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The Current Transcript for June 24, 2016

Host: Piya Chattopathyay

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

I hereby give notice that I have certified the following: the total number of votes counted favour of leave was 17,410,742. This means that the UK has voted to leave the European Union.

[Sound: crowd cheering]

PIYA CHATTOPADHYAY: And with that, a plan that began nearly half a century ago to bring stability and unity to Europe, a project that had 28 members, is now down by one. And as Britons voted to leave the EU, the slogan "keep calm and carry on" comes to mind. Because this morning, global markets are far from calm and the British Prime Minister says he will not carry on in his role for much longer. In a few moments, we'll talk about what happens now, after the Brexit. Also today…

SOUNDCLIP

Meet John. He's currently a patient in critical care, and is struggling to get a good night's sleep. Critical care is a busy place, and a number of factors disturb patients during the night, interrupting their normal day-night routines.

PC: From the beeping of machines to doctors and nurses coming round to do tests, getting a good sleep when you're in the hospital is hard, especially for children. And healthcare professionals say that's not helping in the healing process. We'll talk about what's to be done a little later on.

And after that…

SOUNDCLIP

They were turning without slowing down at intersections, they were running through stop signs. And unfortunately, there was a death in our community.

PC: It's what prompted Meghan Sherwin to remind drivers to slow down, kids are at play. A neighbourhood campaign that has now spread across our country. We'll hear about that, and we'll also go to Sweden, where roadway design has been changed to try and bring pedestrian traffic fatalities down to zero. Hello, I'm Piya Chattopadhyay and this is the Friday edition of The Current.

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Brexit: what happens now?

Guests: Eric Reguly, Nahlah Ayed

SOUNDCLIP

VOICE 1: I'm shocked; I'm gutted, genuinely. I feel very emotional. You look at the stats today morning, about who's actually voted, and the people that have voted to leave are the older generation who won't have to live with this.

VOICE 2: I'm really delighted. I think there's a lot of talented cities up and down our country that have been damaged by the European Union, you know, particularly places on the coast. I think this is just a vote against, just, you know, the out-of-touch politicians in Brussels.

VOICE 3: I think it's an absolute disaster. An absolute disaster. I think it's appalling that nearly 30 per cent of the country didn't vote; I think it's appalling that only just over a third of the country have caused us to leave a union that we've been in successfully for 40 years. I think it's a massive error.

VOICE 4: Nobody on the leave side seems to know what's actually going to happen now. The markets have totally crashed, the pound's down to a record low, and I'd be interested to see which politicians are going to stand up now and say, this is what's going to happen, this is the plan. There doesn't seem to be a plan.

PC: Some voices from the streets of London today reacting to the Brexit vote. 52 per cent of voters in the United Kingdom made it known they no longer want to be part of the European Union. And with the remainder, 48 per cent, saying they wanted to remain within the EU, the UK is a very divided country today. The pundits and polls predicted the vote would be close; still, there is much shock and concern. The British pound is taking a pounding, as are global markets, and David Cameron says with the results, he will step down as Prime Minister in the coming months. The CBC's Nahlah Ayed is in London and she joins us now. Hi, Nahlah.

NAHLAH AYED: Good morning.

PC: Wow, a lot of people, that's what they're saying this morning. What's the mood in the United Kingdom?

NAHLAH AYED: You know, Piya, it's actually-- I was thinking about this before beginning this chat with you, and I just can't say more than it's incredibly hard to know where to start here. In addition to being stunned at this historic result, which as you say, was very close and people had expected it to be close; I think people are just reeling because they're waking up to hours' worth of developments that normally take years to happen in any country, never mind here in Britain. And so the political landscape in just a few hours has been transformed, and so people are waking up, as you mentioned, to the prime minister promising to leave within three months-- essentially, to a live leadership contest that's going on in the Conservative Party. Also, a challenge to the leader of the Labor Party; talk about a possible second referendum in Scotland; one, perhaps, for Irish unity. Imagine all of those really significant political milestones, if you will, coming together in the last few hours. So people are really quite surprised and shocked this morning.

PC: And as we heard from that one man on the streets of London, I mean, everyone was so focused on what the results of the vote would be, all the repercussions hadn't really been talked through in any fulsome way until sort of this morning. And as you say, it's all sort of just, you know, dumping on everybody. Like, this has political, economic, international implications. I want to ask you about the Prime Minister. David Cameron says-- he really staked his reputation on this referendum. Now he says you know, it's clear, I have to go, and he says he'll do that in the coming months. Many people say though now that he didn't have to call this referendum. That he didn't even need it. I mean, put this in context: how do we get to today and what is it really signifying in terms of the politics?

NAHLAH AYED: It is a question that's being asked here by ordinary people, as well. In the lead-up to this, Piya, we talked to a lot of people who wondered exactly the same thing: why were they voting on what, as far as they were concerned, was not one of their top ten issues that are facing British society or British people? What happened essentially is that David Cameron was strong-armed into holding this referendum post-election to settle a dispute within his own party. And as you saw, the party was divided; it was torn apart over this issue. There were the rank and file among the Tories who wanted to have a referendum, who are Eurosceptic and who are not thrilled with the continuation of the status quo, if you will, with the relationship with the E.U. So he promised this referendum, he held it. And at the time he promised he would do it, he, I believe, felt fairly confident that the result would be anything but what you see today. So that's where it all began, Piya.

PC: And of course for those who are claiming this is a great victory, people like Nigel Farage of the U.K. Independence Party. The strongest proponents for leaving the E.U., what does it mean for them?

NAHLAH AYED: It is-- clearly, we heard more from Nigel Farage than just about everybody else, and right from the moment that he cast his vote. And as you can imagine, this has been a lifelong project for him in particular, for that party, the United Kingdom Independence Party. So the Eurosceptics, obviously, you know, they said the genie is out of the bottle and will have to be taken very seriously on the political landscape here, despite the fact that they didn't do as well in the election, which as you recall, I think they won one seat. And so that changes the landscape there. They will have a bigger role, a bigger voice, and also they will have to contend with the fact that the supporters of that party are not the traditional-- you know, they are the anti-elite, they are anti-European, and their voice has now been heard.

PC: Okay, so that's the political side. On the economic side, the remain side warned about the horrendous impact leaving the E.U. would have on the economy, and we're seeing at least the immediate results of that with the pound taking a very big hit this morning, global markets. Just give us a sense of what's going on economically.

NAHLAH AYED: It really has been a rollercoaster, Piya. Yesterday the pound, even as the numbers were coming in, the pound reached quickest one day drop ever, and also the lowest rate it has been since 1985. The markets obviously also reacting. In fact, this morning people are saying that the U.K. is no longer the world's fifth largest economy because of what's happened to the pound and because of what's happened to the market. It has been a stunning plunge and people worry about what this might mean just in the short term. Of course, as you saw, there's a great amount of emphasis right now on stability, on reassurance. And so you saw words from the Prime Minister talking about that things aren't going to change immediately. If you live in Europe and you're British, things are okay. People can still travel in the same way and do business in the same way. Of course, Mark Carney, the Canadian head of the Bank of England was up early and also spoke very shortly after the Prime Minister to reassure the markets. Very soothing words saying that they have contingency plans, they're prepared to do what is necessary to ensure that there isn't a hemorrhaging beyond what was seen today.

