Top reporters offer military media handling tips

Ryerson’s course on handling media has raised eyebrows

By David South

Now Magazine (Toronto, Canada), November 12-18, 1992

The whimsical Certificate of Military Achievement hanging in the offices of the Ryersonian newspaper at Ryerson journalism school is testament to the warm relationship between the armed forces and one of Canada’s top journalism schools.

But a two-month crash course in journalism for military public affairs officers hosted by Ryerson this summer has left a bad taste in the mouths of some participants and critics.

The course, which involved 18 soldiers, included two weeks of classes in each of print, radio and TV journalism, wrapping up with two weeks of “crisis management” training. The 60 instructures included such prominent journalists as Ann Medina and Pamela Wallin.

According to an administration newsletter, the course netted Ryerson more than $350,000. Organizers say the course was merely an exercise in familiarizing soldiers with the needs of working journalists. But given the often conflicting roles of the military and the media, some fear journalistic ethics may have taken some collateral damage.

“The course had nothing to do with national defence or the armed forces,” says course teacher and organizer Shelley Robertson. “They just wanted to understand the roles of journalists from the other side. The military didn’t ask us to teach what we teach our students.”

Robertson says the course also benefited the participating journalists by giving them contacts in the military.

But according to media critic Barrie Zwicker, the exercise blurs what should be the distinctly different interests of journalists and the military. “It’s similar to press and politicians. By getting close to the politician, journalists can get information they couldn’t normally obtain. The negative side is that the media can get sucked in and lose a larger perspective. The same tensions exist with covering the military.

Managing media

“It’s up to the media to break the rules and try and get the story. The military always wants to hide its victims. If a Ryerson journalist strikes up a friendship with a public affairs officer, will the reporter be true to their journalistic tradition?”

Colloquially known as spin doctors, hype-meisters and flak catchers, public affairs officers perform much the same tasks in the military as their civilian counterparts in industry and government – including managing information that gets to the public or media.

In the past, Canadian soldiers had to go to the US for special training at the Defense Information School at Fort Benjamin Harrison. But, according to Robertson, the armed forces were looking for a Canadian spin.

With 4,600 Canadian peacekeepers now stationed around the world, including a contingent in the dangerous and volatile former Yugoslav republics, the chances for conflict – and casualties – have increased.

Lieutenant-commander Glen Chamberlain, who helped coordinate the course, says the military’s increased profile means that the forces have to become more adept at media relations. “There is a great desire among Canadians to know what troops on peacekeeping duties are up to. We have a wonderful story to tell.”

Chamberlain says he works on journalists’ behalf with stubborn military commanders. “The armed forces are finding there is a real benefit to having specialized PA officers. We want to help journalists to tell our story well.”

The crisis management section of the course offered participants a hands-on approach to managing journalists. The officers were presented with two scenarios – a murder at Moss Park armoury and a highway helicopter crash – and then practised handling a group of journalists investigating the events.

Course lecturer Kevin Donovan, who covered the Gulf war for the Toronto Star, remembers the effectiveness and sophistication of PA officers in the field.

“When I was in Riyadh, Saudi Arabia, I walked into a hotel and on the wall were pool reports – news briefs written by US military public affairs officers – that journalists were encouraged to use for stories. There were some journalists going out into the field to cover stories, but a huge number just sat in this beautiful hotel.”

Stop information

Donovan feels uncomfortable about teaching on the course.

“I was asked by Ryerson to give a talk on my experiences in Saudi Arabia, Kuwait and Iraq,” he says. “My initial reaction was no. I hate the existance of public affairs people with a passion. Their job is to stop information.

“I’m uncomfortable with Ryerson being hired by the department of national defence. One officer in the course got very upset when I told them to make contacts with the media and leak stories.”

Course organizer Clive Vanderburgh admits organizers had concerns about conflicts between the role of journalists and military officers. “There was a lot of discussion concerning the potential for conflict – especially that the people hired to teach might think they were there to help the department of national defence to avoid the media

“But we were trying to give a general understanding of the media’s needs. We didn’t sell the country down the drain.”

Another teacher was Robert Fulford, the well-known writer and lecturer on journalistic ethics. “I don’t have a problem with Ryerson teaching the military,”says Fulford. “It’s a way of spreading journalistic technique to people in the DND. It seems to be a natural extension of the work of Ryerson.

