“Helminthic therapy” (taken from the word “helminth,” for parasitic worm) is an upwardly trendy, somewhat controversial but undoubtedly provocative suite of treatments involving small doses of the eggs and larvae of parasitic worms to treat a range of common and incurable conditions.

The idea: to correct improperly functioning immune systems.

The target: chronic auto-immune-related illnesses, including hay fever and other allergies, asthma, eczema, and irritable bowel disorders such as Crohn’s disease, colitis and even—according to some of its proponents—multiple sclerosis.

Helminthic therapy stems from the “hygiene hypothesis,” a theory that dates back to a seminal research paper published in 1989 in the British Medical Journal, which attempted to explain the puzzlingly high incidence of autoimmune disorders in Western nations.

For example, almost 10 percent of Canadians age 12 and over have asthma today, according to the Asthma Society of Canada. That’s up from just 2.3 per cent in 1979 (in adults age 15 and over), and the prevalence continues to rise worldwide by about 50 percent every decade.

What could explain the increase? According to the hygiene hypothesis, we are too clean. This is a problem because not all bugs are “bad.” In fact, some are indispensable—we would not be able to digest food or even live without many of the microbes found in our stomachs.

According to this theory, children’s immune systems fail to learn how to deal with foreign bugs properly without regular exposure to “normal” levels of germs.

People in many tropical nations, where parasites are widespread, suffer lower rates of conditions that involve over-active immune responses such as asthma and allergies. Parasites evolved to dampen the immune system’s ability to fight them—so, the theory goes, if an immune system is overreacting, a small dose of parasites might just be what the doctor ordered.

Except that your doctor will not make such an order. It is not legal to prescribe parasitic worms in Canada. Health Canada has not yet approved any “medicinal maggots,” which they classify as drugs, so it could be some time before such therapies are routinely available. Any Canadian eager to try them out now “should speak to their doctor about clinical trials,” Health Canada said via email.

However, it is legal to order parasitic worms online from a handful of private suppliers. One of the most popular is the web-based company, Autoimmune Therapies.

Jasper Lawrence, who co-founded Autoimmune Therapies three years ago with chemist Marc Dellerba, says he decided to provide parasitic therapies after he managed to control his own ailments with hookworms.

After suffering from severe allergies and asthma for most of his life, Lawrence says he “gave up on modern medicine.” He was inspired to try a dose of parasites after learning about immunologists experimenting with hookworms in Britain.

Unable to find any source of hookworm larvae in the U.S., “even on the Internet, where you can find all manner of weird things,” he decided to go to an area in Cameroon where he says a fifth of the population plays host to the worms. His method of contraction? “I simply walked barefoot through the latrine areas.”

His allergies and asthma vanished months later, and he decided to offer the therapy to people in more palatable forms: sticky patches of whipworm larvae and whipworm eggs suspended in saline. He says he offers the chance of a five-year remission of symptoms (on average), whereas conventional therapies only offer the possibility of a lifetime on antihistamines, inhalers and other medications.

The treatment doesn’t come cheap: $2,900 US for a single dose of hookworm or whipworm, or $3,900 US for a combination of the two. According to Lawrence, the treatment typically works within two or three months, though he says that on rare occasions, patients have had to wait up to 11 months. So far, 180 people in total have received helminthic therapy through the Autoimmune Therapies website.

Is there a valid scientific basis for this?

“There is a growing perspective that a lack of ‘external’ allergenic or pathogenic attacks on developing immune systems leads to immune systems that do not function properly, and there is a well-known link between parasitic helminth infections and allergic responses,” says Professor Dan Brooks, a parasitologist with the University of Toronto, who studies parasites such as worms and how they affect their mammalian hosts. “But the crux of the matter, I believe, is what can we do ethically and morally to stimulate young and naive immune systems without violating the first line of the Hippocratic Oath: Do no harm.”

Lawrence insists that the treatment is low-risk: the doses are too small to result in a full-blown parasitic illness, the eggs and worms will not reproduce in your body (or be transmitted to anyone else), and if at any point you feel unwell (or just find the idea of deliberately infecting yourself with worms intolerable), you can easily rid yourself of them with a routine dose of anti-parasitic medication.

“Between 25 and 30 percent of people who encounter this idea have a strong negative reaction, regardless of their education—it’s clearly because of the ‘yuck factor’… but what is the harm in trying this, especially when conventional medicine has nothing else to offer in the way of a cure?” he says.

Many academics agree that the therapy is not without some risks. Some researchers and clinicians are concerned that in some cases, a dose of worms could actually weaken the immune system. The Autoimmune Therapies website states that “people who are HIV positive or have some other serious chronic and incurable infection will be refused treatment.”

Nonetheless, many researchers say the idea is worth a closer look.

“Helminthic therapies do seem to work, but unfortunately most of the evidence is just anecdotal,” says Professor Derek McKay, a physiologist at the University of Calgary. “It’s still just a hypothesis—not a theory.”

The low rates of autoimmune diseases in tropical, developing countries with high levels of parasitic infections could just be a coincidence. Other factors could be at play and much more research needs to be done, he says.

“But in the meantime, I think there is a place for helminthic therapy as an option for people for whom steroids and anti-inflammatories have failed,” he says.

As fringe as it may seem, these parasites may have much to teach researchers about how to recreate the effects of helminthic therapies in drug form.

“A lot of people confuse fatigue with sleepiness—it’s not the same thing,” says Doug Cook, a registered dietitian and nutritionist at St. Michael’s Hospital in Toronto. Sometimes a viral or bacterial trigger, or other serious illness is the culprit. But fortunately, most of the time there are simple causes that can easily be fixed. “A lot of it is just lifestyle related,” he says. “I think fatigue really is a symptom of the way society is: too busy, burning the candle at both ends. It’s as though what used to be confined to university students as become the norm for all stages of life.”

Here are some common reasons that you might be feeling a lack of a spring in your step and what you can do to feel more energized.

1. You don’t exercise

It may seem counter intuitive, but exercising produces all kinds of helpful biochemicals that ward off fatigue and help you feel upbeat the rest of the time. Think of it as positive feedback: the more energy you put in, the more you get out.

2. You keep poor sleep patterns

Sleepiness is not the same as fatigue (which is a general lack of energy), but one of the most common causes of feeling tired is simply not sleeping enough. In addition to too little shut-eye, keeping irregular sleeping patterns and even sleeping too much can also make you feel tired. To get back on the right track, try to get into a routine of sleeping at consistent times—while only getting as much sleep as you really need—and you’ll be surprised how much better you will feel.

3. You’re carrying extra weight

In addition to making your bones and body bear a greater burden of weight, obesity can result in sleep apnea, which is horribly disruptive to your sleep. According to the Canadian Lung Association, individuals who suffer from sleep apnea can experience pauses in their breathing dozens—or even hundreds—of times in a single night. Sleep apnea can also potentially result in heart problems. If you are concerned about sleep apnea, be sure to speak with your doctor.

4. You might be pregnant

One of the first changes to your body when you’re pregnant—and the most noticeable—is a sudden change to your sleeping habits and energy levels. Pregnancy has a serious impact on your body and feelings of fatigue during your first trimester are very common. If you normally stay up past midnight, then suddenly find yourself wanting to crash out at 9 pm, pregnancy could be a factor. Sleep can also be challenging for new moms, who suddenly have to adjust to the sleep schedule of their baby.

5. You drink too much coffee

If you rely on caffeine to get through your day, you can develop a dependence—so without it you can go into withdrawl, needing several cups of coffee or tea just to feel “normal.” And the worst point of withdrawl? Right in the morning. To make matters worse, caffeine can still course through your system when you’re sleeping if you’ve had any coffee or tea in the evening, which can interfere with normal REM sleep and leave you feeling even more tired. An easy solution is to cut back on the amount of caffeine you consume during the day and steer clear of caffeinated beverages within hours of your bedtime.

6. You don’t eat breakfast

There’s a reason that breakfast is called the most important meal of the day, and everyone has told you not to forget it—from your doctor to your mother, to probably every teacher you’ve ever had. And yet so many of us still skip it on a regular basis, or just cram down a few pieces of toast before heading out the door. Take the time to fit in breakfast every morning and it will help you avoid that mid-afternoon crash.

7. You suffer from iron deficiency

A diet low in iron is often to blame for feeling tired—a lack of red meat in the diet of vegetarians and vegans can result in iron deficiency, but it’s unfair and untrue to assume that people who cut out animal products from their diet automatically have low energy levels. People who eat meat can still suffer from low iron as well, especially if they skimp on wholesome—though sometimes unappealing—foods like spinach, organ meats, and eggs. Women in particular are prone to anemia because of menstruation, as heavy periods can easily lead to anemia in combination with a low-iron diet.

8. You may be depressed

Fatigue is a common side effect of depression, along with other well-known symptoms such as lack of appetite, weight gain or loss, anxiety and lack of interest in sex. If you are concerned that you may be experiencing depression, speak with your healthcare provider.

9. It could signal the onset of diabetes

Diabetes is reaching epidemic levels in Canada, and according to the Canadian Diabetes Association, extreme fatigue or lack of energy are symptoms of the condition. However, many people who develop type 2 diabetes will show no symptoms. The Canadian Diabetes Association recommends everyone over the age of 40 have their blood sugar levels tested at least every three years as a precautionary measure.

10. You’ve started a new medication

Fatigue is one of the most common side effects of pharmaceutical medications, with anti-hypertensives, narcotics, anxiolytics and antidepressants being the most common culprits. When you first begin a new medication, give your body some time to adjust. However, if drowsiness persists for several weeks and begins to interfere with your daily life, it’s time to see a doctor.

Boost your energy the healthy way

By and large, the best things you can do to stay healthy and energized are pretty simple: eat well, sleep regularly, don’t drink too much alcohol (hangovers aside, the by-products in alcohol can make you feel tired), and get some fresh air and exercise.

“I often tell my patients that the fatigue may be their body’s way of telling them to slow down,” says Dr Rhonda Church, a family physician in Nova Scotia. “Many people experience fatigue because of overwhelming life stresses. Keep your stress in check: set limits, make time for yourself and the people you love.”

Why this issue? Back in 2000, 192 nations set eight Millennium Development Goals (MDGs) to be achieved by 2015. These included reducing the world’s number of hungry people by half and providing primary schooling for all boys and girls. Reducing the number of women who die during pregnancy or childbirth by three quarters was one of these goals and so far, maternal health has made the least amount of progress of all the health-related MDGs.

“It is definitely going to be the most important issue on the G8 agenda,” says Jenilee Guebert, director of research with the G8 Research Group in the Global Health Diplomacy Program at the Monk School of Global Affairs in Toronto. “The reason they chose this issue is because we are so far behind on reaching this Millennium Development Goal.”

In order to meet the child and maternal health MDGs by 2015, its going to take an estimated $30 billion which will help fund the 2.5 million healthcare professionals and one million community healthcare workers needed.

Here’s why it’s important to reach the maternal health MDG:

1. Millions of mothers are dying

According to the United Nations Population Fund (UNFPA), the global maternal death rate has remained “stagnant” over the past decade because maternal health is the least funded of all the Millennium Development goals, and is the one that the world is farthest behind in reaching. UN Secretary-General Ban Ki-moon has termed the continued prevalence of women suffering pregnancy-related deaths a “scandal.” While the number of child deaths fell from around 13 million in 1990 to less than 10 million in 2006, the number of maternal mortalities has remained virtually static.

“This is an unacceptable situation, and we are all responsible for it because it has never been funded correctly,” says Dr. Luc de Bernis, senior maternal health advisor for the UNFPA.

2. Death in childbirth can be prevented

Although the number of women who suffer pregnancy-related deaths in Canada is among the world’s lowest, it is a real risk for women in poor countries who do not have access to reproductive health care. Every minute a woman dies in childbirth somewhere around the world–more than half a million mothers are lost every year. Women in developing countries, especially in sub-Saharan Africa, are most at risk—one in seven women in Niger will die due to complications from pregnancy or childbirth.

The main reason for these shocking statistics: too many women are giving birth without a trained or skilled attendant who is capable of alleviating haemorrhaging (the leading cause of death) by providing the hormone oxytocin, preventing an obstructed labour by delivering by Caesarean, or providing basic post-partum shots for tetanus and other infectious diseases. With the proper care and supplies, these complications are highly treatable—Canadian women are also at risk for labour complications, but access to care saves more lives here.

3. Caring for women saves children

Improving the chances of survival and the overall health for mothers also means giving their children a greater chance at living.

“And we’re not just talking about their newborn babies—research shows that when mothers die, the other children in the family have a much greater likelihood of dying,” says Susan White, Executive Director of the Canadian Women’s Health Network. In fact, according to the UN, children whose mothers died in birth are ten times more likely to die prematurely. “The bottom line is that saving mothers’ lives also saves children’s lives,” she says.

4. Funding can help treat birth-related injuries

For every woman who dies in childbirth, another 20—about 10 million every year—will suffer from related injuries, infections and diseases that saddle them with a lifetime of pain, suffering and humiliation.

One of the most horrific injuries: fistula, which occurs when the pressure from an obstructed birth leaves a hole between the vagina and the bladder or rectum. These holes can be surgically repaired, but in poor countries women are often left untreated, and have to suffer the pain and humiliation of losing the ability to control the flow of excrement from their bodies for the rest of their lives.

“There is intense stigmatisation for these women, who are often totally abandoned by their partners and their families,” says de Bernis. “It is very common for us to visit remote communities and discover women who have leaked urine or feces for years and years; nobody ever informed them that treatment was possible. It is a terrible situation.”

5. Access to contraception saves lives

Women in parts of the developing world do not have access to contraception mainly because of a decline in funding for family planning in those countries. This funding has “dropped dramatically since the mid 1990s” according to the United Nations Population Fund. The Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health, estimates that in 2007, donor countries came up $2.5 million short in funding the cost of contraceptive care in developing countries.

According to the institute, providing modern family planning techniques to all women worldwide would reduce the number of unintended pregnancies by 53 million, reduce maternal mortality by a third, and ultimately prevent the deaths of almost 800,000 women and children every year.

6. Young women need sex education

In countries where access to contraception is limited, women tend to conceive at younger ages, when they are at even higher risk of complications from pregnancy. Girls aged 15 to 19 are twice as likely to die in childbirth as women in their 20s; teens younger than 15 are at even greater risk.

“We need to address the sexual education of adolescents,” says de Bernis. “If it is sensitive in our own countries, such as France and Canada, imagine how difficult it is to address in developing nations. It’s almost impossible. We need to face this.”

7. Women are dying from unsafe abortions

The Canadian government has stated that it will not fund programs that provide access to abortions in developing countries as part of its aid package.

However, many experts on maternal health say it’s an issue that needs to be addressed. “It is important to note that many of the countries that have the highest number of maternal deaths have limited access to abortion,” says White. More than 19 million unsafe abortions take place every year, and more than 70,000 women die annually as a result — and neither figure has changed significantly in a decade, according to the UNFPA.

“We are very anxious about these declarations from Canadian politicians,” says the UN’s de Bernis. “It is very important to understand that maternal mortality cannot be reduced without improving access to safe abortions, when legal. We cannot pretend to be interested in maternal health without addressing this issue.”

8. It will improve women’s lives

“This is also a gender issue—it is only women who deal with the real burden of reproduction, only women who face death and disability from childbearing,” says de Bernis. “This really is an issue of human rights.”

Ultimately, improving access to contraception, safe abortions, and the ability to choose when and how many children to have means improving education and social standing for women overall. “The fact remains that women’s needs are not as highly valued as they should be,” says White. “The bigger issue ultimately is empowerment of women.”

9. It will benefit the world economy

“Women who die from giving birth are in the prime of life—they are generally young and active, at a critical stage in life in terms of their role in the economy,” says White. “Loss of their lives is a blow to a nation’s productivity, especially in Africa where it is women who do most of the farming and feed their families.” Right now $15 billion in productivity is lost every year due to the deaths of mothers in developing countries, according to the UNFPA.

Investing in maternal health is a cost-effective way to save money in the future from the pressures of overpopulation: every dollar spent on family planning will save four dollars in future costs to the health care, housing, and other social infrastructures, according to the UNFPA.

10. Canada can change the world

As host of the summit, Canada is an important player on this issue. If we commit to the $1 billion or more in funding we have pledged for maternal health, Gubert says that other rich nations will feel pressure to step up to the plate. “Canadians are proud of their government’s past involvement in initiatives such as international peacekeeping; we think people in other parts of the world should have the same rights that we have in Canada,” says Guebert. “I really think this is an issue that Canadians really care about.”

We’ve all held that long sheet of possible side effects that came with our medication and felt bewildered by the litany of conditions that could come, from swelling and weight gain to seizures and suicidal thoughts. It can be intimidating, to say the least.

“Often my patients come to me and haven’t taken their medication because they were so scared by the printouts,” says Dr. Rhonda Church, a family physician in Bridgewater, Nova Scotia and co-author of Take As Directed: Your Prescription for Safe Health Care In Canada. And even after taking their medication as prescribed, her patients frequently feel uncomfortable and nervous if they notice a new symptom.

Is it a side-effect?

“Whenever people experience anything unusual after taking a new medication often they assume that it is a side effect, when it may not necessarily be,” she says. For example, someone taking an antibiotic for pneumonia may feel light-headed and ascribe it to the antibiotic—when in fact the illness itself may be to blame. Other factors that may cause a person to feel unwell include an incorrect diagnosis, the wrong dose of the medication, or an allergic reaction to the medication.

But side effects do of course happen—a number of studies estimate that between 10 and 20 per cent of hospital admissions are due to side effects from medication, says Philip Emberley, Director of Pharmacy Innovation for the Canadian Pharmacists Association.

“It can be very difficult to predict what people will experience when they start a new medication,” he says. “The whole area of side effects is very individual, and we all react differently—some people will experience no side effects, while others may experience several.”

