Subscribe to our RSS feed

Popular News Stories

  • Fuck poz guys!
  • Tom Hanks in Philadelphia Changed my Life
  • Canadian AIDS Society’s AGM and PHA Forum in Ottawa: some scholarships for HIVers available
  • Semen goes viral – or does it?
  • BareBackRT.com  - the interview

General Health

Nov17

Thinking in silos

Monday, 17 November 2014 Written by // Ken Monteith - Montreal Correspondent Categories // General Health, Health, Opinion Pieces, Ken Monteith

Ken Monteith says "If we are going to take a holistic approach to health and address the people turning to us for help as whole people, when can we start expecting coherence from the government and from our corporate citizens?"

Thinking in silos

For a number of years now, our public health authorities have been pushing the idea that we need to respond more holistically to health promotion and disease prevention. To them, this means pushing organizations working in HIV/AIDS to broaden their reach, to address not only the whole spectrum of sexually transmitted and blood-borne infections (STBBIs), but also complicating factors like mental health, addictions and aging. 

These things are not news to the community response to HIV/AIDS: we have been doing them for years. Prevention activities have long included information on how to avoid, detect and treat other STBBIs, and many of us remember the bad old days when no one would help the people living with HIV with their other problems, so those fell to us, too. Problems with the landlord, fired from a job, refused dental treatment, getting older faster than one’s peers…all of these came back to the HIV/AIDS organization to deal with.

Somehow, the challenge of learning how to integrate knowledge about HIV into their own work was never the responsibility of those other services, so we took that on to make them do their own jobs for our people. 

What is particularly distressing about the current push from government health funders for this massive “integration” is their blindness to their own practices of thinking and acting in silos without regard to impacts in someone else’s field. 

Let’s look at a couple of decision put into place by the Minister of Citizenship and Immigration at the federal level in Canada and the reactions of his peers in cabinet.

First, cutting the interim federal health benefits for refugee claimants (since declared unconstitutional, so the coverage is back, probably temporarily, in a reduced form). No analysis on the health impacts of such a move. Response of the then Minister of Health? “Not my file. See the Minister of Citizenship and Immigration.” That’s the person you want in charge of the health of Canadians, right? 

Second action, much more recent: travel ban for people coming from countries in West Africa affected by Ebola. The World Health Organization has criticized the move, rightly pointing out that this is an action that will not prevent a single person from contracting Ebola and will instead worsen the crisis by heaping stigma atop misfortune (my words, not theirs). I have even heard people in the HIV movement, or at least its peripheries, express their support for this idea, having forgotten what travel bans and a misunderstanding of the transmission of HIV have done for us. The current federal Minister of Health? “Not my file. See the Minister of Citizenship and Immigration.” 

Then there’s that other problem we face with alarming regularity: the criminalization of the exposition to a risk of transmission of HIV (we say HIV criminalization to be brief, but you really have to be precise to grasp the breadth of what is being criminalized in these cases). Public health authorities have pronounced themselves against criminalization and for a more health-based approach to the issue of risk and non-disclosure. [In]Justice marches on, doing what it wants to do without regard to the possible effects on testing, prevention, treatment and the quality of life of people living with HIV. 

There’s a duality in how our corporate citizens act, too. I was quite impressed to hear tell of a Canadian mining company doing business in South Africa that had adopted a policy of providing medical care and support to its employees living with HIV and their families. Want to bet that the same corporation here would quietly not hire or let go the person who disclosed his or her status in Canada? I guess the limits of tolerance are inversely related to the alternatives one might have in the situation (greater selection of non HIV-infected candidates, less tolerance and support). One rule for there, a different rule for here.  

If we are going to take a holistic approach to health and address the people turning to us for help as whole people (like we have been doing since we were created by the affected communities), when can we start expecting coherence from the government and from our corporate citizens?

Arts and Entertainment Section

  • Skimming pebbles: Part two

    Skimming pebbles: Part two

    In part two of Dave R’s story, Andy struggles with what he’s learned and tries to balance deep dilemmas with his own reality. In the end, the choice is taken out of his hands but should he have done more? Would you have done more?
  • Season’s greetings

    Season’s greetings

    Bob Leahy and his dogs on doing what doesn’t come naturally, pet photography and Christmas spent away from home
  • Skimming pebbles: Part one

    Skimming pebbles: Part one

    Fiction from Dave R - a two-part story set in the South Seas. A man tries to escape his past by moving to what he hopes may be paradise. However, the serpent there confronts him with dilemmas he desperately hoped to avoid.

Activism Section

Current Affairs Section

Events Section

  • Living with HIV in Canada?

    Living with HIV in Canada?

    The federal funding agency PHAC wants to hear your views on how they propose distributing funds to the agencies that serve us, and how those services will be delivered
  • Honoured for their work

    Honoured for their work

    PositiveLite.com was at the 2014 Ontario AIDS Network Honour Roll Awards in Toronto last week to celebrate the induction of the four 2014 award winners.
  • Gains and…challenges

    Gains and…challenges

    COCQ-SIDA's new campaign takes on HIV stigma by matching the gains in the fight against HIV/AIDS against the challenges that remain. Ken Monteith reports.

Features and Interviews Section

Health Section

International Section

Legal Section

Lifestyle Section

Living with HIV Section

Media Section

Opinion Pieces Section

  • The chaser’s tale – part three

    The chaser’s tale – part three

    Responding to critics, guest Joseph Sinnott answers some of the accusations levelled at bug-chasers, those people who intentionally contract HIV like himself.
  • Reinventing the language

    Reinventing the language

    To combat fear and stigma, guest Tom Johnston from New Brunswick says “the terms “AIDS”, and “HIV” need to be eradicated from every area of communication and replaced with something more representative of what this virus actually is.”
  • Is HIV getting weaker? Don't count on it

    Is HIV getting weaker? Don't count on it

    From The Body.com “This year's story goes something like this: "HIV is getting weaker." But is it really? And if it is, what does that really mean for the fight against HIV, and for those who are living with HIV today?"

Population Specific Section

Sex and Sexuality Section

  • These are not your grandmother’s female condoms!

    These are not your grandmother’s female condoms!

    Marc-André LeBlanc recently sat down with advocate extraordinaire Jessica Terlikowski to talk about female condoms. Despite being around for 20 years, they are not well known, understood or used. But that is quickly changing,
  • The chaser’s tale – part three

    The chaser’s tale – part three

    Responding to critics, guest Joseph Sinnott answers some of the accusations levelled at bug-chasers, those people who intentionally contract HIV like himself.
  • How to have a threesome

    How to have a threesome

    Lots of couples decide to have threesomes to spice up their sex life together. It can be the beginning of a new stage in their sexual relationship or the end of the whole relationship. FS Magzine finds out how to know if three’s company or a crowd.

MarketPlace