Vaccine alternatives offered by homeopaths 'irresponsible’

A CBC Marketplace investigation has found that some alternative health practitioners are offering unproven vaccine "alternatives" to parents, which is adding to many parents' confusion about vaccines. These treatments are not approved by Health Canada as alternatives to immunization.

Marketplace visited homeopathic practitioners in Toronto and Vancouver to investigate what advice and other options parents were being given about vaccines.

• Watch the complete Marketplace investigation, Shot of Confusion, Friday Nov. 28 at 8 p.m. (8:30 p.m. NT) on CBC Television.

Many myths about vaccines are perpetuated by celebrities and websites that continue to promote discredited and inaccurate research.

Some of the homeopathic practitioners that Marketplace visited offered treatments, called "nosodes," as vaccine alternatives, telling parents that the treatment is as effective as vaccines against diseases such as measles, polio and pertussis (whooping cough), which is highly contagious and can be fatal for infants.

Nosodes are made when diseased tissue or excretions are diluted to the point where any trace of the original substance may not be present. Homeopathic practitioners argue that the memory of the original substance is enough to create immunity. Public health groups have been critical of this approach.

"These diseases are the thing to be afraid of, and the vaccines are just by and far the safest option," says Shannon MacDonald, a registered nurse and adjunct assistant professor at the University of Alberta who researches vaccine trends. (CBC)

Some homeopathic practitioners also downplayed the severity of communicable diseases like measles, which are preventable by vaccination. Measles can result, in severe cases, in brain damage and death, and kill approximately one in 1,000 children worldwide who contract the disease.

Several said the likelihood of contracting these diseases was slim.

But while vaccine-preventable diseases like measles remain uncommon in Canada, a warning by the Public Health Agency of Canada from earlier this year warned of an unusually high number of cases, with outbreaks reported in five provinces.

"I think it's frightening," Shannon MacDonald, a registered nurse and adjunct assistant professor at the University of Alberta who researches vaccine trends, told Marketplace co-host Erica Johnson.

"If the herd immunity level drops and these diseases are introduced into the community, those children are not protected," MacDonald says. "You have well-meaning parents who've been provided an option, which they've been told that it's going to protect their children. And it's a lie."

Vaccine alternatives unproven

While vaccines are safe and effective at preventing a range of serious diseases, myths about risks persist.

The homeopathic practitioners in the Marketplace investigation were selling alternative vaccine treatments for between $16 for a single bottle and $200 for a complete course of treatment covering multiple diseases.

In consultations documented on hidden camera, some said the efficacy of nosodes was equivalent to vaccines, with several telling parents that the treatments were more than 90 per cent effective.

None of the homeopathic practitioners in the Marketplace investigation agreed to be interviewed for the story. Some said they are simply providing information, and it is up to parents to decide whether or not to vaccinate their children.

While no regulations prohibit homeopathic practitioners from offering health advice or alternative remedies, nosodes are not approved by Health Canada as vaccine alternatives, and medical experts say that there is no scientific proof that they are effective.

In a letter to the Toronto Star from 2013, Adam Gibson, Director General of Health Canada's Natural Health Products Directorate, wrote that nosodes are not authorized replacements for vaccines. "Both Health Canada and the Public Health Agency of Canada continue to promote and actively support vaccination of Canadians to protect them from vaccine-preventable illness."

Diseases that we have vaccines for, including measles and pertussis (whooping cough) can be deadly. According to the World Health Organisation, measles is one of the leading causes of death, globally, among young children. (CBC)

Health Canada now requires that manufactured homeopathic products contain a warning label that makes it clear that nosodes are not considered alternatives to vaccination.

But Marketplace discovered that Health Canada doesn't require homeopaths to make a similar disclosure when the product is prepared specifically for a patient.

'Terribly irresponsible'

While Canada does not have a tracking system that gives an accurate picture of vaccination rates across the country, local and provincial statistics suggest that in some parts of Canada the number of children who are not up to date on their shots is rising.

In some communities, more than 40 per cent of seven-year-old children do not have all their shots.

Part of the reason seems to be that common myths about vaccine safety persist, and many parents remain fearful.

"It's very concerning. People are turning to these alternative health-care practitioners for advice, and if the practitioners are not actually trained to know the science behind vaccines, they shouldn't be providing any advice to parents on it. It's not their area of specialty," says MacDonald.

"It's terribly irresponsible."

Part of the issue, she says, is that vaccines have been effective at preventing serious diseases such as polio, and many Canadians don't have firsthand knowledge of the dangers the diseases pose.

"I have worked overseas and in intensive care with children so I have a very real image of what the outcomes of these diseases can be," says MacDonald.

"These diseases are the thing to be afraid of, and the vaccines are just by and far the safest option."

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Ebola male survivors told to 'abstain from sex' for 3 months

The Ebola virus has been found in semen up to 82 days after the onset of symptoms, the World Health Organization says in advising men who've recovered from the virus to abstain from sex for three months.

Ebola is spread through direct contact with an infected person's blood, including urine, saliva, sweat, feces, vomit, breast milk and semen, says the U.S. Centers for Disease Control and Prevention (CDC).

Men who have recovered from the Ebola virus should either abstain from sex for three months after symptoms start or use condoms if abstinence is not possible, the World Health Organization advises. (Bazuki Muhammad/Reuters)

"Men who have recovered from Ebola virus disease should be aware that seminal fluid may be infectious for as long as three months after onset of symptoms," the World Health Organization said in a statement Friday.

"Because of the potential to transmit the virus sexually during this time, they should maintain good personal hygiene after masturbation, and either abstain from sex (including oral sex) for three months after onset of symptoms, or use condoms if abstinence is not possible."

Sexual transmission of Ebola virus disease has never been documented, the UN public health agency notes. Evidence is inconclusive on whether semen that tests positive for Ebola virus is infectious.

More than 15, 300 cases of Ebola have been reported up to the end of November 18, WHO says.

Almost all the cases and deaths have been in Guinea, Sierra Leone and Liberia — the three hardest-hit countries, which reported 600 new cases in the past week, the WHO said in its latest update.

Ebola is not spread through the air, by water or in general, by food, the CDC says.

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Tearful family hear 21-year-old's donated heart beat in veteran's chest

Video

Watch how 21-year-old donor's parents and sister react when they listen to heart beat

CBC News Posted: Nov 28, 2014 3:53 PM ET Last Updated: Nov 28, 2014 3:53 PM ET

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An American family embrace after they hear the heart of their 21-year-old loved one who died in a house fire beat in the chest of a Vietnam War veteran.

Matthew Heisler, a student at the University of North Dakota, died in March. He'd signed up as an organ donor at 16.

As the Heislers grieved, Tom Meeks in Washington state was looking for a heart transplant. The war veteran was diagnosed with a rare disease called amyloidosis, but because of his age and other health concerns, five hospitals refused to consider him for a heart transplant, NBC News reported.

Surgeons at the Mayo Clinic in Rochester, Minn., performed Meeks's transplant.

In total, 60 people were helped by Heisler's donations.

Eight months after Heisler's death, see how his parents and younger sister react when they listen to the heart beat in Meeks's chest. Click on the video above.

Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.

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Note: The CBC does not necessarily endorse any of the views posted. By submitting your comments, you acknowledge that CBC has the right to reproduce, broadcast and publicize those comments or any part thereof in any manner whatsoever. Please note that comments are moderated and published according to our submission guidelines.

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Ebola cases exceed 16,000 worldwide, WHO says

Sierra Leone will soon see a dramatic increase in desperately needed Ebola treatment beds, but it's still not clear who will staff them, according to the top United Nations official in the fight against the disease.

Ebola has sickened more than 16,000 people of whom nearly 7,000 have died, according to figures released by the World Health Organization Friday.

Sierra Leone is now bearing the brunt of the eight-month-old outbreak. In the other hard-hit countries, Liberia and Guinea, WHO says infection rates are stabilizing or declining, but in Sierra Leone, they're soaring. The country has been reporting around 400 to 500 new cases each week for several weeks.

Those cases are concentrated in the capital, Freetown, its surrounding areas and the northern Port Loko district, which together account for about 65 per cent of the country's new infections, Anthony Banbury, head of the UN Mission for Ebola Emergency Response, said in an interview with The Associated Press.

"The critical gap right now in those locations are beds. It's as simple that: We need more beds," said Banbury, who spoke by telephone from Ghana, where the mission is headquartered. Only about 350 of some 1,200 promised treatment beds are up and running, according to WHO figures.

Five more British-built treatment centres will open next month, tripling the current bed capacity, according to the U.K.'s Department for International Development. One near the capital is already up and running.

Still, more beds alone are not enough.

"We're concerned that the partners who have signed up to operate the beds won't be able to operate them in the numbers and timeline really required," Banbury said. He is flying to Sierra Leone this weekend to address that problem.

Sierra Leone is also dogged by unsafe burials. The bodies of Ebola victims are extremely contagious and the touching of dead bodies might be responsible for as much as 50 per cent of all new cases, Banbury said.

Cultural practices call for dead bodies to be washed, and women's bodies are supposed to be prepared by other women. But with very few women on burial teams, Banbury said that it appears people are washing the bodies of women before they call for them to be taken away.