PC: And what happens next, Nahlah, in terms of how does the United Kingdom exit the European Union? What's the timeline?

NAHLAH AYED: Well, the Prime Minister has set out a bit of a plan, and it wasn't one that necessarily everybody had expected. He did not invoke the so-called article 50, which is the article which would begin the process of negotiation to remove Britain out of the E.U. He said that he would leave that for the next prime minister. He, again, in the interest of stability, said that he would stick around for three months, that by October he hoped there would be a new prime minister and that that person will then perhaps invoked that article. And that would start a clock of about two years in which it's supposed to conclude a conversation between Britain and the E.U. on the terms of how this country would separate from the E.U. And so that's the timeline. Whether it is that easy, I mean, people have talked about a multi-year process despite this two year deadline. It's really difficult to say, because this is unprecedented. No one else has ever done this.

PC: And Nahlah, there are people who say this is beyond politics, is beyond economics. That there is a cultural divide in the United Kingdom. That really this country, the country you're in, is about two different countries. Speak to me about what that divide, how it's playing out?

NAHLAH AYED: It's really been interesting, Piya, because even leading up, some of the polling really sort of highlighted some of these divisions. And they're not familiar, of course, because this is only the third referendum ever held in the U.K., and the second about the E.U. So normally, it isn't kind of the, you know, one side versus another. Obviously, in normal elections, you've got a spectrum of different parties and it's difficult to judge those forces that divide people. But in this one, it was very stark. When you look at leave versus remain, it was older people respectively versus young people; those with university education as opposed to those with lesser education; those who are considered the elite as opposed to those who are working class. And so we heard about families obviously being divided by this, people saying, 10 per cent of respondents in one poll said that this issue had driven a wedge in their friends' group. And so it's a very stark division, and although they have always been political divisions here, this is a polarization. And what people are talking about is that not only is there a need to heal that rift, but there's got to be a way to include that voice that has long been excluded from British politics, and that is that nationalist anti-European voice which has really made itself heard.

PC: Nahlah, good to talk to you, thank you.

NAHLAH AYED: Thank you, Piya.

PC: Nahlah Ayed is a CBC correspondent. She was in London, England. Well, the replications of Britain leaving the European Union are enormous politically, economically, locally, and internationally. The Brexit is going to have very big implications. Eric Reguly is the European bureau chief for The Globe and Mail. Eric's in Rome, hi Eric.

ERIC REGULY: Hello. Good morning.

PC: So what's the reaction in Europe?

ERIC REGULY: Well, it's fear and loathing. I mean, obviously, there is a fairly large possibility that Britain would leave the E.U., but I don't think anyone, any of the leaders took it that seriously. In fact, the polls, the markets leading up to the vote last night were very much in favor of Britain staying in the in the E.U. And kaboom, you know, shortly after midnight. But about mid-morning our time, the polls started going against remain, and Europe is now in shock. I mean, the E.U. is about to lose an economy that's tied with France for the second biggest economy in E.U. It's about to lose a NATO member, it's about to lose its most liberal economic voice, its only English speaking country. It is a dead loss for the E.U., and the danger is there could be me, too referendums in the E.U. in the coming years.

PC: Meaning what? Who's the me, too?

ERIC REGULY: Well, that's a good question. The support for, the approval ratings for the E.U. in general have been dropping in recent years I mean, roughly only half of Italians, I live in Italy, only half of Italians support the E.U. And that's ironic, given that E.U. thinks, it actually takes credit for inventing the European Union. Now, the Treaty of Rome was in 1957, it was inspired by Italian political philosophers, the whole notion of the E.U. Already, the right wing party in the Netherlands headed by Geert Wilders is demanding a referendum. In France, Marine Le Pen who's head of the Front National is demanding a referendum. I'm not sure they'll be one in Italy, which is the fourth biggest E.U. economy, but there could be. And the polls say if one was held, roughly half the people in Italy would vote for exodus from the E.U. So the E.U. is losing popularity, and this is going to give other countries the idea to hold referendums, as well.

PC: I know it's early hours, but I mean-- and not to be fear and loathing, but is this possibly the beginning of the end of the E.U.?

ERIC REGULY: Oh yeah, I think so, yeah. I mean, it's almost akin to a Lehman moment, which started the night of the 2008 financial crisis. It's a body blow. It's a huge, it's a huge, huge, shock. And obviously, the E.U. now already in Brussels, the E.U. leaders are hoping this could be an opportunity to bring what's left of the E.U., the rump E.U., even closer together, now that the main Euroseptic part of Britain is on its way out. But the opposite could work. I mean, the opposite could work in the sense that there's centrifugal forces in play. There is an anti-E.U. sentiment very much entrenched in several European countries. There's a rise of anti-E.U. parties, like, as I mentioned, France's Front National. It could backfire, I think, you know, there's going to have to be a total rewriting of the European integration project.

PC: Okay, let me take you to the United Kingdom, which you cover, of course, and specifically how this vote sort of broke down, because it was very-- Scotland, for example, the First Minister Nicola Sturgeon is saying that that this decision to leave the European Union is a mistake, and she said that Scotland will take all possible steps to secure Scotland's place in the European Union. So in Scotland, possibly another referendum on independence. What kind of turmoil lies ahead for the U.K. when we're hearing things like that?

ERIC REGULY: Well, you can see what's happening. Because of an unnecessary vote by David Cameron, the U.K. prime minister who resigned this morning, he has endangered two full unions: the European Union and the United Kingdom. Scotland, two or three years ago, had a referendum on, a Québec-style referendum on separating from the U.K. It lost it narrowly. But in this referendum, most of Scotland voted in favor of remaining in the E.U., as did most of London itself, as did most of Northern Ireland. The rest of the U.K.: north, northeast England, the west of England, voted the opposite, to ditch the E.U. So Scotland's saying, look, we're not going to allow England to our South to drag us out the E.U. We're going to hold a referendum, I have no doubt they're going to win it, a separation referendum, and they're going to be on their way. So you're going to have at minimum United Kingdom broken into two pieces, two separate countries; possibly three, Northern Ireland votes to unite with Republic of Ireland.

PC: And just to be clear, the British Prime Minister David Cameron says he will resign. He hasn't resigned as of this morning, he says he'll do that in the coming months. But Eric, you say it was an unnecessary decision by him to hold this referendum. Why do you say that?

ERIC REGULY: Well, because it was a parochial matter. He had a Eurosceptic rebellion in his conservative party, and he, in an attempt to quell it, he decided to hold this referendum-- no doubt thinking that he was going to win it, right? It probably didn't even occur to him that he could lose this referendum, and it went against him. So what he's done, he's gambled not only the future of the E.U., but the future of the U.K. for a parochial, unnecessary referendum. It was a huge gamble. I mean, this is a geopolitical disaster for Europe. It's inconceivable that virtually overnight, the entire E.U. and the U.K. can be broken into pieces. Don't you find that incredible?

