Hon. Mary Coyle: Honourable colleagues:

Stolen from the plots of quixote Pierrot and the troubled Muddy Waters, these elegiac flowers of Whylah Falls, the Black Mississippi village banished to Jarvis County, Nova Scotia, in 1783, droop with the heaviness of history. Irrigated by liquor and tears and dessicated by blistery blues, they bloom in direct moonlight. Though intended originally for the garden of Whylah Falls, these loose flowers are freely planted here.

The “here” of this poem is Africadia, Acadia, Nova Scotia, the birthplace of former parliamentary poet laureate George Elliott Clarke, the place where Africans first came to Canada. Clarke’s “elegiac flowers” represent the over 3,000 people of African descent who came to Birchtown, Nova Scotia in 1783, like the fictional Aminata Diallo of Lawrence Hill’s Book of Negroes.

I quoted this poem when I spoke in support of Senator Bernard’s Emancipation Day bill. Today I rise to celebrate African Heritage Month, as we call it in Nova Scotia. I want to highlight our province as the birthplace of African culture and heritage in Canada.

African people and people of African descent came to Nova Scotia in a number of ways, including the earlier mentioned Black Loyalists at the time of the U.S. War of Independence. Some ended up leaving to help establish Freetown, Sierra Leone.

In 1604, Mathieu Da Costa, said to be the first Black person in Nova Scotia, is recorded among the founders of Port-Royal, established by Samuel de Champlain on traditional Mi’kmaw territory, close to the town of Annapolis Royal.

The Fortress of Louisbourg on Cape Breton Island was home to 200 Black slaves during the French regime of 1713 to 1758, most coming from the French West Indies.

In 1796, 600 Trelawny Maroons were exiled from Jamaica to Nova Scotia, and many moved on to Sierra Leone.

After the War of 1812, roughly 2,000 Black refugees came, and from the 1920s on, hundreds of Caribbean immigrants came to work in the coal and steel industries in Cape Breton, and today people of African descent continue to enrich our province in so many ways.

As I conclude my remarks, I want to congratulate three important beacons of education in our province: the Black Cultural Centre with its African Nova Scotian Museum in Cherry Brook, the Africentric Delmore “Buddy” Daye Learning Institute in Halifax and the unique Black Loyalist Heritage Centre in Birchtown. Thank you for shining your bright lights on African Nova Scotian history, heritage, culture, people, communities and accomplishments. Your work is important. Thank you, wela’lioq.

Senator Coyle: I’d be delighted to.

Senator M. Deacon: Thank you. I heard you touch on the importance of and how we access those folks who may be marginalized and really hard to access. I just want to say that’s a priority. When we look at the review, so when this bill is passed, and we have two or three years down the road, what would you be looking for in terms of how well this is working? What might you be thinking about in the review part of the process?

Hon. Mary Coyle: Honourable senators, happy Valentine’s Day.

I rise today on the unceded territory of the Algonquin Anishinaabe people to speak at second reading to Bill C-22, An Act to reduce poverty and to support the financial security of persons with disabilities by establishing what is promised to be a generational game changer, the Canada disability benefit.

Honourable colleagues, I would like to start my remarks today with the story of kin — a story about my kin.

When I was 10, my mother, Betty, was pregnant. There were six of us, and were we ever excited. We three girls all wanted a little sister, and my three brothers were rooting for a little brother. On Saint-Jean-Baptiste Day in 1965, our little brother John Patterson was born, and in the end what mattered was that our family had an adorable new baby. I felt like mom had the baby just for me. I was over the moon. Johnny was so sweet and so much fun. I played with him and “took care” of him all the time. I just loved him to bits, and I still do.

My brother Johnny was a very likeable and active child. He was smart, funny, athletic and outgoing. Johnny completed high school and went on to study in a number of fields — broadcasting, recreation and later computers. He worked in the hospitality industry, including stints in Banff; worked in child care; got involved in radio, theatre and improv.

Along the way, when I had already moved out of the house and started my own family, my dear youngest brother developed chronic and serious health difficulties, mental health conditions, commencing at the age of 14. These took years to diagnose and treat, and of course, those were very turbulent and often painful times for Johnny as he tried to finish school, work, pay the bills, have good relationships and make a life in the ways that we all want to do. It was all just so much harder and at times impossible for Johnny because of his health.