Health workers wearing Ebola protective gear remove the body of a man that they suspect died from the Ebola virus. More than 16,000 people have been infected with Ebola and nearly 7,000 have died. (Abbas Dulleh/Associated Press)

Sierra Leone also needs more burial teams: WHO numbers show that only about a quarter of the teams the country needs are trained and working.

The United Nations had hoped that by Dec. 1, the end of the outbreak would be in sight: Two months ago, it said it wanted to have 70 per cent of Ebola cases isolated and 70 per cent of dead bodies being safely buried by that date. That would have drastically reduced the two ways people get infected — through contact with the bodily fluids of sick people and corpses.

World Health Organization numbers show they are significantly short of that goal and Banbury acknowledged that the overall goal would not be met. He stressed that tremendous progress has been made, and many places throughout the region would meet or even exceed the targets set.

"As long as there's one person with Ebola out there, then the crisis isn't over and Ebola is a risk to the people of that community, that country, this sub-region, this continent, this world," he said. "Our goal and what we will achieve is getting it down to zero, but there's no doubt it's going to be a long, hard fight."

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CBC investigation prompts Nunavut health-care review

Nunavut's health minister has ordered an independent external review of how the department mishandled the case of a nurse facing numerous allegations. 

Monica Ell made the announcement in the legislature on Thursday afternoon after a CBC News investigation aired detailing how officials promoted a nurse in Cape Dorset who faced about 20 complaints about her practice and harassment of colleagues. 

Asked if she would make the findings public, Ell said "I would certainly hope so."

CBC News recently obtained internal government emails in which health officials admit that they put the public health of Cape Dorset "at risk" by leaving the accused nurse in her job. She was later promoted to the top nursing post in Cape Dorset.

The nurse in question, Debbie McKeown, 56, of Thunder Bay, Ont., faces nearly 20 complaints about her nursing skills. 

Gwen Slade, a veteran nurse who filed some of the complaints against McKeown, said she welcomed the health minister's announcement of an independent review, saying she hopes it looks at all the officials involved in handling the case.

"But at the same time, they have to take the positive out of this because this is the time to make things better … to face what wasn't right and change it," said Slade about what she hopes will be the broader goals of the review.

However, she was concerned about whether the report will be made public.

"This is a very public matter," said Slade from her Trenton, Ont., home. "There cannot be any secrets. A government, other than the level of national security, should really not have secrets."

'Immediate dismissal' recommended

One of the complaints stemmed from the 2012 death of a three-month-old Inuk boy, Makibi Timilak. The boy died from a common viral infection after the nurse allegedly refused to see him when his mother called the health centre. Nunavut policy requires that nurses see babies under a year who are sick.

Makibi's mother, Neevee Akesuk, told CBC News she's relieved the government is "trying to do something" about how they mishandled the case and said she hopes the report gets made public.

Other allegations include that McKeown brought a premature baby to a smoke-filled party, refused to see other patients and misdiagnosed others.

The government knew about numerous complaints over the past two years and did not remove McKeown from her nursing position. In fact, sometime after Makibi's death, McKeown was promoted to the acting nurse-in-charge, a position that involves not only overseeing a team of nurses but treating patients.

In two separate incidents in 2012 and 2013, the government found McKeown guilty of harassing her co-workers, according to government emails.

Regional health directors recommended "immediate dismissal" of McKeown after investigating her for the second harassment complaint, according to government emails. However, the government's employee relations unit overturned that recommendation, called it a "witch hunt" and instructed the health officials to reinstate McKeown. 

Earlier this year, health directors in the Baffin region recommended that McKeown be "terminated immediately" from her position as supervisor or nurse-in-charge of the Cape Dorset Health Centre. 

A source familiar with the case says the government didn't dismiss the nurse.

It wasn't until May, when the nursing college stepped in, that some action was taken. The college suspended McKeown's licence and is still investigating a number of complaints against her.

Afraid to raise concerns?

Interactive: Death and denial in Cape Dorset (CBC)

In the legislature on Thursday afternoon, David Joanasie, an MLA who represents the South Baffin region where Cape Dorset resides, stressed the importance of making sure health care professionals and Nunavummiut are "not afraid to raise concerns" about quality of health care in their communities.

That was an issue raised with the Cape Dorset story. Slade, the nurse who filed complaints about McKeown, said she felt like permanent nurses were treated like gold while the voices of the large contingency of casual and agency nurses that rotate in and out of the communities weren't heard.

CBC News spoke with numerous sources, including many nurses, who said the government rarely fired nurses because of their difficulties attracting and retaining nurses. The government, in a written statement, said that it's facing the same shortage challenges felt elsewhere.

Recent figures from the territory show that 35 per cent of their full-time nursing positions are not filled.

When asked about ensuring that nurses and residents feel comfortable raising concerns, Health Minister Monica Ell said, "The well-being of all Nunavummiut and the level of service we provide in our health centres are vital."

For the full story on what happened to Makibi and how the government handled the case, read CBC's "Death and Denial in Cape Dorset."

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Ebola safe burial manual published as death toll rises to 4,960

At least 20 per cent of new Ebola infections occur during burials, the World Health Organization said in issuing a new funeral manual developed by an interfaith panel.

Ebola infections can spread when family and community members perform religious rites that involve directly touching or washing a corpse that continues to contain high levels of the infectious virus.

The guidelines released Friday are part of the UN health agency's efforts to reduce the likelihood of Ebola transmission. It includes advice to health workers for "dignified burials" in the Christian and Muslim context.

"It is clear from Islamic juristic ruling that the necessity of religious washing of the body before burial of patients who die from Ebola is overruled," Rehanah Sadiq, a Muslim chaplain with University Hospitals Birmingham NHS Foundation Trust who served as consultant to WHO, said in a release.

Sadiq suggested that health-care workers offer safer alternatives, such as give relatives the opportunity to view the body and to be involved in digging the grave.

The new guidelines also recommend that mattresses and other items handled by the Ebola patient be burned.

Separately on Friday, the WHO said 13,268 cases of Ebola have been reported in the eight currently and previously affected countries, including 4,960 reported deaths, up to the end of Nov. 4.

"Case incidence is declining in some districts in Guinea, Liberia and Sierra Leone, while steep rises persist in other districts," the report's authors said.

"Intense transmission in the three most affected countries demands widespread rigorous control measures. Preparedness in unaffected neighbouring countries is also critical."

The WHO report noted a total of 549 health-care workers are known to have been infected, including 311 deaths.

The agency said early indications are that many of those infections occurred outside of Ebola treatment and care in the three countries with the most intense transmission, Guinea, Liberia and Sierra Leone.

It added that exhaustive efforts continue to increase the supply of personal protective equipment as well as training on how to don and doff the gear to minimize possible risk.

Of the 4,707 Ebola treatment centre beds that WHO estimates are needed in the three heavily affected West African countries, only 22 per cent are currently up and running. The WHO said one of the biggest obstacles to opening more beds is lack of skilled staff trained in infection prevention and control.

In the U.S., where there have been four cases, including one death, public health officials announced they're increasing a national stockpile of Ebola protective gear for U.S. hospitals.

The U.S. Centers for Disease Control and Prevention (CDC) said it has ordered $2.7 million US in personal protective equipment (PPE) that will be distributed into 50 kits that can be rapidly delivered to hospitals.

"We are making certain to not disrupt the orders submitted by states and hospitals, but we are building our stocks so that we can assist when needed. Some of these products are not normally used by hospitals for regular patient care," Greg Burel, director of CDC's Division of Strategic National Stockpile, said in a release.

Elsewhere, the WHO reiterated that quarantining travellers arriving from Ebola-affected nations can create "false impression of control" and may have a detrimental impact on how many health-care workers volunteer to help contain the outbreak.

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Colour-changing marker alerts users to reapply sunscreen

A special ink may one day help protect you from sunburn, say students at the University of Waterloo who still need to tweak the formula and prove its safety to regulators.

The prototype invention is a marker with ink that is designed to change colour to indicate when to reapply sunscreen.

Earlier genetic discoveries in melanoma related to skin pigmentation and moles. (Mary Godleski/Associated Press)

The nanotechnology engineers were fed up with getting sunburned. After checking with their professors, they started a company called Suncayr, which this week was one of the international runners-up in the 2014 James Dyson Award for design.

Watch CBC-TV's Kim Brunhuber get a demonstration of how the product works before and after exposure to UV light.

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New Ottawa centre targets heart disease in women

The University of Ottawa Heart Institute has launched the Canadian Women's Heart Health Centre, which it says is the first of its kind in Canada.

Diane Burton says she always worried about her husband's heart health more than her own, until she suffered a heart attack at 54 years old. (CBC)

The centre will work on prevention, diagnosis and treatment of heart disease, which cardiologists say is the number one killer of women over the age of 35.

Dr. Michele Turek, the medical advisor for the new centre, says she has watched the number of female patients soar in recent years.

"When I started out in practice as a cardiologist a few years ago, most of my patients were men," she said. "I can tell you, there's been an incredible turnaround because now it is at least 50-50, if not more women."

