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The Current Transcript for April 29, 2019

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Prologue

[Music: Theme]

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VOICE: Basically I'm one of them. I'm very much identify with the people who never really settle and always being discriminated for no reason.

ANNA MARIA TREMONTI: That voice seems so quiet for a man whose acts and words boom out across the world. That is Ai Weiwei. His art is celebrated, his films are raw and powerful documentaries that can pack theaters. He's a Chinese dissident who has never backed down, even when he's been put in jail. But when he walks into a room, there is no swagger, no hubris. He's open. He's interested. He wants to talk. And when he came here a few days ago, he wanted to talk about refugees, the subject of his latest film, but also people whose dilemmas he understands because despite all the fame, he is one of them. You can hear my conversation with Ai Weiwei in half an hour. After that, decades ago a library was a place to discover the world. Today, it can be a place to discover your neighbours.

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VOICE: The places that offer us a chance to be in an open space with other members of the community, that is something precious.

AMT: Increasingly, libraries have become a crucial community hubs, offering space for the curious and the vulnerable. As the Ontario government makes funding cuts to its library system, we're asking how libraries have changed and what their presence means to communities. That's in an hour. But we're starting with the nagging questions that persist after a simple heart-wrenching, heart-breaking message went viral out of Nova Scotia last week.

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VOICE: Look into my eyes and tell me that there is no health care crisis in my province of Nova Scotia. I dare you.

AMT: I'm Anna Maria Tremonti. This is The Current.

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Expectant mother worries hospital staffing shortage may mean 200 km drive to give birth

Guests: Stephanie Ellis, Jeannie MacGillivray, Andrew Boozary

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VOICE: I am a 33-year-old mother. I went undiagnosed with anal cancer for two years because I did not have access to a family doctor. It's OK though. Right? Because they caught it. They caught it when it was stage three.

AMT: What began with a video that went viral of a Inez Rudderham's story. No doctor, no diagnosis, until she had stage 3 cancer and then her dare to Nova Scotia's premier to deny there's a health care crisis in the province cascaded over the last week. Within a day the Yarmouth Regional Hospital advised pregnant women in its region that a shortage of anesthesiologists means they may have to travel between two and three hundred kilometres to other hospitals to have their babies. The doctor shortage so acutely highlighted in Nova Scotia is actually more pronounced in some other provinces and we will get to that in a moment, but first Stephanie Ellis lives in Yarmouth, Nova Scotia. She is among those pregnant women being told they may not have access to the hospital in their community because of the shortage. Stephanie Ellis joins me now. Hello.

STEPHANIE ELLIS: Hi, how are you?

AMT: I'm well. Thank you. I'm just wondering about you. First of all, when are you due?

SE: I'm due May 21st.

AMT: And what did they tell you about your ability to deliver at the Yarmouth hospital?

SE: At first they were saying that they only had anesthesiology coverage until the middle of May and now the Nova Scotia Health Authority is saying that they do have it until the end of May. So as long as they don't go too far over my due date I should be OK.

OK. And if you do go over your due date like where would you go if you couldn't go to the Yarmouth hospital.

I would go to Kendall which is about two and a half hours away.

How do you feel about that.

Nervous. It's it's my first baby. Me or my husband have no idea what to expect and just the thought of having to drive that far away in labor with no pain management or no idea what to do if the baby is coming.

It's terrifying to think about that and that when the hospital sent this letter out they also made the point that it's for women who might need care even before delivery like if you need any kind of care that that gets complicated. It's the same problem right. They may not have an anesthesiologist there.

Right. We have a prenatal clinic at the hospital there we still go there for all of our appointments. But if there are any issues and there is no anesthesiologists for pregnant women or not pregnant people they're going to have to go and either go to Halifax Bridgewater or cancel all three of those are two to three hours away.

And do you know other pregnant women then who are facing this.

I do actually I know about 10 people who are pregnant right now that are due either around the same time as me or like in the middle of the summer. A lot of people are hopeful that it'll be fixed by then and I hope so too for their sake because I can't imagine having to having to do that drive that far in labor and amongst yourselves have you talked about what the options are. I know a lot of people are planning on going to Halifax the last week of late before their due date just to stay at a hotel hopefully they'll go into labour while they're there and they won't have to worry about it.

I know some people have been talking about that as do you guys discuss all this why what's the feeling what's the mood.

I think a lot of people are really scared really frustrated because the doctor shortage in all of Nova Scotia is insane like there's clinics in the big and the big city of Halifax that are closing because there's there's no doctors and Yarmouth is a regional hospital like there are two other hospitals within an hour each way of Yarmouth but they can't deliver babies either because there's no anesthesiologists Oh and so they would be though the women in those areas would have normally then come to the Yarmouth hospital.

So there is actually two Yep for sure. Do you have a family doctor.

I do.

Thankfully my husband doesn't though OK because why he can't get in. There's. I want to take him right.

And mine is going to be retiring soon. I he delivered me and I'm 27 so and he's been my doctor my entire life. He's getting up there he's going to retire soon so I'll be without one soon as well.

In the letter it's sent to the Yarmouth Regional Hospital said it is trying to get on another anesthesiologist to be able to come to that hospital to work full time what do you think it's so tough to attract people to work in local hospitals.

I don't know about all local hospitals. I just know that Yarmouth is it's a very small town there isn't a whole lot to do here. Three hours away you have Halifax it's a bigger city there's more cultural activities there's more entertainment there's better schools universities but you have people that were born and raised here that are leaving to go work elsewhere. More opportunities.

You decided to stay there.

Yes. I was born and raised here. I love it here if you're from here. I think it's great. But if you come from away or you come from like a bigger city or something it might seem kind of kind of boring and as Rutter him in that video that went viral said that it's a crisis.

Well what do you think.

I completely agree. There are so many people without family doctors and even hearing elements like there is a hospital in Shelburne and in Digby which is an hour each way from Yarmouth and their yards are often closed. So the E.R. at the Yarmouth Regional Hospital has been packed lately because there is not enough doctors to cover the E.R. and the other hospitals and people are being turned away without being seen or told to come back because it's too busy here are sitting on the floor because there's no seats available because there's so many people.