PC: I think many people are finding it incredible this morning. I also want to ask you about Greece, because there was so much talk about the Greek debt crisis and its place in Europe. Is Greece smiling this morning?

ERIC REGULY: Oh, yeah. I mean, well, yeah, there is a wry smile because little Greece for the last five years has been the single biggest threat to European Union integrity. I mean, it was either going to leave the Eurozone and the E.U. or get pushed out or both. And now, who would have thought that the second biggest economy in the E.U., Britain, was the one that was going to pull the trigger on the E.U.? And I imagine in Athens, they're laughing about this. The irony of it all must be just absolutely delicious. And at the same time, I doubt the Greeks are happy that this is happening, but it must strike some as quite funny.

PC: Eric, it's early hours in terms of digesting this, and many things are moving and in play now. But economically, what are you looking for beyond today?

ERIC REGULY: Well, the big thing I'm looking at is obviously the defect on the rump E.U. and the U.K. Now, the U.K. is an interesting story. The E.U. may decide to make an example of Britain. Britain is leaving, but it also has to renegotiate access to one of the world's biggest free trade zones. It doesn't want to pay tariffs for services or goods. Now, what if the E.U. decides, you know, to hell with you Britain, we're going to make an example of you. Why would you do that? So to discourage other countries from also leaving. So they could really punish Britain and make it very hard for Britain to create, forge a new trade agreement with what's left of the E.U. And the E.U. is still Britain's biggest market by far, it's about 55 per cent of trade goes into continental Europe. And if the E.U. gets nasty, the British economy could hurt very, very badly. And of course, the E.U. economy is going to hurt as well, because it also trades with Britain.

PC: And we here in Canada, as we wake up, and many people surprised at the outcome of the Brexit vote. But beyond being surprised, I mean, are there replications for us here?

ERIC REGULY: Sure, in a couple of ways. One is there's two transatlantic trade agreements: one that's in negotiation between United States and Europe, the acronym is TTIP; the other one that is negotiated but not ratified is the Canada Europe agreement called CETA. This could be the death blow to both agreements, it could be. I mean, these agreements have to be ratified in national parlance, will they do it? Maybe, maybe not. I doubt they're going to do it quickly, they've got other things on their mind. Also, there's Canadian companies in Europe: Bombardier of Montreal has a big aerospace factory in Northern Ireland; the Canadian banks like Royal, RBC, are big in London. They're in the U.K. partly because, you know, it's a big country, but also because it's part of the E.U., which gives them unfettered access to the E.U. That's going to disappear, so it could be that any new investments will be out of London, out of U.K., and in continental Europe.

PC: Eric Reguly, thank you very much for your take on all of this, appreciate it.

ERIC REGULY: Thank you, bye bye.

PC: Bye bye. Eric Reguly is the European bureau chief for The Globe and Mail, he was in Rome. Well what do you think about the Brexit vote? Do get in touch with us here at The Current, you can do so on Twitter @TheCurrentCBC. Post on Facebook, facebook.com/CBCTheCurrent. Or you can email us through our website, cbc.ca/thecurrent. Once you're there, click on the Contact Us link. A story that has ongoing replications that we will be following in the days to come. I'm Piya Chattopadhyay, you're listening to the Friday edition of The Current, we're back in just a bit.

[Music: Sting]

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Sleep crucial to hospitalized children's healing - and they're not getting enough

Guests: Dr. Sapna Kudchadkar, Robyn Stremler, Karen Haas

PIYA CHATTOPADHYAY: Hi, I'm Piya Chattopadhyay, and this is the Friday edition of The Current.

[Music: Theme]

PC: Coming up, how cities across the world are making streets safer for pedestrians. That story heading your way in a half hour. But first, why sleep is crucial to hospitalized children's healing.

SOUNDCLIP

VOICE 1: Spencer? Hey Spencer, wake up.

[Sound: Soft music, rhythmic beeping of medical devices]

VOICE 1: How are you? Are you okay? Do you want to see your mom? See, your mom is here.

PC: Hospitals can be frightening places for anyone, let alone children on extended stays in the pediatric unit. That video by Credit Valley Hospital in Mississauga, Ontario, aims to help children and their families prepare for being in hospital. And while a hospitalized child may be get round-the-clock medical care, turns out children staying in hospital may be missing one of the most important ingredients to their healing and their recovery - that is sleep. Now, new research is making a direct link between sleep and health, and hospitals are starting to pay more attention to ensuring children get a good night's sleep. Dr. Sapna Kudchadkar is an assistant professor of anesthesiology, critical care and pediatrics at Johns Hopkins Children's Center in Baltimore. A year ago, she launched an initiative to improve sleep in the hospital's pediatric ICU, the intensive care unit. She's in Reykjavík, Iceland today. Hello.

DR. SAPNA KUDCHADKAR: Hello. How are you?

PC: I'm okay. Take me into your hospital, or any hospital, for that matter I suppose. How well would you say children are sleeping when they're in the I.C.U.?

DR. SAPNA KUDCHADKAR: Well, I think any patient, adult or pediatric who's been in the hospital knows that sleep has definitely not been a priority one we care for patients because we have this constant need to be doing interventions, and alarms, and making sure that safety and patient health is of the utmost priority. But recently we've discovered that there are ways to optimize sleep for patients in the hospital, and specifically children during a time when we know that sleep is so important for brain development. So we've been working on that very closely.

PC: And is this true for children, I mean, no matter what ward they're in, whether they're in N.I.C.U., or like an I.C.U., or a pediatrics ward, are you seeing the link between those interventions and, you know, those beeping machines, no matter what ward they're on?

DR. SAPNA KUDCHADKAR: Yes, it's very true. It happens in the pediatric I.C.U., which cares for all ages of patients, but also in the neonatal I.C.U., but also on the general hospital wards. Our research is finding that despite being transferred to the general hospital ward when you might be a little less sick, there's still significant disruption of sleep and sleep continuity. So these children aren't receiving continuous periods of sleep, they're being woken up several times for various reasons.

PC: We're hearing a lot about, you know, children in general, I mean, outside of hospital settings, aren't getting enough sleep and how that is not good for their health. But put it in the context of while you're recovering or in the hospital for some medical need, how important is sleep to a child's healing and recovery?

DR. SAPNA KUDCHADKAR: That's a great question. So we know that sleep is really important for all organ systems, and that's for a healthy child and healthy brain development. So you can imagine in the hospital setting when you have all of these different ramifications of critical illness that affect all the different organ systems, if we don't impact circadian rhythms and improve them, that can also play a role in [audio breaks up] It's very important that we start to try to change paradigms in terms of how we look at sleep in the hospital setting, because we may actually be impacting the one thing that could play a major role in recovery over time.

PC: Okay, well let's talk about some of the things that you see needing to be changed. One of them is sedatives, many children are on sedatives while they're staying in hospitals. What did your research find about the connection between being sedated and getting a good night's rest, or enough rest, whether it be night or at other times of the day?

