Tag: healthcare

Training local doctors

Prof. Mark Eidelman, director of the pediatric orthopedics unit at Rambam’s Ruth Rappaport Children’s Hospital, second from the left, with African colleagues at the Black Lion Hospital in Addis Ababa. (photo from Rambam Medical Centre)

Dozens of doctors from Ethiopia and neighbouring countries recently participated in a practical course, the first of its kind, which trained them to fix pediatric orthopedic deformities. The course, held for the first time in Africa, was led by Prof. Mark Eidelman, director of the pediatric orthopedics unit at Rambam’s Ruth Rappaport Children’s Hospital.

Fifty doctors participated in the four-day course. Some of them had already completed their internships, while others were still interns. They attended lectures about different treatment types, attended workshops and participated in surgeries. The Black Lion Hospital in Addis Ababa, Ethiopia, hosted the course, which was sponsored by CURE International. CURE is a nonprofit organization that assists children in developing countries suffering from medical issues, in cooperation with POSNA, the Pediatric Orthopedics Society of North America.

The Ethiopian hospital’s pediatric orthopedic services are directed by two doctors from England who relocated to Ethiopia several years ago. The doctors created the course in order to give treatment tools to local medical teams dealing with one of the most common problems in the country.

“Against the backdrop of genetic diseases and problems, and especially since there is a great lack of knowledge, infrastructure and treatment capabilities with regard to pediatric orthopedic deformities, there are many people in Ethiopia with problems that are taken care of in other countries at much earlier stages,” said Eidelman. “In Israel, like in many other Western countries, they know how to diagnose problems … and treat them in a timely manner. This helps these patients to enjoy a higher quality of life and prevent their conditions from deteriorating. Now, for dozens of local doctors, there are tools and knowledge to help their patients.”

Joining Eidelman on this recent mission were two doctors from the United States: one who was Eidelman’s teacher, Prof. John Herzenberg, a senior doctor in the field from Baltimore; and Prof. Christof Radler, who is also renowned in his field.

According to Eidelman, the main problem in training African doctors is the difficulty of traveling to the United States to receive training there. “The institutions in Baltimore are considered the best in the field in terms of training and teaching, and the city hosts the leading conferences and courses,” he said. “Unfortunately, most of these doctors don’t manage to secure entry visas for the U.S. and, as such, are denied access to this information. This is the reason why we decided to bring the training to them. At the end of a successful course, we decided to continue with this initiative and, in the near future, I’m supposed to return to Ethiopia in order to train additional doctors.”

Teaching about death

Dr. Jessica Zitter has both written a book and a movie about death and dying. (photo by Rikki Ward Photography)

Dr. Jessica Zitter, who works as an attending physician at a public hospital in Oakland, Calif., struggled with her job’s protocols for years. Until the day a nurse opened her eyes to the possibility that there was a better way, one that involved more compassion in the treatment of patients.

Zitter comes from a long line of doctors.

“They were into the art of medicine,” she said of the mentors she had when she first began her studies. “By that, I mean the art of surgery and intervening, and of doing things in a very precise way. There was something about that that I found heroic, and I wanted to be part of that world.

“So, I went to medical school – pulmonary and critical medicine – which I thought of as the most heroic of the specialties. I went on to start to focus on the machines, technologies, protocols and things that were part of the trade of being a pulmonary critical care physician. I tried to really perfect them … [thinking that,] if I use these perfectly, I’ll be able to help a lot of people.”

But, as she went along, she started to think differently. At first, she suppressed the feeling. “It was truly uncomfortable,” she said. “It caused me a lot of suffering.”

Zitter was using techniques and protocols on people who were not going to benefit from them, knowing full well that they would not benefit from them. Not only was she following her training, but she also wanted to please her patients – give them mainly good news and information about various procedures, instead of telling them the whole truth about their condition.

“I didn’t want to tell them, ‘Hey, I don’t think you’ll survive,’” said Zitter. “I didn’t want to say that because it’s too sad. I would communicate about things that were more practical like, if this happens, we will try this.”

A pivotal moment

Zitter’s approach changed after an encounter in the intensive care unit with a nurse from the family support team, called Power to Care.

