Hon. Mohamed-Iqbal Ravalia: Honourable senators, I rise today in support of Bill S-280, An Act respecting a national framework on sickle cell disease. I applaud our colleague Senator Mégie for her extensive consultation with physician specialists and the presidents of the Canadian and Quebec sickle cell disease associations, as well as patient advocates, in helping to develop this bill. I would also like to recognize our colleague Senator Jane Cordy, who championed the designation of June 19 as National Sickle Cell Awareness Day in 2017.

As Senator Mégie has clearly outlined, this bill aims to bridge the current gaps in sickle cell disease knowledge, diagnosis and management. It aims to raise awareness amongst health care providers, improve research and facilitate evidence-based knowledge exchanges through a national registry. It will also help address the existing disparities, and ensure equal access to universal newborn screening and diagnosis.

In Canada, an estimated 6,000 Canadians live with sickle cell disease, and approximately 1 in 2,500 newborns will have the disease.

Sickle cell disease is a hereditary blood disorder characterized by abnormal hemoglobin — the protein responsible for carrying oxygen in red blood cells. The condition primarily affects individuals of African, Mediterranean, Middle Eastern and Indian descent. These deformed red blood cells can block blood vessels, leading to a reduction in oxygen supply to the tissues — the so-called vaso-occlusive crisis.

Individuals living with sickle cell disease frequently experience these crises, characterized by severe pain due to blocked blood vessels. These episodes can occur anywhere in the body, and often necessitate hospitalization for pain management and hydration.

The destruction of sickle cells can lead to chronic anemia, causing fatigue, weakness and pallor. It can also increase susceptibility to infections.

Prolonged vaso-occlusion can result in damage to other organs, often affecting the liver, kidneys, lungs and bony skeleton. Over time, this leads to chronic organ dysfunction.

Sadly, sickle cell disease also increases the risk of stroke, particularly in children. The abnormal blood flow causes sickle cells to clog up arteries, leading to brain damage and neurological deficits.

Honourable senators, in my own experience during my training as a physician in Southern Africa, I witnessed the tragic consequences of this disease and its devastating impact on the quality of life of those affected.

Many countries have implemented newborn screening programs to identify infants with sickle cell disease early, allowing for prompt intervention and management. With our changing demographics, it is imperative that we standardize these screening programs across the country to target at-risk populations.

Addressing pain is a crucial aspect of the management of sickle cell disease. Pain-relief strategies may include medications, physical therapy and psychological support. However, individuals with the disease are often labelled “drug seeking” and denied appropriate medications for pain relief, particularly in settings where there is a poor understanding of the disease and its devastating sequelae.

Despite advances in the understanding and management of the disease, challenges persist. As Senator Mégie outlined, access to comprehensive care, including specialized clinics and medications, remains elusive in many parts of our country.

Sadly, the spectre of anti-Black racism rears its ugly head in the overall response to individuals living with sickle cell disease. These unaddressed issues of racism within the health care system against individuals who are susceptible to the disease create additional barriers to care for those who need it most.

The lack of funding for research in Canada puts us at a significant disadvantage and needs to be addressed by the funding agencies and federal government. There holds strong promise for curative potential using gene therapy and gene-editing techniques, a transformative development that is now available in the United Kingdom.

Colleagues, sickle cell disease is a complex genetic disorder with a wide-ranging impact on the health and well-being of affected individuals. Ongoing research, improved diagnostics and enhanced access to specialized care are essential in mitigating the complications associated with it.

As we move forward, a multi-faceted approach involving medical, genetic and social interventions is crucial to improve the quality of life for those living with this challenging condition.

Honourable senators, this is an important bill and should be referred to committee for further study and consideration.

I thank you. Meegwetch.

(On motion of Senator Martin, debate adjourned.)

Hon. Mohamed-Iqbal Ravalia: Senator Yussuff, there’s a significant concern being expressed, given that we have advances in digital technology, of guns being printed by 3-D measures and other such options, particularly in the underworld. To what extent has your bill studied that concern?

Hon. Mohamed-Iqbal Ravalia moved second reading of Bill C-284, An Act to establish a national strategy for eye care.

He said: Honourable senators, it is my pleasure today to speak to you as the sponsor of Bill C-284, An Act to establish a national strategy for eye care, and designate an age-related macular degeneration awareness month.

Our vision allows us to experience the beauty of our world, to connect with others and to navigate the complexities of daily life. However, for too many Canadians, vision care is a luxury. Access to essential vision care services remains a challenge, and it’s one that we must address with both urgency and compassion.

Advances in technology and virtual care have opened pathways in this regard. Vision care is an integral part of a comprehensive health care system, and we should make it a priority to ensure that high-quality vision care is accessible for all.

In my clinical practice, I have witnessed the tragic sequelae of preventable ocular diseases in many instances purely on the basis of a lack of access or affordability. Vision impairment, whether through experiencing visual challenges or requiring assistance such as glasses, contacts or other aids, has touched the lives of virtually everyone either directly or through loved ones.

Before I begin, I want to express my gratitude to MP Judy Sgro, who has championed the efforts towards a strategy for vision care in the other place and has been a national advocate for people with age-related macular degeneration and various vision health issues.

I also applaud the careful thought and consideration of my members on the Standing Committee on Health in the other place. This past spring, members carefully studied this bill and helped maintain the federal and provincial jurisdictional limits on health care, professional training and guidelines. This bill passed with resounding unanimity, underscoring the collective recognition of the importance of vision care in our society.

We are presented with a unique opportunity to champion a cause that touches the lives of individuals, families and communities across our country.

The vision loss crisis in Canada requires a coordinated response, and this is what the national eye care strategy is all about. Over 8 million Canadians — or one in five — have an eye disease. There are 1.2 million Canadians who live with vision loss or blindness. There were over 1,200 deaths associated with vision loss in 2019 alone.

