Interested in becoming an AIP

instructor? page 13

November 2010

SOGC Council: Call for nominations

page 2

Saving lives with vinegar in Malawi

page 9

Non-Insured Health Benefits for Aboriginals: what you should know page 11

2 November•2010

Call for nominations to serve on the SOGC Council

The SOGC is calling for nominations of exemplary individuals to serve on the SOGC Council for mandatesstartingJuly2011.

There are two vacant positions to be filled by nomination-election:- President Elect (Ontario)- Vice President (Quebec)

There are five positions that will be filled by appointment:- Alternate Chair (Quebec)- Associate member — RM (up for renewal)- APOG representative (mandate starting January2011)

- Junior member representative- Public representative

Council structureThe SOGC is managed by the SOGC Council, a group of 24 members which includes seven executiveofficers;10regionalrepresentatives;one Associate member – Family Physician (FP); one Associate member – Registered Nurse/Nurse Practitioner (RN/NP); one Associate member – Registered Midwife (RM); one Junior member representative; one Public representative; one Association of Academic Professionals in Obstetrics and Gynaecology (APOG) representative; and one Corresponding member.

A Chairperson and an Alternate Chair represent eachofthefiveSOGCadministrativeregions.

Where there is more than one province in a region, the representatives rotate the position byprovince.

Administrative regions• Western:BritishColumbiaandAlberta• Central:Manitoba,Saskatchewan,NorthwestTerritoriesandtheYukon

• Ontario:OntarioandNunavut• Quebec:Quebec• Atlantic:NewBrunswick,NovaScotia,Prince

Edward Island, and Newfoundland and Labrador

Instructions to nominate a candidateTo nominate a candidate for one of the vacant positions on the SOGC Council, please download the Nomination proposal and acceptance form to serve on Council from the SOGC website, www.sogc.org,orcontactthedirectorofcorporate affairs to obtain a copy of the form and instructions.

Complete the form and submit a duly-filled dossier before February 1, 2011, including:

• Signaturesoffive“proposers”(SOGCmembersin good standing to support the candidate)

• Theacceptancesectionoftheform,signedbythe candidate

• Aone-pageletterofinterestfromthecandidate

• Aone-pagebiographyofthecandidate• Ahead-and-shouldersphotoofthecandidate

The dossier should be sent to the SOGC national office at:

The Society of Obstetricians and Gynaecologists of Canada (SOGC)c/o Director of corporate affairs780EchoDrive,Ottawa,Ontario,K1S5R7

General requirements for candidates for any position on the Executive Committee and/or Council• Beamemberingoodstandingoftherelevant

membership category related to the vacant position (Ob/gyn, Life, FP, RN/NP, RM) and reside in the region of the open position (if applicable)

• Priorserviceonaregionalcommitteeispreferable

• BeabletodevotesignificanttimetoattendExecutive Committee and/or Council meetings as well as other meetings

• BewillingtocoordinatecloselywiththeSOGCnational office and be available on short notice

Specific requirements for the positions of President Elect, Vice President and Treasurer• Havedemonstratedcommitmenttothe

success of the SOGC through various capacities, such as previous experience as a Council member and/or committee Chair

• Possessexperienceinmedicalorgovernmental policy or with other health care related partners

• ExpertiseontheSOGCCouncilishighlydesirable

• TheTreasurermustenjoyareputationofintegrity, have experience managing sizable budgetsandpossessdetailedknowledgeofthe finances of the SOGC, preferably through experience with the finance committee

Read more about the responsibilities and duties of the SOGC Council on our website, www.sogc.org.Here,SOGCmemberscanfind additional information on the SOGC bylaws, as well as documents relating to the nomination and election processes for the SOGCCouncil.Membersmayalsocontactthedirector of corporate affairs, Sylvie Cadrin, at1-800-561-2416(extension222)foradditional details.

Executive

Treasurer Vice President Past President PresidentPresident

ElectVice President

Executive Vice President

Regional Chairpersons & Alternate chairs2 Western 2 Central 2 Ontario 2 Quebec 2 Atlantic

Associate member• 1Medical(FP)• 1RegisteredNurse(RN/NP)• 1RegisteredMidwife(RM)

• 1Juniormemberrepresentative• 1Publicrepresentative• 1APOGrepresentative• 1Correspondingmember

3November•2010

We need your support not only in renewing your membership in a timely manner, but alsothroughtalkingtoyourcolleaguesandencouraging other professionals involved in women’shealthtojoinourranks.

Thebenefitsofmembershiparemany.TheSociety provides top-quality CME programs at our regional and national meetings, to which membersreceiveregistrationdiscounts.Wehave opportunities for fellowships in a number ofareas,includinginternationalhealth.TheExecutive Committee of the SOGC and its Council worktirelesslythroughouttheyeartomakesurethat we produce guidelines which are evidence-based and address the needs of both patients andphysicians.

Iencourageallofyoutotakeafewminutestoday to renew your annual membership online orbymail.Pleasedon’thesitatetoemailmeifyouneedanyhelp.

At the SOGC national office, this is the time ofyearwhenweprepareforthemajorityofour membership renewals, and many of you have begun receiving notices by mail or email regardingyour2011dues.

The Society currently has a strong membership ofover3,800physicians,nurses,midwives,residents, medical students and other health-careprofessionals.Together,wecanaccomplishmuch and push forward the agenda for women’s health, and particularly reproductive health, in Canada.

Bothfamiliarandnewhealth-carechallengesarise every day, especially in and amongst the poorest of the poor: refugees, immigrants andourAboriginalpopulation.Throughyourmembershipdues,ourstaffcanworkwithvolunteer members to run our many programs thatmakeasignificantdifferenceforindividualwomen, their families and their communities acrossourcountry.

