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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?”

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African Health Data Revolution

A pioneering tool for gathering health data now being used in Kenya could herald a revolution in the way diseases are tracked and defeated around the world. It uses mobile phones to better connect patients with medical and health personnel, and allows data to be gathered in real-time and used to track health and improve the delivery of services, especially to remote and under-serviced areas.

In the past couple of years, Kenya has become a hotbed of mobile phone and information technology innovation. The now-famous Ushahidi crisis-mapping platform (www.ushahidi.com) is just one example. Social enterprise Data Dyne (www.datadyne.org) – with offices in Washington DC and Nairobi, Kenya – is offering its EpiSurveyor application (www.episurveyor.org) free to all to aid health data collection. It bills itself as “the first cloud-computing application for international development and global health … Think of it as like Gmail, but for data collection!”

EpiSurveyor claims to have more than 2,600 users around the world and is currently being upgraded to a second version.

“With the touch of a button I can see what’s going on across the country in real time,” Kenyan civil servant Yusuf Ibrahim told Britain’s Daily Telegraph newspaper. “It is amazing.”

Ibrahim works in Nairobi as the Kenyan Ministry of Health liaison to Data Dyne.

He uses maps and charts on mobile phones to track deadly disease outbreaks and vulnerable pregnancies.

The EpiSurveyor application works simply: A user logs into the website and builds and creates the sort of form they want. They then download it to a phone and start collecting data straight away.

Ibrahim gathers this data from mobile phones used by health care workers across the country.

“It used to take days, weeks or even a couple of months to find out about an outbreak of polio on the other side of the country,” he said. “Now we know almost instantly. The speed with which we can now collect information has catapulted healthcare and prevention to another level. It has completely changed healthcare and saved countless lives.”

He proudly points out Kenya’s mobile phone data collection system is “probably better than what they’ve got in the West.”

“Although we are a third world country, I’m pretty sure we’ve done this before

Western countries. While they are still collecting information in hard copy on clipboards, we are getting it instantly.”

Packed with data processing power, mobile phones are capable of an immense range of tasks and applications. Some see phones as key to a revolution in how healthcare is provided: the mobile phone becomes one-part clinic, another part mobile hospital dispensing advice and transmitting vital information back to healthcare professionals and scientists in hospitals and labs.

Despite dramatic improvements to the quality of hospitals in Africa and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

The United Nations has a number of initiatives partnering with mobile phone manufacturers, networks and software developers as part of a global campaign to reduce HIV/AIDS, malaria and deaths in childbirth.

EpiSurveyor is being used by more than 15 countries’ ministries of health and is the adopted standard for the World Health Organization (www.who.int) (WHO) for electronic health data collection.

It began as a partnership with the United Nations Foundation, The Vodafone Group Foundation, WHO and the ministries of health of Kenya and Zambia in 2006 to pilot test the software for EpiSurveyor.

At the United Nations Foundation (www.unfoundation.org), chief executive Kathy Calvin equates the impact of mobile phones on global healthcare to the discovery of the antibiotic penicillin.

“Instead of building clinics and roads to remote towns and villages so that people can access healthcare, we are bringing healthcare directly to the people via mobile phones. You get a lot more healthcare for your money,” Calvin told the Telegraph.

By David South, Development Challenges, South-South Solutions

Published: November 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Slideshare: http://www.slideshare.net/DavidSouth1/development-challengessouthsouthsolutionsnovember2010issue

Southern Innovator Issue 1: https://books.google.co.uk/books?id=Q1O54YSE2BgC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 2: https://books.google.co.uk/books?id=Ty0N969dcssC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 3: https://books.google.co.uk/books?id=AQNt4YmhZagC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 4: https://books.google.co.uk/books?id=9T_n2tA7l4EC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 5: https://books.google.co.uk/books?id=6ILdAgAAQBAJ&dq=southern+innovator&source=gbs_navlinks_s

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ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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Citing Wild East: The New Mongolia

Books and papers citing Wild East: Travels in the New Mongolia (ECW Press):

The Adrenaline Junkie’s Bucket List: 100 Extreme Outdoor Adventures to Do Before You Die by Christopher Van Tilburg, St. Martin’s Publishing Group, 2013

Beyond Backpacker Tourism: Mobilities and Experiences, Channel View Publications, 2010

Curbing Corruption in Asia: A Comparative Study of Six Countries by Jon S. T. Quah, Eastern Universities Press, 2003

