Ontario hospitals in grip of a staffing crisis

Guests: Cathryn Hoy, Kevin Smith

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We saw hundreds of people storming the U.N. headquarters in Goma, protesting against the U.N. mission in the DRC, and in particular, its failure to protect the population from violence that has continued for almost two decades.

PETER ARMSTRONG: Violent protests erupted in the Congo last week. People there feel the U.N. has failed in its peacekeeping mission as its decadeslong crisis drags on and a half an hour. We'll hear about the growing anger and continued violence in the DRC. But first, the urgency to fix urgent care. I'm Peter Armstrong sitting in for Matt Galloway. This is the Current.

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PA: Ontario Premier Doug Ford is under fire for what hospital workers are calling a crisis. They say an acute staffing shortage is putting pressure on an already overburdened system, leading to long wait times and dozens of hospital room closures across the province. Judy Stewart recently spent the night in the emergency room in Trenton, Ontario. Here's what she told the CBC.

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In my entire 12 hours there, I saw three nurses. There was only one E.R. doctor. It was a monday night during the midnight hours, and then they had to call in the orthopaedic doctor who was on call as well. And and they set my bones. And then I was released within 12 hours of arriving, and I had to wait ten days for the surgery as well. And you tell me of two major bones, broken tibia and fibula, and that's not the care when I need it.

PA: At a news conference yesterday, which was supposed to be about autoworkers, reporters put Ontario's premier on the defensive.

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JOURNALSIT: What is your message to those people who are in emergency rooms right now waiting for care?

DOUG FORD: Again, I'm just going to repeat the numbers. Nine out of ten people that are going into the emergency areas are getting taken care of within the health parameters. And I believe from the time they walk in, time they get treated, time they leave, it's within eight hours. Can we do better? We can always strive to do better. Can we, can the hospitals do better? 100% they can do better. And can the College of Nurses do better? 100%. Can the province and the Ministry of Health do better? We all can.

PA: Cathryn Hoy is the president of the Ontario Nurses Association. Catherine, good morning.

CATHRYN HOY: Good morning. Thank you for inviting me.

PA: So yesterday, Doug Ford, his quote was. Ontarians continue to have access to the care they need when they need it. What do you make of that?

CATHRYN HOY: I do not agree with that 100%.

PA: Why do you think we've come to this point of crisis in some hospitals?

CATHRYN HOY: Well, why they're not getting the care is because are the nursing numbers are dwindling every single day. We already were short - I'll be fair to the Ford government - previous to him. The Liberals started cutting the health care budget and not replacing registered nurses when they should have. But that being said, Bill 124 was the icing on the cake that started that downward spiral when the pandemic hit.

PA: Now, that's the bill that limited raises that can be given to public sector workers, including nurses. Is that right?

CATHRYN HOY: That's correct.

PA: And what is that done in terms of keeping people not just retention, but bringing new people into the field?

CATHRYN HOY: Well, what it's really done is it speaks to what the government thinks of a female dominated profession. Number one, I always compare ourselves to the police because police used to make less than nurses and they were brought to parity with nursing. And they have surpassed us. So why have we not enjoyed that same [unintelligible] benefit? It it really targets a female dominated profession. And let me be very clear. Police are partners. We respect them. They're part of our team, like EMS, Fire and everyone else that's in health care. It just isn't right that this bill is targeted against a female populated profession.

PA: Okay. I want to dig in to where we're at in this crisis right now. So let's just establish a couple of things. Are there, in fact, enough nurses in Ontario hospitals right now today?

CATHRYN HOY: Absolutely not. And in short, I'd say we're short around 30,000 nurses.

PA: 30,000 nurses short.

CATHRYN HOY: That's correct.

PA: And I mean, I think part of why people were so upset yesterday was that the premier implied part of the situation is that the nurses we do have are taking vacation. Let's just take a listen to what he said there.

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DOUG FORD: These nurses have worked their backs off the frontline. Health care workers have worked their backs off. You know, they're taking some time off on vacation. Well-deserved. But but we need to make sure that we still have more nurses, more docs, more staff used to fill those positions. And no one works harder than the frontline health care workers.