Like many Canadians, Johnny has bipolar disorder and severe anxiety. In his case, these conditions are very debilitating. Today, Johnny’s full-time job, quite frankly, is being healthy, and I can tell you he works very diligently at that. He volunteers in the community, visits our almost 96-year-old mom, swims to stay physically well and works to keep up relationships with a close circle of friends and family. Johnny is a kind and good person who was dealt a hand that included a really tough disability.

Increasingly unable to work at paid employment — it sure is hard to keep a job when you can’t sleep at night and are experiencing other severe symptoms of anxiety and depression — Johnny was initially refused eligibility for the Ontario Disability Support Program, or ODSP, but was eventually approved after being hospitalized in 2001. ODSP pays $1,230 per month for a single person like Johnny. In my province of Nova Scotia, he would be expected to live on $950. While it is good that he receives some modest income support, Johnny says that the financial stress of being on disability is hard on his mental health.

Colleagues, it’s stressful not having enough money for even the basic necessities of life. Ending the financial insecurity of people like my brother Johnny — my kin and yours — and reducing poverty, which is disproportionately high among disabled Canadians, is what Bill C-22 and the Canada disability benefit are all about.

It is also about restoring people’s dignity. My brother would tell you that the stigma around mental health is hard to shake. Johnny still feels shame and guilt thinking that somehow his situation is his fault.

Honourable senators, the Canada disability benefit will provide much-needed material support to people like Johnny, and it could also send an important signal to them that our society understands, respects and values people living with disabilities.

Senator Cotter, the sponsor of Bill C-22, eloquently and comprehensively introduced us to the essential content of this important bill in his speech at second reading last Thursday.

Bill C-22 is a framework legislation that establishes the Canada disability benefit. It’s aimed at low-income, working-age persons with all types of disabilities. It’s the cornerstone of Canada’s Disability Inclusion Action Plan and its highest priority.

According to the legislation, most of the benefit’s design elements will be established through regulations, and those will be developed in collaboration with people living with disabilities. As the slogan rightly states, “nihil de nobis, sine nobis” — nothing about us without us. Nothing about disabled Canadians without disabled Canadians at the table.

Colleagues, when studying this legislation, I was interested in how this new benefit was connected to related policies and initiatives such as guaranteed livable basic income, medical assistance in dying and the new national health care deal. During my first year in this chamber, I joined the All-Party Anti-Poverty Caucus led by our former colleague senator Art Eggleton. We studied a number of poverty-reduction measures, including the now-cancelled Ontario Basic Income Pilot.

Asked at one of our meetings whether the government would consider playing a role in establishing a guaranteed livable basic income for Canadians, Minister Duclos, then Minister of Families, Children and Social Development, was very clear that the government intended to focus its poverty-reduction efforts on targeted groups of the population — children, through the Canada Child Benefit, and vulnerable seniors through the Guaranteed Income Supplement.

We know that the Canada disability benefit is modelled on the Guaranteed Income Supplement for seniors. The maximum GIS payment for single pensioners at the moment is $1,026. We don’t yet know what the CDB amount will be.

Honourable senators, when I spoke on Bill C-7, the medical assistance in dying legislation, I cited a letter from disability advocates that stated:

. . . there is a real risk that those without adequate support networks of friends and family, in older age, living in poverty or who might be further marginalized by their racialized, indigenous, gender identity or other status, will be more vulnerable to being induced to access MAiD.

Those fears were widely held.

Colleagues, a number of disability advocates have indicated that the Canada disability benefit, if well designed and appropriately resourced, could be an important response to those fears about MAID.

The third related matter is the new health care deal currently being negotiated between the federal government and the territories and provinces. Sister Elizabeth Davis, co-chair of the Newfoundland team that produced that province’s Health Accord plan, told the CBC that new funding proposed by the federal government would allow the implementation of half of that province’s Health Accord plan. But without finding ways to address the other half, the plan won’t succeed.

The other half, which addresses the social determinants of health, is perhaps more important and needs even more attention. One of the findings of the Newfoundland Health Accord is that social, economic and environmental factors play a role in 60% of health outcomes, while the actual health care system accounts for 25%, and a person’s genetic makeup, the final 15%. Sister Davis says poverty reduction is crucial — again, an obvious link to the Canada disability benefit.