DR. SAPNA KUDCHADKAR: Great question. So we often, in the hospital, we use this term of sleep and sedation synonymously, which is really a misnomer because the sedatives are known to have disruptive effects on sleep. The most common medications that we use are opioids, things like morphine and benzodiazepines, things like valium or midazolam. And those medications are known to help you fall asleep, which, you know, many out in the community take these medications to help them fall asleep. But the quality of that sleep can be deleterious, so you may not wake up feeling as refreshed after taking those medications. And we're finding that's very similar in these sedated children in the hospital setting.

PC: And so what do you do? I mean, how do you go about-- I mean, get them off sedatives, I suppose would be your answer to my question in terms of sedatives, but how do you go about creating an atmosphere for children to get a better sleep in the pediatric unit?

DR. SAPNA KUDCHADKAR: Sure, it's definitely a culture change for us in the hospital setting and our adult colleagues care for adult patients have also started to work and are making strides. We have to start to think about, in terms of patient-centred care, sleep as an important part of that. One thing with children is we classically have thought that children need to be sedated and completely immobile in order to be safe. We're worried that they're going to pull out the breathing tube, or they're going to pull out their vascular devices. But we're starting to find that keeping children awake during the day and starting early physical therapy actually will help them sleep more at night and create these nice sleep-wake cycles. But again, it's a big culture change for the staff and also for the parents to make sure that we assure them that these children are comfortable and we're treating their pain, but at the same time, not over sedating them to that we can optimize their sleep-wake cycles. So this is the culture change that needs to occur.

PC: In Vancouver, at B.C.'s Children's and B.C. Women's Hospitals, they're working on a project to better serve infants, children, and mothers. And the chief project officer Dave Ingram says a lot of thinking went into these questions about sleep. And one of the important facets he talks about in the new building that they have is it's windows. Just take a listen to this.

SOUNDCLIP

Natural light coming into the room is important in terms of creating a healing environment, and it's also important in terms of helping patients understand night and day. If you're in a room with no window, it sometimes can be difficult to know what time of day it is, and that can knock your body's natural rhythms off. There are some areas where there can be great sensitivities to natural light. If you think about some of our very premature infants that we might treat in the neonatal intensive care unit, they can actually be very sensitive to natural light. Something we've done there is we've built in something called circadian lighting. This is where the lighting system in the room actually mirrors the natural circadian rhythms of the body. Mirrors day, mirrors night.

PC: All right, Dr. Sapna Kudchadkar, how much can lighting have a tangible impact on a child's sleep when they're in hospital?

DR. SAPNA KUDCHADKAR: It can have a significant impact, and he said it perfectly. You know, again, in a survey that we did internationally found that still most I.C.U.s internationally don't have windows with dedicated sunlight or lighting, and so we don't optimize the circadian rhythm of lighting, so that melatonin levels can change optimally. So lighting can claim a huge role, and our neonatal I.C.U. colleagues have started to do a lot of this work, but we need to start focusing on that in terms of architectural design of hospitals and making sure that there's a window that's dedicated for every child with streaming sunlight, because that sunlight during the day can play a major role in melatonin levels at nighttime that also helps to increase restorative sleep at night time, as well.

PC: You know, it's interesting, because as you're saying that, I'm saying, well, we know that. We know we're supposed to have blinds that open during the day and shut during the night, we know that in our own homes and things like that, to work better, for us to all get better sleep and light. It seems kind of obvious, how come hospitals haven't figured this out?

DR. SAPNA KUDCHADKAR: That's a wonderful question, and I get that question all the time. I mean, isn't this obvious stuff, Sapna? Well, it is but at the same time, we need to understand that in the past, the hospital setting has always been about reversing illness. That has always been a focus, and so all of the interventions that we do to reverse illness and make patients better, sleep kind of falls to the wayside. Because sleep is just such a basic natural part of what we do every day; when you're ill, It didn't take priority. But now that we're learning that all of these medications that we're using, many of them do have deleterious impact on sleep, that windows and sunlight are important. And also important for staff perceptions of their own work environment and sunlight, you know, we all feel better when we're getting sunlight, right? So all of these things, it's just a natural shift that we all need to make and our thinking that recreating the environment that's optimal at home is optimal in the hospital setting as well.

PC: I had my boys in a N.I.C.U., and I remember some staff saying to me, because I was beeping all night, and, you know, babies crying and all those things. They said, don't worry, this will turn them into better sleepers in the long run, because they'll learn to sleep with noise around them.

DR. SAPNA KUDCHADKAR: [laughs]

PC: [laughs] All right.

DR. SAPNA KUDCHADKAR: It's an interesting point.

PC: [laughs] What are some of the other changes you've made during your initiative to ensure better sleep?

DR. SAPNA KUDCHADKAR: So in in addition to making sure, for example, simple things like making sure the shade are set at a specific time of day. We're also trying to cohort-- it's things like meals, so it's not completely natural for us to be continuously fed 24 hours a day, correct? We all eat during the day, and for the most part, most of us don't eat at night. So we're trying to optimize meals during the day and making sure that we're not continuously activating the gastrointestinal system. Other things that we're doing are cohorting interventions, so unless an x-ray needs to be done emergently at 3:00 in the morning, we try to cohort that to the daylight hours, so we're not waking a child up unnecessarily, simply because of convenience factors; not giving baths at midnight to the six month old baby who is in the intensive care unit. All of these things are part of, we call it the pick you up initiative ,the pediatric I.C.U. Up Initiative, and also implementing early physical therapy. Often, we think that children are too sick to have physical therapy and early mobilization therapies offered to them; but at the same time, keeping these children active during the day can help them sleep better at night, which then again, keeps them more awake during the day to have that early mobilization activity with physical and occupational therapy.

PC: Thank you for your time this morning.

DR. SAPNA KUDCHADKAR: Thank you so much for having me.

PC: Bye bye. Doctor Sapna Kudchadkar is an assistant professor of anesthesiology, critical care and pediatrics at Johns Hopkins Children's Center in Baltimore. Today, we find her in Reykjavík, Iceland. Our next guest has spent hundreds of nights at the Hospital for Sick Children here in Toronto. Her son Tobin was first diagnosed with a brain tumour when he was just two years old. He went through multiple rounds of chemotherapy and radiation, when the tumour had come back twice. Karen Haas is with me here in Toronto, hi to you.

KAREN HAAS: Good morning.

PC: I imagine what you just heard sounds pretty familiar to you.

KAREN HAAS: It does.

PC: What were those nights like for you and Tobin in the hospital, those hundreds of nights?

KAREN HAAS: Well, filled with a lot of intense emotion, not knowing what he was going to face during the night, the next day, and we just took it a minute at a time.

PC: So like, would they come do tests in the middle of the night?

KAREN HAAS: During certain times of his care, it was necessary. I know the night that he was admitted, it was essential, just because they actually had to-- he was in extreme critical state, and they actually had to make sure that he was going to make it through the night.

PC: And on those nights that were a bit more, you know, not critical, where he was he was recovering or staying in the hospital, what were those nights like for both you and for him, in terms of sleep?

