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Horror difficult to erase for Indonesians as toll tops 1,400

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PALU, Indonesia — For some who survived the massive earthquake and tsunami on Indonesia’s Sulawesi island last week, the memories and the horror of experiencing a disaster that has left more than 1,400 people dead are both hard to erase and understand.

Furniture maker Khairul Hassan recalled working at a shop near the beach in front of a row of warehouses when the ground came alive and shook violently. He ran to a nearby hill and watched as the ocean heaved up and hurled forward. Now he can’t forget.

“I saw the waves come and sweep out everything — buildings, factories, warehouses and some people who were lost, racing from the waves, some of them women and children,” he said Wednesday. “Also, warehouse workers who were trapped under goods, all swept by the sea. It’s so tragic. It’s so scary to remember.”

Five days later, aid was slowly creeping into areas where victims have become increasingly desperate after being left without food, water, fuel and medicine. In one neighbourhood in the city of Palu, residents celebrated as they swarmed a truck delivering aid — clapping, cheering and high-fiving.

“I’m so happy,” said Heruwanto, 63, who goes by one name. He was clutching a box of instant noodles. “I really haven’t eaten for three days.”

The official death toll increased to 1,407 on Wednesday, with thousands injured and more than 70,000 displaced from their homes, said national disaster agency spokesman Sutopo Purwo Nugroho. He said the number of dead would increase, but that rescue crews had reached all affected areas.

The U.N. humanitarian office estimated that some 200,000 people need assistance in the disaster zone and announced a $15 million allocation to bolster relief efforts. Help has been slow to reach many victims, especially those living in areas cut off by impassable roads. But large fuel and food conveys, guarded by security forces, have been making their way in.

Miles (kilometres) of coastline spreading out from Palu are a surreal landscape of debris, beached boats, upturned cars and the foundations of obliterated houses.

All that remained of many beachside homes was their foundations. Wrecked houses still standing were spray painted with appeals for aid. On the wall of one dwelling, “Help us Mr. President” was scrawled in big lettering.

The town of Donggala to the northwest of Palu was relatively unscathed. A few houses had collapsed and a couple of large boats were beached. Residents were relaxed and smiling in contrast to the anguish and tension evident across Palu.

In addition to the quake and tsunami, Indonesia also demonstrated Wednesday what it means to sit on the Pacific “Ring of Fire” when a volcano erupted in another part of Sulawesi island about 940 kilometres (585 miles) northeast of the earthquake zone. It sent a plume of ash more than 6,000 metres (20,680 feet) into the sky. Planes were warned of the cloud billowing from Mount Soputan because the ash can be hazardous for aircraft engines, but no evacuations were ordered in the area.

Experts said it’s possible the quake accelerated the eruption, but there is no concrete evidence to prove that. Activity at the volcano had been increasing since August and began surging on Monday, Kasbani, who heads Indonesia’s Volcanology and Geology Disaster Mitigation Agency and uses one name, told an online news portal.

More than 25 countries offered assistance after President Joko “Jokowi” Widodo appealed for international help. He visited the disaster zone Wednesday, saying there’s still work to be done, but that conditions were improving with businesses starting to reopen, helping people to start returning their lives to normal.He said U.S. President Donald Trump called him Tuesday night, offering assistance.

“We are going in phases. There are lots of things happening related to evacuation, as aid and fuel are also coming in,” he said, noting that 30 people remain buried under rubble at the Roa Roa Hotel in Palu.

Some homeless residents weren’t waiting for help. Dozens sifted through what remained of the flattened complex of warehouses along Palu’s ravaged coastline, looking for anything they could salvage to eat, sell or help them rebuild. They carted away corrugated metal, wood, piping and other items.

Others pulled out small cartons of milk, soft drinks, rice, sweets and painkillers. They were young and old, middle class and poor, university students and sullen young men.

“We have to do this because there’s no assistance from the government,” said Zaitun Rajamangili, 41, adding that his home was swept away but his family survived.

Following widespread looting and aid vehicles being stopped and surrounded by people on roads, Indonesian military chief Hadi Tjahyanto said one soldier and one police officer would be placed on every aid truck and soldiers would be sent to secure markets, the airport and fuel depots to maintain order. He added that a Singaporean military transport plane will help evacuate victims from the airport in Palu. In addition, aircraft from South Korea, the United Kingdom and Japan were expected to ferry aid.

Australia announced it will send 50 medical professionals as part of a $3.6 million aid package.

The U.N. said the Indonesian Ministry of Social Affairs has asked the U.N. children’s agency, UNICEF, to send social workers to support vulnerable children who are alone or became separated from their families. It said the World Health Organization is warning that a lack of shelter and damaged water sanitation facilities could lead to outbreaks of communicable diseases.

