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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US health care businesses chasing profits into Canada

Some fear corporate health care will kill equality of treatment

By David South

Now Magazine (Toronto, Canada), April 8-14, 1993

American-style private health care is slipping across the Canadian border under the noses of three provincial NDP governments, say researchers representing an association of health care workers.

Jackie Henwood and Colleen Fuller of the 7,500-member Health Sciences Association of British Columbia charge in a recent report that a combination of free trade and tightfisted government spending is undermining the universality of medicare and ushering in the beginnings of a two-tier system.

While the health care industry created more jobs than any other sector of the economy between 1984 and 1991, they point out, things have changed dramatically since the Canada-US free trade agreement came into effect in 1989. Now much of this growth is clustering in the private sector.

And they expect that this trend will continue under the forthcoming North American free trade agreement.

“NAFTA will accelerate trends towards a privatized, nonunion and corporate dominated system of health care in Canada,” says the report.

Binding provisions

Chapter 14 of the Canada-US free trade agreement opened competition for health-care facilities management services to US companies. Certain NAFTA provisions will bind all levels of government to consider for-profit health care companies on equal footing with public providers when bidding for services, and entitles them to compensation if they can prove to an arbitration board that they’ve been wronged.

“That represents a substantial encroachment on the democratic right of local, provincial and federal governments to make decisions,” says Cathleen Connors, who chairs the Canadian Health Coalition, which includes labour activists, nurses, doctors and other health-care workers.

This, in combination with health care cutbacks – both federal and provincial – is resulting in service and job cuts, bed closures, increased drug costs and an increase in privatization, the report says.

In the area of home care, for example – visiting nurses, physiotherapists, homemakers and other services – private firms now take in close to half of all OHIP billings. Many of their clients pay out of their own pockets for services.

The Ontario ministry of health doesn’t keep statistics on the private home health care sector in the province, but the Ontario Home Health Care Providers’ Association, a trade group, estimates that private firms in the industry now employ 20,000 people.

The industry is dominated by a small number of large firms, including Paramed, Comcare and Med+Care.

“It’s a market situation,” says Henwood. “If the services aren’t available to people within the public sector, they will go outside of it.

“We’ve seen this in other countries like England, where they had a public system and now have a parallel private system. If you erode a system enough that people get pissed off, they are going to start to look for alternatives, and the people with the greatest liberty are those with money.”

Connors says that because the Canada Health Act only covers the provision of hospital and physician services, the prinicples of universality and comprehensiveness don’t extend down to community-based services like home care.

The study also found that giant US private health insurers are positioning themselves to reap profits in the fertile Canadian market.

Last week, Wisconsin-based American Medical Security Inc. announced it will begin offering American hospital insurance to Ontario residents this month, citing a demand in Canada to bypass lengthening waiting lists for medical treatment.

Giant US west-coast insurer Kaiser Permanente declared in the March 1992 issue of Fortune magazine that they have targeted Canada as the next growth market. And American Express membership now offers the privilege of health insurance.

With private health care services sprouting up like spring weeds, says Henwood, provinces are placing yearly limits on the number of private services covered under provincial health plans, thus preventing people shopping around for services, no matter what their income.

Sheila Corriveau, corporate relations coordinator at Toronto-based Dynacare, Canada’s largest full-range private health care company – which operates labs, retirement homes, homecare services and consulting services – is enthusiastic about expansion plans, and says that removing patients from hospitals into their homes has been a boon for private health-care services.

“I think the health system will benefit, because what you are really doing is off-loading the cost from the public sector and from the treasury to private enterprise,” says Harry Shapiro of Dynacare. “Private enterprise depends on its own ingenuity for survival and its own levels of efficiency.”

But advocates of the public system say the free-market option now looming is being ushered in by the very parties that Canadians have come to rely on to defend medicare.

Medicare stance

Ontario’s new health minister, Ruth Grier, however, denies her government is jeopardizing medicare.

“I want to disagree with that as profoundly as I can,” she says, fidgeting with an ashtray during a recent interview. “Our government has reaffirmed its commitment to medicare. Over the last decade, under conservative and liberal governments, health care costs have increased in double-digit figures. The system would have collapsed at that rate of growth.