KAREN HAAS: He was-- when he was first diagnosed, he was so little, you know, it wasn't even a thought. For parents, it's different, but for kids... Actually, everything that the doctor just said, I think that Sick Kids is actually implementing and has done for quite a while because they do have the lighting, except for in the intensive care units. But on the wards, they do have the daylight. I know that they try to keep those midnight interventions out. They do have to come in and check, you know, for most kids, every four hours, all the vitals. Yeah, it's disruptive, and there's no place like home.

PC: And the thing for when you have a child in the hospital, is you're often in the hospital staying with them night after night. Where were you sleeping? You were pregnant at one point when Tobin was in the hospital, as well.

KAREN HAAS: Yeah, that's right, when he was first diagnosed. So those-- it's uncomfortable.

[Both laugh]

KAREN HAAS: You know, it's fantastic that they, actually they centre the care around having the parents with the kids, because kids need their parents. But you're sleeping on basically plastic.

PC: A chair.

KAREN HAAS: Well yeah, they have chairs now. They didn't back then. But yeah, it's a couch thing, they call it a couch, that turns into your bed. Usually there's no pillow, so it's just plain uncomfortable.

PC: And that affects your ability to help take care of your child while they're in hospital.

KAREN HAAS: It does. Yeah, I know, I was thinking about this and yeah, your mental state, your cognitive ability when you're not sleeping well, and the emotional impact, too. First, you have a very sick child, and then you have a reduced ability to cope emotionally. You know, when you get tired, you're a little more irritable, probably. You don't make good decisions, you can make mistakes. You're just not thinking properly. And this on top of…

PC: Having an ill child.

KAREN HAAS: Having a very ill child.

PC: And the hospital, there were other parents there, obviously, because you were at the Hospital for Sick Kids, I mean, was this thing about sleep and not getting enough and all the time to get interrupted-- for, as you say, good reason, and sometimes maybe reasons that could've waited till the morning. Were there other parents and you talking about why aren't we getting enough sleep? This is kind of crazy.

KAREN HAAS: It's a state of being for parents in the hospital, just kind of, yeah, wandering. If we do get up and leave the room... there's not actually not a ton of communication. Well, I didn't find any. Maybe because we're also focused on our child and we're exhausted, and opening up communication with others isn't possible.

PC: What do you want hospitals to think about, given your experience at one, in terms of getting children to have a better night's sleep?

KAREN HAAS: Well again, like I said, I do believe Sick Kids is addressing this, and has been for quite some time. But for this to be every single hospital, for that normal daytime activity, the light, the physical therapy, occupational therapy to begin, and not to get the kids into sleeping on and off all day, because I think then the adjustment when they get home is hard. And simply, kids need sleep.

PC: How old is Tobin now?

KAREN HAAS: He's 16, just finished grade 11.

PC: 16! How's he doing?

KAREN HAAS: He's fantastic. He actually wants to be a nurse, and yeah, he's fantastic. 14 years, and going through this three times over the years. Yeah, remarkable.

PC: Thank you for coming in and sharing your story.

KAREN HAAS: Thank you so much.

PC: Karen Haas spent many nights at the hospital with her son Tobin while he was getting treatment for a brain tumour. Karen was here with me in our Toronto studio. Well, our next guest has done a survey of hospitals in North America looking at how they're protecting the sleep of children and their parents. Robyn Stremler is an Assistant Professor, at the University of Toronto and an Adjunct Scientist at The Hospital for Sick Children. She's in Cavendish, PEI, this morning. Hello to you.

ROBYN STREMLER: Good morning.

PC: So how much attention is this issue of children's sleep in hospitals getting in our country?

ROBYN STREMLER: Well, you know, I think as you've heard from Karen and Sapna, some attention but I think we've always got room to grow.

PC: And when you look at hospitals across our country, beyond what the doctor and Karen said, are there things that you see that are contributing to a lack of sleep for our children?

ROBYN STREMLER: Yes, and you know, for their parents, as well. So when we talked to hospital administrators, yes, you know, there were lots of things they were trying to put in place, but not all hospitals have formal policies related to sleep in hospital. Things might be a bit informal, and then it's harder for those policies to come into place. Things like visiting hours, families' abilities to be together, the kinds of provisions and tools they give families to help their child sleep better. Those things aren't always in place.

PC: And as you did your survey and looked at hospitals across North America, you said those things aren't always in place. Are increasingly, are more hospitals getting this, that they need to put these things in place?

ROBYN STREMLER: Yes, certainly. And as hospitals redesign their environments, those are just perfect opportunities to redesign rooms. You heard from Karen about the difficulty of the sleep surfaces that we provide to families, whether pillows are available; the kinds of materials that are used in the room, whether they're sound buffering or not; the advances in equipment, so what kinds of signals are sent out by the equipment, and how did they come to the nurses and other health care professionals who need to respond. So instead of a loud noise in the room, can a message be sent to a pager or a mobile phone that the nurse is carrying? So certainly, there are advances being made.

PC: Why is it-- you know, we've known forever that sleeping on a plastic chair does not elicit a good night's sleep. Why has this not been taken care of until now? I mean, why is this sort of being seen as a "new thing?"

ROBYN STREMLER: Well, you know, I think the great news for us who care a lot about sleep is that it's really gained attention in the health promotion field, and I think now we're seeing that filter into the more acute care. So we just recognize more the importance of sleep to acute care, and that, I think, that's why hospitals are now saying, oh yes, of course, you need to sleep at home, we need to pay attention to that in hospital as well.

PC: And you said people are paying more attention to this now, especially people like yourself, who are interested in this issue. How challenging, though, is it, you know, within a healthcare setting, many of them challenge financially, and in terms of priorities, how challenging is it to make sleep a priority?

ROBYN STREMLER: It is challenging, but I think there are ways to be creative about it and I'm really excited about a project that my colleague Krista Keilty and I are going to be taking on at Sick Kids. Sick Kids has the Ronald McDonald House family room. It's a relatively new room. So it's taken a not very large space, and taken a portion of that space and installed sleeping pods. So these are like first class airline cabin seats that recline, they're in a cozy little pod, and the room is staffed so that parents can slip away from their child's bedside to grab a couple of hours of sleep. You know, in my research when we talk to parents, they really struggle with the decision around when to stay at their child's bedside and when to go. We think they might sleep better at home, but they actually tell us they're waking up frequently, worrying about how their child is in hospital. So this is kind of a perfect blend: you're still near your child, there's staff there who can reach you if you need to go back to your child's bedside; and yet, it's a home like environment, comfortable, safe for you to sleep, and so we're going to be evaluating how much extra sleep this helps parents get and what's the impact on other important health outcomes like their stress, their ability to make decisions about their child's care, those kinds of things.

PC: And when we talk about hospitals that are outside of specialized children's care, so outside of, you know, Toronto's Sick Kids or B.C.'s Hospital For Children, I'm talking about the regular hospital anywhere in this country, whether it's rural or urban, that serves most of our children, has a pediatrics ward. Are they also making the kinds of changes that you'd like to see?