PA: Can you just pin this down? Is vacation a factor that's playing into the current shortage?

CATHRYN HOY: I'm just going to say it like it is because I'm a pretty blunt person. Absolutely not. Nurses, yeah. There may be a few nurses off on vacation, but I can tell you across the province, nurses are denied their vacation. You may be lucky to get, you know, one or two nurses off in a unit. And I'm talking about a large hospital. But they are denied. Denied. In fact, they're even denied to switch a shift with someone. So there's still a nurse, there's still a body, but employers hold them hostage so that they know that you're working and I'm off and I'm willing to work, so they'll call me in for overtime. And as far as getting their stat holidays off, they don't even get those off. So, you know, yeah, there might be the odd one off, but no, not like that comment sounds.

PA: I've even heard stories of nurses who did get away on holidays and had their bosses call them on that holiday and say, Sorry, you got to come back, we're too short staffed.

CATHRYN HOY: Yeah, true story. True story. Yeah, that happens regularly. Or they tell them they can't leave their shift. Or they tell them they have to come in tomorrow.

PA: So this bill, 124 is what keeps a sort of systemic raise from being given to two nurses, which has problems in retention, problems in recruiting. I guess there's a workaround on that. The province has said they're going to give nurses - is it a $5,000 thank you bonus? Premier Ford called it a higher pay increase than anywhere else in the country. How does your union see that?

CATHRYN HOY: Well, first of all, it's not a bonus. Those nurses work for every single penny of that 5000. And guess what? Most nurses didn't get $5,000. They were supposed to. That's the way it was introduced. But then it became pro-rated based on if you worked so many hours in a certain period, you got a percentage of it. So we had nurses that seen less than $1,000 of it, maybe $500 of it. We had nurses that retired just days before that, and they'd got nothing for it. It is a balloon payment. It has zero percentage value to it. It is a one time payment. When you give someone a raise, it lasts forever and it builds forever. This has no percentage value at all and not everyone was treated fairly. And I still have nurses that have not received their first payment.

PA: The one of the things the government, the provincial government keeps saying is that they have or are hiring. I believe it's 10,000 nurses. How important is it for us when we hear that to pass out and, you know, these are different, some of them are different classifications of workers or WS or whatever it may be. How many of those 10,000 workers are nurses that will go to addressing that, as you say, 30,000. The short figure that we're dealing with.

CATHRYN HOY: So you have to listen to his words very carefully. He says 10,000 health care workers. Those are not nurses. The majority of those positions that are open are PSWs and PSWs abuse are greatly, greatly needed in long term care and home care, but not so much in hospitals. Out of those nurses, I believe he said, there were 762 that were internationally trained nurses that have been brought in to the place of employment. But those nurses come in every year anyways. They're already in Canada. It's a challenge for them to get their licence. But, you know, they seem to think that this is going to be the answer. It's not because if you don't have nurses in the workplace to orientate them, mentor them, support them, they're not going to succeed. And that's a problem. And there are not enough nurses in the system right now to do that. So we circle back to Bill 124. We need it repealed. So our retired nurses will come back to work and mentor and support the new learners, the new hires.

PA: Have you had and are you going to have the opportunity to sit down and talk to the government about what a path forward needs to look like?

CATHRYN HOY: I repeatedly ask for that. Just sit down. You know, if you go back to the beginning of the pandemic, whether it was, you know, a hard time for health care workers to get PPE, the government sat down with myself and the previous president, Vicki McKenna, and we hammered out Directive Five and that was the direction on the PPE to ensure that our members, while all health care workers had the right to be safe and to get PPE and employers can lock it up in their offices at 4:00 when they left. So we need to do that again. We need to sit down over a weekend at a table and have a working group that we're going to walk away with something not, you know, a half hour meeting here and a half hour meeting there or, you know, we'll have a call on all surprised. This is what we're going to do and we'll let you know where we think it won't work. You know, I could talk about it for hours, but, you know, for example, they were handing out bonuses, $10,000 and $25,000 to commit to a job in a workplace. There's 30,000 jobs out there. You don't need to sign someone up for a bonus to come in and get a job. That money should have been put towards the nurses that are already on the front line that, you know, have slugged it out over the last, what, two and a half years in this pandemic. We don't need that kind of money. We need it at the frontline for the people that are working.