Indonesia, a vast archipelago of 260 million people, is frequently struck by earthquakes, volcanic eruptions and tsunamis because of its location on the “Ring of Fire,” an arc of volcanoes and fault lines in the Pacific Basin. A powerful quake on the island of Lombok killed 505 people in August.

___

Associated Press writers Niniek Karmini in Palu, Indonesia; Margie Mason and Eileen Ng in Jakarta, Indonesia; Rod McGuirk in Canberra, Australia; and Edith M. Lederer at the United Nations contributed to this report.

Stephen Wright, The Associated Press





































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Chrystia Freeland refuses to answer how much Trudeau government has collected via carbon tax

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From LifeSiteNews

By Clare Marie Merkowsky

Deputy Prime Minister and Finance Minister Chrystia Freeland continues to claim that the revenue from the carbon tax ‘goes back to Canadians’ despite data showing otherwise.

Canadian Deputy Prime Minister and Finance Minister Chrystia Freeland has refused to reveal how much Liberals have collected via the unpopular carbon tax, which is set to go up again on April 1.  

During a March 21 session in the House of Commons, Conservative Member of Parliament (MP) Marty Morantz questioned Freeland regarding how much the Liberal government has taken in through the carbon tax.  

“How much has your government collected in carbon taxes?” Morantz asked.  

Freeland responded by dodging the question, stating, “[This is] also an opportunity for me to point out that Manitoba families will be getting $1,200 this year.” 

“Again, minister, if I could just have the number [of] how much you’ve collected in carbon taxes,” Morantz pressed. 

Freeland again refused to answer, instead claiming that the “key point” is that the “price on pollution” is “revenue neutral.”

As Morantz persisted in his question, Freeland alleged that the revenue from the carbon tax is “all money that goes back to Canadians.” 

However, this statement has been proven untrue as the Parliamentary Budget Officer recently revealed that the government rebates are insufficient to cover the rising costs of fuel under Trudeau’s carbon tax, causing many to wonder where their money is actually going.

According to records published in December, the carbon tax cost Canadians nearly $200 million in paperwork since Prime Minister Justin Trudeau introduced the fuel charge in 2019. 

The costs are only expected to rise, as a recent report revealed that a carbon tax of more than $350 per tonne is needed to reach Trudeau’s net-zero goals by 2050.   

Currently, Canadians living in provinces under the federal carbon pricing scheme pay $65 per tonne, but the Trudeau government has a goal of $170 per tonne by 2030.    

Additionally, Trudeau has refused to pause the carbon tax hike scheduled for April 1, despite seven out of ten provincial premiers and 70 percent of Canadians pleading with him to halt his plan.   

Meanwhile, Trudeau and his cabinet continue to attend lavish retreats, with a recent Liberal retreat costing taxpayers nearly $500,000.   

During a media interview following the nearly $500,000 retreat, Trudeau told Canadians struggling with the high cost of living that times are also difficult for politicians.  

“Yeah, people are facing tough times, and yes, everyone is finding it difficult right now. And as leaders, MPs, parliamentarians of all types, part of our job is to be there to take it, to support it as Canadians are worried and anxious, and put out those solutions,” he said.   

“So yeah, it’s not an easy time to be a politician,” Trudeau lamented.

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MacDonald Laurier Institute

Barriers to care persist but access to MAiD keeps expanding

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From the Macdonald Laurier Institute

By Ramona Coelho

Our government has allowed the incredible power of certain lobby groups to control the public discourse and policies around MAiD and its expansion, prioritizing access to MAiD over the safety of Canadians.

My family medicine practice serves predominantly low-income and marginalized patients, including refugees, those who have been in our prison system or are facing charges, and many with disabilities and mental health issues. My patients experience high barriers to care and support and face social isolation and all kinds of discrimination. Observing the impacts of this has left me deeply concerned about our government’s priorities.

When the federal government introduced MAiD (a medical procedure that causes death) to those not at imminent risk of dying, I was appalled to learn that my patients, who are frequently blocked from care as a result of hurdles created by our government and systems, could potentially be offered an expedient death provided by the government.

In 2016, assisted suicide and euthanasia were first legalized in Canada and the term medical assistance in dying (MAiD) was created. Originally MAiD was presented as an exceptional lethal procedure for ending the lives of consenting adults who were experiencing intolerable suffering and were near death. The legislation required that patients meet certain criteria, including having a “grievous and irremediable” medical condition, such as organ failure or cancer, and a “reasonably foreseeable natural death.”