Meanwhile, 75% of vision loss cases can be prevented if patients are diagnosed early and have access to treatment.

Colleagues, the need for a national strategy is necessary to address the gaps and inconsistencies in access and delivery of vision care across the country. As we know, with our 10 provinces and 3 territories, it can feel like we sometimes have 13 separate health care silos or that we’re living in 13 fiefdoms.

Basic eye examinations are not universally covered under provincial health care plans. Some provinces provide coverage for specific groups such as children, seniors or individuals with certain medical conditions. Many Canadians rely on private insurance plans to cover the costs of routine eye exams, glasses and contact lenses. But even with private insurance, there might still be out-of-pocket expenses for vision care, especially for individuals who have no coverage. The cost of eyeglasses, contact lenses and certain eye treatments can be a significant barrier for Canadians accessing the necessary care.

Accessibility also depends on where you live, with urban areas generally having better access to eye care facilities than rural or remote ones. Practically speaking, this can impact the ability of individuals to access preventative care and may contribute to delayed diagnosis and treatment of eye conditions. By detecting these early, the health care system can avoid the costs associated with advanced treatments and complications.

The challenges associated with the delivery of vision care services have been exacerbated by COVID with many Canadians missing regular eye appointments, surgeries and other treatment plans, increasing the risk of more complications.

Vision loss has a profound impact on individuals, their families and society, costing our economy an estimated $32.9 billion a year. Of this cost, $4.2 billion is attributed to reduced productivity in the workplace. Over half the cost — $17.4 billion — is attributed to the reduced quality of life, which is primarily due to a loss of independence, especially in our aging demographic. Over $983 million was spent last year across Canada on injections to treat macular degeneration.

Losing one’s vision increases mental, financial and social hardship. It can lead to a loss of mobility, an inability to live independently, to drive, to read or to participate in physical activity. It can result in the loss of social interaction, which can often lead to loneliness, isolation and the mental sequelae thereof. A national strategy can promote cost-effective and efficient use of health care resources and dollars to help combat vision loss across the country.

The bill before us today is straightforward. It calls for the Minister of Health in consultation with representatives of provincial governments responsible for health, Indigenous groups and other relevant stakeholders, including health care researchers and practitioners, to develop a national strategy to support the prevention and treatment of eye disease as well as the vision rehabilitation plan to ensure better health care outcomes for all.

It outlines the strategy that encompasses preventive care, early detection, treatment and accessibility. The strategy would aim to raise awareness of the impact of vision loss and blindness, improve eye health care and support and foster innovative research to advance new therapies for vision loss and rehabilitation. The bill is also calling on enhanced access to eye health care for Indigenous people.

While there are benchmarks, including timelines, by design, it is not overly prescriptive in what the strategy should entail. The government must be allowed the flexibility to respect the consultative process of this legislation. This legislation would ensure a coordinated national strategy aimed at ensuring Canadians have access to vision care regardless of where they live.

It also recognizes Canadians’ experiences and struggles with age-related macular designation through a designation of February as age-related macular degeneration awareness month.

Age-related macular degeneration is a condition that affects many Canadians over the age of 55 and is the leading cause of blindness among these Canadians. I know that many of us are in this demographic.

This condition affects the central vision, which is the most important part of an individual’s eyesight. It is a progressive condition that leads to vision loss and may increase the risks of other health concerns such as anxiety, depression and progression to dementia.

As our population ages, we must be vigilant in promoting awareness around age-related macular degeneration, increasing accessibility to currently available treatments and supporting the necessary research for developing new treatments needed by many Canadians across our provinces and territories.

We have the opportunity to be one of the global leaders in the delivery of vision care. We can draw from strong examples in other nations for service delivery and accessibility in vision care. While we know that there is no one-size-fits-all model for the delivery of care across different countries, the strategy will examine existing strategies, frameworks and best practices, as well as lessons learned from other jurisdictions.

Honourable colleagues, a national strategy would address the wide inconsistencies in access to care; work to prevent and slow the progression of vision loss, where possible; help us tailor services to the needs of all Canadians in a culturally appropriate manner; and allow us to foster research and innovation to better inform policy-makers on this issue.

This bill is important to millions of Canadians and is long overdue. Let us acknowledge the tireless effort of health care professionals, advocacy groups and individuals who have championed this cause and called for federal leadership. Their commitment to the well-being of Canadians deserves our utmost respect and support.

Making eye health and vision care a health priority requires all of our support. Colleagues, we can work together to ensure that 1.5 million Canadians with sight loss are provided with the necessary supports and the opportunity to live productive, healthy lives. Meegwetch. Thank you.

Hon. Mohamed-Iqbal Ravalia moved the adoption of the report.

(On motion of Senator Housakos, debate adjourned.)

[English]

On the Order:

Resuming debate on the motion of the Honourable Senator Pate, seconded by the Honourable Senator Duncan:

That the Standing Senate Committee on National Finance be authorized to examine and report on a road map for post‑pandemic economic and social policy to address the human, social and financial costs of economic marginalization and inequality, when and if the committee is formed;

That, given recent calls for action from Indigenous, provincial, territorial and municipal jurisdictions, the committee examine in particular potential national approaches to interjurisdictional collaboration to implement a guaranteed livable basic income; and

That the committee submit its final report no later than December 31, 2022.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, it is my privilege to rise to speak to Inquiry No. 5, which draws attention to the budget entitled A Made-in-Canada Plan: Strong Middle Class, Affordable Economy, Healthy Future.

In response to an increase of police-reported hate crimes, including the hate faced by 2SLGBTQI+ communities, Budget 2023 has included plans to introduce a new action plan to combat hate in this country.