ROBYN STREMLER: That's a good question. We focused on pediatric hospitals in our surveys, so I don't have a sense of what more community-based rural hospitals are doing. But the challenges are the same everywhere. You know, you've got to build in the design elements for families to be together, but the issues also go beyond design. So even if you can't change the design of your setting, there are things that we can do for the children themselves. We know that the environment has an effect, but simply being ill has an effect. Kids get overly sensitive to being interrupted for interventions, and so I think an important avenue to explore are ways to help children fall back asleep once they have been interrupted. We know we need to wake them up for certain procedures, but how do we help them get back asleep? And one of my doctoral students developed an intervention using a book that helped lead children through a relaxation breathing technique. So when they were awoken, they would use the relaxation breathing to help calm themselves down, get themselves back to sleep more quickly. We know kids are woken up seven, eight times a night at a minimum, and she found that that strategy helped children get about 45 minutes more sleep a night. So we need to think not just about the design, but about the experience. And those are the kinds of things that no matter what your physical environment is like, you can implement.

PC: Robyn Stremler, thank you.

ROBYN STREMLER: Thank you.

PC: Robyn Stremler is an Assistant Professor, at the University of Toronto and an Adjunct Scientist at The Hospital for Sick Children. Today, she's in Cavendish, PEI. I'm Piya Chattopadhyay, you're listening to the Friday edition of the Current.

[Music: Sting]

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The target for traffic fatalities should be zero, advocates say

Guests: Meghan Sherwin, Matts Belin, Pamela Fuselli

PC: Hi. I’m Piya Chattopadhyay and you’re listening to the Friday edition of The Current.

SOUNDCLIP

What's happened in Toronto is you’ve kind done street by street, ward by ward, depending on whether a particular local elected representative saw a problem. And I think we need now a comprehensive plan because it's happening across the city. It's happening disproportionately to senior citizens and I think the time has come to take an overall approach with regard to road design, speed limits, technology that you’re using, accommodation for seniors getting across the street, and put a plan in place that makes people safer bottom line.

PC: That was Toronto mayor John Tory speaking on CBC Radio earlier this month about traffic safety in the country's largest city. As he mentioned, until now, the city has never had an overall strategy and deaths have been on the rise. Last year, 64 people died in Toronto in traffic accidents. That is higher than the number of deaths caused by gun violence and most of those 64 people who died in traffic accidents were pedestrians. Toronto certainly isn't the only city with a traffic safety problem, but there are many different approaches out there, so today we are asking what some of those strategies are and what cities in Canada can learn from them. If you live in Ontario you might be familiar with one community driven effort to slow down traffic. They’re white lawn signs with a child's silhouette and a slogan reading, Slow Down, Kids At Play. Meghan Sherwin is one of the co-founders of that campaign and she's in Toronto. Hello.

MEGHAN SHERWIN: Hi.

PC: Why did you start the campaign?

MEGHAN SHERWIN: We started the campaign out of a single frustration. As community residents, the only access we had to our political councillors and our policemen were by just calling and complaining about the speed of vehicles in the neighbourhood.

PC: Because they were so fast going down your own street.

MEGHAN SHERWIN: They were coming so incredibly fast. They were turning without slowing down at intersections. They were running through stop signs. And all we did as parents was really just call the councillors and community leaders asking for help. Unfortunately, there was a death in our community and we realized collectively as parents that asking other people to do things just wasn't enough.

PC: Tell me about the accident in your neighbourhood.

MEGHAN SHERWIN: It was on a sunny day. It was a young girl and she was walking home from camp and a car turned at an intersection and, unfortunately, she was struck and killed.

PC: She was crossing the road safely according to the law?

MEGHAN SHERWIN: Correct.

PC: And the car hit her and she died. This is what year?

MEGHAN SHERWIN: 2014.

PC: Okay. You have you have kids?

MEGHAN SHERWIN: I have two boys, seven and five, that play at that park and cross that intersection almost every day.

PC: So, when you hear about this accident you’re thinking what?

MEGHAN SHERWIN: it could have been anyone's child, including my own.

PC: And that's what prompted you, really, to say, I need to do something. But we, as you say, residents and parents, we can’t just always rely on politicians. So, you start this campaign.

MEGHAN SHERWIN: Yes, literally, the night of the accident a group of us were on our front sidewalks and cars were still driving quickly and we thought we had to do something. Just calling and complaining just wasn't enough anymore.

PC: So, where did this idea come from, putting up the lawn signs?

MEGHAN SHERWIN: Really, it was about that collective voice and something easy. You know, it's easy to pick up the phone and that's why people do it. So what else could we do? But that was visible, because what we found was, as we talked amongst ourselves as a community, we had all singlehandedly just called the police, but no one knew that your neighbour was calling as well and the person across the street was calling and emailing. So, we wanted something that was visible so that everyone in the community knew that we cared about this issue, because what that meant was we could make it a priority for the councillors and the police because they could see this groundswell of support around a single idea.

PC: And is your neighbourhood unique, in the sense that, you know, there's a lot of turns and signs, or could this be any neighbourhood in Canada essentially?

MEGHAN SHERWIN: We believe it’s any community in Canada and we've seen significant support across Canada for this campaign. The signs and people that have reached out to us are across Canada. So, we've seen people from Victoria and Markham and PEI, Calgary, even New York and Ireland. It's across the country, but across the world.

PC: So, take me back to your neighbourhood. So, this night in 2014, you guys said you were going to do this. A few months later these signs start popping up in your neighbourhood?

MEGHAN SHERWIN: About a week later.

PC: About a week later. Okay. So, we’re two years since that time about.

MEGHAN SHERWIN: Yeah.

PC: How’s traffic in your neighbourhood? How’s the respect for pedestrians and cars and that mutual respect going?

MEGHAN SHERWIN: I think there is an open dialogue now. Before, I think it was private fights with the councillors on our own and now people are talking about it out in the open and as a community rallying behind this and trying to fix it.

PC: And in terms of-- You talk about that corner where people speed by, I mean, are these signs making a difference?

MEGHAN SHERWIN: Yes, I believe so. Now, granted, everything is a complex issue and are we the sole person or group responsible for change? I don't think so. I think it's complex. But I will say there have been differences in our neighbourhood, so no rights on red, some of the arterial streets have slower speed signs now, and it has become a priority for our councillor. I do speak to him on an ongoing basis about road safety and the strategic plans around our school. So I do believe that it has improved and we're just one cog in the wheel that made that happen.

PC: I have to say, because I know these signs are across Canada and in my neighbourhood in Toronto as well and when I'm driving—

MEGHAN SHERWIN: Yeah?

PC: When I see them, it’s just a kind of reminder: Oh, yes, of course. Be more cognizant. I mean, it's kind of silly that and shameful on my own part that I need that reminder, but it's a reminder that there's lots of people on these roads and kids and to be mindful of them.

MEGHAN SHERWIN: That's exactly it. And that's what we're trying to do with the silhouette of the boy - and there's a silhouette of a girl as well - is just words on a sign aren't enough. We really wanted to connect it to the hearts of drivers and remind them that these are children. It's not just a stick drawing. It's not just a word. These are little children that really are still learning all the rules.