“One day, I was about to put in a line [catheter] into someone who was really, really sick and likely dying, and the woman who headed that family support team was standing in the doorway watching…. I was about to put the needle in and she put her hand up to her face and she said, ‘Call the police,’ on a pretend telephone…. She said, ‘Call the police. They’re torturing a patient in the ICU,’” said Zitter. “And that was my epiphany moment. All these moments, I had this doubt. This was like a relief – you’re right, I am torturing the patient. What the heck? There was a clarity there that was really powerful.

“But, the sad truth is that I still put that needle in. I still put that catheter in that woman. The force of what I call the end-of-life conveyor belt is so powerful … not only the conveyor belt itself, but the drive to ‘protocolize,’ heaping on treatments … the culture in the hospital. It’s hard to break out. It’s hard to stop and take a pause, and say, ‘Wait a minute. What the heck?’”

The intervening nurse, Pat Murphy, in some ways became Zitter’s mentor on what it meant to be a doctor.

“I came to it late and from a place of profound dissatisfaction and moral distress, and I was just extremely lucky that I happened to be in one of four hospitals where this movement was starting to take hold,” Zitter told the Independent.

“And, I happened to have been open to it,” she added. She was able to get over her “human defence of not wanting to look stupid or like I didn’t understand … and to be able to say, ‘OK. Teach me.’

“I feel lucky that those two things were in check at that time,” said Zitter. “Not to say that I wasn’t filled with shame and embarrassment about what I’d been doing all that time, but the psychology…. Once you admit there’s a problem, then find a way to fix it.”

After years of immersing herself in this new paradigm, Zitter felt ready to share what she had learned. She published a book about it, called Extreme Measures: Finding a Better Path to the End of Life, in 2017.

As she was writing it, Zitter realized that, if a picture can impart a thousand words, maybe a movie would be able to convey even more. So, she put together a 24-minute documentary, Extremis.

Of the award-winning film, Zitter said, “It really shows the issues that come up in an ICU…. There is also a discussion guide that goes with it, so people can watch it and then come away from it with some lessons learned.

“This movie reaches a wide audience about really advanced care planning,” she said. “A lot of synagogues are using it, medical schools and nursing schools.”

Death education

Zitter was asked to teach sex education at both of her daughters’ schools.

“I want them to be able to make the best decisions they can make about their bodies and their health, and to be empowered to live the best they can,” she said.

But what about death education?

Extremis came out in late 2016. “It was nominated for the Oscars and a lot of my kids’ friends were watching it. And all these kids were really blown away by the movie and they were having a positive response to it,” said Zitter. “It made me think, ‘Why the heck aren’t we teaching kids about death? Why aren’t we having a conversation in high school, just like with sex ed?’ So, a friend of mine designed ‘death ed.’ We did it in her kids’ and my kids’ schools. It was really impactful.”

Zitter would love to see such a class in every school in the United States and Canada, along with other heath education classes, so everyone can have the opportunity to learn about a range of issues and discuss them.

Both the teachers and the students appreciated the lesson on death education, said Zitter. “There were no negative responses. Although some kids cried, and it was terrifying at first, they would then say, ‘That was sad, but I’m OK.’

“I was like, ‘It is sad that we are all going to die.’ But, you know what? It’s really good for these kids too, [because] it’s part of life. If we pretend no one’s going to die and don’t let our kids go to funerals, etc., we aren’t doing anyone a service.”

So far, Extremis has been translated into 90 languages and has been shown in 160 countries.

“We’ve got to tell people what’s actually happening and try to understand,” said Zitter. “I use myself as a prime example…. Why was I putting that catheter into a woman I knew was dying? What are these factors that are propelling me to do things that don’t make sense to me? The idea is to be more conscious of it, aware of it, and change it.”

For more information about the movie and the book, visit jessicazitter.com. The film trailer can be found on YouTube.

Rebeca Kuropatwa is a Winnipeg freelance writer.