Your membership makes a differenceBy Dr. André Lalonde, SOGC Executive Vice President

Executive Committee• President: AhmedEzzat,MD,Saskatoon

• Past President: Michel Fortier, MD, Québec

• President Elect: MarkHeywood,MD,Vancouver

• Executive Vice President: André Lalonde, MD, Ottawa

• Treasurer: IanR.Lange,MD,Calgary

• Vice Presidents: WardMurdock,MD,Fredericton DouglasBlack,MD,Ottawa

Regional chairs, alternate chairs and other representatives • Western region: StephenKaye,MD,NorthVancouver Radha Chari, MD, Edmonton

• Central region: MargaretBurnett,MD,Winnipeg George Carson, MD, Regina

• Ontario region: Wendy Lynn Wolfman, MD, Toronto William Mundle, MD, Windsor

• Quebec region: Robert Sabbah, MD, Montréal Corinne Leclercq, MD, Ste-Foy

• Atlantic region: Joan Crane, MD, St-John’s KristaCassell,MD,Charlottetown

• Junior member: ChristiePylypjuk,MD,Saskatoon

• Associate member (FP): WilliamJ.Ehman,MD,Nanaimo

• Associate member (RN-NP): JanetWalker,RN,Vancouver

• Associate member (RM): KimberleyCampbell,RM,Abbotsford

• APOG representative: AlanBocking,MD,Toronto

• Public representative: Ms.MaureenMcTeer,Ottawa

• Corresponding member: Senator Lucie Pépin, Ottawa

Council 2010–2011

BelowisatentativescheduleforupcomingguidelinesthatwillbepublishedbytheSOGC.Pleasenotethatthepublicationdateslistedaresubjecttochange.AllguidelinesarepublishedintheJournal of Obstetrics and Gynaecology Canada (JOGC) and are availableontheSociety’swebsite,www.sogc.org.

Upcoming clinical practice guidelines

November• RecurrentUrinaryTractInfection

(English and French) • AsymptomaticEndometrialThickening(French)

December• ReturningBirthtoAboriginal,

Rural, and Remote Communities • OralContraceptivesandtheRisk

of Venous Thromboembolism: AnUpdate

January• GeneticConsiderations

for a Woman’s Pre-conception Evaluation

4 November•2010

An accredited Continuing Medical Education (CME) program by the SOGC

This CME program is offered in English.

the society of obstetricians and gynaecologists of canada780 Echo Drive, Ottawa, Ontario K1S 5R7

Tel: 1-800-561-2416 or (613) 730-4192 Fax: (613) 730-4314 events@sogc.com www.sogc.org

In association with the Ontario Society of Obstetricians and Gynaecologists (OSOG)

Ontario CME Program Update in Obstetrics and Gynaecology

December 2–4, 2010 Toronto, Ontario, Marriott Downtown Eaton Centre

Scientific ProgramVisit our website for complete details – www.sogc.org

Hotel ReservationsToronto Marriott Downtown Eaton CentreTel.: 1-800-905-0667, Group code: SOGC

Register online @ www.sogc.org

Upcoming meetings

SOGC meetings

Ontario CME Program: Update in Obstetrics and Gynaecology December2-4,2010 Toronto, ON

International CME Program: Update in Obstetrics and Gynaecology February28–March4,2011 Ixtapa, Mexico

West/Central CME Program: Update in Obstetrics and Gynaecology March24–26,2011 LakeLouise,AB

Ontario CME Program: Update in Gynaecology and Mature Women’s Health April14–15,2011 Toronto, ON

67th Annual Clinical Meeting June21–25,2011 Vancouver,BC

Program schedule

Location . . . . . . . . . . . . . . . . . . . . . . . . . . Date

Toronto, ON . . . . . . . . . . . . . . December5-6,2010 (in conjunction with the Ontario CME Program)

LakeLouise,AB. . . . . . . . . . . . March27-28,2011 (in conjunction with the

West/Central CME Program)

Toronto, ON . . . . . . . . . . . . . . . . .April16-17,2011 (in conjunction with the Ontario CME Program)

Toronto, ON – Instructor’s Course . .April18,2011

Vancouver,BC . . . . . . . . . . . . . . .June19-20,2011 (in conjunction with the Annual Clinical Meeting)

Other meetings

Birthing the World November25to26,Québec,QC www.birthingtheworld.com

5November•2010

Call for abstraCtsDeaDline: Monday, January 24, 2011

For full details on the 2011 abstract program, visit our website at www.sogc.org.

67th annual CliniCal meetingJune 21–25, 2011 The Westin Bayshore

vanCouver 780 promenade Echo Drive, Ottawa, Ontario K1S 5R7Tel/Tél. : 1-800-561-2416 or/ou (613) 730-4192 Fax/Téléc. : (613) 730-4314 events@sogc.com www.sogc.org

the society of obstetricians and gynaecologists of canada

la société des obstétriciens et gynécologues du canada

This CME Program is offered in English.

An accredited Continuing Medical Education (CME) program by the SOGC

the society of obstetricians and gynaecologists of canada780 Echo Drive, Ottawa, Ontario K1S 5R7

Tel: 1-800-561-2416 or (613) 730-4192 Fax: (613) 730-4314 events@sogc.com www.sogc.org

Ixtapa, Mexico, Las Brisas ResortFebruary 28 – March 4, 2011

International CME Program – Update in Obstetrics and Gynaecology

Direct flights with Air Transat from Montréal to Ixtapa (limited seats)andwithAirCanadafromVancouver,CalgaryandToronto.Add-onflightsfrommajorcitiesareavailable.Forfurtherinformation, please visit our website at www.sogc.org.

