Why I Give a Day – Dr. Winnie Siu

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Dr. Winnie Siu

My first introduction to Jane Philpott was a picture of her smiling at me from a poster card advertising an event where she was to receive an award for her work in raising awareness and funds to fight HIV/AIDS, particularly recognizing her efforts through the Give a Day campaign.

At the time, I was a medical student early in my clinical training, doing an elective rotation at Casey House and entertaining a faint career interest in global health. I had returned from the sub-Saharan African country of Zambia just a few months earlier where I had been working on an HIV research project. The trip had left me pondering questions about social activism, the role of Canadian doctors in international health, and my responsibilities to vulnerable populations as a physician. I had not met very many doctors involved in global health, and I was intrigued by this woman who had spent almost a decade working in Niger and was now receiving an award for championing the cause of HIV/AIDS in Africa locally. A few weeks later, I heard the name Jane Philpott again, in the context of the opening of a family medicine residency program with a focus on global health. I tucked all these pieces of information away in the back of my head.

Fast forward three years, a few more international experiences, a pervasive and growing desire to engage in global health, and a number of residency interviews later, where, at present, you can find me most days working in the residents’ room beside Jane’s office at the Health for All family medicine clinic at Markham Stouffville Hospital. I am now in my second year of residency, and one amongst the first cohort of residents to train in family medicine with an emphasis on issues of multi and cross-cultural health, as well as health of populations that are marginalized and vulnerable both locally and globally.

Despite this, I must be truthful in admitting that many days, the health and well-being of those living on other continents is far from my mind. Residency has a way of making you focus intently on the here and now – the patients on your list for that morning, the on-call shift you are working that night, the presentation you are (frantically, always) preparing for the next day. Mostly, this is good and necessary: I want to give my undivided attention to the patient who is sitting right in front of me. Yet it is so easy for me to forget to consider the global context of the health and wellness of populations – and my reasons for becoming a doctor in the first place.

In as much as Give a Day is a chance for me to contribute in a tangible way to the efforts of fighting HIV around the world, it is also a reminder for me to reflect on the motivations that I promised to stay true to during my medical training, like global health equity, social justice and human rights. What is remarkable about Jane is that I believe these issues are always at the forefront of her mind. For her, Give A Day is lived out every day of the year.

The two organizations that Give a Day supports, Dignitas International and the Stephen Lewis Foundation, have deep personal significance for me, as the founders of both wrote books which directly influenced my decision to pursue a career in global health. If you Google the salary of a second-year resident in Ontario, and divide this number by 210 (the number of working days in a year), I will be donating this amount, rounded up to the nearest hundred, to the Give a Day campaign on Dec. 1.

For some of you, this amount may be too little. To this I say: Great! I’m delighted that you’ll be able to give more!

For some of you, this amount may be too much. To this I say: That’s okay; it’s not how much we give individually, but the sum of our efforts that will make the difference.

And isn’t this the point of Give a Day, after all? The seemingly daunting, insurmountable task of an AIDS-free world will one day be achieved through – and only through – the synergy of our collective contributions.

Borden Ladner Gervais LLP Show Their Strong Commitment

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James Fraser, Co-Founder and Executive Director, Dignitas International

Parisa Nikfarjam, Articling Student at Borden Ladner Gervais LLP writes … On November 28, 2011, a group of lawyers, staff and students from Borden Ladner Gervais LLP had the pleasure of having lunch with James Fraser, co-founder of Dignitas International.

Mr. Fraser described the important work that Dignitas International does at the community-level in Malawi. BLG learned about the innovative medical care facilities created by Dignitas International and the research and advocacy initiatives that have been added to the mandate in recent years. However, it was Mr. Fraser’s stories about his experiences with those affected by HIV and AIDS that really inspired the room, and left some with tears.