BGU finds key protein

Ben-Gurion University’s Dr. Deborah Toiber will be part of a panel in Vancouver called Alzheimer’s, Dementia and You: Research, Risk Reduction and Resources. (photo from CABGU)

Alzheimer’s affects about six percent of people over the age 65 worldwide. For years, scientists have been searching for ways to treat it and to discover its roots, but without much success, until recently.

A group of Ben-Gurion University researchers, under the leadership of Dr. Deborah Toiber, is among those who have made breakthroughs. They have discovered that a certain protein, SIRT6, necessary for DNA repair, is largely missing from the brains of people with Alzheimeir’s. The absence of this protein and the gradual decline in its production by the human body as we age might be what triggers the disease.

On June 5, Toiber will be the keynote speaker at Alzheimer’s, Dementia and You: Research, Risk Reduction and Resources. She will be joined in a panel discussion by Laura Feldman from the Alzheimer Society of British Columbia and Joanne Haramia of Jewish Family Services; Simon Fraser University professor emeritus Dr. Gloria Gutman, one of the founders of SFU’s Gerontology Research Centre, will be the moderator. The event, which will be held at the Rothstein Theatre, is being presented by the Canadian Associates of Ben-Gurion University (CABGU) in partnership with the Jewish Independent, the Jewish Community Centre of Greater Vancouver’s Adults 55+ program, the Alzheimer Society of B.C., Louis Brier Home and Hospital, Jewish Family Services, Jewish Seniors Alliance, and L’Chaim Adult Day Care.

According to David Berson, executive director of CABGU, British Columbia and Alberta Region, “the purpose of the panel is to increase the awareness and understanding of Alzheimer’s disease, dementia and neurodegenerative diseases.”

“Deborah was coming to Canada to visit the community in Winnipeg for a similar event,” Berson told the Independent. “We had a wonderful opportunity to bring the young and dynamic researcher to Vancouver and we jumped at it…. Toiber’s research, as I understand it, is part of a race to discover, isolate and understand the characteristics, components and mechanisms of DNA that will allow us to identify and treat neurodegenerative diseases prior to onset.”

In her email interview with the Independent, Toiber talked about her work and her group’s discovery. She said that DNA deteriorate with age. “It is not something genetic or environmental,” she said. “We repair our DNA and continue going on, but the repairs are not perfect. Some DNA remain unrepaired. As we get older, unrepaired DNA accumulate, and their ability to produce proteins diminishes.”

She further explained: “If the DNA is damaged, and a cell feels it is too dangerous to continue with this damaged DNA, the cell may activate a self-destruct mechanism. If too many cells do this, the tissue with the dying cells will deteriorate, such as the brain.” Essentially, the deterioration of the DNA and the reduced production of SIRT6 protein mark “the beginning of the chain that ends in neurodegenerative diseases in seniors. In Alzheimer’s patients, SIRT6 is almost completely gone.”

Toiber said scientists should be focusing on how to maintain the production of SIRT6 and how to improve the repair capacity of the damaged DNA, because that is what causes Alzheimer’s and similar diseases. Unfortunately, it is impossible to introduce the needed protein directly into the brain. “There is a blood barrier that prevents things from passing into the brain,” she said. “But we are trying to find a way to increase the expression of the protein into the brain.”

Toiber has always been fascinated by the molecular biology of the human brain. “I chose this field because I wanted to understand in-depth how the brain works, to investigate what happens when things stop working,” she said. “I think that molecular biology is the answer to all those questions. It’s like being a detective on the molecular level.”

She realizes that a detective’s work is never easy or fast. “Results take years to build, as they are based on previous findings, ours and other scientists’. My current group, where I am the principal researcher, is about three years old. It is a new lab.”

The research is multifaceted and multidirectional. “We do basic science,” she said. “We use animal models and cells to understand what is happening as we age, what is the cause of disease and what can we learn from this to develop treatments or preventive actions. We also collaborate with medical professionals and other scientists to get a fuller picture of various aspects of aging and neurodegeneration, particularly Alzheimer’s disease.”

Toiber’s group doesn’t work on the pharmaceutical angle of how to introduce the protein into patients’ bodies. Instead, she explained, “We are interested in the molecular causes of aging, such as DNA damage accumulation, and how this leads to disease. We work in experimental biology. These experiments are expensive and difficult. It can take a long time to see and understand the results, but it is also rewarding. Molecular processes help us understand how our organisms work and what happens when things go wrong. We have to be optimistic and keep trying.”