PA: All right, Cathryn, we've got to move on to the next one, but I really appreciate you just sort of casting some light on the actual situation today. So thanks for this.

CATHRYN HOY: You're very welcome. Thank you.

PA: Cathryn Hoy is the president of the Ontario Nurses Association. Now, the Toronto General Hospital has been under what's called a critical care bed alert for weeks now as part of the University Health Network. And Kevin Smith is its president and CEO. Kevin, good morning.

KEVIN SMITH: Morning, Peter.

PA: What do you make of of what Catherine Joyce says about the current staffing crunch from the nurse's perspective?

KEVIN SMITH: You know, obviously, Catherine's an expert in the area. It's a very challenging time for nurses, not only in Ontario, but across Canada, across the world. We've known this has been likely to come for some years and obviously we are now really the crunch culprit and unexpected outcome has particularly exacerbated that. Not only do we have that shortage, but we have a backlog of services that we need to catch up on. We have people who are very tired and have become very burnt out. How did it.

PA: Get here, though? Like, I think I think most Canadians, most Ontarians, most people who are clients of your hospital walk in there and think, how on earth did this happen? We've got, you know, the scaling back of operating hours and tired departments have been shut down. How did things get this bad, at least in your hospital network?

KEVIN SMITH: Yes. So I would say in our hospital. Let me first comment on what the critical care battler, which is not unfortunately an uncommon thing for a number of years and of critical care beds. It really means we are at or very near full in our ICUs. So that allows our colleagues within the hospital to say to other hospitals, please don't accept the transfer until we work with the ICU to see if there's a discharge upcoming or other staff that might be able to be coming in and be cautious about accepting people as we're going beyond the normal ratios. So again, as I say, not completely infrequent. What's different this time, of course, is the longevity. As you said, we've been on it for a couple of weeks. And I think if you look around the world, why is nursing become challenging? Well, attracting people in having adequate numbers of university and college training programmes. As Cathryn mentioned, working conditions. Compensation is always a discussion issue or not. And then do people want to do bedside nursing and do they want to continue to do bedside nursing in places of just as intense as intensive care units and other very demanding clinical environments? So really, it really has been something that's been coming for an awfully long time. I think we're now at the point where we also have to think about the international graduates in Ontario. I've heard the number 26,000 turn around, but lately, if there are indeed 26,000 licenced, unlicensed nurses in Ontario, we really have to work with the college, the government of Ontario, the Nursing Association, to think of how can we safely bring those nurses into the workforce and evaluate whether their foreign training equates to the Ontario standard? If it does, great. If it doesn't, can we give them experiences and oversight and mentorship to get to a point of safe life.

PA: And I think people will hear that and say, how on earth have we not? It's been two and a half years since we've been dealing with this crisis of capacity in hospitals. We don't have enough beds. We don't have enough nurses. And as you say, this has been coming for an awfully long time. How is it that we're only getting to dealing with, you know, the small changes in licencing around 26,000 extra nurses that are just not being utilised right now? Like, how much of this is really just a planning issue that we need to get people planning better?

KEVIN SMITH: You know, of course, it's always in part planning. But I think the other piece of this is particularly around the accreditation of foreign trained graduates. Frankly, it would require our nursing colleagues to do even more. And what's been difficult during COVID is we simply can't ask frontline providers to now take on the training of an additional 26,000 people. The evaluation of their clinical skills. The oversight and mentorship. We don't have extra university and college professors who are hanging around out there who we could immediately call in and then give those nurses a good clinical experience. One of the reasons that people leave first thing is in their first two years of practise, if they don't have great mentorship and great support, which actually requires more people, not fewer than it really, we see many, many more leave the profession. And so, again, that's not perfect storm. In order to get more nurses, we need more nurses. And this extends beyond our nursing colleagues and to other health professions, of course. So it you know, again, I don't think anybody thought enough over the last two years of the last 20 years to try and do a bad job on nursing numbers. It's a complex issue. If it wasn't, it would be. That would be unique to Ontario. It's an international challenge. And as Cathryn mentioned and others will talk about, when we look at quality of nursing work life, there are many issues that we are going to have to address head on to attract and retain people. Cathryn talked about bringing back some of the retired nurses. And again, I think for our retired colleagues to come back, they want to know that their quality of work life, what they can expect in the workplace, the kinds of patients they'll be looking after, the kind of system that they need, not just in hospital but pre-hospital and primary care post hospital back into the community for home care. The crisis really is about flow and having adequate resources across the continuum.