Mr. Fraser explained a conversation he had with a woman in one of the medical clinics in Malawi, who questioned why it was that Dignitas International was supporting complete strangers. Mr. Fraser responded that the reason why more fortunate people, like Canadians, help those affected by HIV and AIDS in other parts of the world is the shared sense of humanity – the idea that regardless of where you are born and in what circumstances you find yourself, your life is as important as the life of anyone else.

This response not only established a deep connection between Mr. Fraser and this woman, but it also reminded the rest of us of the very basic rational of the Give a Day Campaign. This event provides yet another driving force for the various activities planned this week to support the Stephen Lewis Foundation and Dignitas International at BLG.

BLG is looking forward to doing its part on World AIDS Day on December 1st by encouraging people to give a day’s pay to fight HIV and AIDS.

“Activate” by Dr Danyaal Raza

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On November 22 at this year’s Hot Talks, Dr. Jane Philpott challenged the audience to ‘donate, educate and activate’. If you have found your way to this post, you are no doubt already educated to the crisis of HIV/AIDS in Africa and have committed to donate a day’s pay on December 1st. But it is Dr. Philpott’s third challenge, to activate, that asks the most of us.

Without the support of campaigns like GAD, the capacity of Dignitas International, the Stephen Lewis Foundation and their African partners to fight this disease would become seriously compromised. But to begin and end our support at personal financial contributions would betray their full potential to effect lasting change at a time when the fight against HIV/AIDS is at a turning point. Though the collective action of GAD support is important, it will also take the collective action of every Canadian through our government to tip the balance at a time when progress is under threat.

In 2009, the Minister of International Cooperation announced a realignment of priority countries under the Canadian International Development Agency (CIDA). Instead of continuing relationships with many low-income countries in Africa suffering from some of the highest rates of AIDS and related diseases, funding was shifted to middle income countries with which Canada was in free trade negotiations. Long-term partnerships, the bedrock for sustainable change, were severed and inroads made against the epidemic of HIV/AIDS in some of the most afflicted parts of the world were closed. Then, just one year later in the 2010 budget speech, it was announced that foreign aid spending would be frozen, further diminishing our countries capacity to effect change. In the face of the growing enthusiasm and the spirit that the GAD campaign has captured, do these decisions express our collective desire to fight poverty and disease? Clearly, they do not.

A federal budget is now around the corner, with deliberation and debate well underway. With calls for austerity, there is also real concern for further reductions of an already frozen foreign aid budget. From December 17 to January 29, Members of Parliament will be dismissed from Ottawa, and be home in their constituency offices. As Canadians who support campaigns like GAD and organizations like Dignitas International and the Stephen Lewis Foundation, now is the time to activate ourselves and activate our communities. It is time to let our representatives in government know that anything but a cut in the rate of HIV/AIDS is unacceptable.

Dan Raza is a family physician and current Fellow in Global Health & Vulnerable Populations at the University of Toronto’s Department of Family & Community Medicine. He recently completed his residency at Queen’s University and earned his MD from the University of Western Ontario.

Why I Give a Day – Dr. Tim O’Shea

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Dr. Tim O'Shea

Dr. Tim O’Shea, Give a Day Advisory Board member writes…This December 1st I will be in Uganda, where I have been lucky enough to spend a significant amount of time over the last decade. On this trip I have travelled with a friend and colleague who is making his first visit to Uganda, and to sub-Saharan Africa.

Yesterday was our first full day, and after sleeping late to catch up from the trip we visited the hospital where we will be working, so that my Canadian colleague could receive a bit of an orientation. As we walked through the wards I could sense that he was becoming increasingly uncomfortable. We stood on the infectious diseases ward, which, as always, was filled to bursting with patients and their families, the overwhelming majority of whom are suffering from complications of HIV infection. I found myself thinking back to my first visits to this hospital, when these same patients would have had no hope of accessing anti-retroviral treatment. In just ten years an entire infrastructure of health care delivery has evolved here, so that today in Uganda over 200,000 people are on treatment, representing about 40% of the estimated need.

