Nova Scotia-wide doctor shortage has Steven Hall taking in new patients regularly

Some residents are wary of convicted felon Dr. Steven Hall, who opened a new practice in Sydney, N.S. However, with a doctor shortage in the area they have no choice but to seek his expertise.

A Cape Breton woman, who chooses to remain anonymous to protect her job, said she had to call when she found out Hall had openings.

“It’s out of desperation that I’m going there. If there was anything else I could do, I wouldn’t go. It comes down to a trust issue. I wouldn’t trust him knowing his past,” she said.

Hall was released from prison in January 2012 after being convicted for the May 29, 2009 accidental killing of his wife, Isabel Hall, originally from Sydney River, N.S. The incident happened while the couple were living in Kentucky.

His patient knew all about his record when she took the appointment, but did so anyway for her family’s health and well-being.

“I don’t think I should ethically or morally see him, but beggars can’t be choosers … He’s the only doctor in industrial Cape Breton taking patients.”

The appointment is less for her and more for her two children.

“What’s a mom to do? I can’t not have a doctor for my children. Someone put him there and gave him authority, and here I am with no doctor. If he wasn’t there I’d still have no doctor.

While some people are telling the patient she’s made a mistake, she’d given out the practice’s number to three people at the time of the interview.

“We need doctors down here that bad. Your first thought is ‘that is terrible,’ but your second thought is, ‘is he seeing new patients?’”

 Hall returns to roots

Hall has been keeping a busy office since he started back last Monday. He said patients have been “extremely grateful” to see him.

“There’s such a high demand for doctors. There’s a waiting list of 1,000 people, but we have been able to give 500 appointments,” said Hall on Friday.

He said when the Chronicle Herald’s article came out, he was worried how the press would affect patients, but there was actually an increase in bookings.

“Today we had about 50 people call and want to be patients … A lot of people didn’t know that a doctor was available. We have so many people wanted doctors and they don’t care whether I’m a bank robber or whatever.”

Hall came back to Nova Scotia, where he originally went to university, because he wanted to be back with family and those close to him.

“I came to be closer to my wife’s family and her grave. She is buried here,” he said.

Hall comes back to Nova Scotia as the province sits in the midst of a serious doctor shortage.

The 2012 government report Shaping Our Physician Workforce said “while there is planning at the district level, there has been little province-wife planning to determine what types of doctors are needed where.”

In 2011-2012, Nova Scotia had fewer family doctors and more specialists than the national average.

“The current mix is 42 per cent family physicians to 58 per cent specialists, while the national mix is 50-55 per cent family physicians to 45-50 per cent specialists.”

Lorianne MacLean, the coordinator for physician recruitment at the Cape Breton District Health Authority, said in an emailed statement that 31 per cent of family physicians in the area will retire by 2020.

“Family physician shortages means that the demand for non-urgent care increases in emergency departments.  This is a higher cost to the tax payer, and more importantly can lead to fragmented care for the person seeking care,” the statement said.

The statement said the health authority was working on “collaborative care models” with the province to fix the shortage. Hall was hired to replace a retired physician in Sydney.

“With respect to giving him credentials to work in the district, his record came into play.  The College of Physicians and Surgeons of Nova Scotia conducted a comprehensive review of his case, and ruled he was eligible to practice in Nova Scotia under the condition of having a mentor,” the statement said.

He is working under a doctor at the Sydney Family Practice, but had to go through a year-long process of examinations by the board that grants the right to practice first.

The College of Physicians and Surgeons of Nova Scotia approved his application and did a two-day clinical competency examination, written and oral exams and a 13-hour psychiatric examination. The college didn’t return calls for comment on the exact procedures Hall had to go through.

Hall maintains his innocence, although five witnesses stated in trial they saw Hall accelerate his pontoon boat over his wife after she fell into the water on Herrington Lake, in Kentucky.

“(Tara) Silbersdorf testified that she watched Hall turn his boat toward Isabel and accelerate ten to twenty feet,” the Court of Appeal document stated.

Hall was sentenced August 16, 2010 for 2nd degree (accidental) manslaughter. His appeal was denied Oct 21, 2011, and remained in prison until January 2012, serving 36 months after he was sentenced. However, he was never released on bail between his arrest and the trial.