PA: I want to ask you about one one issue that I raised with Cathryn, the notion that the provincial government says they're hiring 10,000 health care workers. She says those have to be nurses, not, you know, other various kinds of health care workers, important as they may be. What is your take on that and what needs to be done in terms of those hires?

KEVIN SMITH: There are many, many vacant nursing positions, so I'm sure Cathryn would know the numbers better than I do across the province. I can tell you at University Health Network, we would have roughly 500 to 600 vacancies for nurses. To be honest with you, I don't think we're going to find those nurses in the short term so or all of them. So I think we will legitimately have to work with nursing colleagues and others to think about what is full scope of practise look like for everyone. So as we've done in medicine and can do more, what what does a physician do that other health providers could do under either supervision or within their own scope of practise or many things? Equally, I think we're going to be looking at technicians, technologists, other professions that are emerging but is occurring in other parts of the world. Right. Who are extending nursing colleagues in very narrow but very specific areas so that there are areas where nurses can and legitimately would say, I feel comfortable with this individual doing that work with this kind of training, and I'm ready to sign off on the skill base having evaluated them.

PA: And just really quickly, before I let you go. August long weekend was a Gong Show and hospitals across the province. Have we reached the worst of this crisis or is Labour Day weekend going to get even worse before it gets better?

KEVIN SMITH: So Peter, if I were a betting man every year. Labour Day weekend is one of our most difficult staffing weekends. So if the past is a good predictor of the future, I think that's going to be a very challenging weekend. Not having been said, we are all going back and looking at what could we do in the week leading up to Labour Day and between now and then, should we be scaling back outdoor activity? Can we accommodate some slowdown so that people get a little bit of time off and downtime, time to recharge and get some time with their kids and family, get them ready to go back to school? But do I believe it'll be a challenge that we can do?

PA: Yeah. Okay. We've got to leave it there. But Kevin, thank you for this.

KEVIN SMITH: Really appreciate it. Thanks, Peter.

PA: Kevin Smith is the CEO of the University Health Network. Now, we requested an interview with the Ontario minister of health. She declined, but her office did send a statement which reads in part. Ontarians continue to have access to the care they need when they need it. We've already added 3100 new hospital beds and 10,500 health care workers, including nurses and personal support workers. We're also working with the College of Nurses to build on the more than 760 internationally educated nurses already deployed across the province. We know more work needs to be done. Continue to work with all partners, including Ontario Health and the 140 public hospital corporations, the regulatory colleges and health sector unions to address any challenges on the ground. That is a quote from the Ontario minister of health. And that brings us to an end of this part. The CBC News is next. And then.

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It continues to face an acute and complex humanitarian crisis. More than three quarters of the population live in extreme poverty. It is the third highest number in the world.

PA: Over the last two decades. Millions of Congolese have left their villages to flee violence and poverty. During that time, the U.N. has been in the DRC trying to stabilise the region. Coming up, we'll hear why some have turned their backs on the U.N. I'm Peter Armstrong. You're listening to The Current.

Congo unrest plunging 'further into an abyss' without more aid, humanitarian warns

Guests: Nelleke van de Walle, Amavi Akpamagbo, Dominique Hyde

PA: Hello. I'm Peter Armstrong. You're listening to The Current.