Reserve before November 30 for better rates!

6 November•2010

Welcome, new members

The SOGC is pleased to welcome some of the newest members to our society:

Associate member (Allied health-care professional):Mr.ScottHarlow

International member:Dr.AdeelaArooj;Dr.LuzAdrianaDiaz;Dr.TaherehNazari

Junior member:Dr.YamalAntonioAfiuniLopez

Junior member (FP): Dr.MelanieHould;Dr. NathalieMarceau-Gauvin

Associate member (FP):Dr.MichelBrisson;Dr. LeciaBuys;Dr.MelanieCharest;Dr.FrancesCousins;Dr.CarolineGagnonOuellet;Dr.JenniferO’Connell;Dr.ElisabethRobitaille

Associate member (RM):Ms.JaneLisetteBaker;Ms.HeatherBrechin;Ms.JessicaForbes;Mrs.JenniferHewko:Ms.ChristyL.LeBlanc;Ms. GenevieveRomanek;Mrs.PaulaSalehi;Ms. ClaudiaSmith;Ms.SaraVildis;Ms.NoreenWalker;Mrs.KarlineWilson-Mitchell

Associate member (RN/NP):Mrs.LeanneJohnson;Mrs.JoeleenMann

Associate member (Students in health-care training): MissKrystinaMariaArnone;Mrs.DianaBoughan;Ms.HelenCotter;Mrs.JanetDucommun;Ms.ChelseaElwood;VéroniqueFournier;Ms. SeirinGoldade;Mr.DavidGurau;Ms.HeatherHoltslag;Ms.TracyKennedy;Ms.TeilyaKiely;Ms.AndreaMacDonald;Ms.LauraMercer;MissNatalia Ng;Mrs. DebraRandall;Ms.CarlyScrymgeour;Mr. MichaelSecter;Ms.BarbaraSproule;Mrs. NicolaStrydom;Mrs.TaraTilroe;Ms.KaylaVale;Ms. SharleneVanEtten;Ms.KatherineWalker

in memoriam

It is with great sadness that we announcethepassingonOctober5ofDr. RichardWarrenWinter,long-timeSOGCmemberandpastpresident.Dr.WinterservedastheSOGC’s38th presidentfrom1981to1982,astreasurerfrom1984to1989,and as chairman of the Manpower andEconomicsCommitteefrom1984to 1989.

Dr.Winter’spresidencysawarevisionoftheSOGCbylaws,undertakentoclarifythestatus of Junior members and to streamline themembershipapplicationprocess.Itwasalso during his term that the SOGC’s Ontario Regional Committee responded to concerns regarding the influence of pressure groups in Ontario on the issue of therapeutic abortion, stating that such issues should be left to the individual’sdiscretionandnotsubjectedtointerference.Inthissameyear,recognitionof competence of subspecialties was discussedbyaspecialtaskforce,whichmaderecommendations regarding requirements for trainingandassessmentforindividualsseekingaccreditation.UnderDr.Winter’sleadership,legal mechanisms were put in place for an education and research foundation, enabling

Members’ corner

the Society to access tax-deductible grantsanddonations.

AsDr.Winter’stermcametoaclosein1982,asculpturebasedontheSOGClogo was commissioned and unveiled at the Annual Clinical Meeting (ACM)inEdmonton.Thesculpture

remains prominently displayed at the nationaloffice.Dr.Winterremainedaninterested member of the Society in his retirement and was an ever-present and welcome face at the gathering of past

presidentsateachACM.

The SOGC’s national office extends its deepest condolencestoDr.Winter’sfamilyandfriends.Werememberhiscontributionstothe specialty of obstetrics and gynaecology, and to the health of Canadian women and children,withheartfeltgratitude.

ItwasDr.Winter’swishthatmemorialdonations be made to the Royal Alexandra HospitalFoundation,O&GPerinatalMedicine,at10240Kingsway,Edmonton,AB,T5H3V9.

AnannouncementofDr.Winter’spassingcanbeviewedatremembering.ca.

Dr. Winter during his SOGC presidency, unveiling a sculpture which is still on display at the national office.

Dr. Winter at the SOGC’s 2009 Annual Clinical Meeting.

7November•2010

lundgard recognized bY the cFpc

SOGCmemberDr.KarenLundgard—whodelivers many of the babies born in Peace River, Alberta, each year — was recently recognized by the College of Family Physicians of Canada (CFPC) for her outstanding professional accomplishments.

Named by the College as one of Canada’s ‘Family PhysiciansoftheYear’,Dr.LundgardreceivedtheReg.LPerkinAwardonOctober15.Eachyear, this honour is given to one family physician fromeachoftheCollege’s10provincialregions,in recognition of exceptional care for patients, meaningful contributions to community health, anddedicationtoresearchandteaching.Peers,patients, colleagues and community leaders nominatedeservingdoctors.

Forover30years,Dr.Lundgardhasprovidedfull-service family medicine care through her office in Peace River, including emergency and inpatient care,aswellasobstetrics.Inadditiontoherpractice, she is a clinical lecturer and assistant clinical professor for the department of family

medicineattheUniversityofAlberta.SheservesaschiefofstaffatPeaceRiverHospitalandinstructs medical staff in Paediatric Advanced Life Support as well as Advanced Cardiac Life Support programs and MOREOBcourses.Dr. LundgardisacouncilmemberoftheCollegeof Physicians and Surgeons of Alberta and a board member of the Alberta Rural Physician Action Plan.

