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I’m a bit disgusted they won't accept their loved ones into their care sometimes. They refuse to be discharged. So they resort to these tactics. This is a common practice that they do. And I'm just appalled that they could do this and get away with it.
AMT: Tom Spanidis says the staff at an Ontario hospital threatened to send his ailing elderly dad to a homeless shelter when he insisted they couldn't send him home because they couldn't care for him. It is the kind of standoff that those who work with families of the frail elderly have heard before—hospitals offloading patients onto families who cannot always cope. They say too many old people are being caught in the squeeze of overcrowded hospitals, long waiting lists for long-term care homes and home care problems with only limited care. We're looking at the problem in an hour. Also today, Maqalate Onyongo had a secret she didn't dare tell her mother.
At first I hid it from her because she did not see the importance of playing football at that time. The culture I come from is that we are not supposed to play football. It has no use.
AMT: She was a nine-year-old girl in a Nairobi slum who was supposed to be taking care of her baby brother, but she'd sneak out to play soccer in a league set up by a Canadian civil servant. She would become the first woman to referee at a professional level in Kenya and that civil servant would change the lives of generations. In half an hour, our project The Disruptors brings us the story of Bob Munro and the idea that changed everything. And it was December of 2015 when the minister of justice spoke with anticipation of a new inquiry into missing and murdered Indigenous women.
No inquiry can undo what happened but it can help us find ways forward because we know as a country, we can and must do better.
AMT: But those who were ready to embrace the government's efforts now say the inquiry is not doing enough. We're starting there. I'm Anna Maria Tremonti. This is The Current.Back To Top »
MMIW inquiry failing families, says Native Women's Association
Guests: Francyne Joe, Waneek Horn-Miller
The inquiry itself is not the solution. It's the action that's going to come out afterwards and that—we only got the inquiry because of the action of Indigenous women activists and families on the ground for decades. And we will only get at the solutions in the future not by waiting for the government to do it but by pushing and pushing.
AMT: That is Mi’kmaq lawyer and Ryerson University professor Pam Palmater. She was one of our guests at a special edition of The Current last March focused on the federal government's inquiry into missing and murdered Indigenous women and girls. Of course there have been calls for such an inquiry for years but since its official launch last September, criticisms have been mounting. Bridget Tolley’s mother died in Quebec in 2001 when a police cruiser struck her. She's one of many family members of missing and murdered Indigenous women who say they've lost faith in the inquiry.
Oh my god. I did lose faith. I did. I was hoping at the beginning. I was really, really hoping, you know? But I did lose faith because there is no communication. Nobody knows what's going on. It's hard on the heart and I do believe so many families died of broken heart disease, not knowing what's happening. You know, all we want is answers. We just want answers as to what happened with our loved ones to help us find our loved ones. There's been so many missing too lately and all I see is families asking for help. I want to be involved, you know? My mother needs to be involved too. Don’t leave us out. Do not leave us out. If this is for all the missing and murdered women in every province across Canada, do not leave us out.
AMT: Bridget Tolley. She's not alone. In a new open letter to the inquiry's chief commissioner signed by more than 30 advocates, Indigenous leaders and family members, it says the process is in serious trouble. This week the Native Women's Association of Canada issued what it called a report card on the inquiry and gave it failing grades. Francyne Joe is the interim president of the Native Women's Association of Canada. She's in Ottawa. Hello.
FRANCYNE JOE: Good morning.
AMT: Why has your association given the inquiry failing grades?
FRANCYNE JOE: Basically we took the terms of reference that were put up by the inquiry at the start of this whole process and put together some measurables and we've found that there was a lack—a lack of communication, a lack of strategic planning—and we need to ensure some sort of accountability in order for this ever to succeed.
AMT: When you say lack of accountability and lack of communication, tell me more about your areas of concern.
FRANCYNE JOE: The biggest areas is as Ms. Tolley had mentioned is that families want to be involved. In order for them to be involved, we need to have a clear communication plan from the inquiry so that know what's happening, where it's happening and how they can meet the commissioners and share their stories and come up with some clear concrete plan so that we can protect our women.
AMT: So people are contacting you to say they have concerns?
FRANCYNE JOE: We've had a number of families that we've worked with through the Sisters in Spirit project back in the mid-2000s and we've developed some really good relationships with those families. So we have a good one-on-one relationship with hundreds of families across this country.
AMT: And they're not getting communication from the inquiry? They're not being able to reach the inquiry?
FRANCYNE JOE: Correct. Exactly. They're calling in. They're signing in on the website and the other side, on the administrative side, they take names, they take numbers and then usually a legal personal contact them at a later date.
AMT: Well, I have someone else who's waiting to join us in this conversation. Waneek Horn-Miller is the director of community relations for the national inquiry into missing and murdered Indigenous women and girls. She is also in Ottawa. Hello.
WANEEK HORN-MILLER: Good morning.
AMT: The open letter says the inquiry is in serious trouble. How do you respond to that?
WANEEK HORN-MILLER: Well, all I can say is that we are working very hard to move forward and to engage the communities. We are working towards our first community hearing at the end of this month and every single day, my team is working to address those issues and I think that those are some very important and critical feedback. But it's important for us to hear what community members, advocates and people across the country. It keeps those important issues on the front of our minds as we're working really hard forward to close that gap. And I can't disagree. Our communication has not been good in the past and this is something that we are—like our new director of communications, Bernée Bolton, she has been in the job three weeks. She is working her team to make sure that this is something that we address and make sure that the families and the organizations get the needed information so they can participate.
AMT: Because that’s square one, right? You need the participation of individuals involved in this who have lost loved ones.
WANEEK HORN-MILLER: Absolutely. Absolutely. This inquiry is about looking into the systemic causes of violence against Indigenous women and girls and we need to hear from the families, the survivors. We need to hear from the LGBTQ2S community. We need to hear from women who were trafficked. We need to hear from women who are incarcerated. We also need to hear from experts like Francyne, all the people that have worked so long and so tirelessly on this issue. But with the hearing the need right across the country like get moving, get moving forward, get to the hearings, there’s that a lot of stress and anxiety and I very much respect what I hear from Bridget. We hear that from a lot of families, that stress, that anxiety that really it's hard. The weight is very hard. We want to move forward fast but we also are hearing that you can't just barrel through. We have to move with caution and ensure that we have a trauma informed process in place so that we are not doing further harm. And balancing those two needs is something that we're kind of walking that fine line and trying to do our best at.
AMT: Francyne Joe, what has it been like for people who want to contribute to the inquiry? What are they telling you?
FRANCYNE JOE: What we've been hearing from say, the White Horse meeting earlier this year, is that this wasn't a family first meeting. This was a meeting to introduce the commissioners, introduce the politicians, the chiefs, the counselors and the families didn't have enough time with the commissioners and they weren't happy with this. They did not know what the schedule was going to entail and they felt that they were being put in second or third place and we need to ensure that families are most respected and most honoured. They have stories they want to share so we need to ensure this is a family first process.
AMT: Well, Francyne, what is the expectation that those who have loved ones who are missing or murdered can go before the inquiry and tell their story? Is that what they want?
FRANCYNE JOE: That is basically what they want. They want to share their stories and then work with the commissioners to find out what could have been done differently and how can they ensure for future reference that their granddaughters, their daughters and nieces are going to be protected in the future.