Colleagues, the case for a disability benefit for Canadians in need is both clear and compelling. We know that 22% of our population consists of persons with disabilities; in my province of Nova Scotia, it’s 30%. Forty percent of us have family members with disabilities. You’ve heard about my brother Johnny. We know that 41% of people living in poverty in Canada are disabled, with 10% of seniors with disabilities living in poverty, and that disabled people make up over 50% of people facing food insecurity in Canada.

Vancouver’s The Province headline on February 9 last week declared that a disability diagnosis is “a prescription for poverty.” Colleagues, that is a shared national shame.

The Disability Without Poverty organization’s submission on Bill C-22 provides even more detail on poverty experienced by persons living with disabilities. They point out how poverty among their members has deepened during the COVID pandemic and how the impacts of inflation and the housing crisis have disproportionately impacted disabled Canadians.

Colleagues, the preamble of the Poverty Reduction Act states that “Canada aspires to be a world leader in the eradication of poverty,” and the act establishes the ambitious poverty reduction target of 50% below the level of poverty in 2015 by 2030.

Colleagues, with this national aspiration clearly spelled out and the obvious case for creating a much-needed financial benefit for disabled Canadians, we have been asked by people in the disabilities community to now do our part to ensure that Bill C-22 moves to Royal Assent with haste. People living with disabilities need financial relief, and they need it now.

Bill C-22 was passed unanimously in the House after a detailed study and with amendments. Our job is not to unduly hold up the bill, while at the same time, we need to work efficiently to fulfill our responsibility to ensure that we have legislation that enables the creation of a robust Canada disability benefit which will have the intended outcomes of significantly reducing poverty and supporting the financial security of persons with disabilities — one which clearly responds to what people living with disabilities are asking for.

They’re asking the federal government to prevent clawbacks of benefits by provinces and territories, prevent clawbacks by private disability insurance companies and ensure that the coming into force and the money actually flowing to beneficiaries happen within the year — we need strict deadlines for every step of the development and implementation process.

They are also asking the federal government to ensure benefit amounts are adequate to actually take people above the official poverty line; have eligibility criteria which are clear, fair and developed in consultation with persons with disabilities; develop a two-track process for determining eligibility so that people eligible for provincial and territorial benefits do not have to prove again that they have a disability and live in poverty; ensure the working-age target group doesn’t leave out disabled seniors — I’m a senior, and I’m still working — ensure there is proactive outreach to all persons who could be eligible. The most vulnerable don’t always file taxes, as we heard Senator Forest mention, and some may not even have social insurance numbers; they need to be reached out to.

Further, the government is asked to ensure the right to appeal refusal exists — and that there’s a tribunal for that — and that mechanisms for complaints are in place; and to include the most critical details in the bill itself, rather than leaving so many details to the regulations.

This is what many are asking us. The Accessibility for Ontarians with Disabilities Act Alliance calls Bill C-22 a well‑intentioned but weak bill. They say we still don’t know how much the benefit will be, who will be eligible for it or when the government will start paying it. Some others are expressing greater trust in the government and the promised co-development process.

Honourable senators, my brother Johnny was 55 when the promise to create the Canada disability benefit was made in the September 2020 Speech from the Throne. In four months, he will turn 58, already almost three years since that promise. Honourable senators, let’s move this transformational bill to committee so our colleagues can investigate whether and how it can best deliver in a timely manner on its important promises of financial security, poverty reduction and dignity — promises to my brother Johnny and to other Canadians living with disabilities. Honourable senators, let’s ensure this promised generational change starts now.

Thank you, wela’lioq.

Hon. Stan Kutcher: Honourable senators, I rise today to speak to Senator Coyle’s inquiry on climate. I will focus on the impact of climate change on human health, and how health care systems could respond.

To begin, let us acknowledge the leadership and hard work that Senator Coyle has demonstrated in creating and advancing Senators for Climate Solutions.

Climate change is not only a threat to our global environment and economy, but it is also an existential threat to human health and our health care systems. In 2009, the medical journal The Lancet identified climate change as the most significant global health threat of the 21st century. These impacts are both direct and indirect. In terms of direct impacts, frequent extreme weather events, such as floods, hurricanes, heat waves and wildfires, impact both health and our ability to provide health care. Various water-borne diseases occur in flooded areas, and access to timely, critical care becomes extremely difficult due to damages to infrastructure, such as roads and bridges. Wildfires disrupt access to acute care sites, while concurrently increasing demand for care due to their impact on respiratory conditions. We are all aware of the impact of hurricanes on health care infrastructure, and how heat waves lead to increased deaths.