Standing on that ward I saw clear progress; my colleague saw something very different. Several patients lie in the main entrance way to the ward, in obviously poor condition, receiving supplemental oxygen. My friend recognized that these individuals, all young, all with concerned family at their bedside, were likely dying. He recognized as well that for each of these patients, treatment existed that could have prevented their illness from becoming so advanced. He asked our Ugandan host what would happen to these people; would they be transferred to the ICU? The answer left him visibly shaken; the ICU was full, accessing it was difficult, and these patients’ cases were seen as too advanced. They would die on the ward.

While I saw the impressive progress that has been made in HIV treatment over ten years, my colleague saw with fresh eyes the realities of life for the 60% of Ugandans in need that are NOT on treatment – largely for the lack of funds. And with fresh eyes he reminded me of how utterly unacceptable this is. That is why I Give a Day.

Exciting Events at McMillan LLP

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Rob Barrass of McMillan LLP writes…Yesterday was “Launch Day” at McMillan LLP, and the campaign is off to a great start.

Brett Harrison, Partner at McMillan LLP, welcomes the group

We were very pleased to have Dr. Michael Schull with us to discuss the work done (and to be done) by Dignitas International. Dr. Schull’s talk helped drive home not only the scale of the challenge presented by HIV/AIDS in Africa, but also the fact that real, positive change is taking root. Although the gains may be fragile, it’s clear that organizations like the Stephen Lewis Foundation and Dignitas International can effect change and save lives.

Dr. Michael Schull, Board Chair at Dignitas International


Our campaign is only just beginning. We have an outstanding e-auction and raffle underway. Enthusiastic canvassers are knocking on doors. We are on the cusp of naming the competitors/victims for McMillan’s Give-a-Dance 2011. (Nothing fuels donations like senior partners in outrageous costumes dancing in public.)

“We need the best of many – not of just a few… We must strive for excellence.”

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Stephen Lewis, Jane Philpott, James Fraser

This morning Stephen Lewis was the keynote speaker at our Hot Talks event.  After his powerful address, I asked the audience to do 3 things: donate, educate, activate.

The 1st goal – to donate – is the most measurable and perhaps the simplest step to take. The results are priceless. Clearly one of the essential aims of the campaign is to raise money for great recipient organizations – the Stephen Lewis Foundation and Dignitas International.

A 2nd goal of Give a Day (GAD) is to educate or “raise awareness” about HIV in the world. And this actually thrills me as much as our fund-raising success.  We keep people talking about important global social issues related to the theme of HIV. Give a Day educates us. And education is so critical – it’s what GK Chesterton calls the “soul of a society”.

Beyond GAD’s challenge to donate & educate is a 3rd goal – to activate. I hope GAD will inspire you to do even more than giving and learning.  A good education leads inevitably to action. Wm Butler Yeats, the Irish poet (and later politician), said “Education is not filling a pail, but the lighting of a fire.” I want to light a fire with this campaign.  And I’d like that fire to burn brightly, to show a vision of a new and better future for the people and places affected by HIV.

48 years ago today, I was a toddler living in snowy Winnipeg Manitoba. On this day 48 years ago, my mother was in our Winnipeg kitchen making a 3-year-old birthday cake for me. Her work was interrupted when she heard on the television that President John F Kennedy had been shot. For our society, it remains one of the most memorable days in modern history. A great man and incomparable leader had his life brutally cut short.  I think about the Kennedy family each year on November 22. I wish I had known the parents of John F Kennedy.  I often wonder: what were the ingredients that inspired the Kennedy siblings to be such leaders – lights and fires – for their generation? But they did more than just lead themselves; they called on others to take up the tasks of the day.  Less than four weeks after President Kennedy was shot, his brother Bobby wrote a new Foreword for a memorial edition of John’s book “Profiles in Courage”. The words written by Bobby Kennedy 48 years ago are relevant to our task today:

“The energies and talents of all of us are needed to meet the challenges – the internal ones of our cities, our farms, ourselves – to be successful in the fight for freedom around the globe, in the battles against illiteracy, hunger and disease.  Pleasantries, self-sustained mediocrity will serve us badly. We need the best of many – not of just a few. We must strive for excellence.”