“I guess I haven’t found a way of blaming free trade for failures of the health care system at this point,” she says.

But critics say in the last year alone, Ontario’s ministry of health has capped health coverage for travellers abroad, removed coverage for physical exams requested by employers, chopped hospital beds and cut back the number of drugs covered on the provincial drug plan.

Grier says that the government’s vision relies on a new view of medical care seekers as consumers who are going to take more responsibility for their own health care

“Government can’t do it all,” she says.

"US health care businesses chasing profits into Canada": Now Magazine April 1993

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Peaceniks questioning air-raid strategy in Bosnia

Muslims say peaceful alternatives will aid cleansing

By David South

Now Magazine (Toronto, Canada), May 13-19, 1993

While Bosnian Muslims continue to demand either airstrikes against the Serbians or weapons to defend themselves, there is little consensus among Canadian peace groups and political parties that these measures are the key to a long-lasting peace.

The differences are as graphic as those between Washington and Ottawa. While president Bill Clinton is asking European nations to support air strikes, prime minister Brian Mulroney has publicly opposed such bombing raids as an answer to the brutal ethnic cleansing of Muslims being carried out by the Serbs.

“We are still developing our position in terms of support for military intervention,” says Roxanne Dube, assistant to Liberal foreign policy critic Lloyd Axworthy.

Dube says, “We need something more comprehensive than just airstrikes, which alone could jeopardize our troops.”

NDP foreign affairs critic Svend Robinson is more willing to consider military action under UN auspices. But first he wants “a vice-like embargo on Serbia and the establishment of safe havens and humanitarian corridors.

“If the slaughter continues, I personally would not exclude the posibility of further military action,” he says.

“The response of the United Nations, and NATO in particular, has been appallingly inadequate. It has allowed the Bosnian Serbs to consolidate their territorial position. And their latest sabotage of the Vance/Owen proposal has left the international community with no alternative but to isolate Serbia.

“The Bosnian Serbs are just continuing their widespread rape of Muslim women, ethnic cleansing, torture – the world has got to say, stop.”

Among peace groups there is a feeling that military intervention is not a longterm solution.

“We don’t have a position,” says Tamara Storic of Greenpeace Canada, a response echoed by the Toronto Disarmament Network. “We’re in much the same situation as the UN. Nobody knows what to do.”

No position

The Canadian Peace Alliance’s Gideon Forman understands the frustration that fuels calls for bombing, but doesn’t believe it is a longterm solution.

“Those who say go in there and bomb are not all crazy,” he says. “They hear about ethnic cleansing, they hear about rape camps – and they see bombing as a way to stop that. But our position is that a little more restraint has to be shown.”

He advocates a combination of sanctions and diplomacy for a longterm peaceful solution.

Maggie Helwig of ACT for Disarmament says she has little to offer in the short term, pointing out, “Maybe at this point there is little anyone can do.” She is also sympathetic to those who want to arm Bosnian Muslims, but feels it wouldn’t help the situation.

She says, “I believe they are the legitimate government. But providing weapons is not going to contribute to a lasting peace.”

Helwig favours targeted sanctions that would allow opposition organizations in Serbia to receive supplies while the government wouldn’t, combined with international support for peace and opposition groups.

“The only way we can end the Serbian aggression to to support the opposition in Serbia, the peace movement and the women’s movement. The reason they aren’t having much influence is that they aren’t getting any international support.”

Fatima Basic, spokesperson for the Canadian Bosnian refugee groups, says that while she supports Helwig’s plans for helping opposition and women’s groups, she is angry that it is being put out as an alternative to military intervention and air strikes. She says the West “should have done something before we lost half a million people.”

Imam Tajib Pasanbegovic, religious leader of Canadian Bosnian Muslims, says of Helwig’s thoughts, “It’s a ridiculous idea by itself. It will take several years, and by then there will be no Bosnian Muslims left. There is not time. Imagine if we gave this chance to Hitler in the second world war – another 5 million Jews would have disappeared.”

