The Last Cookie

When I started this blog, I rationalized my chosen blog name by saying that my thoughts are worth not just “a penny, but a whole cookie”, and not just any kind, “the chewy chocolate chip kind”. Who would have known that the views I would express on this blog would be so extreme that they may even be hard to digest by some people who may hold neutral or opposing views. Well, what can I say, decadent cookies (due to their high fat content) have slow digestibility!

Upon reading over my five previous blog posts, I noticed one very prominent theme in my blogging style. This was that I always write about healthcare by grounding it in personal experiences. My reasons behind this writing style are to capture the reader’s attention and also to present the week’s theoretical leanings in more practical manner. This was one of the main shifts that I noticed in my blogs. My first blog about the Live Right Now campaign was based on my opinion only (not based on evidence or experience). Hence, upon revisiting it, I feel like I can refute my own argument. Reading my own post is giving me the urge to return to those class discussions in which this campaign was discussed, and hear their side of the story as well. Other consecutive posts (in which my opinion is based on real life experiences) are much more believable to me. They evoke the same emotion in me as I had when I was writing them because I am reminded of the times those experiences took place and can relate it to my opinion of that topic. I commend myself for changing my writing style so early because people reading these blog posts may have understood my opinions better after understanding my story and knowing where I was writing from. Grounding our opinions into some sort of experience when writing on a medium which is read by people who do not personally know us, seen us, or heard us; can help establish legitimacy of our opinion and may attract people who have had similar experiences.

By revisiting my blogs, I have also noticed that I tend to be very cynical about the various ways through with community development efforts are being implemented. The reasons I present for my pessimism are that community development is not being placed in the areas where people are in greatest need for it. An underlying question which is the foundation of almost all of my posts is that why are we putting funding towards areas which already developed or people who already have the access?

Meanwhile the community healthcare efforts are still subpar for those who are actually in need. Hence, the idea of community based health care is still very young and needs much more planning and refinement in order to mature and appropriately cater to all the needs of the community dwellers and the reduce the existing gap of accessibility. My opinion overall is that some basic and realistic measures must be taken before we as the community look towards our secondary needs because many people out there are still striving to achieve their primary needs (i.e. safer parks need to be made in more areas before we fund for building ovens in existing parks).

One criticism I do have about my standpoint is that my strong views have hindered my ability to view community based efforts impartially. I seem to have overlooked the fact that many countries and regions do not even promote the idea of community development as well as Canada does. We are lucky to have these small scale programs which bring individuals together and give rise to potential unity that may cause changes in our health care system. Although these programs such as community kitchens may seem unfruitful to me, they still are working towards bringing together a community of immigrants who are coming with newer needs for healthcare. These newer needs have more potential to be heard if a group voices them. We are fortunate for having a system which promotes small steps towards healthcare changes and all of these minute steps are accumulating and gradually making Canada a better place to live.

To conclude, I would say that I have learnt a lot about; my writing style, the manners of writing on the blogosphere, my opinions, and also community based health care through my blogging experience. It was an amazing experience, reading the thought processes of people whom I have seen on a daily basis, yet have not gotten to know. We made our own little community which shows us that together we can come up with great ideas over health care issues. I hope that we have the time, resources, and drive to implement them once we start our professional careers in the field of healthcare. Finally, I may continue to write on this blog if I come across another infinitely curious moment. Yet for now, I will take a hiatus because I need to bake some low-fat cookies to stash away for exam-time fuel.

Blog #5: Cinnamon Toast Crunch Dilemma

One fine Saturday morning last summer, I was looking through the thick stack of flyers in the newspaper, hoping to find a good deal on my favorite cereal, Cinnamon Toast Crunch. I looked in the thin yellow No Frills flyer, the green themed Sobey’s flyer, and the Loblaws one too. All of these stores are walking distance from my home and it would take a maximum of 15 minutes to have that cereal box in my hand! Not that I was so desperate to buy cereal, but you get my point.

The next day I took a stroll down to Loblaws for my mission and to my surprise, a Longos sign was being put up right across the street from it! So was a sign for Rexall pharmacy. It truly did not make sense to me at first. There were literally 3 grocery stores already in our vicinity, not to mention 2 large Shoppers Drug Marts. So what was up corporate gods? It seemed like they forgot to take a quick look around our neighborhood before bringing in new chains. Sure, some of these corporations may be competing, but would they not be more profitable elsewhere?

