‘I felt helpless’: Teachers call for support amid ‘escalating crisis’ of classroom violence

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Last fall, a Grade 2 teacher was with her class when a student planted himself in front of the doorway.

The seven-year-old boy yelled, « No one’s gonna leave the classroom! »

« It was a hostage situation, » the Ontario teacher recalled.

When she called the office, the student began to kick and punch an educational assistant, yelling « in a fit of rage » as 17 other students watched helplessly.

It’s difficult to pinpoint why young children act out against their teachers, said Judith Weiner, a psychology professor at the Ontario Institute for Studies in Education. (Ben Shannon/CBC)

She filed a report and spoke to representatives from her school board and union, but she said nothing happened.

After working as an elementary teacher for over 20 years, she recently took medical leave due to stress.

« I absolutely feel like I failed, » she said. « I’m still beating myself up about the fact that I couldn’t cope. »

The Sunday Edition has agreed not to name the teacher, who fears being identified could affect her employment.

Root of violence complex

Educators say incidents of verbal and physical violence by students targeting staff and fellow classmates are leaving them exhausted — and they’re calling on governments and school boards to provide more support.

Sherri Brown, director of research and professional learning at the Canadian Teachers’ Federation (CTF), describes the current state as an « escalating crisis. »

Last year, the national organization compiled the results of a survey conducted for the Elementary Teachers’ Federation of Ontario (ETFO). The online survey, which polled its 81,000 members, found that 70 per cent of Ontario elementary teachers reported experiencing or witnessing violence during the 2016-17 school year.

Verbal threats, physical assault and incidents involving weapons were among the most frequently reported, according to Brown.

These were the results of an online survey conducted for the Elementary Teachers’ Federation of Ontario in relation to the 2016-17 school year. (Ben Shannon/CBC)

But it’s difficult to pinpoint why young children act out against their teachers, said Judith Weiner, a psychology professor at the Ontario Institute for Studies in Education at the University of Toronto.

Elementary students, in particular, struggle with « emotion regulation » and may be « modeling » behaviour learned at home.

« They hear parents issuing verbal threats at each other, » she said. « That’s a very big part of what the kid has learned of how to deal with issues when someone doesn’t do what you want. »

As for physical violence, Weiner explained, younger children are more likely to display this kind of aggression because of how socialization works.

Children have challenges and complexities, and the system is just starved.– Sherri Brown, Canadian Teachers’ Federation

« Kids just don’t know how to problem-solve in any type of conflict situation, » she said. « As kids get older, they know not to use their fists. They realize that is going to have bigger consequences. »

While CTF’s review of its survey did not identify a root cause, Brown said a child’s socio-economic background, mental health and special needs all possess « escalation potential » for violence.

« Children’s disabilities manifest in behaviours when they don’t have access to proper supports and services, » said Brown.

Larger class sizes have also « exacerbated » the potential for violence, she said.

« It’s not about children somehow being in the wrong. Children have challenges and complexities, and the system is just starved, » Brown said.

Last spring, Ontario’s former Liberal government released the Workplace Violence in School Boards: A Guide to the Law to help schools develop workplace violence policies. At the time, the province also pledged to fund an online reporting tool to simplify the process. The Sunday Edition reached out to Ontario’s ministries of education and labour regarding the status of these measures, but did not receive a response.

Reluctance to report violence

Educators are also reluctant to report incidents of violence by students for « fear of repercussions, » Brown said.

Results from ETFO’s members showed only 22 per cent of teachers said they would report cases of verbal or physical violence, and less than a quarter said steps were taken to prevent future incidents.

« Many feel reporting isn’t going to garner new supports or services, so why would they report it? » Brown said.

The Toronto District School Board declined an interview with The Sunday Edition, but said in an email statement « when incidents happen, the principal investigates and then works with staff, students and/or their families to address the issue.

« As each case is unique, there is no one solution. However, any act of violence can and does result in discipline, which can include suspension, » said TDSB spokesperson Ryan Bird.

« Depending on the circumstances, additional supports can also be offered to help support the students and/or classroom. »

I am not a trained psychologist. I am not a trained social worker. But I am expected to provide these roles for these students every day.– Kindergarten teacher

But a kindergarten teacher, who The Sunday Edition has also agreed not to name, decried « a shortage of support. »

She said she is « kicked, punched, slapped, hit with objects, thrown chairs at, spat at, sworn at » on a daily basis.

Behavioural consultants at the school have suggested calming corners, dimmed lighting and meditation, she claimed, but did little to calm an angry child.

