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If the PM is serious about the plight of mothers...

A mother waits with her child to be tested for malaria in Xai Xai, north of Maputo, in Mozambique on June 22, 2005.


Let's take at face value the Prime Minister's announcement that he wants the G8 to make maternal and child health in poor countries a priority. Heaven knows it should be. Despite some real progress over recent decades, women and children continue to die in huge numbers from conditions that, to some extent, can be easily and inexpensively prevented and treated. It's both a tragedy and a scandal.

If Stephen Harper is serious, I believe there are a number of lessons that can be learned from the many years in which good people have already been trying to meet this challenge. As it happens, I have some experience here, since in the past decade I've written a series of reports on these issues, usually focusing on Africa, for the United Nations, the African Union and for Unicef in Africa.

And that's the first lesson. The Prime Minster must not think he's just discovered America. All kinds of efforts have been attempted for decades to improve maternal and child well-being globally. Those involved have included the United Nations, UN agencies, NGOs, the World Health Organization, government aid organizations like CIDA, and governments and civil society groups in poor countries. But as the ongoing crisis demonstrates, results have been distinctly mixed. That's why so many Canadian NGOs have been urging the government to make this issue a priority.

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I could fill this column with the lofty titles of conventions, charters, plans of action, reviews of plans of action, calls for action, calls for accelerated action, special assemblies, ministerial declarations, formal statements of principle - all aimed at improving maternal and child health. Evaluations have often been surprisingly frank in pointing to disappointing results and helpful in suggesting the reasons.

As a result, in virtually every conceivable area related to the well-being of women and children, there are detailed plans of action and recommended policies and programs outlining exactly how commitments can be implemented. As well, across all poor countries there are countless dedicated NGOs, civil society organizations and local community groups already active in these areas. It would be an unforgivable error if Mr. Harper doesn't learn from these many experiences and work with these dedicated groups.

He must begin by acknowledging that his government has a real credibility gap in this area, not least the abrupt way he's introduced the subject.

We have real expertise on the subject right here in Canada. But much of it is held by NGOs and CIDA staff whom Mr. Harper and his government clearly hold in low regard. Last summer, International Co-operation Minister Bev Oda attacked her own department in a remarkable interview with Embassy Magazine in Ottawa. She complained, for instance, that CIDA did not have a single health specialist whom she could consult regarding a proposed new health project. As Ottawa University Professor Stephen Brown commented, "This statement came as quite a shock for the five or more health experts at CIDA."

In what Prof. Brown also called "an even more shocking statement," Ms. Oda claimed that CIDA employees and its NGO partners only looked at how much could be spent, not what results would be achieved. "In fact, CIDA and the organizations it funds are required to use a tool known as 'results-based management.' As minister in charge of CIDA for almost two years, she has to be aware of this." If the Prime Minister wants his brand new initiative to have credibility, this kind of malicious undermining of those whose help he needs most must immediately stop.

There are other issues in the aid department, both for Canada and its G8 partners. The first is that they never give as much aid as they promise or live up to the commitments they earnestly make. It's getting hard to recall all the G8 meetings in recent years that have promised far more aid, to Africa especially, than they ever deliver. (Watch what happens to the pledges to Haiti over the next few years.) And not a single member of the G8, including Canada, has ever come close to delivering on the promise that 0.7 per cent of GDP would go to aid. Beyond that, we must not forget that large chunks of so-called aid fail to reach poor countries at all. In reality much of it goes to purchases at home, administration, consultants and the like. That kind of "aid" helps us far more than it helps them.

There are other questions we're entitled to ask the PM. If he's now serious about the plight of the world's most vulnerable citizens, why is he shifting Canada's aid focus to Latin America and away from Africa, where the need is greatest? Why were 8 poor African countries, some at the very bottom of the UN Human Development Index, peremptorily dropped from Canada's list of aid recipients?

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We have real expertise on the subject right here in Canada. But much of it is held by NGOs and CIDA staff whom Mr. Harper and his government clearly hold in low regard.

I said that maternal and child health could he helped significantly by inexpensive interventions, as has been shown in many countries. But if anyone is genuinely interested in the overall well-being of women and children, which ultimately will determine both their quality of life and their mortality, larger issues of development and women's rights must be pursued diligently. Birth control, abortion, sexual violence, child marriage, land and inheritance rights, political rights - all these issues related to women's subordination must be faced if their overall physical and mental health is to be improved. Is Mr. Harper ready to sign on to this program?

I'm sure the Prime Minster is well aware that his government cut off funding for Kairos, the church-backed Canadian NGO. I wonder if anyone has told him that Kairos worked in the Congo with a Congolese group that was planning to set up a legal clinic to protect women's rights. One of its intended projects was to support Congolese women who had been raped. Renewing the Kairos CIDA grant would go a long way to convincing Canadians that he is sincere in his concern for women's health.

Perhaps most importantly, Mr. Harper needs to understand that a significant reason for the plight of women and children in many countries is the policies and interventions of us in the rich world. As in Haiti, rich countries get great satisfaction in seeing ourselves as the solution, when too often we're the problem.

A relatively small amount of Canadian aid doesn't begin to compensate for trade policies that make West African chickens more expensive to buy in West Africa than Dutch chickens. Or for mining companies that (with the support of their embassies) bribe local officials, plunder a poor country's natural resources, pay minimal wages and negligible taxes, abide by few safety regulations, and create massive environmental damage. Or for decades of debt repayments, frequently for odious loans, that have often been larger than a country's combined health and education budgets.

Nor can all the aid in the world compensate for the Structural Adjustment Programs that the World Bank and IMF and their rich-country partners have imposed on poor countries for the past 30 years. Extraordinarily enough, for ideological reasons that made no human sense, these have frequently included a ceiling on government health budgets and specifically on health workers, beginning at the very moment when AIDS was exploding across large swathes of Africa. Yet every evaluation of failed health programs point to inadequate capacity in structures and human resources that can only be provided by governments.

So here's the final lesson to be learned. Poor countries, from Africa to Haiti, continue to suffer from this legacy of destructiveness at the hands of the rich, led by the G8, laughingly called donor countries. At all times, women and children are the first to pay the heaviest penalties. We owe them not charity, not compassion, but justice and restitution, because we have benefited so much from them. Despite foreign aid (invariably exaggerated), Africa, like Haiti, has enriched us far more than we have enriched it. Justice does not mean soppy sentiments about us all being members of the human family. It means we have a large debt to pay. That should be the moral principle driving the Prime Minister's new initiative.

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Gerald Caplan is a former New Democratic Party national campaign director and is author of The Betrayal of Africa

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