So how can you know if what you are experiencing is actually due to the medication you are taking? Is it simply “psychosomatic” because you may be worried about side effects? Or is it something you should be concerned about?

Here are some tips on the most common things you may experience:

Birth control pills

Don’t panic: Breast tenderness and weight gain are well-known, but some women don’t realise how common it is to spot and bleed in-between periods. “Some women stop taking their pills because they think they aren’t working, but then they come to me with different side effect altogether: pregnancy,” says Dr Church.

See a doctor: Chest pains, shortness of breath or a sudden swelling in the leg could be a sign of a blood clot in the leg or the lung.

Anti-depressants

Don’t panic: Drowsiness and headaches are common. “In most cases I’d say ride it out,” says Dr Church. If the medication is causing sleepiness, speak with your doctor about taking it at night. “Though most people don’t like to talk about it, sexual dysfunction can be a problem,” she says. “Don’t’ be afraid to mention it to your physician.”

See a doctor: Modern anti-depressants, called SSRIs (for selective serotonin reuptake inhibitors) come with fewer risks compared to the tricyclic medications used in the last century. But though rare, severe side effects can occur—such as feeling more depressed.

Over-the-counter pain killers

Don’t panic: An upset stomach, especially with non-steroidal, anti-inflammatory medications like ibuprofen, is extremely common, and taking medication with food or milk should do the trick.

See a doctor: Using OTC pain-killers on a long-term, regular basis however can cause severe side effects: used regularly, paracetamol (e.g. Tylenol) can cause liver damage, and Aspirin—though good for the heart—can lead to ulceration of the stomach if used excessively for many years. “Chronic use of any medication can be very harmful,” says Emberley.

Lipid-lowering drugs

Don’t panic: Head and stomach aches are common, and some people prescribed niacin (a type of B-vitamin) may experience intense but non-harmful facial flushing.

See a doctor: Though rare, rhabdomyolysis—a breakdown of muscle cells—can be lethal if certain complications occur. A sudden onset of muscle pain or weakness—especially if you are taking a statin lipid-lowering agent—should send you to the hospital immediately.

Antibiotics

Don’t panic: Upset stomachs are common—and, as many of us have experienced, yeast infections. Taking probiotics can help in some circumstances, says Dr Church, “But unfortunately there just is not a single antibiotic that we can guarantee won’t cause a yeast infection,” she says.

See a doctor: Some allergic reactions to penicillin can be lethal. “If you feel light headed, your heart racing or short of breath right after taking it, go to a hospital immediately,” says Emberley. And the same goes for all prescriptions.

Dealing with side effects

The bottom line, says Emberley, is that “most side effects are transient—give it a few weeks and they will probably go away.”

In general, says Dr Church, the most common side effects, spanning the whole spectrum of drugs, are upset stomachs, drowsiness, headaches, constipation, and dry mouth (easily relieved by sugar-less candy).

“I have a general principle—start low and go slow—if somebody finds the side effects a nuisance, one of the things I may consider is lowering the dose,” she says. “But I tell all my patients to be active, and knowledgeable, and to take their own health into their own hands: they should ask their physicians and pharmacists about common side effects—and what the red flags are.”

But this heavy-metal soup of arsenic, mercury and cadmium, mixed with carcinogenic polycyclic aromatic compounds, isn’t fully contained by the sandy bottom of the so-called “ponds”. Industry and government long contended that leaks were marginal and actively managed – but we now know that at least 11 million litres of toxins flow into the Athabasca River every day.

Communities all over the Athabasca rivershed are exposed to whatever flows downstream – and none more so than Fort Chipewyan. This isolated town is made up of just over 1,200 members of the Mikisew Cree, Métis and Athabasca Chipewyan First Nations, who live on the shores of Lake Athabasca, the tail end of every leaky tailings pond.

A tailings pond created by a Syncrude upgrader upstream of Fort Chipewyan. Photo Credit: Jiri Rezac, Courtesy of Greenpeace.

For years, people worried. Fish were caught with tumours on their sides, or with deformities as extreme as two mouths. Duck meat didn’t taste quite right. Moose livers were covered in lesions. This would be disturbing to any community – but especially to one that still hunts, fishes and traps as regularly as the people in Fort Chipewyan. Moose meat and walleye fish aren’t occasional rustic treats for weekend cottagers. Many in Fort Chipewyan eat them every single day.

They noticed people growing sick – much sicker than they had been in the past. Immune diseases. Diabetes. Lupus. And cancer – not just in the old, but also the young. Rare cancers that should not be occurring in such high numbers in so small a community. Dr John O’Connor, the local doctor, was so worried that in 2006 he decided to go public with his concerns, unleashing a battle to get to the truth that is still continuing today.

Cancer cover-up

The federal government’s first response was to rush out a study which concluded that the community did not have higher than average cancer rates, and claimed that contaminants in the river were not at levels that should cause concern. Soon afterwards, to the deep consternation of the community, Dr O’Connor was placed under formal investigation.

Nobody in Fort Chipewyan believed the government’s findings. They commissioned their own study of the rivershed from Dr Kevin Timoney. Published in 2007, it found “worrisome” levels of many heavy metals and carcinogens in the water and wildlife – for example, some 90 per cent of male whitefish exceeded mercury levels that were safe for consumption.

Bowing to pressure, the government agreed to conduct a more thorough analysis. Towards the end of 2009 it published a study that concluded that the rate of cancers in Fort Chipewyan was 30 per cent higher than expected – but, to the community’s frustration, stopped short of concluding that the tar sands might be a factor.

“The argument over whether or not the cancers in Fort Chip are caused by the tar sands is ridiculous,” says Eriel Tchekwie Deranger, a young woman from the Athabasca Chipewyan First Nation who has become a prominent anti-tar sands activist. “The increase in health problems has coincided with the increase in development of the sands.”

One of the leading voices calling for a comprehensive baseline study into local pollution and its health impacts since 2003 has been George Poitras, former chief of the Mikisew Cree. “It is like pulling teeth,” he reveals. “The government doesn’t want to resource anything that will act as an impediment to their ability to exploit the tar sands.”

Mikisew First Nation former chief George Poitras, outside Buckingham Palace on his first visit to London in September, 2009.

This lack of resources has meant paltry monitoring of the state of the downstream rivershed since extraction began in earnest. Another independent study, by Professor David Schindler of the University of Alberta, found “serious defects” in the government’s monitoring programme. The analysis, published in December 2009 in the prestigious Proceedings of the National Academy of Sciences, concluded that pollution in the river was up to five times higher than government figures had stated.

These findings just scratch the surface of how the community could be being affected. Little is yet known about how the different toxic metals and petrochemicals interact, or how their effects could be magnified given that the flow of contaminants into the rivershed during spring melt coincides with when fish fry are growing.

What Fort Chipewyan needs, argues George, is a comprehensive, baseline health study that would do a thorough analysis of the entire community, and then track changes in the future based on that. Unfortunately, the lack of good information from the past means that the baseline would have to consist of current data – 2010 at the earliest. He acknowledges that it wouldn’t be able to show changes to Fort Chipewyan over the past 15 years. “That is disappointing – but we can’t go backwards in time. The next best thing we can do is to determine people’s health now and monitor as we go along.”

Considering that the government has a 50-100 year plan for increasing output from the sands, there will be plenty of monitoring to do.

Licence to spill

Meanwhile, the government continues to grant new licences to any company looking to expand its operations in the region. “Our communities are given no part in the decision-making process when licences for exploration are granted,” says George, who until recently held the role of consultation co-ordinator with government and industry for the Mikisew Cree. “First Nations are kept totally out of the loop. We are only consulted at the application stage for specific projects.”

In many cases it is not the provincial government which consults but a third-party entity, and usually the consultation is no more than tokenistic. “Industry has its hand in the pot that pays these groups to make sure consultation is done,” claims Eriel – who works as a campaigner with the Rainforest Action Network, because “when I first saw the devastation of the boreal forest, I knew I had to devote my life to preserving my beautiful homeland”. She has experienced these sham “stakeholder engagements” first hand. “In many cases, they only consult when they already have the bulldozers lined up. They simply come in, give a presentation, and tick off the box saying they’ve consulted.”

Even more suspicious, she feels, is the groundwork that industry lays down in advance. “They will come in and sponsor things like ice rinks and playgrounds and computer labs – then come in a month later for their consultation process. They will dangle the carrot of a few jobs – it is clearly manipulative. These are communities with deplorable living standards and a severe housing crisis. These corporations know exactly what they are doing.”

Eriel Tchekwie Deranger, a Dene woman from the Athabasca community of Fort Chipewyan demonstrating outside the Royal Bank of Scotland's London headquarters in November 2009.

But in many cases it works. The oil industry has been active in Alberta for 40 years, and, says George, “it has given the impression to the local communities that this is the only industry people should rely on – so they’ve become very dependent on it. Young people see the sands as the be-all and end-all in terms of careers and vocations. It has become a blinding force.”

Yet, as with any economic boom zone, many social problems are now plaguing the industrial heartland of Fort McMurray and spilling over into communities like Fort Chipewyan all over the Athabasca region. “Drug addiction, crime, prostitution, domestic abuse…” lists George. “We are only now starting to deal with these problems head-on, because the cancers have forced us to – we’re just at the tip of the iceberg.”

Nevertheless, Eriel believes it’s easy to understand why some communities do deals with the oil industry. “The communities often feel as though the companies already have the permits. They could spend 10 years fighting them or just strike a deal. The leaders will do what is best for their communities when they need food and jobs, and they figure: “Well, they’re going to destroy our land anyways so we might as well get some money first.” I don’t blame them,’ she says. ‘This is all part of a subjugation tactic by the Canadian Government. If people no longer have the ability to rely on the land, their only choice for an economic base is industry offering them deals.”

Fight for treaty rights

However, as the social, environmental and health impacts of the tar sands bite, more and more indigenous communities are taking a position of opposition. In 2008, chiefs from across Alberta and the neighbouring provinces of Saskatchewan and British Columbia came together to call for a moratorium on all new tar sands developments, and threatened to back this up with legal action.

This poses a genuine threat to the long-term future of the project. All tar sands developments in Canada are taking place on the traditional territories of indigenous First Nations. Most of them signed treaties with the crown in the 19th century giving them certain legal rights, including the right to consultation on new projects that would infringe on their abilities to hunt, fish and trap in their traditional territories.

This is one topic, says Deranger, that the mainstream media in Canada has brushed over in its coverage of the tar sands. “The Government of Canada has recognized native treaty rights in the constitution, but actually going forward and recognizing what those rights mean hasn’t happened in this country yet. It would open a Pandora’s box of issues – this is just not something the Canadian public is prepared for.”

The concept of “free prior and informed consent” – in other words, the right of indigenous peoples to say “no” – to any new development on their lands was recently enshrined in international law through the UN Declaration on the Rights of Indigenous Peoples. But its application has been conspicuously absent in Canada, which has refused to sign the Declaration. Many leaders of First Nations and experts in aboriginal law believe it may be the enforcement of these treaty rights through legal challenges that stands the best chance of stopping further expansion in the tar sands.

However, getting treaty rights taken seriously by the Alberta government is proving to be a challenge. George suspects there may be a racist component to the way Fort Chipewyan’s concerns have been treated. “It’s hard to prove racism, but I suspect they see us as a predominantly aboriginal community ’so to hell with them’.”

Charges of environmental racism are not new in Canada. All over the country, indigenous communities have been affected by industrial developments, from mega-dam projects flooding reserves in Quebec, to reckless uranium mining near Inuit communities in the Northwest Territories, to the construction of petrochemical refineries on land ceded from First Nations in Ontario. The resulting loss of land, health and traditional ways of living – from hunting and fishing to even swimming in lakes – can be summed up in two words, according to Eriel: “cultural genocide”.

Ada Lockridge, a member of the Aamjiwnaang First Nation in southern Ontario, overlooking the Suncor refinery sitting on land that once belonged to her community.

I will not be silenced

The sidelining of critical indigenous voices can have serious consequences for the individuals involved, as George found late last year when he was forced by the oil industry to step down from his position as consultation co-ordinator with the Mikisew Cree First Nation.

“The president of the longest-running company in the tar sands met with our leadership and in no uncertain terms said they did not like that I travel internationally [to raise concerns about the tar sands in Europe and the US] on Mikisew time to bring negative media attention to the tar sands industry,” he explains. “So, they said, either the Mikisew would have to terminate my employment or somehow silence me, or the Nation would lose contracts.”

This, he says, is standard practice. “In a nutshell: penalize the First Nation when they are showing a lack of support. We are simply identifying concerns related to tar sands development, but apparently we are not allowed to do that.”

George admits he found the experience shocking. “You would expect that kind of treatment of indigenous peoples by multibillion-dollar oil companies and corrupt Third World governments where indigenous peoples have no voice whatsoever. But this is Canada, a developed G8 nation! It is 2010 and we are still dealing with the same old issues.”

After fighting the tar sands for five years, and leaving his job as a result, has he had enough? “The thought of giving up did enter my mind, of living my life and having a garden at the back of my house,” he muses. “But only momentarily. Actually, it’s had the opposite effect. When Dr O’Connor was first charged, it lit a fire in me to show to the rest of the world what was going on. This has made that fire much stronger. And now I am able to speak up much more freely.”

His plans now? “This will be my full-time vocation,” he announces. “And as long as they have a 50-100 year plan, you can be sure we have our work cut out for us. I’ll die doing this.”

As the old adage, “water water everywhere but ne’er a drop to drink” goes, fresh water on our planet may seem plentiful and abundant, but we are actually facing an imminent water shortage. Thanks to intensive irrigation for agriculture and industry, we move water around just as we do oil and gas, depleting underground aquifers and damming rivers. The former Soviet Union’s notorious Aral Sea – turned into a parched desert when its waters were drained for cotton production – could be a sign of things to come.

“On water we are four years behind where we are on climate change – it has not yet seeped down into the consciousness of the majority of people or our political leaders,” says Maude Barlow, National Chairperson of the Council of Canadians and Senior Advisor on Water to the 63rd President of the United Nations General Assembly. By 2025, more than two thirds of the world’s population will have to deal with chronic water shortages, according to the UN World Water Assessment Program.

Here’s what you can do with your diet to reduce your water footprint – and improve your health at the same time.

Eat less meat

Eating less meat is absolutely the easiest thing you can do if you’re on the carnivorous side of things, and your heart will thank you. Any kind of farmed animal meat will have a larger water footprint than any fruit or vegetable, due to all the water needed to grow their feed. A kilogram of potato flakes costs 900 litres of water to grow, but a kilo of pork slurped up 4,800 litres in its production. And some meats are even more water-wasteful than others: a kilo of beef requires a staggering 15,500 litres of water to create, compared to just 3,900 litres for a kilo of chicken.

Cut back on sugar

Sugar cane is one of the most water-thirsty crops, coming in with 1,500 litres of water per kilo of white sugar, compared to, say, cereals such as wheat (1,300 litres) or corn (900 litres). An estimated 200 litres of water are needed for the sugar in one can of cola, for example.

Eat local

Water is also required to produce other materials besides food–industrial facilities, whether they produce metals, plastics or fabrics, will need a lot of water. Anywhere from 70 to 170 litres of water are needed to produce a single tank of gasoline (so just imagine the water footprint of air-freighted food). Cutting back on the mileage from farm to your plate will save water, too. And you’ll benefit from fresher food, often much riper when picked and higher in vitamins by the time it reaches your plate.

Eat less processed food

Water is needed for every stage of food production, and that certainly includes any kind of refining, processing, or canning. So pick fresh meats and produce and cook things yourself, rather than buying pre-fab sauces and processed junk food. Eat fresher food, cut back on added sugar, preservatives and chemicals; hone your skills in the kitchen, make a healthier home and host more dazzling dinner parties. What have you got to lose?

Drink less coffee

Go gentle on the java – 140 litres of water are needed for just one cup of coffee. A cup of tea, on the other hand, rings up only 30 litres of water. Save the stains on your teeth, the strain on your tummy and the unpleasant jitters. Your bones, vulnerable to weakening from too much caffeine, will also thank you.

It takes as many as 70 litres of water to grow just one apple.

We use far more water than we realize – for example, a pair of jeans cost 11,000 litres of water to produce. This “hidden” or “virtual” water is invisible to most of us, which is why the Water Footprint Network in the Netherlands is researching the “water footprints” of the things we buy, “to try and make that link between production and consumption, and to help people understand how their choices impact global water supplies,” says Professor Arjen Hoesktra, creator of the water footprint concept. “There are lots of things that people can do, but in the end we are really talking about food,” he says. Around 86 percent of world water use goes to crop production, and what we eat accounts for about 70 percent of the average person’s water footprint.

Wondering how much water it takes to produce the food you eat every day? Here’s what goes into your daily bread…

Apple: 70 litres

It takes 70 litres for a “big mac,” almost entirely from the water soaked up by the trees in an orchard during the apple’s growth. Crop irrigation is also the main factor in an orange’s water footprint, which is 50 litres.

Red wine: 240 litres

It takes 240 litres of water to produce a 250 mL glass of red wine, almost entirely from vineyard irrigation. Beer interestingly comes in lower with 75 litres of water for the same sized glass.

Coffee: 140 litres

A single cup of black coffee takes 140 litres of water to produce. It requires 21,000 litres to grow a kilo of coffee beans, which translates to about 140 litres for the seven grams of java needed to make one cup of coffee. Add in another 20 litres of water for a splash of milk (20 mL), and another 13.5 litres if you take sugar (two teaspoons).

Hamburger: 2,400 litres

A burger costs 2,400 litres of water, almost entirely due to the 2,300 litres needed to create the 150 grams of meat. Beef is one of the most water-needy things you can eat because of how much time and energy is needed to raise cattle: A cow usually produces about 200 kg of boneless beef, taking about three years from birth to slaughter. And in its lifetime, a cow usually eats 1,300 kg of grains, along with 7,200 kg of hay and other roughage, consuming more than 3 million litres to grow the crops over those three years. On top of that, throw in the 24,000 litres of water the cow eats and the 7,000 litres of water for “servicing” (washing the animal and its waste away). And if you slap on a slice of cheese (say, an ounce) that brings the total up to 2,550 litres.

