1. health and fitness

NEWSLETTER
Message from the President, Basanti Majumdar
I was elected as a President of INIG in April 2014. Our executive committee membership was completed
in July 2014 with the help of Penny Lamanna. Since July, we have conducted several meetings for the
executive committee. The first meeting was held face-to-face. We decided to be more cost-effective. The
rest of the meetings were held as a tele-conference. Our executive committee members are Concetta
Buonaiuto (chair-elect), Philicia E. Joseph (Finance officer), Kamala Persad Ford and Victory Lall
(Political officers); Suzette Mahabeer (Newsletter coordinator), Raihana Ludin (Newsletter Cocoordinator), Angela Koipuram and Rira Lee (student representatives). We are in the process of electing
two new members for Membership and Communication officers. Unfortunately, we lost Maja Tuta
(Communications Officer) and Janusz Kaleta (Membership & Education) who resigned due to their out of
Canada commitments. We are in the process of looking for nominations for these two positions. I am sure
by this time, you have read our first newsletter which was circulated in August and the second newsletter
will be coming in November. Our focus for the newsletter is current health issues, various research
findings related to global health, also student’s international experience. Our finance report is up-to-date
and we are financially stable. Though our income is generated mainly by membership fees, we are
exploring other possibilities for income generation. We are trying hard to increase our membership and
modify the present website and create an up to date and user-friendly website. We take every opportunity
to interact with the politicians and advocate in the community our objectives on INIG and RNAO’s
mission and vision. We are also preparing ourselves to submit a resolution on health-care cuts to refugees
which will be in our November newsletter. Raihana led our second newsletter, supported by Suzette. They
are looking forward to hearing from all of the members in future newsletter contributions and your
personal stories. We are working closely with all RNAO activities where we are invited to make sure that
we are up-to-date related to interest group dialogue with the CEO.
I would like to take this opportunity to thank Angela and Rira for their leadership in conducting such a
wonderful student workshop in Sept, 2014, titled: ―Students Becoming Global Citizens: Let’s Talk.‖
(Please refer to INIG’s first student workshop at McMaster University for details.)
I also would like to thank my advisory group Angela Cooper, Cynthia Harris, Vicky McGregor and Olga
Muir who are always willing to give me advice and have provided me with many great ideas. With their
guidance we are trying to function at optimum level.
Our general meeting for the members will be on Dec. 6th 2014 at the Board Room, RNAO from 10 am
to 12 noon. At the end of the meeting we will have dialogue among the members, such as get to know
each other, share some of the exciting stories and discuss future activities they would like the executive
committee to initiate. Please join us and share your ideas to make our INIG a success.
Attached is Vicki McGregor’s Membership report, which will hopefully help us to focus our dialogue at
our meeting December 6th.
With warm regards, Basanti
INIG’s first student workshop: Students Becoming Global Citizens: Let’s
Talk
As our world becomes more interconnected, governing organizations and academic institutions have a
crucial task to increase professionals and students’ awareness of issues that affect the entire globe. The
spread of Ebola is a prime example of how we all are connected as a global village and the responsibility
we have as global citizens to contribute to the promotion of health and the prevention of communicable
and non communicable diseases.
At INIG, we have the strong belief that students are the future leaders of Canada and as such it is integral
for their professional growth to develop competence in global health issues. On September 27th, 2014,
student representatives from INIG, Angela Koipuram and Rira Lee in collaboration with student
volunteers, organized the first student workshop on Global Health for students from McMaster and
Ryerson Universities. Although this was a workshop organized by nurses, participants included students
not only from the nursing program but also from other disciplines and faculties interested in global health
issues.
Dr. Basanti Majumdar, president of INIG, professor at McMaster School of Nursing (SON), introduced
the workshop organizers and provided the opening remarks: ―We are making history with today’s event.