Perhaps less appreciated, however, is the indirect impact of climate change on the geographical spread of disease, or the emergence of new diseases — especially infectious diseases. For example, in my home province, there has been an increase in tick-borne infections that can lead to Lyme disease. This is due to an increase in the numbers and longevity of blacklegged ticks as a result of warmer winters. Their biting spreads the bacterium Borrelia burgdorferi, the cause of Lyme disease, resulting in increased numbers of people who have contracted the disease. According to the Canadian Public Health Association, this outcome — of indirect climate change impacts on human health — is driven by numerous complex changes in the pathways of disease transmission that are sensitive to climate changes. For example, the West Nile virus arrived in Ontario in 2013, and has since spread across that province.

I want us to be aware — now — of some of the nasty tick‑borne and mosquito-borne illnesses that seem to be spreading into Canada due to our changing climate. They have impressive names, such as human granulocytic anaplasmosis, babesiosis and La Crosse encephalitis. Trust me; none of us wants to have a severe case of any of these diseases, even if we could pronounce their names. Their impacts are most severely felt in populations that are already at risk of poor health, and face barriers to appropriate affordable housing, food security and quality health care. The impact of climate change will make those inequalities worse. Addressing this issue requires dealing with the social determinants of health, as well as undertaking actions needed to protect health care settings from severe weather events, such as moving them away from flood plains.

We need to be ready. There are two key areas where preparation within our health systems is needed now: These are treatment readiness and risks to health infrastructure.

The first area is treatment readiness. As we all remember, when COVID-19 arrived, we were not prepared. We had insufficient stockpiles of personal protective equipment; we had insufficient surge capacity in our emergency rooms and intensive care units; our surveillance, reporting and tracking systems were inadequate; we lacked national coordination in our response; and much more. This must not happen again. We need a coordinated national disease surveillance capacity with single-point national accountability. This includes a national health database that can provide real-time information to guide policy decisions, and help direct resources and interventions where and when they are needed.

We also need to be able to rapidly provide treatments that we expect may be required. For example, to treat many various tick‑vector bacterium diseases, effective antibiotic treatments are available; there are medications such as doxycycline, clindamycin and azithromycin. They are not exotic drugs; they are commonly used medications.

But as we have learned, we can’t expect that just because they are commonly used that they will be there when they are needed. We are now experiencing challenges obtaining other types of common medications, such as paediatric fever and pain medication. I recently went to Shoppers Drug Mart stores all over Ottawa to try to find specific medications for sinus congestion and found only empty shelves. We can’t let ourselves get into the same situation again.

In conjunction with this is the preparation of our health care providers. I know there are a number of excellent physicians in this chamber. I do wonder, however, how many of us, if faced with a person who presented with persistent and severe malaise, sweats, headaches, nausea and fatigue, would consider a diagnosis of babesiosis? If our basic workup identified the presence of a hemolytic anemia, which is a condition where red blood cells are being destroyed, we would certainly look at all possible causes, but we might not think of asking for a microscopic parasite analysis or ordering a babesia IFA antibody test.

To be clear, this is not pandemic preparation I am talking about. We might indeed experience pandemic disease outbreaks due to climate change, but we might more likely see a gradual increase in various types of infectious diseases. They will slowly sneak up on us unless we are keeping a close eye out.

In September 2020, The Lancet published “A pledge for planetary health to unite health professionals in the Anthropocene,” which proposed an interprofessional planetary health pledge. The pledge adds protecting planetary health to the fundamental commitments health practitioners make when they enter their profession.

Recognizing that, the Canadian Medical Association’s 2020 strategic plan mentions environmental well-being. The Canadian Federation of Medical Students, through its Health and Environment Adaptive Response Task Force, has been working on developing educational materials that could be embedded in medical curricula.

While much more needs to be done, initiatives across all of Canada’s medical schools are under way, and I am pleased to say that the Faculty of Medicine at Dalhousie University is one of the early leaders in this work.

I have great faith in our infectious disease colleagues. I know they are up to this challenge. I would also like to acknowledge and thank our colleague Senator Osler for her exemplary national work on this file.

I am hopeful that this necessary work will be done well and expeditiously.

The second is the risks to health infrastructure. Health infrastructure is something that many of us, especially in large urban areas, take for granted. The hospital? Yes, just down the road. Ambulance station? There is one about 15 minutes away. Drug store? There is one in the Rideau Centre.

