". Rather than offer an explanation of why he thought that Karzai was a weak man, the spokesperson attacked the news organization for harming the relations with the Afghan government. It may be true that Karzai is a weak man or he may not be weak, unfortunately we may never know because the spokesperson chose to divert attention from the message to vilifying the messenger.

There are two positions that need to be considered here. One is the right of persons to express their opinions freely and the other is to have at their disposal all the information they need to make an informed opinion. Inherent in the latter is access to the information, which can only be supplied by those who are privy to the information. If the information is suppressed or considered secret how can an opinion be expressed and the universal right be maintained? Therefore, the media finds itself in the position of protecting the identity of their sources and in the case of WikiLeaks, have developed elaborate internet technologies that will not only encourage persons to contribute but have virtually assured them protection from detection if they decide to provide information.

What is most disturbing is the attempt by some to shut down national servers using technology (for example the United States and China among others). This has had, to date, very limited success mainly due to the WikiLeaks technology and also the support of friendly organizations who have agreed to host the WikiLeaks website termed "Mirrors". It is assumed that as long as this happens that no nation will be able to completely shut down the WikiLeaks site.

What we need in society are people who are willing to demonstrate integrity by controlling what they say about others in private especially if it is based on rumor or unsubstantiated information. To say one thing in private and the opposite in public is deceitful and leads the public to wrong conclusions. As well, attempts to denigrate the messenger is seen for what it is – an attempt to deflect the truth.