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From pay gap to ill-fitting PPE, female workers highlight challenges in U.K. health care – CBC.ca

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When Dr. Amun Sandhu moved to the United Kingdom a decade ago to study medicine, her superiors predicted her career advancement would be limited.

“You don’t tend to see very many female surgeons,” she said she was told. “You’ll end up being a GP, anyway.”

While Sandhu is now a doctor of acute medicine in East London, the Vancouver native still feels a gender bias. 

She recounted times when she has approached patients’ bedsides, flanked by a male nurse or junior colleague, and the patient will speak over her entirely, assuming the man is the doctor.

“You feel like you’ve done all the hard work and earned this, and you’re still being referred to as either a nurse or not even being referred to at all,” Sandhu said.

Lorraine Sunduza, a chief nurse in East London, said women are often charged with representing their gender when working in a sphere dominated by men. (Submitted by NHS East London Trust)

Lorraine Sunduza, the chief nurse for the East London Trust, has had similar experiences. Originally from Zimbabwe, Zunduza said there have been times when she has assigned tasks to her staff, only to have them question her authority. 

She said these “subtle” yet frequent occurrences have left her wondering, “If I was a man, would they do that? And if I was white, would they do that?”

Of the people who work for the National Health Service in Britain, 77 per cent are women. But while they make up more than three-quarters of the NHS workforce, women account for less than half of its most senior members, on average, according to a study published last month by the University of Exeter.

This lack of representation makes things more difficult for female health-care workers, said Sandhu — from commanding the respect they deserve to earning reasonable pay to being given the proper equipment to do their jobs.

Medical careers based on ’20th-century model’

The Exeter study, led by professor Ruth Sealy of the university’s business school, included an analysis of more than 3,000 directors across the NHS in England, as well as more than 70 in-depth interviews with board chairs, directors and aspiring executives.

The senior female NHS employees Sealy interviewed reported having overcome workplace inequality and domestic pressures to secure a leadership role. “Women who get to senior positions in leadership have been clinging on with their nails,” she said.

Ruth Sealy, a professor at the University of Exeter’s business school, said there are still some hospital alliance boards in the U.K.’s National Health Service that have little to no female representation. (Submitted by Ruth Sealy)

A major factor in determining whether someone in health care can advance to the next rung of the ladder is their ability to get experience in several different areas of medicine, says Sealy.

However, a lack of flexibility from senior decision-makers or an alliance board makes it difficult for women to advance, she adds.

“Medical careers are still based on a … 20th-century model,” said Sealy.

Sandhu said that in her experience, female consultants tend to be more aware of the work-life balance many women in health still navigate today.

When asked to comment on the support available for female staff, a spokesperson for the NHS provided the CBC with an email response, saying the NHS is “offering greater options for flexible working, modern and inclusive recruitment practices and a continued focus on staff health and well-being as set out in the NHS People Plan.”

Poorly equipped

A gender bias can also be seen in pay. According to a review by the U.K. government this year, the overall NHS gender pay gap is 23 per cent.

Similar numbers can be seen in Canada. In Ontario and British Columbia, female doctors earn 30 per cent and 36 per cent less, respectively, than their male counterparts, according to a report published in the Canadian Medical Association Journal in August.

The gap is slightly smaller in the United States, according to a 2019 report published by medical news site Medscape. The average U.S. male doctor earns 25 per cent more than his female equivalent.

Sandhu, centre, poses with female colleagues in their oversized personal protective equipment earlier this year. (Submitted by Amun Sandhu)

Another way the lack of female leadership affects women in the NHS is that they aren’t always provided appropriate equipment.

In the early stages of the pandemic, Sandhu and fellow health-care workers were “fit-tested” to ensure their personal protective equipment (PPE) was sufficient. The test involved having a fine spray, meant to mimic the virus, misted over their masked faces. 

If the PPE was reliable, the wearer wouldn’t be able to smell or taste the spray. But Sandhu and many other female colleagues reported an orange smell and a bitter taste in the back of their throats. In other words, the mask didn’t fit properly.

Sandhu said this demonstrates that female health-care workers weren’t “taken into consideration” with regards to proper PPE, including masks, scrubs and gowns.

Most PPE is based on the sizes and characteristics of male populations from certain countries in Europe and the United States, according to a 2017 report from the U.K.’s Trades Union Congress. That means only three in 10 women in the U.K. have PPE that’s designed for their bodies, the report states.

Sandhu said many of her female colleagues had to use tape to adjust their XXL scrubs, and when surgical caps were in short supply, they re-purposed excess gown material for handkerchiefs to tie around their heads.

“We were told, basically, ‘This is what we have, this is what you’ll need to use,'” said Sandhu.

The quality of supplies has improved greatly since the number of coronavirus cases dropped, Sandhu said, but earlier in the pandemic, the lack of proper PPE left her feeling unprotected.

Sealy said that “when you are in less than a powerful position, it’s much harder to question the way that things are being done, and to question why you don’t have the PPE … and to push when you don’t get what you should be given.”

Women the ‘shock absorbers’ of society

Dr. Roopa Dhatt, a doctor of internal medicine in Washington, D.C., who also serves as the executive director of Women in Global Health, said “there are superhuman expectations on women.”

Dr. Roopa Dhatt is the executive director of Women in Global Health, an organization working towards gender equality in global health leadership. (Peter Braverman)

She calls women the “shock absorbers” of society, saying they continue to work long hours for less pay than men in order to keep their communities moving forward.

Women in Global Health collaborated with the World Health Organization on a 2019 report on female leadership in health, which found that women make up more than 70 per cent of the global health workforce, but only hold one in four leadership positions. 

“If we want to really actually make headway in creating not only stronger, more resilient health systems … women need to be in leadership roles. They’ve demonstrated it. They have the expertise. They have the power,” said Dhatt.

But those who have power also know they can be subject to abuse. 

British Columbia’s chief medical officer of health, Dr. Bonnie Henry, spoke recently about the importance of addressing gender bias in order to ensure better treatment for the next generation of leaders.

In a panel presentation at the Union of B.C. Municipalities last week, Henry opened up about death threats and other negative comments she has received since the start of the pandemic. 

“I sense that people find that [kind of abuse is] OK for a woman who is up-front, more so than some of our male leaders,” Henry said.

WATCH | Dr. Bonnie Henry speaks about receiving abuse:

B.C.’s Provincial Health Officer talks about concerns over her safety as she handles the COVID-19 pandemic. 1:31

Despite the challenges for women in health care, Sandhu said she takes inspiration from female medical leaders like Henry and Canada’s chief medical officer, Dr. Theresa Tam.

“The way that they’re conveying their messages is beneficial to female physicians and nurses and women in health care in general,” Sandhu said.

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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