Eggs and toast: 480 litres

A slice of bread will chalk up 80 litres in water, thanks to the water needed to grow the wheat. And a single egg costs 200 litres in water to produce the grain needed to feed the chickens.

Chocolate: 2,400 litres

Are you ready? It takes 2,400 litres of water to produce just 100 grams of chocolate.

Of course, water footprints for the same product made in different parts of the world will vary. But just because a product from one region of the world has a higher water footprint than from another country doesn’t make it a more ecologically prudent choice. Wines from, say, rainy British Columbia will have soaked up more water in their growth than wines from more arid regions like California. But they represent a more water-wise choice than wines from somewhere like drought-stricken Australia, a continent that is suffering acutely from the ravages of poor water management.

Remember: It’s not just what you eat, it’s where it comes from that counts, too.

Hard, clear and resistant to heat and impact, polycarbonate plastics made with bisphenol A “are excellent,” says Joe Schwarcz, director of McGill University’s Office for Science and Society, “and that’s exactly the problem for suppliers now that BPA has become a dirty word.”

So the race is on to make to make something just as good.

“If it was easy, somebody would have done it already,” says Geoff Coates, a chemist at Cornell University and co-founder of Novomer, a company now testing technology he devised that produces something biodegradable, non-toxic and largely made of carbon dioxide.

According to Prof. Coates, cost is an issue, just as it is for products that employ polylactic acid, which is made from corn and biodegradable but melts at much lower temperatures.

Donald J. Darensbourg at Texas A&M University is, like Prof. Coates, chasing a successor that uses carbon dioxide, but so far can’t offer a replacement for BPA. He points out that there are other hard, clear plastics on the market. One produced in Tennessee by Eastman Chemical Co. contains no BPA, but, again, it is more expensive and melts more readily. “These are totally fine for baby bottles and water bottles – I have one on my desk right now,” Prof. Darensbourg says.

Meanwhile, Kyu Yong Choi of the University of Maryland is taking a different approach. He published a theoretical model last year for producing polycarbonates that minimize their BPA residue, he says, “fairly simply by controlling the reaction conditions.” He has since done the lab work to prove that the process is chemically possible, and now is looking for about $500,000 (U.S.) to carry out a feasibility study.

The future is more promising for the other big source of BPA exposure, the plastic lining on tin cans.

Prof. Coates’s company is working with a Dutch firm on a carbon-dioxide-derived resin that Novomer chief executive officer Jim Mahoney says will be “very cost-competitive” – and should be on the market next year.

The research, published in the scientific journal PlosOne on January 12, found that American men over 60 with the highest levels of BPA in their urine on average had a 45 per cent greater chance of developing cardiovascular disease than men with lower levels of the chemical.

This does not conclusively prove that BPA causes cardiovascular disease, says study author Dr. Tamara Galloway, Professor of Ecotoxicology at the University of Exeter, UK. The association could be influenced by other factors, such as a poor diet featuring large amounts of canned food, she said.

But the finding does add to more than 200 scientific studies that have linked the chemical to human health concerns, including diabetes, breast cancer, obesity, hyperactivity and behavioural problems, and early puberty. Of particular concern is the chemical’s potential to affect the development of infants and babies in the womb (it is also found in umbilical cord blood).

BPA is able to mimic the hormone estrogen (dubbed an “endocrine disruptor”) and numerous studies in lab animals have demonstrated effects at extremely low doses, such as changes to the development of mammary glands in mouse embryos exposed to levels equivalent to just 25 parts per trillion. The average level of BPA in the urine of people sampled in the newest study was 3.3 parts per billion.

Used to manufacture clear, polycarbonate plastic and the epoxy resins used in the lining of tin cans, BPA is found in many plastics that are labeled with the number seven (found in the triangular recycling symbol). It is used to make a wide variety of products including CDs, circuit boards, coffee makers, water cooler jugs, auto parts, sports equipment, cell phones, cameras, eyeglass lenses and medical equipment.

In 2008 Canada designated BPA “toxic” and became the first country to ban the sale and import of baby bottles containing it. The states of Connecticut and Massachussets have placed restrictions on the chemical, and several US senators are forwarding legislation to ban it from baby products. Many large brands and retailers such as Wal-Mart, Toys “R” Us, Playtex and Nalgene have pledged to phase out the chemical.

The newest study is particularly significant because “it is the first major epidemiological study to replicate an earlier finding – this brings a much higher level of confidence in the study’s validity,” says Professor Frederick vom Saal of the University of Missouri-Columbia. His own research has shown multiple effects on laboratory mice exposed to BPA, including developmental changes in the prostate glands, which he says suggest men exposed to the chemical before birth could be predisposed to develop prostate cancer later in life.

“It’s important to note that nobody claims any of the diseases BPA is related to are caused solely by this chemical, but that it could be an important contributing factor,” he says. Based on what we know, it is “lunacy” to allow BPA to be used in products that come into contact with food, he says.

The chemical poses more than just a risk to human health. “BPA is a huge environmental problem – it is estimated to contribute the highest level of estrogenicity released from landfills,” says Dr. Galloway.

Many other chemicals, such as phthalates (found in cosmetics, shampoos, soft plastics and clear plastic food wraps), flame retardants (used in many electronics), and other petrochemicals found in consumer products are also able to mimic hormones and can affect wildlife. BPA has been found to affect the development of snails, for example, at extremely low levels.

But the science isn’t all scary, says Dr. Galloway. BPA is rapidly broken down in the environment, unlike “persistent pollutants” like DDT, flame retardants and “non-stick” chemicals like Teflon, which will remain in the environment for decades. Children born today still carry PCBs in their blood, despite the fact that the chemical was broadly banned in the 1970s. On the other hand, BPA is broken down in the environment quickly.

Moreover, BPA is metabolised rapidly by the body compared to other chemicals, so people can quickly lower their blood levels. The newest study, based on a sample of the US population, shows a 30 per cent decline in average levels of the chemical in the US population since the last survey in 2003. “That’s really good news, and it happened without any legislation,” she comments, noting that public concern over the chemical could have led people to avoid canned food and drink and plastics known to contain BPA.

But many supposedly safe plastic products still contain the chemical. An analysis carried out by the government agency Health Canada in 2009 found that a number of baby bottle brands labeled “BPA-free” still contained trace amounts of the chemical. And a study commissioned by the Milwaukee-Wisconsin Journal Sentinel in 2008 found that BPA leaches into food from plastics not typically thought to contain BPA, including Nos 1, 2 and 5.

And even switching entirely to glass containers from plastic still leaves other routes for exposure, as Rick Smith, executive director of the Canadian advocacy group Environmental Defence discovered. For his book Slow Death by Rubber Duck, Smith experimented on himself by eating food microwaved in plastic containers, drinking canned pop and doing everything he could to elevate his own levels, which instantly shot up.

He then stripped everything suspect out of his diet and saw his BPA levels quickly drop – though not entirely. Clearly, he says, BPA was still able to suffuse his body through other known sources such as newspaper inks, grocery store receipts, recycled paper products and trace amounts in drinking water.

But BPA is something we can feel positive about, he says. ”If we ceased production of this chemicals tomorrow it would literally disappear from our bodies and from virtually every part of the environment – it would fizzle out.” Already chemists are finding new ways to make hard plastics with less (or no) BPA.

“There is absolutely no question in my mind that we will see this chemical disappear,” he says, adding that he is certain the Canadian government will bring in a broader ban in the next decade reaching beyond baby products. ”You would be hard pressed to think of any other single action that should be taken to protect human health than to ban this product from items that come into contact with food and drink.”

Smith believes the US will soon follow Canada’s example, but Professor Patricia Hunt of Washington State University, who has been studying BPA and its effects on lab animals for the past 15 years, isn’t so convinced. “I think it will be a lot more difficult here than in Canada – for one because there aren’t any manufacturers of the chemical on Canadian soil,” she says.

But the shift in public awareness of the chemical over the past 10 years has been “just amazing,” says Prof Hunt. “It’s parents in particular who have been demanding BPA-free products. That’s where change will come from: not from legislation, but from industry bowing to consumer demands.”

On Friday the FDA in the US announced its new position on the chemical, stating that “on the basis of results from recent studies using novel approaches to test for subtle effects [the FDA has] some concern about the potential effects of BPA on the brain, behavior, and prostate gland in fetuses, infants, and young children, [and will be conducting] in-depth studies to answer key questions and clarify uncertainties about the risks of BPA.” The agency has also ear marked $30 million to study the chemical for the next two years.

This is the first time the FDA has expressed concern over the safety of BPA. “This is huge,” says Prof vom Saal. “We finally have science overcoming politics in the US. Previously, under President Bush, the FDA behaved essentially like a public relations wing for the chemical industry.”

The American Chemistry Council, which represents companies that manufacture BPA, states that “consumer products made with BPA are safe for their intended uses and pose no known risks to human health.”

This position is unlikely to change soon, says consumer advocate Smith. “They are manning the barricades, and their game plan is clear: deny, deny, deny,” he says. “They are still fighting any increased regulation of BPA in any form. And based on the leaked minutes of their planning session last year, we know exactly how low they will stoop to maintain sales.”

While the chemical continues to cause controversy in America and Canada, where baby products are colourfully labeled “BPA-FREE”, it is considerably less visible in the UK and many other European countries.

“More attention is given by the media to our research on the other side of the Atlantic,” says Dr Galloway, who works in England. “There seems to be more of a public debate there.”

But what if you just don’t like the bloody thing?

Because not every woman does. “Publicists are always trying to get women’s magazine editors to jump on the diva cup bandwagon – but I’m so not there with it,” says Cathy Garrard, an editor and writer who has staffed at numerous publications including environmental magazine Plenty.

Many women won’t want to convert – try telling a woman with vulvodynia they should give it a whirl. Or a 13-year-old already suffering from the physical and psychological traumas of puberty.

The fact that the cup is not always a comfortable choice – despite the claims made by its manufacturers – could undermine ecologically-friendly products as a whole, which continue to be widely perceived as invariably “ugly” or “impractical.”

Full disclosure: I don’t like the cup. I tried. It wasn’t comfortable. Trying to get it out was far less easy than I was told it would be. A few days was enough before I quit – and it can take up to three months to grow comfortable with it. No thanks.

But less well-known are the equally ecologically and economically sound alternatives: re-usable cotton liners and lined underwear, such as Lunapads and Lunapanties.

Full disclosure: Lunapanties are my weapon of choice. They fit just as comfortably as normal undies, and are genuinely much more comfortable than synthetic maxi-pads, which bunch up and can be clammy (or damned cold in Canadian winters). Best of all: I haven’t had to buy anything in three years.

To be fair, most women who try the cup become devotees. My female friends are eager to endorse its virtues. Zuzia: “Love it.” Amy: “I’ve never had any problems with it – I often forget it’s even there.” Sarah: “I worry less than I did about pads leaking all over my clothes.” Rochelle: “They’re way more convenient.” Bethan: “It gives you freedom.” (Especially, as travelers will tell you, in remote locations.)

Jessie however shared my view: “Sounds good in theory, but I had a rather painful encounter with one of those things. The memory is still too vivid to try it again.”

Regardless what women choose the financial gains are indisputable and the ecological impact is considerable: each year in America alone an estimated 14 billion pads and seven billion tampons end up in sewers and landfills – or wash out to sea. Volunteers with the NGO Ocean Conservancy kindly gathered 17,239 tampons and applicators from beaches in the 2007 International Coastal Cleanup, just a tiny fraction of what remains out there.

And yet global production of white asbestos still stands at more than two million metric tonnes a year – the same as in 1960.

So if more than 40 countries have banned the use of white asbestos (also known as chrysotile, the only kind still used), where is it all going? Emerging and fast developing economies like China, India, Thailand, Indonesia, and Brazil. Though disconcerting, this is not surprising: such nations are less likely to have the stringent health and safety codes in place as the developed Western nations that banned asbestos long ago.

But where the asbestos is coming from is far more surprising, and far more interesting: the world’s second largest producer of white asbestos is Canada – a nation that has itself banned the use of the carcinogenic mineral, and is in fact spending millions at this very moment to remove asbestos from the Houses of Parliament in Ottawa.

The scientific consensus is concrete: medical and scientific establishments have long recognized the carcinogenic dangers of asbestos, whose whispy white fibres breed a particularly painful and incurable form of cancer in the linings of the lungs, called mesothelioma. According to the World Health Organization there is in fact no ’safe threshold’ for white asbestos – meaning that exposure to even the most minute dose, potentially just a few fibres, could spawn a cancer. They advocate a global ban on all uses of all forms of asbestos.

And yet in 2006, when international representatives attempted to add white asbestos to the Rotterdam Convention, a UN-kept list of hazardous substances, Canada blocked the vote, even though Rotterdam would not even prohibit the export and sale of chrysotile but would only require that exporting nations inform importing ones that the product in question is dangerous.

But white asbestos remains off the list, and unlabelled sacks of white fluff continue to flood construction sites in countries like India and Sri Lanka, where workers in flimsy face masks mix it into cement, releasing clouds of sparkly dust into the air (and carry it home in their clothes to share with their families). The Canadian Medical Association Journal has called Canada’s opposition to the listing of asbestos as a hazardous substance under the Rotterdam Convention a ’shameful political manipulation of science’.

But according to the Chrysotile Institute in Montreal – formerly known as the Asbestos Institute (re-branded to avoid the stigma associated with the A-word) – white asbestos can be ’safe to use’.

‘The argument that you can use asbestos safely is the lynchpin,’ says Geoff Tweedale, a Reader in Business History at Manchester Metropolitan University Business School and author of Defending the Indefensible: the Global Asbestos Industry & its Fight for Survival. ‘There is a long history of the asbestos industry corrupting science, in particular by censoring unfavourable studies and selectively choosing data. The argument that certain forms of asbestos can be used safely goes right back to the 1930s because being able to “prove” that white asbestos is safe is the way to save the industry.

‘And this argument carries on today – except that now it is being played out in countries like China and India, the main reason being that there is still money to be made.’

And there is also big money to be lost: lawsuits in the US by sickened mechanics against the auto giants who incorporated asbestos into brake pads would run into the hundreds of billions of dollars if successful.

‘Defendant corporations like GM and Chrysler have gone to extraordinary lengths to reshape the scientific literature to defend these cases, debasing and contaminating the research and public health policies that have to be based on science,’ says Barry Castleman, an environmental consultant who has testified before the USEnvironmental Protection Agency regarding the hazards of asbestos. ‘Vested interests essentially hired scientists to create controversy where there wasn’t any.’

The story is an old one: industry-funded scientists will ‘manufacture doubt’ for vested interests seeking to avoid losing (or keep making) money: tobacco companies did it with second-hand smoke, oil companies with climate change, and the asbestos industry with mesothelioma. For example, just as tobacco giants will label ‘light’ cigarettes as ‘less harmful’, the asbestos industry will brand white asbestos as ’safer’.

Cynically, almost comically, the Chrysotile Institute will use the same language as the scientists and medical professionals who oppose its use: ‘Vested interests in the anti-asbestos lobby have deliberately used outdated science and confusion between the different fibres to advocate for a total ban on all asbestos products … The great asbestos scam is based on deliberate confusion.”

‘This misinformation is absurd, and it kills people,’ says Kathleen Ruff, Senior Advisor on Human Rights to the Rideau Institute in Ottawa. Even more absurd, she points out, is the fact that the Chrysotile Institute has been funded with tax dollars by the Canadian Government for the past twenty years, to the tune of $20 million. ‘Our Government should not be funding this manipulation of science – Canadian scientists should stand up because this is scientifically indefensible as well as morally indefensible.’

And increasingly they are. In January the professor emeritus of public health at the Université Laval, Québec, wrote an open letter to Prime Minister Stephen Harper calling for an end to the ‘perversion of scientific information‘. This August the Canadian Medical Association passed a resolution with a 95 per cent vote pushing for the Canadian Government to stop mining and exporting asbestos – and to stop funding the Chrysotile Institute. And last week a Quebec doctor wrote in La Presse that the Government’s actions are paramount to criminal negligence.

‘This is a real example of how we have to safeguard science and not allowed it to be abused,’ says Ruff.
But more than that, we need to each of us be more aware of the potential for science to be abused, to have the basic scientific literacy to understand how it can be abused – and to take the initiative to protect those who can’t.

The government of Canada is proposing to ban a controversial flame retardant used in textiles, furniture and electronics, known as deca-polybrominated diphenyl ether (deca PBDE), or simply “deca,” joining the European Union in removing it from the marketplace.

The move comes after years of lobbying by Canadians concerned by the chemical’s accumulation in wildlife and in people (Canadians carry the highest level of PBDEs in their blood and breast milk, second only to Americans), and by scientific studies—including a new one published last month by Swedish researchers—that find it to be toxic to the nervous systems and thyroid glands of mice. Studies on potential health effects of PBDEs in humans are scarce, but there is concern, for children in particular, due to its ability to cause hyperactivity and spontaneous behaviour (often described as “ADHD-like” symptoms) in lab animals.

In fact, the federal government banned deca’s manufacture in Canada in July 2008 and is now moving to ban the chemical’s import in electronics as well. “We see this as a victory,” says Dr. Elaine MacDonald, senior scientist with Ecojustice (formerly the Sierra Legal Defence Fund). “This is a great step forward.”

Where it lurks

About 80 percent of deca used in Canada, she notes, is in the hard plastic casing in consumer electronics such as televisions and computers (where it is added to prevent them catching fire from overheating or during house fires). But because Canada has no system in place to test all imports for flame retardants, there is still no guarantee that your new television or carpet will be deca-free once the import ban is in place. “You may have to just do your own research on specific brands online,” she says.

