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The Current Transcript for March 26, 2019

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Prologue

[Music: Theme]

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VOICE: We are the youth and we have a right to speak. We are completely powerless right now, to put it bluntly. Democracy is fluid. It's not black and white thinking. It's not yes or no and opinions change.

ANNA MARIA TREMONTI: There is a whole cohort of British youth who weren't old enough to vote in the referendum that brought Brexit into their lives. They are already frustrated and want a say in how it plays out now. So consider what they're thinking today after watching their elders contort yet again in Parliament. A prime minister whose own employees are trying to shove her out, an opposition that doesn't like her deal and can't think of another one, a parliament deadlocked, a public polarized and a clock that keeps on ticking. We are taking the pulse of the people on Brexit in just a minute. And then, for the last year the CBC's Laura Lynch has been following the journey of one young woman, an Afghan refugee in Canada, learning English, making new friends, all the while waiting to medically address disfiguring injuries inflicted by an ex-husband. Shakila Zareen's determination to forge a new life brought her to this moment.

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VOICE 1: Oh my God. This is really amazing.

VOICE 2: I'm not kidding.

VOICE 1: You're not kidding me? This is right?

VOICE 2: This is right.

AMT: News from Laura that the surgery was finally possible. Shakila will break your heart and make you smile in half an hour. Also today they are increasingly in demand and their jobs are increasingly dangerous. A staggering number of workers in long-term care facilities say they face ongoing violence and abuse on the job.

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VOICE: They say you know I work in long-term care. I go home, I cry my eyes out. We just had a PSW last week that witnessed such a case of abuse that she can't go back.

AMT: We'll tell you more about that in an hour. I'm Anna Maria Tremonti. This is The Current.

Back To Top »

Some young Brits are calling for a new Brexit vote. Others argue it's undemocratic

Guests: Ian Dunt, Lucy Harris, Hugo Lucas

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VOICE 1: Order.

VOICE 2: The I's to the right, 329. The no's to the left, 302.

AMT: You know it could be fodder for a scene from Monty Python if it wasn't so serious. You just heard the late night sound of British MPs seizing control of the parliamentary timetable and with that taking power over the Brexit process away from the prime minister Theresa May and putting it into their own hands. After weeks, months, years, without results on a move to finally make a break from the EU, parliamentarians grew even more exasperated yesterday when Ms. May announced she did not have enough support to justify a third vote on her Brexit deal. That included those in the ruling party. 29 of Theresa May's own Conservative MPs rebelled to support the amendment, including three high profile ministers, who quit their jobs to do it. The government warned the amendments set a "dangerous unpredictable precedent." The days ahead promise to be chaotic and if that has you feeling overwhelmed, Ian Dunt is with you. He wrote a book called Brexit: What the Hell Happens Now? He is the editor of the website politics.co.uk and Ian Dunt joins me from our London studio. Hello.

IAN DUNT: Hello.

AMT: What happened last night?

ID: It's a pretty significant constitutional moment actually. The origins of it actually lie really with the referendum itself. I mean the British democratic system is based on parliamentary sovereignty. The idea that it's parliament that exercises legitimate political power and it gets that legitimacy through the elections to people giving it to people and voting for their own peace. Now since the referendum that fundamentally changed you had this popular moment of democracy where people suddenly sort of talking about the will of the people as if it was this sort of one greatly homogenous thing. And Theresa May the prime minister seized on that from really early on in the Brexit process and went no I'm going to sidestep Parliament or ignore it where I can I won't occasionally not even do what it votes and commands that I do and instead I will say that I am the prime minister who represents the will of the people I get my legitimacy directly from the public last night that process effectively came to an end where MPs voted on what seems pretty technical is essentially to take back control of the parliamentary timetable it's called Standing Order 14 which basically says the Guardian can just the government can back off for a moment and people will now decide what is being debated on Wednesday and we will arrange those motions as we like and that essentially is although it's quite radical it's actually the return of something much more traditional about the way that Britain does politics.

AMT: And what does it mean in terms of the actual Brexit deal. Does that mean the MPs and the house get to like decide what it looks like over what she does?

ID: These are all very good questions and we don't know the answer to any of them right now. The first things first, on Wednesday they're going to have a series of indicative votes. They're not entirely sure of the system. It looks like what they want to be able to do is allow employers to vote on several options at once. The author of this system Oliver Letwin is quite pragmatic conservative and I suspect that his main real goal here is to try and get rid of that idealism the crazed idealism on both sides of the debate which has existed over the last three years in Britain and to try and see if there are pragmatic solutions if there are not enough employees who will give up their ideal option in order to support their least bad option and that possibly there might be a majority that way through. He is not thinking about it like a one time event. He is thinking that there will be no majority for anything on Wednesday and then instead we might be able to see whether avenues for a majority eventually might be found and then he might have maybe another vote maybe on Monday where they could whittle down the options and see if at the end of it one of those options is left standing I suspect and it's a bit of a guess but I suspect that if an option like that exists it will be a form of soft Brexit where Britain clings very closely economically to the EU, even while leaving its political structures.

AMT: OK so you answered my question because I keep reading indicative vote, indicative vote. What is that? But also, I'm reading on the wires that Ms. May will address a meeting of conservative lawmakers in parliament on Wednesday. I mean they want to shove her out. They've been saying look it, we'll do this, but you have to go.

ID: Yeah exactly and that is what we suspect she's going to say at that meeting tomorrow.

AMT: What that she's leaving?

ID: Essentially yeah. The only way to get her deal through is to fall on her sword and then by guaranteeing that she will resign once it's through, she might be able to get enough of the sort of hard line Brexiters to throw their weight behind it. Now that is quite extraordinarily weird state of affairs is very weird even as an incentive for the hardliners because you sort of think why on earth would you sign up to the proposals someone is putting forward if they're going to resign immediately afterwards. Now the answer to that question is very simple it is because they do not intend to sign up to it. They will support the deal for now. Some of them might but later they intend to tear it up once they've got one of their own figures in the lead. On the other side of it Theresa May, I mean you know to put this as charitably as I possibly can, she does not always stick to the things that she said she was going to do when in fact it is comparatively rare when she actually does abide by the things she said she was going to do. So just if she says that she is going to resign, I wouldn't necessarily advise them to take that as gospel. But all of this is really her desperate last chance attempt to try and get that deal through and even then I'm really not sure that she has the numbers. I think it may be too late for her. She's seems to have completely lost control.

AMT: And even then what if they get a deal that is very different, the EU can say sorry. Like there's still that clock ticking on another front.

ID: Yeah there is exactly, although the thing is the EU are quite open to ideas around softening Brexit to be honest. They don't quite say it outright, but they always have a couple of links and they look at Jeremy Corbyn, the leader of the opposition and they sort of say things like well these are tremendously interesting proposals, we'd like it if people came forward with more of this. So I suspect that they would be more open to those ideas. They can say no to whatever they like and then there is a major major problem in front of us and that problem is called the European parliamentary elections. Now those things come in late May. If Britain has not taken part in them it cannot extend its membership any longer. The EU has received legal advice that says if a member state doesn't take part in those elections and remains a member state there is a chance that the parliament the European Parliament will be legally constituted and that means that all of its decisions are open to legal challenge. Basically it would be like a contamination by Brexit of the whole European political system and they will not allow that to happen. So if people want to come up with some new ideas some return to negotiation or another referendum or election whatever they need to. Now in the next couple of weeks before an upcoming deadline confirm that they are taking part in those elections in May. That is a precondition of anything that they tried to do.