“Canadian journalists are ignorant of the military and could do with getting closer. You almost never find a full-time journalist in Canada who knows anything about them. The more you know about the military, the less you will be manipulated.”

But Gideon Forman, coordinator of the Canadian Peace Alliance, fears Ryerson may be helping the military mislead the public.

“Why do these guys practise handling the media so much of there’s nothing to hide? This is just better packaging for the military so they can get what they want from the public.

“I have problems with public money being spent teaching the military to be more effective with the media, while other organizations have their budgets cut or eliminated.

“Is there a similar program for food banks or women’s shelters?”

"Top reporters offer military media handling tips": Now Magazine, November 1992

Note on story context: This story was researched and written after two key events involving Canada's military: the first Gulf War from 1990-1991; and the Oka Crisis in 1990, where the Canadian Armed Forces confronted an armed group of Mohawk "Warriors" in Oka, Quebec.  

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Lamas against AIDS

By David South

UB Post (Ulaanbaatar, Mongolia), November 5, 1997

Manila, Philippines – Since HIV is contracted through sex, the disease has always been a difficult subject for the world’s religious leaders. When there is sex to be discussed, no religion can do it without bringing up morality.

This moral debate about bedroom behaviour has tainted discussion of AIDS in many countries. At the extreme end of the spectrum, some evangelical Christian leaders in the US have painted AIDS as an apocalyptic disinfectant for humanity.

Not surprisingly, this attitude has not helped in educating the faithful that AIDS can happen to anyone and its victims should be treated like any other ill person.

The Philippine conference heard that the standoff between the world’s leaders and public health authorities must stop. Dr Peter Piot, executive director of UNAIDS, pointed to the numerous delegates from the world’s religions and called on others to follow their example.

“In Myanmar, the Myanmar Council of Churches, the YWCA and other community-based organizations have joined hands with local authorities, health workers and Buddhist groups for community-based prevention, care and support programmes,” he told the assembly.

“This is the best practice in action.”

Mongolian delegate Dr Altanchimeg thinks a similar approach could work in this country.

“Now every Mongolian goes to see lamas. It’s a good channel to advocate for AIDS education. In Thailand, lamas are very experienced at this. People believe in lamas.”

Like their colleagues in Thailand and Myanmar, Cambodian lamas have been in the forefront of AIDS education.

Lamas there use festivals and ceremonies to raise the issue.

You Chan, a 30-year-old lama from Tol Sophea Khoun monestary in Phnom Penh, likes to raise the issue delicately, by referring to diseases in Buddha’s time.

“I feel it is difficult to speak about sexual methods with a large audience – I will not speak to sexual methods.

“At first, it was very difficult. People would ask why a monk would say such things. But I tried and tried and the people understood who is helping them.

“My message to Mongolia’s lamas is this: you have a moral responsibility to educate the people about AIDS, that it is happening all around the world and there is no medicine to cure it.

“You have to take care in the name of Buddhism to help people in this world.”

You Chan teaches lamas at 15 temples in Cambodia, who pass the message along to other lamas and congregations.

Update: Interestingly, two decades after this story was written, it seems the other kind of llama's antibodies can "neutralize a wide range of circulating HIV viruses". From ScienceDaily: How llamas' unusual antibodies might help in the fight against HIV/AIDS

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Health Care in Danger

Worrying breakdown in Ontario reforms

By David South

This Magazine (Canada), October-November, 1992

The Senior Citizens’ Consumer Alliance for Long-Term Care’s report on the Ontario New Democratic government’s health care reforms, released in July, documents what many people suspected: the much-needed reforms are mismanaged and dangerously close to chaos.

The report compares the present crisis to the failed attempt in the seventies to move psychiatric care out of institutions and into communities by closing 1,000 beds. Patients were left with inadequate community services, resulting in many homeless and jailed former patients. The alliance fears seniors – the biggest users of health services – could fall victim to reforms in the same way.

According to many health care reformers, Bob Rae’s government seems to have lost control of the issue, resulting in massive job losses and a worrying breakdown in services.

The NDP’s health care document “Goals and Strategic Priorities” reads like a wish list for progressive health care reformers, ranging from disease prevention programmes to improved access to health care for minorities, natives and women. To many, the debate isn’t over these goals but how they are achieved and what the government’s true motives are. Under pressure from big business and its lobby groups, the NDP is desperate to save money where it can, and as Ontario Health Minister Francis Lankin says, “not disrupt or destroy business confidence.”