So, a few months later I went to the grand opening of this Longos and it was like a carnival in there! They had free samples of fruits, bakery items, an open salad bar, chefs giving out pizza samples, a Starbucks, you name it and it was there. Their produce turnover was also very fast so all the produce was in pristine condition while you could get the actual ripe bananas at a reduced price. Score! I started going there with my mother more often. Yes, mostly for their exquisite bakery foods but try to understand, I just cannot deprive my sweet tooth.

Eventually, the competition phase between Loblaws, Sobeys, No Frills, and Longos dwindled down. Many people in my neighborhood were seen back in their natural habitat (whichever supermarket or drugstore they were familiar with initially), and the new guy, Longos put a hold on their free goodies and bought their prices up to their normal range. No one really profited too much. At least not in terms of health. So as health practitioners in training what are these GIS (Geographic Information Systems) we learnt about? Were they used? I recall that governmental and non-governmental organizations use such systems to determine the locations in need of resources, particularly those related to health. Was my town overlooked (or underlooked for that matter)? Or is the answer to this curious case is that corporate culture and business competition is more important than the determinants of health. With the vast number of health inequities existing in our country, is it possible to ignore the determinants of health and give in the corporate fights?

I have seen neighborhoods which are bound to only one supermarket and have to share among an excessively overflowing population. In a recent seminar, one of my peers was telling us that you would see people in her neighborhood bring groceries on the TTC because supermarkets were plainly inaccessible. This made me think. What if I was not fortunate enough to live in a community like mine. I might rather go to my local Tim Hortons and get a coffee and a donut rather than get pushed and shoved on the subway just to get a new carton of milk or fruit for snack! Communities need to be carefully planned out with prioritizing the needs of the residents, not the corporations.

Blog #4: The Lost Little Puzzle Piece

Imagine this; a small group of 10-15 people from different ethnic minorities cramped in a room with a built in kitchen. These people are cooking together, sharing their food, and learning how to make foods from the Canadian cuisine. Yet, half of these people are not fluent in English and cannot communicate their ideas in a clear manner. This is my perception of a community kitchen. So if someone asked me if I were to provide funding or donations to the establishment of such a place, I would out rightly say “No!”.

You may wonder why I hold such cynical views about a community effort that is clearly working towards creating a more accepting environment for newly immigrated individuals in which they can feel empowered and socially supported. These efforts are honorably trying to target the determinant of health of “Social Environments” which has a huge role in allowing new immigrants to become integrated into the Canadian culture and be able to navigate through the health care system in a well manner. Hence, as a future health practitioner, I should be warmer to the idea of community health kitchens.

However, I am not saying that they should not exist; I just do not “believe” in them per se. As an immigrant myself, I initially felt that holding on to my culture from back home assisted me in having a gradual transition into the Canadian society.  Although this transition was slow, I was content with the fact that I had held on to certain parts of my ethnic norms for some time before trading them in for Canadian ones. One of the major components of this ethnicity was food. Food tied me and my family to our country of origin and all of our memories from it. Yes, we were ecstatic that we were in Canada and  part of a much safer and developed society, but the main reason we came here was due to the acceptance of multiculturism in Canada, not for assimilation into unfamiliar cultures and their ethnicities.

Perhaps my reasons for being skeptical about the effectiveness of such programs is due to the fact that we as Canadians are still struggling to combat health disparities, poverty, and the problem of accessibility to healthcare resources. Hence it just makes more sense to me that funding goes into health promotion and public health programs which are more needed. Then again, need depends on the individual. Maybe some people enjoy such programs and find that it helps them integrate and adjust into the Canadian society more efficiently. Yes, this may be true, but are these small scale community kitchens ensuring that their participants are having adequate access to ingredients? Do they even having the means to purchase food? What about language skills which will improve their access to all services in general? One of the participant who shared his ethnic cuisine with the group, required the help of a family member just to communicate a preference of food. This made me think, would it not be better to fund large scale programs that are targeted to the overall improvement of immigrants adjustment into the society? Such programs could include kitchens like these but also provide people with workshops that helps improve their overall lifestyle (i.e. helping them overcome language barriers).