AMT: OK. Ian Dunt, we're glad we have you. Thank you.

ID: Thank you.

AMT: That is Ian Dunt. He is the editor of the website politics.co.uk. He is the author of Brexit: What the Hell Happens Now and he joined us from our London studio. Now the Brits are divided over what the consequences of Brexit may be and how to prepare for that. Some people have been stockpiling goods and medicines in case there are shortages. You've been hearing that for weeks. A BBC radio call-in show called You and Yours asked people what they're doing to prepare.

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VOICE 1: I've decided to try and liberate myself as best I could. I sought and obtained Irish citizenship. Then I transferred enough money to France so that if necessary, I could buy an inexpensive property thre.

VOICE 2: My tiny little back garden, which was just a patch of scruffy grass and some flowers and I've now changed the whole thing into an intensive vegetable garden.

VOICE 3: Just continue on as normal. What will be will be. It's out of our control. The larder is full of tinned and dried produce. Always there if you need to change the menu.

AMT: Well the future is particularly uncertain for Britain's young people. Lucy Harris is the director of Leavers of Britain, a social networking group for people who support Brexit. Hugo Lucas is the director of communications for Our Future Our Choice, a group wanting to remain in the EU, focused on young people. Lucy and Hugo are both in their 20s. They join us from our London studio. Hello.

LUCY HARRIS: Hi.

HUGO LUCAS: Hi there.

AMT: Were you two watching what was going on late into the night in Britain in parliament yesterday or are you sort of beyond this now?

LH: Well I put it on to the vote. I saw what had happened and then I went to bed. There's so many meaningful and I say it in inverted commas, meaningful votes these days that it's just the whirlwind of a situation. It just does your head in after awhile.

AMT: Hugo, what about you?

HL: I find watching these votes is best with a drink in hand sometimes. I was at a p ub and the pub had it on.

AMT: Oh okay. So while the politicians triy to do whatever they're going to do in Parliament, you two are on the streets living your lives and I'm wondering how all of this is affecting you personally. Yeah well Lucy how has this affected you?

LH: Well, so I started up what I do and what I do is basically run a social networking group that's nationwide and I started it up in 2016 after the Brexit referendum vote mainly cause my remainer Italian boyfriend at the time went a bit nuts over it and he told me that I was not committed to him, if I if I didn't vote remain and I thought that was pretty off. But that was one experience but I used to work in publishing I used to go in and I used to be discussing just how racist and terrible back cities were and you know Brexit here and you know it seemed like a direct attack on me and I thought you know one in three people voted leaving London. There must be more people like me out there that are experiencing very similar situations. So I made up a social group and it started off with 10 people now in the London Group alone we have 1500 people and counting that come to our meetings regularly every month.

AMT: Are you still working in publishing?

LH: No not anymore.

AMT: Are you doing this full time?

LH: Yeah I do this full time.

AMT: And what happened to the boyfriend?

LH: Well we broke up and now I have a very lovely pro-Brexit boyfriend. So that's great.

AMT: Hugo Lucas, what about your personal life? How has this affected you?

HL: Well I'm half German. I was born in Vienna. My stepmom is Italian doesn't have a British passport because she never thought that she might need what. So the uncertainty is really quite it's a big deal for people like me who have relatives, boyfriends, girlfriends, friends who come from all over Europe and are looking at the possible case of a no deal. Those people losing their right remain. I have a sister with a long term medical condition who in the case of no deal might have to find an alternative to medicine that keeps her alive. I mean on a more day to day basis I also do this full time so it's changed what I wanted to do after university just because I think if the Brexit deal had been anywhere near as good as what was promised in 2016, I wouldn't be here.

AMT: And you've both focused your activism on young people. Why is that? Hugo, you start.

HL: Well, you said in the intro that theres this new cohort of voters who have come into into electoral age since the 2016 referendum. There's about two million of them. My group did some polling on them and found that they are overwhelmingly pro-remain. They didnt get a chance to have their say like 16 year olds in Scotland did when they had their independence referendum and 87 percent of them -- of those who are certain to vote -- would vote to remain in a further referendum. Young people are the ones who are going have to make sense of this Brexit mess. It's not going to stop anytime soon. Its going to keep going. So that's why I think young people are are deeply affected by this and thats' why Im working primarily with them.

AMT: And now Lucy, statistics show younger people are more likely to vote remain. Give us the argument why should young people support Brexit?

LH: Well I don't actually work predominantly with young people, I work with everyone because I like to see as all coming together and actually having a conversation about this. I think there's a lot that young people can learn from older people. I think sort of intersection lies making us young pitting young people against older people I think is really unhealthy for society. So basically what we do is we get people to talk from different sides of the coin. Weve got young people and old people talking together. Weve got you know left wing right wing. We sort of try and get people actually talking instead of talking at each other which is whats currently happening happening in the current situation Brexit in terms of young people. I think what we're really missing out on is the fundamental basics of democracy. If you start letting votes sort of be manipulated into second referendums without upholding the first referendum, you're starting to slip into a very undemocratic situation. And it's the value we put on democracy, which is most important, and that matters to every single person, not just young people, not just old people.

AMT: So Lucy, you don't want another referendum.

LH: Absolutely not. I think, I mean I didn't I wasn't in the first referendum. I didn't campaign at all. But from what I've heard from friends it was a really ugly affair and I'm sure my friend Hugo here would also say it was a pretty ugly affair the first time around. I am really worried from things I'm hearing on the street and last week I was in the street leafleting ... I had a guy come up to me and tell me that I should be lobotomized. I mean, that's aggressive. It's disgusting. And just imagine if we're actually to have a campaign on those terms, where the country is divided, we're angry, we want to get at each other, we're not talking to one another. It would just be a horrible situation for everyone.

AMT: Hugo, do you want a second referendum?

HL: I do. I find it a very curious thing to say that giving the people a vote could somehow be undemocratic. I mean my group goes all around the country. We are going to 100 universities, colleges, further education institutions in 100 days. We do bus tours all around the country. I'm going on one tomorrow to the northeast. I don't think it's that insulting to people to ask them if they're sure that they still want this when what is actually on the table now is so different from what was promised in 2016.

LH: We just cannot start picking and choosing, you have to implement the first vote and then I think having a second referendum if that's what you wanted, would be perfectly legitimate to campaign for.

HL: But if we were to have a second referendum, after we've implemented the result the first one, we wouldn't be able to go back. We'd have to join the EU and Ask 49 and take on a whole bunch of things that I don't think the country wants. We might have to change.

LH: Well that's democracy, you can't you know vote in the Tory party and go oh crap actually I really wanted to have the Labour Party and then hold another general election until you get it.