In fact, some major brands have already pledged to never use deca, such as Apple and Ikea. But areport from Greenpeace last month found that other electronics companies, such as Hewlett Packard and Dell, still use brominated flame retardants, despite pledges to phase them out.

Even so, deca is being phased out, in this country at least. A few U.S. states have also banned deca, but “Canada is way ahead of the U.S. on this. We are lagging behind [here] in America,” says Dr. Arlene Blum, Director of the Green Science Policy Institute at the University of California, Berkeley, who first identified carcinogenic brominated flame retardants called “tris” in the 1970s.

New retardants, same problems?

But while deca is on its way out, other new kinds of brominated flame retardants are being introduced to replace them, such as decabromodiphenyl ethane and brominated phthalates (a name that should ring alarm bells). Phthalates, plasticizers used to soften polymer plastics, are also being targeted for bans for their toxicity to the hormonal system.

“There is now a huge laundry list of new brominated flame retardants, and there are so few toxicology studies done on these chemicals before their approval, its just crazy,” says Dr. Miriam Diamond, a chemist at the University of Toronto who studies flame retardants and other toxic chemicals in household dust and outdoor air pollution, who published a new study last month looking at how they get into household dust. “Environmental chemists are always playing catch up,” identifying the chemicals in the environment and then looking to see what effects they could have on the wildlife and people they accumulate in.

In fact, deca was introduced as what was thought to be a “safe” alternative to two other PBDEs (called penta and octa), which themselves were used as “safe” alternatives to other more toxic flame retardants. Now, new chemicals are being introduced every year to replace deca, and some might prove to be dangerous—decabromodiphenyl ethane has already been found in red pandas in China and seagulls in North America.

All of this begs the question, is it even be possible to design flame retardants that are safe? “I don’t know of any brominated flame retardants that turned out to be safe,” says Dr Blum. “At the end of the day, in many cases the chemicals just aren’t necessary. We now have fire-safe candles and cigarettes that extinguish themselves. It’s much more effective to deal with the sources of ignition than to put fire retardants in everything.”

Three years ago, Regina Netto felt as if her vulva was on fire, “like somebody had lit up a flame down there.” It was so bad that most days the 38-year-old from Laval, Que., could barely walk. And sex? Forget about it.

Her doctor thought she had a urinary tract infection – but treatment for that only worsened her pain. Blood and urine tests for a UTI came up negative, and then a cystoscopy (examination of her bladder with a small camera) showed nothing.

Thinking she had interstitial cystitis (a chronic bladder disease), a urologist prescribed Ms. Netto medication – but that didn’t work either. Nor did visits to an acupuncturist, naturopath, osteopath or physiotherapist. She saw eight different gynecologists and urologists in search of relief.

Finally, she says, “A family doctor and a gynecologist told me that there was nothing wrong with me and that I needed to see a shrink.”

Ms. Netto had a real condition, called vulvodynia, meaning chronic vulvar pain. But there is no test for it, and while there is some faint visible redness in some women, on the surface most women with vulvodynia look completely normal. This makes the condition difficult to diagnose and leaves sufferers prone to hasty dismissal by their physicians. Most GPs – and many gynecologists – are not even aware of its existence.

But research is now uncovering the concrete, physical markers of vulvodynia, giving therapists the tools they need to develop effective treatments.

In 2006, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians felt the need to print an educational piece on the condition in their monthly newsletter, sent to 150,000 physicians, with information on how to diagnose and treat it.

“Vulvodynia, like many conditions, has historically suffered from a lack of understanding,” says Lori Heim, a director of the AAFP. “But it is real – it is not a psychological condition. And now more is known about it, its extent, and how to diagnose and treat it, so we decided to provide our members with education because the information has evolved.”

“One of the difficulties is that there is no test for vulvodynia,” says Marc Steben, a family physician and clinical researcher of vulvodynia in Montreal. “The diagnosis is one of exclusion.” In other words, when you can’t peg the problem as anything else – say, a yeast imbalance, a bladder infection or interstitial cystitis – then it could be vulvodynia.

If all the tests turn up negative, says Alan Gerulath, a gynecologist at St. Michael’s Hospital in Toronto, properly diagnosing vulvodynia is “based on symptoms, primarily burning – but not itching – discomfort.”

More than a single ailment

To complicate matters, vulvodynia is not just one simple ailment, but an umbrella term for a number of conditions – which may be why the National Institutes of Health in the United States says the condition affects an estimated one in six women at some point in their lives.

One group of women, with what is dubbed “vulvar vestibulitis syndrome,” suffer pain just at the opening of their vaginas, usually only with physical contact. Vestibulitis tends to strike early in life, usually before 25, and because the pain is localized it is easier to diagnose, Dr. Gerulath says.

More difficult to pinpoint is “generalized vulvodynia,” which causes burning pain in the entire vulva without any contact, sometimes 24 hours a day. This commonly starts between the ages of 35 and 44.

Research has shown that all women with vulvodynia have a higher density of nerve endings in their vulvas. And scientists have documented genetic differences in women with vulvodynia that cause them to respond abnormally to infection and injury.

For many women, an injury – say a chronic yeast infection or childbirth – sparks an immune- and nervous-system response that fails to turn off. The initial problem has disappeared, but their nerves continue to fire pain signals to their brains.

Drugs that control levels of hormones, neurotransmitters and other biochemical messengers are frequently prescribed, such as estrogen creams, anti-epileptics such as gabapentin, and tricyclic antidepressants such as amitriptyline (in doses too low to have an antidepressant effect, but enough to dampen the nerve signals).

Allan Gordon of the Wasser Pain Management Centre in Toronto finds that about one-third of his vulvodynia patients respond to medication. But “there have been very few good, appropriate clinical trials – a lot of the ideas are based on anecdotal evidence about what seems to work,” he says.

In another possible clue to the brain’s role in vulvodynia, Canadian researchers published a study last month in the scientific journal Pain that demonstrated evidence of altered brain structure in women with provoked vestibulodynia (a newer and more accurate term for vestibulitis). They found that 14 women who had suffered from PVD had more grey matter in the regions of their brains associated with pain and stress.

What this actually means is “purely speculative at this point,” says Petra Schweinhardt of McGill University, one of the study’s co-authors. It could mean that women who have suffered from PVD experienced changes in their brains as a result of their pain, or it could mean they were born this way. “It could be one or the other, but our speculation is that the increased grey matter might represent an inflammatory response by cells in the brain,” Dr. Schweinhardt says.

Surgical option

Because so little of what is known is conclusive, finding the right solution for each patient is a matter of trial and error, involving a mixture of physiotherapy, diets, drugs and therapies such as acupuncture. As a last resort, some women turn to surgery and have small chunks of their vulvas removed – a procedure recommended only for women with pain in small, specific spots.

But Howard Glazer, a neurophysiological psychologist from Toronto who operates a private clinic for urogenital pain in New York (and who co-authored a paper in the journal Obstetrics and Gynecology on treatment options), says he has seen a lot of women still in pain after surgery.

He is equally disapproving of drugs. He says the best option is to help the body to heal itself by increasing blood flow to the vulva, and therefore the delivery of oxygen and the body’s own repairing mechanisms. He does this by first mapping the physiology of his patients with a sensitive probe, then teaching them how and where to exercise their vaginal muscles to increase blood flow appropriately.

Controversial therapy

More controversially, he also tells his patients to get back in touch with their sexuality, pronto, and have “a minimum of three to five orgasms a week,” since arousal also increases blood flow.

“[Dr.] Glazer’s idea might be a little overstated – I wouldn’t want to put all the onus on the patient – but this could be good as a secondary therapy,” Dr. Gerulath says. “Anything that relieves muscle spasms can help.”

“I wouldn’t recommend intercourse if it is very painful – that would be counterproductive – but I do think that engaging in sexual activity can be helpful, by exercising and helping to improve blood flow,” Dr. Gordon says. “It is still speculative at this point if it will ‘heal’ them, but it is possible. There are a number of anecdotal reports that suggest sexual activity, masturbation and orgasm can be helpful.”

Naturally, many women suffering from the condition have little interest in sex. But Dr. Glazer argues that anxiety weakens the immune system and exacerbates the condition, so he advises his patients to overcome their fear with counselling and patience.

Although Dr. Gerulath feels the best treatments could lie in future drugs that help the nervous system, he acknowledges that vulvodynia is “a problem with the way the brain receives and interprets pain signals. Certainly there are a lot of examples of mind-body interactions, and absolutely you can influence your own symptoms,” he says. “But as to what techniques work, that is a whole other can of worms.”

To think of vulvodynia as “psychological” just because it has a psychological component is a gross oversimplification, Dr. Glazer says. “This does not for a second mean that vulvodynia is ‘all in their heads’ – that is not how the body works. The simplistic thinking that something is either ‘real’ or ‘in your head’ should have died out in the 1950s.”

Lisa Hunt, who suffers from vulvodynia, spent five years looking for a doctor in Calgary who could help her. After a battery of tests by a number of doctors, she too was given dismissive treatment by her GP.

“He told me flat out that this is not a ‘medically recognized condition’ and that it was all in my head,” the 28-year-old says.

With Dr. Gordon at the Wasser clinic, she says she feels lucky because she is “finally seeing a doctor who knows more about this than I do.”

A new alternative remedy that proponents say can cure a wide spectrum of emotional conditions – and a few physical ones as well – is going to be offered in Canada for the first time this spring, starting in the first week of May in Montreal, later moving to Toronto and Vancouver.

Called the Phil Parker Lightning Process, because it is intended to cure in just three days, it was designed in the United Kingdom by British psychotherapist Phil Parker for conditions such as anxiety, depression, obsessive-compulsive disorder and addiction.

Some people say it is the silver bullet that finally cured them. But detractors point out that the Lightning Process is scientifically unproven, have criticized its practitioners for making what they consider extravagant claims, and on occasion labeled the organization as fraudulent.

Origin

“I designed it for people who were stuck – everything I had tried that worked on everybody else didn’t work for them,” Parker said in an interview. “I had run out of tools.”

Parker says this led him to design a technique combining a number of elements from other alternative therapies, such as neurolinguistic programming and hypnotherapy.

The aim is to help patients break out of negative patterns of thinking and behaviour by having them do specific mental exercises in the vein of positive thinking. It is not a treatment or therapy in the traditional sense, but a “training program,” its practitioners say.

“We teach clients to be their own life coach,” says practitioner Maxine Henk-Bryce, a British psychotherapist and hypnotherapist who has trained more than 1,200 people in the process since 2002. She will be offering training sessions in Canada starting in Montreal in the first week of May, in Toronto and Vancouver in July, and later throughout Canada (mostly in Vancouver, where she will be based). Sessions take up to 10 people at a time.

Sunny Sanghera, who lives in England, was trained in the Lightning Process in October 2007 by Henk-Bryce for low self-esteem. She says that not only is she more confident now, but that her entire life has changed.

“It isn’t just counselling, it’s so much more complex than just telling yourself to calm down,” she says. “It changes the way you think about everything. Even that evening, listening to a Prince CD I had played for years, all of a sudden I could hear things in the music I hadn’t heard before.”

CFS controversy

People have trained in the process for a slew of emotional and mental conditions, from stage fright to procrastination to long-term guilt. And Parker says it can also help people with physical conditions like back pain and fibromyalgia (chronic muscle pain).

But the Lightning Process is generating the most attention – and controversy – over its use for chronic fatigue syndrome (CFS). About 80 per cent of people who sign up for the Lightning Process suffer from CFS, or myalgic encephalomyelitis (ME) as it is more commonly known in the U.K.

CFS is a debilitating, persistent illness that affects 1.3 per cent of Canadians, according to Statistics Canada. Afflicted individuals experience aches and pains, severe mental impairment and perpetual exhaustion. They frequently remain ill for many years, even decades, and often must scale back their education and employment considerably.

Physicians have no real cure for CFS. Prescription drugs can only help people deal with symptoms, such as insomnia or pain. Doctors say the best sufferers can do is manage their illness with careful rationing of energy and activity – neither too much nor too little – and slowly improve. Alternative health practitioners offer a plethora of herbal and physical therapies, but none have been proven to work.

One reason for the lack of effective treatments is because research was hampered for many decades by a lack of interest in the syndrome. It was long dismissed as psychosomatic, primarily because patients present no visible symptoms.

“CFS is a real illness, it is not just a bunch of hooey in people’s heads,” says Dr. William Reeves, the principal investigator of the syndrome at the Centers for Disease Control in Atlanta, Ga. The CDC has a public awareness campaign designed to dispel the psychosomatic stigma that has tainted CFS since the 1980s, when it was widely derided as “yuppie flu.”

Scientific studies have shown that there are clear biological markers in CFS patients, such as altered nervous system activity, lower levels of adrenaline, and specific genetic differences. And it appears that CFS may actually turn out to be an umbrella term for a suite of similar illnesses, with different genetic vulnerabilities set off by different triggers.

Although medical science has yet to complete the puzzle, it appears that the illness generally starts with a viral infection of some kind (mononucleosis is one common trigger that has been studied), followed by natural responses of the immune and nervous systems that, for some reason, fail to “turn off” as they normally would.

Though it is not psychosomatic, these responses are centred in the brain in much the same way that Parkinson’s, a physical ailment, is centred in the brain.

“This is a complex, brain-body illness,” says Reeves, noting that the response by the body to emotional, physical and mental stress appears to be the key. “The brain is central to the body’s response to stress, which is manifested through the nervous system.”

This, says Henk-Bryce, is how a verbal technique like the Lightning Process can be used to treat CFS.

“It teaches you how the brain works, and to train your brain and body to work together to influence your health,” she says. “We look at how the mind influences the body and how the body influences the mind.”

It may sound implausible, but thousands of CFS patients – desperate to recover, and with no real cure available – have decided to try it.

Stephanie Dotto, a 21-year-old from Montreal, is one of them. She was diagnosed with CFS three years ago.

“It’s incredible how tired you are,” she says. “I felt like I had the body of an 80-year-old.”

At her worst, she was spending 15 hours in bed a day, was seeing her doctors at least three times a week, and was taking 26 different supplements and pills every single day. And she wasn’t getting better.

She had heard about the Lightning Process from other CFS sufferers, so she decided to fly to England in November 2007 to try it.

“I was trying to be as open-minded as possible, but it’s hard not to wonder how something like that could physically heal you,” she says.

But Dotto says she made a full recovery and has gone off all her medication. “I’m not sure how it worked. All I know is that it worked, so I am thankful. I feel like they gave me my life back.”

Thousands of other people who were once crippled by CFS also say the Lightning Process has cured them.

But as anecdotal reports have fuelled hope in some, the Lightning Process has also generated controversy. It is scientifically unproven, and not endorsed by any medical authority. And to some CFS support groups, the claim that a verbal method could cure a physical ailment seems to imply that CFS is a psychological manifestation after all, a notion they find offensive.

John Greensmith, a CFS sufferer and campaigner with the British advocacy group ME Free For All, also questions the fact that people who train in the process frequently go on to become practitioners themselves.

“That seems to me like a pyramid scheme,” he says, noting that at a cost of around $1,200, the training program doesn’t come cheap.

“We think their claims are extravagant,” Greensmith adds, pointing out that Lightning Process practitioners assert that the training program should work in all cases so long as patients properly follow instructions.

“If you use it properly you will get the results each and every time,” asserts Henk-Bryce.

Greensmith isn’t sold. “So if patients get better, they claim the success of the treatment – but if they don’t, they say the patient is responsible.”

Isobel Bennett, 49 years old from London, says it didn’t work for her when she tried it last year. In fact, she says it made her worse.

“It encouraged me to push myself beyond my natural limits, and afterwards I crashed badly, becoming housebound. I’m just gradually beginning to pick up now,” she says.

Others recount similar stories of relapses after going through the process.

“I think it is potentially a useful technique,” says Bennett. “But I am bitter that they are not very open to recognizing that it doesn’t work for some people. It needs to be tailored more to individual cases rather than just a ‘one size fits all, so if it doesn’t work for you then tough’ attitude. CFS is so little understood – it’s not the same illness in everybody. For some people, it potentially could be dangerous.”

Research

“We are dealing with a number of disorders, and we are still not able to divide the subgroups carefully enough – we’re looking at apples and oranges and plums,” agrees Dr. Leslie Findley, an expert in Parkinson’s disease and a clinical neuroscientist in Essex, England.

He is conducting a pilot study with CFS patients and the Lightning Process – the first independent study of its kind – and he says so far, his research indicates it benefits about two-thirds of patients. For the other third, there is no change in their illness, and in a small number of cases there can be bad relapses.

While the findings are not as high as the 100-per-cent success rate some practitioners of the Lightning Process claim, it does imply that the training program can help some people, and that a verbal technique can be used as a treatment for this physical illness.

“Do I believe that CFS is psychosomatic? The answer is an emphatic no. It is a disorder of the brain,” Findley says.

But, he adds, he doesn’t think the Lightning Process is going to be the definitive treatment for CFS. “Most patients, if properly managed, will recover on their own. I just see this as another way of helping patients that haven’t responded to much simpler approaches.”

“Talk therapy” takes on chronic fatigue syndrome: coming soon to Canada

“It was very much like being a dead person … I could only lie there.” The victim of an exhausting, little-understood malady, this young woman spent six long years confined to a darkened room. Zoe Cormier describes how a new – and surprisingly simple – therapy brought her back to the light

NORWICH, ENGLAND — Anna Debbage suffers from wanderlust. At this very moment, she is backpacking in Thailand, which isn’t unusual for someone her age, except that she hasn’t exactly lived her 26 years to the fullest. Ms. Debbage has yet to finish high school, has never dated seriously and, until a few months ago, knew precious little about the infamous terror attacks of Sept. 11, 2001.