We live in a time of increased polarization, with the rise in hateful messages and misinformation targeting many, but in particular our queer and trans communities, fostering fear and isolation. The federal government recognizes this, and steps have been taken, including the development and implementation of the 2SLGBTQI+ plan. The plan in 2022 helped advance equality and the rights of community members throughout Canada and is helping several queer and trans organizations and communities across the country build resilience in the wake of increasing hate.

Just this past August, in my home province of Newfoundland and Labrador, the federal government announced funding through the action plan to two local organizations, First Light St. John’s Friendship Centre and the Quadrangle LGBTQ Community Centre, whose respective goals are to support, among others, Indigenous women and 2SLGBTQI+ communities. The projects receiving support are focused on ending gender-based violence and providing affirming health care.

The 2SLGBTQI+ communities contribute immeasurably to Newfoundland’s cultural fabric, arts and business communities. They are our friends. They are our family. They are our neighbours. They continue to play a leading and ongoing role in the broader movement for their rights and acceptance in our country through advocacy, education and visibility. Colleagues, we must stand by them.

In May, the Newfoundland and Labrador Queer Research Initiative launched a collection of rare documents and photographs detailing the province’s LGBTQ+ past. With credit to Sarah Worthman, the non-profit’s Executive Director, the new archive tells the hidden stories of gay, lesbian, bisexual and gender-diverse Newfoundlanders and Labradorians throughout our history. As Ms. Worthman eloquently stated in an interview, “. . . it’s much harder to hate on someone that you know as opposed to someone that you don’t.”

In my own career, I have witnessed the devastating impacts on the mental health of 2SLGBTQI students — students who are stigmatized by name-calling, microaggressions, marginalizations, exclusion and sometimes violence.

The implementation of this plan to combat hate is an essential next step to continue on the progress that we’ve made. This plan signifies a continuing commitment to tackling the systemic issues that have perpetuated discrimination and violence against these communities. It recognizes that in order to secure a prosperous future for all Canadians, we must confront the hatred and prejudice that undermine our values of equality, diversity and inclusivity.

The significance of this plan extends far beyond its immediate impact on hate crimes. It goes to the heart of what we stand for as Canadians — a nation that values the dignity and worth of every individual, regardless of who they are or whom they love. By addressing hate, we are not only helping safeguard the lives of 2SLGBTQI+ Canadians, but also reinforcing our commitment to building a society where everyone has an equal opportunity to thrive.

Honourable senators, I look forward to seeing the development and implementation of this plan with specific measures to combat hate as we move towards a more equitable, inclusive and, hopefully, prosperous future for our 2SLGBTQI communities and other marginalized groups. A prosperous future in the truest sense is one where every Canadian can live their lives authentically without the fear of discrimination or violence.

Thank you, meegwetch.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, it is my privilege to rise today to recognize the Make-A-Wish Foundation of Canada, which for the past 40 years has granted 38,000 life‑changing wishes for children with critical illnesses across Canada. With a robust team of volunteers, this national organization is responding to the needs of children across the country.

In 1983, Nigel Brown and Robb Lucy established the first Canadian chapter of the Make-A-Wish Foundation. They were inspired by a 13-year-old who was diagnosed with leukemia and wished to go visit her grandparents in Germany. When Nigel and Robb heard the story, they paid for the trip personally.

In my home province of Newfoundland and Labrador, the VOCM Cares Foundation was established in 1986 by the Butler family, owners of Radio Newfoundland, with a commitment to supporting charities. The foundation recognized the urgent requirements to provide the hope, strength and joy to a wish child facing critical illnesses in my province, and helped pave the way for our provincial chapter.

With the integral support of devoted volunteers, over 900 wishes have been granted for children in my province, ranging from the Avalon Peninsula to northern Labrador, and this number continues to grow. For Connor, a young boy from central Newfoundland with cancer, travelling to Disney World with his family provided hope and joy that he had not seen in the darker days of his treatment. For Ali, a young girl from Westport with complex genetic conditions, having “Rock Solid Builds” build her a dream home playhouse provided a haven from the hospital beds she had become so accustomed to. For Theo, who is with us here today, attending a fortieth-anniversary trip to the Give Kids The World Village in Florida with 40 wish families across Canada meant a sense of togetherness and connectivity.

The support of my province for the Make-A-Wish Foundation of Canada is unwavering, from ATV rides in rural communities to the Doctors for Wishes team in central Newfoundland, to the HMCS St. John’s navy crew riding over 900 kilometres across the province to raise funds and awareness.

Catalyzing this remarkable effort is Dr. Desmond Whalen. His altruistic spirit, generosity and unwavering support embody and reflect the essence of my province and its long history of always being there for those in need.

Honourable senators, please join me in welcoming the team from Make-A-Wish Canada in our chamber today, as well as Theo and his family, as they continue their work to brighten the lives of children with critical illnesses in our communities. Thank you. Meegwetch.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, it is my pleasure to rise today to speak to the inquiry initiated by Senator Woo. The purpose is twofold: to celebrate the invaluable contributions that Chinese Canadians have made but also to reflect on the prejudice, exclusion and discrimination that Canadians of Chinese descent have faced and continue to face.

I would like to thank Senators Jaffer, McCallum, Simons, Oh and Kutcher for speaking to this important matter — and, of course, to our speakers today as well.

The contributions of the Chinese community in Newfoundland and Labrador are a significant but often overlooked aspect of our province’s history. The Chinese community has played — and continues to play — a vital role in shaping our cultural, economic and social fabric.

The first Chinese immigrants arrived in Newfoundland in the 1890s, and word spread throughout St. John’s that two Chinese immigrants would be opening a laundry business. Over the next few decades, the city and the province would continue to attract Chinese immigrants.