With the collaboration of INIG, RNAO and McMaster University School of Nursing , we are holding this
first student workshop on global health and have the participation of students from two universities. We
hope in the future we will have students from all colleges and universities of Ontario.‖
Nathan Kelly, Member-at-Large, Socio-Political Affairs, RNAO, Board of Directors, was not able to
attend the workshop; but sent a message to all participants: ―Today I bring brief remarks on behalf of
Doris Grinspun, Vanessa Burkoski, and the RNAO collective, and would like to thank all of you for
coming today and sincerely wish you all enjoy the activities throughout the workshop. Students are the
future registered nurses who will bring the knowledge, experience, and vision to the landscape of our
global village. Global citizenship is not just a sense of belonging but a responsibility to look after each
other within the depth and breadth of humanity. As you all sit here today; know that you all share a
similar interest and passion to help others; today and into the future. With this, we must respect our
diversity of opinions, as it is through this diversity that strength can be found for the betterment of our
profession and the world we live in. Together, I believe we can achieve anything we collectively agree to
do.‖
Dr Carolyn Byrne Associate Dean and Director of the School of Nursing at McMaster University also
welcomed workshop participants. She commented on how wonderful it was to see nursing students from
other Universities and also students from other disciplines attend the workshop. She highlighted ―the rich
learning opportunities that are available to students who are interested in global health and are willing to
learn and participate in health care in other cultures. The experience that comes from working in other
cultures assists us in deepening our understanding about ourselves and provides rich experiences that can
change our lives forever."
INIG Student Workshop: (Left to Right)
Rira Lee, Angela Koipuram
After the opening and welcome remarks, a panel of experts provided their experiences about studying and
working in global health. Professor Barbara Carpio (moderator), Professor Nina Cavey and former global
health students from McMaster SON, Rebecca Cosby (alumna) and Alex Chung (level 4 student)
provided great insight about the rewarding experiences they had after working in Latin America, Asia and
Africa. Participants were enlightened by the discussion from the panelists as they shared their lived
experiences abroad. They inspired students to learn more about developing cultural competence and how
to become globally responsible citizens and nurses. All panelist commended participants for their interest
in global health and encouraged them to continue learning about the world and the issues that may affect
the populations they will care for.
In the second half of the workshop, participants were placed in small groups and had the opportunity to
meet faculty facilitators with experience in global health. Facilitators included: Professors Barbara
Carpio, Iris Mujica, Laura Banfield and Suzette Mahabeer from McMaster University. Facilitators
discussed the importance of incorporating global health theory and concepts in the curriculum along with
clinical experiences both international and in Northern Canada working with indigenous peoples. Student
participants from McMaster and Ryerson University shared their perspectives and were able to discuss
how they are exposed to global health in their curriculum. They mentioned the importance of learning
about global health in terms of developing more culturally aware citizens, in exposing students to
different views of health-care systems and meta-paradigms; in learning about health promotion strategies,
i.e. vaccination programs; social determinants of health and the significant influence of government in
health care. The small group facilitation not only allowed students to share their own perspectives about
global health and to learn from an expert; it also allowed them to develop a student network between both
universities.
The Keynote speaker was Professor Iris Mujica, Chair of the Global Health Education Committee at
McMaster University SON. She spoke about the importance of preparing before having a global health
experience and the rationale for raising awareness in globalization and health care. She highlighted that
health is affected by many factors and that global issues are also local issues. She also stated that it is an
ethical and moral responsibility for health professionals to gain knowledge about the world and to
understand the factors that affect the health of the population they care for.
Many international research posters done by previous students were displayed at the workshop which
gave ideas to the participants on how they could get involved in international work and research in future.
Angela Koipuram displayed her research, done last year as a level four student, related to knowledge and
attitude of Asian seniors with type 2 Diabetes living in the Greater Toronto Area (GTA). Other posters
related to research in HIV/AIDS in India, and primary health care in Africa were displayed as well. Nikita
Arora and Natasha Dhingra, McMaster University BHSc students, supervised by Dr. Basanti Majumdar
presented their research work entitled ―A Novel Disha‖ (direction). Their research poster highlighted the
experience of women suffering from mental health issues, and their limited access to health care due to
cultural and language barriers.
This first student workshop on global health was productive, informative and increased knowledge
regarding the importance of understanding globalization in nursing. It raised awareness regarding
globalization in nursing and discussed how students can be engaged in understanding global issues and
become informed global citizens.
Participants were encouraged to be members of RNAO and INIG. RNAO and INIG pamphlets were
distributed with the workshop brochure and program.