HL: Well I think democracy is a process, not an event. You know it didn't stop in 2016. People are allowed to have their say on this now.

LH: No it didn't. Which is why I'm saying implement the first one and then keep going on your process.

HL: But there is so much disagreement on how to implement it.

AMT: I'm going to interrupt because I want a few more thoughts from you and I can I appreciate you're both coming from different points. Hugo what do you want to tell Lucy that you're most worried about with Brexit? What do you want her to understand about your stance?

HL: I think it's important to understand that young people under any Brexit deal are going to suffer economically. Our group did a report which suggested that any Brexit deal is going to cost us in future earnings. That's using the government's own figures. I'm not sure the economics of it is necessarily the most important point though. We've also got polling that suggests that young people are overwhelmingly in favor of things like freedom of movement by a margin of 22 to 1 and I think what I'd like most to communicate to Lucy is to realize that we are a very, very different generation to the ones that have come before. We have different priorities and a lot of those priorities rest on continued membership of the European Union.

AMT: Lucy, what do you need Hugo to understand?

LH: Well for me it goes back to the fundamental issues to do with the EU in the first place. We talk a lot about young people, but what do we actually mean? Who we are talking about when we talk about young people of the EU? And if you look at southern Europe, you can see a 30, it's gone down slightly since a few years ago, was at 40 percent unemployment youth in Italy. It's gone down to 30, but across the southern part of Europe there is a high rate of unemployment of young people and that's down to the Euro, it's down to the borrow lender situation and the current economic system of the EU. And the opportunities that that kind of person that would actually have coming to UK is rubbish restaurant jobs. They get sort of taken advantage of here in the UK and they're not getting proper pay. And I think it's almost using them.

AMT: So you're worried about the people in Europe, you're not worried about British people. You're saying that this is for.

LH: I'm worried about. I have obviously solidarity with people across across Europe, but I also think that we have to start looking at the issues that are for young people in Europe itself. If we're going to talk about young people, why should we exclude European young people from that?

AMT: And given the polarization, given that there is no agreement on any way to leave the EU, what do you think Britain's going to look like six months after this separation happens, Lucy?

LH: After the separation?

AMT: Yeah.

LH: I would like to see a renaissance in how we do politics in this country. I think it's about time that we started listening more to the general public in their opinions. I think there's a large swathe of people on my side that feel that they haven't been listened to you for such a long time. I think now what we're going to see is the political two main political parties are going to really fight it out to actually have them on their side, which will actually means of ending austerity, will actually means of directing a bit more legislation and policy towards them. And I think that's a really positive thing that's Brexit has actually bought back.

AMT: And Hugo, what do you see Britain looking like six months after if this goes forward and you leave the EU?

LH: This is where I somewhat question the divisive points. I agree with a lot of what Lucy said there, I just think that people think that if we leave, whenever we do leave with this deal, that that's somehow the end of Brexit. That we'll suddenly stop talking about. It's not. This is the end of the beginning. We have years and years of negotiations to come after this. The idea that somehow just getting over the line will be enough to quell quell discussion around the issue make people stop talking about it allow government to focus their bandwidth on issues that really need attention like climate change like a housing crisis like knife crime epidemic like mental health epidemic. I think it's a real mistake to think that we're going to be able to achieve these things in the months after Brexit because we're still going to be talking about it.

AMT: We have to leave it there, but I appreciate both of you sharing your opinions and sitting next to each other to do it. Thank you.

LH: Thank you.

AMT: That is Lucy Harris, director of Leavers of Britain, a social networking group for people who support Brexit. Hugo Lucas is the director of communications for Our Future Our Choice, a remain group focused on young people. They were both sitting together in our London studio. Stay with us the news is next and then.

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VOICE: Monday, Tuesday, Wednesday.

[Laughter]

AMT: You met Shakila Zareen, a young Afghan woman here on The Current a year ago. She is adjusting to life in Canada. We have an update on one woman's determination to overcome, next on The Current. I'm Anna Maria Tremonti.

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Back To Top »

'I feel I am not alone anymore': Afghan woman shot in face by her husband is building a new life in Canada

Guests: Laura Lynch

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

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AMT: Still to come, long term care homes are for people who are vulnerable and need around the clock support. Increasingly, the staff providing that support say they feel vulnerable as well and it's because of their patients. In half an hour, we'll look at abuse of caregivers in long-term care facilities. But first, the story of Shakila Zareen, trying to find peace in Canada, after the unthinkable happened.

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VOICE: Translation: Right after the police station, that night I went to my mom's and I could hear footsteps eat the door. My eyes were trying to adjust to see who was there, but I could see a hunter's rifle pointed at me and I remember thinking to myself there's no way that they could be this ruthless. But I got very scared and I said, "Please God, don't let them hurt me." And then that's all. That's all I remember. It went black.

AMT: That's a young Afghan woman named Shakila Zareen who was speaking with translation on The Current a year ago. She spoke to guest host Laura Lynch about her life in Afghanistan and a violent marriage that ended in bloodshed. It was her husband who shot her in the face that night. Shakila Zareen survived and she fled to India with her mother and younger sister before coming to Canada. Laura Lynch has kept in touch with them over the past year as they settled into new lives in Vancouver. She's watched as Shakila has navigated a year of surprising triumphs and difficult challenges. That's a turn she could have never imagined growing up as a girl in Afghanistan. Laura Lynch joins me from Vancouver to share an intimate look at Shakila's new life. Hi Laura.

LAURA LYNCH: Hi Anna Maria.

AMT: Remind us a bit about Shakila's story,.

LL: Shakila is now 23-years-old, but in 2012 she was actually a teenage bride living in Mazar-i-Sharif in northern Afghanistan and she had been forced to marry her cousin by her brother-in-law. Now her husband beat her. He raped her. The first time he raped her she said was on their wedding night. So after months of abuse, Shakila decided she'd had enough and she went to the police.

AMT: Well we know police in Afghanistan don't always take domestic abuse allegations seriously. What did they do?

LL: They didn't do anything. In fact, they told her that she was lucky because he hadn't cut her nose off. So they didn't investigate, instead they tipped off her husband about her complaint. And so later in the cloak of darkness, her husband came to her mother's home, where she was staying and listen to Shakila's mother describe what happened next.

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VOICE: That night, that night it was very stormy. It was a very stormy night and it was a very scary night. I was praying when I heard a noise, so I ran and I saw Shakila lying down. I thought she was asleep. I turned her over and I said to myself, oh my God. There was so much blood. I thought she was dead. I tried to lift her up and I pressed her against me and I thought, my God, they killed her. They killed Shakila

LL: Now Anna Maria, I should tell you that this is actually the first time that Shakila's mother has spoken publicly about what happened. She was initially reluctant to speak to me about it because she worried people would blame her for not protecting her daughter. And plus always talking about this, this brings back such painful memories for her.

AMT: I can't imagine what it would be like for her to find her daughter like that. And she thought she was dead.