AMT: And Waneek Horn-Miller, what is the expectation of the inquiry? Do they want to hear from every of every family group, family member who has lost someone? Is that what they want to make available?
WANEEK HORN-MILLER: Absolutely and there's many different ways. We are providing ways to participate in the national inquiry through testimonials, through artistic expression, through statement taking. Even we're looking at because so many of our Indigenous people live in very far remote places and we want to ensure that we have all avenues open for them, so even by teleconferencing. We are seeking ways because we know that our Indigenous people all don't live in urban settings. They live in a lot of different places. So we are working very hard to do that. But we have to put a lot of things in place and we heard from Whitehorse a lot of great feedback. We heard a lot of the families give us feedback. It was an amazing experience to be up in Whitehorse. We worked closely with the Yukon women's advisory group up there that consists of the Indigenous women's groups as well as Minister [unintelligible] and a lot of very invested and strong women who are holding our feet to the fire and making sure that we listen and we hear what they have to say. We have to be flexible. We have to work with the partners on the ground and that flexibility is something that they told us we had to have. You have to listen.
AMT: Okay. But your feet must be getting pretty hot because they've been talking about this for a while that they don't—Francyne, am I right? The individuals who want to talk don't feel that they have been able to talk yet?
FRANCYNE JOE: The individuals were so excited last fall when they heard that this inquiry is going go forward and when the doors were supposed to open in September, they were extremely disappointed. And then in October 4th, vigil came forward and still they had heard nothing from the inquiry. This pause that they're taking for the summer to be talking to technicians, this is what probably what we should have started with last fall. Speaking with the technicians, and at this point we should have been meeting with a number of families already.
WANEEK HORN-MILLER: Well, all I can tell you—and we definitely hear those criticisms—is that we are working every day. I can tell you that my team right now is in the Yukon meeting with families in Watson Lake actually today to help through the intake, my community relations as well as legal and health supports. So all we can do is listen to that criticism, try to honour all of the work that all of these advocates have done and work really hard to make this inquiry get on its feet, get on track and be as inclusive as possible.
AMT: We asked for an interview with Carolyn Bennett who is the federal minister of Indigenous and northern affairs. She was unavailable to us. But we have a clip of what she said yesterday when asked to address concerns about the inquiry.
VOICE 1: Well, as we remember, the objective of the striking the commission was two things: to stop the tragedy but also the healing of the families. When the families have concerns, I have concerns. And so it is clear that the importance of listening to families is to hear their insights, to be able to get an excellent report and recommendations to stop this tragedy. But it's also the healing process for the families. And so as you know, the commission is totally arm's length from government and I look forward to the response of the commission to this letter.
VOICE 2: Would you give an extension if the commission asks?
VOICE 1: It's going to be very important that the commission to explain what they are doing and their work plan and we will always consider what is best for the families.
AMT: I want to pick up on that question from the CBC's Karina Roman there about giving an extension. Francyne Joe, the first interim report is due in November.
FRANCYNE JOE: Twenty-four weeks.
AMT: So did they just not give the inquiry enough time?
FRANCYNE JOE: I thought that there was enough time when it was first announced last fall. But we are 24 weeks until November 1st and if we're taking the summer off to meet with technicians, that's going to leave us about eight weeks to actually come up with a report for November 1st. I’m a little concerned that the report will not be as fully engaging as we hoped, but I'm still hopeful.
AMT: Waneek Horn-Miller, the inquiry is holding three days of family hearings in Whitehorse at the end of the month. But then after that, there is that break. Why the delay?
WANEEK HORN-MILLER: Actually there is and this is where our communications piece has to get better because there is not a pause. We're meeting with families all summer. My team is going to be finally hopefully at full strength, so my liaisons will be across the country and we'll be going out to communities to inform and engage and do intake of family members who want to participate. So this is going to be happening across the country. I hope to have that schedule with my team for release by at least early June, very early June because we have to evaluate how my team is doing right now in the Yukon and ensure that we debrief and look at how it went. And then I'm excited. I'm excited to get out there and be meeting with families. That's exactly what my team is meant to do and wants to do.
AMT: And once you have heard from the families, what is the job of the commission after that?
WANEEK HORN-MILLER: From this summer or after the community hearings?
AMT: The whole thing. What's the final goal of this inquiry?
WANEEK HORN-MILLER: The final goal of this inquiry, we have the interim report that's coming up which there there's a lot of information that we already have. We are going to be having expert panels as well that are going to be happening throughout the summer and into the fall. So there's going to be a lot of information that can be included. The final report is to make strong recommendations on and to look at what the systemic causes that have caused our women and girls to be in such situations of danger, to have been murdered, why is it that their cases are not adequately investigated or investigated at all? Why are our women incarcerated at a higher rate? Why are our women trafficked at a higher rate? These are all issues that we have to look at, including one of the issues that really is close to my heart is the violence against the LGBTQ2S community. We have to make some strong recommendations, but those recommendations then are something that our community as well as our political leadership and Canadians can say we need to implement these recommendations.
AMT: Francyne Joe, what do you think?
FRANCYNE JOE: I think if we can see sooner rather than later a clear strategy plan, a clear communications plan, a clear budget, that's going to start repairing the emotional trauma that's affected families so far. It's been an emotional rollercoaster for so many of these families and I don't think we're providing the correct supports at this moment for either the families or even the staff.
AMT: Francyne, you talk about trauma informed. What does that mean?
WANEEK HORN-MILLER: Trauma informed reflects on—we need to be considerate of what the family has gone through since losing a loved one and we need to be respectful of the individual and ensure that they're being looked after both physically and mentally and holistically before, during and after this whole process.
AMT: And why is that different from other inquiries the government has held? Just speak to me a little bit about some of the people who are going to talk about this.
FRANCYNE JOE: Well, we've learned a lot from the truth and reconciliation process and they put in a service by bringing in Indigenous people who were trained in counseling and in cultural traditions to work with people who were sharing their stories from a residential school and from the Sixties Scoop and we need to ensure those types of supports are being made available to the families today.
AMT: Some of these families have never talked about their missing.
FRANCYNE JOE: Some of these families are not comfortable sharing this information so it's very deep emotion that they're bringing to the commissioners. So we need to honour those stories.
AMT: And Waneek Horn-Miller, this isn't like a court case or a case where somebody can take a step back. This has become so personal. How do you do that in the time you have? You’re going to be at a two-year deadline here.
WANEEK HORN-MILLER: Well, I cannot agree more with Francine about providing it in a trauma informed way and that includes ceremony. That includes the supports they need. The reason why we move forward with such immense caution, there’s family members that work within this inquiry. Survivors have I’ve worked with in this inquiry. And we absolutely respect and honour and value the stories that we are going to be hearing.
AMT: But when are you going to hear them? If you're on such a tight timeline and you do have to make space to hear all this and you do have to have all these things in place, and it's already May, when are you going to hear all of them?
WANEEK HORN-MILLER: Well, we will be hearing some at the end of this month. I can tell you that we're hearing them at the Whitehorse hearings, so that's the beginning. We'll be preparing people all summer to be prepared because there is a legal aspect to this inquiry. We need to request court documents.
AMT: Precisely. So my question is then do you need an extension? Can you get all this done?