For almost six years, she was a prisoner in her own bedroom, consigned to a life she now characterizes as “like being dead, like being in a tomb.”

The young woman from Norwich, two hours northeast of London, had fallen victim to a baffling illness that medical science for years refused to recognize and even now has yet to devise an effective treatment. At her worst, she was unable to move her arms or legs and couldn’t tolerate even the tiniest sliver of light or the faintest sound. She kept her blinds drawn tight, her eyes covered and the power indicator on any electronic devices coated with foil. Even the quietest sounds were so painful that her parents added insulation to her walls and bought her industrial headphones.

Ms. Debbage had contracted a case of chronic fatigue syndrome (CFS) so extreme that she thought she would never get better. And yet, after being robbed of nearly a decade of her life, she has made a full recovery, for which she credits a strange – almost implausible – new treatment that is coming soon to Canada.

“HYSTERICAL NONSENSE”

Chronic fatigue syndrome is a true mystery. Some experts feel the affliction has always been with us, but it first came to the attention of medical science midway through the 20th century as a bizarre, debilitating condition sparked by an initial flu-like illness. Preliminary investigations suggested the fatigue was linked to inflammation in the brain and spinal cord, and the condition was dubbed “myalgic encephalomyelitis” (ME), as it is still known in England.

But no symptoms were visible. All that seemed to unite its victims was their exhaustion. (Even now, there is no diagnostic test for it.) So, in 1970 two psychiatrists writing in the British Medical Journal dismissed the condition as mere hysteria, an assessment that stuck for decades. Young doctors were taught that CFS was “hysterical nonsense, a non-disease,” says Charles Shepherd, medical adviser to the ME Association in Britain. “So it became something that few people were willing to investigate,” and retained its “psychosomatic” status through the 1980s when it was derided as the “yuppie flu” suffered by self-obsessed hypochondriacs.

“But now the research shows that this is undoubtedly not a psychological problem,” Dr. Shepherd says.

CFS researcher Anthony Komaroff, a professor of medicine at Harvard Medical School, agrees, pointing to clear evidence of “objective, biological differences” between chronic-fatigue sufferers and the rest of the population.

“The central nervous system and the immune system are measurably different,” Dr. Komaroff says. People with CFS have less grey matter in their brains and abnormal functioning of the hypothalamus, as well as elevated levels of cytokines (proteins released by the immune system), impaired white blood cells and lower adrenalin levels. And now researchers have found genetic differences, which may lead to a gene-based diagnostic test.

CFS is now taken so seriously that Statistics Canada estimates as many as 1.3 per cent of Canadians suffer from it and the U.S. Centers for Disease Control and Prevention has launched a public-awareness campaign to dispel the “psychosomatic” stigma.
Still, there is no “cure.” The few drugs commonly prescribed can only address the symptoms, such as pain and sleep deprivation. And few of the many alternative remedies available offer much relief.

Most sufferers hope that by looking after themselves and pacing their activity, they can manage the illness. But for some that simply isn’t enough.

EXHAUSTED BUT SLEEPLESS

Anna Debbage belongs to this select group. For a few years after she fell ill in 1998, her father, Noel, says, “I read about CFS as much as I could, and I thought, ‘We are getting away lightly with this.’”

But slowly she grew increasingly tired, missed more and more school, and spent more time in bed. A devout Christian, she now says it was almost a blessing that “I had no idea how bad it would get.”

The condition slowly took control. No matter what they tried – vitamins, herbs, medications, magnesium injections, oxygen supplements, gluten-free diets – nothing worked. Any activity exhausted her and, paradoxically, rest didn’t help: In a cruel irony, CFS sufferers are plagued by insomnia. Ms. Debbage went weeks without proper sleep.

At first, she would feel worse in the winter and pick up in the spring, but in the third winter she went down and stayed there. In December, 2001, she lost the use of her legs, followed two months later by her arms and hands. By April, she could no longer see, and by June she could no longer hear.

“One thing that helped me cope was a sense of humour,” she says. “If you try hard enough, you can see the funny side in almost anything.”

But then she started to lose something that made no one laugh: the ability to breathe. She began to panic. “I really thought I might have been dying.” With concentration and the help of her family, she regained control. But almost every minute for the next year was spent focusing on breathing slowly and regularly.

The mental fatigue was just as acute. “It was very much like being a dead person. I couldn’t remember things, I couldn’t imagine, I couldn’t plan. I could only lie there.”

No light. No movement. No music. No visitors. Minimal, whispered conversations with her parents. Her relatives sent her letters and tape recordings. “But nothing held any meaning any more,” she says. “All I needed to hear were the words ‘I love you.’ But so many people just don’t know to say it. Maybe it’s our culture – we’re very reserved in England.”

Most friends abandoned her. “People who would come to see me wouldn’t come back. They just couldn’t take it in.” Life was hell for her parents. (Mr. Debbage says Anna’s mother “hated the fact that light, of all things, would make her ill – there’s something so awful about that.”) By 2002, “the depression broke me,” Anna says. “I felt suicidal.”

Yet her dark, lonely paralysis was interrupted on occasion: In 2003, she managed to listen to a few minutes of music, turned 21, taught herself to whistle, felt God’s presence return and had her depression ease. By November, she says, “I was well enough to cry.”

And then, in the winter of 2004, she really started to improve. She tolerated light a few minutes a day and by March she could listen to the odd track by her favourite singer, Elvis Presley. In April, her eyes were well enough to see her younger brother, now a grown man. By July, she could read Winnie the Pooh, feed herself with a remote-controlled arm and be taken out in a wheelchair. In August, she managed to stand for 10 seconds.

She grew so hopeful that she attended a friend’s wedding in her wheelchair. But it was too much. She relapsed to square one: motionless, silent, super-sensitive to light – unable even to chew.

“But one thing that always brought me courage and hope was the metaphor of a butterfly chrysalis: They spend a lot of time alone in the dark, unable to move, while turning into something beautiful.”

BOLT FROM THE BLUE

The butterfly began to emerge last May when Ms. Debbage underwent a new therapy so unusual that it’s difficult to believe it could possibly work.

Known as the “lightning process,” it was devised by British alternative-health practitioner Phil Parker to help people snap out of negative patterns, such as smoking, depression, anxiety – and CFS. The goal is to strike like lightning: do it all in just three days.

Available in Britain for about seven years, the program combines elements of various alternative therapies, such as osteopathy, hypnotherapy and neurolinguistic programming. The end product is essentially a blend of behavioural therapy, “positive thinking” and a few posture exercises. No injections, no pills, no ointments.

Not that CFS is a figment of the imagination, the London-based Mr. Parker says. “Just because we approach an illness from a partially emotional side doesn’t make the illness purely emotional,” he insists. “This is about neurologically restoring balance from the inside rather than the outside.”

Robert Fulcher, a stroke specialist at the Norfolk and Norwich University Hospital, endorses the notion that the brain can be “rewired.”

“When you are bedridden,” says Dr. Fulcher, who is also trained as a hypnotherapist and who introduced Ms. Debbage to the lightning process, “certain pathways in the brain can become fixed, and a lot of what we do becomes unconscious.”

But those patterns can be broken. Not unlike stroke victims who must build new neural pathways to regain lost brain functions, he explains, “in order to get better, CFS sufferers need to actually establish in their mind that they are not going to be stuck in bed for their whole lives.”

Still, it all sounds a little far-fetched, and critics have called the process unscientific, New Age rhetoric. Ms. Debbage was certainly not very hopeful. “I had already accepted that I wouldn’t have my life back until my 30s, maybe my 40s – I was sick of false hopes.”

She had good reason to be skeptical, says Dr. Shepherd of the ME Association. “Some new alternative miracle cure comes along every two months or so – such as anti-candida diets, multi-vitamin shots, co-enzyme Q-10 pills. Most hang around for a year and disappear from the scene. None has really stood up to scientific investigation.”

Although he believes that CFS is a brain disorder, “I am equally skeptical of ‘talking treatments.’ … They all claim incredible success rates, but they have never been subjected to a proper medical trial.”

The exception, he says, is the lightning process, which is the focus of a small independent pilot study conducted by Leslie Findley, a clinical neuroscientist who has spent decades working with Parkinson’s disease, CFS and other neurological disorders.

Because he feels that CFS sufferers “are vulnerable to exploitation, and there have been all sorts of quackery and bogus treatments,” Dr. Findley is very skeptical. But after tracking more than 100 of his own patients who have undergone the therapy, he feels that there may be something to it.

About two-thirds of his subjects seem to have some benefit. This is quite a bit short of the success rate lightning-process practitioners claim (they say that, done properly, it should work for everybody), but there is a measurable benefit nonetheless.

“Whenever something new comes along,” Dr. Findley says, “I’m keen to see if it has anything to offer – and there’s no doubt that this does.” He believes the key is the way the process helps people manage stress, which accentuates any illness. For example, stress worsens the tremors in Parkinson’s patients.

Does this mean that CFS really is all in the mind?

“No,” Dr. Findley says. “The fact that we are changing the functioning of the stress system by a verbal technique does not imply in any way that this is psychosomatic – only a fool with a superficial understanding of the way the brain works would make this assumption.”

But neither does he feel the tactic – which will reach Canada this spring when psychotherapist Maxine Henk, trained in the procedure by Mr. Parker, moves to Vancouver – is for everyone. “This is a collection of techniques packaged in a way that effectively helps some patients – but not all of them. I see it as another way of managing some patients, mainly those that haven’t yet responded to much more simple approaches – the majority won’t need it.”

And in some cases, it could do more harm than good. “If a patient is offered this with the belief that they will get better because their recovery is entirely up to them,” he says, “if it doesn’t work, they could go off with more guilt and a sense of failure, which just perpetuates their stress and, therefore, their illness.”

There is certainly no shortage of reports online describing how the lightning process has failed and disparaging its cost (about $1,200), principles and claims.

“I myself was by no means convinced that this was going to work,” Noel Debbage says. “But it did. The doctor talked to her, gently asked her if she would try and open her eyes – and she did.”

Being a math teacher, he says, “the idea that you can use language to reach in and switch a button in your head to impact your body is still very hard to believe, even though I saw it happen.” And yet his daughter seems to have made a full recovery.

“She was undoubtedly the worst case I have ever treated,” Dr. Fulcher says. “This girl hadn’t been out of a darkened room for years – and yet by the end of the third day of training, she went to a market with her mother and bought some chewing gum.”

HAPPY TO BE ALIVE

Over the next few months , Ms. Debbage reclaimed her life. She learned to walk again. She started swimming and biking. And she moved back home from the full-time care facility where she had lived since 2004.

Someone who met her today would hardly suspect that she lost almost a decade of her life, although she looks like a teen, having seen so little sunlight for 10 years, and is overjoyed at things others her age take for granted. While warming up for her Thai adventure, she was thrilled to drink “a whole Bailey’s” during her first-ever evening out.

But enormous challenges lie ahead. While she was in the dark, her friends left her behind (most are married or working now), and she has to get to know the world again.

“Anna seems to be walking free,” her father says. “But she can’t just live as though it never happened – it has changed her irrevocably. But as a parent I don’t want to foist my own schemes on her; she has to decide what kind of person she wants to be.”

She’ll make that decision in time. For now, Ms. Debbage is content to bask in rekindled happiness. “I love so much just being able to feel the sun on my face. I don’t know if this will fade – it may – but I think I have an appreciation for life will be with me forever.”

FADED GENES

What makes a person prone to chronic fatigue syndrome?

The answer is written in our genes, researcher Anthony Komaroff says.

“The disease is a consequence of some biological vulnerability that patients are born with,” explains Dr. Komaroff, a professor of medicine at Harvard Medical School, “and then something in their environment exposes that vulnerability.”

Scientists now believe the sequence is something like this: First, a viral infection leads to a flu-like illness – for example, studies have linked CFS to a number of viruses (including those for Type 6 herpes and its cousin Epstein-Barr, a common cause of another exhausting illness, mononucleosis). Although in most cases, the immune system responds and the people recover, for an unfortunate few, the illness persists, and the immune response never shuts down.

It appears that the fatigue becomes chronic because of malfunctions that occur in a number of cranial control centres, but there remains a great deal that doctors don’t know. For example, there is growing evidence that rather than being just one illness, “CFS” may be an umbrella term for several.

- Zoe Cormier

THREE DAYS TO HEALTH

Day 1
Your trainer will help you explore which factors are preventing you from getting what you want. With the chronic fatigue syndrome seminars, this includes an in-depth discussion of the complex physiology of the condition, and especially considers the role of dysfunctional adrenalin levels in the maintenance of the condition.

Your trainer will take you through the key steps of the process, individually tailoring the process to your needs and abilities. The key steps include a series of body movements, postures and core questions to stimulate new neurological pathways.

As the brain has the ability to create new pathways rapidly the changes can be achieved very quickly.

Days 2 and 3
Trains you further in ways to change old established neurological pathways and create and stabilize new more effective ones.

Source: Phil Parker’s website lightningprocess.com

She was 19, visiting a Calgary physician about her chronic tonsillitis. After examining her throat, he told her to stand in the centre of the room and asked her to take off her top. She
did.

She started to feel uneasy. But, she thought, he’s a doctor. He must have a good reason for asking, right?

Then he asked her to take off her bra and said he needed to listen to her heart and lungs. With his head and one hand against her back, he groped her breasts with the other hand.
For 10 minutes.

“You must be thinking, why would you stand there and let this man do this to you?” says Beth (not her real name). “Well, I was raised in a Catholic 1960s home: doctors and priests are infallible and don’t you dare question them.”

When she left the office, Beth felt sick. The same doctor was going to operate on her in a week. If he grabbed her breasts when she was awake, what would he do when she
wasn’t? Instead of being angry with the doctor, however, she became angry with herself. “I thought, how dare I think that about a doctor?”

Several days later, sitting in Calgary’s Grace Hospital waiting for her surgery, she broke down. A nurse wandered in and Beth told her what happened. The nurse promised her: “Don’t you worry. You will not be left alone with him.”

True to her word, nurses made sure she was never alone with him during her stay. “It was like this sisterhood of nurses protecting me. That was the first time I felt the power of women supporting each other,” recalls Beth.

For 13 years, not a word passed her lips. A part of her still thought she must have misunderstood, or it must have been her fault in some way. Then, when she was in her early 30s, she saw a counsellor and realized she had been assaulted. Now 39, Beth says, “it breaks my heart that I would have allowed that.”

Beth’s story is not unique. Even the 2000-year-old Hippocratic oath refers to sex with patients as an “intentional injustice” and prohibits it. However, according to a 1991 Ontario telephone survey, eight percent of female respondents over the age of 15 had been sexually harassed or abused by a physician. Behaviour ranged from inappropriate comments and groping to sexual relationships. Perhaps even more revealing was an Ontario Medical Association survey conducted the following year in which 11 per cent of doctors said they had knowledge concerning a colleague who had sexual contact with a patient.

How do they get away with it? For starters, experts on sexual abuse report that those who are in positions of authority – clergy, teachers and health professionals – make up a disproportionate percentage of offenders.

According to Saskatchewan law professor Marilou McPhedran, one of Canada’s top experts on the sexual abuse of patients, doctors in particular are given a very high level of trust. “The abuse can therefore happen relatively easily, because people come to them in a state of vulnerability. They say things to a health professional they would say to nobody else – this ramps up the potential for the abuse of power and trust.”

And because doctors are held in such high regard, victims feel less willing to come forward and report the assault. “What has been the most telling is the fact that the ‘mister stranger danger’ was, and continues to be, the stereotype of an assailant. That was what we were combating all the time – somebody with a position in the community was not considered suspicious,” according to Pat Marshall, a co-founder, along with McPhedran and others, of the Metropolitan Action Committee on Violence Against Women and Children (METRAC), one of Toronto’s first organizations devoted to ending violence against women.

“This all goes back to what has historically been a profound misunderstanding of sexual abuse involving breach of trust. The impact of those breaches of trust are misunderstood and trivialized, and yet are so long-lasting and intense. When your basic trust foundations are gone, the whole world becomes topsy-turvy,” says Marshall, an anti-violence advocate for over 30 years.

Many victims do not even realize at first that they have been assaulted. However, they suffer the same repercussions as other victims of sexual assault: shame, confusion, guilt, self-doubt, anxiety, depression and even suicidal thoughts. Their health is likely to deteriorate because they may also avoid doctors altogether – some women go decades without seeing a physician.

If the problem is so serious, why aren’t more doctors punished?

The only authority that can strip a doctor of their medical licence is a self-governing provincial college of physicians and surgeons. The same goes for nurses, psychologists, chiropractors, dentists and other health professionals.

According to many who work in the field, the self-regulation of the medical profession is one of the biggest factors.

“I think it is idiotic that sexual abuse falls under self-regulation,” says Susan Armstrong, a violence counsellor in Vancouver. “For a botched operation, I buy that you need another medical professional to assess what is appropriate. But you don’t need a medical background to know whether someone’s hand should be on my breast.”

Historically, provincial colleges have not been eager to investigate the abuse of patients by their members. Dr. Gail Robinson, a psychiatrist and another co-founder of METRAC, recalls what happened in Ontario 20 years ago.

“When we first went to the college about these issues, they tried to minimize them. We knew for years that they had been getting complaints and that they had been dismissing them,” recalls Robinson. To its credit, the organization appointed a task force of lawyers, counsellors and psychiatrists in 1990. McPhedran led the task force and Robinson and Marshall were two of its members.

The task force produced a groundbreaking report that came to the conclusion that the only way to fix the problem was to enact a law based on the policy of zero tolerance of sexual abuse. Any regulated health professional (including nurses, dentists, chiropractors, psychologists and more than 20 other disciplines) found guilty of acts that constitute the sexual abuse of a patient should be stripped of their license, period, said the report. Even if the sex appeared to be consensual, the report continued, a strict barrier was needed to protect patients because of the inherent power imbalance between a health care provider and a patient.