Many scientists in related fields of study are interested in Toiber’s work. “I have talked about our research at the international neurochemistry meeting in Paris and at conferences in Crete and Israel,” she said.

To hear her speak in Vancouver, register at eventbrite.ca. There is no cost to attend.

Olga Livshin is a Vancouver freelance writer. She can be reached at [email protected].

Music helps body and mind

Perla Barabak gave a music workshop on April 17 as part of Jewish Seniors Alliance’s Snider Foundation Empowerment Series. (photo from JSA)

The fourth session of this season’s Jewish Seniors Alliance Snider Foundation Empowerment Series was held with the co-sponsorship of Congregation Beth Israel on April 17. The theme of “Laughter and Music: Feeding the Soul” continued with a program entitled Perla’s Music Workshop.

About 65 seniors were present to enjoy the afternoon event, which began with the regular Tuesday seniors lunch provided by Jewish Family Services. Queenie Hamovich of JFS welcomed everyone and introduced Ken Levitt, president of JSA.

Levitt reviewed some of the JSA programs, including the peer support services. He asked audience members to consider joining JSA and encouraged them to think of volunteering for some of the peer support initiaves. He then introduced the speaker for the afternoon, Perla Barabak.

Barabak believes that music helps the body and mind to relax. It also touches the heart and soul, she said, making it easier for feelings to surface. Thus, music can provide multiple benefits.

Barabak began with some exercises, asking the audience to sound out their names musically. She began with her own name and many people joined in. She talked about active and passive listening; for example, listening at a concert as opposed to hearing background music in an elevator.

Throughout history, she noted, music has been used in communication, movement and at social events (weddings, b’nai mitzvah, banquets).

Songs represent a culture, she said. In this way, music is the song the heart sings. Songs remain with us into our senior years, when other memories may fade. Songs and singing can create pleasure and empowerment.

Barabak then did a guided meditation, getting everyone to close their eyes, listen to the music and imagine a colour. Barabak – who has used music in her work as a psychologist – pointed out how relaxing this is and how music balances our thoughts and feelings. She said she feels that, where there is life, there is music.

As the event ended, many in the audience got up and danced to the music being played.

The next Empowerment Series event – Music for Our Hearts and Songs We Love – will take place on June 25 at Beth Tikvah Synagogue. Caviar and Lace, with Michelle Carlisle and Saul Berson, will perform a mix of classic, jazz and folk songs.

Shanie Levin, MSW, worked for many years in the field of child welfare. During that time, she was active in the union. As well, she participated in amateur dramatics. She has served on the board of the Jewish Federation of Greater Vancouver and is presently on the executive of Jewish Seniors Alliance and a member of the editorial committee.

JNF of Canada honours Isaac Messinger

Isaac Messinger being presented with a certificate of appreciation last year for his contributions to the Jewish National Fund of Canada and Beit Halochem. (photo from JNF Pacific Region)

Isaac Messinger was born in Poland in 1929 and spent some of his early years in Siberia. Although his family tried to flee back to Poland when he was 12 years old, he ended up alone and orphaned in Russia and has spent the years since then living a very colourful life.

Among the notable moments, Messinger worked as a cowboy on horseback, chauffeur to a Polish officer, in a garage, as a prizefighter, a soccer player, a tinsmith and a traveling carnie with a roulette wheel. And he still had time to open a steakhouse and deal in diamonds, while lending money to some of the original landowners along the Las Vegas Strip.

Messinger has long been a strong supporter of Israel and he is currently focused on funding a project of JNF Canada that works with Israeli veterans, a special fitness centre at Beit Halochem Ashdod.

At first glance, the fitness centre at Beit Halochem looks like any other fitness club. There are lots of people working out on the equipment, weight training and stretching. Upon closer examination though, the difference is quite clear. Not only is much of the equipment and machinery slightly different, but the members are as well. Here, veterans young and old, with a wide spectrum of disabilities, come to improve their strength, flexibility and cardiovascular health. They exercise side by side, some on special equipment designed for wheelchair access or amputee-specific machines, and there are trainers on hand to explain and assist the veterans.