Both he and Basic are bitter that while Clinton seeks European support for bombing, “Prime minister Brian Mulroney is going behind his back telling the world not to interfere.”

Life embargo

Pasanbegovic says if the West will not intervene with at least half the bombing if did in the Gulf War, “They should life the arms embargo and return things to a starting point. If the West is not going to defend us, at least let us defend ourselves.”

However, Carolyn Langdon of Voice of Women, a peace group working with peace and women’s organizations in the former Yugoslav republics, says, “Our position is against intervention, including limited military strikes. We are supporting the civil society groups, the opposition against the nationalism and war policies of their governments.”

Her group sets up rape crisis centres and sponsors women to come to Canada to raise awareness.

David Isenverg, a senior research analyst at the left-leaning Washington-based Center for Defense Information, says sources tell him that the Clinton administration believes air strikes are only a means of levelling the playing field for the Muslims.

He says a Pentagon report released this Wednesday will discredit the claims of air strikes’ accuracy, citing failures during the Gulf War. Clinton will decide on air strikes after Saturday’s referendum in Bosnia, when Serbs will vote on whether to accept a Western peace plan.

"Peaceniks questioning air-raid strategy in Bosnia": Now Magazine, May 1993.

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Somali killings reveal ugly side of elite regiment

By David South

Now Magazine (Toronto, Canada), May 6-12, 1993

Canada is touted around the world for its commitment to the ideals of peacekeeping. But something went seriously wrong with the Canadian Airborne Regiment at Belet Huen in Somalia.

Since the revelation of the March 16 shooting death of Somali civilian Shidane Omar Aroni at the hands of members of the regiment, three more killings of civilians by Canadian troops have come to light. Two of the deaths, including Aroni’s, are being investigated internally by the military, while others are subject to a government-ordered inquiry.

Military watchers say the problem permeating the Canadian Armed Forces' approach to peacekeeping goes beyond the inappropriate behaviour of a few gung-ho members of the airborne.

Warning ignored

They say the department of national defence has ignored the warnings of the United Nations and its own internal papers regarding the ever more complex duties of international peacemaking and peacekeeping. The Canadian forces and other coalition partners, they say, are playing with fire in Somalia by neglecting to prepare troops with the skills they need in negotiation, conflict resolution and cultural sensitivity.

And they point out that the assigning of peacekeeping duties to the Canadian airborne – an elite force with a fearsome reputation – illuminates everything that is wrong with the current approach.

“The opposition is calling for the airborne to be dismantled, but they are prepared for high-intensity combat,” says defence consultant Peter Langille. “It’s just a dumb decision – somebody used them for the wrong thing.”

If Canadian personnel were properly trained, the incidents at Belet Huen would not have happened, says Gideon Forman of the Canadian Peace Alliance.

“Peacekeeping is a special skill that requires courses in non-violent conflict resolution and negotiation. A peacekeeping training centre – which the Canadian Forces pooh-pooh – would be very useful.”

Indeed, the unfolding of the horrifying drama in Belet Huen posed acutely difficult problems for army personnel. It took a small-town journalist on a press junket intended to show off the work of the airborne to force the army to go public with the death of Aroni.

Jim Day of the Pembroke Observer, located near the airborne’s home base at CFB Petawawa, spotted a commotion over the attempted suicide of master corporal Clayton Matchee, one of the soldiers arrested in the death.

It wasn’t until March 31, two weeks after an internal military investigation had begun, that the military admitted to the investigation.

Day says watching the troops in Somalia made it clear there was a mismatch between the personnel and the mission.

“They are trained for a combative role. They’re considered the cream of the crop, very tough physically. They want to use their training, as opposed to being trained for combat in rugged exercises and then ending up handing out water.

“What hit me quite strongly down in the camp was how they spent their leisure time. I watched them set up a spider fight. They had such intensity – they were watching these two spiders devour each other for 20 or 25 minutes, coaching them along, pumping their arms in the air and rooting and screaming.”

Creates aggression

Observers who know the regiment say the training is meant to create extremely aggressive behaviour while reinforcing elite status. Through “jump school” – three weeks of punishing training where subjects drop from planes – soldiers experience exhilarating highs and terrifying lows.