Despite fears the report would gather dust, many of the task force’s recommendations were incorporated into various provincial laws, including the Regulated Health Professions Act of 1994. The Ontario law is clear. A physician found guilty of sexual abuse – which can include anything from sexualized behaviour and inappropriate touching to sexual intercourse – faces disciplinary penalties, with the toughest being a five-year mandatory revocation of his licence if found guilty of any of the following: “sexual intercourse, genital to genital, genital to anal, oral to genital, or oral to anal contact, masturbation of the [doctor] by, or in the presence of the patient, masturbation of the patient by the [doctor], encouragement of the patient by the [doctor] to masturbate in the presence of the [doctor].” Doctors guilty of so-called lesser sex offences may have their licence suspended for six months or more, or conditions may be attached to their licence by the college. For example, a physician could be prohibited from conducting physical examinations of female patients without a nurse present.

Adds Kathryn Clarke, senior communications coordinator for the Ontario College of Physicians and Surgeons: “In cases where sexual abuse of a patient has been proven, the doctor cannot apply for reinstatement until five years have elapsed.” However, Clarke goes on to say, the mandatory penalty of revocation is not applicable to all cases of sexual abuse, and the discipline committee “uses its discretion” when imposing penalties.

Ontario’s zero-tolerance approach influenced similar laws in P.E.I., New Brunswick, Alberta and B.C. And in a groundbreaking 1992 Supreme Court of Canada case, Norberg v. Wynrib, the court found that “where such a power imbalance exists, it matters not what the patient may have done, how seductively she may have dressed, how compliant she may have appeared, or how self-interested her conduct may have been – the doctor will be at fault if sexual exploitation occurs.”

Some 16 years later, however, some of the original task force members say the promise of zero tolerance has not been fulfilled and the few advances made by the college have largely been eroded.” The pendulum has swung back everywhere, the issue has largely disappeared,” observes McPhedran.

A glance at the College of Physicians and Surgeons of Ontario annual report from 2006 shows that few complaints reached the discipline committee. Of the 2,364 investigations the college made into public complaints in 2006 (42 of which involved sexual abuse complaints), fewer than half were forwarded to the college’s complaints committee. The college’s complaints committee took no action in three-quarters of the 1,033 of the complaints. And just 33 cases, or 3.2 per cent of the all complaints made, were sent on to the discipline committee (the annual report does not specify the outcome of cases involving sexual abuse).

One way the current system avoids sending doctors to a discipline committee hearing is to shunt complaints into alternate dispute resolution – a form of private mediation that tries to create a mutually satisfying solution between a complainant and physician. Although alternative dispute resolution is cheaper and quicker, blame is never assigned and patients usually have to agree not to discuss the abuse they experienced or how the case was resolved. So these cases stay off the public record.

There are further problems with Ontario’s system and with others across the country. One is that if a doctor appeals the decision of the college, he can usually continue to practice during the years that appeal may drag on. Patients, on the other hand, do not have the ability to appeal. Second, physicians can rely on their legal insurance plan run by the Canadian Medical Protective Association to cover their costs, but patients have no such support. Third, those who bring complaints forward are only allowed in as witnesses at the proceedings; they cannot bring forth evidence or ask questions of the doctor and his witnesses.

“The justice equation is unbalanced,” observes McPhedran. “Money, power and authority have access to money, power and authority -
that’s how it works.”

Another shortcoming is that there is no direct compensation for victims, unless a victim wins a civil suit, which they must fund themselves. However, Ontario does require the college to set up a fund to pay for some therapy and counselling for some sexually abused patients. It has paid out more than a million dollars for more than 100 applications since 1994.

And yet, even when a physician is found guilty, the ordeal can be horrendous for victims. More than 20 years after a Toronto pediatrician grabbed Sharon Danley’s breasts and stuck his tongue down her throat when he was supposed to be examining her disabled two-and-a-half-year-old son, she filed an official complaint with the College of Physicians and Surgeons of Ontario.

In 1993, the doctor was found guilty by the College. Yet, Danley says that, after four years of having her personal life scrutinized, watching other victims denied the opportunity to testify and then seeing the doctor receive a three-month suspension of his licence, it felt as though she had been “emotionally gang-raped.”

“The tribunal was much worse than the actual violation. The system absolutely traumatizes you. At the time, I was still under the delusion that they would do something. Now, I just wish I had had a Tony Soprano in my life – at least then I would have had some justice.”

Perhaps most troubling of all is that unless a doctor (or any other health-care provider) is found guilty after a full disciplinary hearing at the college, a complainant cannot find out whether other complaints have been made against a doctor.

When Karen found out that several sexual complaints with the College of Psychologists of Ontario had been filed against her psychologist, she was outraged. Her therapist coerced her into a sexual relationship that lasted several months. What made her even angrier was that, when the college eventually did take away his licence to practise as a psychologist, he was still allowed to treat patients as a “therapist.”

“I went through hell, and he was still treating patients,” she says.

In part because complaints against those providing therapy are common, Ontario’s Health System Improvements Act of 2007 brought in a new requirement which requires that anyone practicing under the title of “psychotherapist” must belong to a regulated health profession -
one of the existing colleges or the new College of Psychotherapists being established under the act.

The Criminal Code of Canada does contain prohibitions on sexual assault involving non-physical coercion by authority figures. And often, doctor-patient sexual abuse cases could qualify for a straight charge of sexual assault. South of the border, 22 U.S. states have made sex between a psychotherapist and a patient a felony punishable by up to 15 years in prison.

Gary Schoener, a psychologist who helped form the Minnesota law, believes that coercion is difficult to prove. “You would have to show beyond a reasonable doubt that the sex was accomplished only because of the power differential,” says Schoener. “Not just that it played a role, but that it was the reason the sex happened. And remember, the benefit of the doubt would go to the defendant doctor – this is not the lower level of proof needed to take [away] a licence or registration, or even win in a civil case.”

Ultimately, the fact that health professions in Canada are allowed by provincial governments to act as investigator, prosecutor, judge and jury when there are allegations of abuse by their own members is the greater concern, according to McPhedran.

“It all basically comes down to the same thing,” she says, “layer upon layer of privilege and access that is built on the subjugation of women…But that’s old news.”

Robin Savage is worried about her son Jarret. He can hardly read. He can barely write. And math? Forget about it. But worst of all: he’s almost 12 years old.

“He’s in grade six—but he’s really at a grade two level. It’s heartbreaking,” says Savage, whose son has severe Attention Deficit and Hyperactivity Disorder (ADHD) and a number of other learning and behavioural problems. “He’s very aggressive. He’s been suspended more times than I can count.”

Her son’s problems have been “a huge financial burden,” she says. Before she had a health plan, Savage was forking out $400 a month for his antipsychotic medication.

“But my biggest concern isn’t what happens today; it’s what happens when he’s 18,” says Savage, who works at a correctional facility. “I work with men who were diagnosed with childhood ADHD. Young offenders have all the things Jarrett has.”

Sadly, Jarret’s problems are not unique. About 10 per cent of Canadian children have some kind of learning disability, and another 20 per cent have some kind of behavioural problem. This is more than just a headache for their parents. Children who fall behind in school are at risk for unemployment and crime later on. Mental health problems are estimated to cost the Canadian economy around $50 billion a year; even a one-point drop in our average IQ costs us $6 billion a year.

Mental disabilities can be inherited. But there is little doubt that environmental factors—namely, dangerous chemicals in industrial pollution and in consumer products, which Canadians are exposed to every single day—can damage the fragile, developing brains of children.

Between the 1920s and 1980s, lead was required to be added to gasoline—leaving Canada blanketed in millions of tons of the metal, which will never break down. It was also widely used in food cans, plumbing, and children’s toys. Lead was also added to paint for many years. Based on Statistics Canada estimates, about one in five children in Canada live in pre-1960s homes and are at risk of exposure to old paint. And smelters are still a big source: Canadian industry released more than 3.5 million kilograms of lead in 2003 alone.

Today we know that for every increase of four micrograms of lead per decilitre of blood, children suffer a one-point drop in IQ. The “safe” limit for lead has been set at 10 micrograms per decilitre. But in the 1970s, almost 90 per cent of American children had blood lead levels above this level.

Dr. Herbert Needleman, a Pittsburgh physician, made history in 1979 when he reported that children with higher blood lead levels have lower IQs. Then in 1996, Dr. Needleman reported in the Journal of the American Medical Association that 12-year-old boys with higher lead levels were more likely to have behavioural problems, like bullying, vandalism, shoplifting, and arson.

Thanks to the ban on leaded gasoline, blood lead levels have fallen by about 80 per cent since the 1970s. But lead is still a massive problem. A 2002 study in the journal Environmental Health Perspectives (EHP) estimated that lead poisoning costs the American economy $43.4 billion a year—compared to $2 billion for asthma, a problem we hear much more about. More than a million American children still have blood lead levels that exceed the “safe” limit [good lead statistics are not available for Canada].

And that “safe” limit should be revised. A 2003 paper in the New England Journal of Medicine showed that even below 10 micrograms per decilitre, children still suffered IQ deficits, leading most experts to conclude that there is no safe level for lead.

“I believe that we don’t know how smart our kids can be,” says Dr. Needleman. “I am angry that we are so stupid about this.”

Lead is just one of many “heavy” metals that we release into our environment that are harmful to our brains: cadmium, manganese, arsenic, copper, nickel, zinc, and mercury are all routinely detected in Canadian produce.

In high doses, children exposed to mercury in the womb reap cerebral palsy, seizures, deafness, blindness, and retardation. Low doses result in brain damage and IQ loss. Mercury is mainly used in electronics, then leaches from landfills when old computers are thrown out. Metal smelters and waste incinerators release it into the air. By far, however, the largest source of mercury in North America is coal-fired power stations. Altogether, Canadian smokestacks released more than 112,000 kilograms of mercury in 2003.

In the United States, it is estimated that one in six babies are born with mercury levels exceeding the “safe” limit [as with lead, Canadian population estimates are not available]. Children most at risk for mercury poisoning eat sport-caught fish, because the metal can “magnify” up the food chain.

Mercury is not the only brain-damaging chemical that concentrates in meat eaters. Polybrominated diphenylethers (PBDEs), a type of flame retardant chemicals, have made headlines in recent years as scientists have found astounding concentrations in fish, birds, grizzlies, seals, orca and beluga whales, polar bears, and (of course) humans.

PBDEs are used to stop fire-prone products from igniting, like electronics, airplanes, carpets, curtains, and furniture. Some products contain as much as 30 per cent PBDEs by weight. PBDEs have never been made in Canada, but about 1.3 million kilograms of the chemicals were imported from the US in 2000 to be added to consumer products here (and that doesn’t include imports laced with PBDEs).

Safety concerns prompted Germany, the Netherlands, and Sweden to restrict these chemicals in the 1980s. But Canada and the US did not, and a 20-year love affair with them has left Canadian women with 10 times more PBDEs in their breast milk than European women.

Although good research on the impacts of PBDEs on humans is lacking, results from animal studies are disconcerting. Mice exposed in the womb to even just a few parts per billion PBDEs suffer brain damage—hampering their attention, learning, memory, motor skills, and behaviour (dubbed by many scientists as “ADHD-like”).

Pesticides—often linked to cancer—can also damage the mind, and the research is disturbing.

Dr. Elizabeth Guillette, an anthropologist at the University of Florida, travelled to the Yaqui Valley in Mexico in the late 1990s. One agricultural town in the valley had used pesticides intensely since the 1950s, while another town in the foothills had shunned them. What she discovered shocked her and everyone who read her 1998 paper in EHP.

When she asked the valley children to draw a person for her, they drew bizarre figures of sticks and circles that didn’t look like anything—and especially not like a person. “This blew my mind,” she says. “At first I thought the drawings might have been some kind of a tribal symbol, but they weren’t. The kids actually saw this as reality.”

The biggest sources of heavy metals in the country, aside from coal-fired power plants, are the large metal smelters in Ontario and Quebec, like Alcan, Stelco, and Alcoa. Alcan ranks as the top producer of developmental toxicants in the entire country. It owns the bulk of the top 10 producers as ranked by Pollution Watch, using government data.

It is, however, possible for a metal smelter to lessen its impact. Dofasco cut its releases of developmental toxicants by more than 234,000 kilograms between 1998 and 2002 at its Hamilton plant. According to Bill Gair, a spokeman for Dofasco, the company was able to cut its releases of heavy metals by sending its hazardous waste to a US recycling facility instead of a landfill.

The top releasers of lead and mercury in Canada are both recyclers: Stablex Canada’s facility in Blainville, PQ, released more than 32,000 kilograms of mercury in 2004; and Zalev Brothers Co., a recycler outside of Windsor, ON, pumped out more than 3.8 million kilograms of lead that year. It is, of course, hard to point the finger at them. They’re only disposing of what we throw away.

Some recyclers, however, do go the extra mile. Noranda Recycling in Brampton, ON, is considered to be the only one of its kind in Canada. The facility processes more than a million pounds a month of old electronics, before shredding employees first remove parts containing heavy metals. Then, during shredding, the dust itself gets sucked up and recycled, instead of being vented outside. “We are imposing more costs on ourselves, but we want to exceed government standards,” says Kelly McCaig for Noranda. “We are zero landfill and we participate in no export to developing countries, unlike most recyclers.”

Although old electronics are still full of heavy metals and PBDEs, many of the big names are eliminating hazardous materials from their products. Around the world, lead-tin solder is being phased out. Giants like Apple, Philips, Sony, Samsung, Panasonic, Hewlett-Packard, and Dell have all eliminated all PBDEs from their products, often using phosphorus-based flame inhibitors instead.

Ikea [due in part that the company is based in Sweden, which banned all PBDEs many years ago] has also banned PBDEs. None of its children’s mattresses have contained any PBDEs for 15 years.

Although the environmental records of both the Liberals and Conservatives are by no means impressive, the government has taken some important steps towards protecting the health of Canadians recently.

In December 2006, Prime Minister Stephen Harper and then-Environment Minister Rona Ambrose announced that Health and Environment Canada scientists had completed a review of 23,000 chemicals in use in Canada, and a new plan had been drafted to regulate them. This announcement was made with much fanfare and backslapping. Of course, none of our politicians mentioned that the review began seven years ago because the law required improvements to the Canadian Environmental Protection Act.

Then Ambrose announced that carmakers and steel mills will now be required to remove mercury switches from all vehicles before they are recycled. This is good—but a long time coming.

Then the government announced the creation of a StatsCan biomonitoring program: a sampling of the chemicals and metals in the blood of 5,000 Canadians, to be completed by 2009. This will finally give us good estimates on things like lead and mercury levels. Experts have been asking for this program for years [the US has done large-scale biomonitoring at the Centers for Disease Control and Prevention since the 1990s, and has had a comprehensive testing program since 2001].

Nevertheless, provincial and federal governments still have a lot to work on.

The government needs to curb heavy-metal pollution. According to a 2005 analysis from the Commission for Environmental Cooperation, Canadian facilities emit 13 times more lead than their American counterparts. Coal-fired plants, and the mercury pollution they spawn, are still chugging away, especially in eastern Canada. The Ontario government broke its promise to close the province’s coal-fired plants by 2007.

Moreover, the federal government recently decided not to regulate lead in cheap costume jewelry. “It’s a situation of trade trumping health—costume jewellery is all imported junk,” says Kathy Cooper, senior researcher with the Canadian Environmental Law Association.

And, contrary to what the government claims, they are doing nothing to prevent the flow of PBDEs into Canadians. The government proudly announced in the fall of 2006 that they had classified PBDEs as toxic, and would ban them. Despite its claims that it is protecting Canadians, the government has actually done nothing, and is deliberately misleading the public.

Here’s why: PBDEs come in three forms: penta-, octa-, and deca-. Penta- and octa-, which are considered far more dangerous than deca-, have already been phased out almost everywhere in the world; the vast majority of PBDEs used in Canada are deca. Industry contends that deca- is safe, and that it does not break down into the more dangerous octa- and penta-. But recent studies show that deca- is itself toxic and that it does break down.

The proposed regulations ban penta- and octa-, but not deca-. So the government is prohibiting the two kinds of PBDEs that aren’t used anymore, and they aren’t regulating the one that is. “Under law the government is obliged to ban this chemical,” says Lisa Gue, environmental health policy analyst for the David Suzuki Foundation, which has legally challenged the new PBDE regulations.

One of the most important and overlooked problems of children’s exposure to brain-damaging chemicals is the fact that children who are already disadvantaged are the most exposed. Children who live in poverty, who already suffer from poor nutrition, and are more at risk of dropping out of school tend to live in older homes with lead paint; they tend to eat sport-caught fish, live with old, crumbling foam furniture, and be exposed to insecticides in derelict urban housing (to control rats and roaches).

“This isn’t just a health issue; this is a social justice issue,” says Cooper.

When Anet Greenley got sick four years ago‚ what upset her the most wasn’t the continual nosebleeds‚ the numbness in her limbs‚ or even the fact that her stool had turned green. What really bothered her was the fact that nobody would take her seriously.

“My doctors all told me I was stressed out‚ that it was all in my head‚ that I was having panic attacks that upset my stomach‚” says the 38–year–old Ottawa native. “Even some of my family told me it was in my head.’”

But Ms. Greenley knew she was genuinely sick — so sick that she had to quit the University of London and fly home from England. And several months later‚ after going from doctor to doctor‚ she finally found out she was right: She has multiple chemical sensitivity (MCS)‚ a condition that makes her extremely sensitive‚ you could say allergic‚ to synthetic chemicals.

These days‚ Ms. Greenley can control her symptoms‚ as long as she avoids everything she reacts to: cologne‚ dryer sheets and car exhaust are just three irritants on a very long list. Other than that‚ though‚ there’s nothing much she can do. The syndrome is so new that doctors still don’t know what causes it — or how to treat it.

