AlDS Orphans- a global issue

Alone but never alone.  We have your back beautiful one!

Larobane foster home, Butha Buthe, Lesotho

Arms in Love

An orphan's desperate cling and a warm lap for her to land on.

November 17/18

I am heading home tomorrow.  This ends my ninth trip to Lesotho.  We had dinner in Durban, South Africa tonight with my good friend, Duncan Hay.  Duncan played an instrumental role in Bracelet of Hope's first $ 1 million campaign.  A group of students from the University of Guelph pledged to raise $100,000 of that $ 1 million and they succeeded.  By 2009, the community of Guelph and the University of Guelph had reached that goal and in doing so, provided life-saving treatment to 10,000 HIV positive patients in Lesotho.  It was a tremendous community effort.  I look back now and realize how ambitious the university's goal was and how innovative these students were.

To raise what they had pledged, they contacted Duncan at the University of Kwa Zulu Natal in Pietermaritzburg, South Africa.  Duncan was the head of the Rural Development Department at the time.  His job was to support and create rural development projects which included the support of the Inina Craft Agency in Eshowe South Africa.

Inina was a small group of very poor, very marginalized women who made traditional Zulu jewellery and crafts.  Duncan directed the students from the University of Guelph to Inina.  The students ordered 5.000 beaded red and white bracelets to sell on campus.  These bracelets became the signature of our campaign and inspired our name change from The Masai for Africa Campaign to Bracelet of Hope.  That order was the first of many.  Inina was able to expand from a handful of crafters to 150 women, many working from their homes, to complete our orders.   Their lives were transformed by this work.  It gave them the ability to support their families at a time when AIDS was devastating entire communities in sub-Saharan Africa.  

In 2008, the partnership between Inina, Bracelet of Hope and the University of Kwa Zulu Natal was honoured with the Global Best Award for Africa by the Conference Board of Canada and the International Partnership Network.  I had forgotten about this award.  Duncan and I received the award on a ferry that was crossing from Helsinki, Finland to Stockholm, Sweden.  

That was a long time ago.  What I remember most was rushing back to my cabin before the evening's celebrations were done.  I was sea sick for the next 12 hours.  

There have been many awards and many celebrations in Bracelet of Hope's thirteen-year history.  There have also been many difficult, often disabling trials that have brought me to my knees.  Providing care to those afflicted with HIV in Canada and Lesotho and building a system of support for some of the most vulnerable children orphaned by AIDS was never on my radar.  My first love is my husband and now grown children.  My second, medicine.  But then, in 2006,I watched a 2-year-old die as we held her hands in a decayed hospital in Leribe, Lesotho and everything changed.  My heart broke and my view of the world was shattered.   

I have often struggled with who I am and where the real me fits into this difficult and exhilarating journey.  Am I the mom, the doctor, the AIDS activist, or the leader of an international effort? 

My closest friend from high school, Debora Anzinger, was sitting behind me during the church service at the Apostolic Faith Mission Church in Butha Buthe, Lesotho last week.  There are six orphans living in the church right now.  One of the main purposes of this trip was to break the ground for a new foster home where these abandoned kids will live on the church property with people who will love and care for them.  The funds raised in the 100 km cycle in September will be used for this purpose.  The team I travelled with fell in love with every one of these children last week.  We didn't realize that the feelings were mutual.  They raced to us as we walked into the church. We embraced them during the whole service.  Not a single lap was empty.

Leslie

One little girl fell asleep in my lap, her hands dangling over my shoulders, reminding me of the days when my own children did the same.  I am dressed in a traditional Basotho dress, bright purple with a lovely intricate pattern.  It honours the people of Lesotho when we wear their traditional clothing.  This picture moved me more than any other taken on this trip.  It represents who I am and why I do what I do.  

I am a woman and a mother with a deeply broken heart, broken by a world that stands by and watches 18 million AIDS orphans suffer more than any living thing should ever be allowed to suffer.  I am a doctor with a profound sense of responsibility for the health of my beloved patients, my community and the world.   I have found solace and healing by creating an organization that works to see the end of AIDS in Lesotho while caring for a growing number of children orphaned by AIDS and poverty.

I am a mother, holding a child in need in a country and culture I have come to love with people that I deeply admire and respect.

Dr Anne-Marie Zajdlik MD CCFP, MSM, O.Ont

Founding Director, Bracelet of Hope

braceletofhope.ca

The end of your doctor's career?