Doctor putting life back together

Hall is still devastated by the loss of his wife.

“Isabel was the love of my life. We were married 21 years, we never fought and we were both faithful to each other. Isabel’s loss is tremendous. She was the mother of my children,” said Hall.

Her sister, Susan MacVicar stated her family was “dealing privately with the matter.”

She called Isabel an amazing woman and said the family holds no ill will toward Hall for the incident that caused his wife’s death.

As for the meantime, Hall is looking forward and trying to put things back together.

“I’m trying to put the interests of my boys first. I have my medical career on track and I finally have the chance to be a productive citizen after doing nothing for four-and-a-half years.

The company blamed soft sales in seasonal clothing for decline

Retail company Target continues to open Canadian stores despite a 28.5 per cent drop in profits during this year’s first quarter.

The company blames softer-than-expected sales in “seasonal and weather-related categories” for the dip, which saw after-tax profits fall from $697 million to $498 million.

The company refused requests for an interview and wouldn’t discuss first quarter results. It wanted to wait until the Aug. 21 unveiling of the second quarter results to discuss financials.

The March 2013 sale of their customer credit card receivables to TD Bank Group allowed for a pre-tax gain of $391 million within the company. However, the company paid off debts of $445 million. They declined to specify who they paid back, but the payment combined with the softer sales in the U.S. accounted for the striking change in finances last quarter.

Target could see long-term gains due to expansion

While the loss of profit could be a warning sign, Dalhousie’s economics department chair and professor Kuan Xu says the company’s financials could see large long-term gains.

“Zellers was bought by Target. They (Target) closed down profitable stores and suspended service. But they’re starting to inject their new format and product in hopes of gaining more revenue,” said Xu.

He says any new investment will “generate some additional revenue as well as profit,” but those gains may not be seen in the short-term.

In Canada, costs incurred from opening and renovating stores left the Canadian segment of the company with a $205 loss in earnings before interest and taxes (EBIT).

But Target made clear it was happy with the performance of its stores north of the border.

“We saw a surge in sales in Canada soon after opening our initial stores, especially in home and apparel,” Target said in an emailed response.

They said sales in Canada have recently leveled off, but say their guests are “responding positively to the brands and products that differentiate us in the marketplace.”

To date 68 stores have opened in Canada, including 44 since the end of the first quarter.

Target plans to open their first stores in Atlantic Canada and Quebec in the fall, and in the end should have 124 stores by the end of the year, according to their emailed statement.

“There’s a disconnect between what you read in the quarterly report, and what can come in the future,” said Xu. “With any new investment you won’t expect profits to turn around quickly.”

He says the replacement of Zellers with Target is something “most Canadians are looking forward to.”

“There are upsides to taking over companies or expanding and some Canadians will be happy to see the competition and products with a low price.”

But he warns the Target will have to differentiate itself from competitors like Wal-Mart to be successful.

“You can’t differentiate much in products and merchandise. But you can differentiate in service, layout and attracting the consumer.”

Going forward, Target will have to find a way to set itself apart in a new market.

“They will have to diversify … The big U.S. companies cannot rely on the domestic market alone to continue to grow,” he said.

“The retail space is crowded. Canada is certainly a new market to get into for Target.”

Shirley Shane loses appeal, figuring out next step

Shirley Shane’s slip on an icy Halifax sidewalk left her with a permanent ankle injury.

With her most recent appeal dismissed, she is unsure of where to go next.

“This is a precedent-setting case. They (the defendant) want to make an example of me to deter people from suing when they slip and fall,” she said.

Shane was walking on Hollis St. to work on Jan. 7, 2008 when the accident occurred.

She was wearing “good winter boots”, and couldn’t believe it when her legs went out from underneath her.

“I went down on my back and my foot turned out 180 degrees,” said Shane.

She was taken to hospital, where she had screws and plates put into her ankle.

She spent eight weeks off the job in a cervical cast and she had to slowly ease back into walking.

“I went from a wheelchair to crutches to a cane,” she said. She still has a limp and ongoing pain. She has developed arthritis in her knees.