Turek said heart disease remains "the leading cause of death, disability and hospitalization for women in Canada." Risk factors include poor diet and lack of exercise.

Diane Burton wants other women to take heart disease seriously. The mother of two and former public servant had a heart attack at 54. She said she ignored fatigue and pains for four days before she realized her situation was an emergency.

"If I had continued to ignore it, I may not be here today," Burton said, describing a 99 per cent blockage of her heart.

Burton's husband's father died after a massive heart attack at the age of 52 and she was always more worried about her husband's heart health.

But cardiologists say heart disease is the number one killer of women over the age of 35 and heart attacks go unrecognized in women up to 54 per cent of the time.

The chance of dying within the first year of a heart attack is also 50 per cent greater among women than men. Burton said that is because women often downplay their own symptoms.

The University of Ottawa Heart Institute wants to change those statistics, so it launched the new centre to focus on helping women find information and support. 

It will work with women who have a high risk of developing heart disease and with those already dealing with cardiovascular problems.

It also plans to reach out to health partners across the country to share its message and resources. A main focus is prevention.

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Ebola outbreak: Amber Vinson says she wasn't trained properly

A nurse who was infected with Ebola after treating a sick patient said she didn't have enough training beforehand on how to protect herself.

"The first time that I put on the protective equipment, I was heading in to take care of the patient," Amber Vinson told NBC's Today show in an interview broadcast Thursday.

Vinson was one of the more than 70 medical personnel who were involved in the care of Thomas Eric Duncan at Texas Health Presbyterian Hospital Dallas. After being sent home from the emergency room Sept. 26, Duncan returned two days later and was quickly diagnosed with the virus. He died Oct. 8.

'We didn't have excessive training where we could don and doff, put on and take off the protective equipment, till we got a level of being comfortable with it.'- Amber Vinson, Texas Presbyterian health care worker

"We didn't have excessive training where we could don and doff, put on and take off the protective equipment, till we got a level of being comfortable with it," Vinson said. "I didn't have that, and I think that's very important for hospitals across the nation, big and small."

Vinson still baffled how she contracted Ebola

But Vinson told CNN in an interview broadcast Thursday night that she has no idea how she became infected.

Several dozen nurses from Texas Health Presbyterian Hospital gathered in front of the hospital to show support for their employer Oct. 20 after it came under heavy criticism following three Ebola infections, including one case that was fatal. (Chip Somodevilla/Getty Images)

"I go through it almost daily in my mind: What happened, what went wrong. Because I was covered completely every time. I followed the CDC protocol for donning and doffing every time. I never strayed," she told CNN. "It is a mystery to me."

Vinson flew Oct. 13 on a commercial jet from Cleveland to Dallas, one day before feeling the first symptoms of her virus. She said in the Today interview that she monitored her temperature and checked in with health officials before flying. She said reports that she felt sick while travelling were false.

The federal Centers for Disease Control and Prevention in Atlanta has acknowledged that Vinson wasn't stopped from flying. CDC Director Tom Frieden later said that was a mistake on the agency's part.

"I would never go outside of guidelines or boundaries or something directly from the CDC telling me I can't go [or] I can't fly," Vinson told Today.

No qualms about treating Ebola patients again

Vinson attended to Duncan on Sept. 30, the day he tested positive for Ebola, according to medical records that Duncan's family released to The Associated Press. Like another nurse who became infected, Nina Pham, the reports note that Vinson wore protective gear and a face shield, hazardous materials suit, and protective footwear. At the time, Duncan's body fluids were highly infectious if someone made contact with them. At one point, Vinson inserted a catheter into Duncan.

U.S. President Barack Obama hugs Dallas nurse Nina Pham at the Oval Officeon Oct. 24. Amber Vinson said she was "floored" when she heard Pham had contracted Ebola, and increasingly worried about her own condition. (Larry Downing/Reuters)

She said she became fearful after learning that fellow nurse Pham, who also treated Duncan, was suspected of having Ebola.

"I was floored," she said told Today. "I was afraid for myself and my family because I did everything that I was instructed to do every time and I felt like if Nina can get it, any one of us could have gotten it."

Medical experts say an Ebola patient who survives the disease gains lasting immunity to the strain with which they were infected. Vinson said Thursday that she feels good, but still gets tired sometimes. Asked whether she would be willing to treat another Ebola patient, Vinson said "absolutely."

She told CNN that her engagement ring was among her personal items that were destroyed when her apartment was decontaminated. "I was crushed," she said.

Also Thursday, Texas health officials said the last of 177 people known to have been in contact with Duncan, Pham or Vinson would come off monitoring Friday. In addition, those who flew on the same flights as Vinson have also recently been cleared from monitoring. None of those people became infected.

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Homeless people's life expectancy half of average in B.C.

A new report released by a Vancouver-area street magazine says the life expectancy of a homeless person is about half that of the average British Columbian.

Megaphone Magazine's survey, entitled "Dying on the Streets: Homeless deaths in British Columbia", used data from BC Coroners Service, and claims to be the first ever report released on homeless deaths in B.C.

The study looked at statistics between 2006 and 2013 and found that the average age at death of a homeless person is between 40 and 49 years old, while the life expectancy of the average British Columbian is around 82 years old.

The survey also found accidental deaths accounted for 47 per cent of homeless deaths in the province over eight years, compared with just over 18 per cent for the general population.

The report, from a group that supports homeless people in Vancouver and Victoria, says homelessness is a life-threatening health hazard and steps need to be taken to prevent deaths related to housing insecurity.

Among the recommendations to help solve the problem are that the B.C. government implement a poverty-reduction strategy and that the federal government implement a national housing plan.

Sean Condon, the report's author and the executive director of Megaphone, says the number of deaths in the homeless population is deeply disturbing, in part because they're preventable.

Megaphone is a magazine sold on the streets of Vancouver and Victoria by homeless and low-income vendors. They buy the paper for 75 cents and sell the magazine for $2.

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CBC investigation prompts Nunavut health-care review

Nunavut's health minister has ordered an independent external review of how the department mishandled the case of a nurse facing numerous allegations. 

Monica Ell made the announcement in the legislature on Thursday afternoon after a CBC News investigation aired detailing how officials promoted a nurse in Cape Dorset who faced about 20 complaints about her practice and harassment of colleagues. 

Asked if she would make the findings public, Ell said "I would certainly hope so."

CBC News recently obtained internal government emails in which health officials admit that they put the public health of Cape Dorset "at risk" by leaving the accused nurse in her job. She was later promoted to the top nursing post in Cape Dorset.

The nurse in question, Debbie McKeown, 56, of Thunder Bay, Ont., faces nearly 20 complaints about her nursing skills. 

Gwen Slade, a veteran nurse who filed some of the complaints against McKeown, said she welcomed the health minister's announcement of an independent review, saying she hopes it looks at all the officials involved in handling the case.

"But at the same time, they have to take the positive out of this because this is the time to make things better … to face what wasn't right and change it," said Slade about what she hopes will be the broader goals of the review.

However, she was concerned about whether the report will be made public.

"This is a very public matter," said Slade from her Trenton, Ont., home. "There cannot be any secrets. A government, other than the level of national security, should really not have secrets."

'Immediate dismissal' recommended

One of the complaints stemmed from the 2012 death of a three-month-old Inuk boy, Makibi Timilak. The boy died from a common viral infection after the nurse allegedly refused to see him when his mother called the health centre. Nunavut policy requires that nurses see babies under a year who are sick.

Makibi's mother, Neevee Akesuk, told CBC News she's relieved the government is "trying to do something" about how they mishandled the case and said she hopes the report gets made public.

Other allegations include that McKeown brought a premature baby to a smoke-filled party, refused to see other patients and misdiagnosed others.

The government knew about numerous complaints over the past two years and did not remove McKeown from her nursing position. In fact, sometime after Makibi's death, McKeown was promoted to the acting nurse-in-charge, a position that involves not only overseeing a team of nurses but treating patients.

In two separate incidents in 2012 and 2013, the government found McKeown guilty of harassing her co-workers, according to government emails.

Regional health directors recommended "immediate dismissal" of McKeown after investigating her for the second harassment complaint, according to government emails. However, the government's employee relations unit overturned that recommendation, called it a "witch hunt" and instructed the health officials to reinstate McKeown. 

Earlier this year, health directors in the Baffin region recommended that McKeown be "terminated immediately" from her position as supervisor or nurse-in-charge of the Cape Dorset Health Centre. 

A source familiar with the case says the government didn't dismiss the nurse.

It wasn't until May, when the nursing college stepped in, that some action was taken. The college suspended McKeown's licence and is still investigating a number of complaints against her.

Afraid to raise concerns?

Interactive: Death and denial in Cape Dorset (CBC)

In the legislature on Thursday afternoon, David Joanasie, an MLA who represents the South Baffin region where Cape Dorset resides, stressed the importance of making sure health care professionals and Nunavummiut are "not afraid to raise concerns" about quality of health care in their communities.

That was an issue raised with the Cape Dorset story. Slade, the nurse who filed complaints about McKeown, said she felt like permanent nurses were treated like gold while the voices of the large contingency of casual and agency nurses that rotate in and out of the communities weren't heard.

