A health crisis of our own making?

Manitoba is currently in the grips of multiple health crises. The highly publicized increase in local crystal meth use and addiction, the broad opioid epidemic and a local syphilis outbreak are some of the issues that have been given particular attention by the provincial government, who are responsible for the health care of Manitobans.

But while Premier Brian Pallister’s ruling Progressive Conservative government has been quick to place the blame for these crises on any number of behaviours, they seem unwilling to examine the role played by their own catastrophic gutting of health care in Manitoba.

In February, the Government of Manitoba announced that the province is in the midst of a serious syphilis outbreak. Dr. Michael Isaac, the acting chief provincial public health officer, spoke at a press conference, reporting that there were more than 350 syphilis cases in Manitoba in 2018 (a marked increase from 118 in 2014), and that 10 infants were born with the infection.

The language that Isaac used to advise Manitobans on syphilis prevention was troublingly moralizing. The first measure he suggested for reducing the risk of contracting syphilis was “being in a long-term, mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis.” The only other suggested preventative measure was condom use.

Isaac also noted that this outbreak was especially troubling in that it showed an increase among heterosexual women, because “in the past, syphilis outbreaks have occurred mainly in urban areas of Canada between men who have sex with men.”

The provincial government linked the outbreak to another health crisis gripping Manitoba: the increase in intravenous drug use, evident in Winnipeg’s growing meth and opioid addiction epidemics.

“We’ve noted that some of the moms with congenital syphilis have been using crystal meth and injecting drugs, so that certainly could be exacerbating the situation,” Isaac said.

Isaac also pointed to the fact that several of the mothers who gave birth to babies with congenital syphilis did not access prenatal care. While this statement stressed the importance of seeking prenatal care during pregnancy, it neglected to acknowledge the massive gaps in access to treatment that have opened in the wake of the Pallister government’s health-care cuts.

Since its election to a majority in 2016, the Pallister government’s cuts to health care in Manitoba have been sweeping and constant. For instance, in July 2017, the Province announced the closure of all but one of Winnipeg’s QuickCare Clinics. These walk-in clinics served as a crucial resource for Manitobans without family doctors or quick access to treatment.

These were followed by emergency room closures: Misericordia’s ER closed in October 2017, with Seven Oaks and Concordia Hospitals to follow this July. At that point, the only ERs in Winnipeg will be at Health Sciences Centre, St. Boniface Hospital and Grace Hospital.

The staff at existing hospitals have also been slashed to a bare minimum, a move that has disproportionately had a negative effect on the care of newborn infants and those giving birth.

Despite the province’s alarm over babies being born with syphilis, inadequate medical care for newborns since the Pallister government took power has skyrocketed, including an instance in which a lack of proper equipment and staff led to a child being born with a spinal cord injury, brain damage and paralysis.

Can it really be a coincidence that major health crises are arising at the same time as the Province is making it harder to access the necessary care to mitigate those crises?

The Province has stated that their stripping away of health care protections is a “streamlining” of the system meant to reduce wait times and cost. But there’s no evidence suggesting that the Province is tracking the demographics of those affected by the syphilis outbreak, or how those demographics intersect with populations losing access.

While there’s no data to indicate that Pallister and company’s cuts have improved the health of Manitobans, there are plenty of examples that suggest their conduct is causing real harm.

Despite widespread concern about meth use, there seems to be more enthusiasm to penalize drug users than to help them access treatment. Following a rise in meth-related violence in hospitals, the Province was quick to announce their intentions to give security guards sweeping new powers to detain patients.

However, their action on addictions treatment has been much slower on the uptake. Press coverage of the meth and opioid crises have been full of reports of Winnipeggers seeking addictions treatment being forced to wait months for treatment, if they’re even able to access treatment at all.

Despite an increase in intravenous drug use and its alleged role in the syphilis crisis, Pallister has remained steadfast in his opposition to safe injection sites in Manitoba, stating as recently as December that “I don’t think safe injection sites work, and I don’t think experts agree on the issue,” despite the fact that evidence overwhelmingly shows that they do, both in terms of saving lives and increasing access to treatment.

The provincial government has taken some positive steps toward increasing access to addictions treatment, such as selling the old Vimy Arena at low cost to Manitoba Housing to facilitate the creation of the Bruce Oake Recovery Centre. However, multiple groups fought tooth and nail to oppose the opening of the treatment centre, including MLAs within the Progressive Conservative party.

When all is said and done, the Pallister government hasn’t made it easy to quantify the impacts of their health care cuts in raw numbers. There isn’t available data to concretely examine the overlap between health-care cuts, addiction, illness and access to care. But it doesn’t take a rocket scientist to see the ways in which their health-care policies serve to exacerbate Manitoba’s health crises, not solve them.

Published in Volume 73, Number 24 of The Uniter (April 4, 2019)

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