WANEEK HORN-MILLER: You know what, the only way we can say whether we do or don't need an extension is that can’t be said by myself. It has to be evaluated by everybody with this inquiry—all the directors, all of my staff which I work together as a team and the commissioners. And as we're rolling out, we are working very hard to get to those hearings and to hear those stories and I know that in the next few weeks we are going to be coming up with a schedule and we are looking forward to getting to the community hearings.
AMT: Francyne Joe, are you hearing anything to up your grading of this inquiry so far?
FRANCYNE JOE: I think we're going to go back to the actions speak louder than words model. Right now we've been waiting since September. And once we see a schedule, once we see a clear communications plan, then we can start working with this inquiry and working with the staff and start the healing process.
AMT: Okay. And Waneek Horn-Miller, after these first three days of hearing families, when will you hear families again?
WANEEK HORN-MILLER: Well, that's exactly what Francyne said. It’s about coming up with that schedule and ensuring that we release that in a timely manner with a good communication strategy. My team, the community relations team is going to be out all summer engaging with families to help prepare them. You know what? I look forward every single day, I wake up every single day, my team, to work hard, to make my actions speak louder than my words and I will remember to do that. Thank you very much, Francyne.
AMT: We have to leave it there. Thank you both. Francyne Joe is interim president of the Native Women's Association of Canada. Waneek Horn-Miller is the director of community relations for the national inquiry into missing and murdered Indigenous women and girls. They are both in Ottawa. This season, The Current has been hosting a series of public forums across the country on the issue of missing and murdered Indigenous women and girls. You can listen to all of our coverage at our website: www.cbc.ca/thecurrent. Let us know what you think about where this inquiry is, what the expectations were versus where it is right now. Tweet us. We’re @thecurrentCBC. Find us on Facebook. Go to the website. I'm Anna Maria Tremonti. This is The Current on CBC Radio One. And in a moment, we're going to be hearing about the disruptions and the life of the slums of Nairobi, one soccer tournament at a time.
If we lose, we lost together and I think that’s the same way that a country works. When you work together, there's a lot you can achieve.
'Kids are going to school because of football': How a Canadian gave Kenyan youth a future
AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.
AMT: Still to come, patients being pushed from hospital beds to homeless shelters? We will hear from one Ontario man who says that's what a hospital threatened to do with his father. The future of Canadian elder care in half an hour. But first, changing lives one soccer game at a time.
[Music: The Disruptors theme]
AMT: This season on The Current, we are bringing you the stories of disruptors, disruptive ideas that are changing the world. Today's comes from a Canadian public servant. Back in the 1970s and eighties, Bob Munro was assigned to work on the environment and that work took him to UN conferences and world commissions around the world. But it was his work outside the conference halls in the slums of Nairobi, Kenya that put him on our radar today. Bob Munro's disruptive idea had to do with soccer and its power to disrupt thousands of young lives. He helped launch an organization which has not only been nominated twice for a Nobel Peace Prize; it is now run by the very youth it serves. Freelance journalist Dick Gordon brings us the story from the Nairobi slum of Mathare.
[Sound: Children playing]
DICK GORDON: This small soccer pitch is surrounded by rope netting and waist-high boards. It looks more like an outdoor hockey rink in summertime. A couple of dozen young boys gather around a young woman in charge.
MAKRINA: Okay, listen to me. Listen.
DICK GORDON: She’s the coach and she has to explain n what happens if one of the teams scores a goal.
Okay, we're going to start. I'm going to throw the ball. And when the other team scores, you're going to do the hand-washing steps. Okay.
DICK GORDON: Soon after, one side scores and the other team gathers around its captain for what they call: the "hand-washing steps.”
VOICE: You wash your hands.
MANY VOICES: You wash your hands.
VOICE: You take the soap.
MANY VOICES: You take the soap.
VOICE: You wash between your fingers.
MANY VOICES: You wash between your fingers.
VOICE: The other fingers.
MANY VOICES: The other fingers.
VOICE: You scrub your palm.
MANY VOICES: You scrub your palm.
DICK GORDON: The young soccer players are all wearing jerseys marked with four letters: M-Y-S-A. "MYSA" stands for the Mathare Youth Sports Association. Mathare is one of the biggest slums in Kenya's capital city of Nairobi. This is a story about MYSA and a guy called Bob Munro, and a remarkable change that the Kenyans have brought to their community. It all started 30 years ago. Bob Munro was spending a lot of time in long meetings at the UN offices in Nairobi. When he got bored, he'd walk to the nearby slum of Mathare.
[Sound: Music playing in background]
DICK GORDON: Mathare is a place where over half a million people live in tiny shacks. The walls are built of mud and old boards. The roof is a rusty sheet of tin. The narrow alleyways are open sewers. I sit with Bob on a stone bench near Ngong Road. I ask him to take me back to that day in 1987, the day in the slum when he and a friend were watching children on a little patch of dirt kicking a soccer ball made of paper and string.
BOB MUNRO: These kids had gone in like this was a stadium. They’d put two rocks at each end and there was only four of them. They must have been only four or five years old. So I'm standing there and one of the kids kicked another kid and the other kid was going to punch him or kick him back. But then he saw this white guy standing there who was watching. I gave him a look, you know? And he didn’t. But he found a way of sort of accidentally missing the ball and kicking it back a few minutes later. So I tweeted and said that's a foul and we have to have a penalty kick. Now, the kids got so excited that all of a sudden, their game was official with a referee. They didn't notice that when one of them was standing in the goal, and one of them was taking a penalty kick, there was no place for the ball to go. They were just so excited that they were going to have a penalty kick.
DICK GORDON: Bob asked his friend if there was any organized soccer in the slum. There wasn't, so Bob said he'd help set something up, but only if the kids helped.
BOB MUNRO: I had a consulting business to run and a fairly large family so I was busy enough. So I made [unintelligible]. If you do something, I'll do something and if you do nothing, I'll do nothing. That was to protect me, huh? But it didn’t. It turned out to be a big mistake because I had no idea of their determination and capacity to do things. And so I've been spending the last 30 years trying to hold up my end of the bargain because they just kept doing things, [laughs] expecting me. Okay, we've done something. You do something.
[Sound: Children playing soccer]
DICK GORDON: Bob Munro had contacts. HE got a bit of money together and started up his league. Boys and girls could play. Maqulate Onyango grew up in the Mathare slum. We sit beside one of the soccer fields to talk.
MAQULATE ONYANGO: I didn't have hope back then because I come from a very large family, and my mum and dad were not working. And I am the first born and I had to take care of my siblings, so I had even to sacrifice not to start school early so that I can take care of my little brothers. I don't have sisters. I have only brothers. And for us, I come from a family where we only survived on one meal a day and it's just a meal you can count on. It was a very small meal that you can rely on. I was very tiny then. I was very small simply because we didn’t have enough to eat then. We did not have clothes. I remember I only had two clothes that time. So I could wear one and wash the other one, wait for the other one to dry and wash the other one.
DICK GORDON: So you had little brothers. They couldn’t help.
MAQULATE ONYANGO: They couldn’t help.
DICK GORDON: What could you do as a young girl to help bring money into the family? Was there any jobs you could do or anything like that?