In the Dec. 17, 2010 decision from the Supreme Court of Nova Scotia, the company that maintained the parking lot adjacent to the sidewalk was rejected in their pursuit of a summary judgement dismissal.

They admitted “there was ice present on the sidewalk” where Shane slipped.

The company, recognized as 3104854 Nova Scotia Limited in the court documents, is an offshoot of Greater Homes Incorporated, according to Shane’s lawyer Michael Dull.

Those are two of many companies owned by the Saberi brothers Navid and Saeid, who often find themselves in the news as of late. Navid is also president and director of the numbered company in the lawsuit.

Greater Homes Inc., the company Dull mentioned, has since been closed for non-payment, and became Greater Homes Realty Inc. Saeid was president and director of the first company, with Navid taking over the second one.

Saeid Saberi never returned calls for comment on the case, nor did the lawyers for the defendant.

“Big business means big money. That’s what I’m up against,” said Shane.

The supreme court document states the sidewalk has been under municipal jurisdiction since 2006, so the company didn’t think they were responsible for “removal of snow, or ice, or spreading salt or sand.”

Dull, working for Wagners Law, said HRM’s only responsibility was to “plow 24 to 48 hours after a snow event.”

“They did that … We could sue if they had a policy and didn’t follow it. But they don’t have a responsibility under their policy to clear ice from the sidewalk.”

The judge said an exception to the fact that municipalities are responsible for sidewalks is that if conditions of their property “flow off and cause injury to persons nearby.”

The judge found enough evidence to send the case to trial.

Co-worker Jason Salis said he found Shane “lying on the sidewalk.” He had often seen ice on the sidewalk before.

“He had formed the habit of crossing the street to avoid the area,” said the Supreme Court Decision.

Employee for the defendant, Philip White, said he salted the parking lot “in its entirety, seeing no snow to remove.”

There was agreement the lot was “at a higher elevation than the adjacent sidewalk,” and pooling of water could occur on the sidewalk, though White saw none.

Shane tried to use the dismissal of the previous motion to prove her case, but the court was not in agreement.

Shane subsequently filed an appeal, decided on July 7, 2013.

She said in the court documents the previous judge “erred in law by failing to examine alternative theories of causation … to determine the probable cause of hazard.”

Her appeal ended the same way the court decision did; with a loss. Her “migration theory” for the water needed to be proven, and she failed to do that. But she is determined to find justice.

“This wasn’t caused by the city. It was caused by the fact the parking lot is on a steep incline, and they push snow to the top. It melts, comes to the sidewalk and freezes,” she said.

“I’m still struggling with the results of this injury, and I will the rest of my life.”

Office of the Fire Marshal still requesting more staff for the future

The Office of the Fire Marshal wants more staff and resources to inspect schools and hospitals in the province, repeating a request first recommended by an Auditor General in 1987 to fix “unduly lengthy”  inspection wait times in schools.

Fire Marshal Harold Pothier’s office is finally caught up on an inspection backlog in hospitals and schools dating back to at least 2010. The office posted a list of schools to be inspected on their website in response to a 2011 Auditor General report that raised concerns about school inspection frequencies.

The report said the office wasn’t doing an adequate job “protecting the public from fire safety risks in buildings” and outlined 26 recommendations that needed to be addressed.

“Our biggest concern is getting resources and requirements to meet our action plan to go forward,” said Pothier. “(The staffing requests) are going through the process at this time. We wait to hear word from the province on a regular basis.”

The office was operating with 14 staff at the time of the audit, and had eight Deputy Fire Marshals in the field. Staffing changes were needed to fulfill the recommendations set out by the Auditor General.

“We now have 16 staff. We added two, and four staff members were also transferred to us from another division. Essentially, we raised our levels by six people,” said Pothier. He notes the number jumped from 14 to 16, and those four people were already in the department.

“We just saw a realigning of their duties,” he said.

They still have eight inspectors in the field, the same number as 2010. However, with one staff member working on the database full-time and other administrative duties taken off inspectors’ shoulders, they are able to focus more on inspections.

“It is much easier to meet our mandate now,” said Pothier.