The physical rehabilitation aspects of working out in the fitness centre are clear to all. Less obvious is the psychological benefit that the disabled vets get from taking an active role in their rehabilitation.

Going beyond clothing

Donna Karan’s Urban Zen includes pieces to be worn year-round. But the project is grander than a fashion line – it is a broader approach to life that she hopes will speak to many people. (photo from fashionmodeldirectory.com)

With the sun finally out for days running, spring has truly sprung. We can now satisfy the urge to take out our colours from the back of our closets. That bright pink silk blouse in its garment bag is once more seeing the light. Whatever the current look may be, nothing compares to feeling at home in our classics; those pieces that are, at least to us, forever “in.”

In 1985, Donna Karan introduced to the world of fashion the “Essential Line.” In her first private collection, there were seven simple pieces that continue to be timeless. These include the oversize sweater, a bodysuit, jersey dresses, Lycra tights (no longer just for exercise class), a white shirt, loose trousers and a tailored jacket. Over the years, she would incorporate new pieces, in her go-to favourite colour, black.

Karan, born Donna Ivy Faske, in 1948 in New York, was raised by a fashion-model mother and suit-designer stepfather – she was practically destined to have a lifelong career in fashion. The many awards she has received are but one proof of her talent for it.

At the age of 14, Karan quit school and embarked into that world, working in a boutique. At 20, she was accepted into the renowned Parsons School of Design. After graduating, she became, at 26 years old, head designer of the Anne Klein fashion house.

In 1984, Karan divorced her first husband, Mark Karan, and married Stephen Weiss. With full force, she began her own label. The line was geared to “design modern clothes for modern people.” She wanted to create clothing that she herself would wear and in which she would feel comfortable.

After dressing the likes of her best friend, Barbra Streisand, many A-list Hollywood stars and high-powered women in politics, Karan launched a new brand in 1988, DKNY, a line of less-expensive clothing. Seventeen years later, her business expanded into a men’s fashion line, fragrances, bedding. She also wrote a memoir, The Journey of a Woman: 20 Years of Donna Karan, among other accomplishments.

Karan’s Urban Zen came to fruition in 2001. While watching her beloved husband lose his battle to lung cancer and experiencing the sale of her empire to the multinational LVMH (where she stayed on as head designer until 2015), Karan learned that everyone must “find their calm in the chaos around the world.”

Urban Zen includes pieces to be worn year-round. But the project is grander than a fashion line – it is a broader approach to life that she hopes speaks to many people.

Karan believes it is fundamental to blend Eastern healing together with Western science. While watching her husband undergo chemotherapy, Karan found mediation, yoga, acupuncture and other holistic remedies essential for healing, and for acquiring some sense of inner peace. She built a harmonious sanctuary in the hospital where her husband was being treated, Beth Israel Medical Centre in New York. The sanctuary is a place for patients, loved ones and staff to go to recover from broken spirits and find solace. Its philosophy and practices have helped ease suffering to such a degree that, now, many hospitals and hospices have adopted its methods. The concepts are taught to doctors and nurses through Karan’s foundation, UZIT, Urban Zen Integrative Therapy Program.

On a personal level, this fashionista-writer, who has always loved and appreciated the fun of fashion, also experienced an “aha” moment while researching this article. Being a cancer survivor and having overcome some unwanted surprises life has thrown my way, this spring, I am determined to embrace perfecting my downward dog as much as finding my new bag – devoting time to practising gratitude and investing in my most important asset, me. My tranquility and health are more important than any blouse.

Ariella Stein is a mother, wife and fashion maven. A Vancouverite, she has lived in both Turkey and Israel for the past 25 years.

Alberta’s Jewish home

On the 14th floor of Edmonton’s Our Parents’ Home, one can enjoy panoramic views. (photo from OPH)

In 2015, Edmonton opened Our Parents’ Home (OPH), still the only kosher seniors home between Winnipeg and Vancouver. OPH offers 80 independent living suites and 50 Alberta Health Services supportive-living units.