Health care settings are subject to extreme weather events that can damage or destroy anything from roads, making it difficult to access a hospital in an emergency, to damage to ports and, thus, to the smooth functioning of the medical products supply chains. This reality raises the uncomfortable possibility that when this critical infrastructure is most needed, it can be unavailable.

Let’s take the issue of floods, for example. In a study of the impacts of floods on health infrastructure, it was noted that health care facilities faced both diminished capacity and increased demands. Regarding the recent floods in Bangladesh, UNICEF noted that:

The flooding damaged water points and sanitation facilities increasing risk of waterborne diseases . . . . Access to healthcare and nutrition services was reduced due to the damage of 90 per cent of health care facilities.

Closer to home, during the recent British Columbia floods, numerous patients had to be evacuated from hospitals and long‑term care facilities, and access to acute-care settings in flood‑ravaged areas became problematic.

A recent flood mapping exercise of Canadian health care centres at risk of flooding concluded:

There are a surprising number of facilities at risk of flooding in most provinces and territories. Manitoba and Yukon have the largest percentage at risk of flooding. . . . Yukon’s high percentage of facilities in the floodplain and small total number of facilities illustrate how weather-related disasters driven by climate change could disrupt and damage important health infrastructure when it is most needed.

So, in the face of our climate change reality, what is to be done? Thankfully, many things. We can consider opportunities for action in two complementary categories: developing environmentally sustainable health care facilities and creating climate-resilient health care facilities.

Health care systems account for about 4% of total global carbon emissions, and health care facilities can act to substantially reduce their carbon footprint. At COP 27, the World Economic Forum produced an article entitled “Here’s how healthcare can reduce its carbon footprint,” which addresses this important issue. For example, hospitals have the highest energy intensity of all publicly funded buildings and emit 2.5 times more greenhouse gases than commercial buildings. Therefore, switching from fossil fuels to renewable energy can have a major impact.

Other innovative solutions can also help.

Another direction is shifting outpatient care away from hospitals into more energy-efficient community settings and by increasing the use of high-quality virtual care with less environmental impact, such as home-based health monitoring systems and telehealth care. A secondary gain will be the avoidance of travel from home to hospital, thus decreasing the carbon footprint of transportation.

Health care facilities also need to become more climate resilient. In this domain, some good initiatives are under way. I will briefly touch upon a few of them here.

The World Health Organization has created the WHO Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities. More recently, the WHO report, Measuring the Climate Resilience of Health Systems, has provided substantial guidance on how to mitigate climate-change impacts on human health and health care.

Our federal government has created the Climate change and health vulnerability and adaptation assessments: Workbook for the Canadian health sector. This is designed to help health care facilities evaluate and then address their climate-change preparedness.

The Canadian Coalition for Green Health Care, in partnership with the Province of Nova Scotia, has created The Health Care Facility Climate Change Resiliency Toolkit that can be used by health care settings to assist them in their climate preparedness work.

As we can see, honourable senators, much work is being done, but much more is needed.

Canada’s health systems, collectively, have the third-largest per capita carbon footprint in the world. Our health care systems were responsible for about 5% of Canada’s annual greenhouse gas emissions prior to the pandemic. Per-capita GHG emissions in our health sector actually increased from 2018 to 2019.

In 2021, Canada committed to the WHO COP 26 Health Program initiative directions, which include building climate‑resilient health systems, developing low-carbon sustainable health systems, adaptation research for health, the inclusion of health priorities in nationally determined contributions and raising the voices of health professionals as advocates for stronger ambition on climate change. To those, I would add this: ensuring that our Indigenous, Inuit and Métis communities are fully integrated into the creation, development, deployment and evaluation of all the work that needs to be done.

We need a cohesive national initiative to set directions, coordinate efforts across jurisdictions and support legislation and implementation of sustainable changes to health systems. That will require collaboration amongst federal-provincial-territorial partners; input from Canadian expertise, such as Health Canada, the Public Health Agency of Canada, l’Institut national de santé publique du Québec, our universities and granting agencies; and international expertise, such as the WHO and the U.S. Centers for Disease Control and Prevention. The National Adaptation Strategy currently under way is an ideal place to address this need. We must not let this adaptation strategy get stranded on the rocks of inactivity.

This is a tall order — an existential challenge — but it is our challenge. As we Canadians have shown time and time again in our history, we are up to any challenge. Wela’lioq, thank you.