Emily Phillips, president of the Registered Nurses’ Association of Ontario, is blunt: “The NDP’s plans sound good on paper, but they can’t give a budget or direct plan on how they hope to carry out reforms. They are going about things backward. They cut hospital beds and lay off staff without having community health care services ready.”

The national trend in health care is to deinstitutionalize and bring services to homes and communities. It is hoped that emphasizing prevention and healthy living will significantly reduce the need for hospitals, expensive drugs, surgery and high-tech equipment. The NDP has pledged to spend $647 million to reform long-term care services by 1997 – creating services that will allow seniors to stay in their own homes.

Problem is, the NDP has embarked on radical down-sizing of hospitals – closing beds and laying off thousands of health care workers – right now. Lankin claims that in the worst-case scenario, layoffs this year wouldn’t exceed 2,000, but the Ontario Hospital Association claims 14,000 jobs are in jeopardy. Phillips believes it will be hard to estimate job loss: “It is hard to even record the number of nursing jobs lost, because for every full-time job cut many part-time and relief positions go with it.”

Chaos will result when people who depend on hospitals have nowhere to turn but the inadequate community health care services, which are uneven and narrowly focussed. To make things worse, the same funding restrictions placed on hospitals have also hit the services that are supposed to save the day.

“I haven’t heard of any change in the quality of care. It is just too early,” says Phillips about the effect of layoffs on hospitals. “Right now the nurses are picking up the slack, but soon they will burn out. I don’t feel confident this government has the management skills to do this. I’d like to see a plan in place before moving people into the community.”

Training for laid-off hospital workers will have to come from the $160-million allocated for retraining workers laid off by cities, universities and school boards – all of whom are coping with record-low budget increases.

In February, Lankin appealed to hospitals to do everything in their power to make layoffs painless and to trim doctors and administrators first. But the NDP has yet to pass legislation that would bind hospital boards to make the right cuts. The boards operate at arm’s length from government and continue to make unnecessary decisions, ignoring the NDP’s moral pleas.

Rosanna Pellizzari, a member of the Medical Reform Group and chair of the Ontario Association of Health Centres, wants better community accountability for hospitals before they lay off staff and cut services: “Sometimes it makes sense to bring people to hospitals. Planning must be at the community level and open and democratic. Health care workers, who are mostly women, should not be scapegoated for financial problems. Doctors and management should go first. Physicians experience very little unemployment.”

Carol Kushner, co-author of the book Second Opinion, which evaluates the country’s medical system, sees chaos resulting from the conflicting agendas of governments and health care reformers: “Will the tremendous contradictions of institutions be transferred to the community? The federal government is rapidly draining money from medicare while provincial governments are having a hard time. This hasn’t produced extra funds for re-allocating services to the community – which was recommended by reformers. You have to ask: who is going to fall through the cracks?”

This Magazine (Canada), October-November, 1992.

Psychiatric care lacking for institutionalised seniors

By David South

Today’s Seniors (Canada), November 1992

“Don Weitz wears a T-shirt bluntly saying, “Fry rice - not brains.”

Seniors who live in nursing homes and homes for the aged are receiving an inadequate amount of psychiatric care, according to a study conducted by Toronto’s Baycrest Centre for Geriatric Care.

Dr. David Conn, director of psychiatry at Baycrest and an author of the report, says action must be taken to remedy this situation, since at least 80 per cent of elderly long-term care residents suffer from some form of mental disorder.

The issue of psychiatric care for seniors is complex. There are many, often strongly-held, opinions about the nature of this care and what measures will genuinely improve the mental well-being of seniors in institutions.

According to The Senior Citizens’ Consumer Alliance for Long-Care Reform, Ontario has the highest rate of institutionalisation of seniors in the world, with 7.5 per cent of seniors over the age of 65 and 15 per cent over 75 in institutions. The Alliance demanded in its reforms in Ontario that seniors’ mental health problems be taken more seriously and be included in any assessment for care.

Baycrest’s report surveyed 1,148 medical directors and nursing directors in over 500 nursing homes and homes for the aged across Ontario. The 601 who responded reported that 37 per cent of their residents received no psychiatric care, while only 12 per cent received more than five hours per month. The most common psychiatric problems under treatment were depression, agitation, wandering and physical aggression.

“Recognition of significant mental disorders in nursing homes is a recent phenomenon because geriatric psychiatry is a relatively new field,” says Dr. Conn. “The usual approach has been to reach for the prescription pad. We know now that antidepressants have been underused and tranquillizers overused.