Going Places: A Reader’s Guide to Travel Narratives by Robert Burgin, Libraries Unlimited, 2013

Historical Dictionary of Mongolia by Alan J. K. Sanders, Scarecrow Press, 2010

A History of Russia, Central Asia and Mongolia, Volume II: Inner Eurasia from the Mongol Empire to Today, 1260 – 2000 by David Christian, Wiley, 2018

Modern Mongolia: From Khans to Commissars to Capitalists by Morris Rossabi, University of California Press, 2005

Mongolia: the Bradt travel guide by Jane Blunden, Bradt Travel Guides, 2008

Mongolia: Empire of the Steppes by Claire Sermier, Odyssey, 2002

Moron to Moron: Two Men, Two Bikes, One Mongolian Misadventure by Tom Doig, Allen & Unwin, 2013

Reviewed Work: Wild East: Travels in the New Mongolia by Jill Lawless, Review by: Alicia J. Campi, Mongolian Studies Vol. 25 (2002), pp. 112-114 (3 pages), Published By: Mongolia Society

Alicia J. Campi in Mongolian Studies.

Transiberiana by Simon Richmond, EDT, 2009

Truth, History and Politics in Mongolia: Memory of Heroes by Christopher Kaplonski, Taylor & Francis, 2004

Ulaanbaatar Beyond Water and Grass: A Guide to the Capital of Mongolia by M. A. Aldrich, Hong Kong University Press, 2017

One Steppe Beyond: two years witnessing the birth of a new Asian democracy.

© David South Consulting 2022 © Jill Lawless 2022

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This work is licensed under a
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David South Consulting Books | 1997 – 2014

Southern Innovator Magazine Issue 5: Waste and Recycling, Editor and Writer: David South (ISBN 978-0-9920217-1-9) (ISSN 2222-9280) (Online: ISSN 2227-0523): Southern Innovator’s fifth issue tackles the theme of waste and recycling in the global South. It has unearthed radical new ways to use the Earth’s resources while efficiently raising living standards for the world’s majority. Waste no longer needs to pile up and pollute the environment and communities; it can be a source of wealth and provide sustainable livelihoods.
 
Radical ways to alter how things are made, such as the production model called cradle-to-cradle, have the potential to meet human needs without harming the environment and human health. Effective use of renewable energy technologies and sources also could eliminate energy poverty in the global South, dramatically raising living standards and boosting human development.

“We are proud to present our first book entry in David South’s 5th Issue of the Southern Innovator Magazine. The general focus of this paper is to show the rise of the south as a strong economic power, this year’s issue is focussing on the dilemma of strong population growth and limited resources with the focus on waste and recycling issues for example the elephant dung paper production in Thailand, the banning of plastic bags in Uganda or the creation of green fashion in China.”NEEMIC

“@SouthSouth1 is one of the best sources out there for news and info on #solutions to #SouthSouth challenges.” Adam Rogers, Assistant Director, Regional Representative, Europe, United Nations Office for South-South Cooperation (UNOSSC)

“Btw, I really enjoyed reading them, impressive work & a great resource. Looking forward to Issue 6. My best wishes to you & your team at SI.”

“… great magazine, nice design.”

On Google Books: https://books.google.co.uk/books?id=6ILdAgAAQBAJ&dq=southern+innovator&source=gbs_navlinks_s

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Southern Innovator Magazine Issue 4: Cities and Urbanization, Editor and Writer: David South (ISBN 978-0-9920217-0-2) (ISSN 2222-9280) (Online: ISSN 2227-0523): Southern Innovator’s fourth issue tackled the theme of cities and urbanization in the global South and how innovators are grappling with one of the biggest challenges of our time: the largest migration in history as the world becomes a majority urban place. Southern Innovator profiles new building technologies and innovative designs and also offers social solutions to make living urban better, while improving human development.

“I liked your latest Southern innovator! Always inspiring.” Joana Breidenbach, betterplace.org, Berlin, Germany

“The magazine looks fantastic, great content and a beautiful design!”

On Google Books: https://books.google.co.uk/books?id=9T_n2tA7l4EC&dq=southern+innovator&source=gbs_navlinks_s

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Southern Innovator Magazine Issue 3: Agribusiness and Food Security, Editor and Writer: David South (ISSN 2222-9280) (Online: ISSN 2227-0523): Southern Innovator’s third issue tackled the theme of agribusiness and food security in the global South. It found innovators were proving it is possible to boost farm yields with new techniques that are not costly nor harmful to the environment. It also found the rise of new information technologies, such as mobile phones, offers unlimited options to make farming and food distribution more efficient, profitable and food secure. These information technologies can turn small-scale farmers into agribusinesses if applied correctly.

