Children, health, & human rights in Canada

Anum Irfan Khan ’10 is an international student from Pakistan who received a Louis D. Brandeis Legacy Fund for Social Justice Fellowship to intern with UNICEF Canada. Having just finished her placement, she reflects on her work and the social justice issues facing Canadian society.

“There can be no keener revelation of a society’s soul than the way in which it treats its children.” ~ Nelson Mandela

This year the world celebrates the 20th anniversary of the UN Convention on the Rights of the Child (CRC). I spent the summer in Toronto as the Domestic Advocacy Intern at UNICEF Canada (www.unicef.ca), working on a series of projects revolving around the CRC and its implementation both in Canada and abroad.

The majority of the time during my internship was spent working on projects that were part of UNICEF Canada’s domestic portfolio titled Canada’s Children: This Generation. In honor of the 20th Anniversary of the CRC (http://www.unicef.ca/portal/SmartDefault.aspx?at=2063 ), UNICEF Canada produced a Canadian supplement to UNICEF’s Annual State of the World’s Children Report. The supplement report was a collaboration with the National Collaborating Center for Aboriginal Health (NCCAH) – titled “Aboriginal Children’s Health: Leaving No Child Behind.” The publication explored the differences in health outcomes between Aboriginal children (primarily First Nations, Metis and Innuit communities) and other Canadian children. In a series of health indicators ranging from infant mortality to rates of TB — in fact, in almost any measure of health and well being — Aboriginal children are at least two to three times worse off than other Canadian children. The report also touches upon other issues including lack of education, poverty, substandard housing, improper nutrition and limited access to health care facilities, considered to be among the several social determinants of health that negatively impact the health status of Aboriginal peoples in Canada.

Much of the inequity present in Aboriginal communities can be traced back to Canada’s colonial history and the residential schooling policy imposed on the Aboriginal peoples decades ago, that dislocated children from families and perpetuated disparity, generation after generation. Despite an official apology to the Aboriginal people, jurisdictional discrimination remains rampant on a number of levels, from the federal government excluding Metis communities from the NIHB (Health Canada provides eligible First Nations people and Inuit with a specified range of medically necessary health related goods and services when they are not covered through private insurance plans or provincial/territorial health and social programmes through the NIHB) to the underfunding of child welfare programs for First Nations by almost 22% compared to Canadian children on average.

This is the story told by the numbers:

• 1 in 4 First Nations children lives in poverty compared to 1 in 9 Canadian children, on average

• On-reserve First Nations child immunization rates are 20 per cent lower than in the general population, leading to higher rates of vaccine-preventable diseases.

• In cities of more than 100,000 people, approximately 50 percent of Aboriginal children under the age of 15 live in low-income housing, compared to 21 percent of non-Aboriginal children.

• 38: The percentage of deaths attributable to suicide for First Nations youth aged 10 to 19. In 1999, the suicide rate among First Nations was 2.1 times higher than the overall Canadian rate. The rate of suicide for Inuit is 11 times higher than the overall rate of the Canadian population.

• Between 33 and 45 per cent of Inuit, Métis and First Nations children (on and off reserve) report chronic illness

• Only 63 per cent of First Nations children on selected reserves accessed a doctor in 2001; 46 per cent of Inuit children and 77 per cent Métis children did so, compared to 85 per cent of Canadian children on average

One of the Convention’s guiding principles states that no child should be treated unfairly on any basis, including race, religion, where they live or whether they are rich or poor. The UN Committee on the Rights of the Child told Canada in 2003 that it was deeply concerned about the health of its Aboriginal children. In fact this year, the government of Canada is due to report to the UN Committee On the Rights of the Child regarding its progress. These statistics indicate the depth and breadth of disparities prevalent across a series of indicators for standard of life, signifying one of the greatest children’s rights challenges Canada must address.

While the media, donor agencies and the development community as a whole tends to focus both attention and resources on developing nations, the internship brought me into close contact with issues affecting “rich” nations. It seems that membership in the OECD (Organization for Economic Development) cohort and the deceiving label of a “developed nation” cloaks the real issues beneath the glossy GDPs (Gross Domestic Product) and seemingly high scores on HDI (Human Development Index). The fact of the matter is that severe inequity is rooted into the governance structures of several developed nations – the plight of the Aboriginal people in Canada is hidden by national averages and despite the country’s progress, the issue of social justice remains a prominent one. These under-served and underrepresented populations are a testament to the fact that progress is not defined by financial stability or global political presence. Sadly, the root of this inequity is not a lack of resources but rather a lack of political will and commitment to social justice and equality for all Canadian children.