Colleagues, this was at a time when Newfoundland’s population was almost entirely White, Christian and English-speaking. In 1906, the province had legislation — the Act Respecting the Immigration of Chinese Persons — that imposed a $300 head tax on each Chinese immigrant entering the colony. This equalled between one and three years’ earnings and was a significant barrier to entry for Chinese immigrants. Despite the challenges and prejudice faced by Chinese Newfoundlanders, their perseverance and strength as a community remained remarkable, and their contributions to our society and growth continued to be exceptional.

In the 1920s, the Chinese community turned towards opening restaurants and is now credited with helping build the dining-out culture in our province. Early Chinese restaurants served foods Newfoundlanders knew about and loved, like fish and chips and roast chicken. Despite this, Chinese immigrants maintained their traditional cuisine at home and faced the challenges of sourcing traditional ingredients. In downtown St. John’s in 1968, Mary Jane’s was the first health food store to carry some Chinese groceries. Today, there are multiple grocery stores in St. John’s as the community continues to grow and thrive.

When Newfoundland joined Confederation in 1949, the Chinese head tax came to an end. With changes to immigration policy in 1967, Chinese immigrants to Newfoundland and Labrador became more diversified in their professions, backgrounds and practices, including health, science, engineering, mining and the fishing industry.

In 1976, The Chinese Association of Newfoundland & Labrador was established to promote Chinese culture and tradition throughout our province and nurture communities in preserving and celebrating Chinese heritage. The association is operated by volunteers who organize and promote events, including Chinese New Year celebrations, performances and memorial services. In 1981, the association, along with their community partners, erected a memorial in Mount Pleasant Cemetery in St. John’s to honour the Chinese immigrant community in Newfoundland from the time of their first arrival in the 1890s.

Elsewhere in St. John’s, a different memorial stands to honour the 300 Chinese men that had to pay the head tax in Newfoundland. This monument was created in 2010 by the Newfoundland and Labrador Head Tax Redress Organization, a group working to educate on and preserve the awareness of this dark chapter in our history. The monument is placed on the site of Saint John’s’ first Chinese hand laundry, which was opened in 1895.

In 2006, the Government of Newfoundland and Labrador made a formal apology for the Chinese head tax, delivered by then‑premier Danny Williams.

Today, our Chinese community is the largest visible minority, representing 1.3% of St. John’s’ population, or approximately 1,500 people. In broader Newfoundland, there are approximately 2,300 people of Chinese ethnicity, making up 0.5% of the population of our province. Despite these seemingly small numbers, the Chinese community in Newfoundland is strong, active and heavily influential.

I’m also proud to say that the growth of Memorial University has been a source for an increase in Chinese immigration to Newfoundland, with students and academics being drawn to the province for their education and for educating us.

Members of the community have continuously brought their traditions to Newfoundland and Labrador and generously shared their culture with the non-Chinese community. Recently, members of the community have brought traditional music to St. John’s audiences with performances featuring the traditional instrument, the guzheng. The YY Guzheng Ensemble has been performing for the St. John’s community and spreading the love for Chinese music throughout the community. The group has 15 members with ages ranging from their early teens to their 70s with a common love for music and tradition.

Honourable senators, despite a dark chapter and the incredible difficulties that the community faced, today they are an integral part of our province’s history. Chinese immigrants and their descendants continue to play a crucial role in our economic, cultural and social development. Their legacy of resilience and determination serves as a testament to the importance of recognizing and addressing historical injustices, like the head tax, while celebrating the rich diversity that makes my beloved province a unique and inclusive place to call home. Thank you, meegwetch.

(On motion of Senator Petitclerc, debate adjourned.)

Hon. Mohamed-Iqbal Ravalia: Honourable senators, today I rise to speak in support of my colleague Senator Stan Kutcher’s Motion No. 113 to authorize the Standing Senate Committee on Social Affairs, Science and Technology to study health misinformation, its impacts on Canadians and potential remedies. Today, I would like to focus my time on discussing some of what we currently know about vaccine hesitancy and misinformation in Canada, its causes and potential solutions.

As the world continues to work through the COVID-19 pandemic, vaccinations continue to play a critical role in keeping our communities safe. We must recognize that the pandemic had a once-in-a-generation impact. It is inevitable that there would be diverse viewpoints on such a seismic event. Unfortunately, in a digitized age, it is easier than ever before for those with views based on misinformation — whether intentionally so or not — to spread their message. At this time — when the need for vaccine uptake is at an ultimate high — vaccine hesitancy has only grown, and continues to increase not only for COVID-19 vaccines, but also for other routine immunizations. In effect, this creates windows of opportunity for the spread of preventable diseases — many of which we’ve even forgotten about — and the attendant risk to human life.

While it is true that any vaccine may have varying side effects as it is introduced to an individual’s immune system, overall vaccines remain a safe and critical way to prevent severe diseases and save lives. We have known this since Edward Jenner first developed the smallpox vaccine in 1796, which later eradicated the disease. From the beginning of the development of the first vaccines until today, humanity has continued to witness the strengths and benefits of vaccines, as they have prevented mass deaths from diseases like polio, measles, rubella, tetanus and hepatitis B.

In the past few decades, recently developed vaccines have provided people with safety against diseases like shingles; increased access to protection against HPV; and given children protection from the painful childhood disease — which I’m sure many of us have experienced — chicken pox. Just last week, Dr. Katalin Karikó and Dr. Drew Weissman were awarded the 2023 Nobel Prize in Physiology or Medicine for their work that enabled the development of effective vaccines against COVID-19 using the mRNA technology.

New vaccines are currently being developed, and give us hope for the prevention of future pain and suffering. As researchers work hard to find protection for the world’s most vulnerable populations from diseases like malaria and HIV, we must stay vigilant in ensuring that public trust in vaccines and scientific research is not tarnished by misinformation. The hard work of doctors, scientists and researchers to prevent the spread of these diseases will only be realized if the vaccines are taken up by the public, and proper protocol is developed and employed to ensure accurate education about the benefits and potential side effects — I repeat, potential side effects — of any given vaccine, given the fact that nothing is 100% proven.