“To deliver effective psychiatric care requires more than just psychiatrists - teams of psychiatric nurses can also be involved. Hopefully the staff of these institutions will become better educated as a result of this report.”

Dr. Kenneth Shulman, head of psychiatry at the Sunnybrook Health Sciences Centre, feels the worst neglect occurs in private rest homes.

“There is general lack of accountability when it comes to geriatric psychiatric services.” Schulman advocates a coordinated, comprehensive regional network of services.

Dr. Conn is sensitive to reports of sexual, physical and mental abuse of residents in some institutions. He says staff as well as residents of institutions can benefit from psychiatric consultations. “If more psychiatric consultants were available, the staff could also receive help in working out their problems,” he says. “Unfortunately the fee-for-service system doesn’t include paying for visiting staff.

“Being in an institution is not easy for anyone. It often means being apart from family, living with strangers, loss of freedom and having to live by the institution’s timetable.”

One of the most controversial of psychiatric treatments is electroconvulsive therapy (ECT). ECT involves placing electrodes on the sedated patient’s head and passing 100 to 175 volts of electricity into one of the lobes of the brain to induce grand mal seizure and coma.

Opponents of ECT say the procedure can cause memory loss and confusion, and in some cases proves fatal. A 1985 Ontario government task force report recommended against using ECT in certain cases: “For patients whose work requires a clear and precise memory, ECT is probably contraindicated.”

But many other sources say that while ECT has been abused in the past and, like many other medical procedures, may not be a pretty sight, it is sometimes effective in combating depression.

Dr. Conn confirms that the controversial procedure is still being used on seniors. “ECT is used on very depressed people,” he says. “It is a hospital-based service. The patient is admitted to a psychiatric unit of the hospital. We do it at Baycrest. It is only a last resort and has often been life-saving.”

Don Weitz, a senior citizen and spokesperson for Resistance Against Psychiatry, doesn’t mince words about what he says is the adverse effects of electroshock therapy and psychiatric practice in general. He wears a T-shirt bluntly saying, “Fry rice - not brains.”

“We have known about the adverse effects of shock for years,” says Weitz. “Research from the ‘40s and ‘50s was very clear that there was brain damage.

“What doctors mean by improvement is in fact post-injury euphoria - the brain will overcompensate with giddiness, and this only lasts for two to four weeks. Doctors seldom test people for more than two or three months afterwards.”

“What we know for sure is that within the institutions, they would rather give drugs or shock than talk to seniors. I think this should be called elder abuse - what else could it be? Is it such a mystery why people are depressed in institutions where they are abused? Psychiatrists have a vested interest in billing OHIP for pushing the button.”

But Dr. Shulman disagrees with blaming the atmosphere of institutions. “It is simplistic to think that the environment is responsible for aggressiveness or other problems,” he says. “These people are cognitively impaired - it could be medication-related or something else. These are complicated issues.”

For any nursing home workers who want further advice about psychiatry, Baycrest has produced a “Jargon-free” guide called Practical Psychiatry in the Nursing Home.

"Psychiatric care lacking for institutionalized seniors": Today's Seniors, November 1992

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Philippine conference tackles Asia’s AIDS crisis

Mongolians attend for first time

By David South

UB Post (Ulaanbaatar, Mongolia), October 28, 1997

Manila, Philippines – More than 2,500 delegates have gathered in the steamy hot Philippine capital to renew the fight against HIV and AIDS.

Working up a sweat alongside other participants at the Fourth International Congress on AIDS in Asia and the Pacific are nine Mongolians – a first that isn’t going unnoticed.

The Congress opened Saturday (October 25) to the pounding beat of a theme song performed by teenagers, championing defiance of death and celebration of life.

That tone was echoed by Dr Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS. He said the epidemic can be slowed down with the right public health measures – a positive message for Mongolia as it grapples with an STD crisis that many believe leaves the country at risk of an HIV/AIDS epidemic.

The magnitude of that epidemic outside Mongolia is startling. Around the world, 23 million people are infected with HIV, the virus that causes AIDS. Between 5 and 7 million of them live in the Asia/Pacific region.

“The point is that prevention is feasible,” Piot told the Congress. “The results can be seen in those countries in the Asia-Pacific region where the epidemic has stalled or is in retreat.

“A good indicator for unsafe sexual behaviour is the STD rate. I am impressed at the sustained decline in STD rates in Australia, Hong Kong, Singapore and Thailand over the past decade.