Anecdotes abound about the secretive and violent behaviour of the regiment.

“There’s a good deal of resentment,” says Dave Henderson, who puts together a weekly news infomercial called Base Petawawa Journal for Ottawa’s CHRO TV. “A lot of the other soldiers on the base shun them. Their nickname in some quarters is ‘stillborne.’

“I know from people in other military outfits that when you go up against the airborne, there is a fear factor,” says Langille, whose company Common Security Consultants, has lobbied the government to change peacekeeping training.

“In exercises where the airborne take over a base or something, if they catch you, they beat the shit out of you. It’s not surprising they got carried away in an ugly environment.”

Frustrating pace

Nor is it strange that the regiment chafed at the pace of the Somalian daily round. “The soldiers believe the Somalis are very slow in their ways,” says Day. “They’re used to ‘boom, boom.’ Whatever it is they do, even if it’s building a trench or putting up a fence, they are very quick about it.”

But the military argues that the best preparation for peacemaking and peacekeeping duties is the general combat training every soldier receives.

“The best peacekeeper is a well-trained soldier,” says veteran peacekeeper colonel Sean Henry of the Conference of Defence Associations.

“When you look at the make-up of the coalition force in Somalia, you find that just about every other nation has contributed either airborne troops or special troops, simply because they wanted a well-trained unit at short notice.”

Henry thinks those who argue for peacekeeping training are missing the essence of the armed forces mandate. “It’s counter-productive. You might as well forget about the armed forces and sign up a bunch of social workers.”

Does the UN know what it’s doing?

By David South

Now Magazine (Toronto, Canada), July 22-28, 1993

The United Nations’ bloody hunt for elusive Mogadishu warlord general Mohamed Farah Aideed has many observers wondering whether the world body is making up the rules as it goes along.

Some critics, such as George Cram of the Canadian Council for International Cooperation, an influential umbrella group for Canadian non-governmental organizations of NGOs, question if the obsession with Aideed isn’t just burying the UN in a deeper image problem with the Third World.

Critics point to the fallout of growing resentment from the July 12 attack on Aideed’s compound – killing more than 70 civilians – boding ill for a peaceful reconstruction of Somali society.

The fact that among those killed within the compound were clan elders who were negotiating a peace has upset Somalis even more, says Cram, a Horn of Africa researcher.

“The UN has lost its credibility, its moral authority, lost its blue-beret neutrality,” says Cram bluntly.

The degree to which Aideed should be the main focus of current UN actions has some relief agencies scratching their heads. Aideed has become Somalian bogey man number one with UNOSOM’s (United Nations Operations in Somalia) head, US Admiral Johnathon Howe. He has placed a $25,000 price on Aideed for an arrest.

“I don’t recall the UN ever going out and actually attempting to arrest individuals – they certainly haven’t done it in other conflict zones,” says reverend David Hardy of Saskatoon-based Lutheran Relief, who has organized relief flights into Somalia.

Cambodian example

He cites the example of Cambodia, where the UN brokered a controversial peace with those purveyors of the genocidal killing fields, the Khmer Rouge, in order to secure free elections.

David Isenverg of the Center for Defense Information, a liberal Washington-based think tank, worries that doggedly going after Aideed while ignoring the other factions will paint the UN as siding with one faction over another.

“The protracted effect is to turn the US and UN into partisans to the conflict.”

Hardy believes Aideed, who is adept at seeing which way the wind blows, has inflated his stature as an opponent of the UN as foreign invader.

Then there are other criticisms. Some observers wonder whether the UN is too proud or too blind, or simply oblivious when it comes to seeking advice from the locals it went in to protect.

Even Canada, while supporting the UN’s military effort since Aideed “is obstructing relief supplies,” believes that national reconciliation should be a main focus, says external affairs spokesperson Rodney Moore.

He says Canada continues to urge the UN to move quickly on national reconciliation, bringing together women’s groups, clan elders and other non-warlord groups.