Dr.Lundgardandherhusband,Jerrold,havethreesons,KrisandwifeDanielle,Lee,andKjol,aswellasonegrandson,Kael,andanothergrandchildonthewayinApril.AgraduateoftheUniversityofAlberta,Dr.Lundgardlendshercreativeenergytosewingbabyblanketstosupport an annual women’s shelter fundraiser, and also supports a local gun club — where she enjoysshootingtrapandbeatingherphysiciancolleagues.SheischerishedasaveteranGirlGuideleader,enjoystakingcoursesinstainedglassandorganizingabookclub,aswellascookinginand diningout.

Members’ corner

Low receives award from the City of Kingston

Dr.JamesLow,long-timeSOGCmember,receivedoneofthe2010Mayor’sAwardsgivenbytheCityofKingston.Dr.LowwasgiventheFirstCapitalHonourableAchievementAwardataceremony in July, recognizing his many years of volunteering.

Dr.LowhasbeenpartoftheKingstoncommunitysince1965,anduntilhisretirementin1991workedattheKingstonGeneralHospital.HehassincefoundedtheMuseumofHealthCareatKingstonandhasbeenitsvolunteerexecutivedirectorforalmosttwentyyears.TheMuseumhasacquiredover30,000artifacts,openedoutreach galleries in five satellite locations, and developedextensiveeducationalprogramming.Inconjunctionwiththiswork,Dr.Lowbecamethe volunteer director of the Administrative Record Management and Archival Program at KingstonGeneralHospitalin1993.

AnaudiointerviewwithDr.Lowisavailableathttp://www.cityofkingston.ca/cityhall/mayorawards.asp.

Low receives award from the City of Kingston

Dr. Low was recently honoured by the City of Kingston.

Dr.JamesLow,long-timeSOGCmember,receivedoneofthe2010Mayor’sAwardsgivenbytheCityofKingston.Dr.LowwasgiventheFirstCapitalHonourableAchievementAwardataceremony in July, recognizing his many years of volunteering.

Dr.LowhasbeenpartoftheKingstoncommunitysince1965,anduntilhisretirementin1991workedattheKingstonGeneralHospital.HehassincefoundedtheMuseumofHealthCareatKingstonandhasbeenitsvolunteerexecutivedirectorforalmosttwentyyears.TheMuseumhasacquiredover30,000artifacts,openedoutreach galleries in five satellite locations, including the SOGC’s reception area, and developedextensiveeducationalprogramming.Inconjunctionwiththiswork,Dr.Lowbecamethe volunteer director of the Administrative Record Management and Archival Program at KingstonGeneralHospitalin1993.

AnaudiointerviewwithDr.Lowisavailableatwww.cityofkingston.ca/cityhall/mayorawards.asp.

Have you been recognized? If you’ve recently received an award or have been honoured for yourwork,theSOGC News wants to hear from you! We love highlighting contributions to the specialty and the health of Canadians — if one of our members is winning an award, pioneering an innovative new approach to care, or simply deserves recognition for adistinguishedcareer,let us know!

IfyouhaveastorythatyouthinkCanada’shealth-careprofessionalsinob/gynwouldliketoreadabout,youare encouraged to send submissions, articles or story ideas for the SOGC NewstoeditorHeatherBellbyemailathbell@sogc.com,ortoll-freebyphoneat1-800-561-2416,extension 325.

8 November•2010

handa Wins race relations aWard

Throughout her career as a Toronto-area Registered Midwife, SOGC member Manavi Handahasprovidedmaternitycareforwomenand newborns, while also striving for equality in thehealth-caresystem.Ms.HandawasrecentlyawardedtheUrbanAlliance2010RaceRelationsAward in recognition of her dedication to those underserved by the health community: new immigrants,womenwithnoOHIPcoverageandwomenwithoutdocumentedstatusinOntario.

As a child of immigrant parents and a woman of colour,Ms.Handaisonlytooawareofthesocialdeterminantsofhealthandhealthinequities.Shehasworkedtirelesslywithdifferentagenciesto provide uninsured clients with valuable lab tests such as ultrasound and access to obstetrical consultants.AschairoftheDiversityWorkGroupat the Association of Ontario Midwives (AOM), Ms.Handahashelpeddeveloptheassociation’sdiversity statement, a tip sheet for other midwivesworkingwithundocumentedanduninsured clients, and is providing input into an

Members’ corner

ongoingprojecttotranslateclientdocumentsintonumerouslanguages.Apassionatepublicspeaker,shehasaddressedtheneedsof

Ms. Handa was recognized for her dedication to those underserved by the health-care community.

hoW the iWhp is Fighting cervical cancer

TheSOGC’sInternationalWomen’sHealthProgram(IWHP)isworkingtobring attention to the unbalanced burden of cervical cancer in low-resource countries.Wearepleasedtoannouncethefollowinginitiativeswhichwilltakeplace over the next few months:

• TheIWHPisproducinganewpamphletoncervicalcancerpreventionandtreatment in low-resource countries, which will allow members and the public to gain an understanding of the issue and encourage them to get involvedinadvocacyeffortsaimedatraisingawareness.

• TheSOGCwillreleaseapolicystatementoncervicalcancerpreventionin low-resource settings, developed in collaboration with the Society of GynecologicOncologyofCanadaandtheSocietyofCanadianColposcopists.

• TheInternationalWomen’sHealthCommitteewilldeliverapresentationoncervicalcancerinlow-resourcesettingsatupcomingCMEevents.

• TheIWHPrecentlyfeaturedanadvertisementinthepoliticalnewspaperThe Hill TimesinlightofcervicalcancerawarenessweekandinanefforttoraiseawarenessamongParliamentarians.