What kind of answers do you want from your government on this.

Honestly I wish that they would just kind of acknowledge that there is a problem of they've been saying oh there's no health care crisis in Nova Scotia. And I think it would be nice for them to at least acknowledge that there is an issue and kind of step up to the plate and try a little harder to get us some doctors around here.

Okay. Well Stephanie thank you for speaking with me today. Thank you.

Stephanie Ellis is expecting her first child in mid-May. She lives in Yarmouth Nova Scotia that's where we reached her physicians and other frontline health care workers in Nova Scotia. No many patients are at a loss to get the doctors they need but many like my next guest feel powerless to fix things. Dr. Jeannie McGillivray is a general surgeon from Antigua Nish Nova Scotia late last year. She closed her hometown practice. We've reached her in Kent Phil Nova Scotia today. Hello. Hi Anna Maria.

Why did you close your practice.

I know I was one of three general surgeons in Antigua Nash for almost 12 years and again this is a small community where we have specialist care and we can really only support three general surgeons did it to do the elective work the owners burden and lots of communities in Nova Scotia feel this with small groups of specialists. You do very frequent calls so my call was 1 and 3. So that means that I do my my day job every day I'm in the operating room with the endoscopy room at the office and then I cover the emergency room and not just the one at my hospital but five or six other small rural hospitals as well at night. And that was becoming increasingly onerous over time.

What would what would that mean that you might have to drive to another E.R. in another community at night.

You know I couldn't do that I actually one of the restrictions restrictions with call is that I can't leave town I can't be more than 15 minutes from the hospital so they can bring someone to you they will bring someone to me. Yup. And so there's a lot of waiting through the middle of the night. You know if I get a call at 11:00 p.m. That person may not arrive from Kansas Sherbrooke guys growing until 3:00 a.m. and then then go through their workup. So I can be awake all night just waiting for that person to arrive. And you decided this was not sustainable. I recognized that probably five years before. I had to close my practice I had met with senior physician leaders to say you know I have some solutions I've some some some options here to try to make this sustainable and I now know as I travel around the province doing locums that it's absolutely not just me and it's not just general surgery I spoke with an internist in Truro this week who is doing also one in three call and it is he he also uses the word unsustainable. We can do this for a while but not forever. What's a locum a locum. So I'm in a community right now that really should have a full complement of five general surgeons just with some restructuring of the Surgery Department they just have for and that call burden is onerous for this particular community they're incredibly busy from a surgical point of view and they really could use five. And so I'm here to cover a call I'll cover the emergency departments and the inpatients for. For that surgeon I'll I'll take his call this weekend and give him a bit of a break.

It sounds like you still work pretty hard though.

There's lots of locum work in this province. My colleagues there are three groups in the province where they're also 1 in 3 and in those both of those regions have contacted me to provide call coverage as well.

So what you decided to close your practice because of the the the conditions you talk about what happened to the patients who were scheduled for surgery with you.

I had it my my resignation was not a textbook resignation.

I had to call the College of Physicians to say you know I can't follow your Web site instructions because this is a little unusual. Usually a physician would only close a practice suddenly in the cases of sudden illness or death. So usually what we try to do is is closed down or practice is gradually and give referring physicians time to redirect referrals elsewhere in time for us to arrange for someone else to care for for the patients under under our care and I had been given a deadline of November 30th and on that date I was to decide whether I was going to apply for an extension of my leave of absence whether I was going to resign or whether I would return to practice and I I wasn't sure because I there had been no dialogue or no discussion. None of these suggestions I had made to make my my practice more sustainable. So a few days before this deadline I sent an email to The Zone medical chief to say I need some clarification here I need to know some day the exact description of the job from which I'm resigning or to which I will return. Am I a one in three general surgeon where I have absolutely no ability to modify that job and I just didn't get a response from to that email. So I had been waiting until the end of November 30th of that day to see if I would get a response so I would know what decision to make here. And at that time I got a call from the emergency department at St. Martha's telling me that I was on call and I did not know that I was out of town and I'm going to move you along though I just knit.

So basically did they tell you you were done before you told them you were done.

No I was just in a situation that I couldn't meet the requirements on that particular day. I felt that that that I didn't know I there was no there were no changes to the job so therefore I felt that I had no choice.

OK so what happened to the patients get surgery get scheduled way ahead. What happened to the patients who were scheduled to have surgery with you Did you have to refer them and where they accepted.

I had to cancel those patients and I had referred them to I was told that I should refer them to the other surgeon. At that time there were two other surgeons and anti Ganesh. I was told to refer the patients there but then I get e-mails back telling me that those patients would not be accepted to those surgeons. And then I had to send out the other letters to all my patients again telling them that I would have to refer them back to the family physicians and I were almost out of time here.

But you offered solutions to make this better and the the the the authorities and what did they say to you. I don't nothing.

We didn't engage. There was no discussion I have no idea why why none of these solutions were considered feasible some of them were an attempt at a part time option. I actually found someone to share my practice so we would have been a full time general surgeon. We would have been one full time equivalent where one of us would have been there at any one time and that was deemed to be an unacceptable option. So there would've been no loss to services to the community.

Jeannie McGovern we have to leave it there but thank you for sharing your story with us. You're welcome. That is Dr. Jeannie McGillivray general surgeon she closed her practice in Antigua Nash late last year you heard the backstory on that we requested interviews with the Nova Scotia Premier Stephen McNeil the minister of health and wellness.

And the health authority.

No one was available to us today. I've got some stats from CBC Kelly Crow according to a patient registry in Nova Scotia 52 thousand people are actually looking for a doctor in Nova Scotia beyond Nova Scotia. These issues play out across the country. Other provinces actually have a higher percentage of people looking for family doctors in Nova Scotia it's about 10 percent in Alberta it's 18 B.C. at 16 in Quebec 26 percent of people do not have a family doctor. Dr Andrew Basri is a primary care physician and the executive director of Health and Social Policy at the University Health Network in Toronto. He's with me in our Toronto studio. Welcome. Thanks so much for the invite. Thank you. What's going on with the health care system in Nova Scotia. Let's start there.