Global trust in data-driven science is critical for the safety and health of all populations across our globe, and to prevent societies from backsliding into preventable health crises. UNICEF has reported that the public perception of the importance of vaccines for children has declined through the pandemic in 52 of the 55 countries it studied. One of those countries, unfortunately, is Canada. UNICEF has indicated that factors contributing to this decline include “. . . uncertainty about the response to the pandemic, growing access to misleading information, declining trust in expertise, and political polarization.”

This increase in vaccine hesitancy coincides with an increase in preventable diseases among children who are unvaccinated. UNICEF has reported that the number of measles cases in the world doubled in 2022, and the number of children with polio increased by 16% over the previous year.

The spread of COVID-19 vaccine hesitancy, along with more generalized fear mongering and misinformation about other vaccines, is of great concern. Confidence in vaccinations has been declining in Canada to the detriment of the health of our communities and our children as we see outbreaks of preventable diseases here in our own nation. Well-proven vaccines are being baselessly attacked in some circles, with fewer people accessing them — leading to preventable childhood diseases, like tetanus and measles, that have a negative impact on communities and those who are unfortunately impacted.

We also know that many of the children in Canada who missed vaccines throughout the pandemic live in communities that are often marginalized or in hardship areas. However, we have evidence from various studies that shows us there are ways to support Canadians who are hesitant about vaccines, and to rebuild the trust in our public health system.

According to recent surveys through the Public Health Agency of Canada, the most trusted source of information on vaccine safety continues to be medical health professionals. Among those who were hesitant about vaccines, the most common path that led to them choosing to have their children vaccinated was the discussions they had with their doctors, nurse practitioners, public health nurses and other public health representatives. These findings are reassuring in that they emphasize the significant role that public health care workers play in dispelling myths about vaccines and educating community members about the safety, efficacy and significance of vaccination and immunization.

In my own experience with children in Newfoundland and Labrador, I have always been impressed with how vigilant our public health nurses are and continue to be in ensuring that children’s immunization records are well-kept and that those who are missing immunizations are followed up and vaccinated in a timely manner. Where hesitancy comes up, appropriate consultation with health care providers is arranged.

The incidents of preventable childhood diseases in Newfoundland and Labrador are very low, and I believe this reflects the solid foundation of community immunization that has been established by a rich tradition of public health nurses and physicians.

This is an example of the strength of community-based efforts in public health education in support of vaccination. Establishing and re-establishing trust in vaccines is critical in protecting the health and well-being of all of our communities.

Honourable senators, it is important that we learn more about the effects of misinformation on vaccines and public health across the communities we represent in this country. I thank Senator Kutcher for opening this platform to dialogue and bringing forward such an important initiative. And for those of you who have not yet had your shingles vaccine, my prescription pad is ready and waiting. Thank you, meegwetch.

(On motion of Senator Martin, debate adjourned.)

On the Order:

Resuming debate on the inquiry of the Honourable Senator Woo, calling the attention of the Senate to the one hundredth anniversary of the Chinese Exclusion Act, the contributions that Chinese Canadians have made to our country and the need to combat contemporary forms of exclusion and discrimination faced by Canadians of Asian descent.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I have the honour to table, in both official languages, the second report of the Standing Joint Committee on the Library of Parliament entitled Reappointment of Heather Powell Lank as Parliamentary Librarian.

Hon. Mohamed-Iqbal Ravalia, Joint Chair of the Standing Joint Committee on the Library of Parliament, presented the following report:

Tuesday, June 20, 2023

The Standing Joint Committee on the Library of Parliament has the honour to present its

FIRST REPORT

Your committee recommends to the Senate that it be authorized to assist the Speaker of the Senate and the Speaker of the House of Commons in directing and controlling the Library of Parliament, and that it be authorized to make recommendations to the Speaker of the Senate and the Speaker of the House of Commons regarding the governance of the Library and the proper expenditure of moneys voted by Parliament for the purchase of documents or other articles to be deposited therein.

Your committee recommends:

(a)that its quorum be fixed at six members, provided that each House is represented, and a member from a non-government party or recognized parliamentary group and a member from the government are present, whenever a vote, resolution or other decision is taken; and

(b)that the joint chairs be authorized to hold meetings to receive evidence and to have that evidence published when a quorum is not present, provided that at least three members are present, including a member from a non-government party or recognized parliamentary group and a member from the government, provided that each House is represented.

Your committee further recommends to the Senate that it be empowered to sit during sittings and adjournments of the Senate.

A copy of the relevant Minutes of Proceedings (Meeting No. 1) is tabled in the House of Commons.

Respectfully submitted,

MOHAMED-IQBAL RAVALIA

Joint Chair

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I rise today to recognize the meaningful work of Dolly Parton’s Imagination Library as well as the very exciting expansion of this initiative to my home province of Newfoundland and Labrador.

The Imagination Library is the main program provided by Dolly Parton’s Dollywood Foundation, which was founded by the legendary musician in 1995 to honour her father who could not read or write. The program seeks to promote early childhood literacy and a love for reading by gifting children a book at no cost every month during their first five years of life. The books are carefully selected by developmental professionals and are age appropriate for the children receiving them. Since the program’s initiation, over 174 million books have been mailed to children in five countries, with 1.9 million books being mailed to children every month.

After learning that Newfoundland and Labrador had not yet been involved in the Imagination Library program, Carolyn Clarke, a member of my community and a devoted educator, championed the efforts herself to find sponsors in the Twillingate, New World Island and Boyd’s Cove areas. It is now reported that 90% of children in our communities have been successfully registered for the program and have already received their first book. She has received invaluable support from Renee Sherstobetoff, who is also a fellow Newfoundlander.