Society of Obstetricians and Gynaecologists of Canada780 Echo Dr., Ottawa, ON K1S 5R7 Tel: 1-800-561-2416 or (613) 730-4192; Fax: (613) 730-4314 www.sogc.org

http://iwhp.sogc.org

Preventing cervical cancer to achieve global health equity

Cervical cancer awareness week will take place this October 24th to 30th, bringing the world’s attention to a widespread disease which takes the lives of more than 288 000 women each year.

Women don’t have to die from cervical cancer; we have the solutions and know-how to prevent these needless deaths.

However, these solutions aren’t made available to the women who need them most. 85% of global deaths from cervical cancer occur in the developing world.

Cervical cancer represents a very critical global health inequity.

Canada can make a diff erence by ensuring that cervical cancer prevention is an integral part of the broader agenda of meeting women’s health needs around the world.

It is a matter of injustice to have the solutions to cervical cancer presented only to the population who suff ers its burden the least.

10Oct_SOGC_HillTimesAd.indd 1 13/10/2010 8:20:04 AM

underserved clients at numerous community and healthforumlecturesandevents.

Inrecentyears,Ms.HandahasbeenappointedasassistantprofessortoRyersonUniversity’sMidwiferyEducationProgram.Shebringsananti-oppression perspective to her teaching and is exploring research in the areas of maternity care and uninsured women, youth pregnancy in the Caribbean community, and using various modelsofprenatalcaretoempowerwomen.Herdedicationtosharingherknowledgeandimproving access to health care for others has also seen her mentor medical students and nurse practitioners interested in care for marginalized communities.

Four winners were honoured at a gala dinner in September.TheUrbanAllianceonRaceRelationsis a non-profit organization that promotes a stable and healthy multiracial and multi-ethnic environment in Toronto through public education,researchandadvocacy.

9November•2010

saving lives With a bottle oF vinegarBy Dr. Ilona Hale

As many of us were recently engaged in the National Pap Test Campaign during Cervical CancerAwarenessWeek,thisisanopportunetime to reflect on the millions of women around the world who do not have the luxury of access tocervicalcancerscreening.

Although cervical cancer is largely preventable withscreening,globally,275,000womenstilldiefromiteveryyear.Morethan80percentofthesedeaths happen in developing countries, primarily duealackofadequatescreening.

Although universal Pap test screening programs require a degree of infrastructure that is unachievable in many low-resource countries, there is an excellent alternative: Visual Inspection of the Cervix with Acetic Acid (VIA) combined withcryotherapyina“SingleVisitApproach”(SVA).VIAisassensitiveasPaptests,canbedone even without electricity and uses locally-availablegrocery-storevinegar.Thecryotherapytreatment of positive lesions can be done at the same visit when required, reducing patients losttofollow-up.BothVIAandcryotherapycanbe performed by non-physicians after a short trainingperiod.TheSVAisfelttobethemostappropriate strategy for reducing the burden of cervicalcancerindevelopingcountries.

WhileworkingatadistricthospitalinMalawifor two years, I saw first-hand the results of not screening for cervical cancer: countless women presentingwith“vaginaldischarge”wouldleavewith a diagnosis of inoperable cervical cancer, with huge, palpable lesions often extending

almosttotheintroitus.Forthesewomen,itwastoolate.

But,onefeistylocalMalawianpolicewoman, Lucy*, came to my office one day and told me, ‘My mother died of cervical cancerandIdon’twantto.Iknowthereisawaytoscreenforthis.Whycan’twedoitat our hospital?’ I learned that the nurses, too, were aware of VIA screening and had wanted to initiate the program for some time, but the locally available training was prohibitivelyexpensive.WiththehelpofanAmericangynaecologistDr.SueMakin,whohadbeenworkinginMalawi(anddoing VIA) for ten years, we had soon trained a team from our staff and obtained anewcryotherapymachine.

At our first screening day, we were overwhelmed by huge numbers of women fromthecommunity.Itwasrefreshingto

seethejoyandexcitementofthesewomen,whorecognized what an opportunity they were being given.ThecontrastbetweenthisandthemanyCanadianwomen’slackofenthusiasmaboutPaptestingwaspoignant.Athomenow,Ioftenshare this story with my patients reluctant about coming for their Pap tests, to help them see thingsfromadifferentperspective.

On the first day, five women screened positive and were subsequently treated – one of them wasLucy.Sincethen,clinicshaverunweeklywithonlyperiodicsupportfromDr.Makin.The motivation and ingenuity to continue and expand the screening clinics into outlying areas comes from the incredibly dedicated team of nursesrunningtheprogram.Dr.MakinandI,bothnowbackinNorthAmerica,continuetogetupdatesonthesuccessoftheprogram.

With the international community’s new commitment to women’s global health, I hope simplescreeningprogramslikethiscanbemorefrequently utilized to help prevent at least some oftheunnecessarycervicalcancerdeaths.

*Patient’s name has been changed.

The screening clinics were well-attended by Malawian women.

Dr. Hale (back) and Malawian health-care professionals pose with a cryotherapy tool.

10 November•2010

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11November•2010

Non-Insured Health Benefits and Aboriginals

Accordingtothe2010UrbanAboriginalPeoplesStudy,71percentofFirstNations,InuitandMétis people reside in an urban setting — and thisnumberislikelytoincrease.Asthishappens,urban pharmacists and doctors will continue to see an increase in Aboriginal people claiming Non-InsuredHealthBenefits(NIHB).

NIHBisanationalhealthbenefitprogramthat provides health coverage for eligible First Nations and Inuit people residing in Canada (Métispeoplearenotcoveredbythisplan).The aim of the program is to supplement a recipient’s provincial or territorial health benefits by increasing access to health-care services and reducing the cost of medical, dental and pharmaceuticalservices.

