Blog Audit - The Final Say

Looking back at my first blog entry dating back to January, I can see that social change is undoubtedly a recurring theme in all the posts. Although this may be due to the fact that this theme itself is a major component of this course, I did still notice that my blog entries transformed from focusing on the issue itself (the Shona Holmes commercial attacking Canada’s Medicare), to looking at different issues through the lens of social change and community awareness.
By revisiting my posts, it seems as though I am learning to use the tools provided in classrooms to view the world. For example, in the first week, we learned about how Canada’s Medicare system came to be, and I was furious when I saw the message Shona Holmes was sending out to American residents discrediting the system because it did not adhere to her specific needs the way she would have liked. My entire post revolved around defending our healthcare system, of which countless citizens are thankful for. In the weeks that followed, we learned about social change – why it is necessary, how it is advocated, and the difficulties that come with actually achieving it. I have to be honest in saying that sometimes the concepts did seem redundant; because it felt like the same messages have been brought up time after time in classroom discussions. But to my surprise, rereading these blog posts made me realize that perhaps these messages are actually being absorbed and internalized. This is because the more recent posts discuss different issues, events, and stories in terms of social change. From the story about the starfish washed up on the beach shore, to Malcolm Gladwell’s speech on social change, to my dear friend Jennifer’s bone marrow drive, I am able to take all that information and either look at them in terms of social change or marvel at the level of community involvement I can see and notice. Suddenly, the redundancy in the classroom does not seem to be a problem anymore.
I saw in a few of my posts that I had questions which came to mind as I explored the topic, and they remain largely unresolved, and to-date, I feel as if they are worth further investigating. The first I would like to bring up again is the roles of dietitians and nutrition professionals; are our roles changing? And if so, where does it lead to? Where does it leave us? The past few months of class has brought me to recognize that we are pushing for social change – to achieve a healthier community with healthier individuals. Since change is most obviously observed on a local level, it must also start there. Community involvement is where we want to begin; this involves raising awareness, as well as providing means for the community to be involved – speaking up, being heard, and driving for change. And my question remains: should we achieve this, where all levels of the community are actively involved in better the health of everyone, how does the role of dietitians change? How many jobs will there be still? And will those who are out of the profession due to a decrease in demand fall into the (for example) low income category – the very same category of people they were helping? This is still very ironic to me; perhaps it is necessary to further clarify the role of dietitians and nutrition professionals.
Secondly, I have not stopped thinking and wondering why, after all these years, we appear to still be in the same position as before. I mentioned in my blog ‘Getting to the Next Step’ that despite all the awareness campaigns, issues such as hypertension and childhood obesity remain on a rise, and I wondered why. One new theory that has come to mind is that perhaps to achieve social change, all levels of the community must be fully committed to make the change. What I mean is, there cannot be second-guessing whether it is the prevention technique doing its work, or is something else at play; if we want to push for the population rather than the high-risk approach, then we need to make a decision and not look back.
This blogging experience has been an interesting one to say the least. I do 100% believe it helped me grasp the concept of the course more completely, and showed me how I can apply all these theories, concepts, and views in a practical setting. I saw an article talking about the government wanting to give immigrants access to healthcare (without the 3 month wait) and it immediately grabbed my attention. I cannot say whether I will continue to post after this course, but I know for sure that I will be looking at everything through one more lens.