MAQULATE ONYANGO: We used to collect the nails. They used nails. We used to go to a ditch where there is running sewage and water and we put our hands inside. We tried to look for the nails. We would get the nails and the metal. There is a place where you go sell them. They’re weighed and you sell them and get some money out of it. So every day, I couldn’t miss like 20 shillings in a day. And once I get the 20 shillings, before my mom is back because she also went to wash for other people’s clothes so that she can get some money. When she comes home, she finds that I’ve already prepared dinner because I have the 20 shillings to be able to feed my brothers.
DICK GORDON: And you were how old at that time?
MAQULATE ONYANGO: I was very young. I was nine years. I was nine years. So I became responsible at a very tender age because there was no one else to help us. We were all alone.
DICK GORDON: When Maqulate had time to wander, she'd go down to the Mathare Depot field, where the other kids played soccer.
MAQULATE ONYANGO: One of the coaches then just called me and asked me my name, nothing else. And then I said my name. I was a bit afraid. He asked me where do you stay? I said just down here. He said do you pay football? I said no. Do you want to join football team? I said yes. Can you play football? I said no. And then he asked if I can come for the daily trainings in the evening. So it was tricky for me to say yes because at that time, our last born brother was very young and I couldn’t come for the trainings in the evening because I had to bring the baby to the field and it was dusty. And I knew my mother was going to beat me if I bring the baby to the field. So I said I cannot manage to come for the training. And they asked me why. I said because I have a little boy I’m looking after. So the coach was very nice and he told me I will be passing by your home because our home was just along the road to the field. I will be passing by your home and I’ll be taking care of the baby while you train. But I had to make sure that I get home before my mom gets home.
DICK GORDON: So she never knew that you were playing football.
MAQULATE ONYANGO: She never knew that I was playing football. So at first, I hid it from her because she did not see the importance of playing football at that time. And where I come from, the culture I come from is that we are not supposed to play football. It has no use.
DICK GORDON: Girls are not supposed to play.
MAQULATE ONYANGO: Girls are not supposed to play. They think it has no use to participate in sports. There’s no benefit. Because at that time, the benefit my parents wanted was money. So everything they were thinking and talking about is how can we get money? So if you want to go and do sports and sports is not giving you money, what's the point of doing sports? That's why I hid it from my mom for a couple of years.
DICK GORDON: At the beginning, diplomats and bureaucrats and agencies in Europe offered some support to MYSA. FIFA got interested. Word got around the Mathare slum that this little soccer league would help pay school fees. In MYSA’s second year, Bob had 21 teams.
BOB MUNRO: We went August to December and in December, we had a championship with real trophies and real referees out there. There’s a picture of the commissioner of sport in the slum presenting a trophy—a good trophy, a good sized healthy trophy—to a kid from a slum called Kinge whose team had one. That was in the newspaper the next day. That was stunning. There had never been good news or positive news. It was always about drugs and prostitution and mob killings and changa’a, the illegal brew. Here was a positive picture. So three weeks later when we opened up registration, instead of 21 teams we had 122 teams. And that's part of the secret of MYSA is we can never say no. If a bunch of kids showed up barefoot, ripped shirt, torn pants and said we're a football team, can we join MYSA? How can you say no? So MYSA just started multiplying. Ten years later, it was a thousand teams, 1,200 teams. And today we’re 1,800 teams.
DICK GORDON: Eighteen hundred teams?
BOB MUNRO: Twenty-five thousand players.
DICK GORDON: Just in Nairobi?
BOB MUNRO: Just in the Mathare slums and the neighbouring slums.
DICK GORDON: Eighteen hundred teams. That’s this year alone. The league is now divided into zones from all over the Mathare slum. MYSA has its own soccer complex with fields and an administration building, but it's the young players who do most of the organizing. Unlike Canada where kids sports are run by the grownups: coaches, refs, fathers and mothers, in MYSA, it's the soccer players who do the organizing, scheduling matches, electing their captains, deciding which players need financial help.Bob Munro knew from the outset that the league would never succeed unless the Kenyan kids saw it as their league. He loves to tell the story of little Charity Mathoney. She’s from a part of Mathare called the Kaolo Zone.
BOB MUNRO: I see this little head go by, and I see this little girl go in and see my head of the sports department, and then she comes out and I see here going into the finance department. So next time she came out, I called her in and I said who are you? I'm Charity Mathoney, she said. How old are you? Nearly… nearly 12. And why are you coming in? Because I'm the chairman of Kaolo Zone. The newly elected chair of the Kaolo. Eleven years old. I sent it off to my friends in FIFA and they admitted that she was probably the youngest elected football official in the world. [chuckles]
DICK GORDON: There's one other secret to the success of MYSA. Bob worked for years on environmental issues, arguing for safe clean housing. But like so many others, trying to make that case to the politicians, he kept getting frustrated. But Bob knew something the politicians didn't. He knew that the cleanliness in the slums matters to the people who live there. So, MYSA offers the kids a deal. If they want to play, if they want soccer balls and fields, goal posts and trophies, they have to do a small bit of community service. They have to help clean up the slum.
BOB MUNRO: The garbage is a killer. They live on slopes in Mathare Valley. And when the rains come twice a year, the rains are going through all that waste garbage that’s not collected. So when the rains come, they wash through that garbage and also the human waste because there aren’t toilets. And the kids get sick—typhoid, cholera, stuff we think of as from the Middle Ages—and they die. So we set that every team had to do at least two garbage cleanups a year and we got wheelbarrows and rakes and shovels. So the garbage clean-up was to save lives. They initially didn't do it because they thought this is a great thing to do, clean garbage. They did it because for every football match they won, they got three points. For every garbage cleanup they did, they got six. Still today, we’re probably the only sports league in the world where the columns are games one draw, lost, garbage. Total points. And you can't win and go on to the playoffs unless you've done at least one.
DICK GORDON: And who polices this? Who makes sure that those little kids are out there cleaning up the garbage?
BOB MUNRO: The captains.
DICK GORDON: The team captains.
BOB MUNRO: Yeah, because when it’s six points, the captains tend to make sure they have to have at least 10 of their players there in order to get the points.
Maqulate Onyango, the little girl who was once so busy feeding her brothers in the slum, she became a gifted player. She then trained as a referee. She was the first woman to ref at the professional level in Kenya.
MAQULATE ONYANGO: If these young boys and girls are not here, then we could not be here, because you'll find that MYSA is an organization that does not hire from outside. We don't employ because we have degrees. We don't employ because you are the son of a minister .We employ our people from the slums because they have the passion to do the job.
DICK GORDON: We're sitting here beside one of the practice fields and one of the senior girl's teams is playing right here. These young women, they all have other responsibilities though, right? It's their job to find young girls like you?
MAQULATE ONYANGO: Yes.
DICK GORDON: And help them?
MAQULATE ONYANGO: Yes.
DICK GORDON: But it’s not just something they should do, it's something they have to do, right?
MAQULATE ONYANGO: It is something they have to do because it’s giving back to their community. Somebody gave back to them, so it’s their time now to give back. And they have a responsibility each to form a girls' team, specifically a girl team.
DICK GORDON: Each one of these players has to form a girls’ team?
MAQULATE ONYANGO: Each one of the players because by giving back to your community, it is making sure that you do what was done to you. And also our conscience will not be clean if we don't mentor the young girls because that has been the tradition of the culture and tradition of this organization. So we do it unconsciously but it is something that we must do.