LL: But she wasn't. She was alive just barely. And the only doctors who could help her were actually hundreds of kilometres away in Kabul. So her mother managed to get her into a taxi and she survived the harrowing seven hour drive to the Afghan capital and it wasn't just a shotgun blast to her face Anna Maria. She actually miscarried, even though she didn't know she was pregnant. In the days that followed that, Shakila lay in a coma. And her mother began to roam Kabul streets, trying to find justice for her daughter.

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VOICE: After a few days, I realized the government didn't know what had happened. So I reported it to a women's rights group. Again, nothing happened. So I went to the gates of the presidential palace and I stood there yelling at them to let me talk to the president and I said I'm not moving till you talk to me. Eventually the guards let me in and I spoke to a man who said he was an aide to the president. He said there are at least 1000 women a day who go through this. Women who are attacked and there isn't anything we can do. I was very angry and I left. Nobody cares about Afghan women's rights. They are ground into the dirt and trampled by powerful men.

AMT: Did nothing happen to her husband for shooting her in the face, Laura?

LL: A lot of this is unclear. I don't know what he was charged with but it appears he only served seven or 10 months in prison before he was released tequila her mother and her younger sister Samira were very scared that he would come after her again. So they fled to India.

AMT: While she was still recovering?

LL: Yeah and doctors in Afghanistan have stabilized her and then they saved her life, but that was just the beginning of the medical journey. The other thing that India offered was medical care. She would end up undergoing nine more surgeries over the next three years in India and all the while that ex-husband and her brother-in-law sent threats to them from Afghanistan that they would kill her and her mother and her sister and then also Anna Maria, she would experience cruel taunts from men in the street.

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VOICE: There were a lot of people, but I will mention one. When he passed he said, hey blind girl, get away from me. Then he said look at her face. She's so ugly, she's not even worth looking at. It made me really sad. How can someone look at a human being and say something like that? I tried to show him that I don't care, but inside in my heart, I was crying.

AMT: So awful, that on top of everything else. So they didn't feel safe in India, which is why she wanted to go to Europe or North America. Wasn't she initially supposed to go to the US?

LL: That's right. The UNHCR first asked the United States to resettle Shakila along with her mother and sister and the United States accepted them. But then Donald Trump was elected and six months later they received a letter stating that their application had been rejected because of "security related issues.".

AMT: What security related issues?

LL: Letter never laid that out, but they believed it had something to do with her husband's ties to the Taliban. Shakila was devastated by that, but the UNHCR quickly shifted focus to Canada. They were accepted to Canada after what I'm told was a process that moved at lightning speed and then Shakila and her family came here in January of last year overwhelmed with gratitude. But she still needed extensive facial reconstructive surgery. So one of the first orders of business was a consultation with Dr. Kevin Bush who was a tough plastic surgeon in Vancouver.

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VOICE 1: Hi.

VOICE 2: Hi

VOICE 1: Kevin Bush, nice to meet you.

VOICE 2: Hi I'm Shakila, nice to meet you.

VOICE 1: Have a seat. And this is, are these all the x-rays?

VOICE 2: Yes x-ray.

LL: So let me set the scene here. We're all in a cramped exam room at Vancouver General Hospital as Dr. Bush tries to get an exhaustive history of what she's had done and although at this point Shakila's English actually isn't bad, there's a man serving as an interpreter to ensure there is no misunderstandings. Shakila tells him she's had a lot of trouble breathing through her nose and it's painful for her to eat.

AMT: And how bad at this point are her injuries still?

LL: Well she's missing pretty much still missing half of her face. So her nose is gone. Her cheek bone, her eye socket is gone. Most of her jaw, lower jaw and teeth are gone on one side of her face. So and there's also obviously where the skin was, they put another patch of skin from another part of her body over that, but you can easily see it because the colour of the skin doesn't match the rest of the skin on her face. So there's a lot of injuries still there.

AMT: And in that meeting, did Dr. Bush give her a sense of what he was going to be able to do?

LL: No he didn't because it was still too early for him. He had a lot to go through, but I've got to tell you what happened next was heart wrenching.

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Shakila speaking in Dari.

LL: Shakila had a question for Dr. Bush.

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Shakila speaking in Dari.

LL: And it was so, so raw, so honest that the interpreter choked up and he needed a moment to compose himself before he could translate it.

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VOICE 1: Will I get my face back?

VOICE 2: Yeah you know, I think we can do some things to make things better for you, okay. The honest answer is that we can't get you right back to where you were before, okay, but we can make things better for you.

LL: Now Dr. Bush was obviously trying to put a positive spin on it, but it's clear there were limits to what he was going to be able to do and in that moment Shakila quietly started to cry and it was a really hard moment for all of us in theere.

AMT: It sounds so hard. I guess it's important that the surgeon be honest though, so that her hopes don't outpace what is possible. When was her surgery?

LL: It actually wasn't until much later. There were more consultations there were tests over the next couple of months on her remaining eye, on her ears, on her throat and surgery wasn't the only thing on her plate. She was trying to adjust to a new life.

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Friday, Monday, Tuesday, Wednesday.

[laughter]

LL: Now that is Shakila and her mother practicing English over lunch in their apartment.

AMT: They sound so close, so connected.

LL: They are. I mean everything they've gone through has clearly created this incredible bond. They've been going to English classes with other refugees. They've been making. They've been making friends. You can often see them when they're walking down the street, holding hands. One of the friends that they've made though who I want to talk about is Friba Rezai who tracked Shakila down after she heard her first interview on The Current last year. Friba is also Afghan and she moved here to Vancouver with her Canadian husband years ago. Friba has been trying to make sure that Shakila has fun She even took her and her sister dancing, but Friba recognizes the road ahead isn't going to be easy.

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VOICE: Her life has been a rollercoaster in Vancouver for sure. There are many challenges that she face and she still faces, but I also knew deep inside that she's very very strong. I also felt, the second I saw her for the first time, I also felt that this is what women suffer in Afghanistan. This is what happens. We were at the cashier, we were standing in line waiting for a coffee. There was an angry man, maybe he didn't have a good day or something. She saw him and she got so scared, she started shaking and I held her hand and I hugged her I said it's okay, it's going to be okay. He's not hurting you. So I could see the trauma.

AMT: Sounds as if there are triggers for her everywhere.

LL: Yeah it's not a surprise that given what she experienced that someone just yelling or shouting, especially a man would be that kind of a trigger. But the good side of things Anna Maria is she's making friends, beyond Friba, she's making other friends. Have a listen to this.

SOUNDCLIP

Sound of music and dance.

LL: This is from the final day of a training course that Shakila took for immigrant and refugees women who want to support other women who are newly arrived to Canada. And you should see her. Shakila was dancing with a big smile on her face. She was looking as happy as I had ever seen her.

AMT: It's wonderful to hear. The music is wonderful too. What was she learning on this course?

LL: She was learning basic information that she could pass on to other women about our health care system and where to find counselling, but it was more than the simple information. It was this group that supported that embraced her for who she is. She seemed to gain strength and confidence from the other women in the group from just the way that they treated her and made her feel like she was one of them.