But the Canadian discourse around MAiD rapidly shifted to facilitating access and there has been a broadening of the number and criteria of those who qualify for MAiD. In 2021, Bill C-7 came into effect and removed some of the safeguards within the original pathway, now called Track 1, and created a new, second track, Track 2, for adults with physical disabilities[1] who are not  dying. Furthermore, there is a planned expansion, though the timing is currently being debated in Parliament, for patients whose only medical condition is mental illness. Parliamentary recommendations in 2023 included future expansion to children and to incapable adults who signed advance directives for euthanasia.

Currently, those in Track 1 with a “reasonably foreseeable natural death” can potentially have their life ended the same day as the initial request if all the criteria are met and practitioners are available.

For those in Track 2, those not dying, death by lethal injection is set at a minimum of 90 days after the completion of the first MAiD assessment. To qualify for this track, a patient must also have a “grievous and irremediable” condition and experience intolerable psychological or physical suffering. Suffering is treated as purely subjective with no requirement for further validation. There is also no legal requirement for standard treatment options to be accessible or tried, only that a patient be informed that they exist. This means that a patient who says they are suffering intolerably could access MAiD having declined treatments that would remediate their condition. This could be because the treatment is inaccessible, or unaffordable, or if the patient declines therapy.

The Canadian Association of MAiD Assessors and Providers (CAMAP) has received 3.3 million dollars in funding from Health Canada to educate clinicians assessing and providing for those who have requested the service. So although the existing Track 1 and Track 2 pathways have different safeguards, in aiming to allow those near death to have access to MAiD quickly and with no barriers, CAMAP has created a guidance document that suggests clinicians can be flexible as to whether someone fits Track 1’s reasonably foreseeable natural death, since the law does not require that the person be terminally ill or likely to die within 6 or 12 months. It also states that a person may meet the reasonably foreseeable criterion if they’ve demonstrated a clear and serious intent to take steps to “make their natural death happen soon, or to cause their death to be predictable.” This could come about from a refusal to take antibiotics for an infection, stopping oxygen therapy, or refusing to eat and drink.

This means that people with disabilities can state their intention to or make themselves sick enough to qualify as having a reasonably foreseeable natural death, as is currently happening with adults who are not dying and yet are having their lives ended within days of their first MAiD assessment. In one case, a man had a mild stroke and received MAiD shortly after, even though he wasn’t terminally ill. The reason? He was approved for track 1 as he was temporarily eating less. This was due to following a cautious meal plan ordered by the treating team which was intended to prevent choking and aspiration risks.

Currently, some places in Canada have MAiD rates that are the highest in the world. By the end of 2022, there had been almost 45,000 MAiD deaths across Canada since legalization—more than 13,000 of which took place in 2022 with 463 of those individuals accessing MAiD through Track 2. Estimates based on provincial reporting approximate 16,000 deaths in 2023. Health Canada and MAiD expansionists have tried to reassure the public that the overwhelming number of MAiD deaths have been mostly Track 1 deaths (implying they were dying anyway) but we do not know how many of those persons were “fast-tracked” and may have had many decades of life left to live and the potential to recover with time and care.

The CAMAP guidance document that seems to circumvent Track 2 safeguards is just the beginning of many serious problems with MAiD legislation and practice in Canada.

Patient safeguards for MAiD are lacking

Other jurisdictions in the world where MAiD practices are legalized, such as New Zealand and Victoria, Australia, frown on or prohibit raising death as a treatment option. This is due to the power imbalance that exists between physician and patient, coupled with the patients’ assumption that the provider will only suggest the best options for their health. Raising  MAiD unsolicited could cause undue pressure to choose death.  Yet Health Canada’s 2023 Model Practice Standard for Medical Assistance in Dying recommends that MAiD should be raised to all who might qualify if the practitioner suspects it aligns with a patient’s values and preferences.

The model practice standard’s approach to “conscientious objection” is equally troubling. Health care providers who object to providing MAiD, even in specific cases, are considered conscientious objectors. A physician who is concerned that MAiD is not a patient’s best option is supposed to ignore their conscience or professional opinion and simply refer the patient on so they can seek access to a MAiD death.

This is further echoed in a CAMAP video training session where experts explain that patients might be driven to MAiD by unmet psycho-social needs. The expert leading the session responds to a trainee’s concerns: “If withdrawing is about protecting your conscience, you have [an] absolute right to do so.” But he adds: “You’ll then have to refer the person on to somebody else, who may hopefully fulfill the request in the end.” This demonstrates precisely how effective referrals can funnel patients toward death despite legitimate professional concerns and obligations that should have instead led to the process being stopped or paused.