[Music: “Sheria” - Sarabi]
DICK GORDON: George Ndiritu is one of Nairobi's notable young activists. He's also a musician and a writer. This hit song of his called “Sheria” details the difficulties that ordinary people face with corruption in Kenya. George says he learned his lessons as a little kid on a soccer team with MYSA.
GEORGE NDIRITU: My team as a young kid, we fought for one mission—to win every match every week. Be the best team, you know? If we lose, it’s not the goalkeeper. It’s not the defender. We lost together and we can sit down and say here's how we can win next week. There's the mistakes we made. How can we rectify that? And I think that's the same way a country works, that when you work together, moving forward, there's a lot you can achieve. It’s more collective. When I was a young kid meeting Bob in the nineties, he always kept telling us that one day MYSA will produce leaders for this country. And I think that's what many of us are becoming, whether in civic positions or in civil society where we keep on pushing the government to do the right things.
DICK GORDON: As a matter of fact, in the next Kenyan election, another MYSA graduate, Patricia Metheu Musyimi is running for a seat on Nairobi City Council.
PATRICIA METHEU MUSYIMI: How did I make my networks again? I made my networks through MYSA. How did I learn all this about leadership skills? I learned them from MYSA. I didn't go to any school to learn all this. I learned from MYSA. I know how to organize people better. I know how to organize leagues. I can ref. I can play soccer. I became an all-rounded woman. Okay? I'm good at public speaking. I am passionate about my community. That is what drives me because only one person believed in me. So if I can be that change—and I've seen it work—if I can be that one change, why not? I'll knock myself out. I go for it and I go for it. And like I said, I don't know how to stop. I'm going to go for it.
DICK GORDON: As MYSA marks its 30th anniversary, it has an growing list of successful alumnae. Some of the soccer players have gone on to professional teams in Europe. MYSA has its own professional team now in Kenya. Others from the slum finished school and went on into business and education. It’s these people who are now taking over as the main financial supporters of MYSA. Maqulate Onyango sees the change in her own family.
MAQULATE ONYANGO: I remember when I first got employed in 2000, I moved my parents from Mathare. They're still in the slums, but they're not in Mathare slums. They’re in a better place now. We used to live in a mud house. They now live in a stone house. My brothers, now they’re in school and even our last born brother has joined the secondary school because whatever MYSA is paying me, I make sure that I pay the education of my siblings. And life has really changed. And even today when we sit with my family on a round table to talk, they can't believe that they are eating football and sleeping football and their kids are going to school because of football. Up to today for us, it’s still a dream and my dad even today asks me: this football thing, I didn't know that it could change somebody's life.
DICK GORDON: While Bob Munro gets credit for starting MYSA and designing the league, he did something unusual with this mix of sports and development. He stepped back. The young people do the work because it's their league. They keep it going because they know they are getting better schooling and their slum is cleaner. What's most important, they’re in charge. They're not waiting around for someone else to try to do the work for them.
[Music: “Sheria” – Sarabi]
AMT: We've been listening to a documentary produced by Dick Gordon and The Current’s Josh Bloch. And if Dick Gordon's name is familiar to you, no surprise. Long-time CBC journalist, foreign correspondent, wonderful story teller. What a story that one was. Thank you Dick Gordon for that story.
[Music: The Disruptors theme]
AMT: Well, on to another disruptor we've been tracking this week at The Current. Our smartphones have definitely disrupted our lives and they may be just a disruption some people can no longer live without.
[Sound: Phone buzzing]
VOICE 1: I’m on my cell phone all day.
VOICE 2: A nomophobe gets the jitters when the phone is out of reach. It's no mobile phobia.
VOICE 3: When I forget my cell phone at home, I feel empty.
VOICE 2: If you formed a nation of nomophobes, it would be the third or fourth largest nation on Earth. We're talking about hundreds and hundreds of millions of people.
VOICE 4: I’m on my phone 24/7, can’t put it down. It’s an addictive thing.
VOICE 2: Seventy-five per cent of people now say that they can reach their phones 24 hours a day without having to move their feet.
VOICE 5: I'm addicted to my phone. Just a few weeks ago, my phone screen was broken and I had to go like a week and a half without it. I felt like I had lost a friend.
AMT: Some of the voices we've heard from this week discussing the addictive qualities of smartphones and screens. We heard from author Adam Alter. His new book about addictive tech is called Irresistible. We also heard some Canadian teens who say they are hooked on their phones and also from a counselor who helps them. You can find all those segments on our website, www.cbc.ca/thecurrent, or on your CBC Radio app. Here's a bit of what we heard from you.
VOICE 1: Susie Erjavec Parker tweeted: “As a digital marketer and mom, I'm constantly telling my kids to drop the tech and read a book or go outside.”
VOICE 2: On the other hand, Dave Mitchell tweeted: “My teen daughter is on quite a bit. I have no concerns. This is a natural progression of technology, and society will adjust.”
VOICE 1: Maggie Laidlaw from Guelph, Ontario wrote in to say: “I recently watched a family of eight at a restaurant, as all but the grandmother and the baby she was holding were on some sort of device. I despair of the future if this is what ‘family time’ has become.”
VOICE 2: Rick Fauteux tweeted a different perspective: “It's the parents’ need for constant contact that drives teens getting a cell phone in first place. Then use causes addiction.”
VOICE 1: Brittany Burek tweeted: “It's important to know smartphones and technology are a lifeline for some students with learning disabilities at school to access learning.”
VOICE 2: Michael Fricker from Edmonton wrote in to say: “It seems more like we need a war on addictive tech. I'm a high-functioning autistic. Now when I'm sitting in a silent room full of people all avoiding each other, I find myself feeling the least autistic present. For sanity's sake, turn off your phones and get your kids to put theirs down. You have a choice that real autistics don't. Your phones aren't your lives, but they are devouring them.”
VOICE 1: We also heard from many of you who have decided to forgo smartphone technology altogether. Farha Guerrero from Whistler, BC wrote about her device-free family: “We wake up each morning to the sound of vinyl records on our vintage turntable. Our dining room is always littered with books. After school my boys practise guitar, draw, make exquisite origami models, build forts outside, walk the dog or practise wheelies on their mountain bikes. They arrange play dates with their friends in person at school. They never whine to me about no screen time. They understand that mom wants them to be creative and to use every hour of their lives in exploring their worlds with all of their five senses.”
AMT: If smartphone use is something you struggle with or your kids do, try taking the challenge of tracking your use over 24 hours. We have links on our site to a few of the apps that help you do that. Try it. Let us know what you find out. Let us know about any surprises. And yes, that is right, I'm asking you to spend even more time on your device to find out how much time you spend on your device and then spend more time on your device telling us how you spend time on your device. [chuckles] Let us know by writing, recording your thoughts. Send us the audio. Then we will go to our device and see what you had to say. Reach us on our website: www.cbc.ca/thecurrent. Just click on the contact link or put your phone in a sink of water. Coming up in our next half hour, from hospital bed to a homeless shelter. Some patients say they are experiencing hospitals hell-bent on discharging patients. It's a trend that is only likely to get worse. We're talking about it in less than 90 seconds. I'm Anna Maria Tremonti. This is The Current on CBC Radio One, Sirius XM, online on www.cbc.ca/thecurrent and on that radio app on that ubiquitous smartphone.