I mean I think from you know the gas area will be here I mean it seems like it's under a lot of duress and in some ways this isn't unique to Nova Scotia. I think this is an issue where you know I think the term crisis was used you know in some ways I think if you look at the data of the last few years sort of the last decade it seems to be a chronic crisis that's sort of been you know happening across Canada. So as you know it's a heart wrenching story in terms of what's happening to patients. It's concerning to hear about the dress that some of your sort of frontline colleagues have or sort of surgeons and physicians have and nurses in other areas and other jurisdictions of our own countries. So I mean it's incredibly concerning and I think it's been something has been raised that's been happening for quite some time.

And so I just kind of listed off other provinces where people are looking for primary care physicians.

Is it Waterson in error in smaller communities that urban. I want to see urban rural but not even rural like smaller communities versus the big cities.

Yeah I mean it's a great question I think that actually one of the if we are to use the term urban rural I mean I think if you look at that divide in rural parts of this country have seen you know worse access to healthcare have had worse health outcomes. A recent study by Dr. Cooper here interests of trying to put Ontario would show that for patients who've had a stroke they actually had worse health outcomes if they were from a rural or small town or community.

And that's because they can't get to the proper care in time.

Part of that can be some of it can be screening in the other part of it I think to talk about if we're looking at issues of zip codes if you look at areas in terms of rural neighborhoods in rural towns it's also about what that would look like in terms of some of the other social factors that would go into it in terms of what sort of access people would have in terms of housing in terms of income education and other access issues so when it's also about health care.

But I think it's also about the sort of social conditions at play in and in the statement it's sent to and as a writer ham the Nova Scotia Health Authority said that her story shows them quote why that why we need to continue efforts to recruit providers expand access to primary care make sure our system is better connected and ensure that timely supports are available to all in the province. That's the quote. Where do they where we're where we're just start with a list like that. And is that list similar elsewhere.

Yeah I mean I think that from you know as a physician as a researcher it's hard I'd be hard pressed if see that you could find an area of investment that might be better than primary care or public health you know in terms of where we could see real impacts on population health and improved health outcomes and people's fear of having better access. And that's been a challenge I think again a chronic challenge for a country in terms of access. But the other piece about is I think you know it's also about connecting our system. I think one of the biggest challenges for us are sort of real sort of attractions has been that we haven't really been able to work as a health system. I think some people kind of scoff at the notion when the Kansas Health System is even referred to as one given it's sort of siloed and fragmented nature. So I think part of it is one of us sort of thinking about the investments in primary care getting people access. But for people who do have access to a family doctor it's already really difficult to navigate our health care system even if you're in the loop you know and I think that these are the sort of system issues. These aren't individual failures you know whether it's you know surgeons who are stepping away from practice or patients who are unable to connect. These are not individual issues. These are issues that I think are coming through from the system.

Now the Ontario government is looking at connecting some of that is it not. It's not what it's it's announced a policy to do that.

AB: Yeah. So I think there's some excitement and optimism about Ontario health teams that sort of were announced just last month. You know I think to you know sort of where the conversations have been I think the point that Dr. MacGillivray raised about solutions and you raised about you know are we engaging people in solutions. To me one of the I think the most exciting pieces about the Ontario health teams is that patients are supposed to be central to any applications that come through and I think if we are going to have a sustainable system or a high performing system, patients need to be involved with a co-production or co-design of what health care looks like.

AMT: Shouldn't, it's all about the patients though, isn't it? Why is that such a leap?

AB: Yeah it's you know I think that it's this is unfortunately been a characteristic of our health care system I think from its roots or its its foundations. There was a power differential between providers and patients. I think that fortunately we've seen a democratization of this. I think this has improved. We've gone from patient engagement to now hopefully what we're talking about patient co-production and code design and what I think the encouraging piece on to our whole team is that patients have to be a central piece of any application to go through. And the idea is that you'd actually get a lot of different health care providers and people weren't necessarily health care providers but people involved who do great work for health like social workers other community agencies involved from the get go so that patients aren't slipping through the cracks. Patients aren't falling through any sort of the safety nets that are there and there is sort of an ability to have a bit of a more holistic view of the patient experience.

AMT: You raise a lot of good points some that hopefully we can keep talking about in the future including navigating health systems. Thank you for coming in.

AB: Thanks, Anna Maria.

AMT: Dr. Andrew Boozary is the executive director of Health and Social Policy with the University Health Network. He joined me in our Toronto studio. Let us know what you think of this conversation. You can tweet us @TheCurrentCBC. Find us on Facebook or go to our website cbc.ca/thecurrent and click on the contact link. You've got experiences you want to share with us, go ahead, we want to hear what you have to say. Stay with us. The news is next and when we come back, I'm speaking to Ai Weiwei. This is The Current.

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Canadians held in China will feel 'forgotten,' says artist and dissident Ai Weiwei

Guests: Ai Weiwei

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

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AMT: Still to come, in an age of e-books and Google, what's a public library really for? With cuts coming to library systems, the role they have to play in the 21st century is coming into focus. In half an hour, how libraries are evolving into the digital age. They're doing a lot more than lending out books. But first, Ai Weiwei.

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[Sounds from protests in Calais, France]

AMT: If you could see the images with those sounds you'd see police armed with batons and shields wearing body armor helmets visors. Go back go back. They are saying one jams a baton into the chest of a young man to force him away. That's the scene at a migrant encampment in Calais France one of the many confrontations between authorities and refugees captured in a powerful new film by Ai Weiwei Ai Weiwei is the acclaimed Chinese dissident artist and activist who was jailed in 2011 for 81 days. The official charges were tax evasion. The more likely reason was that his work criticized the regime. In 2015 Ai Weiwei fled China for Berlin. And since then the key focus of his art has been the plight of refugees.

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I tried at times to get degrees but I couldn't. The first time. When we tried when we got on the boat. When we were all underwater. Suddenly. The word. Broke down. He was close. To kill my family and my son. I can't go nowhere. I cannot go back to Afghanistan. I cannot go to Greece. I don't know what to do.

AMT: Well the voice of a desperate man in a scene from the rest by Ai Weiwei. The film is screening in Toronto as part of the Hot Docs film festival. Ai Weiwei has been in our Toronto studio before and he came back to talk about his latest film. Here is our conversation.