In response to this legislation, many from the disability community have advocated for safe spaces where MAiD can’t pose a risk to their lives. The Disability Filibuster, a national grassroots disability community, stated in an open letter that its members have raised fears about seeking health care where death could be offered to them and if at their lowest, they might agree.

The disability community is not being alarmist in this concern. Health care providers often rate the quality of life of those with disabilities as poor despite those patients rating their own quality of life as the same as aged-matched healthy individuals. Put differently, many physicians might consider that patients with disabilities are better off dead, consciously or unconsciously, which might lead them to suggest MAiD.

Besides the problems of mandatory referral and raising MAiD unsolicited, there is another important factor to consider. Persons with physical disabilities systemically lack much of the essential care they need to live and consequently suffer higher rates of isolation, poverty, and marginalization, all of which can make death their most accessible option. The Canadian government commissioned a University of Guelph study, published in 2021, in which the researchers noted that some persons with disabilities were encouraged to explore the MAiD option—even though they had not been contemplating doing so—because of a lack of resources that would enable them to live. Those with disabilities can be approved for MAiD based on their disability, but it is their psycho-social suffering that can drive their requests.

The United Nations Special Rapporteur on the rights of persons with disabilities, the Independent Expert on the enjoyment of all human rights by older persons, and the Special Rapporteur on extreme poverty and human rights have all warned the Canadian government that the current MAiD framework could lead to human rights violations. Their concerns are validated by the numerous fact-checked stories about MAiD abuses that are emerging in Canada. These should give us pause. For example, Sathya Dhara Kovac, 44, ended her life through the MAiD program. She lived with a degenerative disease and her condition was worsening, but she wanted to live but lacked the home care resources to do so. “Ultimately it was not a genetic disease that took me out, it was a system,” Kovac wrote in an obituary to loved ones. All Canadians have a right to humane living conditions, to be treated with respect and dignity, and to receive appropriate timely medical care. Considering the living conditions and lack of care that as a society we allow persons with disabilities to have, choices to die might be understandable for those like Sathya. But we should ask ourselves if choices, made under inhumane conditions, are made freely if driven by structural coercion.

Disturbingly, there are MAiD assessors and providers who seem to be ok with proving MAiD under such inhumane conditions. One such provider testified at a parliamentary committee on MAiD that if someone had to wait a long time for a service that would remediate their suffering, she would still consider that waiting to be irremediable suffering and grant them MAiD in the interim. Therefore, it is not surprising that patients with unaddressed psycho-social suffering are being given MAiD by assessors like her.

When it was considering Bill C-7, the federal government asked the Parliamentary Budget Officer to estimate cost savings to our health care system of the legalization of MAiD. The office did this by looking at the comparative cost savings of MAiD versus palliative care at the end of life. Through this impoverished lens of valuation, it is clear that the cost savings will be even greater when, by many years, we prematurely end the lives of people who have higher care needs, especially when we factor in social services, disability benefits, equipment, and other costs on top of the direct savings to health care budgets. But this is not how we should create budgets or measure outcomes. Our socialized health care system is meant to serve those with disabilities, not consider them a cost to the system.

The Canadian government is currently deciding on the timing for its further roll-out of MAiD, this time for mental illness and with no legislative changes to the current safeguards. This expansion is alarming given what we know is happening already to disabled Canadians under the existing MAiD regime. The Canadian Association of Chairs of Psychiatry wrote a letter in 2022—and some testified more recently in Parliament—that we are not ready for this development. They have warned that there is no evidence to guide decisions about who with mental illness would not get better. The evidence suggests that for every 5 people whose lives would be ended based on the sole medical condition of mental illness, 2 or 3 would have recovered. We expect to have much higher numbers qualifying for MAiD on the grounds of mental illness in Canada than in other jurisdictions that allow assisted death for this reason, since barriers to care and unmitigated psycho-social suffering do not have to be rectified in this country (as they do elsewhere) before being granted MAiD.

Our government has allowed the incredible power and influence of certain lobby groups and their members to control the public discourse and policies around MAiD and its expansion, prioritizing access to MAiD over the safety of Canadians. Besides the current discussion about when to legalize MAiD for mental illness, the parliamentary committee has also recommended expansion to children and MAiD by advance directives. With eligibility for MAiD continuing to broaden, we are not giving priority to serving those most in need, but instead seem intent on rapidly expanding a path to end their lives.

[1] Disabilities is an umbrella term that includes impairment, chronic illness and/or other conditions.

Dr. Ramona Coelho is a family physician in London, Ontario. Her practice largely serves marginalized patients.

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