Report put fire inspections under microscope

When the Office of the Fire Marshal came under scrutiny from the Auditor General, the report that followed outlined numerous problems, chief among them being the infrequency of building inspections and the lack of a reporting system for organizing what inspections were done and when.

“The Office of the Fire Marshal is not meeting minimum fire safety inspection frequencies specified in legislation,” the report said.

The minutes of a Jan. 2012 Public Accounts meeting in the legislature, which Pothier attended, show the challenges the office faced in regard to not keeping track of their inspections.

Associate Deputy Minister for the Department of Labour and Advanced Education Jeff Conrad said the Auditor General was left “in a difficult spot” when he did his audit.

“We are saying to him that we’ve been there … but there’s absolutely no proof. As I’ve said, certainly the … material that we’ve been able to find indicates that we’ve been in the facilities that we’re supposed to be in doing the work – not doing it as we’re supposed to do it, I will grant absolutely.”

Pothier was promoted to acting fire marshal in May 2010, and that position has since been made official.

He wouldn’t comment about the bookkeeping and backlogged inspections he observed before he became Fire Marshal, despite being the Deputy Fire Marshal since 1992 in the office at the time of the audit.

“I can only comment on my involvement directly. I took the position and met with the Department of Labour (and Advanced Education). We took on the firm commitment to deal with all the Auditor General’s recommendations at that time.”

Office is finally catching up

In the last three years, his office has inspected all backlogged hospitals and schools except one school district, which they hope to have finished by “early September.”

“This coming fall, we’ll commence our next cycle. We’re right on schedule,” said Pothier.

Of the 26 recommendations put forward between April 2009 and February 2013, the office has completed 14 as of June, according to their departmental update. The other 12 are listed as “works in progress,” but some significant recommendations still don’t have a permanent fix.

An interim system for tracking inspections is in place, but Pothier says the fire marshals and provincial government are still working on a “permanent database solution across government.”

The update document says a local Information Technology consultant has been “working on the database since Feb. 2012”, which the (Office of the Fire Marshal) is “implementing phase one of.”

Missed inspections, poor bookkeeping and a lack of basic guidelines were brought to light in the Auditor General’s report.

“We determined fire safety inspections are not taking place as required by legislation or policy,” the Auditor General report stated.

It also found “untimely reporting” of serious issues in buildings and “no evidence of follow-up” on problems they did end up finding.

Pothier says the biggest problem in his department was a “documentation issue.”

“We know the work was being done … But without a database or documentation, it was hard to argue what work was done and what wasn’t. We feel we can show what work is being done now.”

The department did have a database, called the Fire Department Management System, but it did not “capture important information on fire inspection and fire investigation activities.

The Fire Department Management System does not “include an inventory of all buildings requiring inspections by the Office of the Fire Marshal nor are all completed inspections and investigations recorded in the database,” the report said.

Staffing levels continue to be a concern

Pothier has more staff and is still asking for more, but staffing levels aren’t a new issue within the office.

Many of the issues that plagued the office in 1987, 2001 and 2010 were the same.

“The inspection intervals for school inspections … seem unduly lengthy. The Fire Marshal’s Office has not been able to carry out its inspections of hospitals within the frequency it would like,” said the report.

In 2001’s Auditor General report, there were still “numerous instances of noncompliance with public safety legislation” and the office was still “unable to comply with the frequency of inspections specified in legislation or policies.”

The perceived reasons for these issues was the “limited resources available to the Office.” The Auditor General recommended a need for more resources in 1987.

Robert Cormier was the fire marshal for the province for 16 years before his retirement in 2010.

“There was only one reason we had trouble, and that was a lack of resources,” he said.

“The municipalities refused to take responsibility for inspecting schools under the Fire Safety Act,” he said. Halifax is excluded, as they inspect their own schools.

That’s approximately 525 schools (to inspect), added to the other things that needed to be done … We had someone set specifically for inspecting schools and they couldn’t get it done.”

He cited travel distance, preparation for inspection, reports and office responsibilities as things that could suck up inspectors’ time.

“Without the adequate resources, you can’t carry out elevated inspections unless you’re incompetent in them. We had eight inspectors at that time with vacation time.