“One of the areas where the UN operation went wrong is the tendency to deal with the ‘superpowers’ of Somalia while ignoring groups like women’s collectives,” says World Visions’ Philip Maher, who has just returned from Somalia.

“Part of the problem is misunderstanding,” Maher says. “The UN hasn’t done a great job of telling Somalis what they are doing.”

Many point to the peaceful north, where the as yet internationally unrecognized Somaliland offers a successful model, combining women’s groups and elders to wrest control.

"Does the UN know what it's doing?": Now Magazine, July 1993.

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Aid organization gives overseas hungry diet food: Diet giant Slim-Fast gets tax write-off for donating products

By David South

Now Magazine (Toronto, Canada), December 2-8, 1993

Doling out diet supplements to recipients of food aid may sound bizarre, but that’s what US diet giant Slim-Fast has been doing.

The company’s cans of powder have been distributed to the conflict-ridden former Soviet republic of Georgia and other parts of the collapsed Soviet Union by the aid agency Americares.

Critics say Slim-Fast is far from appropriate and is, at best, in bad taste. New York-based food-aid critic and writer Michael Maren says such contributions are simply the result of agencies being used as dumping grounds for tax write-offs.

As an example, he cites Somalia, where he recenly spent time researching an upcoming book critical of aid programs. Pharmaceutical firms, he charges, are dumping unnecessary drugs in that country.

“If you want to help people, give them what they need, not the crap we have around here. That a so-called aid agency would bring over Slim-Fast is absurd.

“The attitude that they should take any shit we give them – it’s arrogance,” says Maren, who believes many donors have a beggars-can’t-be-choosers attitude to people in need of help.

At Slim-Fast’s corporate headquarters in New York, Adena Pruzansky acknowledges that the donations are tax write-offs, but insists that their product is very nutritious. No one, she says, has complained about their contribution.

Powdered cure

“If you look at our powdered products, there is a lot of nutrition in there. Certainly for people who don’t have food, this is something that could be useful to them.”

A spokesperson for Connecticut-based Americares, which directs surpluses donated by 1,100 firms to relief operations in 80 countries, praises Slim-Fast.

“They are a fine group of humanitarians,” says Elizabeth Close.

“Americares was just written up in Money magazine as the most cost-effective nonprofit agency,” she says of the organization, whose donations consist of overstocked, discontinued or obsolete items.

“We only accept a product for donation when we know we have a home for it. So we are not giving something inappropriate,” she says.

Close provides no details, however, about Slim-Fast’s participation. “Without their permission, I’m not really supposed to go into any further description of what they donated,” she says.

But those who see the devastating effects of eating disorders on women say Americares exercises poor judgement when it accepts such diet supplements.

“I think it’s quite bizarre,” says Merryl Bear of the National Eating Disorder Information Centre. “Many of these diet plans are starvation diets. In many of the diets, the caloric intake is less than or equivalent to what the Nazi concentration camps delivered.”

Slim-Fast’s chocolate drink powder, for instance, is made of skim milk powder, sugar, whey powder, cocoa, fibre, calcium caseinate, corn oil, fructose, lecithin, salt and carrageenan. It relies on mixing with milk to gets its nutrition.

Lynne Martin of the Toronto Hospital’s eating disorder clinic says Americares is encouraging dieting among starving people who need calories first.

“Women need a minimum of 1,800 to 2,100 calories per day – to meet that requirement with Slim-Fast, you would need eight glasses per day,” she says.

Low calories

Martin say the low calories available in the supplement become even lower if recipients don’t have access to milk and try to mix it with water.

“The protein level isn’t given without the milk, so you don’t know how much is in the powder, but certainly the calories would change if one were to mix it with water.”

At food relief agency CARE in Ottawa, program officer Ivan Connoir says what “the hungry need isn’t Slim-Fast but what is called a human daily ration (HDR).

“It is prepared in the United States especially for emergencies. It has no pork, so it can go to any country,” he says. “It is a kind of lentil stew and vegetable soup – just add water and it’s ready to eat. You even find bread in it. It can last for years.

“Of course the best thing is family food parcels that last one month.”

"Aid organization gives overseas hungry diet food": Now Magazine, December 1993.

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