The Ontario Provincial Government wants to reduce your physician's pay by 33 %. They are proposing to stop paying doctors to do your

Pap Tests,

Your Mammograms

Your colorectal screening test,

Your flushot,

and your children's immunizations.

They want to charge your doctor for the cost of your visit to the emergency room. They want your doctor to find another job or leave the province of Ontario because, realistically, we won't be able to keep our offices open. Arbitration starts next week. I am getting prepared for the worst outcome. Are you prepared?

My swollen face and $31,000

My Beloved and Me:  He paces me and I draft him.  It's a good lifelong deal!

Well folks, the job is done.  When I looked at this shot, I wondered where the swollen face came from, then realized it was the three doses of motrin I took to survive the ride.  Nothing like fluid retention in a 55-year-old woman.  

My goal was to raise $20,000.  With one off-line donation of $6,000, and several donations still trickling in, we raised over $31,000.

I cannot believe it.  The UN says we have 12 years before the effect of global warming will have permanent and catastrophic effects on the environment.   We are going to hear a lot from the powers that be about why we cannot prevent this outcome.  My answer, " Just open the hearts and minds of the billions of good people on this planet, and lead them well, and we will find many solutions".

Thank you for opening your hearts and minds.  Your generosity has buoyed me and given me hope and strength.  That's all I need to keep leading this effort that will see Lesotho AIDS-free.  If the human race can end AIDS, and believe me, it can, the human race can do anything.

These funds will be used to build a new foster home in Lesotho.  We will break the ground for this home next month as a team of 10 travels to this 'home' of my heart.  Here is the magical piece: 4 young men who were raised in the foster homes we support have graduated from high school and gone on to acquire a trade.  They will join the team of contractors who will build this new home.

That is successful and sustainable international development and my pride and joy.  

WE DID IT!

I could not raise my arms after cycling 101 km but, the B man could!

$31,000

101.6 km....and I am alive and well to tell the tale

One Cycle: One Country AIDS Free

Over $17,000 in just 18 days.

Just $3,000 to go.

My deepest gratitude.

Nobody made a greater mistake than he who did nothing because he could do only a little.

Sir Edmund Burke

Many donations, large and small, will lead to a new foster home for 6 children.  This is big!

Let's reach the goal.  

Donate here:    https://bit.ly/2QBm3MV 

Blessings to you and yours.

Happy Thanksgiving

Anne-Marie

Thanks,

Anne-Marie Zajdlik, MD CCFP O.Ont, MSM

Director of ARCH Clinic Guelph and Waterloo

Founding Director of Bracelet of Hope

Founder of Hope Health Centre

Bracelet of Hope

(226) 326-4673

www.braceletofhope.ca

Training run, in the rain of course
Owen Sound

My Beloved Millennials: A generation that will shine

McMaster Convocation Speech

May 24, 2018

Graduating Class of Medicine and Health Sciences 2018

Madame Chancellor, President Deane, Dr.O'Byrne, Honored Guests, Friends and Family,

Thank you very much for inviting me here today and for this great honour, not only for this honorary degree but also for the opportunity to speak to this beautiful group of young people.

I am a member of the 1988 McMaster Medical School class, well before it was the Michael G. Degroote School of Medicine.   Three weeks ago, our class celebrated our 30^th med school reunion.  You are at an incredible time in your lives.  There are so many exciting life changes ahead of you….but thirty years will pass by in a flash.

Between 1990 and 2008, I delivered 2,000 babies.  They are now part of the generation we call the Millennials.  Most of these are now finishing university degrees, moving away from home, getting married.  I have cared for them for over 2 decades and they are near and dear to my heart. 

The world has shifted and changed so dramatically in the last 10 years.  Your generation is living in a world that looks totally different from the one that existed when I delivered the first millennial baby in August of 1990.  Your lives will be very, very different than the lives of your baby-booming parents. 

I am deeply concerned for all of you.  It is now commonplace for me to prescribe anti-depressants to young people with parents calling me weekly asking me to see their suicidal teenagers.  Forty percent of students entering post-secondary school programs today are on some sort of psychotropic drug to settle pervasive and disabling anxiety or treat life-threatening depression

You are the Millennials.  You have developed your generational characteristics and reputation at a younger age than any other generation before you.  Some would say you are more hopeless, directionless, depressed, and incapable than any generation before you…..the people who have labelled you this way, the boomers in particular, are definitively and utterly wrong. 