I like to emphasize this point after Stephen Lewis speaks because his matchless speaking skills can be a little intimidating. Even in a confident crowd, many of us may feel inadequate and ill-equipped in comparison.  But it takes more than the actions of Stephen Lewis to combat the forces that propagate the AIDS pandemic. What did Bobby Kennedy say? We need the best of many – not of just of few. We must all strive for excellence. Strive is an action verb. To strive means to put your whole & considerable force behind this effort.

I hope you are already quite convinced that we should do our part to address the realities of HIV in the world. If so, you are not alone. Let us donate. Let us educate. And let us activate all the resources within our reach to strive together toward a world without AIDS.

What does “solidarity” mean to you?

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Last year, a group of Give a Day (GAD) volunteers gathered to discuss the essence of the GAD movement and to think about how we could describe it in a few words.  After talking about why we “give a day”, we came up with the tagline, “Global solidarity – Local solutions”.

Since then, I hear that the word “solidarity” causes some confusion and misunderstanding.  What do you think of the word “solidarity”?

Some of us are old enough to remember the mass protest in Poland in 1980 under the leadership of Lech Walesa.  The movement took the name “Solidarity” to describe its demands for the right to form a free trade union and the right to strike. Our use of the word “solidarity” is better explained in another way.

To me, solidarity is the deepest expression of community spirit.  Solidarity is very closely connected to the concept of “Ubuntu”, an African philosophy that has been translated: “I am what I am because of who we all are.”

Solidarity reminds me of the concept of “collective efficacy” which is well described in Helen Epstein’s book, “The Invisible Cure”. Epstein’s book reviews the common features of communities who have most successfully worked together to respond to HIV. She notes:

The key to their success resided in something for which the public health field currently has no name or program.  It is best described as a sense of solidarity, compassion, and mutual aid that brings people together to solve a common problem that individuals can’t solve on their own.  The closest thing to it might be Harvard sociologist Felton Earls’s concept of “collective efficacy” meaning the capacity of people to come together and help others they are not necessarily related to.

In the scientific world, an object is solid if the particles within it are very closely bound together.  So if we as a global community are “solid”, it means that we move together.  What affects one of us affects all of us. This evokes the classic quote of Dr Martin Luther King Jr who said:

Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.

Let me know what “solidarity” means to you.  If I knew that the “solidarity” tagline caused more confusion than inspiration, then perhaps it should be reviewed.  But until then, I’d say it well describes the sentiment behind why I give a day.

Will you join us in an act of pragmatic global solidarity?

Do you want to help now? If so…

Around December 1, I hope many will give a day’s pay in recognition of World AIDS Day.

Here are some other ways you can help…

  1. Share this. Tweet this.
  2. Follow us on Twitter.
  3. Like us on Facebook.
  4. Join our mailing list.
  5. Engage your community or workplace in a Give a Day campaign.
  6. Plan a harambee.
  7. Leave a response and let us know what you think!

Give a Day at Osler LLP

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Susan Elliot of Osler, Hoskin & Harcourt LLP writes…Our firm is alive with all things Give a Day! The office is buzzing with contests, bake sales, bingo games and more to raise awareness of the incredible work being done in-field by Dignitas International and the Stephen Lewis Foundation. I think being involved in the Give a Day public service announcement shoot this month has helped to stir up interest in the legal community. I am amazed that all these legal professionals, despite their unbelievably demanding schedules found a way to stop in the middle of their day, and hike over to our offices for the shoot. And how our own Kim Eadie managed to coordinate the scheduling is, well mystifying!