The Imagination Library program in Newfoundland and Labrador is now set to expand across the province after The Waltons Trust provided a generous gift that will make it possible for the children all across my province to have access to these gifted books. This is made possible with the integral support of Senior Regional Director Jeanne Smitiuch and her team.

Honourable senators, I know we can all agree on the importance of childhood literacy development and encouragement of reading habits early on in a person’s life and health. I encourage everyone who is interested in exploring the work of the Dolly Parton Imagination Library to visit their website to learn more.

I’d like to thank and recognize our former Senate colleague Diane Griffin, whose passionate advocacy led to Prince Edward Island being the first in Canada to launch this program as a province-wide initiative. Her tremendous efforts continue to impact the lives of many as she writes her next chapter, and we miss her dearly. Thank you to Nora Briggs from The Dollywood Foundation U.S.A., The Waltons Trust and the Northwest Territories Literacy Council for your ongoing commitment to childhood literacy, development and to our future.

Perhaps what saddens me the most today is that “Jolene” could not be here; she, unfortunately, did take off with her man. Thank you, meegwetch.

Hon. Mohamed-Iqbal Ravalia: Thank you, Your Honour, and let me add my name to the list of congratulations to you. It’s wonderful to see you in the chair.

Honourable senators, I rise today with a deep sense of respect and gratitude as we recognize the remarkable achievements of Dr. Ian Bowmer, who is joining us today. A highly skilled clinician, medical educator, researcher and trailblazing leader, Ian has carved out a career that has influenced an entire generation of medical practitioners.

As an internist, infectious disease specialist and HIV/AIDS care provider and researcher for 40 years, Dr. Bowmer is recognized as an international authority and global expert in this field. He has held several pivotal positions throughout his career. He was elected president of the Royal College of Physicians and Surgeons of Canada in February 2019. Effective March of this year, he accepted the role in an interim position. His resolute and steadfast commitment navigated the Royal College through the turbulent waters of the recent pandemic. Ian has also served as executive director and CEO of the Medical Council of Canada for 11 years, retiring in October 2018. He is the recipient of several honours, including Canada’s One Hundred and Twenty‑Fifth Anniversary of the Confederation of Canada Medal; election to the Royal College of Physicians of London, England; and the Senate One Hundred and Fiftieth Anniversary Medal for contributions to the community — just to name a few.

Beyond his professional accomplishments, Dr. Bowmer is known for his compassion and dedication to serving underserviced communities. He has been actively involved in outreach programs, volunteering his time and expertise to help improve access to health care and reduce health disparities, making a significant impact on the lives of many.

My own career has been profoundly influenced by his vision and support of enhancing rural and remote medicine. Dr. Bowmer is professor emeritus and the former dean of medicine at the Faculty of Medicine at Memorial University. He appointed me to the faculty in 1992, meaning that, yes, he is indeed my former boss and someone who I continue to admire and respect. He laid the foundation for medical training in a longitudinal fashion outside of a tertiary care environment in my province. Ian has a deep passion for the arts and literature, superb culinary skills à la Gordon Ramsay and a truly altruistic and caring persona balanced by a mischievous sense of humour.

My colleagues in this chamber and I applaud you for your many contributions to our home province of Newfoundland and Labrador and to our country and for your global achievements.

Thank you. Meegwetch.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, this past Wednesday marked the beginning of Ramadan, the ninth month of the Islamic calendar and an important religious holiday celebrated by Muslims in Canada and around the world. Ramadan is a time for prayer, spiritual introspection, reconnecting with loved ones and giving back to your community. The traditions of Ramadan honour the values at the heart of Islam, like benevolence, generosity, peace and service to others.

Ramadan reminds us of the essential importance of caring for one another, despite our differences. During Ramadan, Muslim families and friends fast during the daytime and break their fast in the evening with an iftar. Fasting during Ramadan is one of the five pillars of Islam. These pillars, or duties, form the basis of how Muslims practise their religion.

Honourable senators, this evening I have the honour of co‑hosting an iftar dinner in the Senate foyer with His Excellency Fahad Saeed Al Raqbani, the Ambassador of the United Arab Emirates to Canada, at 7 p.m., with the breaking of the fast beginning at 7:25 sharp as the sun sets. I sincerely hope that you will consider joining us for an authentic Ramadan meal.

For all those who are observing the sacred month in my home province of Newfoundland and Labrador and beyond, I’m wishing you all a blessed and peaceful Ramadan. On behalf of my fellow Muslim senators — Senators Ataullahjan, Jaffer, Yussuff and Gerba — and, in fact, on behalf of all of us in this chamber, I would like to wish all observants a Ramadan Mubarak! Thank you. Meegwetch.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I rise today to speak in support of Bill S-248, An Act to amend the Criminal Code (medical assistance in dying), introduced by Senator Wallin. I would like to thank Senator Wallin, whose continued advocacy for expanding eligibility for advance requests for medical assistance in dying, or MAID, is grounded in evidence-based research, compassion and a patient-centred approach.

This bill contains two main objectives, the first being that it would amend the Criminal Code to permit an individual whose death is not reasonably foreseeable to enter into a written agreement to receive MAID on a specified day if they lose capacity to consent prior to that day. The second objective is to permit an individual who has been diagnosed with a serious and incurable illness, disease or disability to make a written declaration to waive the requirement for final consent when receiving MAID if they lose capacity to consent, are suffering from symptoms outlined in their written declaration and have met all other relevant safeguards outlined in the Criminal Code.

In effect, this bill would allow competent persons to make advance requests for medical assistance in dying. In the most practical sense, it would broaden the range of options for patients who are faced with difficult circumstances and, at times, agonizing decisions.