This was a stark contrast to what I had seen and experienced in my home country of Pakistan, where poverty, corruption and lack of political stability form the basis of high infant mortality and low scores on other child health measures. The nation’s inability to provide for its youngest and most important citizens, its children, is visible on the streets of Karachi with scores of child beggars surrounding cars on traffic lights to the high degree of child labor that runs rampant and unchecked throughout the country, or the pediatric and maternity wards of overcrowded and understaffed government hospitals that cannot serve the rapidly growing population with even basic health care.

Canada, on the other hand, from the sprawling metropolis of downtown Toronto to the coasts of Vancouver, prides itself in providing for its citizens an HDI of 3 — among the highest in the world. But the tragedy lies in the fact that a few hours from the main cities, on Aboriginal reserves the HDI falls to a drastic 68 (for First Nations reserve communities) and infant mortality soars to 16 (IMR in Nunavat where approximately 85% of the population is Innuit), almost equal to that of Sri Lanka or Fiji. There is no doubt that an industrialized nation such as Canada possesses the resources and the technical knowledge to close the gap, yet the status quo remains unchanged. It was sometimes frustrating that agencies like UNICEF in a developed country like Canada are inhibited by their mandates requiring them to direct programming funds towards poorer countries who are in more obvious and desperate need for assistance. Yet, the fact is that money is not the issue; Canada has more than enough resources to tackle the problem, yet year after year it seems the problem slides further and further down the government’s list of federal priorities.

The solution, as UNICEF Canada and its collaborating partners see it, includes more culturally acceptable community-based health services to ensure that Aboriginal families do not have to move far from home to find the services they need. Funding for all groups of Aboriginal children must be raised to the level provided to other Canadian children. UNICEF Canada and its partners are directing efforts to promote Jordan’s Principle – the most widely supported child policy movement in recent Canadian history (www.fncfcs.com/more/jordansPrinciple.php) – a pending legislation that will ensure that First Nations children have equal health care treatment – so that no child languishes during disputes about who will provide or pay for what service, as was the case for five-year-old Jordan River Anderson, as the government of Manitoba and the federal government battled to evade liability for the costs of his out-patient treatment while the little boy fought for his life in hospital.

Besides legislative changes, in order to address the underlying social justice issue it is essential to increase Aboriginal people’s capacity to actively govern their own social, health
and education initiatives and collect more data of better quality on Aboriginal health and wellbeing to address the huge gaps in knowledge. Requiring only the will to act, these steps — some of which require greater investment, some that warrant investment merely equal to that for other Canadians, and some that cost nothing — can actually close the gap for good.

I also got the opportunity to work on a number of other projects, including UNICEF Canada’s dissemination for World Breastfeeding Week 2009 (WBW) “Breastfeeding: A Vital Emergency Response – Are you Ready?”, highlighting the benefits of breastfeeding and its link to increased child survival in the annual WBW’s global campaign. This particular project exposed me to the startling contrast to breastfeeding in industrialized nations, where the differences in family structure and employment norms/regulation affect the relationship between the mother and the child and subsequenetly a child’s development. Until the year 2000 only 6 months of maternity leave was granted in a majority of Canadian provinces, which negatively impacted the rates of breastfeeding. Despite a recent increase to 12 months which has helped to increase rates of breatsfeeding, Canada still lags behind many of the other nations in the OECD contingent.

I was also able to take part in the second phase of a grant proposal for a project entitled “Straight Up: Educating Canadian Children and Young People on their Rights in Respect of Participation in Armed Forces and in Conflict,” an on-going project that has developed a youth-friendly version of the Optional Protocol on the UN CRC regarding the Involvement of Children in Armed Conflict (OPAC) considering employment in the armed forces across Canada. I was able to get an insight into the mechanics of grant writing and processes of the UN’s collaboration with government agencies — the challenge of balancing the goals and needs of different stakeholders while staying true to UNICEF’s mission.

My contributions to these projects ranged from researching and preparing ancillary documents and pre-publication reviews to writing press releases and handling outreach to the major political and civil society networks. I also experienced the inner workings of the UN system and the network of relationships between different UN agencies. Being exposed to the policy side of development on each project was also a very different experience from my previous internships which focused more on field work rather than crafting policy and implementation strategies.

I am currently assisting with the peer review of UNICEF’s Innocenti Research Center’s upcoming report on the implementation of the CRC in Canada – due for official release later this year. In line with the 20th Anniversary of the CRC, the IRC is assessing the implementation of the CRC in industrialized countries, with a particular focus on Canada by tracing the evolution of children’s rights in the nation since it ratified the CRC in 1991.

For more info on the CRC and UNICEF Canada’s efforts visit – http://www.unicef.ca/portal/SmartDefault.aspx?at=2063

Posted by Anum Irfan Khan ’10
aikhan@brandeis.edu