AI WEIWEI: Hello.

AMT: This is your second feature documentary about the plight of refugees. Why has this subject been such a preoccupation for you?

AI WEIWEI: Well first the subject is ongoing. It's the scale is unbelievable. We are living in this world have over 1 7 2 million refugees lost their home. And the numbers are continuously growing globally starts just so why region but you almost covered the whole road. The new film The rest of it trying to focus on the ravages already escaped once they arrived in Europe. So that step seems very important for refugees. But what happened when once they arrived in Europe is Europe really welcomed them or they can't really accommodate their need or are they just being refused the push to way and set up all kinds of policies to make their life even more difficult.

You know I there's so many scenes I remember from your first film on this human flow and the powerful huge scenes and this one becomes almost more intimate more intense because you really focus on individuals and we we watch them in L in a limbo that they've got nowhere to go when we heard it in that clip too.

Can you describe some of the conditions you saw these people living in in that in that moment they arrived they think they've got somewhere to go and then they're stuck in their experience are devastating first you when you see the situation first say you were to shake your hand sadly this is not a Europe that this is not the land which always talk about democracy human dignity and individual rights but he basically see Europe doing very little or almost nothing in many many cases. So you'll see people has being this kind of detention sometimes for years the release of anybody really to inform them what will be next.

And you capture that frustration and that anger in this film.

I still think of what it did is a very superficial not very deep. Life itself is so much harder than what being seen in this film.

Why why do you say that. Do you think that that there's something that no film can capture.

Life itself is second best second day by day I know you. How do you staying hands which has no light as a ringing and the whole do you go.

Why did you take a shower in all and what he'll waiting online for a cup of soup could take a two three hours and if God is just a event or a few days maybe it's OK but if it's four months or years and then you are basically cut off from your own language neighborhood or religion you know I did get some of that message in your film that you're talking about to give you credit in the sense that that when we think often of refugees we think of of the camps and you show this inhuman flow where they're all in a in a nice neat geometric row pattern and then people walk between but what you show us in the rest is the scattered kind of ad hoc way of living like sitting on a railroad track or just like being nowhere you know on the rocks by the shore. And nowhere to go. We meet a man from Iraq who says Europe has no respect for human beings.

While many of them has been you may return back to Germany sending back people from Afghanistan back to their home because Germany way Afghanistan as a safe nation which is observed in Afghanistan probably is the most dangerous society. After three years of a war created by us and by Europe there is also anger from people in the places where the refugees have arrived. What are some of the things you heard from people who lived there who went who were dealing with this influx well when people say these are those tongue received the ravages of course as a general matter beginning the more there was it was with some compassion. You know to say we cannot push them into the water but very soon they realize those people is going to stay. And basically they are they are being forced to stay in the location. They just arrived. So the Canada spread out. So that will ruin ruin the local economy or you know the we'll have more direct conflicts based on the local people.

There was a woman who said they can't fish anymore because of the dead bodies in the water. She was complaining.

Yeah. She says we cannot eat fish anymore because they see dead bodies as sound the libido cereal. But it's true. You know you often see that bodies there and so many people being killed by the ocean and because no one wanted to provide any safe passage for those victimized people.

It seems that attitudes are hardening against the people who are part of this migration Why do you think that is I think the world is more divided than the rest in case should be.

After globalization we think the economically we share so much and we profited from globalization by same time there's a bigger gap between rich and poor. Big corporations and and local you know ordinary people. So as those can the problem become even more much stronger.

Did you think the rest of the world was kinder before you got out of China.

Yes of course. Still it is kinder but it's a very relatively speaking. If it doesn't touches their interests yes. But still it's quite disappointing.

To what extent do you identify with the people in this film.

I basically I'm one of them. I never had a home. Even you know I born in China. Christine in China but still you are being always being forced to new locations because my father was exiled. So I'm very much identify him as the people who never really settle and always identify with people who are being discriminated for for no reason for anybody. And just look at them. They would know OK. Those people need help you know. But I don't know why this kind of hatred towards those people.

I remember when we talked last year you were five years old weren't you when you went into exile. Because you were forced to next year.

I was born. I think. In 1957 my father was exiled. So I curl up with him in my room or to the area code in jail or is the area. They put a Will were camps today. So I grew up there.

And so when you were making this film and you saw infants and toddlers did the toddler a little boy and you did that the debt take you somewhere.

Yes. Do you see yourself. You know it's very easy you try to imagine. Wonder why the what happened if the person see you you know why did you learn why you are so young. And there you see people has been treating your family so unfairly and and that's such a pity they have to give that image to young youngsters and. And for years they will never receive right education.

How do you see your responsibility as an artist to address political issues.

I first see myself as a human being. And art has to as this certainly is the kind of profession or identity I have. So but to the core meaning of being artist. So you have to be conscious you know while you formed and also you give out your emotions and judgment through your or your work.

I trying to integrate my so-called myself.

My experience in dealing with the reality will you open an exhibit in February at the Gardner Museum in Toronto and you released a statement at that time sharply critical of Western governments for pretending not to notice China's human rights abuses or in some cases being a willing partner.

Why is it important for you to do that.

I clearly may see today w under China has the relationship become a more uneasy or not so stable.

But how to really recognize a society like China which has won six of the world population and fast growing. Of course everybody is benefited by globalization. The Chinese European or West relations but at the same moment we realize China is not recognized those common values democracy you cannot even talk about democracy in China and independent.

Price and freedom of expression although since there simply are not.

Are you sure. Caveman tuck up hard. So. So what kind of societies.

China.

I was just reading that China has cracked down on its own film industry more than before. It is only green lighting films that don't fit a certain view.

It's always like that. Not only in film but your film is popular. But television or writing or even rock candidate or Sun or you know Anderson it recognizes how important artists. Yes you have to only give a clear reason why they are freedom or more art. I always ask you know why. Therefore you know about art because art is directly associated with personal freedom and a state like China certainly cannot talk about personal freedom. So that kind of society why getting so powerful. What benefit to the humanity or not. That's a question.