CBC News spoke with numerous sources, including many nurses, who said the government rarely fired nurses because of their difficulties attracting and retaining nurses. The government, in a written statement, said that it's facing the same shortage challenges felt elsewhere.

Recent figures from the territory show that 35 per cent of their full-time nursing positions are not filled.

When asked about ensuring that nurses and residents feel comfortable raising concerns, Health Minister Monica Ell said, "The well-being of all Nunavummiut and the level of service we provide in our health centres are vital."

For the full story on what happened to Makibi and how the government handled the case, read CBC's "Death and Denial in Cape Dorset."

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P.E.I. abortion policy not led by health minister

P.E.I. Health Minister Doug Currie says the policy to maintain status quo and not allow abortions in the province is not his policy.

Last month investigation into documents received by CBC News through a freedom of information request revealed it was Currie that ended a Health PEI process into establishing an abortion clinic on the Island. According to a business case prepared by Health PEI that clinic would have saved the province money.

Currie avoided interviews on the subject for weeks, but on Thursday while speaking to CBC News on another issue, he was asked why he stopped the process.

"This is not a Doug Currie policy, I want to be clear on that," said Currie.

"This is a position, a policy by government, and we've been working very hard with the Medical Society and Health PEI to make sure that Island women have good information to access the services."

Currie was asked whether the policy came from the premier's office.

"This is government policy and, as I say, I am the health minister and I have to respond and answer questions on policy that are related to my responsibilities, and I'll do that," he said.

P.E.I. is the only province in the country that does not provide abortion services. It pays for the service, but women must travel out of province for the procedure covering their own expenses for the travel.

The government argues it is offering timely access to abortion and is meeting its needs under the Canada Health Act.

Currie said his department has made many efforts to improve access to abortion services on the mainland, including contracting with Maritime Bus, offering assistance to low-income patients, and posting information on the Health PEI website.

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Quebec in vitro fertilization program to be scaled back

The Quebec government is about to limit the province's free in vitro fertilization program and change the way it offers financial support.

Health Minister Gaétan Barrette is planning to present an overhaul of the plan in the coming weeks.

The previous Liberal government started the program in 2010.

Quebec was the first province in Canada to fully fund IVF treatments.

But the program became so popular that it ran over budget. 

In his previous job as head of the Quebec's Federation of Medical Specialists, Barrette criticized the program,. 

He called it an "open bar" and said it was not an essential service.

According to Radio-Canada, Barrette is looking at limiting the program to infertile couples, with financial aid in the form of tax credits.

That would exclude others from the program, including single mothers and gay and lesbian couples.

The decision to limit aid to infertile couples would have to be studied in a National Assembly committee to make sure it does not run afoul of Quebec's Charter of Human Rights and Freedoms.

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Ebola outbreak: death toll falls, WHO says

The World Health Organization said on Wednesday it continued to see a slowdown in weekly Ebola cases in Liberia, although incidence of the disease was still rising in Sierra Leone and stable in Guinea.

The three countries have reported 1,828 Ebola cases of the disease over the past 21 days, the maximum incubation period of the virus, and 64 per cent of those new cases were in Sierra Leone, 22 per cent were in Liberia and 14 per cent in Guinea.

The slowdown in Liberia, first announced by the WHO a week ago, has surprised many experts who had warned that the disease was set to continue spreading exponentially.

The WHO has said it may be the first evidence that efforts to tackle the disease are working, while warning that the outbreak is still not under control.

All three countries 'capitals reported rapid rates of transmission of the disease over the past week, but there were no new confirmed cases in the epicentre of the outbreak, the district of Gueckedou in Guinea.

The WHO revised the cumulative death toll downwards for a second week running, with 440 fewer deaths reported in Sierra Leone than in data published last Friday, but 284 deaths added to Liberia's tally and 23 to Guinea's since then.

It said the revision was caused by a change in the source of the data. Previously it had combined patient databases and country reports from health ministries and WHO offices, but it had switched to relying entirely on the country reports.

It did not explain the reason for the change, but graphs in the WHO's update suggest it is taking a conservative approach, since numbers in patient databases appear to have fallen below those in situation reports in recent weeks.

The WHO has previously said it was working to improve the quality of the data and warned that could lead to upward or downward revisions.

The latest report put the total death toll at 4,818 out of 13,042 cases as of Nov. 2, compared to 4,951 deaths in Friday's Ebola update; but the WHO repeated a warning that the figures continued to be too low because of under-reporting of cases.

The response to the outbreak depends on building up health care and increasing the number of safe burials of Ebola patients, since bodies of those who have died from the disease are highly contagious.

The WHO said it now needed 528 dead body management teams, having given a target of 370 eight-person teams earlier in the week. It so far has only 27 per cent of the revised number.

Another key target is tracing contacts of Ebola patients, and although the data showed 95 per cent of contacts were being traced, the WHO said it mistrusted that figure, as Sierra Leone officially averaged seven contacts per patient and Guinea four.

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Nunavut put community's health 'at risk' by mishandling nurse

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Ebola outbreak: cases surge in Sierra Leone amid lack of treatment centres, UN finds

The number of Ebola cases is surging in Sierra Leone as the country suffers from a lack of treatment centres, while lack of food and basic goods is forcing some people to leave quarantine areas, the United Nations said.

The UN Mission for Ebola Emergency Response (UNMEER) said in its weekly report that a total of 1,062 people had died in Sierra Leone from the virus, with the outbreak particularly virulent in the western areas around the coastal capital Freetown.

Sierra Leone is emerging as the focal point for concern in the worst Ebola outbreak on record. The World Health Organization said on Wednesday that 4,818 people had died in the epidemic and said the number of cases was still rising in Sierra Leone, though it was stabilizing in neighbouring Guinea and slowing in Liberia.

Sierra Leone has 288 beds spread across four Ebola Treatment Centres (ETCs) treating 196 confirmed cases of the disease as of Nov. 2, UNMEER said.

However, the UN mission said it suspects an average of 50 per cent of cases of the Ebola virus disease (EVD) are not being reported across Sierra Leone.

UNMEER said a total of 1,864 beds were needed by December. Ten new treatment centres are currently planned, with a capacity of 1,133 beds.

"An additional 731 safe beds need to be planned, secured and made available by the first week of December," UNMEER said in its report, released late on Wednesday.

"Lack of available beds in ETCs is forcing families to care for patients at home, where caregivers are unable to adequately protect themselves from EVD exposure, thereby increasing transmission risk."

It said a lack of clarity of evacuation procedures and hazard pay was deterring foreign and national medical staff from coming forward to run the units.

UNMEER reported a growing incidence of families leaving their quarantined homes due to lack of food and non-food items, but did not provide further details.

It said that the World Food Programme (WFP) has been distributing one-month rations to quarantined household and communities in the hard-hit area of Waterloo, in the outskirts of Freetown, where 80 per cent of people in need have already received rations.

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Spanish nursing assistant who beat Ebola discharged

Spanish nursing assistant who recovered from Ebola credited health care workers with saving her life and offered Wednesday to donate blood to help cure others.

Still, Teresa Romero slammed Spanish officials for killing her beloved dog, saying the mixed breed named Excalibur was unnecessarily "executed."

The 44-year-old Romero issued a statement as she was released from Madrid's Carlos III hospital after spending 30 days there, most of it in quarantine.

Her husband, Javier Limon, read Romero's remarks about Excalibur as she listened at his side, saying his wife was too emotional to talk about the dog that was like the childless couple's own child.

Madrid health officials euthanized Excalibur on Oct. 8, saying the dog posed a potential public health risk for Ebola transmission. But the dog of a nurse who got Ebola in Dallas was simply quarantined and then later reunited with its owner.

Killing Excalibur "wasn't necessary," Romero said in her statement. "The worst part of all of this is that our dog was not given a chance."

Romero said she still feels weak but praised her treatment team, hoped her recovery could help doctors figure out a cure for Ebola and offered to donate blood. Plasma from an Ebola survivor was among the treatments she received.

"If my blood works to cure people, I'm ready to give it to the last drop," she said.

Doctors said Romero, who was critically ill for about a week, received various treatments and they were unable to say what ultimately worked.

Romero helped treat two Spanish missionaries who died of Ebola in August and September after they were flown back from West Africa.

Doctors have said Romero told them she might have become infected by touching a protective glove to her face. But Romero said she did not "know what went wrong, or if anything went wrong."

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Marijuana grow facility heads to court over rejected application

Health Canada's troubled medical-marijuana program is again under fire, with the launch of the first court challenge by a company denied a government licence to grow the product commercially.

Lawyers for New Age Medical Solutions Inc., which has a grow facility in rural British Columbia, filed a motion in Federal Court last week against Health Minister Rona Ambrose, asking that a judge review the decision not to grant a licence.

The company, founded and run by marijuana activist Sam Mellace, applied almost a year ago to become a licensed producer, under new Health Canada rules that are creating a billion-dollar commercial industry.

Health Canada rejected the application Aug. 10, saying the firm had not hired an acceptable quality-assurance specialist.