To top it all off, Give a Day founder, Dr. Jane Philpott, Ida Mukuka of the Stephen Lewis Foundation and James Fraser of Diginitas International spoke at our firm launch event on Monday November 14th – so exciting to be part of Give a Day!

What’s a primary care doctor like me doing in a vertical response like this?

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If you’re involved in primary health care or global health, you may have heard that primary care is all about “horizontal” programs.  Those of us who live and breathe the wonders of primary care regularly cite the benefits of health care that is broad and comprehensive. We even point to evidence that shows how a focus on primary care results in better health outcomes at lower costs that is more equitable and accessible.

I believe in the benefits of primary care with all my heart, soul and mind.

So how can I simultaneously devote so much time and energy to something like GAD that seems clearly based on “vertical” interventions focused on a single issue like HIV?  What a good question!

Well, my first line of defence would declare that even a dedicated primary care doctor can recognize that there must sometimes be an exceptional emphasis on certain issues.  HIV is one of these. I remember former UNAIDS Director, Dr Peter Piot, who repeatedly declared the exceptional nature of HIV. That always resonated with me. HIV is exceptional because of the sheer numbers of people affected.  (By this measure, other illnesses such as tuberculosis would also qualify as exceptional.) HIV is exceptional because, more than almost any other infection, its spread is driven by the social determinants of health (economy, education, gender). Piot used to describe how HIV has “revealed the fault lines of society”.

But my other line of defence in any accusation about the validity of focusing on a vertical program comes from recognition that solving the problem of HIV in the world requires the very essence of what primary care is all about.

Addressing HIV requires public infrastructure and strong health systems along with broad-based educational and economic solutions.

Countries, regions and communities that have successfully reigned in the impact of HIV have done so through great public health systems with the aid of excellent primary care.

Gregg Gonsalves said this in Mexico in 2008:  Without continuing sustained focus on AIDS treatment, many millions of the poorest and most marginalized people in the world will die, period. And without breadth, not only will AIDS treatment be incomplete, but we will miss the greatest opportunity in history to build functioning health systems in some of the poorest countries of the world.

Finally, the organizations to which GAD recommends donations (Stephen Lewis Foundation and Dignitas International), do their remarkable work for people affected by HIV at the community level using the very principles on which primary care depends (including engaged communities and patient-centered care).

So I will continue to advocate on behalf of those affect by HIV. I will continue to ask everyone to give a day’s pay on World AIDS Day (December 1) in response to the exceptional issue of HIV.

As we address HIV we must use the principles of primary care to build the public health capacity that will have lasting impact on the communities most severely affected by this scourge.

What do you think? If you believe in primary care, will you join me in recognizing World AIDS Day by giving one day’s pay to one of GAD’s recommended recipients?

And while you’re at it, here’s how you can help now!

  1. Join us in giving one day’s pay on World AIDS Day, December 1!
  2. Share this. Tweet this.
  3. Follow us on Twitter.
  4. Like us on Facebook.
  5. Join our mailing list.
  6. Engage your community or workplace in a GAD campaign.
  7. Plan a harambee.
  8. Leave us a comment, a question or a note of encouragement.

New Legal Community Video to Support Give a Day

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What would you do if you saw colleagues you admire, working towards a world without AIDS? Would you create a plan to encourage even more people to join in?

The legal community has done just that, and we couldn’t be more pleased with the end result.

Some members of our Legal Committee got together and came up with a brilliant idea to create a campaign resource that could be shared across the legal community.

They asked some friends to help, and worked collaboratively to find a way to bring some incredibly busy people to the same place on the same day.

Next they needed some music to help set the scene, which they found, courtesy of Madagascar Slim.

And what is the result? A wonderful new video in support of the Give a Day campaign, created by law firms working together to challenge their colleagues to join them in giving a day’s pay.

Have a look here.

Once again, we are inspired by the leadership and generosity of the legal community, and we thank them for all they do.

World AIDS Day is on December 1. Will you give a day?