It's like you become the most dangerous man because of your art.

Strangely enough I become more Stenger as a man and only because I speak hard. What might main feeling so I know why I wouldn't call it a truce but a relay to me as a truce.

I need the personal freedom to to be artist talk to me a little bit about what allows you to do that. What is in you. You couldn't just live your life in China so that nobody would point to you or give you trouble. What is it about you inside of you that bubbles out.

I think it may come from my father. He has a point. His dad in Paris in the 1930s. I see this man as very very innocent man and loves art and poetry and I tried to do involve himself for this nation's independence. He's been named as a people's point the most important one but he has been totally trashed by the Communist Party exile underfoot 20 years clean the public toilet. Not a lot to write Anderson. So I see him leaving next to me. You know I say example you know as someone who was so purely just uses the words poetic words is not human and communist. By the being seen as an enemy of the people. So the way they treat him or his generation and are so brutal. You know there's a half million of so-called rightist being sent to labor camp and he survived. He came into several times committed suicide but his Nada Oh now he passed away. But he survived but many many people just disappeared and nobody even today you cannot talk about what happened to them. China still doesn't recognize all of the historical mistakes. It will not see that as a mistake. They said that's necessary. So then as the artist is Nada I I'm trying to choose strategy or assumption is is part of me. If they take away freedom of speech it takes the most precious meaning of life. I will not have expression. I will not have a fight that today. You know it's all sense to us. For me is the most precious part of my life. So I I did those five times which is absolutely necessary. Doesn't matter what kind of consequence to me come to me. That's me for I don't have that I'm simply not a living person.

Do you think about what it is then in a society that makes you go one way and you just explain no one makes a whole bunch of people go the other way and want to put those handcuffs on you or your father or put you in prison for a long time what what makes people who face those same things go the other way and for lack of a better phrase roll over for the stink eye is as really question as a human.

A question I would ask myself every day why is that over one point three billion no four billion people are not really respond or react to this clearly and healthy or injustice society. I cannot answer it is maybe part of the culture maybe because communist stopping being so strongly cut half those people every so-called working unit or every corner of this society. Anybody want to question the situation has been punished under only the whale or listen to them has been rewarded. So for past 70 years after this kinda very sickening process there's almost no ground for anybody to research question you know even students or the report Professor you know this happens of just like in the Cultural Revolution happened to report away for each song reports their father and the commonest use that as a tactic to really controls humans mind.

And you you know what it's like to be detained in Chinese prisons. I have to ask you because you know in China right now there are two Canadians Michael spanner and Michael coverage. What what do you think they might be experiencing can you even fathom.

I think they probably in the same kind of condition when I was 10 so is total isolation. So make you feel you are totally vulnerable because you cannot see your lawyer or your family and nobody knows what's going on. So so the idea is to isolate you on the break your nerves down so make you feel nobody cares. And that is can be very powerful. Well this is an isolation can be very painful to hear. It's is painful but it also adds make you disassociated with what you believe. You know so that date. It puts you into a condition you feel the whole world was like that. I think that's the most the worst feeling you can get is nobody care about your condition anymore. Well what do you think the Canadian government should do. I think they should do their rights and that means that they have to demand a very basic human treatment or respect the law. You know in our society may now or never do sense the same. If you don't respect that you don't respect the whole establishment of the law for society I want to go back to your documentary the rest.

Is there a way you expect or would want us to feel at the end of that it's not have propaganda is it simply just to reveal what I have experienced off on I have seen. After they said they would have their own conclusions I came away with a profound sense of guilt I think I also do and I feel in a certain sense if and your tragic moment happens to any society we all have a sense of acute guilt is one thing but then you have to kind of be more open.

I'm guessing you don't like. It's not good enough just to feel guilty.

Your guilt is kinda almost religious feeling but as a human being where you want to or will act if someone is dirty we have to clean up. We have to you know make it better. And this is for our own children and conditions.

While Anneke I should say that's the other feeling I had that there is so much about the people you focus on that is just like the rest of us. These are people with families with hopes who left homes with things they cherished. They're not a lot different from the rest of us are they.

AI WEIWEI: No. Not at all. If we understand ourself trying to find the right neighborhood for our children you know we want to use them for them and for them and get a better education. So later they may have a chance to meet the competition and challenge ENDA to to have a easier life so to ever use their live for me. So we should not make other peoples life more difficult. You know we cannot solve, you know they can never go back to their country. You know it's still in such a unbelievable condition, but to make it easier for them, it's not such a big deal.

AMT: There's a lot to think about in your films Ai Weiwei. Thank you for coming in. Thank you for your work.

AI WEIWEI: Thank you.

AMT: Ai Weiwei, the acclaimed Chinese dissident, artist and activist. His film, The Rest, is screening in Toronto as part of the Hot Docs film festival. His exhibition Unbroken is on view at the Gardner Museum in Toronto through the 9th of June. Ai Weiwei was with me in our Toronto studio. I got a selfie with him. He likes to take the selfie. And so it becomes a piece of art because he took the photograph. You can see it on my Instagram feed @AMTremonti. What were you thinking as you listened to him? Tell us. You can tweet us @TheCurrentCBC. Find us on Facebook. Tell us there or go to our website cbc.ca/thecurrent and click on the contact link. Ai Weiwei, his latest film called The Rest.

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AMT: In our next half hour, forget shushing, librarians and libraries today are doing much more than lending out books and providing a quiet place to study. We will step inside the library of the 21st century, as funding cuts threaten the work libraries are aspiring to do. 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.

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Meals, medical aid and more: The evolving role of public libraries and what they stand to lose

Guests: Kathleen Peverill, John Pateman, Amanda Oliver

AMT: Hello. I'm Anna Maria Tremonti. This is The Current.

SOUNDCLIP

VOICE: So this is our weekly teen music jam called, It Might Get Loud, in our media studio. We have a media studio at the Central Library where people can come in for free, use our recording spaces and our professional equipment. We have recording gear, as well as a number of instruments like guitars, bases and digital drums. Kickstart their passion.

AMT: Well that is Danielle Dungy of the Halifax Central Library. You got it, library, taking us on a tour. The weekly session of It Might Get Loud is not the only surprising thing happening at the library these days.