Jenn 'Pho' Ever

Jenn Pho Ever

In these past two weeks, I have had the privilege to experience and witness first-hand what, to me, was the most heart-felt social change in my community.
In December 2010, my friend Jennifer – an amazing young woman – was diagnosed with acute lymphoblastic leukemia. She underwent her first round of chemotherapy, but the disease proved too strong, and now her only chance lies with finding a match for a bone marrow transplant. Knowledge of her condition brought shock, fear, and sadness to the hearts of her family, friends, and volleyball team mates. However, what I witnessed was not a patient who dwelled on her misfortune by asking “Why me?” but a family who brought together different communities to form a new one, now connected by the common goal of helping Jenn find a compatible bone marrow donor.
The event might have started because something so terrible is happening to such a young, vibrant, and active woman, but it certainly is not where it ends. What began as a call of help to friends and family escaladed into an entire awareness campaign to encourage the Asian community to join OneMatch.ca. Thinking back to the Malcolm Gladwell speech that critiqued some social change as having too much emphasis on the ‘knowing’, and not enough on the ‘doing’, this is an example that demonstrated successful social change which began with raising awareness, and almost simultaneously translating that into actions to facilitate change. Through mediums such as Facebook, various news broadcasts, word of mouth, and radio broadcasts, the word of Jenn’s story spread through Toronto, accompanied by information of how each person is possibly capable of saving a life by a simple swab test. I attended Jenn’s bone marrow drive two weekends ago, at the Sheraton Hotel, and was amazed when I overheard one man tell the volunteer that he did not know Jenn personally, but simply came to know her story and how he could potentially help many other leukemia patients by coming to swab his cheeks for a DNA sample. There have been subsequent bone marrow drives after that which were very successful, despite the fact that she has yet to find a matching donor.
While it is true that we don’t know how many patients, if any, have benefited from this awareness campaign; but one thing we do know for sure is awareness was increased, and people responded. It might not be visible on a national, even a provincial level, but it sure was a huge movement to me; it was our community raising awareness on a topic that was close to heart, and mobilizing our resources - the choice to donate our bone marrow - to help create a healthier community.

Translating from Knowing to Doing

Social Change

Last week I began to really think about the distance between our “knowing” of community health nutrition and actually translating that to actions that will lead to desirable changes. One thing I can definitely conclude is that the gap is huge. I guess the social economic gap isn’t the only distance we need to pave.
Malcolm Gladwell’s speech regarding social change was an inspiring piece to me. In fact, it evoked so much in me that I thought it deserved another week’s spotlight on this blog. After this week’s discussion on building healthy communities through social change, it has further reinstated my belief that awareness itself is not enough, but at the same time, absolutely necessary.
When I first heard Gladwell’s speech, I was sceptical for a while about whether or not awareness was as useful as the amount of investment required suggests. But a very important person in my life gave me one simple, but surprisingly moving example to wash my scepticism. The story began with a big wave that washed up thousands of starfish onto a beach. The starfish began dying on the beach, and one single little girl began picking them up one by one, and throwing each back into the ocean. She did this for hours, and still it seemed the same thousands of starfish remained on the beach. At this time, a man jogging on the beach passes by the little girl, and asks what she’s doing. She replies by telling him that the starfish are dying, so she’s trying to save them by picking up each one and throwing them back in the ocean. The man laughs, and tells the girl that she would never be able to save them all, as there were simply too many. The little girl was not discouraged; she smiled and told the man that she knew she couldn’t save them all, but she would not stop trying, and each one she manages to throw back into the ocean would be one life saved. The man continued running, a little ways down the beach, he stops, picks up a starfish, and throws it back into the ocean.
The way I interpreted this story is similar to how I perceive social change must occur. We cannot satisfy everybody, and sometimes our actions may not be agreed by and acknowledged by everybody. However, sometimes it isn’t about how many people you yourself can directly help; it is also about inspiring other people to do the same. Similar to what Kingwell said on the same night; sometimes change begins with inspiring others to be empathetic.
My question now is about creating healthy communities. We discussed in lecture that difference can be seen most on a local level, but do these small changes always lead to our goal of making Canada a healthier country?

Getting to the Next Step

Within the safety and comforts of our class room walls, we have learned about the nutritional issues at large. These issues range from childhood obesity, the aging Canadian population, to most recently, the increasing burden on our healthcare system. We discuss the underlying issues, and brainstorm possible action plans or directions; none of which, I’m sure, haven’t already been discussed by current nutrition and healthcare professionals. But why, then, are we still talking about the same issues, causes, and correlating variables as we have for the past decades? One question brought up in our class discussion, for me, really hit the point: How do we get to the next step? As Malcolm Gladwell so convincingly addressed in his speech on social change, how do we get from the Knowing, to Doing?
After listening to his 15 minute speech, I spent a good night thinking on it, and after hearing the rest of the program and the debated between Gladwell and Kingwell, I’ve come to some sort of conclusion of my own.
In the context of nutrition, creating social change – addressing issues of resource placement, raising awareness on the concept of health, and eliminating stigmatization – in Canada is especially difficult. We can look at countries like Japan and Denmark, study them, and try to find out what it is that they are doing different from us which contribute to their success; but one very important confounding variable is the diversity of our society. Canada is known as a country of multiculturalism (this statement is controversial in itself), and for this reason, people have very different definitions of health, equality, equity; these are the same things we try to give our citizens. How can we achieve this when the definitions in itself are so diverse?
Gladwell makes many important and thought provoking statements in his speech, one that sticks out to me is when he reminds us how little we actually know. We believe that we know what is going on, but we are only seeing a glimpse of the whole picture. This statement draws me back to humility and reminds me that sometimes, maybe things just have to run their course.
I do believe awareness is an important part, and has given us some large strides; but like our knowledge of the global and national issues that we might wrongly believe to have a completely understanding, our increased awareness is only a small step towards our ultimate goal, which may very well change as our exposure increases.