What do you need to know?In2009,therewere815,800AboriginalpeoplereceivingNIHBbenefits.Thismarksa72percentincreasesince1990,accordingtoHealthCanada.ThelargestportionofNIHBrecipientsliveinOntario,ManitobaandSaskatchewan,andtheaverageageofarecipientis30.NHIBcoversawiderangeofservicesandpharmaceuticals.Forexample,NHIBcoversmaternalhealthneedssuch as prenatal vitamins and folic acid; however, in order for Aboriginal people to access any of theseitems,theymustfirsthaveaprescription.This requires doctors to write prescriptions for items that typically do not require a prescription, suchasvitaminDandironsupplements.

Difficulties accessing coverageEligible Aboriginal people sometimes face difficultlyaccessingNIHBservicesandpharmaceuticalsduetomisinformation.SomedoctorsandpharmacistsarenotawarethatNIHBcoverage is not limited to Aboriginal people residingonreserve.AnyeligibleAboriginalpersonisabletoaccessNIHBcoverage,regardlessofgeographicallocation.

Aswell,despitetheimportanceofNIHB,accesstocertainmedicationsislimited.UnderNIHBguidelines,NIHBwillonlycoverthecostofthelowest-costdrugavailable.Generally,thismeansthatNIHBwillonlyprovidecoverageforgenericdrugs.Accordingtoa2004studybytheUniversityofToronto,theCanadianAssociation

of Pharmacists and the Association of Iroquois and Allied Indians, cite ‘drug exemption’ as a majorbarrierinprovidingpharmaceuticalstoNIHBrecipients.Theyexplainthatitisalengthyprocedure to have exempted drugs approved to becoveredbyNHIB.Thisprocedurecantakeupto a few months to complete, depending on the geographicallocationoftherecipient.Theycitepatients waiting four months for drug approval in communities that have only rolling access to specialistsandphysicians(Rana,2004).

What can you do?There is a lot that you can do in order to help your patients accessNIHBcoverage.BelowarefourtipstohelpfacilitateNIHBaccess for you patients:

1)BecomeinformedabouttheNIHBprogrambyvisitingtheNIHBwebsiteandspeakingtoyour patients about how they usetheprogram.

2) Increase your awareness about the social and economic reality of Aboriginal people residing in Canadaandinyourcommunity.

3)Becomeawareofpersonalbiases towards gender, race, culture, sexual orientation, ability, language, educationandsocio-economicstatus.

4) Provide information in your waiting room, officeorstoreonNIHBcoverage.

Resources and links IfyouwanttolearnmoreaboutNIHB,youcanvisit the following websites:

Assembly of First Nations NIHB handbook (for recipients)www.afn.ca/cmslib/general/AFN_NIHB_Handbook.pdf

Health Canada’s NIHB website www.hc-sc.gc.ca/fniah-spnia/nihb-ssna/index-eng.php

References EnvironicsInstitute.(2010).UrbanAboriginalPeoplesStudy.Toronto:EnvironicsInstitute.

HealthCanada.(2009).Non-InsuredHealthBenefitsAnnualReport2009-2010.Ottawa:HealthCanada.

Rana,Z.B.(2004).AccesstoEssential Medicines and the Canadian Aboriginal Population: Core Feature of the Drug Program andPolicyIssues.Toronto:UniversityofToronto.

12 November•2010

Spread the word not the disease.

Knowledge is sexy. Want some?

La connaissance est sexy. En veux-tu

Passez le message pas le virus.

New resources

Public education brochure for your office or clinicThe SOGC offers a series of public education brochures for your patients; these are excellent resources to prepare patients for a medical appointmentortorefertoafterone.Thesebilingual brochures are reviewed by the SOGC’s subject-matterexpertsandare based on the SOGC’s clinicalpracticeguidelines.

All brochures can be orderedatwww.sogc.org— and all SOCG members receiveadiscount.Printer-friendly digital versions can be downloaded for free.

Pap testing This new publication for patients emphasizes the importance of routine Pap testing, discusses what to expect during

an exam, and explains the difference between normal and abnormal results, and what these couldmean.Therearehelpfulgraphicswhichillustrate tools that are commonly used, the steps of the Pap test, and the development of abnormalcellsovertime.

Multilingual HPV chart The SOGC has produced a new public awareness tool which discusses – in 13languages!–howHPVistransmitted,thesigns and symptoms of infection, as well astreatmentoptions.Limited print copies have been produced, a portion of which will be distributed with the print edition of this newsletter, and downloadable, printable copies will be available at hpvinfo.ca.

Background document for health-care professionals on healthy weight gain during pregnancy In2009,HealthCanadaadoptedtheU.S.Institute of Medicine (IOM) recommendations

for gestational weight gain, outlined in the IOM report Weight Gain during Pregnancy: Reexamining the Guidelines.

To help support the implementation of the newly adopted recommendations, HealthCanadahasdevelopedEating Well and Being Active: Towards a Healthy Weight Gain during Pregnancy, abackgrounddocumentforhealth-careprofessionals.Toviewanddownloadthisdocument,pleasevisitHealthCanada’sPrenatalNutritionsite,www.hc-sc.gc.ca/fn-an/nutrition/prenatal/index-eng.php.More web-based and print information to help women learn more about healthy weight gain during pregnancy willbeavailablefromHealthCanadainJanuary 2011.