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PA: Wow. That is the sound of law enforcement officers in the Democratic Republic of Congo desperately trying to disperse a crowd of protesters. For days, the northeastern part of the country has been engulfed in demonstrations. People are calling on the U.N. to withdraw its peacekeeping troops from the country, describing the mission as a failure. For more than two decades, the U.N. has been trying to stabilise the DRC, but armed groups continue their attacks. Nelleke van de Walle is an analyst with the International Crisis Group. She leads the organisation's coverage on DRC, and she's also previously worked for the UN's peacekeeping mission in that country. Nelleke, h ello.

NELLEKE VAN DE WALLE: Hi, Peter.

PA: So can you just describe the protest scenes that have been playing out in areas like Goma?

NELLEKE VAN DE WALLE: Yeah, I think you already described it quite well, what we saw last week. We saw hundreds of people storming the UN headquarters in Goma, protesting against the presence of the UN mission in the DRC and in particular its failure to protect the population from armed group violence. That continues, that has continued for almost two decades. We also saw that protests took place in beni and butembo. Also targeting the u.n. Basically meant that protesters were looting the premises, smashing windows, etc.. And last sunday we also saw that i think it indicated how tense the situation is that u.n. troops fired at the local population when a U.N. group, when you and troops tried to cross the border between Uganda and the DRC. And overall, we've seen that during the violence of the past two weeks or the past week and a half, that four U.N. peacekeepers were killed and about 32 civilians died in the violence.

PA: And what are the protesters main grievances? Because there's a bit of an overlap with what they're angry about and what they're angry at the U.N. about. Can you pass those out for us?

NELLEKE VAN DE WALLE: Yeah. So it's it's basically about the fact that despite the UN presence, you rightly indicated that the UN force has been in country since 1999. The UN has failed to stop the violence in eastern DRC. We see that armed group violence in the east continues. There are about 120 armed groups active in the east. And in the past few weeks, we've seen tensions building. We see the idea of the Democratic forces, a group that has ties to Islamic State, continue its attacks against the population in Beni Butembo, where several of the protests took place. And we also see the M23 militia that has stepped up its attacks.

PA: Now, the violence over the years has had a sort of ebb and flow to it, as has the level of dissatisfaction towards the peacekeepers that are there. Have you ever seen, though, this kind of level, this kind of anger and dissatisfaction towards peacekeepers?

NELLEKE VAN DE WALLE: Anti UN rhetoric, or any time when this violence is indeed not new and we've seen it happening over the past two decades. I think the death toll of the current protests is particularly high, but it's a bit of a cycle. What we often see is armed groups stepping up their attacks, then the Congolese army launching operations to target those armed groups, but basically failing to eradicate them. And then we see the armed groups stepping up their attacks, retaliating against the local population. And the local population, of course, sees the UN and noticed its failure and then targets the UN. So then we see the UN protests happening. The UN is quite a visible actor. It has a clear mandate to protect the civilian population. But as I said, we've seen that happening over the last ten years or so. But the death toll of the current protest is quite high. And the fact that we also saw the UN firing on the local populations, there wasn't a particularly good sign.

PA: Obviously the failure to eradicate the armed groups is is front and centre and obvious and so incredibly frustrating for anybody who's just trying to raise a family and run a business and live their lives. But what is there any progress that the U.N. has made in stabilising the country and bringing some relief from not just the violence, but just the broader situation?

NELLEKE VAN DE WALLE: Yeah, I always find that quite a difficult question because we talk about such a big country and the UN has been there for over 20 years with a mandate that changed over the years. So I think the UN, when it came in, in 1999 to oversee the implementation of the Lusaka peace agreement that ended the Congo wars, I think the UN was then quite successful in sustaining the violence, also cooperating with Joseph Kabila, who was then the president. They also played a big role in making sure that the elections in 2006, the first democratic elections in the DRC, that they took place in an orderly way. But over the past few years, we see more of a mixed, mixed result. Violence continues. But the UN has also already agreed on drawing down its mission. So we see that it's now mostly active in the eastern DRC, so mostly in North Kivu, South Kivu and the three provinces where it has already decided to leave all the provinces that they did manage to stabilise. So yes, there is on the one hand the failure, but it's also because the mission is is stretched quite thin. The DRC is the size of Western Europe. There's 16,000 blue helmets to protect the civilian. Population and the UN has to cooperate with the Congolese army. That isn't a particular reliable actor in in in this conflict.