SOUNDCLIP

VOICE: I am very happy to participate in women's support group. I make new friends and I feel I am not alone anymore.

AMT: She sounds confident. That English too, her English is so forceful there.

LL: Yeah, it is coming along.

AMT: Do people know her story?

LL: More and more people are learning about it and that's partly because she was invited to speak at a national conference in Ottawa for people working with domestic abuse survivors and women living in shelters. Now this was clearly an important moment for her. It's a moment when she could see the impact of her words.

SOUNDCLIP

VOICE: Thank you for participating today and helping to changing tomorrow. And do not be silent in the face of violence. It is up to you to fight. And you can. I'm proud of all the women. We are the super women. I would never be quiet. Thank you so much.

[Applause]

LL: And she's certainly inspired them, this young woman from Afghanistan who's only just learning English, she got a standing ovation.

AMT: That must have felt empowering.

LL: I'm sure it did. I kind of saw that because she took all those good vibes and all that energy and she marched up to Parliament Hill and she went into a meeting with the Immigration Minister Ahmed Hussen. But before he arrived, Shakila met another Afghan woman.

SOUNDCLIP

[Shakila speaking to Maryam Monsef in Dari]

LL: This woman is a refugee who is now in cabinet. Maryam Monsef, the Minister of International Development and the Minister for Women and Gender Equity.

SOUNDCLIP

[Maryam Monsef speaking to Shakila in Dari]

LL: Now this is clearly an emotional moment for two women who had come so far from Afghanistan to meet in Canada's halls of power. Ms. Monsef is assuring Shakila in her native Dari, that she should continue raising her voice to defend women in Afghanistan and around the world. And then after Minister Hussen arrives, Monsef stays to help with the translation and Shakila presents him with a list of issues that she and other refugees face.

AMT: And what was on that list?

LAURA LYNCH: Not surprisingly, she talked about the sky high cost of living in Vancouver, as well as the lack of counselling she's received. She's had only 10 hours of therapy in the time that she's been here. She still has nightmares. Now Minister Hussen listened and he was sympathetic, but he wasn't making any promises and to this day Anna Maria, she actually hasn't had any more counselling and she wants more counselling. But watching her in this meeting was to see a young woman who was determined and unafraid and smart enough to bring a gift for him, a t-shirt with a message on the back.

SOUNDCLIP

VOICE 1: This is for you. Read this one.

VOICE 2: I want every woman to remember that we're not victims, we're the survivors, the warriors and we're super women. Power to all.

[Shakila speaks in Dari]

VOICE 3: That's her quote.

VOICE 2: Thank you.

LL: In case you didn't catch it there, the quote that Minister Hussen read out on the t-shirt, that was a quote from Shakila.

AMT: So she's not easily intimidated in those halls of power. What about the other issue, you said she raised the cost of living for refugees. It is so tough for so many people in Vancouver. What has it been like for her and her family there?

LL: It's hard. They arrived as goverment assisted refugees, which means it qualifies them for the equivalent of B.C welfare rates, plus a monthly $200 top up and they also got free public transit passes plus that limited counselling. They also got their training in English. In BC that worked out to roughly $1100 a month for each of them after you factor in the value of the transit passes. But that program only lasted 12 months, so it ended at the end of January.

AMT: And how are they getting by now?

LL: Well they're still in the provincial welfare system, but they lost the top up and the transit passes. So so in real terms, it's roughly $700 each. After paying the rent for their two bedroom apartment, which is $1600 they've got about $450 a month for the three of them to live on.

AMT: And that's not a lot of money.

LL: No it's not. And so they turned to a local food bank. I joined them for their first visit and that's where they met a woman named Theresa Raskina.

SOUNDCLIP

VOICE 1: I know chick peas is your favourite right. So I put a lot of chick peas, tomatoes. If you need anything, just ask.

VOICE 2: Can I see?

LL: Now you can hear Shakila asking there if she can get closer to the shelves because she can't see very well out of her remaining eye. She and her mother were actually surprised to learn the food didn't just supply free food, but other basic necessities like towels and bed sheets that they needed. Shakila even picked up a stuffed teddy bear for her sister and then Teresa surprised them pleasantly by buying them traditional Afghan flatbread. That meant a lot to them.

AMT: It sounds like it did, yeah. But even with the food bank, you point out there isn't much money left over after they pay their rent. Do they qualify for subsidized housing?

LL: They do, but the problem is the BC housing authority's enormous backlog. Even for someone like Shakila who is prioritized for housing, it is still not easy to find a place.

AMT: And is finding a job an option?

LL: Not for Shakila because of her medical condition and her mother is trying to find some part time work as a cook or maybe in a gardening center, but that's difficult because of her limited English. Her younger sister Samira has been working a bit part-time, but she's alsotrying to finish high school because she's in grade 12.

AMT: So it's not an easy transition and of course Shakila's waiting for surgery with all of this as well. What's happening with that?

LL: Okay I talked to Dr. Bush last December to find out the latest because we still haven't been given a surgery date. He had been preparing and what he showed me was really impressive. They created this 3-D image of Shakila's skull and it helped with the meticulous planning he and his team need to do.

SOUNDCLIP

VOICE 1: So there are these bone fragments that are still in there that are covered up. We're going to try and find those.

VOICE 2: Right, so these are other actual pieces of her skull that have been displaced.

VOICE 1: Yeah these are pieces of her cheek that just shattered and pushed into this position.

LL: So the idea is to get that and at the same time take a bone graft from her leg to rebuild the missing cheek bone, meaning that she'll get a new prosthetic eye and one that fits.

SOUNDCLIP

VOICE 1: When you're talk about rebuilding that orbit there, her eye hangs down so much.

VOICE 2: It'll fall out, yeah. Yeah the idea is that we can't give her another eye. We just can't get her vision out of it. You know that kind of an eye, but what we can do is we can try to support that prosthetic, so that it's not just hanging in the soft tissues and that will give her a better look.

LL: And after months then of planning and preparation, Dr. Bush said he finally had a date for the first surgery.

AMT: Wow it's so complicated too. She must've been so excited about getting a surgery date.

LL: Well in fact they had just scheduled it. So he hadn't even had a chance to tell Shakila yet. She didn't know and guess what, I was able to share the news with her.

SOUNDCLIP

VOICE 1: The reason I really wanted to come here today is because yesterday you were asking me to make sure I talked to Dr. Bush about the fact that you wanted to get your surgery soon.

VOICE 2: Oh yes. What he say? At least let me know.

VOICE 1: He said that you're going to have your operation in 10 days, a week from Friday.

LL: I'm laughing because I remember that moment so well that you heard the microphone get muffled because she gave me a big hug. She was really happy. She started to cry a little bit too as it sort of hit her, but then the first thing she wanted to do was spread the word on social media like so many other young people.

AMT: I'm starting to cry.

LL: And I get that because it was this mix of excitement, anticipation and fear and on the morning of the surgery, all three of them were up before 5 o'clock in the morning just to get to the hospital. And I was there as Shakila was being prepared for surgery and she was smiling right up until she said goodbye to her mom and her sister.