PC: Yeah, they can be unpredictable at times. My own sometimes jump out onto the street and I’m like, what are you doing? Have you not heard me? But, alas, they’re children. So, you said these signs-- You're getting calls from across the country, they are across the country. Are there common themes that you hear when people call you?

MEGHAN SHERWIN: You know, there's one that always sticks out for me and it's a woman, she's up in Northern Ontario and she lives across the street from a park where children play and she's not even a mom. But she's terrified of all these trucks that drive by and she's called the councillor, she's called the police and complains and nothing's happened and she lives across from this park and she's terrified that something will happen. So, every day, literally, every single day, she told me, she goes outside and waves her hands to try to slow down these trucks and she writes down license plate numbers and she's just she knows she's one person and she's trying to make a difference, but for her the signs are just another way for her to try to make that difference.

PC: So, you say you now have the ear of your councillor and, as we heard at the top, whether it's Toronto’s mayor or other municipal and other politicians, you want them to do something about it. What do you want politicians and planners, here in Toronto, other cities, to think about when they're designing traffic systems?

MEGHAN SHERWIN: Comprehensive plans. And I know that's not easy. If it was easy—

PC: What does that mean?

MEGHAN SHERWIN: It means looking at every aspect of the community in its entirety. So, it's not about just looking at arterial roads. It is not just looking at school zones. It is not just looking at intersections. It's looking at road design. It's looking at sidewalks. It's looking at the through fares and trying to recognize this ecosystem that exists and coming up with a holistic plan. One of my biggest concerns about what's happened in our community is they made choiceful decisions on where to impact change and, yes, those are meaningful, but without that holistic view, we're not going to solve the problem.

PC: Meghan, thank yo.

MEGHAN SHERWIN: Thank you.

PC: Meghan Sherwin is the co-founder of the Slow Down, Kids At Play lawn sign campaign. She’s in Toronto. Sweden has some of the safest roads in the world, according to the World Health Organization, with only three deaths per 100,000 drivers. By comparison, in Canada that number is 5.2, according to Transport Canada. About 20 years ago, Sweden adopted a strategy called Vision Zero, with the explicit goal of reducing traffic fatalities to zero. Many countries consider it the gold standard in road safety. Matts Belin is the Project Manager at the Vision Zero Academy, which is part of the Swedish Transport Administration. He is in Borlänge, Sweden. Hello.

MATTS BELIN: Hello.

PC: Tell me about the Vision Zero philosophy. What makes it different from a more traditional approach to traffic safety?

MATTS BELIN: Vision Zero is based on the idea that people of people. Humans are making mistakes and we can’t dream about the perfect human behaviour. We have to accommodate that everyone has to use this road transport system, from kids to all people, and everyone has to have access to it. And people are [indecipherable]. We know that people have a certain tolerance against external violence. For example, if you get hit by a car in 50 kilometres, the risk to get killed is 80 per cent. But if you hit by a car in 30 kilometres, the risk is less than ten per cent. So it's a dramatic difference between getting hit by a car in 30 or 50 kilometres. And as an individual road user we don’t understand this. We don't understand the difference between 30 or 40 or 50 or 60 kilometres per hour therefore, in Vision Zero, the overall responsibility on safety is on us as system designers.

PC: So, take me to Sweden. I mean, when Vision Zero came in what changed on the ground, so to speak?

MATTS BELIN: Yeah, a good thing, because, of course, when Vision Zero was adopted it was a policy; it was a piece of paper. But, fortunately, now we have been able to do a lot of new things based on this philosophy and if you go to a municipality in Sweden and compare that municipality, let’s say, in the late nineties, with the situation now you will see a lot of roundabouts, you will see lots of speed bumps, you will see lots of special lanes for bicycles. So, we have dramatically changed the design of our road transport system. We also have decreased the speed limits and so on.

PC: So, you’ve forced people to drive slower by things like roundabouts?

MATTS BELIN: I would not say ‘force’. I would say nudge a little bit more because it's a way for us to help people to do the right thing. And the designers here, they have a very important role to play, actually, to help us, the individual road users, to make the right decisions.

PC: So, this has taken root since 1997. As you say, it started with the policies on paper; it's now come to fruition on the roads. In those 20 years, I mean, why did Sweden need a National Traffic Safety strategy?

MATTS BELIN: Well, although in the middle of the nineties we had one of the safest of transport system already in that time, it became obvious that this is not something that we have to just accept. We have to understand that still in a country like Sweden road traffic injuries is one of our major leading causes of death. So, even if we are doing well, we have to go further. And that's why [indecipherable] to come up with the idea of a road transport system without fatalities and serious injuries.

PC: And because the goal, as I said earlier, of Vision Zero is to - the name itself - is to take traffic fatalities in your country to zero. How has Vision Zero affected that?

MATTS BELIN: Yes. So in the mid-nineties, we had around seven fatalities per 100,000 and, as you said the in the beginning, now we have less than three fatalities per 100,000 inhabitants. And that is quite dramatic, actually, especially for a country that is already high performance country to make it even better. Now when we start to discuss this I think that to most of us thought a little bit more like that is a vision. It's not really something that we will be able to achieve. But now with new technology and everything is around the corner we think that this is really achievable.

PC: You were in Toronto last fall to talk about Vision Zero, and I'm just wondering when you came here, how did driving here and traffic safety here compare to what you see in Sweden?

MATTS BELIN: I guess the major difference between, let's say, North America and Europe is in your countries it's so car dependent and it's so car focused designed. And that is what, in Europe, in Sweden, you will see that there is much more balance between these different road users. And we also, like a country like Sweden, we would like to expand pedestrians and cyclists now, because it's good for health, it's good for the environment and so on. And to do that, one of the major barriers is safety, actually. So we need to work to save the unprotected road user. And my passion from North America now is that’s the biggest challenge now, to accommodate for all these different road users.

PC: So, what do you say to those politicians? We hear it here in our country, from some elsewhere as well, who say you know what? It is unrealistic, first of all, to think that we can eliminate fatalities, or to implement strategies, like the one that Matts Belin has been telling us has been working Sweden, are too expensive. What do you want to say to them?

MATTS BELIN: Well, our experience from Sweden now is that actually we had a lot of support from the citizens. When we started to discuss this with the citizens and the politicians about the idea of having a safe road transport system, we got very much political support. The major barrier that we have is the system designers, is people like myself, actually, working for a Swedish transport administration, these bureaucracies, because they have to start to change the way that they design and they plan. And they also thought this would be a very expensive thing, but it turned out that that is not the case. We have found lots cost effective solutions, actually, based on this philosophy.

PC: Matts Belin, thank you. Good to talk to you.

MATTS BELIN: Thank you.

PC: Matts Belin is the Project Manager at the Vision Zero Academy. He was in Borlänge, Sweden. Well, to help us understand how Canada's approach to road safety compares to other parts of the world, we’re joined now by Pamela Fuselli. She is the vice-president with Parachute Canada. It’s a national charity that focusses on injury. She’s here with me in our studio. Hello.