Mellace retained the Toronto firm Chaitons LLP, which is seeking the court's permission to extend a deadline for legal action. Papers were filed last week. Mellace could not be contacted and his lawyer declined comment.

An Ottawa lawyer who specializes in assisting companies with their grow applications to Health Canada said the case may trigger other legal challenges from companies denied licences.

"I know, speaking to many applicants, that nobody really wanted to be the first one," said Trina Fraser. "The barn door is open now.… There's a feeling there's strength in numbers."

Health Canada swamped

As of last month, 226 applications had been refused, said Health Canada spokesman Sean Upton, who confirmed the department has been advised of the legal challenge.

Health Canada has been swamped with more than 1,100 applications from firms wanting to cash in on an industry the government says could be worth $1.3 billion in a decade.

Only 22 licences to produce have been issued, none in the last few months, while some 291 are still in process. (About half of all applications have been returned as incomplete.)

Fraser said the approval process has slowed to a crawl, prompting other complaints to Health Canada as investors get nervous about whether there will be any payback.

'They're burning through money like crazy,'—Trina Fraser, Ottawa lawyer for firms seeking medical-marijuana production licences

"Everybody's going bananas, out of their minds, frustrated with the process," she said.

"A lot of these applicants have already started or finished construction, they've got investors to answer to, and they're burning through money like crazy."

Canada's commercial medical marijuana industry kicked into high gear in April this year. The department has dramatically changed the rules of supply, from a cottage industry in which approved patients grow their own or buy from small producers, to a free-enterprise system with no limits on the number the large-scale growers charging what the market will bear.

The changeover has come with problems, including a so-far successful court challenge that allows some patients to continue to get their supply under the old rules, three product recalls and complaints about the initially high cost of medical marijuana in a free market.

Company may shut down

Mellace has a 6,000-square-foot facility near Mission, B.C., now empty and not in production. He said he has invested some $1 million in the project, half of it for research and development, and that he planned to employ between 60 and 150 people.

Health Minister Rona Ambrose speaks to the Canadian Medical Association in Ottawa in August. The minister is being taken to Federal Court after a company was refused a medical marijuana production licence. (Sean Kilpatrick/Canadian Press)

"The failure of the minister to issue the company a licence is highly prejudicial and will cause the company to have to shut its operations," says the court filing in Toronto.

Many of the 291 firms with pending applications for a lucrative production licence have their own grievances, as an opaque approval process leaves them guessing about when, if ever, they'll get a licence.

"They're changing the rules as they go," said Fraser, who has acted for or spoken to dozens of applicants. "There was certainly a first-mover advantage because the bar is much higher now."

Health Canada, she said, has cranked up security requirements since the first wave, leaving firms now in a "never-never land, security-clearance abyss."

Many businesses still in the queue are hurting financially, their lawyers say. Simply assembling the paperwork for a credible application is about a $50,000 investment, followed by leasing costs for facilities and payroll, which can drive costs over a million dollars.

Fraser cites documents she obtained under the Access to Information Act as showing that what had been a two- to three-month application process in 2013 has become an 18- to 24-month ordeal, partly because new security requirements appear to have created a backlog at the RCMP, which does inspections under the new program.

Vancouver lawyer Kirk Tousaw, who has worked with many applicants, agrees that Health Canada's processing has ground to a halt.

"The application process has essentially come to a standstill and there are dozens, if not hundreds, of people that want to be growing and selling medical marijuana to sick Canadians that have had their applications disappear into the void."

Follow @DeanBeeby on Twitter

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Ottawa temporarily restores most refugee health-care coverage

The federal government will temporarily restore health-care coverage to refugee claimants beginning Wednesday pending the outcome of an appeal at the Federal Court, but some still won't have coverage for drugs.

"We are doing this because the court has ordered us to do it. We respect that decision while not agreeing with it," Immigration Minister Chris Alexander said following question period on Tuesday.

The government had until the end of today to review a 2012 policy the Federal Court deemed unconstitutional, "cruel and unusual" last July.

The government had asked for a stay until an appeal is heard, but that request was rejected on Friday. A date for the appeal has not been set.

"Under the temporary measures, most beneficiaries are eligible to receive coverage for hospital, medical and laboratory services, including pre- and post-natal care as well as laboratory and diagnostic services," the government said in a notice posted on the website of the Department of Citizenship and Immigration over an hour after the minister spoke.

Children under 19 years of age will receive full coverage, while pregnant women will be covered for all but supplemental health benefits.

Supplemental benefits include "limited dental and vision care, prosthetics and devices to assist mobility, home care and long-term care, psychological counselling provided by a registered clinical psychologist, and post-arrival health assessments."

However, refugee claimants in seven of the 12 categories included in the government's chart will not be covered for drugs or supplemental health coverage.

Those who won't be covered for drugs or supplemental health benefits are:

• Privately sponsored refugees who are not receiving support through the resettlement assistance program.
• Protected persons.
• Designated country of origin refugee claimants.
• Non-designated country of origin refugee claimants.
• Rejected refugee claimants without a deferral of removal for generalized risk.
• Individuals who receive a positive decision on their pre-removal risk assessment.
• Individuals with ineligible refugee claims but eligible to make a pre-removal risk assessment application.

The Canadian Association of Refugee Lawyers, one of the groups that took the government to court over the changes the Conservatives brought in back in 2012, says the temporary plan does not comply with the Federal Court ruling.

"The government is still being punitive, they're being selective and the court told them to reinstate all benefits," said Peter Showler, co-chair of the refugee lawyers' group and a former chair of the Immigration and Refugee Board of Canada. He is also an expert in refugee law at the University of Ottawa.

Showler was critical of the government's decision to deprive certain refugee claimants of coverage for prescription medications. 

"They are not in compliance with the decision based on the information that the government put out on its website today."

Showler said he will discuss today's announcement with two other groups who challenged the government in court – the Canadian Doctors for Refugee Care and Justice for Children and Youth – but said it's likely their lawyers will go back to court and file a contempt motion asking the court to order full compliance.

NDP multiculturalism critic Andrew Cash was critical of the government's approach, saying it can't simply "pick and choose which refugees they're going to cover."

"It's certainly not the spirit of the court ruling," Cash said.

Liberal immigration critic John McCallum said the court ruling made no mention of restoring partial benefits to some and full benefits to others.

"The court ruling was a blanket order to restore the interim federal health-care program or something equivalent to it. There was no statement they could put some in, take some out, there was an order to restore the whole thing."

McCallum said the minister could risk being found in contempt of court if he tried to "weasel out" of compliance.

Alexander said the government would "comply" with the court ruling until such a time as an appeal is heard. He added that the temporary measures would cost the government $4 million to implement.

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Junior hockey player slams league’s insurance after injury

A former junior hockey player in Alberta says he feels "used" by a sport that demands physical sacrifice, but fails to provide adequate medical insurance.

Tim Nolte, 22, spent thousands of dollars having dental surgery after getting a stick in the face.

Nolte says that throughout his four-year career, even immediately after his injury, he understood he would be "100 per cent covered" for accidental injuries.

Tim Nolte lost three teeth and underwent a year of surgeries. (Tim Nolte)

"I was even told by my coach to get the best (treatment), make it look good. It's all covered," Nolte said.

However, all was not covered.

Nolte was reimbursed only $2,500, the maximum payable per accident under Hockey Canada's dental insurance program.

In an email, Hockey Canada's Todd Jackson told Nolte that he understood his "frustration" but that "we are working within the policy limits with respect to your accident. I am sorry but we are tied to this amount."

"It's ridiculous," Nolte said. "You go for a few dentist appointments it's $2,500.

"I feel like I've been used."

High-stick led to a year of dental surgery

In September 2013, Nolte was captain of the Spruce Grove Saints of the Alberta Junior Hockey League.

The Saints were playing the Whitecourt Wolverines during the AJHL's annual Showcase, a weekend series attended by college and Major Junior scouts.

Late in the game, with the Saints winning, Nolte was hit with a high stick, smashing loose three of his front teeth.

"You definitely don't forget the taste of teeth in your mouth. Then, just the shock of blood pouring out of your mouth."

Nolte left the ice and went to hospital, first in Stony Plain for stitches, then to University of Alberta Hospital for further assessment.

He said for the next year he visited three different dentists, often two or three times a week. He required multiple procedures including root canals, bone grafting and post and core surgery.

Throughout it all Nolte continued playing for the Saints, going to the rink six or seven times a week, while at the same time working as a welder to support himself and pay his dental bills.

"I'd get up at five, go to work, start at 6, then get off in time for hockey," he said.

Nolte said he missed a lot of work because of dental appointments.

"My first year of welding I wasn't making the best wage. I saved every penny I could. I had hopes of maybe buying some land for farming, starting up a welding truck, and then to see it all go to teeth," he said, his voice trailing away.

'We tried our best,' team owner says

Saints' owner Darren Myshak told Go Public he can understand how Nolte would have thought  he was fully-covered.

"I know when my boys grew up I thought the same thing."

Myshak said he was aware of the $2,500 limit but was still surprised the Saints' policy didn't cover Nolte's expenses.