And Ms. Greenley is not alone. According to a Statistics Canada study released last week‚ more than one million Canadians are suffering from illnesses that are stumping their doctors.

The most commonly reported conditions are MCS‚ chronic fatigue syndrome and fibromyalgia (all of which affect twice as many women as men). Reports of a host of other mysterious diseases — such as Morgellons and vulvodynia — also seem to be increasing in both the United States and Canada.

What these disparate illnesses have in common is patients’ struggle not only to find a cure for baffling symptoms‚ but to establish legitimacy for their complaints. The causes of these conditions remain controversial — and many doctors continue to label symptoms as delusional.

Some of the skepticism patients encounter is understandable — especially when they claim to have something as bizarre as Morgellons disease. People who suffer from this affliction say they are plagued by constant itching‚ burning and crawling sensations‚ open sores that won’t heal‚ and strange “fibres” (black‚ white‚ blue and red) erupting from their skin.

Although at least 4‚000 people have now registered with the Morgellons Research Foundation in the United States — including former Blue Jays pitcher Billy Koch — the vast majority of doctors do not consider Morgellons disease to be anything more than a textbook example of “delusions of parasitosis” or DOP‚ a psychiatric condition.

This is what Stan Skoumal’s dermatologist clearly thought was his problem. After waiting seven weeks for an appointment‚ the 54–year–old from Victoria says his symptoms were simply dismissed.

“The whole visit took 11 minutes‚ I received a seven–minute lecture about the wonders of the mind‚ I was given a psychotropic medication‚ and then I was out of there‚” he says. “The man never came any closer to me than about 10 feet.”

Frustrated‚ Mr. Skoumal launched a lobby and support group called the Morgellons Society of Canada last fall. He avoids medical doctors and treats himself with baths‚ diets and exercise. And he combs blogs and chat rooms‚ where suffers have posted hundreds of amateur microphotographs of their skin showing their “fibres” and the parasites they believe have infected them.

Still‚ some medical professionals believe that such attempts — while addressing patients’ helplessness and anger at the reaction of conventional health practitioners — may do more harm than good.

“Interpreting things under microscopes are fraught with danger — you’ll find what you’re looking for‚” Dr. Jay Keystone says. “Lie on your back and look at the clouds. It’s a good analogy.”

Dr. Keystone‚ who practises with the tropical medicine unit at Toronto General Hospital‚ has studied parasitic diseases for more than 30 years and has treated many patients with DOP‚ and a small number of whom claim to have Morgellons. “From time to time‚ I do see what they’re looking at‚ I do see the occasional ‘fibre‚’ ” he says.

He adds that‚ in response to stress‚ the nervous system releases chemicals that can cause some strange symptoms.

But he also says all the lab tests have shown absolutely no evidence of parasites. He is certain that most patients have open sores because they have itched and scratched themselves raw.

Not all doctors agree. Dr. Vitaly Citovsky‚ a professor of biochemistry and cell biology at the State University of New York‚ says he found a gene from agrobacterium — a germ that normally infects plants — in skin samples from two Morgellons patients.

This is just an idea‚ though — two samples do not constitute proof that the condition is not psychosomatic. And it’s a long way from an idea to a treatment. All of which means patients may suffer for years‚ even decades‚ waiting for answers.

Even when a mysterious syndrome has been concretely established‚ the stigma of earlier psychosomatic diagnoses can remain‚ affecting patient care.

For example‚ roughly 15 per cent of women experience vulvodynia — debilitating‚ sometimes crippling‚ genital pain caused by muscular and nervous dysfunction. Mainstream medicine has recently recognized vulvodynia as a real disease‚ but doctors continue to tell women that their condition is “all in their heads.”

“Doctors tend to go through their routines‚ and if their routines don’t give them an answer‚ then they say it’s all in your head‚” says Dr. Kaye Kilburn‚ who studies MCS at the University of Southern California. “It is shoddiness‚ and it is widespread. But it doesn’t mean the physicians who are in the minority aren’t right.”

Laurie Clark can attest to this. When the 53–year–old from Regina starting having constant burning pain on her vulva‚ she was told that she had emotional problems. “So I went to a psychiatrist‚” she says‚ “and even though I wasn’t depressed at first‚ you start to become depressed because you go from doctor to doctor and nobody can tell you what’s wrong.”

Michelle Living was luckier. When the 24–year–old’s pain started two years ago‚ just before she got married and moved to Victoria‚ she got a diagnosis fairly quickly — in seven months. Unfortunately‚ her dermatologist did not tell her about any treatments.

On her own‚ Ms. Living discovered anesthetic creams and chemical “nerve blocks” that could help her. Before then‚ she says: “I was depressed‚ hopeless‚ I didn’t think there was anything I could do.”

None of these treatments have universal success‚ however. And‚ although vulvodynia affects six million women in the U.S.‚ there have been only eight studies funded by the National Institutes of Health.

Indeed‚ researchers who study unexplained syndromes all complain of the same thing — that there is simply not enough money for research. Funds tend to be earmarked for high–profile‚ fatal diseases such as cancer and heart disease.

As for the million–plus Canadians who suffer from MCS and chronic fatigue — conditions that have been dubbed “yuppie flu” and “20th century syndrome”?

Studies are emerging to explain the cellular and biochemical causes of these strange disorders. For example‚ researchers affiliated with the University of Toronto are looking into enzymes that they say are slightly different in people with MCS‚ preventing them from detoxifying foreign chemicals properly.

But effective treatments are still a long way off. Ms. Greenley‚ for one‚ doesn’t think she will ever be cured — so she and her husband have installed charcoal filters on the air vents in their new house and purchased a $4‚000 hypoallergenic mattress.

“When you have MCS‚ it is very easy for people to think you’re a paranoid person‚” she says. “I’m not. I’m just trying to protect myself and make it so I can have a normal life.”

Ada Lockridge, of the Aamjiwnaang First Nation in southern Ontario, and the Suncor plant that neighbours her reserve. Photo Credit: Zoe Cormier.

Stand in the middle of Aamjiwnaang and look straight ahead in any direction. Beneath the trees are small houses‚ trailer homes‚ a babbling creek‚ children scampering about. It looks like any other Canadian native reserve.

But it doesn’t smell like one. Instead of crisp breezes and pine needles‚ the air smells of sulphur and diesel fuel. Lurking behind the trees and the homes are giant smokestacks and gas flares behind the massive chemical plants that surround the 2‚700–acre reserve. Look closer at the creek and you’ll see a sign that reads: ‘KEEP OUT Talfourd Creek contains toxic substances known to cause serious health risks’. As for the children – very‚ very few of them are boys.

Down and out in Chemical Valley

Aamjiwnaang (pronounced ‘Om–ji–non’) sits in the middle of Canada’s ‘Chemical Valley‚’ located just south of the city of Sarnia‚ in the southern tip of the Canadian province of Ontario. The region prides itself on being home to Canada’s largest industrial zone‚ one of the largest in North America. There are more than 35 petrochemical‚ polymer and chemical factories here and more on the other side of the St Clair River in the USA. All the big names have plants in Sarnia‚ including Bayer‚ Shell‚ Suncor‚ Dow‚ DuPont‚ Nova‚ Royal Polymer and Imperial Oil.

From almost anywhere you can see a smokestack or flare peeking out from the treetops. Just beyond the old daycare centre you can see the pipes and towers of a Nova factory. Aamjiwnaang’s cemetery is surrounded by giant vats of volatile chemicals owned by Suncor‚ fringed with sirens and security cameras. So polluted is the land that different areas of the reserve even have their own distinctive smells – some are like rotten eggs; others like gasoline; others like dental freeze.

Chemical spills and releases are so common that the residents often ignore the warning sirens‚ which go off up to four times a month. According to Riverkeeper‚ an environmental watchdog‚ there have been more than 800 spills into the St Clair River from both sides of the border in the past 20 years.

More recently‚ the release of a cloud of hydrofluoric acid at the Suncor plant in July 2006 sent 23 workers to hospital. ‘The workers were dropping‚’ says Ada Lockridge‚ a member of Aamjiwnaang’s environmental committee. ‘We could see them running‚ holding their mouths‚ just falling to the ground. There were fire trucks‚ and helicopters landing on the front yard.’

‘They didn’t even tell us about it – and we are 40 feet from Suncor’s front door‚’ adds Ron Plain‚ another committee member and native of the resident Aanishnaabek tribe.

A lot of the time‚ they don’t even know what the accidentally–released chemicals are. ‘One time‚ these black and green clouds came towards us from Suncor – they just told us it was “non–toxic”‚’ says Lockridge. ‘Well‚ I don’t know how it got there‚ but this thick white goopy stuff was landing on people’s cars – this thick substance that bubbled‚ it was actually eating the paint off the cars.’

Even if accidents like that never happened‚ each factory in Chemical Valley releases its own unique brew of toxic chemicals every day – including benzene‚ ethylene‚ phthalates‚ vinyl chloride‚ ammonia‚ a slew of heavy metals (including lead‚ mercury‚ nickel and cadmium)‚ and dioxin (widely considered to be the most toxic chemical known to man).

Sold down the river

There are three main ways in which the federal government has failed to curb pollution in and around Sarnia.
One: when accidents happen‚ the federal government rarely holds the chemical plants accountable. Until a recent bill was passed in Ontario prescribing fines for spills‚ ‘the ministry wasn’t taking any enforcement action‚’ says Ramani Nadarajah‚ a lawyer with the Canadian Environmental Law Association.

Two: the cumulative impacts are not taken into consideration. Each industrial facility is given a certificate of approval dictating how much of a chemical they are allowed to release‚ but the location of that facility is not considered. For example‚ if a new plant wants to be able to emit a certain amount of lead‚ the ministry does not consider how much lead is being emitted by neighbouring factories. ‘That is a huge weakness in the regulation‚’ says Nadarajah.

And‚ three: when toxic waste is dumped on their land it is – believe it or not – legal.

It’s a giant gap in Canadian environmental legislation‚ and it works like this: there are no national laws that prohibit toxic spills on land. Instead‚ each of the 10 provinces has its own laws. But native reserves – like army bases and government buildings – are considered to be federal land. So technically – legally – there are no laws whatsoever to prevent toxic dumping on Indian land. ‘You could literally pull up here in a truck and open your hoses up in our ditch‚ and the most you would face is a $125 fine‚’ says Ron Plain.

He’s not being hyperbolic. In 2004 one of the Aanishnaabek agreed to let somebody (Ron declines to say who) store barrels of styrene and toluene on the reserve. ‘The barrels leaked all over‚ it was a nightmare. Environment Canada‚ the Ministry of Indian Affairs and the provincial Ministry of the Environment just argued back and forth over who was going to pay the bill – while the stuff was leaking all over the ground.’

‘Probably the reason there are no laws‚’ explains Gord Miller‚ environmental commissioner for Ontario‚ ‘is because Aamjiwnaang is the only Indian reservation where you can move hazardous waste just by crossing a road. Anywhere else‚ you would have to put it on a truck and move it many miles‚ where we would legally be able to stop you. But in Sarnia you just cross a line and you’re in Indian land – and you’re scot–free.’

When they signed a treaty with the British in 1827 (Canada did not become a country until 1867)‚ the Aanishnaabek were ‘given’ about 5,000 acres. Then during the 1940s the big chemical companies started to move in‚ looking for sites to make rubber for the war effort. At that time and up until the late 1950s‚ when a company wanted to purchase some Aamjiwnaang land‚ the Aanishnaabek would first have to hand the land over to the government‚ who would then sell it on their behalf. The government was keen to get them to sell – and knew how to convince them.

‘“Surrender votes” were usually held in the Fall – and the government of course knew that a lot of people [who mostly worked as construction workers or farmers] were unemployed between November and April‚ and were more in need of the extra money‚’ explains 67–year–old Wilson Plain‚ who was a child at the time.

‘During those meetings‚ some of the elders said things like‚ “What about the smoke that’s coming from the stacks now? What is that doing to our health?” They spoke in Ojibwe – but their concerns were never ever recorded‚ even when the recorder spoke Ojibwe too. I feel it was deliberate – so that when‚ later on‚ people objected to the pollution‚ the government would be able to say‚ “Well‚ nobody said anything at the proceedings”.’ And the Aanishnaabek could do little to negotiate – registered Indians in Canada were not even allowed to hire their own lawyers until 1961.

John Beaucage‚ Grand Council Chief of the Union of Ontario Indians‚ explains how this situation came about. ‘The Indian Act [of 1876] set out specific rules that differentiated between “status” and “non–status” natives‚’ he says. ‘Those who chose to live on the reserves were granted official “status” but were prohibited from voting‚ and from becoming teachers‚ lawyers‚ soldiers or members of the clergy – and from hiring lawyers.

‘So companies would come into our territories‚ and it didn’t matter what flowed into the waters – they weren’t hurting regular people‚ they were hurting people who had no right to vote.’ For this reason‚ in both the USA and in Canada‚ the rule of thumb for a century has been to use native reserves as unofficial dumping grounds for all kinds of waste – uranium tailings from mines‚ toxic waste from nuclear plants‚ and‚ in Aamjiwnaang’s case‚ barrels of toxic petrochemicals.

Although revisions to the Indian Act since 1961 have greatly expanded their legal rights‚ the 750‚000 reservation natives throughout Canada still live a world apart from the rest of the country: infant mortality is 1.5 times higher‚ men die seven–and–a–half years younger‚ diabetes is three times more common‚ tuberculosis is eight times more frequent. Reserves everywhere are plagued by malnutrition‚ unsanitary water‚ derelict housing‚ and the usual fare of impoverished communities: drink‚ drugs‚ smoking and suicide. So bleak is life on most reserves‚ that an aboriginal youth is nine times more likely to commit suicide than his white counterpart.

Boys will be girls

The 850 inhabitants of Aamjiwnaang didn’t used to worry about the factories. Twenty years ago when they swam in Talfourd Creek and an oil slick would come by‚ they would just get out of the water and wait for it to pass before diving back in. But by the late 1990s‚ people started to get concerned. Every now and then they’d find a deformed animal on the reserve – recently they came across a sickeningly twisted kitten‚ and a couple of years ago one of their dogs gave birth to a litter of severely deformed puppies.

To find out exactly what was going on the Aamjiwnaang‚ Ada Lockridge started going door to door‚ asking questions. The answers stunned her – ‘I felt sick to my stomach‚ I cried‚’ she says.

Sixty per cent of the Aanishnaabek children suffer from asthma – three times the national rate. About a quarter of the children have some kind of learning or behavioural disability. Forty per cent of the women on the reserve experience miscarriages and stillbirths – some of them as many as six in a row.

But what really shocked Lockridge was that only one–third of the children born around the turn of the millennium were boys.

Worldwide‚ the proportion of boys to girls born every year is relatively constant – about 102 to 108 boys for every 100 girls. Although this ratio in any community naturally varies over time‚ Aamjiwnaang’s boys didn’t just vanish in one fluke year – they disappeared gradually over time. Before 1990‚ the ratio of boy to girl babies was relatively constant. Then the number of boys started to fall‚ gradually‚ until by the period 1999 to 2003‚ only 34.8 per cent of the babies were male.

Ada Lockridge is certain that she knows what is responsible: endocrine disruptors (chemicals that mimic hormones).

Dr Shanna Swan‚ director of the Center for Reproductive Epidemiology at the University of Rochester School of Medicine‚ who in May 2005 published the first study to link prenatal exposure to phthalates to outcomes in human babies‚ thinks she may well be right. ‘Sex ratio is a sentinel event for endocrine disruption‚’ says Swan. ‘When you see an altered sex ratio of this magnitude‚ something is altering the hormonal functioning at a basic level.’

Popularly known as ‘gender benders’ endocrine disruptors behave like hormones – most mimic estrogen‚ but some can suppress testosterone‚ or interfere with natural hormones in other ways. Endocrine disruptors have been linked to a huge variety of abnormalities in both humans and wildlife around the world‚ including ‘feminised’ animals‚ population crashes‚ cancers‚ immune system malfunctions‚ and skewed birth ratios. A recent study found that 45 per cent of the white perch in nearby Lake St Clair are ‘intersexual.’

Many of the chemicals released by Sarnia’s factories are known and suspected endocrine disruptors. These include dioxins‚ phthalates‚ hexachlorobenzene‚ heavy metals‚ and many polycyclic aromatic hydrocarbons (PAHs). According to PollutionWatch‚ a non–profit environmental group that analyses government pollution data‚ Sarnia facilities released more than 223‚000 kilograms of suspected endocrine disruptors to the air during 2003 alone.

In 2005‚ The Environmental Defence‚ a sponsor of PollutionWatch‚ tested the blood of a number of Canadians‚ including three people from Aamjiwnaang. Wilson Plain (Ron’s cousin)‚ his son Wilson Jr‚ and his granddaughter Jessie volunteered. Wilson Sr had 32 chemicals in his body (including 16 endocrine disruptors)‚ Wilson Jr had 36 (21 endocrine disruptors)‚ and Jessie had 20 (12 endocrine disruptors) – including mercury‚ lead‚ arsenic‚ cadmium‚ manganese‚ PCBs‚ PAHs and a variety of pesticides. While Wilson Jr had the highest total number of chemicals in his body of anyone tested‚ it was the number of endocrine disruptors in the three people from Aamjiwnaang that is the most suspect.

Many environmental scientists believe that the ‘missing’ boys in Aamjiwnaang are due to one of two possibilities: either that all the estrogen–mimicking chemicals in the environment have caused the men to produce more female and fewer male sperm; or that the pollution is causing a disproportionate number of male babies to miscarry. However‚ many in the chemical industry dismiss Aamjiwnaang’s missing boys as a ‘statistical anomaly.’

Meanwhile‚ the Aanishnaabek charge that Health Canada (the government branch responsible for monitoring and protecting the health of Canadians) has made every attempt to ignore their pleas for help. They say that while scientists from around the world have visited their reserve‚ the government has shown almost no interest. ‘They refuse to acknowledge that there is a problem at all‚’ says Ron. ‘And the reason they won’t acknowledge there is a problem here is because that acknowledges liability.’