SOUNDCLIP

VOICE: So I'm going to show you our light therapy lamps. So we have two lamps in the library that people can use. It's very simple to use. There's just a switch on the side and we just turn it on and then we can use this button on the front here to adjust it to whatever height or angle that we prefer. Light therapy at the library. Yes it's very exciting.

AMT: Daniel Dungy of the Halifax Central Library telling our producer Mary-Catherine McIntosh about the library's light therapy lamps. If you don't have time for a light therapy session during your visit to the Halifax library, you can always borrow a lamp to take home along with your books. Clearly as the needs of their patrons shift, libraries are moving beyond books. You are just as likely to see a row of computers in a library as a row of encyclopedias and many patrons are not even looking for books or computers at all. They want a warm place to spend a few hours. That reality has forced librarians onto the frontlines of some difficult social challenges such as homelessness, mental illness and addiction. Meanwhile, as libraries offer a broader range of services, some of them are facing shrinking budgets. In Ontario, the latest budget cut provincial funding for libraries in half. To talk about the evolving role of libraries and the impact all of this is having on librarians, I'm joined by three people: Kathleen Peverill is the director of Public Service at the Halifax Public Libraries. She joins us from Halifax. John Pateman is the CEO and chief librarian at the Thunder Bay Public Library. He's in Thunder Bay, Ontario. And Amanda Oliver is a former school and public librarian in Washington D.C. Earlier this month she wrote her experience about her experience with what she called post-traumatic stress like symptoms as a result of her job. She joins us from Riverside, California today. Hello to all of you. Welcome.

JP: Good morning.

KATHLEEN PEVERILL: Good morning.

AMT: Kathleen Peverill, I want to start with you because we heard that clip at the very beginning at the Halifax Main Library. Why is it offering studio space to a teenage metal band?

KP: Our public libraries really have become community hubs and gathering spaces and we really want to reflect the community that we're serving and so we truly knew there was a need across our system for four creative spaces spaces where we could nurture local talent and so we created media studios. There is a huge waiting list. We know we've had really successful some great successful community podcasts from our Creative Labs as well as our media studios as well as some aspiring musicians have got their start at our media studios. We're really excited that that we rose to the to the need of the community by creating those media studios.

AMT: Well and you don't stop with the with that youhave a food literacy specialist, do you not?

KP: Absolutely. So we recognized that that food was a challenge for some food security was a challenge in some of our communities and so we we decided that we would start applying for grants for food literacy and food security and so we. We have been offering warm snacks. We've been offering a hot cup of coffee, not only at our central library but at our branches throughout the system. In fact, we're even putting in community kitchens in some of our branches and in Central we're actually renovating our Creative Lab to put in a community kitchen because we recognize that our community really... There was a need for food literacy, so we actually hired a dietitian who is... Food literacy is not a traditional area of public library service. so we we turn to a specialist who'd help us develop programs and services and knew how to develop kitchens. And so the response has been overwhelming.

AMT: John Pateman, what do you think patrons in Thunder Bay want from your library?

JP: Well we went through a very comprehensive strategic planning that closes to determine what were the aspirations and concerns of the community we were looking really at what were their needs and in terms of the Labor Service. But in terms of the city in general we found the issues such as racism and homelessness came very close to the top of that agenda. And so we now have a five year plan that is focused on decolonization the Labor Service making it safe for our Indigenous community and also tackling homelessness and creating safe and clean environment. Those are the kind of issues that I think are relevant modern public life service should be focusing on and the way we do that is by providing what I call Democratic publics case within our lady buildings and that kind of space is at a premium these days because usually you need a reason to go somewhere to use a service or you have to have money. The public library is unique in offering that democratic public space the public square as I would call it. And of course everything on pretty much everything we provide is free. Which is also very important which is why when there are cuts to funding it erodes that kind of space that I'm talking about.

AMT: When you talk about colonizing, what are you offering there?

JP: Well for example in one of our major labs in Thunder Bay we went into a partnership with an indigenous organization that offers education and training facilities and we came to an arrangement whereby the they've moved into the lower floor of the library to offer those services in a seamless way so they're not it's not a landlord tenant arrangement. It's very much a partnership arrangement. And through that we've seen the clients of that service coming into the library who are mostly indigenous and that's to increase the use of the library.

AMT: What else might surprise people about what happens in your library John Pateman?

JP: We have street nurses who come in and treat people with their various issues they may have and we also have a social worker who's available. There's no weight in this. People just come in and see the social worker who can help them with their needs. So we're very much becoming that community hub that was mentioned earlier in the Halifax context whereby we're opening up the space within the library to partners to offer a whole range of services.

AMT: Amanda Oliver, It was just about a week ago that you wrote a newspaper article about the stress involved in being a librarian in a library in downtown Washington DC. What what did your typical day look like?

AMANDA OLIVER: It's hard to say there wasn't really a typical day other than when I arrived in the morning. There was a minimum of 10 people experiencing homelessness who had either slapped just outside of the library or had just walked over from one of the homeless shelters in the area. And so a typical day was approaching the branch and saying hello to the regulars and then going inside and getting ready for the day. But then from from there on out it was I never really knew what what I was going to get during the day and who was going to come in and what their needs were going to be.

AMT: Give me an idea of some of the needs that people had that your library was trying to deal with.

AO: Sure. So it's important to understand that the main branch of the D.C. Public Library is closed right now for renovations that won't reopen until 2020 or 2021. And my branch was the next closest branch to that location and that branch was three floors and a lot of homeless shelters in D.C. where bussing people in from the shelters in the morning so that they had a place to go and when that branch closed down a lot of those people were displaced or where they could be between the hours of when their shelters closed in the morning and when they they reopen in the evening. So my branch absorbed a lot of that population but we were much smaller. So we were about the size of the new fiction area of the MLK Library and that was a corner on the first floor. So we didn't really have the space to absorb that but the majority of my population were people experiencing homelessness addiction severe mental health issues. We had many sex workers and other local members of the community and some of those people would act out what would happen. So you know and given living on the streets and also the amount of people with mental health issues there was a lot of psychotic episodes that would occur within the library. There were overdoses there were people passing out from drugs and alcohol and violent outbursts which again were usually maybe directed at us but nothing had actually occurred it was something that they had imagined.