On Google Books: https://books.google.co.uk/books?id=AQNt4YmhZagC&dq=southern+innovator&source=gbs_navlinks_s

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Southern Innovator Magazine Issue 2: Youth and Entrepreneurship, Editor and Writer: David South (ISSN 2222-9280) (Online: ISSN 2227-0523): Southern Innovator’s second issue tackled the theme of youth and entrepreneurship in the global South. It discovered a growing youth population across the global South and found a disconnect between the enthusiasm and talent of youth and their ability to connect with local economies. This was causing systemic unemployment among youth and wasting a great opportunity to spur growth and innovation in poor countries.
 
Southern Innovator chronicled various business models that were applicable to young entrepreneurs. Importantly, the business models have been proven to work in developing countries.

“Thank you David – Your insight into the issues facing us a “global Village” is made real in the detail of your article – 10 out of 10 from the moladi team.” Moladi: Building Communities

On Google Books: https://books.google.co.uk/books?id=Ty0N969dcssC&dq=southern+innovator&source=gbs_navlinks_s

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Southern Innovator Magazine Issue 1: Mobile Phones and Information Technology, Editor and Writer: David South (ISSN 2222-9280) (Online: ISSN 2227-0523): Launched in May 2011, the new global magazine Southern Innovator profiles the people across the global South shaping our new world, eradicating poverty and working towards the achievement of the Millennium Development Goals (MDGs). They are the innovators. It chronicles what has been called the Development 2.0 Revolution: the use of innovative new technologies to radically alter the dynamics of development.
               
Southern Innovator’s first issue tackled the theme of mobile phones and information technology in the global South. It identified mobile phone pioneers and transformative information technologies reducing poverty and boosting human development in the global South. It was one of the first publications to document and capture this trend.

“What a tremendous magazine your team has produced! It’s a terrific tour de force of what is interesting, cutting edge and relevant in the global mobile/ICT space… Really looking forward to what you produce in issues #2 and #3. This is great, engaging, relevant and topical stuff.” Rose Shuman, Founder & CEO, Open Mind and Question Box

“Looks great. Congratulations. It’s Brill’s Content for the 21st century!” Conan Tobias, Managing Editor, Canadian Business

What they are saying about SI on Twitter: From “@CapacityPlus Nice job RT @ActevisCGroup: RT @UNDP: Great looking informative @SouthSouth1 mag on South-South Innovation; @UNDP Great looking informative @SouthSouth1 mag on South-South Innovation; @JeannineLemaireGraphically beautiful & informative @UNDP Southern Innovator mag on South-South Innov.”

“Beautiful, inspiring magazine from UNDP on South-South innovation. Heart is pumping adrenaline and admiration just reading it” Peggy Lee on Pinterest 

On Google Books: https://books.google.co.uk/books?id=Q1O54YSE2BgC&dq=southern+innovator&source=gbs_navlinks_s

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Wild East: Travels in the New Mongolia by Jill Lawless (ISBN 1-55022-434-4): Covering the period of the late 1990s, with Mongolia embroiled in a major economic, social and political crisis, Wild East gives an insightful snapshot of life lived in a country undergoing significant turbulence.

“Jill Lawless’ book is not a scholarly tome per se, yet it is of definite value to the contemporary Mongolian scholar, because it captures a mood flushed out by anecdotal detail of a specific period – detail that only a resident, not a visitor, can really discover. Thus the book provides the researcher with all-important firsthand observations of key social and political events, which give life and context to historical analysis.

“Lawless’ period is 1997-1999, the heart of the tumultuous and ill-spent years of Democratic Coalition Government. These years, not fully representative of Mongolia in the 1990s, were a period of great hopes for democratic flowering and free market enterprise leading the nation to prosperity and progress. The pipe dream was dashed by the immaturity and selfishness of the Coalition party members. Still, those were heady years, and Lawless, as editor of the English language independent newspaper the UB [Ulaanbaatar] Post, was … “ Alicia J. Campi, Mongolian Studies, Vol. 25 (2002), pp. 112-114

“As Canadian journalist Jill Lawless points out in the introduction to this engaging portrait of modern Mongolia, the short version of the country’s history is simple: They came thundering out of nowhere, terrorized and conquered most of the known world, and then they went home.