They also did fire investigations and had to log travel time … People don’t recognize the issues going into timing for people who have to carry out these activities.”

“I believe we were doing as good a job as anyone in this country with the resources we had.”

Cormier wouldn’t comment on whether he had ever asked the Department of Labour for more staff and resources.

“All I can say is there weren’t adequate resources to carry out the work in accordance with Auditor General called for in the reports.”

The Department of Labour wouldn’t comment on why staffing levels weren’t increased after the 1987 or 2001 reports.

“We can’t speak to why previous governments did or didn’t do things to implement the auditor general’s recommendations,” said Chrissy Matheson with the Department of Labour in an emailed statement.

“What I can say is when the province received the auditor general’s report in 2011, the importance of making changes to the system to protect the health and safety of Nova Scotians was recognized and understood.”

“This is not to say that the process has been seamless. There have been some challenges with changing technology and resources, and we are working through that and remain on track.”

Pothier is looking forward to the future of the Office of the Fire Marshal.

“We are taking a little more time to fulfill our documentation. Things are being overseen and put in a database, and things are flowing as we like to see it,” he said.

“I think the recommendations were a benefit and helped in our work process. They helped us move forward.”

Halifax needs more funding for the arts, especially for renovating the galleries, theatres and buildings that house them. According to the latest data from Statistics Canada, Nova Scotia does not receive any steady funding for maintaining or improving these buildings, from either the provincial or federal government. The data shows there was no money provided to support these buildings since 2005.

These buildings, theatres and galleries are actually few and far between in Halifax. They would include spaces like the Dalhousie Arts Centre, Neptune Theatre, Alderney Landing Theatre, The Veith Street Gallery, The Khyber Art Gallery, and several other smaller venues. These facilities are specifically for visual, literary and performing arts activities.

The map below shows the different spaces in Halifax used for arts and culture activities and details about them.

Lack of funding, lack of clarity
The municipal government does not provide any money for these venues either, according to Dawn Sloane, Councillor for District 12 Halifax Downtown. Sloane is focusing her campaign for the 2012 municipal election on the need to improve the arts and culture sector in Halifax, and she says a lot of problems are generated by not having appropriate space for arts activities.

“The structures that we have right now are very limiting,” she says. “It needs to change to reflect how other cities support the arts.”

Sloane explains that the spaces currently being used for large performances and arts shows aren’t actually arts venues by definition. She lists the Halifax Metro Centre and Halifax’s Grand Parade Square as examples of this. These venues are often host to large concerts, shows and various types of performances but one is actually a civic entertainment centre and the other is a historic parade square.

“It just doesn’t work that way in other cities,” says Sloane. “They have the appropriate spaces for each event.

Councilor Sloane is not the only one pushing for more government focus on space for arts and culture activities. A report that was produced in 2007 shows Nova Scotia needs to improve its arts and culture venues on every level, according to the respondents of the survey. It explains that even the policies, inventories, and programs that focus on these buildings for the arts are only vague at best.

The report is called The State of Cultural Infrastructure in the Atlantic Region and it is the most recent report available that focuses specifically on arts venues. The report was produced by researcher Keith McPhail for the Centre of Expertise on Culture and Communities at Simon Fraser University.

The author of the study surveyed all people who are responsible for running and operating the arts and culture buildings, both government and non-government. According to the author, the responses show a serious lack of organization and a need for more information.

The author explains that non-government respondents of the survey said securing funding for these buildings and spaces has been a challenge.According to the report, these respondents felt that arts venues in Halifax “did not usually receive the same support as multi-purpose spaces, indicating that non-cultural reasons for support are more heavily favoured.”

The lack of funding is the only other problem in the report presented as being more serious than the lack of knowledge. According to the report, “a number of government respondents and reports did suggest that facilities were underfunded and it was at, or becoming, a critical situation.”

The possibility of public support
The Bella Rose Arts Centre in Halifax West High School is mentioned in the report as an example of a publicly funded arts centre. Despite the fact that the venue has seen funding from all levels of government in the past, it currently runs its own fundraising campaign to be able to cover maintenance and equipment costs that are necessary for completing the space. As a result of this process, the centre has taken years to develop, according to the report.