AMT: Were you trained to deal with that kind of thing?

AO: I was not. No and in library school when I received my Masters in 2011 you know this was not anything that was covered.

And then we were not trained within within a system to know what to do in these situations carefully and several as you listen to her how much contact librarians in Halifax have with with issues of those suffering from mental illness or addiction.

And of course that not you wouldn't have everyone acting out I should make that really clear I understand that. But but in terms of people with very specific needs.

Well our downtown library like like many downtown libraries is you know being an inclusive space. It's well used by all community in including some of our most vulnerable community members. Ah. I are our first stages in ensuring a safe places to him approach. Other users from a place of respect and empathy so it's important important for us to earn the trust of our vulnerable community members learn people's names and making sure that we have staff have conversations with them our food our food grants that we talked about allow us to sometimes our first discussion in the morning with what some of our most vulnerable people are is over a cup of coffee and a snack. Because those relationships build trust with our community so often we we tend to be a place where they feel respected and so we feel that that's actually is actually what creates the public safety within our branches.

And John Paterson you made the point that you as well have a community hub. So how do you how do you address the needs of the vulnerable people who come to your library for because of that space.

Well we very much see the lobby as being open to all. So we want to welcome all members of the community into the library but also with this new strategic plan we've got. I think the focus is going to be very much on people with the greatest needs. Who are the people who need the lobby the most and what can we do to help them meet their needs. But the other point I want to make is that the library through this democratic public space idea has got the ability to be the social glue that kind of holds the community together because we find many communities are fragmented are along racial or class or poverty or other lines. And the I think the public lives in a unique position to bring communities together into the same space to talk through these issues and come up with common solutions. And that's why threats to funding really undermine that approach. And if I may I just want to bring in very briefly my experience in the UK before I came to Canada. Which is why I came to Canada in the first place in 2012. That's because there were drastic funding cuts to the public library service in Britain. And as a result hundreds of public libraries have closed thousands of larvae workers have lost their jobs. And what we're seeing now in those communities where the lobby no longer exists is that things are falling apart. Health has got worse education standards have got worse. Teenage pregnancy has increased drug use has increased crime has gone up I'm not saying that's just because the life is closed but it just proves what happens when you start to damage the social infrastructure of a community is that things can go wrong very quickly. There's actually more efficient to fund the Labour service than to make cuts and then have to put other other measures in place to deal with the consequences.

So I mean you're all telling me essentially that a library the place that we knew as a place to maybe borrow books or do our homework or study as kids decades ago these are social hubs that that serve a much more vast community need today and you're all trying to like you're trying to address that.

As far as I'm concerned the traditional standalone public library no longer exists. We're now becoming multiple-use community hubs that are being driven by a community's needs, they're being community led and they've been needs based. And it's a fundamental shift to where we were in the past. However we still provide the same basic core services around a free book loan service and information etc. But to make the light be relevant and to make it have a future because we've been around for over 100 years and we're very resilient. But to make sure we can sustain ourselves into the future we do have to take this broader social basis approach and be open to everybody to meet their needs.

Amanda you actually had a situation where there are a bunch of small children in the library and somebody came in with threats. What happened.

It was actually my second day in the public library and I had just finished up a baby and toddler story time and as I was cleaning up a man approached the desk and began grabbing anything that he could find close by. Box signs newspapers and started showing them at everyone behind the circulation desk and making threats to kill us. And so we had a panic button underneath the desk that we could press that would alert library police and the Metropolitan Police to come out. But unfortunately the children hadn't left yet. So the caretakers were trying to get them behind the larger bookcases to hide them from witnessing what was happening.

And how did everyone respond to that day and what how did it leave you.

It left me pretty rattled. The people who had been there for a while weren't fazed by it and that was information that I took in in the moment that gave me an inkling that this was not uncommon.

But I. Yeah I was I was shut up in the moment I wasn't expecting that to happen but there was certainly compassion towards him and everybody just kind of tried to wait it out and de-escalate the situation as best they could. And he actually left before people police officers were able to respond to the situation.

Kathleen libraries in Winnipeg in Peterborough Ontario have introduced security measures searching patrons before they're allowed in. How do you think libraries should balance public access in these spaces as they expand and public safety.

I think. As I said as I said I think leaning into our community and and working to create an inclusive city really as is is where public safety starts and we've ensured our staff are receiving non-violent crisis intervention so that they're comfortable de-escalate an issue in the in the event there isn't a visitor who arrives that needs it that needs support. We've received mental health the staffer receiving mental health first aid and I and I will say we at Halifax Central Library we have one point four million visits a year and the amount of incidents that we have here are actually just a handfuls very small per month. So we really we really are ensuring that our spaces are inclusive and open to all.

And John Pitman we know some librarians are now getting training on how to administer naloxone in case of opioid overdoses. Some have said librarians are not first responders and shouldn't have to play that role what do you think.

I think if we're going to be the kind of service we say we are in terms of open tool all meeting those with the greatest needs that we need to upscale ourselves to be able to meet those needs whether that's given the kind of response you've just mentioned but obviously we need to support our staff give them the training give them the confidence to deal with these issues. We can't ever guarantee that a baby will be a fully safe space because it's open. Anybody can walk in off the street of the street comes into the lobby the community issues come into the library. But I think where the shift has occurred is that we now recognize that we have a role an important role in dealing with those issues and that means moving beyond the traditional low skill set and basically moving into areas that are more uncomfortable to deal with but will actually give the lobby a future.

Amanda Oliver what do you think it sounds like Canada is doing some really progressive work and I have to agree with John. When you were talking about administering naloxone librarians we see a problem and we work to fix it. We don't ask why is it my job. And we've been trained to find accurate information on just about anything and that should include Narcan training. I wish that in the States we have some of the training that Kathleen mentioned the nonviolent crisis intervention the mental health first aid training that's phenomenal to hear that was the type of training that I was advocating to the library system to please provide for us. There was never an unwillingness to do that work. There was just discomfort around I didn't feel properly trained to provide for my patrons in the way that they needed and deserved.