“But I am concerned actual declines in HIV in this region have occurred only in Australia, New Zealand and Thailand.”

The countries to Mongolia’s immediate south and north are experiencing exploding health crises. In China, HIV/AIDS is increasing at a rapid rate due to factors including growing prostitution, drug use and travel – all by-products of a booming economy. The infected population is estimated at 400,000 and is expected to reach 1.2 million by the year 2000, according to China’s national AIDS committee.

To the north in Russia, a complete collapse in the public health system has dramatically slashed life expectancy and led to an upsurge in many diseases, including tuberculosis and HIV/AIDS.

With many Mongolians doing business in both these countries, there are numerous opportunities for AIDS to enter the country.

A wide range of topics is under discussion at the gathering, with women, youth and STD-control measures of particular interest to the Mongolian delegates.

For the Mongolians, the Congress is an opportunity to learn from other countries’ successes and failures in the fight against AIDS.

Mongolia’s nine-member delegation includes four doctors – Dr K. Davaajav, head of the AIDS/STD Department of the Research Centre for Infectious Diseases, Health Ministry representative Dr S. Enkhbat. Medical University director Dr Lkhagvasuren and Dr Darisuren from the United Nations Population Fund.

Also in the team are Democrat MPs B. Delgermaa and Saikhanbileg, UNICEF’s B. Bayarmaa and two representatives from women’s NGOs: S. Tsengelmaa from the Women’s Information and Research Centre and N. Chinchuluun, executive director of the Mongolian Women Lawyers Association.

On Sunday, several presentations focused on the difficulties of getting people to use condoms.

In Fiji, studies found the majority of the population was aware of AIDS and had access to condoms, but still chose not to use them.

Lisa Enriquez, a Filipino woman who is HIV-positive, gave a sobering speech on the epidemic.

“One of the most important things I’ve learned from the epidemic is human nature. AIDS is such a humanizing disease. It reminds us of being human, complete with all the weaknesses and imperfections of being human.

“Let us not kid ourselves: changing behaviour is not easy. One doesn’t change because somebody tells him or her to do so.

“We will need to get our act together, institutionalize our efforts and continue working harder with passion and perserverance.”

The Congress continues until October 30.

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Taking Medicine to the People: Four Innovators in Community Health

Preventing and treating illness at home or in small local clinics makes financial sense. It also makes patients a whole lot happier.

By David South

Canadian Living (Canada), January 1993

Your health is your wealth, my grandmother used to say. It certainly is our most valuable resource – and when its caretaker, universal health care, is under attack, people take notice

Provincial health ministries across Canada are scrambling to find new cost-efficient ways to deliver health care, and community health care is an increasingly talked-about option.

“Every royal commission has suggested we need to shift resources to community care and stop focusing on institutions,” says Carol Kushner, co-author, with Dr. Michael Rachlis, of Second Opinion (HarperCollins, 1990), a blockbuster book that challenges the way we approach health care in Canada. According to Rachlis, health care nationally cost more than $60 billion in 1992 and is primarily delivered through hospitals and doctors’ private practices. Yet 20 per cent of all patients in acute care hospitals don’t belong there, and about five per cent of hospital admissions for people over age 65 are the result of improper use of prescription drugs.

One study of the Toronto Health Unit found that as many as 50 per cent of seniors residing in nursing homes who were admitted to hospitals with pneumonia had contracted it through mouth infections. If they had received regular dental check-ups in the community or at institutions, these unnecessary and costly admissions could have been avoided.

Increasing numbers of people see community health care as the way of the future. In this model, health care providers – doctors, nurses and support staff – work as a team, and users of health care are involved in making important decisions. Community-based care supplements a medical approach to illness, with emphasis on social and environmental factors like work-related stress. Its advocates say community care can wean us off our addication to expensive hospitals (where one bed costs at least $100,000 a year), drugs and surgery – and make us all healthier.

“Fee for service” encourages doctors to see as many people as possible, emphasizing quantity over quality. In community health centres, doctors are put on a salary and encouraged to give as much attention as necessary to each patient. By simply spending more time with each patient, and by taking into account factors such as illiteracy and cultural differences, community clinics can cut down on misuse of medication.