Special thanks to our sponsors who provided in-kind support: McMaster University School of Nursing;
Doug Rosser, First Stage Enterprises; Sharon and Daniel Lee, Fortinos and Metro supermarkets and
Albert Snow (manager of hair salon).
Ebola Update
―The Public Health Agency of Canada has two teams of public health experts and epidemiologists on
standby in case a patient tests positive for Ebola – one in Winnipeg and another in Ottawa. The team
closer to the site would race to the hospital. The team closer to the site would race to the hospital. They
would bring laboratory expertise to quickly confirm the diagnosis, and needed supplies such as masks,
gloves and face shields. They would be responsible for the hands on treatment of the patient who would
remain in quarantine‖ (Renne, 2014).
―RNAO's CEO Doris Grinspun says she has spoken with nurses at two Ontario hospitals with suspected
cases of Ebola. Grinspun learned these nurses had received no instructions or education in dealing with
the virus. RNAO is adamant that this must change immediately.‖ (Di Costanzo, 2014).
―Alarmed by the case of an Ebola-infected New York doctor; the governors of New Jersey and New York
ordered mandatory 21-day quarantine for all medical workers. Also those who are arriving travellers and
have had contact with victims of the deadly disease in West Africa were asked to be quarantined. Many
New Yorkers were dismayed to learn that after he came home, Dr. Craig Spencer rode the subway, took a
cab, went bowling, visited a coffee shop and ate at a restaurant in the city of 8 million‖ (Marchione &
Stobbe, 2014).
―Dr. Howard Zucker, acting New York state health commissioner, said any medical personnel who have
treated Ebola patients in the three Ebola-ravaged West African countries – Sierra Leone, Guinea and
Liberia will be automatically quarantine. Twenty-one days is the incubation period for the Ebola virus.
Those who are forcibly quarantined will be confined either to their homes of if they live in other states, to
a medical facility, the governors said. Those quarantined at home will receive house calls from health
officials‖ (Marchione & Stobbe, 2014).
Dilorenzo (2014) stated that ―more than 10,000 people have been infected with Ebola and nearly half of
them died, according to figures released Saturday by the World Health Organization, as the outbreak
continues to spread. The Ebola epidemic in West Africa is the most significant outbreak of the disease
with a rising death toll in Guinea, Liberia and Sierra Leone. There have also been cases in three other
West African countries, Spain and the Unites States.‖ (Dilorenzo, 2014).
―The U.N. health agency said Saturday that the number of confirmed, probable and suspected cases has
risen to 10,141. Of those cases, 4,922 people have died.‖ (Dilorenzo, 2014).
References
Dilorenzo, S. (2014). World Health Organization. Number of Ebola-linked cases passes 10,000.
Marchione, M. & Stobbe, M. (2014) U.S. governors order quarantine to fight Ebola. The Hamilton
Spectator (Oct. 25, 2014).
Rennie, S. (2014). Rapid Response to Ebola. The Hamilton Spectator (Oct. 20, 2014).
Di Costanzo, M. (2014). Ontario (RNAO) is calling for a provincial plan to deal with the potential threat
of Ebola. Registered Nurses of Ontario (October 15, 2014).
Health-care cuts to refugees
By: Suzette Mahabeer
As Canadians, many of us do not have dental or vision coverage. We require extended health benefits that
we receive from either a full-time job or thorough insurance coverage. It is important for all citizens to
have equal access to health care, and refugees should not be an exception to this. Some of them may be
fleeing countries of war or disease. However, they will still be allowed to access health care through
various programs to provide emergency and essential care. This issue is related to health-care disparities.
If people do not have equal access to healthcare, they might be at risk for developing more acute or
chronic illnesses.
This article was written in The Hamilton Spectator – July 4, 2014 –
OTTAWA – ―The Federal Court has ruled Ottawa's cutbacks to health-care coverage for refugee
claimants constitute "cruel and unusual" treatment — particularly to children — and should be struck
down. Ottawa trimmed medical benefits for newcomers in 2012, leaving most immigrants with basic,
essential health care but without supplemental such as vision and dental care. Ottawa trimmed medical
benefits for newcomers in 2012, leaving most immigrants with basic, essential health care but without
supplemental such as vision and dental care.‖ (The Hamilton Spectator, 2014)
―However, rejected refugee claimants — and refugee claimants from countries the government considers
safe — will be eligible for care only when they pose a threat to public health. Government lawyers had
argued the new rules bring health benefits for newcomers in line with what other Canadians receive and
deter those who would abuse the health-care system.‖ (The Hamilton Spectator, 2014)
Research shows that certain ethnic groups in Canada—including Canadians of South Asian, Asian, Latin
American and African heritage—and Aboriginal people are at higher risk of developing diabetes.