"We pay our insurance through Hockey Canada, and for him not to be covered was very disappointing for us," Myshak said.

He said the club tried to get Hockey Canada to reimburse Nolte but was unsuccessful.

"Tim was a fantastic leader for us and we tried every avenue we could to gain some funds for Tim."

Myshak said the Saints make no profit and weren't in a position to pay Nolte's bills.

"We tried our best to do what we could for Tim," Mychak said.

Insurance coverage 'outrageous,' union head says

"This is happening right across the country," said Jerry Dias, national president of Unifor.

Union president Jerry Dias is calling for a national inquiry into junior hockey players' working conditions. (CBC )

The union is calling for a national task force to examine junior hockey players' working conditions.

"For (Hockey Canada) to have $2,500 insurance for junior hockey players is outrageous," Dias said.

"I mean $2,500 may be applicable if you're working for the National Ballet but this is a violent sport, this is an aggressive sport. So somehow to leave this young man hanging out to dry is completely irresponsible."

Dias said players' accident expenses should be 100 per cent covered.

"A young man that is working for an employer, a for-profit company, ought to be taken care of. I mean this is just absolutely ridiculous."

Hockey Canada lips sealed on dental plan limits

Go Public made three requests to Hockey Canada for comment. The organization declined the request and referred us to its website.

On the website it describes its insurance as "an exceptional insurance program that has been built with the needs of its members in mind."

It also shows that only eight per cent of the premiums paid into its insurance program go towards accident and dental coverage.

More than half of the premiums pay for commercial general liability coverage, including for sexual misconduct.

A dentist, contacted by Go Public for background, said $20,000 for the procedures Nolte got is not extraordinary and that those procedures were the best option for hygiene, permanence, comfort and for least disruption to other teeth and bone.

The dentist said $2,500 would have been adequate to cover the necessary repairs to Nolte's mouth and a partial plate of dentures, an option chosen by many people. He said the $2,500 coverage was in the mid-range of accident coverage.

'Wrong decision' to not quit hockey earlier, player says

Nolte says he decided to quit hockey after his first year at the junior level but then changed his mind.\

"Wrong decision, that's for sure."

Nolte said he had been cast as an enforcer, despite being only five feet 10 inches tall and weighing 180 pounds.

"I was 17. I was fighting guys who were 20 years old. That was pretty much my only role," he said.

He decided to go on playing after all and was rewarded with more ice-time and eventually the captaincy, though not the scholarship or semi-pro career he was hoping for.

Nolte says he did everything his team asked of him and feels he was let down.

"You're getting told to do whatever you can to win a hockey game," he said

"If you have to fight you have to fight. If you have to block shots, you block shots.

"And then when you do get a stick in the face because you are doing your job to stay in that league, you're not even covered."

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Date-rape drugs may not be as prevalent as you think

The discovery of a 16-year-old girl at a Halloween party in Quebec who was found naked with traces of the date-rape drug GHB in her bloodstream has renewed concerns about the prevalence of these incapacitating substances.

The incident occurred at the Spookland Halloween party at Mont Cascades Ski Resort & Water Park in Cantley, Que., just north of Ottawa, on Friday. In total, six girls and three boys were taken to hospital.

While police continue to investigate the incident, one partygoer told CBC News that someone was handing out pills on her bus as she was heading to the event.

What are date-rape drugs?

Date rape drugs are substances that, according to the Vienna-based International Narcotics Control Board, are used "to weaken the resistance of individuals, for example to exploit their property or body with their apparent consent, without them having the slightest recollection afterwards of what happened."

The most common ones are GHB (gamma-hydroxybutyrate), rohypnol (flunitrazepam) and ketamine.

University of Saskatchewan student Michelle MacDonald told CBC that she believes she was given a date-rape drug at a Saskatoon bar in 2013. (Don Somers, CBC)

GHB and rohypnol are central nervous system depressants that are odourless and flavourless, which means they can be added to an alcoholic drink without being detected.

Another common drug is ketamine, which is used by veterinarians to anesthetize animals.

The use of date-rape drugs is not a new phenomenon.

According to a 2009 report by the INCB, benzodiazepines such as flunitrazepam have a history of misuse. Flunitrazepam was first included in the Convention of Psychotropic Substances, a UN treaty to control psychoactive drugs, in 1984.

What are their effects?

The effects of all these substance can include dizziness, memory loss, confusion and loss of consciousness.

The RCMP web site says that the effects of GHB "can be felt as soon as 10 to 20 minutes after ingesting it, and can last up to four hours."

How easy are they to detect?

According to a report prepared by the University of Alberta, the most ubiquitous date-rape drugs can be difficult to detect because the human body processes them fairly quickly.

For example, GHB can be untraceable in the urine after only 12 hours, whereas rohypnol will be traceable in the urine and blood for up to 72 hours.

How are they classified under the law?

GHB and rohypnol are illegal under Canada's Controlled Drugs and Substances Act.

According to the RCMP, the drugs that are in circulation have been manufactured in illegal laboratories.

How commonly are these drugs used?

A 2009 study by the Canadian Medical Journal found that 21 per cent of reported sexual assaults involved date-rape drugs, up from 12 per cent in 2003.

The study screened 882 women over the age of 16 who had been sexually assaulted. 21 per cent, or one in five, believed they were intentionally drugged prior to being sexually assaulted.

Edmonton Police display some of the 106 litres of GHB seized in a drug bust in 2013. (CBC)

However, of the substances found in the women's systems, "very few of those were what people classically refer to as date-rape drugs," says Janice Du Mont, an associate professor at the Dalla Lana School of Public Health at the University of Toronto and the lead author of the study.

"We found only one case of GHB, no rohypnol, a couple of cases of ketamine."

Du Mont acknowledges it can be hard to pinpoint how widely date-rape drugs are used, precisely because GHB and rohypnol are both untraceable after 72 hours.

Even so, Du Mont says "the big drugs" that came up in the 2009 study sample were street drugs such as marijuana, cocaine, amphetamines and analgesics such as codeine and morphine.

She says that there is "a lot of hype" about so-called date-rape drugs, but she says the amount of media coverage of them might be misleading.

"It's not that women and some men aren't being surreptitiously drugged and sexually assaulted, but maybe the question might be the common drugs that are being used."

What is the most common date-rape drug?

Du Mont says that, generally speaking, "alcohol is implicated in 50 per cent or more of sexual assaults, either the victim or the assailant or both."

This points to the fact that "alcohol is the number one-date rape drug," says Lenore Lukasik, chair of the Ontario Coalition of Rape Crisis Centres.

"You're at risk of experiencing sexual violence if someone slips something in your drink, absolutely, but there are also folks that get people drunk, and that's how they then perpetrate the violence," says Lukasik.

Is it possible to charge someone with the use of a date-rape drug?

A key determinant in bringing a charge of sexual assault against someone is a lack of consent on the part of the victim. And "if somebody's impaired by alcohol or any other substance, they cannot consent to a sexual act," says Eugene Oscapella, a lawyer and professor of drug policy at the University of Ottawa.

That said, charging someone with "drug-facilitated sexual assault" is challenging because it is difficult to prove that a person intended to incapacitate another individual, says Oscapella.

This is especially tricky given how quickly date-rape drugs can leave the bloodstream.

"How do you go about showing that this person gave this substance, knowing what it was, and used it for this purpose, so that they could facilitate the act?"

Oscapella says if police found a person who committed sexual assault in possession of GHB or rohypnol, they could make a reasonable case that it was premeditated.

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Refugee health care: This is deadline day for Ottawa's new policy

The federal government has until the end of day today to introduce more inclusive health-care coverage for refugees, after a Federal Court gave the Conservatives four months to draft new policy after overturning changes they made in 2012.

Immigration Minister Chris Alexander told the Commons on Monday that he would have some "details" to announce in short order but that providing health care to "failed" refugee claimants was not part of the Conservative government's repertoire of "basic Canadian values."

A decision by the Federal Court last July found that changes made by the federal government to refugee health-care funding in 2012 were unconstitutional. The effect of the cuts were deemed "cruel and unusual" and the court gave the government until Nov. 4 to review its policy.

The government asked for a stay until an appeal is heard. But that request was rejected on Friday.

The debate over how much health care should be provided, which has often been acrimonious, came up during question period on Monday as Opposition New Democrats and Liberals pressed Alexander for details about today's deadline.

NDP MP Andrew Cash said "the minister ignored the protests of doctors, refugee advocates, provinces and parliamentarians, and took health care away from children and pregnant women."

"Will the minister finally give up his lengthy assault on basic Canadian values?," Cash said.

Alexander replied "On our side of the House it is not among basic Canadian values to offer health care – often health care that went beyond that provided to Canadians – to those whose immigration and refugee claims have failed, or to those who were deliberately fraudulent in their representations to the Immigration and Refugee Board.

"And we will continue to stand up for the interests of taxpayers in that respect," Alexander said.

Canadian doctors have taken issue with the government's distinction between "bogus" and "genuine" refugees, arguing that the changes brought in 2012 also applied to those claimants whose applications are being processed and who are in the queue waiting for a hearing.