Who covers the cost?

There were plans earlier this year for Health Canada to conduct a comprehensive health study of the entire region. The chemical companies offered to fund the study‚ but‚ as even Sarnia’s mayor Mike Bradley points out‚ ‘industry should not be involved in the financing – the credibility would be compromised.’ Health Canada’s official line is that ‘all stakeholders should share the costs.’ But neither the city of Sarnia nor Aamjiwnaang has that kind of money. Since ‘the community is requesting that Health Canada fund the study in full‚’ the government at this moment has no plans to conduct the full study.

Regardless‚ a 2005 peer–reviewed scientific paper in the journal Environmental Health Perspectives has already shown that the decline in births of boys in Aamjiwnaang is statistically real. Moreover‚ another First Nations community in Ontario – which is genetically similar to Aamjiwnaang‚ and has roughly the same lifestyle – has a normal birth ratio.

This isn’t the first time that boys have gone missing from a polluted community: the birth ratio fell in Seveso‚ Italy after an industrial explosion that released a cloud of dioxins; and in Minamata‚ Japan‚ after the lake was poisoned with mercury by upstream factories. However‚ what makes Aamjiwnaang important for us all is that this may be the first time that missing boys cannot be linked to one single environmental catastrophe. Rather‚ the culprit is one we all face: long–term exposure to chemicals at legal levels.

While they wait for the government to take action‚ the Aanishnaabek are doing what they can. There are plans to conduct their own studies – funded‚ ironically‚ with the very money they get from allowing the factories to construct pipelines under their land. They aim to keep the media aware of their struggle – there is talk of a documentary on the history of the Aanishnaabek‚ right from the beginning‚ so that the rest of the world can understand how things got this way. But beyond that‚ there is little they can do to stop the factories polluting their land.

So for now they have to settle for small victories. They did manage to prevent Suncor from building a new plant on their borders two years ago. They now know that they can force companies to cough up many millions of dollars for pipelines‚ as opposed to 60 years ago‚ when they settled for pitiful sums. And there are proposals for a few new plants – and if they can’t stop them‚ at least they can make it ‘very‚ very expensive for them to build‚’ says Ron Plain.

Meanwhile‚ Ron’s third child was born in September. ‘I’m wrestling with myself right now‚’ he says. ‘Every instinct is telling me to protect my children‚ to take them the hell out of here. But if I do that I’m abandoning my community and my relations‚ and I would carry that guilt with me.’

There are rumours that the government may decide to offer each resident of Aamjiwnaang a sum of money – maybe C$100‚000 – to move to a new reserve about three hours’ drive north (Ron says he’s even seen the area they have staked out for them). Ron says he won’t leave for such a sum because ‘there’s no employment up there‚ there’s no opportunities for anything – where could my children work? If my children can’t work they’ll be on welfare – and C$100‚000 does not go far.’

Compared to most natives in Canada‚ the Aanishnaabek are well off. They are nestled in one of the most populous and bustling areas of Canada‚ and live next to the US border. Unlike many reserves‚ Aamjiwnaang is in an affluent part of the country and there are a lot of jobs available. ‘We’re in a perfect location‚ it would be hard to give that up‚’ says Ada Lockridge.

Most of the tribe members might agree to move – not because of their wallets‚ but because of their health. But in so doing they would cease to be themselves. For the aboriginal peoples of Canada‚ their land is far more than just property – it’s an integral part of their history and their identity.

‘I ask non–native people – where do you have to go to find your great–great–grandfather’s grave? Most don’t know. I do‚’ says Ron Plain. ‘I can tell my son stories about his great–great–grandfather‚ and we can sit on his grave while I tell him those stories. That’s why it’s important to me‚ it’s a connection to the past.’

But‚ given the ubiquity of the pollutants that surround them and the damage it has wreaked on them‚ it seems as though the Aanishnaabek people‚ ultimately‚ have few options other than to leave their land‚ and their past‚ behind.

Fourteen–year–old Sarah Mediouni of Orangeville‚ Ontario‚ started campaigning three years ago against garden pesticides. Concerned about the risk of cancer to children‚ she wanted a ban placed on the herbicides and pesticides that residents spray on their lawns and gardens every summer.

Last year‚ Mediouni herself became sick. She was diagnosed with acute lymphoblastic leukemia—one of the most aggressive kinds.

Today‚ she is still campaigning against pesticides. “I don’t want other kids to go through what I am going through‚ just because somebody wants a perfect lawn‚” she says. Even in the cold of March‚ Mediouni is distributing flyers to neighbours‚ talking about the evidence linking pesticides to cancer and suggesting organic alternatives.

Mediouni’s friend‚ Scott Rafferty‚ died in April 2006 from soft tissue sarcoma‚ which has been linked to the herbicide 2‚4–Dichlorophenoxyacetic acid (also known as 2‚4–D)‚ a widely–used herbicide. You can buy it off–the–shelf in Canada in weed killers like Killex.

Frustration at the wide availability of such dangerous chemicals bothers Mediouni’s co–campaigner and friend Miranda Brar. “I don’t think it’s fair that people are allowed to spray their lawns‚ ruin the air and the water‚ and people like Sarah get sick‚ who’ve never sprayed a weed in their life‚” she says.

There is controversy about whether or not 2‚4–D causes cancer in humans. The International Agency for Research on Cancer (IARC)‚ a branch of the World Health Organization‚ categorizes 2‚4–D “possibly carcinogenic to humans.” The Pest Management Regulatory Agency (PMRA)‚ part of Health Canada‚ announced in February 2005 that the herbicide is safe. But a study by Canadian scientists published this May in the scientific journal Paediatrics and Child Health directly contradicts the PMRA‚ stating that “2‚4–D can be persuasively linked to cancers‚” and concludes that “Canada needs a stronger regulator for pesticides.”

The Ontario College of Family Physicians released a comprehensive literature review
in 2004 highlighting the link between pesticide exposure and serious illnesses and disease‚ including cancer. Both the OCFP and the Canadian Cancer Society oppose the cosmetic (versus agricultural) use of pesticides.

According to the Canadian Cancer Society‚ 38 per cent of women and 44 per cent of men will develop cancer at some point in their lives. It estimates that 153‚100 new cases of cancer will be diagnosed this year‚ and 70‚400 Canadians will die from the disease.

Statistics show that cancer is more common than it used to be. According to Winnipeg researcher Lissa Donner‚ who uses data from Canadian Cancer Statistics‚ the age–adjusted incidence of cancer increased by 27.7 per cent in males and 17.8 per cent
in females between 1976 and 2001—meaning that if you account for the aging population‚ the incidence of cancer as whole has increased by more than 20 per cent overall.

Some experts have argued that the apparent increase in cancer is simply due to better science—we’re detecting more cancers than we used to. But cancer has clearly increased in children. “Childhood cancers‚ according to historical records‚ were much less common hundreds of years ago‚” says Dr. Warren Bell‚ past president of the Canadian Association of Physicians for the Environment. “We just don’t see large numbers of skeletons with traces of cancer in the bones.”

According to Donner‚ the incidence of cancer among girls 19 and younger increased 29 per cent between 1976 and 2001 and was up 13.5 per cent among boys.

SEARCHING FOR THE SMOKING GUN

Cancer is a maddeningly complex disease—hundreds of different factors can interact to spawn a tumour. Sun exposure‚ poor diet‚ lack of exercise‚ alcohol and smoking are all well–known risk factors. And genetics don’t account for the increasing numbers. This has left many people pointing to an invisible‚ ubiquitous suspect: chemical carcinogens.

Carcinogens are all around us. We breathe in polyaromatic hydrocarbons (PAHs)‚ benzene and cadmium in vehicle exhaust. Cosmetics‚ household cleaners and food additives contain a slew of carcinogens‚ from methylene chloride in stain removers to dioxins (carcinogenic industrial waste products) that end up in many products such as soap‚ tampons and plastic bottles.

And let’s not forget about industrial smokestacks. According to PollutionWatch‚ more than 8.7 million kg of suspected and known carcinogens were released into the air in Canada in 2003. Most of the big emitters of carcinogens are waste incinerators‚ petrochemical factories and mining operations.

We know that many synthetic chemicals can cause cancer because people who are exposed to them on the job get certain types of cancers more often. People who work with asbestos‚ solvents‚ inks and dyes‚ and petrochemicals—such as printers‚ auto workers‚ welders and miners—are all known to be at increased risk.

PIECES OF THE PUZZLE

Far more controversial is whether or not chemical carcinogens in the environ–
ment are responsible for the prevalence of cancer in people who do not work in risky jobs. But increasingly‚ evidence implies that this is indeed the case.

A study published in the Journal of the American Medical Association in March 2002‚ which looked at 500‚000 Americans between 1982 and 1998‚ found that rates of lung cancers increase with air pollution. Based on this study‚ most health professionals‚ including Dr James Brophy‚ epidemiologist and executive director for the Occupational Health Clinics for Ontario Workers‚ conclude that “about ten per cent of lung cancers in the US are attributable to air pollution.”

Consumer products are also coming under fire. A 2004 study in the Journal of Applied Toxicology linked parabens in deodorant and skin creams to breast cancer after finding high concentrations of the chemicals in 18 of the 20 breast tumours they examined.

A huge number of studies have linked pesticides to cancer—not just in farmers‚ but also in people exposed to pesticides and herbicides in their gardens and in their homes‚ including insecticides used on pets.

The best evidence‚ Dr Bell says‚ comes from Sweden‚ where chlorophenoxy herbicides and phenoxyacetic acids (a group that includes 2‚4–D) were banned in 1977 and 1978. A study in the journal Environmental Health Perspectives in November 2003 demonstrated that rates of non–Hodgkin’s lymphoma increased steadily between 1971 and 1990‚ and then fell between 1991 and 2000—which is exactly what you would expect‚ given the many years it takes for a tumour to develop after exposure to a carcinogen. “This study showed something that could not be misinterpreted. It really is quite clear cut.”

SUFFER THE LITTLE CHILDREN

Skeptics point out that most people are simply not exposed to a high enough concentration of any potential carcinogen to be at risk. They argue‚ “It’s not the poison‚ it’s the dose.” This has always been the paradigm when it comes to cancer research—but now it’s being turned on its head by new evidence.

We now know that it’s not just the dose—it’s the timing. According to a 2005 EPA assessment‚ a carcinogen is ten times more potent in a baby than in an adult.

Studies have shown links between a parent’s job and their child’s risk of getting cancer‚ and most experts think the damage begins in the womb‚ or even in sperm and eggs. Children of farmers and other people who work with dangerous chemicals have been shown time and time again to have higher rates of cancer.

Exposure to chemicals from everyday products may also spawn tumours before birth. A June 2003 study in EHP found that the mothers of men with testicular cancer had much higher concentrations of PCBs and other pollutants in their blood than mothers of sons without testicular cancer‚ pointing to exposure in the womb.

Children are also vulnerable while growing up‚ especially during certain “windows” when they are especially sensitive to the effects of carcinogens‚ such as at the onset of puberty. “The whole system is on fire‚” Dr Brophy says. “If young women are exposed
to pesticides during key moments‚ it could have a huge impact on their risk for breast
cancer later in life.”

DON’T MIX YOUR DRINKS

There is one more aspect of the “it’s not the poison‚ it’s the dose” paradigm that public health officials have failed to take into account. People are exposed to dozens‚ perhaps hundreds‚ of carcinogens every day. Could it be that tiny amounts of a multitude of chemicals can cause cancer? “There has been some remarkable research showing that combinations of things are much more dangerous than individual items‚” Dr Bell says.

For example‚ studies have found that certain mixtures of individually innocuous pesticides can kill tadpoles‚ reduce the size of mouse litters‚ impair immune systems‚ and cause all kinds of damage to lab animals.

Unfortunately‚ Health Canada assesses chemicals for safety individually—not in combination. To study the impact of all the permutations of the thousands of chemicals with which we come into contact every day would take tens of thousands of years.

WORKING AT THE GAP

There are 23‚000 chemicals currently in use in Canada‚ many of which were approved
for use decades ago under more relaxed guidelines. Fortunately‚ the federal government is taking a second look at them. Under section 73 of the Canadian Environmental Protection Act (CEPA)‚ Health Canada and Environment Canada are re–evaluating all of them. The government categorized a list of those 23‚000 chemicals on September 14‚ 2006. The list will be made public in October.

In some respects CEPA falls short of its EU counterpart REACH (Registration‚ Evaluation and Authorization of CHemicals). REACH requires industry to provide scientific data on their chemicals before they are approved for use. “Europe is putting the
onus on industry … that’s a real difference‚” Fe de Leon‚ researcher with the Canadian
Environmental Law Association‚ says.

Moreover‚ the EU has already taken measures to phase out certain controversial chemicals that the Canadian government has said nothing about restricting‚ such as
phthalates‚ the pesticide atrazine and PBDEs‚ just to name a few.

Critics say there are other gaps in Canadian cancer policy. Labelling of consumer products is a thorn in the side of cancer activists. Until now‚ cosmetics and personal–care products were not required to list all their ingredients. This will change in November 2006‚ when new labelling laws take effect under the amended Canadian Cosmetic
Regulations. But ingredients will be listed by their proper chemical names‚ which most
people will not be able to understand (ever heard of sodium dichloroisocyanurate dihy–
drate? It’s sodium salt‚ a corrosive irritant that causes dermatitis in allergy sufferers). Moreover‚ the new regulations will only apply to personal–care products‚ so ingredients in items like household cleaners‚ detergents and insecticides will not be disclosed.

“We should have hazard–based labelling—which means that if something has a carcinogen in it‚ it should have a label‚” Mae Burrows‚ a founder of the Labour Environmental Alliance Society (LEAS) says. “It should be clear and easy for people to understand.”

She says people shouldn’t feel helpless about their exposure to carcinogens and hazardous chemicals around them. One can take matters into their own hands.

“THERE ARE ALWAYS ALTERNATIVES”

Frustrated with the lack of information about hazardous chemicals in schools‚ LEAS worked with custodians and staff at schools in the Burnaby‚ Langley and Nelson school districts in British Columbia to identify carcinogens. They looked for trichloroethylene in spot cleaners and degreasers in the cafeteria‚ perchloroethylene in upholstery cleaners and floor polish‚ and methylene chloride in stain and graffiti remover‚ among others. They then replaced these chemicals with non–toxic alternatives. “There are always alternatives‚” Burrows says.

The $10 CancerSmart Consumer Guide from LEAS (www.leas.ca) has more information on toxic chemicals and their alternatives. Since Burrows started producing the guide‚ she says she has seen a big trend in companies offering non–toxic ways to keep homes clean.

Canadian company Sensible Life Products became the first in North America to produce a botanical disinfectant in 1999 when it introduced Benefect. The company has grown by leaps and bounds since then‚ with total revenues jumping from $114‚000 in 2000 to almost $1.5 million in 2005.

“That’s really positive‚” says Burrows. “It shows us that the world doesn’t have to stop. Commerce can still go on. People can still make a buck on the product and still get the toxins and carcinogens out of there.” The increasing popularity of organic farming‚ organic lawn–care companies‚ and botanical cosmetics all testify to this.

Husky Injection Molding‚ one of the world’s largest suppliers of injection molding equipment‚ eliminated the release of 250‚000 litres annually of the suspected carcinogen trichloroethane by converting to water–based washers.

Valle Foam Industries‚ which makes polyurethane foam for mattresses and furniture‚ managed to reduce its releases of carcinogens by almost 184‚000 kilos—a decrease of more than 90 per cent—between 1998 and 2002 at its location in Brampton‚ Ontario. It eliminated the known human carcinogen methylene chloride from its production process and replaced it with liquid carbon dioxide. The federal government has mandated that methylene chloride be eliminated by 2007‚ but Valle Foam was able to remove it
five years ahead of schedule.

Other companies are proving that taking action to reduce harmful chemicals can be profitable. Toronto pharmaceutical manufacturer Novopharm was one of the largest air emitters of methylene chloride in Canada in 1998‚ releasing more than 440‚000 kilos of the chemical annually from two facilities. In 2001‚ the company cut that number to 46‚000 kilos after switching to water–based coating processes—and netted a total savings of about $1 million per year.

Carpeting and flooring giant Interface‚ Inc. also saved money by eliminating releases of all carcinogenic substances from its production‚ such as the heavy metals involved in dye production. As a result of all its sustainability measures‚ which also include absolutely zero water emissions‚ the company saved about $12.8 million all told in Canada (and $299 million worldwide).

FROM THE GROUND UP

Even if the federal government is slow to deal with some cancer risks‚ we can try to protect our health at the local level. Over 100 Canadian municipalities have prohibited the use of pesticides‚ typically only allowing people to spray in the event of severe infestation. The City of Toronto will fine lawn companies as much as $5‚000 if they fail to comply. This May‚ Quebec became the first province to ban the pesticide 2‚4–D (commercial enterprises such as golf courses and farms exempted).

Of course‚ pesticide manufacturers are not happy with the wave of bylaws spreading across the country. Debra Conlon‚ executive director of Urban Pest Management for CropLife‚ a pesticide industry group says‚ “Any bylaw that I have seen has been a huge
waste of time and taxpayers’ money because pesticides are already regulated by the federal and provincial government.” CropLife Canada took its case to the Supreme Court of Canada when Toronto implemented a pesticide bylaw—and lost. Now any city in Ontario has the prerogative to prohibit pesticide use.

Which is just what Mediouni and Brar are hoping for their home town. Orangeville passed a ban this spring‚ but they call it weak and inadequate because it only restricts residents from spraying in July and August. Their resolve unabated‚ Brar says they are planning to take their case to the province: “We are inheriting the earth that they are polluting‚ so we have a right to make a stand.”