I am so happy to be here in front of this large and glorious group of graduating millennials because, in 7 minutes, I hope to help you change your collective, generational self-image, your image of the world and the image of your future in it.

What people don’t understand about your generation is that you are struggling to develop within the context of three massive global forces that are all accelerating at an unprecedented rate:  Information technology and social media, climate change and globalization.  We could call this "The age of accelerations". 

You understand social media, we all understand climate change. 

Globalization is the process of integration and interdependence of peoples, cultures, countries and economies.  We are more connected on a global scale than we have ever been. 

Information technology, globalization, climate change; the world is not just being changed by these three accelerating forces, it is being reshaped on a daily basis and the rate of change has now exceeded our human capacity to adapt to these changes.

In the past, major advancements were slow.  We had lots of time to change our government systems, educational systems and social systems as the changes occurred.  But now new technologies are moving us forward at a dizzying speed. We cannot adapt our societies fast enough to protect citizens from the negative aspects of these forces while giving them access to their limitless value.

At a societal level, our inability to adapt quickly enough has allowed for this enormous space in which the worst impacts of information technology, globalization and climate change are thriving: turmoil in politics in both developed and developing countries, the rise of narcissists elected in part, because of the power of false information and social media, information breaches, terrorism, mass shootings and one environmental disaster after another.   

The world is in an unstable state.  It’s teetering, uncertain, dizzy and confused. 

How can young people, how can you as new graduates, figure out your world, your place in it, your identity in a world that is changing shape every day.

Your path forward in all this craziness is blurred.  You may have difficulty finding your identity at a time when finding your identity and your place in the world are two of your most important developmental mandates.

   

We are all, at least momentarily, disoriented.

But Not for long

 “The unprecedented advancements in IT and the rate of these advancements is driving more potential solutions for climate change and a whole host of global challenges like infectious pandemics, poverty, and gender inequality.” 

 And……most of the solutions to the world’s big problems will come with scientific progress.  This is a great room to be in because you are all scientists, and you are brilliant.  I am an eternal optimist and I will always believe in the inherent power of one and the collective power of many to drive positive change, to adapt in a crazy world and to learn to thrive.

You will learn to thrive.

You will prove the naysayers wrong.

Here is one miracle of science and technology that has spanned the relatively brief life of my career.

At the age of 23, I was a second-year medical student doing an elective in infectious disease at Dalhousie University.  I just happened to be in the room when the first dose of AZT ( one of the first drugs available to treat HIV) was given to the first patient in the country.  AZT was not effective on its own and he did not survive but his life inspired me to grow a career that involved caring for those with HIV.

I helped young men die a terrible death for the first 6 years of my practice.  Then, in 1996, a cocktail of HIV medications was found to be effective in controlling the disease.  Just one month after prescribing these medications and my terminally ill patients returned to good health.  We called it the Lazarus effect.  The drug regimen was complicated with handfuls of pills taken several times a day.  There were often toxic and even deadly side effects.

In 2007, that complicated HIV drug regimen was replaced with Atripla:  three combined medications in one pill given once a day.

By 2012, research showed that if you treat an HIV positive person and reduce their viral load to undetectable levels, they virtually cannot transmit the virus.

In 2013, stats showed the effectively treated HIV positive person can live a normal life expectancy.  

By 2016, 5 one-pill once daily regimens became available that are so powerful they have the capacity to keep patients alive until the cure with almost no side effects and very rare serious complications.

In 2018, we believe the cure for HIV is less than 10 years away.  The WHO has set new targets, the 90:90:90 treatment targets to the end of AIDS by 2030:  90% diagnosed, 90 % treated, 90% with an undetectable Viral Load.

Our collective intelligence, our ability to collect and share vast amounts of information and use technologies to create effective treatments will allow us to end AIDS in my lifetime.

Information technology may have thrown us temporarily off balance but it has also connected us.  There are still 1 billion people who are not connected but

 “Once we are all connected, the collective brainpower that will be generated will be staggering.  It is and will reshape every man-made system that modern society is built on.”

Your generation is not directionless and incapable.  Your generation is on the front lines of one of the “greatest transformative moments in history”.

You have at your fingertips, extremely powerful tools in the form of science and technology and I believe these tools can solve every global crisis that exists, but not if you behave the way we did.