Lesley Jacobson assisted Irving Kipnes on the project for more than a decade, until recently retiring.

Jacobson grew up in Sydney, Australia. She made her way to Calgary in the early 1970s, a place she called home for 27 years, before moving to Edmonton some 20 years ago. “I was always involved in [Jewish] federations in some way or the other,” she told the Independent.

About 12 years ago, Jacobson began working for Delcon Development, which was founded by Kipnes.

“Irv is one of the major proponents of this [OPH] project, and has been on the committee working to develop this facility for over 20 years,” said Jacobson.

The project was incorporated as a nonprofit organization under the Society Act of Canada in 1996, and obtained a charitable number from Revenue Canada that same year.

“It wasn’t until about a dozen years ago, after fundraising and much discussion about what the project should entail that the committee determined to move ahead,” said Jacobson. “Irv took the lead in that, and started investigating sites and plans seriously.”

The committee included Jewish community members who felt it was important that Edmonton have a facility that caters to the needs of Jewish seniors.

It took several false starts before a site was secured, detailed drawings were developed and a $6 million grant was secured under the Affordable Supportive Living Initiative of the Alberta government at the time. Construction began in 2012 in a prime location on Jasper Avenue, at the corner of 119th Street, next door to Beth Shalom Synagogue.

photo - Our Parents’ Home in Edmonton opened in 2015
Our Parents’ Home in Edmonton opened in 2015. (photo from OPH)

The original name chosen was the Hebrew, Beit Horim, which means Our Parents’ Home. “Once we started building and dealing with contractors, banks, etc. … many of the non-Jewish professionals who we were working with had trouble with the pronunciation…. So, we dropped the Beit Horim and just became Our Parents’ Home,” said Jacobson.

While the residence caters to Jewish seniors wanting a place to live where they can keep kosher, the home does offer menu options for people of all religions and has a non-kosher kitchen as well.

At press time, there were 17 independent living suites available (one- and two-bedroom apartments), while the supportive-living space – the units overseen by Alberta Health Services – was running at full capacity.

“They have a two-year waiting list of people trying to get into the supportive-living space,” said Jacobson. “If someone needs to be in assisted living, wants to be at OPH and they are Jewish, we try to get them to the top of the list. But, we have no control over that, because it’s mandated and controlled by Alberta Health Services…. On the independent living side of things, people are self-sufficient. The rent includes 20 meals per month, so people have that option … while those living in supportive care are provided with all meals and snacks.”

The home’s 50 supportive-living units cover three floors, which are staffed by care personnel 24/7. The two memory care floors are secured, so residents cannot leave those levels unless accompanied by someone with a fob. A third floor is for residents in need of care but with no memory issues.

Since the facility is open to the general public, regardless of religion, there are varied faith-based offerings. While there is a rabbi-led Shabbat service offered on the third Friday of each month, there is also hymn singing once a month led by a non-Jewish chaplain and a variety of other programs.

“We had beautiful seder [last] year and several non-Jewish residents of our community came, because they were interested,” said Jacobson. “People can come to whatever program they wish.”

Jacobson, while not on staff at OPH, worked with the staff to ensure the place became all that it was intended to be by the other committee members.

“It was exciting to be on the committee designing the building, to sit with the architects and interior designers,” said Jacobson. “We chose designs and fabric for the furniture, picked colours and selected the china and silverware. It was a pleasure to facilitate meetings with such dedicated and enthusiastic board members.”

According to Jacobson, when you walk into the OPH building, “it’s like walking into a boutique hotel. It doesn’t look like an old folks’ building. We have modern art on all the walls and, from the common rooms on the 14th floor, one can enjoy panoramic views of downtown Edmonton and the beautiful river valley. You walk into the dining room and it’s like walking into a first-class restaurant … linens on the tables to complement the china – no paper napkins.

“Seniors come here to live, not to die,” she stressed. “During the summertime, we take people from the memory care floors to walk in the neighbourhood, through the green streets. There are many activities designed to physically, socially and intellectually stimulate our memory care residents.