Honourable senators, we have heard from Senators Wallin, Seidman and Kutcher, who delivered well-researched and articulate arguments as to why this bill needs to be further studied at committee. Senator Wallin’s proposal for expanding the right to advanced requests for MAID isn’t new. As Senator Seidman highlighted, it was a recommendation made more than six years ago to the Special Joint Committee on Medical Assistance in Dying, which she was a member of, by many witnesses with knowledge and expertise in the areas of law, health and ethics. Senator Wallin also proposed this amendment last year during our study of Bill C-7, which passed in this chamber but was later rejected by the government of the day, who handed it over to the Special Joint Committee on Medical Assistance in Dying for further study and consideration.

I would like to commend the work of the Special Joint Committee on Medical Assistance in Dying, which, as we are all aware, has conducted a parliamentary review on some of the key issues in Bill C-7, including advanced requests. The committee, co-chaired by our honourable colleague Senator Martin, recently tabled their second report, Medical Assistance in Dying in Canada: Choices for Canadians. This work is supported by our honourable colleagues including Vice-Chair Senator Mégie and members Senators Dalphond, Kutcher and Wallin. I’d like to highlight that in this report, the committee recommends that the Government of Canada amend the Criminal Code to allow for advance requests following a diagnosis of a serious and incurable medical condition, disease or disorder leading to incapacity.

Honourable senators, legislation can often seem theoretical, distant and cold. However, Bill S-248 involves real people, real families and agonizingly real choices made in a context that cannot possibly be understood by those who have not lived or experienced it.

I recognize that this is a deeply emotional and polarizing issue, and I respect the deeply held moral and spiritual beliefs of many in this chamber that we should not be in the business of making it easier to end a human life.

My perspective on this issue comes from over 35 years as a practising physician and having the gut-wrenching experience of witnessing incurable medical conditions slowly and steadily destroy everything that resembles life and living. I have witnessed the harsh toll that these conditions take on both patients and their loved ones. And so, the polarity of emotions in my own head and mind seem to be at constant odds. This is indeed a sensitive subject with a strong emotional and spiritual foundation, and based on my lived experiences in caring for individuals with cognitive impairment, neurodegenerative disorders, brain tumours and other neurological diseases that slowly and steadily strip away so much of what makes us who we are.

Honourable senators, I have always marvelled at the complexity of the human brain. Weighing a mere 1.4 kg, it shapes so much of what it means to be human, and its degeneration leaves behind sequelae that are heart-rending. Medical advances mean that we live longer and have a plethora of diagnostic and therapeutic options. The progress and understanding of medical science is indeed a marvel to behold. And yet, when it comes to understanding the brain, we remain somewhat in the dark.

Many of us have witnessed the effects of loss of cognition in our loved ones, friends and communities. The process is hardly ever linear. Plateaus and systematic decline are interwoven until all that remains is a shadow of what was a productive life.

In medical school, I had the opportunity to study dementia and neurocognitive disorders. During an elective in Edinburgh, Scotland, I had my first experience of working and studying in a “dementia unit,” as it was called. It was here that I first witnessed the impact of the loss of higher function on loved ones and caregivers. I felt so helpless and forlorn, and this memory would come back to haunt and remind me of how very cruel this malady is as I took charge of caring for my own unit and individuals in various stages of cognitive decline in my beloved Twillingate.

Honourable senators, let me categorically state that I would never canvass, suggest, coerce or advise MAID. It is a decision that must and should always be left to the individual and their determination as to why, how or when they might seek such an option. If asked, I will offer all options for individuals and families to consider and include the key members of my team in that complex and emotionally charged process. I’ve often turned to clergy and psychologists myself for personal reflection, and perhaps redemption, when facing these questions.

My time in practice has taught me that even when every treatment option is offered to those in cognitive decline, there is a progressive point in some individuals that does cause irremediable pain and suffering, physical and emotional pain, searing dissociation that is caught in the eyes of the victim — haunting, cruel and unremitting.

Does life’s moral compass always bend towards justice? I don’t know the answer to that. But watching people that I’ve loved so dearly go through this agony has left me wounded and scarred. I have witnessed countless tragic and painful experiences: the angst of confusion, agitation, delirium, combativeness, personality changes, loss of bodily function, infections and often helplessness.

A dear friend once said to me, “Ravs, all I can remember is the pain and confusion in mum’s eyes. All my other wonderful memories have been drowned out by this one image. What could we have done differently?” My answer is that I’m not sure. I’m hurting too. She knit me a pair of woollen socks, she baked me pies and she loved inviting me in for pea soup on Saturdays. She was so wise. I miss her, too.

We, as the providers of care, often feel the most helpless, trying our best to provide evidence-based care for our community members — people we know and love so dearly.

So yes, I’ve seen a lot of suffering and pain, and I do not have all the answers. But the memories linger and surface. There are the blood-curdling screams, aggression and agitation and cruel verbal assaults on loved ones. Even when you know why it is happening, you live with it, day in and day out, in a state of disbelief and despondency.

So the difficult question arises repeatedly from patients: “What if I did not have to go through this? What if it did not have to be this way? Can I make this decision? What if I change my mind? Will I still go to heaven? I’m afraid. I can’t bear to watch my family agonize over me if I lose it altogether.”

Honourable colleagues, Bill S-248 offers competent patients options. It is our duty to assess whether those options are feasible in allowing Canadians the choice of how they wish to plan their lives when faced with such unbearable situations. This is an important piece of legislation. It requires all of our careful thought, consideration and study at the next legislative step at committee. Thank you, wela’lin.

(On motion of Senator Martin, debate adjourned.)