PAMELA FUSELLI: Good morning.

PC: So, where does Canada rank, in terms of road safety, when we compare it with other countries?

PAMELA FUSELLI: We're certainly not the best and we're not the worst.

PC: Middle of the pack?

PAMELA FUSELLI: About the middle of the pack, yes.

PC: Okay. So, when you hear from our previous two guests - one in Sweden saying we've got this approach and one in Toronto saying we’ve got this neighbourhood approach. What's going through your mind?

PAMELA FUSELLI: I was happy to hear both of those speakers. They hit on a number of major points. I think one that-- It is a systems approach and it takes multiple actions to actually achieve the outcomes that we're looking for and that there are things that can be done at the local level, but it also needs to be something that's done at provincial and national levels.

PC: I don't want to be Toronto focused, in a sense-- We have had, recently again, a sharp rise in pedestrian traffic deaths, something that’s concerning people in the city, but this is not a Toronto-centric problem. It happens in Canadian cities and in Canadian towns as well. But what are the national trends when we look at our country, in terms of traffic fatalities?

PAMELA FUSELLI: Well, the good news is that in transportation-related injuries the trend is actually on the downward trend, which is good. In other injuries we see somewhat of an upswing, like in falls. Ontario itself actually has the safest roads in Canada, but there are still lots more to be done, because it still is a high cause of death. So, when you look at some of the vulnerable road users, like seniors or even children, you see that in kids under 14 transport related injuries account for about 50 per cent of the deaths.

PC: 50 per cent of the deaths?

PAMELA FUSELLI: Yes.

PC: But the national trend, the national numbers are actually going down for overall.

PAMELA FUSELLI: Yes.

PC: Okay. And then in this city, they're going up. So where's the disconnect?

PAMELA FUSELLI: Well, that's the difference between looking at national level data and the local level data. So in pockets you will see different trends between the national picture--

PC: So, who's going up?

PAMELA FUSELLI: Well, I think when you look at cities and places where there's lots of interaction between cars and people or bikes and people that those are the places where these kinds of things can happen. Edmonton is a city that has adopted Vision Zero as their strategic plan for the next five years. They've dedicated resources, in terms of human resources and funding, to make those changes in that city. They've only had this for the last year, so we need to wait and see what the outcomes have been. But, certainly, in other cities, like New York, that have had it in place for a couple of years they're seeing significant reduction.

PC: New York has adopted this as well?

PAMELA FUSELLI: Yeah. There’s about 13 cities in the US that have adopted Vision Zero. And New York in particular, when we're talking about pedestrians, has seen a significant reduction because that is actually what the impetus was for bringing Zero in, was they were seeing so many pedestrian deaths.

PC: And in Canada only Edmonton?

PAMELA FUSELLI: Edmonton is the only city that officially has adopted it. British Columbia as a province has adopted Vision Zero. And our national Road Safety Strategy 2025, it’s called, is using Vision Zero as a framework, but Parachute just did a webinar with about 100 people this week and there is a lot of interest. And I think you've seen here in Toronto, with the recent announcements around the Toronto strategy, as Matts indicated, that people are really looking for these kinds of actions because they don't want these deaths to take place.

PC: You said the BC government has the endorsed it.

PAMELA FUSELLI: Yes.

PC: But not specific municipalities, which is interesting in that cities run roads. I mean, in terms of redesigning them and stuff - this is all urban planning.

PAMELA FUSELLI: Right. So cities have the infrastructure responsibility for themselves. Provinces, I think-- And the Ontario Ministry of Transportation also has responsibilities for certain roadways, especially outside of urban areas. So we all have a role to play.

PC: So, when we listen to Matts, Sweden is a country-- I don't know. I think it's about six million people. And here we are, a very spread out country, different, big cities, small towns, all those things. Is it easy to compare Sweden and Canada, for example, when we're talking traffic safety?

PAMELA FUSELLI: You know, we tend to compare Canada to similar environments, like Britain, and countries like Germany and Sweden and Australia even. So I think that the fact that 13 US cities and Edmonton and BC have adopted it is that it can be portable. There may be some unique issues that we have in terms of at what level does this be more effective. Sweden, as a country, has taken this on. In North America, you've tended to see the cities.

PC: And when you look at Edmonton, what have they been doing?

PAMELA FUSELLI: Well, they've been doing things that, like Matts has explained, they've reduced speeds. They've used a lot of data. So they've done a lot of tracking about where are the incidents happening? Where are the high death and fatality intersections or roadways? And what exactly are the things that could be done? So, reducing speed, redesigning the intersections, restricting turning, light timing, things like that. So, it's a multitude of actions that they've taken. But what I like about what they've done is they've actually based it on existing data and knowledge.

PC: And also balancing that with traffic flow and all the other pressures for cities to deal with.

PAMELA FUSELLI: Exactly, yeah.

PC: Okay. So, beyond this Vision Zero model, where else do you turn to to look at approaches that are successful?

PAMELA FUSELLI: Well, I think what the Vision Zero model does is put a framework around some of the known strategies that we have. And I think that's why the uptake has been so easy is that it doesn't require us to throw out everything that we've been doing. But it but it puts in a framework and it gives us a goal. We were a little concerned about Vision Zero. Could it be achieved?

PC: In terms of reducing fatalities to zero?

PAMELA FUSELLI: Exactly. But when you think about your own family, what is acceptable for your own family? And it's zero. And I think when you look at the deaths and fatalities piece, we understand that some of these infrastructure changes, like the roundabouts that Matts talked about, we actually may see collisions go up but the fatalities, the impact goes down. And so I think the things that we've been doing, like speed reduction, like looking at timing and pedestrian crossing, and looking at a balance, separating bike lanes, all of those things together work together to achieve this goal.

PC: Overall, how satisfied are you with Canada's - well, I know it differs - but with our current approach to traffic safety in Canada?

PAMELA FUSELLI: Well, we can always do better, for certain. I think we're on the right road, if I can use that terminology, but there are lots more to do and I think this concept of Vision Zero has really reinvigorated a lot of people.

PC: Pamela, thank you.

PAMELA FUSELLI: You're welcome.

PC: Pamela Fuselli is the vice-president for Parachute Canada. She was here in Toronto. We do want to hear from you, of course, on this and other things you hear on our program. How safe do you feel walking or driving in your neighbourhood? Tweet us @TheCurrentCBC. Comment on this story on our Facebook page, or visit our website, click on the contact link to send us an email, cbc.ca/thecurrent. By the way, I’m on Twitter. My handle is @piya. That is The Current for this Friday. And since The Current’s summer season starts on Monday, we thought we'd leave you today with a sunny weather song. This one's called Limoncello. It's a new track by Canadian producer Scratch Bastid and it features CBC Radio One's very own Shadrach Kabango – Shad. I'm Piya Chattopadhyay. Thank you so very much for lending us your ear here on the Friday edition of The Current.

[Music: Limoncello by Scratch Bastid, featuring Shad]

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June 24, 2016 full episode transcript

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