PA: And I mean, people in the military would tell you they're only as effective as their leadership. But what of the political body in DRC? Is is is the government in a position to try to to take some of this on and and and really come up with a plan that can address this.

NELLEKE VAN DE WALLE: Yeah. Well, there are people that say that the authorities were actually involved in instigating the violence that happened the past few days. We saw that the head of the Senate, Bahati Lukwago, said that it was time for the UN mission to package fight, especially because the UN had argued two weeks ago that because of the return of the M23 militia that I just referred to, the UN isn't able to target the group because it's it is behaving more and more as a professional army. But I think we should also note that we are heading towards elections already. We see President Tshisekedi, who needs to, on the one hand, address the grievances of the Congolese population. But on the other hand, also relies heavily on one is called for political support in particular, but for military support as well to make sure that the East is stabilised, which is one of his main electoral promises. And he also needs the UN in order to prepare for the 2023 elections.

PA: So just in closing then, how important is it for the UN to deal with the public backlash and and, you know, show itself as a as a force that can be responsible and can be responsive? And how on earth does it go about doing that?

NELLEKE VAN DE WALLE: Yeah, that's a very good question. The UN itself has already said that it is only in the country on the invitation of the Congolese authorities. So if the authorities no longer want the force there, then there could be a decision taken to withdraw the troops and the mission to end. I don't think that's likely, as I just said. We see that the UN headquarters in New York already dispatched its Under-Secretary-General for peacekeeping, Jean-Pierre Lacroix. He went to the east during the past few days. I think that indicates how serious the UN also sees the current situation. I think it's important that at some point the authorities express their support for going to school. So President Tshisekedi already asked for a meeting with the UN. I think at some point he needs to state that he continues to rely on the presence of the UN forces and he wants them in-country. And that said, maybe as a conclusion, I think what we often see in the DRC is that the Congolese population that is rightly frustrated with the violence rises up either against the authorities or against the UN. But they do not have the means to continue their demonstrations for weeks on end just because they don't have the wealth they need to go back to their jobs, etc.. So it's likely that violence will subside in the coming days.

PA: All right. We'll keep an eye on it. We really appreciate your insight on all this. Thank you for this.

NELLEKE VAN DE WALLE: Thank you.

PA: Nelleke van der Walle is the International Crisis Group's project director for the Great Lakes region, which includes the Democratic Republic of Congo. Decades of violence has taken its toll on the DRC. More than 5 million people are displaced. Malnutrition is rampant and food insecurity is at its highest level on record. Amavi Akpamagbo is the country director for Save the Children in DRC. Amavi, Thank you for doing this. If you could just lay the land for us here. How safe is it right now to live in the DRC?

AMAVI AKPAMAGBO: Yes. The Democratic Republic of the Congo is their country with immense resources and potential, but also a number of challenges. It continues to face an acute and complex humanitarian crisis. More than three quarters of the population live in extreme poverty, with less than 1.9 where they live die. It is the third highest number in the world. Wow. So this affects people in different parts of the country. However, insecurity accentuates this risk and vulnerabilities in the east of the country where armed conflicts have been going on for years. And talking specifically of children, a total of 3546 cases of grave violations of child rights where verified in 2021. This is about the recruitment and use of children by armed forces, killing and maiming of children, abduction and and detention of children, rape and other forms of sexual violence, attacks on schools and health facilities and denial of humanitarian access. So definitely, DRC is one of the hardest places to be attacked in the world today.

PA: And is your organisation, is Save the Children even able to meet the needs of the population with the resources it has at hand?

AMAVI AKPAMAGBO: While we will establish a thorough and well accepted in the field, they live in, the DRC [unintelliglbe] and Save the Children is able to respond only to a fraction of this needs. The result is that high value information at the end of July 2022 that just last week only 21% of the amount needed by the country for humanitarian response this year is funded.

PA: So you have this situation where, as you say, when the violence comes in two regions, it is getting more fierce. You are seeing more attacks against women and against children. What are the other factors that are at play here that are forcing people to leave their homes and move into two population centres to try to get aid?