Despite this example, the Nova Scotia branch of the Canadian Centre for Policy Alternatives is still pushing for more publicly funded arts venues. The independent research organization released an alternative municipal budget on August 28th, in which they discuss their own priorities for the city of Halifax.

The budget recommends Halifax invest in more community-owned and operated arts buildings. According to the organization, “Better interpretation of public art and art institutions and practices would encourage the public to engage and participate, generating an engaged, active and safe community.”

Public funding is only one possible approach to the money problems. As Sloane mentions, Halifax could benefit from just a clearer understanding of which particular buildings are for the arts, what their policies are, who is responsible for sustaining them and who is responsible for securing their funding.

Small steps towards improvement
These points are also raised in a  more recent report, a Cultural Framework that was produced in 2011. This Cultural Framework is a study that seeks to analyze the arts and culture sector as  a whole, and identify where its strengths and weaknesses are in hopes of improving. The framework was produced by a Kelco Consulting Ltd. for the Communities, Culture and Heritage Department of the provincial government.

This framework, though released five years after the infrastructure report, talks about  the same problems. According to the framework, Nova Scotia still needs to determine the availability and the roles of infrastructure for its arts and culture sector.

Sloane also says that these problems are still not being discussed, and she blames some of it on a lack of participation from the local government.

“There are ways the municipality could be helping (to improve arts venues) but they just don’t,” she says. “If one of these suggestions comes up, we’ll stifle it. We turn it into a complex rubix cube that no one can solve.”

Sloane’s recommendations for improving the situation are based on making small changes. She suggests  making improvements and renovations to the existing arts buildings, and keeping the discussion alive.

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Health professionals in Nova Scotia are hard pressed to help mothers in the province reach World Health Organization recommendations of six months of exclusive breastfeeding – largely because of a lack of information.

Exclusive breastfeeding, also recommended by the Canadian Pediatric Society, has been linked to reduced illness in children and babies, including fewer ear infections and much lower rates of gastro-intestinal illness. There are some studies that show that improved immune system responses last well into childhood, and that breastfed children may even be smarter than those who receive formula.

Is the formula good enough?

Unlike the US’s Centers for Disease Control and Prevention, which regularly publishes annual breastfeeding report cards to show how states are doing, Public Health in Nova Scotia must count on health indicator data collected by Statistics Canada in its annual Canadian Community Health Survey, which covers a range of health indicators that range from participant’s general perception of their health, to whether they smoke, to whether they wear a bike helmet. Just two questions relating to breastfeeding are asked.

Respondents are selected to represent Canadians in general, rather than Canadian mothers in particular, and the breastfeeding questions are asked of any mother who has had a baby in the past five years.

The StatCan data shows that 80% of Nova Scotian mothers breastfeed at least once, but that only 27% continue to do so exclusively for the full six months.

Because of the breadth of the survey, the robustness of the breastfeeding data is questionable, says Holly D’Angelo Scott, Senior Epidemiologist, Public Health at Capital District Health Authority.

“As a district and a province, we should be collecting our own information on a regular basis,” she says. “If you talk to moms, five years is a long time to try to remember when you stopped breastfeeding.”

Local Efforts

Hospitals throughout the province collect data on how many mothers are breastfeeding when they leave the hospital, but very little is collected after that.

“We don’t really know when it falls off,” she says. “I want to know whether [mothers] stop breastfeeding at two weeks or two months. We also want to know why. What’s going on at this point? […] That would help us figure out what we should be doing.”

Statistics Canada collected specific breastfeeding data in the late 90s and again in 2003, but since then has rolled those questions into the Canadian Community Health Survey.

In contrast to StatCan’s general health data, the United States not only keeps excellent records on breastfeeding, but is committed to making that information publicly available in an easy-to understand way. According to the Centers for Disease Control’s Breastfeeding Report Card for 2012, the rate of mothers who breastfeed at least once is similar to Nova Scotia’s numbers in most states. The CDC not only publishes the data regularly, but gives access to the detailed data to any researcher who requests it. It also looks into factors like access to lactation consultants, La Leche League leaders, and early introduction of formula, which allows health educators to zero in on concrete things they can do to improve rates.