You know when we talk about that of course libraries need government support to do some of the things we talk about and we spoke to Dina de Bernadette who is the CEO and chief librarian at the public library in Dryden Ontario. Listen to how she describes the potential impact of cuts announced by the Ontario government in the last few weeks.

We really feel that these cuts are going to disproportionately impact northern and rural libraries. A lot of the larger libraries and bigger centres they don't need to rely on the Ontario library service the same way that we do. They already have you know a lot of purchasing power on their own just because of their size and the number of patrons they serve. So we're very concerned that the cost of these cuts is going to disproportionately fall on small rural northern libraries. And we're the least able to absorb those additional costs.

A down payment what do you think of what she's saying there.

Yeah I agree absolutely. I mean these cuts are going to affect every library in the whole of the province of Ontario north and south. But perhaps it is those more remote First Nations and rural libraries that have got very few resources to start with which are very dependent on Ontario labour services is n intolerably low in service for example the ability of Thunder Bay Public Library to absorb some of those costs is better because we're better resourced. But then that will detract resources away from our anti-racism work and our homelessness work. Decolonization works. There will be an impact. And what's happening in the north is that we're coming together to fight these cuts to to oppose them. I personally think that they're ideologically driven. We can see by the actions of this provincial government who they're targeting it is the the marginalised the disadvantaged the vulnerable and they see liberties as a soft cut and they think they can get away with that but they are gonna be surprised by how much the community has value their lives how much they love their libraries and there will be a coordinated campaign by the Lobby service with its trade unions with its community members to oppose these cuts and get them removed.

I have another piece of tape this is from 2011. Doug Ford now the Ontario premier is a Toronto city councillor at the time of this clip. He had questioned whether Toronto needed all of its neighbourhood libraries and he's being interviewed by a radio host then radio host now Mayor John Tory.

I believe it is possible. I want you to tell me your view that you could for example I'll pick a number of 10 percent cause that's the number that's popular out there in terms of budget reductions that you could have a library system with 89 branches instead of ninety nine and actually have better service at the end of that. I believe that's possible do you.

I agree 100 percent. I use my ward as an example. I have the libraries approximately every two two and a half kilometres maybe three kilometres and driving distance and there's one library that's in an industrial area that I drive by every single day and it's in a little strip mall that no one knows it's even there.

Kathleen Pavel as you listen to that in an age of tighter budgets is there a way to cut some branches and neighborhood libraries and still maintain the services they provide.

Here's some of our smallest branches have the highest impact in our communities and we have we have branches in in like large urban centers like our central library and we have rural libraries in places like sheet harbor and Hubbard which are really focused on natural resources. So it really to me a divestment in libraries is always disappointing as it signals to me that there are people who just don't understand our modern role in the great return on investments that the in library spending.

I want to ask about the modern role because critics and likely those imposing the cuts say that libraries may have outlived their usefulness. With the advent of the Internet they're just not as necessary. John Pitman How do you convince them otherwise.

Well I think it's difficult to convince people when they come in with an ideological point of view and I think the the kind of philistine views that were expressed there by Rob Ford and we know that he went looking for the so-called that was Doug Ford by the way. So he does feel that his brother Rob Ford went looking for the so-called gravy of the Toronto Public labor service and didn't really find the problem. The problem with these politicians is that they know the cost of everything and the value of nothing. And when it comes to libraries, is like the critical thing about libraries is they have to be community based. They're based in the community. They're a neighborhood service. And you can't centralise them. You can't expect people to bus into them or drive into them they need to be on the street corner if they're going to have a social glue effect that I mentioned earlier.

AMT: And as we talk about the of the libraries evolving. Kathleen, what's the role of a library in an age of misinformation and misinformation and so-called fake news?

KP: Well our public library has always been that space that you know you can come in and whether it's you know traditionally there were books that were reviewed by librarians so any material that came into our library branches in the form of of of of a hardcover book was reviewed. So we knew the information was accurate that someone had reviewed it. So now. So now we have online databases and we have staff that are trained to to look at information sources so we can. So so in the age of information overload you know that the library is still that place whether it's a reviewed Booker or reviewed online source that the that the staff are providing that accurate information that the community needs.

AMT: Amanda Oliver, what do you think?

AO: I'm in an interesting position where when I was in the public library that was not necessarily a huge part of my day, but when I was a school librarian, I worked in elementary school and I began every lesson, I saw every class 45 minutes once a week by putting a news website up on the board with six articles and I would ask my students what do you, which one do you want to talk about? And then we would go through how do we know if this is a reliable resource? Where did it come from? What does the website end in? Is it a .com, is it a .edu? And we spent a lot of time talking about how we know if information is truthful.

AMT: John, in an era where people are not even able to agree on basic fact, how do you make sure people still trust librarians and libraries as a source of information?

JP: Well interestingly, when we did our strategic planning that I mentioned earlier, one of the questions we asked was who do you trust in the community? And the public library was pretty much top of the list because there has been an erosion of trust in other institutions. So we are trusted. We know that we can help people navigate fake news, but also we're not uncritical of so-called mainstream media as well including the CBC, but that we see our role as being a source of information that gives all of the different perspectives on whatever the issue is, so that people can come in and hear all sides of the argument and then make an informed decision. And that's why libraries have been called you know the last bastion of democracy. And there's a movie just been released in the States called The Public. It's all about a public library that defends its homeless community.

AMT: Yeah that's Emilio Estevez?

JP: Correct yeah. And that line comes out and that film was based on real practice within the public library sector in the States.

AMT: OK well we have to leave it there. Thank you all for talking about this today. It's great to hear your voices. Thank you.

JP: Thank you.

AO: Thank you.

KP: Thank you.

AMT: That's Kathleen Peverill, director of Public Service with Halifax Public Libraries, John Pateman, CEO and chief librarian at the Thunder Bay Public Library and Amanda Oliver, former school librarian and public librarian in Washington D.C. That's our program for today. Peter Frampton joins Tom on Q today. Wait for that. I'm Anna Maria Tremonti. Thanks for listening to The Current.

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Apr. 29, 2019 episode transcript

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