AMAVI AKPAMAGBO: Definitely armed conflict is of course the primary cause of displacement and [unintelligible] in Congo. In addition to that, other factors that the U.S. population mobility includes natural disasters. For example, last year there was a volcanic eruption in Goma, which led to thousands of people moving to other places, including in neighbouring Rwanda. We have flooding in South kivo for example. The eastern DRC has many great lakes and for climate change, there are rising levels of water in these lakes, which is now causing significant flooding, specifically in the town of [unintelliglbe], where we have the Lake Tanganyika, there are thousands of people who have been displaced.

PA: So on the one hand, the armed conflict side of this is getting worse. The natural disasters that are forcing people from their homes and into the population centres are growing in frequency and you and other aid organisations simply don't have the amount of stuff you need to address this growing crisis. What would you like to see the international community do and frankly, just understand about what is happening in your country.

AMAVI AKPAMAGBO: Where you are. See if an active, protracted crisis with the huge needs that require immediate and sustained attention from the international community. The key areas where we believe that the international community can play a major role. First of all, is both stepping up the financial support to humanitarian actors in the country, but also prioritise transition and long term development interventions. Professional civilians is very concerning. There are a lot of frustration amongst the population at this time. Due to force of the population policy, there is a limited result from the international community. So stepping up to support to humanitarian actors to address their national organisation or in the country to protect civilians, protect the humanitarian workers, as well as providing necessary financial support to manage humanitarian access. For example, one of the challenges we are facing is that so many actors is access and logistics. Travelling from Goma is farther than probably from Geneva to Kiev, a cause $1,500 their ticket on a UN flight. So this is a high operating costs that this is challenges that we are dealing with. So we will to request the understanding and support of all the international community to deal with these challenges.

PA: Well, listen, it is an unbelievably difficult task at an unbelievably difficult time. We thank you for the work you're doing and really just for taking the time to speak with us today.

AMAVI AKPAMAGBO: Thank you for having me on a programme.

PA: Amavi Akpamagbo is the country director for Save the Children in DRC. The UN's refugee agency says despite the desperate humanitarian need in the DRC, funding for humanitarian groups remains extremely low. Dominique Hyde is UNHCR director for external relations. She's in Geneva. Dominique, hello.

DOMINIQUE HYDE: Hi, Peter.

PA: So you visited the country last week and the refugee camps there. What did you see and what needs did you see that that need to be addressed most urgently?

DOMINIQUE HYDE: You're absolutely right. I just returned from Ituri, which is the eastern part, an eastern province of the Democratic Republic of Congo. And when I left, I left feeling so angry. Angry by the sheer impact that the underfunding is having on the lives of the displaced populations that I met. You know, I'm not like some of the previous speakers. I'm clearly not a DRC expert. But what I want to share with your audience is what I saw, what I felt, and the plight of so many. Just because we don't have the funds to do the bare the bare minimum, there wasn't. There's you've heard the numbers. There are over half a million refugees in the country, but there are over 5.6 million internally displaced people as well in the Democratic Republic of Congo. And sadly, the security situation just keeps on deteriorating. And since April, this spike in violence that we've heard on the show has just generated so much displacement. And the violence is caused by these over 120 military armed groups that have pushed over 160,000 people into further displacement.

PA: I mean, it's it's almost outrageous hearing Amavi speak about the gaps in what they need to do versus what they can do from what you saw. How drastic is the funding gap and UNHCR ability to address the needs on the ground?

DOMINIQUE HYDE: So for us, the country is amongst the most underfunded operations worldwide. We're only funded 19% of the 225 million that we need at the start of the year. And but what this is, it's half of what we had at the same time last year. So this has real implications on the lives of those that have been forced to flee. There wasn't a single displaced person that I met in Bunia who hadn't suffered the loss of a family member or in the case of women who had been the victim of sexual violence. We are doing our best to provide mental health or psychosocial support. But the underfunding is so dire that we're just able able to cover the bare minimum and and the impact goes on. We have 82% of the country's internally displaced people that are not going to be able to receive adequate shelter support, which means that displaced women, men, girls, boys are forced to sleep in churches, schools, stadiums, out in the open and or they're going to try to go home and at that point, risk becoming targets of these sustained and continuous attacks by these armed groups. And this is a place where sexual violence is rampant and a locked door can make such a difference.