13November•2010

Report from the 2010 Normal Labour and Birth Research Conference

SponsoredinpartbytheSOGC,the2010NormalLabourandBirthResearchConferenceinVancouverwasagreatsuccess!Seventy-fivespeakerspresentedfindingsaboutdiversetopicsrelatedtothebenefitsandchallengesofpreservingphysiologicbirth.Interprofessionalcollaborationandcommunicationandclinicalinnovationstosupportnormalbirthwerethemostcommonthemesamongthetopics.Therewere265participantsfrommorethan20 countries,includingtheU.S.,U.K.,Netherlands,Mexico,Lebanon,Australia,Brazil,Chinaand Germany.

Dr. Buitendijk, Ms. Saraswathi Vedam, and Dr. Stuart at the

2010 Normal Labour and Birth Conference.

There were 265 attendees, from over 20 countries, at the conference.

IWHP volunteers on the go

Many volunteers of the SOGC’s International Women’sHealthProgramrecentlytravelled,orare preparing to travel, to several countries to offertheALARMInternationalProgram(AIP).

• Dr.JohnGuilfoyleandDr.EricStearnstravelled to Guyana in October to deliver a five-dayAIP course.

• Dr.MarieHatemandDr.AudeBeauchampvisited Morocco in the beginning of November forasix-dayAIPcourse.

• InearlyNovember,Dr.SuzanneRoberge,Dr. DonnaCherniakandMs.HélèneLangloisdeliveredtheAIPinBurkinaFaso.

• Dr.JanetNorthcottandDr.JaeleneMannerfeldt will assist the Society of Rural Physicians of Canada in rolling out an AIP courseinKurdistaninNovember.

• Dr.GuilfoyleandDr.MannerfeldtwillvisitGuyana at the end of November to offer a three-dayAIPadministratorscourse.

• AsubsequentAIPcourseinMoroccoisalsoplannedforearlyDecember.

Interested in becoming an AIP instructor?The SOGC has received several requests from members wishing to participate in international initiatives, such as the ALARM International Program.InordertobecomeanAIPinstructor,members must first complete a training course on the principles and practices covered by the 4th editionALARMInternationalProgram.

In response to the interest of members, the SOGC is considering offering an AIP instructor course earlynextyear.Thefacilitiesandlogisticsofthetraining course would be covered by the SOGC, however participants must be willing to cover thecostsoftravelandaccommodation.

Anyone wishing to participate in the course, and become an AIP instructor, should send an email toiwhp@sogc.comexpressinghisorherinterest.Basedonexpressionsofinterestreceived,theSOGC will determine whether there will be sufficient participation to proceed with planning anAIPinstructortrainingcourse.

International

Dr. Lalonde, SOGC executive vice-president, introduces

Dr. Buitendijk at the conference.

14 November•2010

report on the governor general’s conFerence on Women and Security

Women and SecurityThe Governor General of Canada, the Right HonorableMichaëlleJean,convenedaconference on Women and Security on September9thand10th,2010,inOttawa.Over120womenandmenparticipated.The participants were leaders from many communities and constituencies representing Canada in all its diversity of race, ethnicity, class, disability, language, sexual orientation, ages,fromeveryprovinceandterritory.Participants issued this Declaration at the conclusion of the Governor General’s Conference, with a call for urgent action, addressed to the Government of Canada and governments in Canada at all levels, to renew their commitments to the full realization of women’s human rights, as set out in international human rights treaties that Canadahasratified,andtomakeimmediateand adequate allocations of resources to achievethatend.Participantsnotedthatpolicies and programs that promote equality and flourishing for all Canadians cannot be developed without the participation of women.ParticipantsalsourgedallCanadians,womenandmen,tojoinwiththemintheirorganizations and communities to build a Canada in which women and men can flourish equally.

Therefore, recognizing:• Thatinjustice,stigmatization,exclusion,

silence and violence are shared experiences of those whose equality and security are not protected, especially women;

• Thatsocietieswherewomen’sequalityandsecurity are promoted and fulfilled, flourish and are more stable than societies where women’s equality and security rights are compromised and undermined;

• Thatastrongsocialsafetynetisessentialforthe protection of the equality and security of themostvulnerableinsociety,themajorityofwhom are women and children;

• Thattherehasbeenaseriouserosionofbasicsocial programs and services, such as social assistance and affordable housing, that are the foundations of an egalitarian society;

• ThatAboriginalwomen,womenofcolour,immigrantwomen,LGBTwomen,womenwith disabilities, and girls are particularly vulnerable to stigmatization, violence, injustice,exclusionandsilencewhichresultsin insecurity and inequality;

And recognizing further that:• ViolenceagainstwomeninCanada,especially

Aboriginal and other marginalized women, is an urgent and widespread problem, and a human rights violation which compromises the physical and psychological security of women and girls;

• Persistentinequalityinthelabourmarketcompromises Canadian women’s socio-economic security;

• Womenarenotequallyrepresentedinformal positions of political power and do not have equal influence or effective access to democratic engagement with their governments;

• Women’saccesstojusticehasbeenseverelydiminished by cuts to funding to legal aid, especially civil legal aid and to the Court Challenges Program, and by official and

otherattacksonstatutoryhumanrightsinstitutions;

Therefore, be it resolved that:• Asamatterofurgency,anationalstrategy

supported by all levels of government be developed with clear targets and goals to ameliorate women’s inequality and strengthen women’s security;

• ThatCanadafully,andwithoutqualification,endorsetheUNDeclarationontheRightsofIndigenous Peoples;

• ThattheGovernmentofCanadarevitalizedueprocess protections and reverse regressive criminal law reform measures which have been held out as protective of victims, particularly women and girls, yet are actually fuelling the increased criminalization of women and girls;

• Thatfullyadequatefundingandresourcesbecommitted immediately by both federal and provincial governments to ensure that women can exercise their constitutional and statutory human rights and enforce their other legal entitlements and protections;