SOUNDCLIP

Sound of Shakila saying bye to her family.

LL: Now Anna Maria, all three of them are crying in that moment. Shakila told her mother and sister that if something happens to her, stay strong. She'll always be with them. Her mother would not hear of it. She said to her you've left those days behind, you're safe and now you're only going to get stronger. You're a brave girl and I believe in you.

AMT: Oh my God, it's so emotional. They've endured so much.

LL: They really have and it was just so powerful.

SOUNDCLIP

Sounds of operating room.

LL: And then she was wheeled into the operating room for the 14 hour procedure. I sat in there for an hour watching two surgical teams work both on her face and the bone graft on her leg.

SOUNDCLIP

Sounds in operating room.

AMT: So he says on track. It was successful? What happens now?

LL: It was successful. It was quite a long recovery, but he was pleased with what they were able to do. She had a lot of pain afterward, the tracheotomy tube was hard for her to tolerate, but she's now recovered and she's just found out the date for her next surgery, which is on May 1st. Dr. Bush is going to rebuild her nose. This is another complex surgery using skin from her forehead and bone from her skull and after she recovers from that, there's surgery to fix her jaw, which the doctor hopes will allow her to get dental implants and ease that chronic pain to allow her to eat more easily. Those are the big surgeries. There will likely be other small procedures in the years ahead, but Anna Maria she's getting there the way she always has, with a lot of determination.

AMT: What an amazing surgical crew she must have too with Dr. Bush. What a remarkable story. What a remarkable woman.

LL: She is Anna Maria. She's really impressed me.

AMT: Well thank you for bringing us this story, Laura.

LL: Thank you. It was my pleasure.

AMT: Laura Lynch, senior correspondent with CBC News, based in Vancouver. You often hear her as a guest host on The Current. Let us know what you think of the story of Shakila and what Laura has brought us with her story. You can tweet us @TheCurrentCBC. Find us on Facebook. Go to our website cbc.ca/thecurrent. And stay with us, coming up next, the patients need a lot of care and the caregivers are stretched in trying to provide it. Staff in Ontario's long-term care homes are speaking up about what they say is a dangerous mix. I'm Anna Maria Tremonti. This is The Current on CBC Radio One, Sirius XM, online on cbc.ca/thecurrent, on podcast and on your radio app.

[Music: Theme]

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'Seen as part of the job': Ontario nurses, PSWs report 'pervasive' abuse in long-term care facilities

Guests: Sue Moore, James Brophy, Jane Meadus

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

SOUNDCLIP

VOICE: Ontarians deserve to have access to high quality health care, whenever and wherever they need it. They also need safe, comfortable space in which to receive their care.

AMT: Well that is the sound of Ontario's health minister making plans. Just a week ago, to get her province ready for a wave of aging baby boomers, Christine Elliott announced more than 1000 new beds in long-term care homes across the province. Now her promise is part of an even bigger goal. Over the next five years Ontario's Progressive Conservative government says it wants to add 15,000 more long-term care beds. Advocates for people who work in long term care say beds are not the whole problem, that chronic understaffing is. And that leads to dangerous conditions, not solely for residents, but also for staff. A new study shows that facilities experience high rates of violence and abuse. It found that 62 percent of PSWs, personal support workers surveyed, experienced physical violence on the job at least once a week. My next guest knows what it is like to be on the front lines of long-term care. Sue Moore is a registered practical nurse who works in long-term care and she joins me in our Toronto studio. Hi.

SUE MOORE: Hi.

AMT: So when we talk about violence, what are we talking about? What would have you gone through?

SM: Experienced physical violence, verbal assaults, sexual assaults, bullying, intimidation. I've experienced it and I've witnessed it.

AMT: How common is it?

SM: Every day. Every day it happens in long-term care. I believe it happens throughout healthcare every day. It's minimized. It's normalized. It's a systemic problem. It doesn't get reported unless somebody actually sustains an injury. So that's very difficult to actually capture exactly what's going on when nobody is reporting it because it's so minimized.

AMT: And so this is coming from the long-term care residents.

SM: We experience yes, violence from our residence. We experience violence from family members, from visitors, who are then called advocates for their family members, which is very difficult. I think that yes absolutely, it's an emotional time when families have residents who are being hospitalized in long-term care. It does not however excuse bad behaviour and it doesn't excuse bullying and intimidating staff.

AMT: And so can you give me an example of something you've gone through with families?

SM: For me I have an experience from a few years ago where I had some family members who were bullying intimidating all of the staff on our floor. We were unable to reach an incomplete any of the tasks that they wanted. We couldn't do our jobs in an appropriate manner. I apologize. This is very emotional for me and we express concern on a daily basis it was talked about all the time to our supervisors and it was minimized. When I tried to advocate for the staff on my floor in the care of all the other residents on my floor I was alone. I became the target of this family. It went on for months. It began with them calling me vile disgusting names to everybody on my floor turned in to yelling at me while I was out my mad carrot they would swear at me and then it would become verbal threats. It wasn't until I had a man at work say to me I am really afraid of you. You need, I'm afraid for you. You need to be careful. That was the first time that I had actually felt that somebody knew what I was going through. And when I brought it to the highest level of our home I was told there is no written reports about this family. So although we had been discussing it and talking about it on a daily basis and the struggles that we were going through and that I was enduring personally because nothing was submitted in rading there were no specific concerns taken seriously.

AMT: And what did you do?

SM: I called the police because my employer did not take the steps to keep me safe. I felt anxiety-ridden through each of my shifts. It affected who I was as a nurse and the care I could provide on a daily basis. It affected me and when I went to the highest level and they didn't still take my concerns seriously that they were going to look at some more interventions for this difficult family, I felt that it was time that I take care of my safety so that nobody else had to go through that anymore. It wasn't acceptable. My job is to care for the residents and I work with families on a daily basis and the majority of our families are fantastic. We're there to take care of their loved ones, but I can't do that when I'm being bullied and intimidated. It takes away from that care and providing for their loved one as well as everybody else I'm caring for.

AMT: And when you called the police what happened?

SM: They did come in and they did me with the family. I wasn't privy to that meeting nor did I want to be. I didn't want to press charges. I just wanted somebody to clearly communicate to them that they couldn't continue with this behaviour. That what they were doing was wrong. It wouldn't be allowed anywhere else. So why should it be allowed in my workplace where I'm supposed to be safe, so that I can care for our residents.

AMT: Did you ever get an apology from members of that family?

SM: No I however did get a letter from my employer telling me they were committed to my safety.

AMT: After you called the police?

SM: After I called the police.

AMT: You can still barely talk about this. How long ago was this?

SM: Four years.

AMT: It had such an impact.

SM: It did because I don't think that anything has been learned. I don't think that employers are understanding what a significant role they play in keeping us safe so that we can do what we got into nursing. Why were there and thats really sad. Is it such a horrible thing to ask to be safe in your workplace. I don't think so. I shouldn't have to demand that it should be that that's what they wanna do. Because if they do that I will go above and beyond every single day to ensure that my residents are well cared for in the best possible manner.