I do understand that every step towards better health counts but I still stand by my point that if funding must be provided to community health programs, it should be reserved for those which are multifunctional, because frankly, community kitchens alone seem like a sad missing puzzle piece which a kid had thrown under the sofa.

Hunting for Treasure

Last month, a conversation with a friend revealed that she was experiencing mental trauma. My first instinct was to advise her to pay a visit to her doctor’s office and explain the condition which had clearly started to affect her physical health. My fellow Nutrition students would know that this recommendation was based on 3 years of studying the professional practice of health sciences. Our professor have relentlessly placed great emphasis on the responsibility that the health practitioners hold (or should hold) to redirect their patients into the right direction in order to seek the appropriate health services.

My friend (let’s call her X), followed my advice and told me that her doctor (who is of similar culture and religion as X) referred her to the Shaw Clinic at York Central hospital, which specializes in psychiatric treatment. That was all fine and dandy, right up until her doctor told her that the referral entitled her to seek help for “anxiety and depression”. Unfortunately, that was not what my friend was looking for. She needed specialized counseling over issues that had little to do with anxiety or depression. However, according to her doctor, those issues weren't being covered by the Shaw clinic. Hence, X was disappointed because despite mustering up the courage to communicate her issues with a complete stranger (even if it was her family doctor), the appropriate help seemed unattainable. Yet, the disappointment did not end here, the doctor also told her that this referral was adequate enough for only one visit. After her initial visit, the health practitioners at the clinic would charge a fee per any additional sessions.

Fortunately, the doctor sensed X’s disappointment and asked her if she knew about the division of her local mosque which specializes in providing counseling for people dealing with similar issues.  X told me that this information helped her relax but she still remained skeptical in regards to this “division’s” existence and credibility. So she asked me if I had known about this facility in our local mosque.

I did not.

So why didn’t I? I had been to that mosque countless times. The health care freak within me would have spotted the marketing campaign for such facilities from a mile away! Was it even “advertised”? Community health centers such as the ones located within this massive mosque are clearly a great way to cater in religiously/culturally-sensitive care. People from the community have quick and easy access to it and they can explore solutions to problems which health practitioners of other backgrounds may not be able to understand. With such an immense amount of funding, donations, time, volunteer-ism, and knowledge of experts going into these sorts of establishments, it is only reasonable that its existence should be made known on a substantial scale. Perhaps there has been a shift from the lack of accessibility of such resources to the lack of promotion of the available resources.

Thousands of immigrants and refugees from varying origins are pouring into Canada every year. As human beings, we share similar mental and physiological health issues, however the ways to deal with them must be tailored to our diverse needs. Community health centers are an amazing phenomenon which can provide such immigrants with a greater fit of health care.  However, searching for them shouldn’t turn into a treasure hunt for people who may already be having troubles accessing the basic resources.  The facet of publicity that lies within the notion of accessibility must not be ignored.

The Burst Bubble

Upon landing in Canada we thought; “Life has never been better!”. Who would have thought that education could be free? Back home even going to kindergarten cost an arm and a leg! What about healthcare, you ask? If you were lucky enough to find a Doctor for your kidney transplant, his fee to perform the surgery would be enough to cover the purchase of a third kidney for spare use! So how could we “pay” for a blood test here just by a simple swipe of a plastic card? It all seemed absurd yet amazing at the same time.

Of course, at the time, I was young and did not understand the tax system, however, when I did grow up, the small percentage I paid on top  of my purchases seemed like a minor price to pay for all the resources to which we had a freedom of access. Yet, I also started noticing people complaining about high taxes not measuring up to these promised resources.. Obviously, upon hearing these statements such as; “I waited with high fever in the emergency room for three hours!”, the patriot in me was confused as to why people negated the advantages of the system and voiced their opinions so loudly on its shortcomings.

Then, a time came when loved one of mine needed prompt medical help. We automatically relied on the healthcare system to guide us to the best specialist. However when the family doctor told us that the earliest appointment available was 2 months later, we were literally in a state of shock. Needless to say, the family member traveled back to my home country on an urgent basis and obtained the medical help he needed. The cost of a 22 hours flight and medical fees accumulated to an amount which would have been better spent in obtaining private health care in Canada. The problem was that there was no such thing available.