PA: And I mean, we've seen how those challenges have have really exacerbated the UN mission, for example, where their chronic inability to address these like massive problems that are way outside of their scope have caused a backlash against them. How does that sort of sentiment complicate UNHCR work in the country?

DOMINIQUE HYDE: Well, I think you heard it also from my Save the Children colleague. And it's becoming more and more difficult to operate in this very volatile situation. I was in Aru again in the Ituri province last week and I was in the refugee camps that house South Sudanese refugees, 8000 South Sudanese refugees. And on that day, the village I was staying in our town was violence erupted. Youth took onto the streets. They started throwing rocks at our cars. There was tires burning. And my colleagues were asked to stay put.

PA: It must be so frustrating, though. And on the one hand, you know, can you feel for can you understand the frustration of the people that are throwing rocks at the trucks, the people that are ostensibly there to try to help? But these people have just they've been left with so very few options.

DOMINIQUE HYDE: Peter, you know, it's whether you're in the Democratic Republic of Congo, whether you're in Ukraine, whether you are in Bangladesh. Everybody wants the same. They want their children educated. They want healthy lives. They want safety, and they want jobs and opportunities. And right now, that's not what's happening in the country. And if I look again, of course, you know, for us, our mandate is also about refugees, as is in our title. So displaced populations, which is the larger populations that we support. But if I look simply at the refugee population. Every child should have the right to primary education. And in the Democratic Republic of Congo, only 16% of the South Sudanese refugee children are able to attend primary school as a result of the underfunding. And at the current level of funding that we have, we're not even able to support a single refugee child to attend secondary school. So the impact of this will have will last a lifetime on these children. And what happens is that once you're displaced many times inside your country, what you start doing is you start getting on onto moving outside of your country. And already since the beginning of the year, we've seen 57,000 Congolese seek refuge in Uganda. And that's already one of the countries that hosts the largest numbers of refugees in the country.

PA: You know, we've spent this chunk of the morning trying to talk about this and understand what's happening. I'd like to end with a question, but simply what's at stake here if we don't get some kind of an adequate response?

DOMINIQUE HYDE: Huh. That's a tough question, Peter. I think what's at stake, this is 30 years of of a crisis and a poverty just going further into an abyss. And I think what you're going to be seeing is exactly what we've been seeing in the past few months, an increase in or a deterioration in the security situation. That is going to increase the number, the violence, especially with the elections that are coming up next year. I think we will see a further displacement not only inside the country. It is the on the African continent, the country with the largest number of displaced people. We will see this displacement moved into other bordering countries that are also quite challenged. And for me, it really begs a question who are we? Who are we as a society? You know, you would have thought after COVID pandemic, after the climate crisis, that we would have felt closer as one planet, as a humanity has humanity, and that we would have been willing to help each other more. And we're not there yet.

PA: Here we are. Well, listen, it is a heartbreaking and incredibly frustrating story, but we really appreciate your help and in getting us to better understand what's happening over there.

DOMINIQUE HYDE: Thank you.

PA: Dominique Hyde is UNHCR director for External Relations. The Democratic Republic of the Congo has asked the spokesperson for the UN's peacekeeping mission, MINUSCA, to leave the country. He's accused of contributing to the tensions there. We requested to speak with a spokesperson from the U.N. peacekeeping office. We did not hear back. And that's our programme for today. Stay tuned to CBC Radio One for q. On today's show, Tom Power speaks with Bernie Tobin, the legendary songwriting partner of Sir Elton John. I'm Peter Armstrong. I'm sitting in this week for Matt Galloway. I'll be back here again tomorrow. Hope you will be too. Thanks for listening to The Current.

The Current Transcript for August 4, 2022

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Ontario hospitals in grip of a staffing crisis

Congo unrest plunging 'further into an abyss' without more aid, humanitarian warns

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