AMT: Do you still see this kind of thing four years later?

SM: Yeah. We call them advocates and most families are advocating for their family members and they're doing it in a manner that does not bully and intimidate us. That doesn't make it difficult to do our job.

AMT: But some people think advocating means intimidating.

SM: And yelling and you know with the short staffing I mean how incredibly unrealistic is it to think that when the short staffing, chronic short staffing and long term care first of all across the board, two PSWS assisting 30 full care residents with one nurse, how can you possibly meet the needs of our residents to provide dignity to them in the last years of their life. It's really difficult and you're not supposed to speak of short staffing. You're not supposed to tell families that you're short staffed. You just run around, people work through breaks. It's the staff going above and beyond for this population because they matter to us. They become our family. I have devoted my in my career in nursing because I want to care for residents who are elderly, the way I would want my parents to have been cared for and the way I cared for my parents. I can't do that with short staffing and then the violence that comes with it due to short staffing. It's increased exponentially.

AMT: It's really important to hear your voice. Thank you for coming in.

SM: Thank you so much.

AMT: Sue Moore is a registered practical nurse. She works in long-term care and she joined us in our Toronto studio. Well her experience is unfortunately not unique. A new study out today looks at violence against long-term care staff and raises some disturbing patterns. The study was funded by the Ontario Council of Hospital Unions and it was co-authored by the researcher who's sitting across from me. James Brophy is with the Occupational and Environmental Health Research Group at the University of Stirling in Scotland. Hello.

JAMES BROPHY: Hello.

AMT: When you hear what Sue Moore is saying, what are you thinking?

JB: First of all, it echoes what we, Margaret Keith and I heard in focus group interviews, group interviews across Ontario. I have to say though it gave me the chills. I don't know if it's clear how courageous she is to have spoken out because the fear among caregivers in long-term care about speaking publicly is palpable. They literally, that's the reason they don't report because there's such reprisal against healthcare staff and long-term care staff that it's almost impossible to get anyone to be willing to speak publicly and so what she has just described is really important.

AMT: So let's talk about your study then and what you've got the numbers that are behind it because I've got some of the statistics here. First of all, you surveyed workers. You surveyed about 1100 workers and then you did focus groups in seven long-term care facilities. Am I right?

JB: There were two parallel investigations. The first one was a qualitative study where we did group interviews in seven communities across Ontario involving 56 long term staff employees in 30 from 13 different facilities and then after really after our study was completed the Ontario Council of Hospital Unions, CUPE initiated a private polling of long-term care to see what was whether our study essentially reflected what was occurring and it did. In fact probably even more graphically in some sense.

AMT: So I've got this here. 62 percent of personal support workers experienced physical violence at least once a week. 51 percent registered practical nurses experienced physical violence at least once a week. 88 percent of registered practical nurses experienced physical violence at least occasionally. 89 percent of public support workers experienced physical violence at least occasionally. Where do they go with that?

JB: Well the Ontario Health Coalition says the long-term care may be the most violent workplace residents in Canada. I mean it is so pervasive physical violence verbal abuse racial and sexual harassment and sexual assault that it's become normalized as Sue said. It's become literally seen as part of the job. That's why it's discounted that it's really being treated as if that's what is part of your work. And of course it's not. And I think one of the things that was so clear to us as we did the study and it actually was reflective in the previous study we did on hospitals. This is a population a work population that's dominated by women. And when you hear this it comes to you immediately that this is violence against women in the workplace and it's a fear I get parallel so much of the history of domestic violence against women where the free first thing that's asses are was in suitcase in many other cases is what did you do. The victim is immediately put on the defensive end blamed if the cast whatever took place. Then there is all of this fear of reprisal for speaking out and blaming and their constant unsupported emotional trauma begins to develop where people don't feel validated or supported. So that you can have an incident where four years later you can barely talk about it. And this is so common. So it is so clear and the end fear of talking about it. That's what's so amazing about what Sue had to say publicly today. Health care workers are afraid to speak out because they'll be fired.

AMT: I want to ask you about who's in those long-term care homes. We think it is the frail elderly. Who's in there?

JB: No it's not just the frail elderly, although you know thinking of long term care and the people at the end of their life being treated in the fashion that they are is very disturbing but now what was happening is more and more people that aren't our you know how loud the stay if you will and our healthcare system and our hospitals are being set. So people with acquired brain injuries or disabilities that you know can be treated in our normal health care system are now finding themselves in long term care, so you might have a 20 or 30-year-old person with an acquired injury, a brain injury with someone who's 95.

AMT: And that brain injury can do things as well that can be a part of that dynamic right that can.

JB: That's right. Totally inappropriate placement of people with different needs.

AMT: And then she's talking about the families as well. So it's not like the families are part of this. It may be the person who's actually receiving the care is not the issue.

JB: That's right, but you also have people that are are agitated that are dealing with you know cognitive issues all kinds of health traumas. So you have to relate to them in a very different way because there are these conditions the working conditions that she was describing this task oriented efficiencies were you literally you know have two minutes to try to get somebody up and dressed and ready for breakfast. This is a an environment in which things like violence can easily occur.

AMT: And how much of this is about, she talked about really being stretched about staffing. How much of this is about the fact that you don't have enough people?

JB: There is no question. The underfunding, understaffing, the lack of serious attention to this issue. Again I think because women are the majority of who is in these facilities, working in these facilities, regulars don't take this seriously. They don't regulate what's going on. The compensation system is failing. We have a crisis in the healthcare system and these workers health is the barometer for that.

AMT: We did request an interview with Ontario's Minister of Health and Long Term Care, Christine Elliott to respond to this. She was not available. We did get a statement, I'm going to quote it here. "All staff providing direct care to residents must receive annual training and behaviour management, mental health, including caring for persons with dementia and abuse recognition and prevention. Minister Elliott looks forward to reading the report once it is released. The previous government left a fractured health care system that does not work for the people of Ontario. That is why we are building a connected and sustainable public health system that is centered on the needs of Ontario's patients, families and caregivers." What do you make of that?

JB: Did I miss that they didn't talk about violence against healthcare staff because there is no indication, the current government, not to mention the previous government, is seriously addressing this issue.

AMT: Okay and what do you hope will come out of your research then?

JB: The main reason I'm going, I'm speaking with the media is to give voice to the people whose voices can't be heard. What is happening in these facilities really needs to be a very public discussion. I fear, I honestly fear, what could happen in this environment. The day to day experiences bad enough, but you know it's a perfect environment, a cauldron for something even more serious. So if we dont address this, we're not only failing those workers, but staff, our health care staff, they're devoting their lives to helping the elderly, but we're failing the residents who live there, our mothers, our fathers, our aunts, our uncles.

AMT: James Brophy, thank you for coming in.

JB: Thank you.

AMT: James Brophy is a researcher at the Occupational and Environmental Health Research Group at the University of Stirling in Scotland. He's with me here in our Toronto studio. We did contact the Ontario Long Term Care Association. It represents 70 percent of Ontario's long-term care homes. It did not have anyone available to speak to us. The problems identified in this latest report are familiar to those who advocate for residents. There have long been concerns about understaffing in care homes and while the problems seems particularly acute in Ontario, it has parallels across the country. Jane Meadus is a staff lawyer and institutional advocate at Advocacy Centre For The Elderly. She's with me in our Toronto studio. Hi.