I regularly see more and more people migrating back to their countries to acquire timely health care access. In my opinion, the problem does not lie in gaining access to the primary level of health care. We have sources such as family doctors, walk-in clinics, TeleHealth, all of which are strong channels which can provide us with the proper means to attain specialized help (if needed). However, the number of specialized clinicians in Canada is not growing as fast as the expansion of the Canadian population. From personal experience, most of the students of Life Sciences who aspire to enter into Medical School show great pessimism towards practice in Canada. Many of them migrate to the United States in order to successfully obtain the rights to practice. The health practitioners which are immigrating into Canada face the challenge of not having proper medical education that is up to the Canadian standards. Many of them falter under the stress of countless obstacles and re-evaluation procedures that they either change professions or settle for jobs which are a waste of their specialization.

Health care reform is an idea that is worth commending. However, some of the problems with the “status quo” are related to lack of accessibility. Hence, if health care reform is placing an emphasis on cohesion with “other levels of care” (i.e. hospitals and specialist care), the need for expansion of these services is also mandatory. We health practitioners need to keep up with the ever-growing population of Canada and its needs. International practitioners should also be encouraged and given the chance to practice. These small steps would bring us from treading on the path of mere hope, to change.

A weighty matter...

It is a topic that has been discussed in four out of the five courses that I am taking this semester. No, I am not talking about the list of assignments we have been bombarded with on our first week back. I am merely referring to class discussions revolving around the  Live Right Now campaign’s infamous reality TV show; Village on a Diet.

Perhaps it is the fact that we are Nutrition students and we feel compelled to discuss anything nutrition-related in the media, be it the horrors of the KFC Double Down sandwich to singing praises of the new Vitamin D DRIs. Or maybe, we are just feeling a sense of pride in seeing “No Name” branded ice-cream on a TV show (even if it is reality TV)!

Anyhow, regardless of the purpose behind these discussions, it compelled me to go onto the CBC’s Live Right Now website and watch an episode of Village on a Diet.

Needless to say I enjoyed it very much. It will fill any Nutrition student’s heart with joy if they were to watch hundreds of people striving to work towards a goal of a healthier lifestyle. The scene in which a Dietitian dumps out 3 packages of butter (6 cups!) from a family’s fridge, may even move some of us to tears of happiness.

However, after watching the show and listening to those class discussions,  a question has been preoccupying my mind: Why is the TV show stirring such a controversy?

Let me explain my views on it. When reading the past week’s notes from class, I came upon a familiar diagram; The Ottawa Charter for Health Promotion. With the controversy fresh in my mind, I automatically started to compare the charter with the elements of the campaign and its TV show.

CBC’s Live Right Now campaign has made a great attempt at showing that all people can  attain a healthy lifestyle. It establishes supportive environments while also helping to create strong community action. Not only does the campaign connect people in like situations, but it also provides them with access to appropriate tools for achieving their goals. The village welcomed a team of health professionals (Doctors, Dieticians, Psychologists, Personal Trainers ) who work with individuals in terms of tailoring the health information in a way that is more comprehendible and suitable for their specific needs. Furthermore, the campaign provided the villagers with a sense of belonging to a community of people participating in the same cause, which can be a huge factor of motivation.

Yes, even though this campaign may not be around forever and the team of health specialists may leave the village of Taylor, but have we not learnt that if health promotion messages make a lasting impact on even a small portion of the population which they were targeted to, the health promoter team has achieved its goals? Something is better than nothing! Also, let’s not also forget those class discussions last year in which we have agreed that conditioning children about good health behaviours can last them a lifetime.

So, what if the TV show producers have some sort of hidden agenda to mostly show the success of the villagers? It still shows the public that "everyone can do it".

Perhaps the may even be using the TV show as a big advertising ploy to direct the public to the Live Right Now campaign on CBC's website. What is the harm in that? I only saw benefits when I logged on to it.

Another point of controversy is that the show and the campaigns may be pinpointing the “wrong” ways that people are living and telling them to change their lifestyles to the “right” way. However, as health practitioners, won’t that be our job to do so in the future?

The people of Taylor signed up for it. They benefit because they are getting an ample amount of help in terms of their health goals. We as the viewers benefit because it contributes to our motivation and also helps us take away health education and ideas to accommodate proper diet and activity into our lifestyle.  I see it as  a win-win situation!