When will it be our turn to 'reform'?

After having concluded our three week trilogy with Health Promotion, here is what I had to take away from it all. We are working towards a goal; and that is to enable individuals to increase control over their lives. This, to me, is the heart of health promotion; helping individuals help themselves. And only when we reach this goal, will the burden on our current health care system truly be alleviated. Here is my question: what happens when that goal is reached? What happens to the role of nutrition professionals?
In our discussion regarding community health centres, the take-home message was “Healthy individuals make healthy communities”. Suppose sometime in the future, our goal is reached, and individuals are well aware of nutritional faux-pas, what happens then to the professionals that are no longer needed? What is there left for us to do with our years of education and training? It’s not that I don’t want to help people, but I also want to make sure that we won’t be left, at the end of this journey, as the ones who now need help because we’re unemployed.
Currently, there is a need for health care reform, in order to ensure the sustainability of our health care system. Perhaps a ‘Nutritional professionals reform’ will be called for in due time?
Several weeks ago, an elderly couple approached me and asked which types of olive oil they are supposed to cook with, because they had been told that you cannot cook with certain types. This question caught me so off-guard. First off, I did not realise there were olive oils that ‘should not’ be used in cooking. Second, I felt so embarrassed that as a fourth-year nutrition student, I was unable to answer this old man’s seemingly simple question. I eventually did some research at home and was relieved to find out the only negative thing about cooking with certain olive oils is causing it to lose its taste. Now looking back at this incident, I can’t help but wonder what would happen when the public (lay people) will know more about these nutrition-related information than us? Is there a need for our roles to evolve as the health of our communities do so?

Medicare's Public Enemy

After watching this commercial in class, Shona Holmes – our own ‘High Treason’-committing Canadian citizen, I had to get a better idea as to why someone would go the length to talk about our healthcare system – of which so many Canadians are thankful for – in such a light. A simple search on Google returned with a hefty amount postings from angry citizens tearing apart what apparently is a huge lie. First off, Shona Holmes apparently did not have a life-threatening tumour; it was claimed by many to have been a non-life threatening cyst. Secondly, there have been many reports accusing her of receiving funding from companies to shoot this commercial. I must admit, it made me feel a little big relieved that our health professionals might not have, after all, told a cancer patient with a life-threatening tumour to wait 6 months to be treated.
But suppose there was a true case much like that of Shona Holmes, would that be sufficient to question the appropriateness of our healthcare system? I had to think back to what our values as Canadians were, the same values upon which Medicare is built upon; fairness, compassion, equity, and solidarity. The first thought that came to my mind was how many patients and families would suffer if it were not for our free health care. Imagine if we had to pay for every time we needed to see our family physicians – a sprained ankle, a stomach ache, a headache, allergies, common cold. I could imagine many people either getting very sick, or else very poor from having to pay for assessments.
I don’t dare say I could understand how someone like Holmes would feel. In fact, I am quite sure that unless I have been put in that situation, I would never be able to justify how someone could speak so selfishly. Our system is far from perfect, and we are learning each day from our mistakes, and mistakes of others; seeing what works, and what doesn’t.
I can’t help but think that maybe we are so focused on trying to improve on what we have, that it blinds us, and makes us forget temporarily how fortunate we are. However, reading some of the responses to Holmes’ commercial on Youtube showed me that there are many Canadians out there who appreciate Medicare, and are standing by readily to defend attacks against our healthcare system.

http://www.youtube.com/watch?v=XwLp2KJCLOQ&feature=player_embedded