Your job as graduates from one of the best universities in the world is to collaborate. A generation not self-focused on consuming and wealth but focused on healing, renewal, regeneration, fairness, inclusiveness and equality:  the common good.

I love this excerpt from Thomas Friedman’s book, “Thank you for being late.”

"Information technology is vastly amplifying the power of one.  What one person can do both constructively and destructively has been multiplied to a new level.  One person may now have the power to destroy many but the flip side is also true, one person can now help so many more people, educate millions, inspire millions; one person can now communicate a new idea, a new vaccine, or a new application to the whole world at once.

And information technology can amplify the power of many.  Human beings as a collective are now not just a part of nature; they have become a force of nature.  All of us, acting together, now have the power to do good at a speed and scope we have never seen before:  to reverse environmental degradation, or to feed, house and cloth every person on the planet, if we set our collective minds to doing so."

Have no limits on your curiosity or the different disciplines you might draw on to drive change.  Be radically inclusive.  Create your ideas using as many relevant people, processes, platforms, disciplines, organizations and technologies as possible.

You have a great wealth of unleashed potential.

Your generation is and will be a great shimmering power. 

You will end AIDS.

You will end poverty

You will wipe out gender inequality

You will reverse the effects of climate change

You will create a fair and equitable world where every person is safe

Congratulations, for succeeding at earning one of the best educations at one of the best universities in the world.   You are privileged and to whom much is given, so much is expected. 

Best of luck, to my beloved millennials.

Dr. Anne-Marie Zajdlik MD CCFP O.Ont, MSM

Founding Director Bracelet of Hope (braceletofhope.ca)

MARCH 8, 2018

HAPPY INTERNATIONAL WOMEN'S DAY

LOVE TO OUR COLLEAGUES IN LESOTHO

International Women's Day was established in 1975 by the United Nations.  Here are the United Nations 2030 goals.  We will get there and the world will be a better place when we do!

By 2030, ensure that all girls and boys complete free, equitable and quality primary and secondary education leading to relevant and Goal-4 effective learning outcomes.

1. By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education.
2. End all forms of discrimination against all women and girls everywhere.
3. Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.
4. Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.

$ 6 million a year revisited

AM and SAM Z

I am reposting this blog.  Originally posted almost two years ago, it was unintentionally prophetic.  As we approach a provincial election, it begs to be reviewed again.  The cut to physician's income is now at 15 %.  We are in the middle of a flu epidemic.  Your GP is working way beyond any healthy capacity.  The after-hours clinic manned by the doctors I work with is churning through over 30 patients in an evening with people lined up in the parking lot.   We are not reimbursed for this vitally important work.  Doctors agreed to this arrangement as part of the contract we struck with this government 10 years ago in good faith.

 I will write a future blog that outlines how they have illegally over-ruled that contract leaving all of us in a very unhealthy position.  A government that 'loses' billions of your dollars through mismanagement and recklessness and then cuts your health care ( hospitals, nurses, doctors) and your education system ( God love the teachers who have survived )in order to make up for what they have 'lost', should not be allowed to continue governing.  A government that uses deceitful tactics to make you think these beautiful front line folks deserve to be sacrificed does not deserve to continue governing.

I am not of any particular political persuasion.  I am an advocate and an activist for people who cannot speak for themselves.  I am now advocating for you and your health.  On June 7th, you will have a voice.  Let's use our voices very, very wisely.

April 2016- updated

How disappointing.  Ontario's Minister of Health stood up on a podium with a poster beside him today.  The poster announced that one doctor in the province made over $6 million last year.

Really?   Does the bloated salary of one doctor represent the average salary of your hard working GP?  Come on.  Your government wants you to believe that all doctors can afford more cuts to their income.  Apparently, the 7 % cut we have already taken is not enough.  They must have one heavy-handed agenda if they are resorting to misleading you in this way.

Let's put a dose of the truth out there;  no pun intended.

I BILL OHIP $470,000 /year

I CARE FOR APPROXIMATELY 2000 PATIENTS

I am an average GP

I WORK OVER 40 HOURS A WEEK

(well over 40 hours a week)

I EMPLOY 5 STAFF PEOPLE:
(at a cost of $250,000 annually)
A nurse, an office manager, two receptionists and a nurse practitioner.

We all provide care to these 2000 patients

RENT, UTILITIES, INSURANCE, MAINTENANCE, MEDICAL SUPPLIES....