JANE MEADUS: Good morning.

AMT: Let's start with your reaction to what we've just been hearing.

JM: Well I don't know that there's particularly anything new about this study. I think we've been hearing about these kinds of things for years and these kinds of statistics have been coming out across the board. It's not this government, it's not the last government, it's just an absolute failure in our system since I've been working for the elderly for over 20 years. We've been seeing it getting steadily worse under any government. And that's the problem.

AMT: So what do you heari from residents and their families about violence in long-term care facilities?

JM: Well of course we hear more about residents violence against the residents and issues with respect to families having issues, but I think it's across the board. I think we hear both sides of it I think families certainly do cast and are concerned about their loved ones perhaps striking out at other people. We're actually seeing quite a bit of criminalization of the elder abuse or when people get into these situations the police sometimes are called and then went to jail you know the big problem is and I think you know we've heard this from both the previous speakers. There is not enough funding and it's a whole cascading effect so the staff don't have time to provide the proper care. So they're just going from patient to patient to patient very quickly they're not able to deal with the person's needs. We have short staffing we have agency staff come in who dont know the residents that causes you know if youre coming in you only have five minutes to dress and bathe and whatever a person youre not able to deal with those needs and those behaviours that they might have and sort of could draw people and deal with them in a proper manner and thats not a slam against the staff its they all have the time. So thats when youre going to get these kinds of behaviours and that's when you're going to get families getting upset too because they see this and they get upset.

AMT: Are there regulations around staffing levels in long-term care facilities?

JM: So in Ontario the staffing level is one RN per facility. Thats it.

AMT: And how many people would be in that facility?

JM: It could be 20, it could be 400. That's the only specific, with respect to the nursing staff. You know they have to have a medical director, they have to have a dietician, but there's nothing that says how many PSWs, personal support workers, how many hours of care or how many staff per resident. There's nothing like that in the regulations in Ontario.

AMT: And you know how that compares to the rest of the country?

JM: I think there's some levels in other provinces. Certainly anecdotally, we certainly hear that Ontario seems to have sort of the worst stats in Canada and it certainly has historically not been well funded that way.

AMT: So its basically you've got all of these things working against each other. This intersection of low staffing and people frustrated and people scared on both sides.

JM: And I think there's another issue too and we were hearing just about you know we're you know we've talked about the deinstitutionalized of psychiatric patients and people with developmental disabilities, well it's not deinstitutionalized. They're going to long-term care. We also have a sicker population so we have people with more dementia because people live longer, they have more dementia and with that comes some behaviours. So you're getting a very different population then you would have had 20 years ago. You're getting people out of what would have been psychiatric facilities chronic care hospitals and the funding hasn't kept up so maybe the acuity has gone up you know a huge amount but the funding levels only gone up a small amount. What level of investment would it take to solve this huge huge amount of embarrassment. You know we're seeing some programs like the butterfly program for example and people that has just happened recently. It was a wonderful program and it had it do. So they provide more staff they provide more time for the staff to sit down in nicer environments but it's really that time we think with the residents and being able to provide the kind of services and outlets for the residents and learning about the residents so they can provide, they can be properly cared for and also fulfilled during the day, as opposed to stuck in a corner. But it probably doubles the staff.

AMT: And so this becomes a societal issue. This is the amount of money we as a society want to spend on the elderly or on ourselves as we get older. Do you see it changing with the narcissistic baby boom generation turning into the people who are going to go there?

JM: Well certainly we see that with the family use because they're certainly demanding more in the system and that's where you do get families getting quite upset. You know part of the problem is that we're trying to get everybody out of hospital and so we talk a lot about beds and so people are always building beds, but they're not putting the increased staff that's required.

AMT: And so again where do you see that going? Because again this is we decide, right, every politician will tell you children, like the most vulnerable matter. One the one end it's children, on the other end it's the elderly, but that seems to where everybody gets nickeled and dimed.

JM: Yeah and I think it's definitely the elderly. We wouldn't put up with it with children, the kind of behaviour. I think people really just have to go to their politicians to say, yes we need more facilities, but we also need that level of funding. We heard that at the inquiry into the murders this summer about how funding is going to be so important because of the level of care that's required.

AMT: And do we need to look at a whole different system do you think?

JM: I think that there is certainly there are some people looking at different systems like the butterfly alternatives, the Eden alternate. I think we do need to work out better systems. We need certainly to change the way many of the homes are still and have these big words but we need to provide I think not only the care so it's not only just hands on care but it's also programming of things for people to get them out of bed and keep them occupied because when they're bored and that sort of thing. This is when all of these things happen as well.

AMT: How long have you been doing this?

JM: Over 20 years.

AMT: And what have you seen change?

JM: Certainly the acuity level people who are living in long-term care are certainly a lot sicker. A lot more push to get people out of hospital in back home where it doesn't work very and then you're ending up with people going long-term care in crisis systems. A big push for the private sector. So they're certainly trying to get people to use retirement homes, which are not long-term care homes and that's a huge difference. We didn't see that 20 years ago and now people are telling them, hospitals actually tell people that it's mandatory that you go to retirement homes, which of course it's not.

AMT: And did you see everything in crisis? Like when this happens, it's always like we've got to do this now. There's no planning.

JM: Absolutely everything is in crisis. You know there's homes where you can't get into that home unless you're in crisis. We're seeing homes that can't find staffing. So that one RN that I talked about, there are many homes in Ontario who are breaching that I'm sure right at this moment because they kept can't hire an RN staff because they can't afford it. The staff are going to hospitals, which pay better. The work is much harder and much more difficult in long-term care. RNs don't want to work there, so they're not even able to meet that one RN staffing requirement. People don't want to work in long-term care, it's too hard. It's very difficult and it's a big crisis.

AMT: We have to leave it there. Thank you for coming in.

JM: Thank you.

AMT: Jane Meadus, staff lawyer and institutional advocate at the Advocacy Centre For The Elderly. She's with me in our studio. Let us know what you think of this. What you think we need to be asking our governments on this issue. Tweet us @TheCurrentCBC. Find us on Facebook. Go to our website cbc.ca/thecurrent. That is our program for today. Stay with Radio One. It is piano week on Q today and so that continues with Olliver Jones who got his star, Canada's master of jazz piano, five-years-old start in Montreal's famous Little Burgundy neighborhood and Tom will be speaking to him. Before you go, I have perhaps an unpleasant reminder for you. It is tax season. You have a month to dive in to that old shoe box full of receipts and compile your T-slips, the 3, the 4, the 5, whatever they are. We're going to leave you with a song to get you going from Aloe Blacc and "I Need A Dollar." I'm Anna Maria Tremonti. Thanks for listening to The Current.

[Song: "I Need A Dollar" by Aloe Blacc]

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Mar. 26, 2019 episode transcript

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