Jane Underwood, director of public health nursing for the regional municipality of Hamilton-Wentworth in Ontario, says we have reached the limit of what hospitals can do to improve health. “Other factors are now more important than a strictly medical approach, which was the foundation of the old health care system. In 1974, a Health and Welfare paper urged a behavioral approach – stop smoking, get more exercise. Now we are moving to a socio-environmental approach, looking at poverty, social isolation, and unemployment, and their effects on health.”

“Community health care is inevitable because we can now do many procedures on an outpatient basis. With the new technology, all kinds of things can be done outside institutions,” says University of Toronto professor Raisa Deber, co-editor of the recently released book Restructuring Canada’s Health Services System (University of Toronto Press, 1992).

“Just as people can work out of their homes because of computers and faxes, technology can take medical care to the home.” This trend can already be seen in the treatment of cancer. Many patients now receive their chemotherapy at home, with the help of computerized IV pumps.”

If the debate over community health care often seems confusing, it may be because of the haphazard patchwork of programs across Canada. Quebec is the only province that took community health care seriously enough to set up clinics across the province in the 1970s and make those clinics an integral part of the provincial system. Elsewhere in Canada, programs sprang up in the ’60s and ’70s at the initiative of community activists but were met with indifference or hostility from government.

The challenge for community care advocates is to educate both the public and governments. Jane Underwood admits it will be a tough struggle. “Governments are beginning to understand, but the public still has reservations. They panic when there are fewer surgeries and feel that lots of high tech will provide a safety net for health. In fact, it is more scientific to probe for the true causes of illness and not think that just taking a pill will make us better.”

Four Innovators in Community Health

South Riverdale Community Health Centre, Toronto

This fully functioning health centre opened in 1976 in Riverdale, a multicultural and economically diverse neighborhood. The staff consists of doctors, nurses, chiropodists, social workers, health promoters and a nutritionist. Innovative in taking on economic concerns of the community, the centre has set up a community food market to provide cheap and healthful food and recently started workshops with business and community members to come up with strategies to recover jobs lost during the recession. "We consider ourselves part of a movement," says executive director Liz Feltes. And this is played out in projects with local groups and citizens on a variety of issues - from wife assault, drug abuse and sexually transmitted diseases, to medication literacy for seniors. 

Victoria Health Project, Victoria

Originally started in 1988 to tackle the problem of poor communication between hospitals and community health providers, the project first targeted Victoria's large senior citizen population. Twelve programs were launched, including Wellness Centres, palliative support teams for patients dying at home and elderly outreach service focused on mental health. The project has been successful at getting local services to cooperate and eliminate duplication. "There are 500 different agencies for seniors in Victoria, so we linked up with them and increased cooperation," says Susan Lles, excutive coordinator of the project.

It was such a great success that the minister of health created the Capital Health Council to expand the program to the rest of the community. Now, for example, in hospital emergency rooms, quick response teams of nurses assess whether a patient would be better served by other services in the community or by being admitted to hospital. 

Centres locaux de services communautaires (CLSC), across Quebec

Started in 1972 as part of province-wide health reforms, these comprehensive health centres now number 158, with more than 500 satellite offices all over Quebec. Every citizen is guaranteed access to a CLSC, even in remote areas. With five per cent of the provincial health budget, they are able to serve 41 pr cent of the population. They also involve the community through elected boards. "We think it is a unique model in that it integrates health and social services in the same place - both prevention and cure," says Maurice Payette, president of the federation of CLSCs. Because CLSCs are close to the community, governments, schools, community groups and other organizations have turned to them for advice during the last five years. In rural areas, CLSCs have been crucial in reducing the number of farm accidents. 

Canadian Healthy Communities Project (CHCP), across Canada

Started in 1989, the program is aimed at municipalities and gets them to pledge that they will review all their actions with community health (including impact on the environment and economy) in mind. CHCP is part of an international movement linked with the World Health Organization's Healthy Cities movement. With more than 150 participating programs, it is an innovative attempt at getting the powers that be to plan for overall health. "We bring together community leaders to make a list of top 10 health problems and then decide what can be done with the existing budgets and staffing," says David Sherwood, project director. The city of Sherbrooke, Que., is a classic example. Facing reduced funds for road and sidewalk repairs, the city concentrated on repairs in neighborhoods with hig numbers of the disabled and elderly, thereby reducing the number of accidents. Unfortunately, funding was recently reduced dramatically by Health and Welfare Canada, but programs in Ontario, British Columbia and Quebec continue with the help of their own provincial government. 

"Taking Medicine to the People" was published by Canadian Living in 1993.

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