• Thatnewmechanismsbedesignedtodocument and hold accountable police, prosecutors,judgesandcorrectionalauthorities for their treatment of women who are victims of male violence, or who are prisoners, immigration detainees, or otherwiseinvolvedwiththejusticesystem;

• Thatinclusiveandequitablecurriculabedeveloped to reflect the contributions, challenges and achievements of women and to educate students about equality and security for women at primary, secondary and post secondary levels of education;

• Thatapublicinquirybeconductedanda national action plan, led by Aboriginal women’s organizations, be implemented, to address the disappearances and murders of hundreds of Aboriginal women and girls, which is a massive and systematic violation

A declaration was drafted at a recent conference — hosted by the the Right Honourable Michaëlle Jean in September, shortly before the end of her term as Governor General — with the hope that it will be the beginning of wider organizing to secure equality for all women in Canada. The SOGC supports this initiative and encourages all members to keep the tenets of this declaration in mind during their every day work to ensure the health of Canadian women.

Below is a reprint of the full declaration.

(continued on page 15)

15November•2010

of human rights, needing official and priority response by Canada;

• ThattheGovernmentofCanada’ssocial,economic, and cultural policies and practices reflect the commitments made by Canada in international human rights treaties and respect and promote the indigenous value of women’s equality;

• Thatwomen’shealthbetreatedasaprioritythat calls for awareness of women’s unique healthneedsthroughouttheirlifecycle.New and sustained investments in policies, programs, education, research and innovation are urgently needed to optimize health outcomesandtoachievetheUNMillenniumDevelopmentGoals.Itisvitaltoensureequitable and timely access for all women within a publicly funded, not-for-profit health-care system;

• Thatconcretestepsbetakentoensuregreaterparticipation of women in the electoral process and that democratic processes and funding supports be designed, with women’s full participation, to ensure effective dialogue and engagement between women and their governments;

• Thatgovernmentsatalllevelsreversetheerosion of the social safety net in Canada and ensure that it is fully able to respond to the essential needs of women and children to achieve equality and security;

• Thatyoungwomenandgirlsbeprovidedwithaccess to empowerment opportunities to grow their strength and confidence including self-defence, sexual health education and self expression through the arts;

• Thattheimplementationoftheserecommendations be monitored, utilizing adequate quantitative and qualitative data, that is publicly accessible, and reported on by the Minister Responsible for the Status of Women, to the Parliamentary Committees on the Status of Women and Public Safety and HumanRightsatleasteverytwoyears.

(continued from page 14)mis: Laparoscopic hysterectomy training

Endosurgery (Johnson and Johnson Canada) and Covidien Canada, the SMIG has been able to offer afull-dayprogramfocusingon“LaparoscopicHysterectomy”.

OnSeptember29,Dr.PhilippeLabergehostedour first one-day program in Québec City and included didactic sessions and a hands-

onlaboratorysession.Theprogram offered an intimate learning environment focused on approaches in laparoscopic hysterectomy, an opportunity to try various energy modalities and laparoscopicsuturingstations.

Upcomingprogramswillbeoffered across the country and open to a limited numberofparticipants.Wehopetoseeyouatone of these programs or other SMIG sessions givenconcurrentlywiththeSOGCCMEevents.Further details can be found at our website, www.smig.ca.

Sincerely,

Dr.S.SinghExecutive director, Society of Minimally Invasive Gynaecology

Minimally invasive hysterectomy, performed vaginally or laparoscopically, offers significant advantages to our patients when compared to traditionallaparotomy.Thereisclearevidenceof benefit for the less invasive hysterectomy types, including shorter length of stay (often same-day discharge), less pain and decreased overallmorbidity.

If we are to help increase access to MIS hysterectomy in Canada, there must be a means by which to support greater adoption of thisapproach.BarrierstoMIShysterectomyincludealackofadequate hospital resources and equipment, inappropriate fee structure for longer and complex MIS cases and alackoftrainingopportunitiesforpracticingsurgeons.

The Canadian Society of Minimally Invasive Gynaecology (SMIG), in partnership with the SOGC,hastakeninitialstepstohelpaddressthe issue of continuing surgical education forMIShysterectomy.Througharecentunrestricted educational grant by industry partners, including Olympus Canada, Ethicon

Scheduled events

Date Event Location

December1 LaparoscopicHysterectomyCourse(One-Day Program)

Toronto, ON

December 3 Concurrent Session with SOGC Ontario CME&AfternoonHands-OnDryLabSession

Toronto, ON

June2011(withSOGCACM) LaparoscopicHysterectomyCourse(One-Day Program)

Vancouver,BC

16 November•2010

Medical information: 1 888 666-0611 medicalinfo@duchesnay.com

www.ladysystem.ca

An improved and reliable therapy for the active woman suffering from urinary stress incontinence

_______________________

For _________________________________

Address _____________________________

LadySystem

15 minutes twice a day

Signature: ___________________________5 cones of identical shape but of different weights (grams)

No. 1 No. 2 No. 3 No. 4 No. 5 4.9 g 20.5 g 32 g 44 g 55 g

• As effective as electrostimulation (physiotherapy).(1)

• Effectively retrains the pelvic floor muscles.

• Ensures that only the correct muscles are contracted through a biofeedback mechanism.

• Exercises are performed privately at home without disrupting usual activities.

EFFECTIVE

NON INVASIVE

COST/TIME SAVINg

Available in pharmacies (behind the counter). Covered by several private insurance plans.

(1) Oláh K et al. The conservative management of patients with symptoms of stress incontinence: A randomized, prospective study comparing weighted vaginal cones and interferential therapy. Am J Obstet Gynecol. 1990;162:87-92.

15 minutes, twice a day, for 3 months