“Our independent residents live the lives they’ve always lived – they go to the opera or ballet, the gym, to their friends and to family. If they need a ride, we have a car that will take them. They live independent lives and, as a plus, enjoy all the extra activities provided – the book club, bridge club, fitness room, movies, social programs, etc.

“The people who have been involved are to be commended for their vision and enthusiasm,” said Jacobson. “Special credit needs to go to Tulane Rollingher, who conceived the idea in the very beginning, way back in the 1990s, of having a Jewish home. She was the very first person to start getting this group together.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

2018 CHW campaign begins

Canadian Hadassah-WIZO’s 2018 annual campaign, Come Together, Right Now, began on March 1 in support of various CHW projects. This pillar of CHW’s fundraising efforts provides $1.5 million in support of children, healthcare and women in Israel and Canada.

CHW is a non-political, nonpartisan national network of dedicated volunteers and professionals who believe that the advancement of childcare, education, healthcare and women’s issues transcends politics, religion and national boundaries.

Over the last century, CHW has been involved in all aspects of Israeli life, supporting women, children and families around the world. CHW’s support has strengthened, and continues to strengthen, the very fabric of Israeli society.

“I can give you 161,453 reasons to be proud of being a donor to Canadian Hadassah-WIZO (CHW),” said Debbie Eisenberg, CHW national president. “It’s really quite simple: this is the number of lives CHW positively impacted in Israel just this past year. This is the difference you made through your generous support of CHW.”

“For me, the theme for this year’s annual campaign encompasses everything that our supporters do for CHW,” said Alina Ianson, CHW national executive director. “Each person has their own reason for supporting the work of CHW, but when we come together, we make a statement about our belief in endorsing the mission of CHW.”

For information on the projects CHW supports, and to contribute to the Come Together, Right Now campaign, visit chw.ca.

On access to palliative care

The way a society treats its most vulnerable speaks volumes about its principles. There are few more vulnerable than those reaching the end of life. The physical, emotional, interpersonal and spiritual challenges confronted at life’s end are immense. Just as we expect our healthcare system to be there for us throughout our lives, so too must it support each of us – and our families – as we enter life’s final chapter.

Palliative care is a policy issue that has the potential to touch every family across the country. According to the Canadian Hospice Palliative Care Association, only 15% to 30% of patients approaching the end of life have access to palliative care. With Canada’s population continuing to age, existing shortfalls in the system will only grow in the coming years.

While the federal government has taken the vital step of announcing additional federal funds for home care and palliative care, more can be done to ensure that no patient seeking palliative care is denied. This is why the Centre for Israel and Jewish Affairs (CIJA) has taken a lead role in mobilizing an interfaith coalition to urge Ottawa to take action on this issue.

Working with Catholic, Evangelical and Muslim allies, CIJA’s efforts achieved a key milestone in late 2017, when Parliament passed Bill C-277. This bill, which received strong support from MPs across party lines, called for the establishment of a national palliative care strategy. Our next step is to ensure that the national strategy that flows from Bill C-277 strengthens end-of-life care for all Canadians.

For this reason, in partnership with others, CIJA is organizing an expert working group to provide us with advice regarding Canada’s national palliative care strategy. An essential portion of these suggestions will be based on the patient and family experience, which is why I invite every reader to consider whether they have personal insights they can share with us.

Can you attest to the importance of high-quality palliative care, perhaps having had a loved one who received excellent end-of-life care? Or, do you have a family member who, despite seeking it, was unable to access appropriate hospice or palliative care? We want to hear your stories – and government policymakers need to hear how these policies affect real lives. Email [email protected] to share your experiences with palliative care.

It is an extraordinary act of chesed to care for a person in their final days of life. Our healthcare system, in which Canadians rightly take pride as evidence of our nation’s innate sense of kindness, must do better to ensure that those who need palliative care are never denied this essential service.

Steve McDonald is director, policy and strategic communications, at the Centre for Israel and Jewish Affairs (CIJA).