The debate became increasingly partisan when Liberal immigration critic John McCallum poked Alexander over the government's losing streak before the courts.

"When I heard the courts had rejected the government's request to delay restoration of a fair refugee health policy, my reaction was: thank goodness for the judges and the Charter of Rights. They are one of the few constraints on the mean-spirited actions of this majority government," McCallum said.

"Will the minister respect the law and reinstate a decent refugee health plan... which is what the court has demanded or will he stand in contempt of the court?"

Alexander said, "All I can say in response to that is, thank God for this Conservative government. We are the only ones in this House that can be relied upon to protect both refugees and the interest of Canadian taxpayers.

"We remain disappointed in this decision. We are appealing it. We will have more details to offer on our response to the latest decision very shortly," Alexander said. 

The latest decision came from the Federal Court of Appeal last Friday when it rejected the government's bid for more time before implementing a new policy.

Lorne Waldman, a lawyer for the plaintiffs, says that, in theory, the only way the government could try to get around the Federal Court's rejection of a stay would be to seek leave to appeal to the Supreme Court. 

"On an issue like this, the chances of getting the court to intervene on the dismissal of a stay is very slight," he wrote in an email. "If there is no appeal to the Supreme Court on the order denying the stay, the government must comply."

If the government doesn't comply it could be found in contempt of court.

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Night shift effects on brain comparable to chronic jet lag

People who work night shifts for a decade show poorer memory and other cognitive impairments compared with day workers, say researchers, who also found recovery is possible.

Shift work, like chronic jet lag, disrupts the body's internal clock and has been linked to physical health problems such as cardiovascular disease and some cancers. Less is known about its potential effects on cognitive abilities.

To find out, researchers followed more than 3,200 employed and retired workers in three regions of southern France who had annual medical assessments from 1996 to 2006. Just under half of the workers had worked shifts for at least 50 days of the year.

The participants did tests of their memory and speed of processing on three occasions. They were 32, 42, 52 and 62 years of age when the first data was collected.

"Shift work chronically impairs cognition, with potentially important safety consequences not only for the individuals concerned, but also for society," Philip Tucker of the psychology department at Swansea University in Wales and his co-authors concluded in Monday's online issue of the journal Occupational & Environmental Medicine.

Most shift workers become progressively sleep deprived, partly because of the difficulty in sleeping well during daytime hours. (Akira Suemori/Associated Press)

The effects of shift work on cognition were equivalent to six years of normal cognitive decline from aging, Tucker said.
Researchers aren't sure why, but they suspect it's as if shift workers are constantly jet-lagged.

"It may be that the desynchrony, if you like, between people's work schedules and what their body clock would like them to do is actually affecting their brain structures," Tucker said in an interview.

It's increasingly recognized that sleep deprivation has significant effects on cognition, said Dr. Brian Murray, a neurologist and sleep specialist at Sunnybrook Health Sciences Centre in Toronto.

One of the reasons we sleep is to remove metabolic debris, said Murray. "A space in the brain opens up to facilitate clearance of these toxic products. If people don't sleep well, they're more likely to develop neurodegenerative diseases."

Sleep quality differences

Most shift workers become progressively sleep deprived because daytime sleep tends not to be as good as that obtained at night, said Murray, who was not involved in the study.

For example, the brain's hippocampus has actively dividing cells. One hypothesis is that during a stressful situation, cortisol is released that could impair function in the hippocampus, and that can impair memory formation, Murray said.

Tucker said the good news is that subjects also showed signs of recovery. "Those signs didn't occur until at least five years after giving up shift work."

The study's authors suggested that since the problems don't kick in until people worked in shifts for at least 10 years, perhaps workers could look for another job before that.

Mitigating night-shift work

Mohammed Sadique of Toronto drives a cab overnight and drinks coffee to stay awake. "I don't have to look at any map or GPS," he said of his memory.

But Sadique said he doesn't have much choice about when he works.

For employers and employees, experts suggest some ways to mitigate the effects, including :

• Set work schedules that involve only a few nights at a time so that the body clock remains in a relatively day-oriented state.
• Rotate shift work schedules in a clockwise fashion, which is easier to adapt to than counterclockwise.
• Get adequate sleep time when possible in a dark, quiet room.
• Encourage family and friends to respect sleep time.

The researchers acknowledged limitations of the study, such as the need to group some types of atypical work schedules and the possibility that there was some shift work in the control group.

The study's authors also said it's possible that those who quit shift work a long time ago may have higher cognitive abilities and were able to move into non-shift jobs at an earlier stage of their career.

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Naloxone could curb rising trend in prescription drug-related overdose deaths, WHO says

More than 20,000 deaths might be prevented every year in the United States alone if naloxone, used to counter drug overdoses, was more widely available, the World Health Organization said on Tuesday.

Few countries have such good data as the United States, but the WHO estimates about 69,000 people around the world die each year from overdoses of heroin or other opioids, with Iran, Russia and China known to have high numbers of opioid users.

Naloxone, a generic drug, is used to counter overdoses of heroin and prescription opioids including hydrocodone, oxycodone, codeine and tramadol.

If opioids are easily available in people's bathroom cabinets, it might make sense for naloxone to be equally available, a WHO expert says. (CBC)

Opioids are prescribed for chronic non-cancer pain such as lower back pain, but they are the most addictive substances in common use and the most commonly prescribed drugs in the United States, said WHO expert Nicolas Clark.

The United States has seen a tenfold increase in prescription opioid use in a decade, and they caused more than 16,500 deaths in 2010, while heroin deaths numbered about 4,000.

Most people overdose because they misjudge the dose or their own tolerance for the opioid and their death is often witnessed by a family member who would be on hand to administer naloxone, Clark said.

"If opioids are easily available in people's bathroom cabinets, it might make sense for naloxone to be equally available," Clark said.

Previously its use was limited by the need to inject it, but recent advances had shown it was effective as a nasal spray and it could work within 2-3 minutes, with no side-effects.

"We're happy to recommend the intranasal approach as an effective approach," Clark said. "Naloxone is cheap but it's limited really to emergency departments and some ambulance departments."

Addiction experts writing in the British Medical Journal welcomed the new guidance, saying it would help save more lives among heroin addicts.

Last month, Scotland, the first to introduce a national program to provide naloxone, released results showing a marked reduction in opioid overdose deaths among people just released from prison, a particularly high risk group, from 9.8 per cent in 2006 and 2010 to 4.7 per cent in 2013.

Schemes to make available are being implemented around the world after Scotland's national take-home naloxone program began in 2011, with Wales's scheme starting the same year.

City and state schemes have recently started in parts of the United States, Europe and Australia.

Naloxone is already being used to save lives in a number of Canadian cities, including Vancouver, Toronto and Edmonton.

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U.S. human gene patent blocks quality patient care, Canadian hospital officials argue

An Ottawa hospital is challenging the legality of gene patents that hamper the ability of doctors to freely screen for potentially deadly genetic diseases without fear of being sued for patent violations.

On Monday, the Children's Hospital of Eastern Ontario (CHEO) started a legal process in Federal Court that could decide if human genes can be patented in Canada.

"It's about whether Canadian hospitals can provide genetic testing to Canadian patients and really give them the top quality of care," said Richard Gold, a lawyer and intellectual property expert at McGill University in Montreal, who is advising the hospital pro bono.

There is a concrete example of a U.S. patent holder trying to hold up Ontario labs and hospitals from being able to deliver a genetic test to patients, says lawyer Richard Gold. (CBC)

Currently, some genetic tests can't be done in Canada because U.S. companies hold patents on the tests and the genes and have threatened legal action if the patents are violated by doing the tests in Canada, rather than the U.S.

The U.S. Supreme Court ruled last year that naturally occurring human genes can't be patented and threw out patents held by Myriad Genetics Inc. to look for mutations on the BRCA 1 and BRCA 2 genes associated with much greater risks of breast and ovarian cancer, including a mutation that actor Angelina Jolie revealed she inherited.

CHEO's case centres on patents for genes associated with long QT syndrome, an inherited heart rhythm disorder that typically presents for the first time as a fainting spell or seizure during exercise or tragically in sudden death, said Gail Graham, head of medicine genetics at the Ottawa hospital.

"Genetic technology is just exploding. It's increasingly embedding itself at the heart of medicine," Graham said in an interview.

"Genes are not inventions. They belong to all of us," she added during a news conference.

Long QT syndrome is treatable, but it often results in sudden death of a young person. With genetic screening, doctors aim to treat it before tragedy strikes.

The hospital is not allowed to screen for genes associated with long QT syndrome because a U.S. company has patented the test and the genes.

"One of the licensees that's holding these patents wrote a letter to Ontario and said, 'By the way, we have a patent here: stay away," said Gold. "So Ontario did stay away. And so we have a very concrete example of this patent holder trying to hold up Ontario labs and hospitals from being able to deliver this test."

The U.S. Supreme Court ruled last year that naturally-occurring human genes can't be patented but there's been no similar gene patent case in Canada.

Beyond the specific example of long QT syndrome, CHEO hopes the Canadian legal case will also clear the way to allow more advanced genetic testing that can screen thousands of genes linked to human genetic conditions.