[Music: Sting]Back To Top »
Elderly patients in hospital need adequate long-term care plans before discharge, say families
Guests: Tom Spanidis, Jane Meadus, Dr. Samir Sinha
AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current. As Canada's population ages, hospital beds are in shorter supply and that's a situation which appears only bound to get worse with time. You may be surprised to hear how bad it may already be in some areas. Imagine being told that you or your elderly parent had to give up a bed and be discharged even if you had no place to go. Imagine being told by the hospital that you'll be dropped off at a homeless shelter. That's what Tom Spanidis and his family say they have experienced. Tom and his wife care for his father Illias. She works. He's semi-retired and has been taking care of his dad at home for a decade. Illias is 88 years old and he had a fall earlier this year. After rushing him to the Stouffville Markham hospital in the Toronto area, they say the hospital has been trying to rush him out the door. Tom Spanidis is with me in Toronto. Hello.
TOM SPANIDIS: Hi.
AMT: So your father was rushed to emergency after a fall. When was that?
TOM SPANIDIS: Well, his first fall he had on January 13th. He had lacerations on his head and on his back. He was bleeding. It was around two in the morning. Called the ambulance, stopped the bleeding and they took him to the hospital, looked him over and he was discharged that same day. He was brought home. Everything was fine. What happened March 24th, his physician diagnosed him with congestive heart failure and at which point the medication was prescribed to him which is called furosemide or Lasix. Now that medication causes severe dizziness. So he was on that medication. That could have been part of his dizzy spells that he was getting in causing him to fall.
AMT: So he falls again.
TOM SPANIDIS: Well, he fell again in his bedroom on March 26th during the night.
AMT: Okay. And what happens?
TOM SPANIDIS: On March 27th, he was admitted to the hospital by ambulance.
AMT: So you have him taken back to the hospital. It's March.
TOM SPANIDIS: Right.
AMT: And how long does he stay that time?
TOM SPANIDIS: About a week.
AMT: Okay. And what happens?
TOM SPANIDIS: They try to discharge him and I protested that. He was not ready to come into my care. He was still dizzy. We haven’t found what's causing his dizziness. They suggested it was vertigo. So they couldn't treat him any more in their opinion so they're discharging him.
AMT: But at somewhere along this line, you realize you're not really able to take care of him at home. When do you realize this?
TOM SPANIDIS: The week of March that he's in the hospital, so what I did is I inquired about a long term care application which was started and I was told within the next couple of weeks, Community Care Access would be calling you and setting up an appointment to do an assessment with him and to finalize it.
AMT: And Community Care Access is the Ontario agency that is supposed to work and coordinate in-home care. You can't care for him at home without some help, why not?
TOM SPANIDIS: It's not the care so much I was concerned about. It was more or less the monitoring. If left alone, especially at night when he wakes up to three or four times a night, if he has another fall, if there's nobody around he could be dead. CCAC cannot provide more than six hours a day, seven days a week which is a lot of time to commit. So no matter how much in-home care you throw at him, it's still not enough. He needs monitoring. So I managed to get a few more days out of them until I was confident enough that he can come back into my care. He was discharged on April the 4th and in two days, April 6th, he woke up in the middle of the night with excruciating pain to his head. So in the morning we brought him back to emergency in the hospital and this is the third time that he's come back to the hospital. And at that point they find that his spine is cracked. So they put him in a collar. I was told it would take six weeks to heal. They started talking about discharge planning again within the first week that he was back in hospital.
AMT: Discharge planning meaning they started talking about when they're going to send him home again.
TOM SPANIDIS: Yes. They said there's medically nothing more we can do for him. So he has to go home and heal.
AMT: And you refused?
TOM SPANIDIS: I refused because we're back in the same situation. I emphasize that like he was worse off now. And you know there's still a lot that you can do and I'd like to start rehab too. And they said well, he's not a candidate for rehab. He has to go home and heal on his own and then you can do rehab in the community.
AMT: You refused.
TOM SPANIDIS: I refused that.
AMT: So they say to you if you won't take him home, we'll send him home in an ambulance.
TOM SPANIDIS: Yes.
AMT: What else did they tell you? If you won't take him home for care, what else did they say they would do?
TOM SPANIDIS: Well, the day that they were supposed to discharge him by ambulance, I went there at four to feed him. At five o'clock, they called the police. And so three police officers show up in the lounge area where he was with me and with the acute care unit manager and they started interrogating me about whose home it is.
TOM SPANIDIS: Well, I guess because he has a right to be in his home. The other question was who pays the rent, of course to see if he's contributing to the rent. And I told them we do. So then later the conversation went to my responsibilities and how we should take care of our parents and his right to be in his home. And I said I've never denied that he can't be in his home. It's just that you're not going to force him into my care. I don't appreciate being strong armed into accepting his discharge and he said well sir, that's not our intent. And I said well, what do you call it when you've got three cops in the room here? You've got your two managers here and it's just me and my father and the guy's been stressed out because he's seeing all this conversation take place right in front of him.
AMT: But the hospital then makes another threat. What's the threat?
TOM SPANIDIS: Well, I went to pick up my wife from work. I left at six o'clock. And on my way out, they said well, he's deemed homeless now. And they said we're going to send him to a homeless shelter.
AMT: Were you surprised to hear them say that?
TOM SPANIDIS: I was surprised but I wouldn't put it past them. When I came back at seven o'clock with my wife to see how he was, if they had discharge them into a homeless shelter, he was still there. I said how are you doing? He says well, they took me over to the nursing station. They put me on the phone with a Greek interpreter because he doesn't speak English and the Greek interpreter told him that you'll be going to a homeless shelter where there's no nursing care.
AMT: How did he react?
TOM SPANIDIS: Well, he was in tears. He says get me out of here. I can't take this anymore.
AMT: Where is he right now?
TOM SPANIDIS: He's in the transitional care unit of the hospital.
AMT: What do you think your father needs in terms of health care now? What would it be?
TOM SPANIDIS: Monitoring mostly and also adjustments of his medications. He's not as he was when he first came into the hospital. He needs a walker. He can't walk on his own and he can't do stairs.
AMT: And what would make it better for you and for him?
TOM SPANIDIS: A nursing home or if he gets treated enough that he could come home and be stable enough and make me confident enough that I can leave him alone.
AMT: But you’d need some kind of home care on a regular basis.
TOM SPANIDIS: At this point, 24 hours.
AMT: Twenty-four hours. And what's the waiting list for the nursing home, long-term care home?
TOM SPANIDIS: Well, for this particular one it's eight months to a year.
AMT: And what's the ability to get—you’d need 24-hour home care. Can you even get that?
TOM SPANIDIS: No. You have to pay yourself privately.
AMT: Can you do that?
TOM SPANIDIS: No. He can't do that right now. I know he's worried and I know he's scared because he doesn't know what's happening at this point.
AMT: There are hospitals that argue that they have their own funding cut back. They have only so many acute care beds, that they're not long term care facilities and they cannot keep people in need of long term care but no longer in need of acute care in the hospital. Do you have any sympathy for where they might be coming from?