I PAY A TOTAL OF $360,000 annually in expenses,

 and together, Ontario's Doctors employ a huge network of healthcare and administrative workers supporting a substantive economy 

THAT MEANS THAT AFTER EXPENSES, AN AVERAGE GP LIKE ME MAKES

$110,000 annually

Now pay Licensing Fees, medical education fees

and I am left with a grand total of....

wait for it.....

$100,000 annually

Subtract the taxes and RRSP's, remember docs do not have pensions or extended health care plans, and
I don't even want to know what the final tally is but it is less than your lawyer, your accountant, your dentist and most likely, less than the police officer who cruises your streets.

WHY IS THE AVERAGE FAMILY PHYSICIAN'S SALARY AFTER EXPENSES NOT ON THE MINISTER'S POSTER?

THE GOVERNMENT WOULD LIKE YOU TO THINK YOUR DOCTORS ARE FAT CATS.

More cuts to healthcare will be dangerous, very, very dangerous.

The minute we have to re-consider whether or not we can afford to stay in practice, your healthcare is in jeopardy.

Your healthcare is my responsibility.

I take that, very seriously

 WE ARE ON THE BRINK OF A SERIOUS DISINTEGRATION IN HEALTH CARE IN ONTARIO

And that doctor who bills the government over $6 million a year?  He should be thrown out of the province and his government should curb his income instead of making him their poster boy.

Unfortunately, that disintegration is well underway, as predicted.

Dr.Anne-Marie Zajdlik MD CCFP, MSM, Order of Ontario

Founder ARCH Clinic

Founder Hope Health Centre

Founder Bracelet of Hope

Thanks,
AM

Just an MD on the front lines of healthcare

I have tried really hard not to blog about this.  I hear a voice in my head telling me to suck it up.  I have a good job.  I love my work.  But, at this rate, no one on the front lines of healthcare will survive the onslaught of the ever increasing demands of an ageing population in the setting of shrinking health care resources and a government that doesn't give a damn about me or you or our health.

I now spend 10 hours a day at my job.  I work through lunch with no breaks.  I spend 3 hours of the day smothered in paperwork.  I could use those hours to see real patients but our professional lives have become overwhelmed by regulations and legislation.  Everywhere I turn, a new guideline pops up, smothering any creativity or intuition I once used to care for my patients.  Patients that once required 10 minutes of my time now need 30 minutes.  Don't get me wrong, I love my ageing patients.  Their complex health issues require all my intellect and problem-solving abilities.  That is exactly what I signed up for.  But, it is becoming increasingly difficult to keep up.

Today, I saw four people whose specialists have found ways to abandon the system.  I don't blame them at all.  It now takes 12 months to see a dermatologist, 6 months to see a psychiatrist (if you can find one), 8 hours or more, to see an emergency room doctor, 18 months to have a joint replaced and 8 months to be seen at a pain clinic.  Three out of 10 referrals I make come back with a notice that the specialist is overwhelmed and can't accept the referral.  My staff spends hours looking for alternatives.  They are as dedicated to their work as I am.  I have stretched and extended my scope of practice to make up for these deficits, ineptly trying to pull together the unravelling strings of an imploding system.  Your government is more than happy to leave me in this spot.  They have to pay that specialist five to 10 times more than they pay me.  Cheaper healthcare is their goal, not better health care.


Your average family doctor belongs to a really good bunch of people who set out to tackle a career that involves the constant care of others.  We love that work.  We love our patients.  We are deeply concerned about their needs and search for ways to meet them.  We care for our patients over the course of their lives.  We have the privilege of delivering their babies and watching them grow into adulthood.  I know the intimate details of the lives of 2,000 people and every detail is kept in strict confidence.  I celebrate with these folks and I grieve with them.  They bring me their greatest joys and their lowest moments.  Every day, thirty people need my full attention, 15 minutes at a time.  By the end of the day, I have made thousands of decisions that directly affect the health of my patients.   We become that unseen part of every family that is critical to their health and wellbeing.  I fully understand the weight of this responsibility and I carry it on my shoulders with great humility and respect.

But, you have a government that disrespects the health and well being of every person who works in this system.  If we can no longer manage, people will die.  It's as simple as that.

I don't know how to change this mess we are in.  I am too busy trying to survive.  There is no time for activism.  God help us when 8 million baby boomers become increasingly ill and frail.  That will finally sink the ship.  Reckless mismanagement will finally sink the system and people will die needlessly.  My guess is, they already are.