It’s probably not too much of an exaggeration to imagine Mongol warlords at the peak of their power in the 13th century sitting around with Genghis Khan debating the merits of attacking Russia or sacking Burma. Within a space of a few decades they had subdued an area stretching from Korea to Hungary and Vietnam to Afghanistan.

But the empire of the Khan imploded and the world’s consciousness of these fascinating people, and the great grasslands and deserts of their homeland, faded as they disappeared for centuries under the iron-fisted domination of first China and then the Soviet Union.

In Wild East, Lawless brings us up to date. Yes, more than half the population of this Europe-sized country still lives on the steppes in felt tents with their horses, sheep and yaks.

But now you can surf the Internet in Ulan Bator, find Mercedes in the streets, party in Western-style nightclubs and see trendy teens rollerblading around Soviet-era apartment blocks.

Lawless gives us a revealing, and often amusing, account of her journeys through a beautiful country awakening from a tumultuous era that saw it wrenched from feudalism to communism and then into the uncharted future of rampant capitalism, searching for its future in the new millennium.” The Globe and Mail, Laszlo Buhasz, 25 November 2000 

Designed in Mongolia

Environmental Public Awareness Handbook: Case Studies and Lessons Learned in Mongolia by Robert Ferguson (ISBN 9992950137): The Environmental Public Awareness Handbook was published in 1999 and features the case studies and lessons learned by UNDP’s Mongolian Environmental Public Awareness Programme (EPAP). The handbook draws on the close to 100 small environmental projects the Programme oversaw during a two-year period. These projects stretched across Mongolia, and operated in a time of great upheaval and social, economic and environmental distress. The handbook is intended for training purposes and the practice of public participation in environmental protection.

In its 2007 Needs Assessment, the Government of Mongolia found the EPAP projects “had a wide impact on limiting many environmental problems. Successful projects such as the Dutch/UNDP funded Environmental Awareness Project (EPAP), which was actually a multitude of small pilot projects (most costing less than $5,000 each) … taught local populations easily and efficiently different ways of living and working that are low-impact on the environment.” Many of these ideas live on in the work of both the World Bank and UNEP in Mongolia. 

Designed in Mongolia

Mongolian Rock Pop by Peter Marsh (ISBN 99929-5-018-8): In the Mongolian language, the book explores how Mongolia’s vibrant rock and pop music scene led on business innovation and entrepreneurship in the country during the transition years (post-1989). Written by an ethnomusicologist, it details the key moments and events in this story, while splicing the narrative with first-person interviews with the major players. 

David South, Editor-in-Chief, Julie Schneiderman, Research Editor.

Designed in Mongolia

In Their Own Words: Selected Writings by Journalists on Mongolia, 1997-1999, Editor-in-Chief: David South, Research Editor: Julie Schneiderman (ISBN 99929-5-043-9): In their own words compiles by theme the vast number of stories and features by journalists on Mongolia’s transition experience from 1997 to 1999. A rich and unusual resource for a developing country, this book offers the reader a one-stop snapshot of how a country handles the wrenching social, political, cultural, economic and environmental challenges of changing from one political and economic system to another.

An excellent resource for scholars of austerity crises and for those seeking understanding on how to plot a path out of an austerity crisis. In particular, the collection of articles and stories show the impact austerity has on people and their lives. Unadorned by backward-looking historical narratives, these are accounts fizzing with the energy of the moment: a first draft of a tough time for most Mongolians. 

Read online at Google Books or visit the University of Toronto’s Library Catalogue: http://search.library.utoronto.ca/details?3403065

Designed in Mongolia

Mongolian Green Book by Robert Ferguson: In the Mongolian language, the book details effective ways to live in harmony with the environment while achieving development goals. Based on three years’ work in Mongolia – a Northeast Asian nation coping with desertification, mining, and climate change – the book presents tested strategies. 

Mongolia Update 1998 Book, Editor and Writer: David South, Researcher: G. Enkhtungalug: Whilst in Mongolia as head of the United Nations’ communications (1997-1999), I wrote an update on how Mongolia was coping with hyperinflation, shock therapy, austerity and the Asian economic crisis. The mission simultaneously had to deal with the 1997 Asian Crisis and the worst peacetime economic collapse in post-WWII history.

This work is licensed under a Creative Commons Attribution 4.0 International License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2017