TOM SPANIDIS: Absolutely. And I understand the plight that they're going through because there's just not enough nursing homes around right now. But at the same time, I'm not a doctor. I can't provide the care for him in the home right now especially as his condition continuously changes every day. I'm just appalled that they could do this and get away with it.
AMT: Well, it's pretty disturbing. Thank you for coming in.
TOM SPANIDIS: Thank you, Anna Maria.
AMT: Tom Spanidis, currently at odds with a hospital trying to discharge his 88-year-old father. He joined me in our Toronto studio. We did contact the Markham Stouffville hospital for an interview. It declined. In the past a hospital spokesperson has stated—and I'm paraphrasing here—that the hospital runs at close to 100 per cent capacity at all times which presents a challenge for admitting new patients. But it says it would never discharge a patient that is not medically stable. Homeless shelters in Toronto say they are grappling with this issue of patients being discharged from hospitals and sent to them sometimes by taxi. Sylvia Braithwaite is the director of shelters and women's 24-hour drop in services at the Fred Victor Centre in Toronto. She says some of the former hospital patients who are brought to their door are already homeless but some are not. Sylvia Braithwaite says it is a struggle for centres such as hers to deal with people who need a high degree of medical care.
For example for someone, a senior, who comes to a shelter with an open wound or someone who needs more care because they've been diagnosed with stage four cancer, those are people that are referred to the shelters. But we’re unable to—I mean we take them and we try to help them but we send them back and then sometimes they're sent back to us the next day or the day of. I just did a bit of a count with it this morning on one of my sites and out of 70 people, we have about 15 people in the shelter that need care. So we will pay for some of the care, some PSW work to support them. But this is very taxing on us but also on the staff. Depending on the situation, you have people who are really ill. People are dying in shelters too. So it's emotional for the staff as well.
AMT: Sylvia Braithwaite. She points out that with an aging homeless population, that problem is getting worse. Shelters such as hers are discussing the issue with hospitals to try to raise awareness. My next guest says that she sees a growing number of Ontario families feeling pressured to bring an elderly relative home from the hospital too soon or without adequate care lined up and she would like to see the province do more to help. Jane Meadus is a lawyer and institutional advocate at the Advocacy Centre for the Elderly in Toronto. She joins me now. Hello.
JANE MEADUS: Hi.
AMT: What do you make of the story we just heard from Tom Spanidis about his father's experience?
JANE MEADUS: Well, it's not an uncommon story unfortunately. Families are constantly battling with the hospitals around the kind of care that can be provided in the community. There's this suggestion that just everybody can be cared for in the community, that you can take your loved one home and provide adequate care and that's just not true. And the unfortunate reality is that some people need to go from hospital to long term care. The problem is the system is broken. There's no beds to go to.
AMT: This idea that they will send your loved one to the homeless shelter if you don't take them home—how common is that?
JANE MEADUS: It's hard to say how common it is. We get those comments at our office once in a while where this threat happens. I think that as the clip showed that a lot of the people who are going are those people who are already marginalized. And I think it's not only people who are marginalized that are already homeless. It's people who perhaps lived in an apartment or something like that, can't get the care and the hospital says well, we're not providing that care. You need a long term care home. Too bad. We're sending you to a homeless shelter and dumping it on them.
AMT: What about the idea of police officers coming to talk to someone? How common is that?
JANE MEADUS: I've had it happen a couple of times recently. It seems to be a bit of a growing trend. I actually think in general it's illegal. The hospital’s actually breaching the privacy of the patient. So it's quite problematic. This is not a role for the police. And that shows you how desperate the hospitals are becoming.
AMT: Now you advised Tom on how to deal with his situation. What kinds of things can someone do if they're facing the need to care for an elderly relative but they can't do it alone at home and they don't seem to be getting the help they need?
JANE MEADUS: So we provide a lot of information to people because a lot of what we're getting is people are coming to us with misinformation. So being told you can't apply from hospital. You have to go home to complete the application and that sort of thing. So we provide the callers with sort of the information about what they're allowed to do in the process so that you can apply from hospital. But we also give them the stark reality which is that hospitals don't provide very good care to people for the long term in hospital. There's also hospital borne infections, other problems there. The waiting lists for the homes are very long, so up to 10 years for some homes in Ontario. So the question is do you want your loved one in the hospital for 10 years or whatever it is. So we provide them with the various options. You could go to a retirement home. That's not always a great option but it's for some people. And you have to make that personal option as to what's best for them, not what the hospital says it's what's best for them. And then we help them fight it if we need to.
AMT: How much of this is a result of the larger issue of overcrowding in hospitals?
JANE MEADUS: It's a huge part of the overcrowding problem but it's also a bigger problem and that we don't have enough long term care homes and this fallacy that everyone can just go home with some home care. Even if you get as you heard, six, eight, 10 hours a day, if you have someone who wanders, who falls out of bed, who needs constant monitoring, you just can't do that at home. There's lots of hours left in the day after the CCAC leaves.
AMT: And also not everyone's home is conducive to the kind of new kind of medical help somebody might need.
JANE MEADUS: Absolutely. People have stairs. Where are we going to put them? And they fear for their parent at home and it's not that they don't want them in home. It's that they are unsafe in that situation. And the hospitals take the position well, we don't have the ability to care for them here which it's true. They need the beds and nobody argues with that. But you don't send someone to an inappropriate place because you have a systems problem.
AMT: What has to change to fix this?
JANE MEADUS: I think we need to prevent people from coming into hospitals. So provide the care in the community for many people. We need to have more alternatives in the community, so to have some of the people who end up in long term care who perhaps shouldn't. We have lots of people who have acquired brain injuries, people with Down's Syndrome, younger people who shouldn't be in long term care. That would free up some beds. Prevent people from getting into a situation where they're in the hospital and at the end of the day, I think we're going to need to have more long term care beds.
AMT: Now you're looking at Ontario but you must talk to others in other provinces. What are you seeing around the country?
JANE MEADUS: Well, in other provinces they have different rules and it can be worse there. So hospitals will ship people off into homes in any part of the province in some places. They don't have the kind of rules around consent that we have here. So we're actually a bit luckier, believe it or not, in our province.
AMT: And do you see any kind of concerted effort to change this? I mean this is a slow moving train. We know a number of seniors is growing and the health care needs are there. Do you see anybody actually confronting it?
JANE MEADUS: We haven't seen really a good plan yet. We don't have a very good seniors’ care plan. They sort of throw things, money at the little sections but we don't have an overall strategy as to how we're going to deal with this.
AMT: The Ontario government recently announced new funds for hospitals as well as home and community care. How much will that help?
JANE MEADUS: It's really only most of the money is going to long term care for example, will help with some of the inflationary pressures. It isn't adding any new beds. There's no new licenses because you have to have a licence for each bed. So that's not going to change that. The homecare, unfortunately it does get piled onto the people who are leaving the hospital. As you heard, Tom's dad got six hours of care. That's huge in the home care world. That's a lot of care. And that's where all the care is going is to get the people out of the hospital so that all those people in the community who might require care to keep them there aren't getting it because it's being used up in other places. Unfortunately right now we don't have good solutions and they need to create more beds in Ontario and that's just the stark fact.
AMT: Jane Meadus, thanks for coming in.
JANE MEADUS: Thank you.