Moreover, factors such as insufficient income, stress and access to health services can both increase the
risk of developing diabetes and prevent adequate management of diabetes. There are programs available
to help prevent and manage diabetes in the general population. Unfortunately, there is limited information
on how to address the specific needs of high-risk populations such as new immigrants, low-income
earners, and seniors and shift workers (Public Health Agency of Canada, 2011).
According to Gushulak et al. (2011), all permanent residents including refugees, refugee claimants and
some temporary residents receive an immigration medical exam. This is based on their place of origin,
duration of visit (over six months) and occupation (workers in close contact with others). Screening is
completed to assess the potential burden of illness and a limited number of risks to public health. It is not
specifically designed to provide clinical prevention services and it is linked to ongoing surveillance or
notification actions only for tuberculosis, syphilis and HIV. Health status is not equal among all
subgroups of immigrants. There are specific immigrant groups that may be at higher risk of infectious
disease, cancer, diabetes and heart disease. This has clinical implications for individuals providing care to
immigrant communities. Multiple contextual factors influence the heath of immigrants in Canada
including environmental, economic, genetic and socio-cultural factors. Immigrants must also learn to
adapt to their new place of residence. Other factors including employment, education and poverty as well
as the accessibility to the Canadian healthcare system will influence health outcomes.
Access to health services and health conditions of some immigrant populations are different from
situations among Canadian born patients and these disparities have implications for preventive care and
provision of health services (Gushulak et al. 2011).
The increasing prevalence of chronic non-communicable diseases (NCD’s) in refugees’ countries of
origin suggest that chronic conditions may be increasingly common among recent refugees and
emphasizes the importance of developing an increased awareness and understanding of NCD’s in this
population. The global increase in chronic NCD’s has significantly marked the possibility that adults
from low and middle income areas will enter the United States (US) with pre-existing chronic conditions.
However, there is limited research available on the extent to which refugees in the US may be affected by
NCD’s. Refugees with chronic NCD’s may encounter significant barriers to healthcare, which will place
them at higher risk for poor health outcomes (Yun et al. 2012).
References
Federal Court rules against Ottawa's health care cuts for refugees. (2014). The Hamilton Spectator.
Gushulak, B., Pottie, K., Robers, J., Torres, S., & DesMeules, M. (2011). Migration and health in Canada:
Health in the Global Village. CMAJ, 183(12).
Public Health Agency of Canada (2011). Reducing Health Disparities related to Diabetes. Catalogue No.:
HP5-111/2011E-PDF ISBN: 978-1-100-18786-0.
Yun, K., Hebrank, K., Graber, L., Sullivan, M., Chen, I., & Gupta, J. (2013). High prevalence of chronic
nonCommunicable conditions among adult refugees: Implications for practice and policy. Journal of
Community Health, 37(5).
Possible Proposal for Afghanistan
By: Raihana Ludin
For more than 30 years, the people of Afghanistan have faced many conflicts, both internationally and
civilly, economical hardship, famine, epidemics and drought. Women in particular, have faced their own
challenges in the country. From cultural to religious conflict, the women of Afghanistan have fought
many battles to regain their basic human rights. The right and access to health care education have been
longstanding issues in Afghanistan for all citizens, particularly women. In 2002, 60% of Afghans had no
access to basic health services (Bartlett et al., 2005), p.864). The lack of health service access for women
has led to maternal and infant mortalities to be longstanding problem within the country. The lack of
equipments, medical facilities and medically trained personnel available have contributed to both the
mortality rates of mother and infant. Raihana Ludin and Professor Basanti Majumdar are in the process of
creating a research proposal to train and use first responder trained health-care workers to prevent further
issues, promote recovery, and preserve the lives of both mother and child during labour as well as
providing post-partum care. Knowledge and recognition are key to the process of labour, and we believe
that these tools can help contribute to more successful live births, as well as prevent maternal and fetal
mortality. Currently, collaboration has been initiated at a local government level. Search for funding is a
challenge and we hope that we will be successful with this project. If any of our readers have any
suggestions or funding sources, please let us know.