For example, if a newborn in the neonatal intensive care is thought to have a genetic condition that can't be identified conventionally, it's now possible to take a blood sample from the baby and read through about 5,000 genes that are associated with genetic diseases.

"If we were to incidentally discover that that child would have long QT syndrome, that wasn't what we were looking for, but we found that it was there, we would be prevented from learning that information and prevented from transmitting it to the patient and the family because of the existing patents," Graham said.

"What we are trying to achieve from a broader perspective is a court ruling that says, 'No, these particular patents are invalid or would not be infringed by the type of testing we would like to do.'"

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Radical rest homes: Old people should live everywhere

It sounds like a bit of an oxymoron: "Radical Resthomes."

But that's the theme that Janet Torge and her website have been expounding. Radically different from the stereotype.

Aren't seniors' residences boring places for bingo, movie afternoons and white bread sandwiches with the crusts cut off? Or worse, prisons for the incarcerated elderly?

Not in Torge's world. For 30 years she has been imagining and re-imagining a different way of growing old.

Then, a little while back, she heard a Sunday Edition documentary about the Baba Yaga's House — a group of aging feminists in Paris who designed a vibrant community where they could grow old together. And that helped focus some of her ideas. 

Torge, a freelance documentary film producer, lives in Montreal and wants to see similar experiments take hold in Canada, for men and women; alternatives to the profit-driven, regimented seniors' residences popping up all over the country.

She has found hungry audiences, many of them women in their 50s, 60s and 70s wherever she goes.

"I am 67 years old," she says. "I have no registered pension plan, I still work."

Montrealer Janet Torge wants us to start talking about new ways of living as we age. (Photo courtesy Janet Torge / CBC)

For Torge, money has always been tight and a couple of years ago she downsized from a 7 ½ room apartment.

She now lives on the first floor of a small duplex she bought with her son, who lives with his family on the second floor.

"It works perfectly for now," says Torge. But she is not sure it's going to last

"How will I pay my bills if I get sick and can't work?" she asks. "Who is going to be my caretaker? Will I have to totally depend on my son and daughter in law?"

Women in the audience in this Ottawa backyard nod their heads in agreement.

'Not getting it'

Torge has spoken to a number of groups over the last year about her ideas of alternative living arrangements for seniors.

She talks about the effect the growing number of seniors will have on families and on the economy.

Living arrangements

Finding the right architectural and interpersonal design — the right amount of togetherness or solitude — can be a life-long challenge. 

Today, many people are experimenting with things like co-housing, tiny portable houses and with radical de-cluttering, not to mention off-the-grid hermitage. 

This season, The Sunday Edition is paying special attention to people doing it a little differently. 

And so if you know about an original kind of living arrangement — or have put together one yourself — please let us know about it by visiting our website, or emailing the program at: thesundayedition@cbc.ca.

If you're really alternative, you can sit down and write a letter to The Sunday Edition, CBC Radio One, P.O. Box 500, Station A Toronto, M5W 1E6.

"There are a whole bunch of businesses that are trying to figure out how to make money off us," she says. "Cars are being designed so we can get in and out of them. There are cool-looking walkers."

But Torge says the housing industry has "really got it wrong."

She recently attended a presentation by federal civil servants on the future of seniors' housing, and left disappointed "because it is all about quantity of seniors and not about the quality of the lives that we want to live. They are not getting it."

Torge says she often hears housing experts promoting institutional living, but says "I do not want to lose my decision-making about where I want to live."

"When I look at what is an alternative," says Torge, that means "to me you create the rules of your own living. You do not walk into somebody else's rules."

Torge says there are all kinds of alternatives to large institutions for seniors. She says there is no problem coming up with ideas, though some of them require having a bit of a nest egg to start things off.

In Montreal, Torge has started Radical Resthome discussion groups, and was surprised when people in their 40s and 50s showed up wanting to participate and start planning alternative living arrangements.

"When do we do this? This is the big question that everybody has," she says. "I do know that it will happen after you have accepted that you have to downsize and before you get sick. Those are the only parameters I know. You will have to learn to share with others."

Build a network

Torge's vision is to build a Radical Resthomes network so that all those with real housing alternatives can share their experiences, resources and solutions to problems.

"We're going to run up against some real challenges as we age, get ill and need help.

"If a housing project in Saskatoon has figured out how to deal with a housemate who is getting dementia, I want to know what they came up with. We have to help each other if we want to stay in control of our lives."

Torge says that over time she has finally defined what makes a real "radical resthome."

They are "run and managed by the people who live there," she says. "Residents look after each other, and when help is needed resources come to you, you are not shipped out. And we die in our own beds, not in an institution."

Torge says that years ago someone asked the urban planner Jane Jacobs where old people should live and she said "everywhere." That's also one of the parameters.

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UN's Ban Ki-moon warns against quarantining Ebola health workers

United Nations Secretary-General Ban Ki-moon warned on Monday against "unnecessarily" strict restrictions on the movement of health workers who have been fighting the deadly Ebola virus in West Africa.

In some U.S. states officials have imposed quarantines on health professionals returning from three Ebola-ravaged West African countries, but the U.S. federal government opposes such measures.

Canada and Australia have barred entry for citizens from Liberia, Sierra Leone and Guinea, where the disease is widespread, and some U.S. politicians have called for a similar ban by the United States.

"The best way to stop this virus is to stop the virus at its source rather than limiting, restricting the movement of people or trade," Ban told a news conference in Vienna. "Particularly when there are some unnecessarily extra restrictions and discriminations against health workers."

"They are extraordinary people who are giving of themselves, they are risking their own lives."

Major international airlines and shipping service lines should continue normal trade, movement and transportation, he said.

Medical experts say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and is not transmitted by asymptomatic people.

"Of course, when somebody has a symptom (of Ebola) those people should be immediately treated and supported and evacuated when necessary," Ban said.

Meanwhile, a doctor in Sierra Leone has died of Ebola — the fifth local doctor in the West African nation to die of the disease, authorities said Monday.

Dr. Godfrey George, medical superintendent of Kambia Government Hospital in northern Sierra Leone, died overnight, according to Sierra Leone's government.
 
George's death, which was announced by Dr. Brima Kargbo, Sierra Leone's chief medical officer, was a blow to efforts to keep desperately needed health care workers safe in a country ravaged by the deadly virus.
 
George had been driven to the capital, Freetown, after reporting that he was not feeling well.
 
Doctors and nurses have been particularly vulnerable to contracting Ebola, as the virus is spread through bodily fluids.

The most deadly outbreak of Ebola on record has killed nearly 5,000 people, all but a handful of them in Liberia, Guinea and Sierra Leone.

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Canada leading global study on Inuit suicide prevention

Canada is leading an international effort to pull together the most effective ways to prevent suicide among aboriginal youth in the Arctic, an ongoing tragedy across the circumpolar world.

This month, officials from the eight countries that ring the North Pole gave final approval for researchers to visit northern aboriginal communities to study how they're dealing with the problem.

Nunavut's chief coroner called a special inquiry in January after 45 people killed themselves in 2013 -- a significant increase from the previous high of 34.

That record number put the territory's suicide rate at more than 13 times the national average.

But it's bad elsewhere, too.

Suicide rates among Alaskan aboriginals are about three times the United States average. In Greenland, 2010 government data reported about one suicide a week in a population of about 56,000.

Statistics in Norway, Sweden and Finland for the aboriginal Saami population are difficult to tease out. But available data suggests suicide and mental health are issues in their communities as well.

"I think that's clearly why the Saami health leadership as well as the government of Norway is supportive of this project," said Malcolm King, science director for the Canadian Institutes of Health Research, which is co-ordinating the project.

Teams are already at work in the participating countries of Canada, the U.S., Norway, Sweden and Denmark, King said. He's hoping Russia, which is also said to suffer high Arctic aboriginal suicide rates, will join.

Suicide across the circumpolar world seems to have some common features, said King. It affects predominantly young people up to their mid-20s, and seems to involve rapid cultural displacement that Arctic people faced as southern governments exerted their authority over their northern regions.

"A common thread that's emerged in a lot of this so far is what we might call cultural continuity," he said. "Issues around formation of identity, and disconnections with the community. That may not sit as a cause in mainstream thinking, but it certainly has been talked about a lot as a common thread among indigenous peoples."

King said common themes are also beginning to emerge about the most effective prevention programs. 

"There are certainly some indications that involving youth in various ways in finding their own pathway to mental wellness is an important part of projects," he said. "Good practice models all involved active participation of youth."

Often, those models are as simple as giving youth a voice, such as a photography, theatre or film project. Some involve peer support through social media.

"They get people thinking positively about their mental well-being, providing a positive alternative to what otherwise might be negative," King said. "Overcoming a sense of being alone, in itself, is probably a good thing."

The government of Nunavut has long run suicide prevention programs of its own. Mental-health advocates say services in the Arctic don't even come close to meeting the demand. They point out Nunavut doesn't even have a residential substance abuse program. 

The overall report is expected at the next Arctic Council meeting in March in Iqaluit. The Canadian government has contributed $1 million to the project.

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