AMT: Jane Meadus is a lawyer and institutional advocate at the Advocacy Centre for the Elderly in Toronto. We asked Ontario's Health Minister Eric Hoskins for an interview on the systemic issues with overcrowded hospitals and the pressure to discharge. Minister Hoskins was not available. His office sent us a statement and I'm going to read part of it. Here's the quote: “We're increasing investments in home and community care including funding for new innovative models that will offer patients and care providers more choices and put patients first.” From the Ontario government. We also contacted the Ontario Hospital Association for the interview. It too declined to speak to us. It too sent us a statement. Here's the quote: “It may not be appropriate for hospitals to provide care to patients who are ready to be discharged and in many cases when patients are frail or elderly, it may be a health risk to keep them in the hospital. All hospitals are held to specific accountability standards when it comes to discharging patients. However it is clear that when a patient or family does not feel they have a place to go, that a systemic issue exists.” That comes from the Ontario Hospital Association or someone who does their communications. My next guest is a geriatrician who researches how government can help serve an aging population. Dr. Samir Sinha is the director of geriatrics at Mount Sinai and the University Health Network hospitals in Toronto. He is also the former provincial lead on Ontario's seniors’ strategy and he joins me now. Hello.
SAMIR SINHA: Good morning, Anna Maria.
AMT: How widespread is the issue of Ontario seniors being sent home from hospital without adequate home care or long term care in place for them?
SAMIR SINHA: I think this is becoming a growing issue mainly because we're seeing a system that's dealing with more and more complex older adults within it. And that's just a result of an ageing population and a health care system that really fundamentally was designed for 27 year olds and not for 72 year olds.
AMT: And have you seen times when elderly patients end up in homeless shelters because they have no other options?
SAMIR SINHA: None of my patients have been put in this situation. But I think what you're hearing about or what we're hearing about increasingly is that with hospitals having 15 per cent of their beds with individuals who just can't go home, can't transition to a long term care bed, can’t get rehab or home care in a timely way, they end up waiting. That's 7,500 Canadians today and that costs our overall health care system $2.4 billion for the inefficiency of having those people wait in a place that frankly they don't want to be waiting in.
AMT: Okay. So we know there's a need and we know there's a problem. And as you say, this whole system was designed for younger people. But it's not a surprise that we have this. It didn't happen overnight. People grow old year by year. So why have governments not been able to get ahead of this?
SAMIR SINHA: You know for some people it feels like a surprise because in 1965, when we started developing Medicare across Canada, all that’s enshrined in our Canada Health Act today are hospital services and physician services. We do not guarantee home care. We do not guarantee long term care. They are not fundamental parts of the system. Retirement homes exists in Ontario but they are not governed, if you will, in terms of they're not actually provided public funding.
AMT: What's the situation in other parts of the country?
SAMIR SINHA: It's a similar situation everywhere. When we first of all take the time to say okay, what is the challenge? What's the barrier to helping this person transition to a better place, to a place where they want to go too? First of all, the key part is communication here. So there's not good communication in place and that's the fundamental problem here in many cases.
AMT: Well, it sounds like people are being bullied too, certainly the experience of our first guest. The police are called to lecture him. He certainly felt bullied and intimidated.
SAMIR SINHA: And I can't speak to the specifics of that case, right?
AMT: No, of course not. Of course not.
SAMIR SINHA: It was interesting. We have an ombudsman here in Ontario now and Christine Elliott just recently reported the other week that out of the 1,500 complaints that she's received so far, 60 per cent of them are due to poor communication. And I think that's the fundamental piece because I think there's a lot of misinformation that happens in the system and I think this is where we need to step back early and say here's what's happening. What are your concerns? How do we actually help you figure that out? Because what I could hear in the first story was here's a person who has a lot of good questions, has a lot of concerns. Obviously there's a hospital that wants to—says that we don't think this individual needs to have their care in the hospital anymore. But I'm hoping that what we can always remember is we need to make sure that we appreciate that everybody in these situations are stressed. We don't have a health care system that's been quite right sized yet to meet those needs. So how do we actually start communicating well? Because otherwise, things escalate.
AMT: And we know that they need more than communication. They need some hard like facts on the ground as well, right? And speaking of communications—which is all I get from the minister's office—we got a communications person giving us a statement. But they say that they're increasing investments in home and community care including funding for new innovative models that will offer patients and care providers more choices. Do you have any idea what that means? What innovative models is the Ontario government looking at?
SAMIR SINHA: Right. So I think some of the innovative models they were speaking that was just reflecting what some of the hospitals for example across Ontario have started to do to innovate in this space for example. So as we said, right now there are certain parts of the province where there is a lack of home care or there's a lack of long term care spaces or waits are longer than usual. So some of the hospitals for example have been working to partner with families to help figure out what are those gaps in care and finding creative ways to meet the gaps. So at our hospital we had a lady who was on a wait list for long term care. She didn't want to be in the hospital but she had no family. She no longer had a home to her name and she had money to pay for a retirement home which is not publicly funded. And so what our social work team did in partnership with her for example was they actually found her a retirement home. They actually went to IKEA. They furnished that place for her and then they were able to help transition her. And everybody was happy in that situation but that's not the usual work of a hospital. But it speaks to the creativity in mind. But in that case, there was a gap. This lady needed someone who had that extra time. And so what the government has done in the recent budget is recognizing this problem. Not only have they actually increased the base funding of hospitals to take some of those pressures off of them, which is great, they've continued investments in home and community care. But to specifically hone in on this issue, they've talked about tens of millions of dollars specifically to allow hospitals to continue this further work of experimenting and being creative.
AMT: So again, this comes down to communication and also officials who recognize a problem in a hospital being willing to say to someone else in the hospital: see if you can work with these people.
SAMIR SINHA: I think it’s a few things. It’s making sure everybody has their facts right because I think unfortunately I still hear about occasions around the province where families are told that you're going to be charged a thousand dollars a day. Our former minister and our current minister and the ministry keep repeating that hospitals cannot charge a single family a thousand dollars a day to wait in hospital. If they are on the long term care waitlist, you can only charge the long term care rate. So it's making sure that everybody has their facts straight.
AMT: Before I let you go, just briefly—is there a country that does this in a way that Canada should be looking at?
SAMIR SINHA: There's some interesting Nordic models where what they've done is they actually make the responsibility of getting people home the responsibility of the municipality. So for example in Sweden, they fund the system so that if a person's waiting in hospital and the municipality can’t put home care or other creative solutions in place, the municipality foots the bill for that hospital stay. That motivates people to be more creative in thinking about how do we get people back into our own communities where they live? We need good communication first and foremost.
AMT: Okay. Thank you for coming in.
SAMIR SINHA: Thank you very much, Anna Maria.
AMT: Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network hospitals in Toronto. He's also the former provincial lead on Ontario's seniors’ strategy. That's our program for today. Stay with Radio One for q. And we're going to leave you with something. We're going to revisit a voice that we met in Dick Gordon's documentary about the youth soccer teams in the slums of Nairobi. Dick introduced us to George Ndiritu, an activist, a musician who says he learned a lot of life lessons from participating in the soccer league. So we will leave you with more of his music. This song is “Sheria”. I'm Anna Maria Tremonti. Thank you for listening to The Current.
[Music: “Sheria” – George Ndiritu]
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