View the CDC’s Report Cards on Breastfeeding:

Nova Scotia has a breastfeeding program where Public Health Nurses call mothers in the first few days when they return from the hospital. The help can be invaluable to new mothers who may be uncertain about whether their newborn babies are getting enough to eat, and may be having trouble establishing a good breastfeeding relationship without the constant support of the hospital environment.

But D’Angelo-Scott wonders if it is the only time mothers need help.

To help find out, Capital Health has just launched a pilot test survey to help address the shortage of data collected by StatCan and the Department of health. The pilot will survey mothers across the district about breastfeeding when they leave the hospital, then at two weeks, six weeks, two months, and six months later. D’Angelo-Scott aims to get enough responses that she can look at data down to the community health board level, if not individual neighbourhoods.

But for now, the province is counting on the StatCan numbers and breastfeeding initiation data collected by hospitals to take steps to improve breastfeeding rates. Nova Scotia’s Breastfeeding Policy was formally signed in 2005, and the Capital Region Health District launched a campaign called “The First 6 Weeks” in 2009. The IWK Hospital, the province’s largest maternity and children’s hospital, has been working on achieving “Baby-Friendly” status, even hosting a Breastfeeding Conference later this year.

A mother’s perspective

Public Health programs, like their home visit, drop-in clinic and phone support launched as a result of the 2005 strategy seem to provide help where it’s needed, at least for those who’re willing to ask.

“I think I had what I needed, between public health, friends and family who had breastfed, supportive husband and a little girl who seemed to figure it all out pretty easily,” says Heather Ternoway, who is just beginning to wean her 11-month old daughter, Helen.

She says she knows mothers who stopped breastfeeding when their babies were still young, often “for lifestyle reasons” and others who breastfed for several years.
“I think it all depends on your personality, your baby, your support network and your lifestyle,” Ternoway says.

She notes that compared to some of her friends’ formula-fed babies, Helen seemed to get fewer colds, and to get over them faster. She also hasn’t had many digestive problems.

Ternoway was surprised to hear about the lack of concrete breastfeeding data in the province and expressed hopes that this would change soon.

Where are the numbers?

D’Angelo-Scott notes that there has been a fairly successful project in Cape Breton to collect breastfeeding information at several time periods. But she notes that she only had access to that information because she was working on her PhD at the time.

“We don’t get to see that data. This is part of the problem as well,” she says. “You really can’t compare across the province.”

StatCanada numbers for Nova Scotia’s Health Authorities don’t help. With the exception of the Capital District Health Authority and the Cape Breton District Health Authority, StatCan deems the numbers “too unreliable to publish.”

Looking at the numbers across Canada, Nova Scotia 80% breastfeeding initiation rate is at the low end of the. Only Newfoundland, New Brunswick, and Nunavut have lower numbers, with Newfoundland trailing the pack at just 54% of mothers breastfeeding at all.

Statistics Canada: Canadian Community Health Survey

While the data for many provinces is unpublished, Nova Scotian’s 27% six-month exclusive breastfeeding rate trails other provinces’, like those in British Columbia and Manitoba, where rates are 10% higher.

Statistics Canada: Canadian Community Health Survey

Canada’s not alone in sketchy figures. International breastfeeding data is also pretty sparse.

Initiation of breastfeeding figures for 2006 as reported by the World Health Organization:

What’s needed and where do we go from here?

D’Angelo-Scott is optimistic about the pilot project at Capital Health. More important than the numbers, though, is the context they hope to collect, particularly about women’s breastfeeding challenges and reasons for introducing formula.

She noted that an issue that came up in her analysis of the data in Cape Breton is that many women are unaware of how the benefits of breastfeeding might outweigh other lifestyle choices.

“Our moms don’t know things like if you smoke, you should still breastfeed. The benefits outweigh,” she says. “We strongly recommend that you don’t smoke, but it’s not a reason for you not to breastfeed.”

Better information on what keeps people from continuing to breastfeed will help D’Angelo-Scott and her colleagues develop strategies and tools to help support mother and ensure that more babies in Nova Scotia receive the benefits of extended breastfeeding.

Breastfeeding Promotion – A Timeline