References:
Bartlett et al. Where Giving Birth Is a Forecast of Death: Maternal Mortality in Four Districts of
Afghanistan, 1999––2002. Lancet, vol. 365, no. 9476 (2005), p. 864-70.
INIG Student Workshop Facilitators:
Left to Right: Alex Chung (Student Panellist), Rebecca Cosby (Panellist), Nina Cavey (Panellist), Iris
Mujica (Keynote Speaker), Laura Banfield (Facilitator), Barbara Carpio (Panellist/Consultant), Basanti
Majumdar (INIG President), Carolyn Byrne (Dean of School of Nursing – McMaster University), and
Suzette Mahabeer (Student Consultant) Front Centre: Angela Kopuiram and Rira Lee
PowerPoint presentation below by Concetta Buonaiuto and Vicki McGregor
2011...277
2012...265
2013...253
2014...289
MEMBERSHIP SURVEY

Sent to 252 members via email and posted on Facebook group

Response rate = 7% (18 members responded)
Responses
https://www.surveymonkey.com/results/SM-DH9XH3T/
https://www.surveymonkey.com/results/SM-GPW863T/
These are the experiences of two forth-year nursing students from McMaster University, Lori
Martin and Kendra Plett
On September 1 of this year, we embarked on an adventure that would forever change our lives. Two
plane rides and an eight-hour car ride later, we arrived in Jamkhed, India, a small rural town that would
become our home for the next three months. The purpose of our time in India was to complete a global
health clinical placement that is offered to forth-year McMaster University nursing students. While we
were in Jamkhed, we were working with Comprehensive Rural Health Project (CRHP), a nongovernmental organization that takes a community-based approach to health-care provision, based on the
principles of equity, integration and empowerment.
Our time spent at CRHP was full of a wide variety of community and public health nursing experiences.
We were involved with the mobile health team that regularly visits CRHP’s project villages. During these
village visits, we provided education to community members on self-management of chronic diseases,
such as diabetes and hypertension, which are on the rise in this area. We provided health education at the
Adolescent Girls Program that is run weekly by CRHP, as well as at the Joyful Learning Preschool on
CRHP’s campus. We also spent some time in CRHP’s Julia Hospital, where we were involved with
everything from performing dressing changes on leprosy outpatients to providing care to newborns.
Additionally, we had the opportunity to witness natural and C-section deliveries, surgeries and a tubal
ligation camp.
Two months into our stay in India, we had the opportunity to visit Dr. D. Y. Patil College of Nursing in
Pune. This visit allowed us to experience a completely different side of nursing in India, as we observed
GNM and BScN nurses providing healthcare in a large, urban, 1270-bed hospital. We were also able to
interact with students at the college who were in their final year of the GNM or BScN program. This
college impressed us, as the faculty greatly encourages their students and staff to participate in research
and evidence-based practice, as well as to pursue post-graduate studies.
Throughout this global health experience, we have been able to see how social determinants (for example:
income, social support network and culture) greatly impact the health of an individual, community and
population as a whole. We have learned that health prevention and promotion is just as important as
curative health care.
Our time spent at CRHP has taught us the
importance of addressing the root cause of an
illness, rather than simply focusing on treating
the illness after it has occurred. We came to
India with the expectation that we would be
providing health care to patients with diagnoses
such as infectious diseases and malnutrition.
However, to our surprise, we spent the majority
of our time working with patients living with
diabetes and hypertension, chronic diseases that
are also prevalent in Canada.
We believe that our time spent in India will
greatly benefit the health care that we provide to
our patients when we return to Canada, as we
have learned the importance of providing
holistic and culturally sensitive care. We have
learned a different approach to health care, one
that addresses the root cause of illnesses and the
various aspects of health: social, mental and
spiritual, as well as physical. We hope that this
valuable learning experience will significantly
impact our nursing care in any setting where we
might work in the future. It has been time well
spent and we are forever thankful for this
opportunity provided to us by McMaster
University.