On the Order:

Resuming debate on the motion of the Honourable Senator Ravalia, seconded by the Honourable Senator Duncan, for the second reading of Bill S-253, An Act respecting a national framework for fetal alcohol spectrum disorder.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I have the honour to table, in both official languages, the report of the Canadian NATO Parliamentary Association concerning the Bureau and Standing Committee Meetings, held in Athens, Greece, from April 9 to 10, 2022.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I have the honour to table, in both official languages, the report of the Canadian NATO Parliamentary Association concerning the Spring Session, held in Vilnius, Lithuania, from May 25 to 30, 2022.

Hon. Mohamed-Iqbal Ravalia: Thank you, minister, for being here today.

Canada is facing an unprecedented shortage of doctors, nurses and many other health professionals. In our home province of Newfoundland and Labrador, our government has recently announced new measures to recruit internationally educated registered nurses, who can fill health care vacancies. Our government has also introduced legislation that will make medical licensing more streamlined.

Recognizing the provincial-federal jurisdictional divide, can you speak to what measures the Government of Canada is taking to help address these critical labour shortages, including in health care but also other sectors?

Hon. Mohamed-Iqbal Ravalia: Honourable senators, my arrival on the Hill, like many of yours, was a vortex of confusion: phone calls, endless meetings, signatures, security screenings, group canvassing and an overwhelming sense of dislocation. On day two, while wandering around in a state of disassociation, Senator MacDonald kindly directed me to my hotel on Kent Street. On my way there, I decided to grab a bite of comfort food — spaghetti and meatballs — from the Bier Markt.

Out of the corner of my eye, I noticed a rather dapper gent making his way towards me. Flowing locks and a bright bow tie reflected in the bright sunshine. “Oh, my god, it’s Eric Clapton,” I thought. You look wonderful tonight. He said, “Hello, senator. I’m Dennis Dawson, one of your colleagues in the chamber. May I join you?”

We spent the next two hours covering a wide array of topics: politics, our role as parliamentarians, the subtleties of the chamber of sober second thought and life in general. The weight of confusion that I was feeling at the time began to dissipate and felt that this moment of serendipity was truly seminal. In the face of my perceived confusion and despair, Dennis had appeared as a compass and beacon in his quiet, unassuming way, a political stalwart who had taken the time to reach out to me with kindness, warmth and camaraderie, his mischievous sense of humour demonstrated repeatedly with a twinkle in those eyes. You held my hand when I most needed an anchor.

In the next chapter of our friendship, I had the privilege to witness his remarkable political skills on the international stage. At an Inter-Parliamentary Union meeting in Serbia, accompanied by Senator Saint-Germain and Senator Ataullahjan, I witnessed Dennis seamlessly navigate the complexities of an international parliamentary gathering where contentious issues were debated, and I marvelled as he expertly navigated these issues with aplomb and clarity. He defined and protected the rights of the LGBTQ2S community, supporting universal health access and minority rights.

His passion for his beloved Quebec and his unwavering Liberal roots have shaped a remarkable career. Dennis, my friend, you have impacted and influenced so many of us in this chamber, and I will always reflect fondly on your kindness and generosity to me personally. I wish you nothing but the best in your next chapter. Our loss will be your beautiful family’s gain.

[Translation]

Good luck, my friend. Thank you. Meegwetch.

Hon. Mohamed-Iqbal Ravalia: Honourable senators, I rise today to recognize the outstanding career of Craig Pollett, CEO of Municipalities Newfoundland and Labrador, as he is set to retire at the end of December.

Formed in 1951, Municipalities Newfoundland and Labrador, or MNL, represents the interests of the growing number of municipal councils in the province, representing nearly 90% of the provincial population.

Throughout Craig’s 21 years of service, MNL has supported small town and urban constituencies to further enable them to respond to the ever-evolving issues raised by residents.

With the support of the hundreds of municipal leaders, including the board of directors of MNL, Craig has enriched the landscape of municipal governance. He has developed MNL into a leading organization for research and advocacy. MNL engages directly with municipalities, including by facilitating workshops and hosting an annual symposium to explore the pressing issues that communities are faced with, such as changing climate and an aging population.

Craig has taken steps to strengthen the municipal legislative framework to give councils more and clearer authority to respond to residents’ concerns. He has strategized how to achieve long‑term sustainability for the province by exploring regionalization. He continues to advocate for governments to amend their waste water systems effluent regulations to allow hundreds of communities to come into compliance. Honourable senators, the Organisation for Economic Co-operation and Development, or OECD, has recognized MNL’s regional economic development work as a best practice.

Craig gives his deepest thanks to his family for their support, specifically his parents, Earl and Ruth Pollett, his partner, Gail, and his children, Grace and Abby.

Colleagues, healthy and sustainable communities are the building blocks of a prosperous province and country. Please join me in thanking Craig for his tremendous accomplishments, and for directly helping to support our vibrant communities that we all know and love on our beautiful rock of Newfoundland and Labrador. We wish you all the best in your next chapter, sir.

Thank you, wela’lioq.

Hon. Mohamed-Iqbal Ravalia: A pleasure to see you, minister, and thank you for being here today.

My question today is regarding health in general and fetal alcohol spectrum disorder, or FASD, which is a diagnostic term used to describe the broad spectrum of presentations and disabilities resulting from exposure to alcohol in utero.

There are little or no FASD multidisciplinary diagnostic teams in rural regions of Canada. Families often have difficulty accessing their services, and, because of the lack of clinics available and the distance rural residents have to travel, it is often a huge burden to them.

As outlined in Canada’s Rural Economic Development Strategy, since 2015 the federal government has made investments in rural communities, including efforts to improve connectivity through affordable high-speed internet and enhanced infrastructure to improve education and health facilities.

Would you please speak to what measures are being taken to improve access to health diagnostic clinics in general but, in particular, for support for individuals with FASD and other more complex health issues?