Jewish take on health issues

Attendees engaged with panelists, left to right, Drs. Eric Cadesky, Brian Bressler and Jennifer Melamed at a Kollel event Jan. 29. (photo from Kollel)

A small but passionate group gathered at the Ohel Ya’akov Community Kollel Jan. 29 to engage with Drs. Brian Bressler, Eric Cadesky and Jennifer Melamed on the topic of Canadian Health Care Challenges Through the Jewish Lens, which focused on the legalization of marijuana, the treatment of addiction, the practice of harm reduction, the opioid crisis and medical assistance in dying (MAiD).

Cadesky, who chaired and moderated the event, is a family doctor in Vancouver and president-elect of Doctors of B.C.; until last summer, he was also medical coordinator at the Louis Brier Home and Hospital, a position he held for some eight years. Bressler is a gastroenterologist at St. Paul’s Hospital and a clinical assistant professor in the University of British Columbia’s department of medicine, while Melamed is co-owner of the Alliance Clinic, an addiction services facility in Surrey.

Bressler framed the conversation in terms of what he called the four principles of medical ethics for a healthcare provider: autonomy, respecting a patient’s choice and their right to understand and consent to treatment; beneficence, doing or recommending everything that could benefit a patient; nonmaleficence, taking into account all known risks to a patient and doing no harm, or the least amount possible, if harm is unavoiadable; and justice, making treatments available to all patients.

“I wouldn’t distinguish between those principles and Jewish ethical principles,” said Bressler. “I think they’re entirely consistent.”

Within this framework, the doctors’ dialogue with the audience took place.

One exchange was sparked by Melamed’s criticism of harm reduction clinics. “This is the dilemma we face,” she said, “is addiction insanity? Should we respect the patient’s autonomy even if the addiction has impaired that autonomy and they are not truly free to make decisions for themselves anymore because of the effects of the addiction?”

She said, “I refuse to accept harm reduction as the end result, as the highest result for my patients.”

Arguing that there “is really no such thing as a safe injection,” she said she believes such clinics are doing more harm than good.”

An audience member countered that recovery might be a realistic goal for working and middle-class patients, who have seemingly more to recover for; but, for addicts living in extreme poverty, who have a history of trauma and/or mental illness, they may not have a realistic chance of recovery. “With harm reduction, we keep them away from crime and treat them like human beings.”

The Kollel’s Rabbi Avraham Feigelstock said that, from a Jewish point of view, the community has a responsibility to do everything in its power to help a person recover. However, the question of how harm reduction clinics could go beyond their current purpose and move towards recovery was not pursued.

Discussing opioid use, Bressler expressed both a cautionary approach, based on his own practice (Crohn’s patients are at particular risk for addiction), and the opinion that it is important to focus on addressing the sources of pain, not just pain itself.

Both Bressler and Melamed were negative about the legalization of marijuana and its use in a medical setting. They said there was some evidence that marijuana was effective for a very limited number of conditions – neuropathic pain and nausea were mentioned – but that the risks of marijuana, such as cognitive impairment and a link to developing psychosis, were well-evidenced.

Melamed expressed concern about what she thinks will be the massive costs of policing marijuana intoxication, among drivers or industrial workers, for example.

When one person raised the potential of increased teen use of the drug, Melamed said teens were already using and she didn’t fear an increase, though she was concerned about the potential for increased use among adults.

Another audience member suggested the Jewish community should protest marijuana’s legalization.

The doctors took a less defined stance towards medical assistance in dying. Both Bressler and Melamed said they had personal and professional experience with it but did not take a stand in favour or against it, instead highlighting issues to consider. Bressler acknowledged the right of Canadians to MAiD but also pointed out that the practice conflicts with Jewish law.

Feigelstock said the general principle in Judaism is to prolong life but not necessarily to prevent death. “According to Jewish law, generally speaking, you may choose not to do things to prolong the life of someone who is dying,” he explained, “and you may give medicines to relieve suffering, which have the side effect of possibly shortening life, but you do not do something that will directly kill the patient. Every case must be dealt with separately, however, case by case; one cannot make general statements about what to do.”

Matthew Gindin is a freelance journalist, writer and lecturer. He writes regularly for the Forward and All That Is Interesting, and has been published in Religion Dispatches, Situate Magazine, Tikkun and elsewhere. He can be found on Medium and Twitter.