« The list is really endless of what I’m trying and it’s very sad not to be able to have an answer or a strategy that’s working. »

« I am not a trained psychologist. I am not a trained social worker. But I am expected to provide these roles for these students every day. »

Verbal threats, physical assault and incidents involving weapons were among the most frequently reported incidents of verbal and physical violence, according to the Canadian Teachers’ Federation. (Ben Shannon/CBC)

The teacher recalled an incident when a seven-year-old boy was hitting other students with a shovel in the schoolyard.

When she intervened, he « hit me with a shovel on my right leg, repeatedly, over and over again, while he swore at me, » she said.

The teacher called for help from staff, but in the meantime, stood motionless in the hopes the boy wouldn’t turn his attention back to the students.

She filed the required reports, but nothing happened, she said.

The kindergarten teacher recently took an extended leave, though she’s now back in the classroom.

« I don’t want to be forced out of my profession and my love of my job because of a lack of support. »

David Mastin, ETFO’s Durham local president, says his region is losing teachers within their first five years on the job.

« We have so many of our members off on long-term disability because of the anguish and mental strain that is part of their jobs, » he said.

Teachers, unions leery of training

Some Ontario schools and boards are encouraging educators to take Nonviolent Crisis Intervention training, a de-escalation program, run by the Milwaukee-based Crisis Prevention Institute. The training can range from a one-day classroom seminar to four days to become certified to teach it.

Trainees learn how to calm a child in the midst of a crisis by detecting signs of anxiety and anger, and how to respond to a physical altercation, including how to safely hold a child. 

« I really don’t believe half a day or a day is enough, » said Terri-Lynn Platt, health and safety coordinator with the Elementary Teachers of Toronto. « It can become very violent, very quickly. »

The training stresses that physical intervention should only be used if the child is in « imminent danger, » Platt said. Regardless of that caveat, teachers and unions remain leery of the program.

Platt argued that whoever takes the training ends up becoming the school’s defacto crisis person.

« I will tell teachers it is wise not to have that training. »

Chris Broadbent, a former health and safety manager at the Toronto District School Board who is part of the province’s Working Group on Health and Safety, stressed that in the case of a violent incident, teachers can always « summon immediate assistance, » whether it be from principals, educational assistants or other staff.

« There’s no doubt that there are issues in our province and some of our schools. But to paint the situation that this is happening every day in a majority of our schools in the province is probably not accurate. »

I felt helpless not being able to reach out and wrap my arms around these kids and say, ‘We’re going to have a good day.’– Grade 2 teacher

Broadbent said where the safety of a child is in danger, teachers are required to intervene just as a judicious parent would.

« The Education Act is pretty clear about the expectations of a teacher, » he said.

« I understand … the hesitation … because there have been situations in the province where a teacher is seen to have violated that expectation and is sent home pending an investigation. »

« But, if they have followed [training], then there should be no further consequences. »

Students are ‘the victims’

For the Grade 2 teacher, the last straw came when her vice-principal gave her a package that included a protective jacket, with padding in the chest and shoulders.

« As I opened it up, I’m looking at it, going, what the hell is this? »

Personal protective equipment can include Kevlar jackets, neck, shin and wrist guards, helmets and spit guards.

« Nowhere in my teaching career did I ever expect to have to put one of these on in a classroom, » she said.

She went on medical leave shortly after.

But wants to make it clear that despite the physical and emotional duress she has endured, she worries most about the students — those who act out, and others in the classroom.

« I felt helpless. I felt helpless not being able to reach out and wrap my arms around these kids and say, ‘We’re going to have a good day; we’re going to learn; we’re going to have fun; we’re going to feel safe; it’s going to be OK, » she said.

« They are the victims. »

The Sunday Edition wants to hear your thoughts and experiences about violence in the classroom. Send us a message here.

‘Hard Lessons’ is produced by The Sunday Edition’s Alisa Siegel. Story written by Jonathan Ore and Amara McLaughlin.

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Saskatoon joins world as Women’s March rallies against gender-based violence – Saskatoon

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The Amphitheatre at River Landing in Saskatoon saw some heavy foot traffic Saturday morning, as over 100 men and women braved the cold for the third annual Women’s March.


READ MORE:
Hundreds brave cold Calgary temperatures for 3rd annual Women’s March

Kate Lardner of the event’s Saskatoon chapter said more than 15 countries around the world are marching today, showing support for women’s rights.

“There is still disparity between the genders,” she said. “Globally, one in three women will experience sexual or physical violence in her lifetime, and in Canada it is especially evident for our Indigenous sisters.”

Mary Ingram, also with the Saskatoon chapter, said they want to see action and advocate for change around the world, including right here in Saskatoon.

“[We want to] share the message of stopping gender-based violence,” she said. “Focusing on violence against transgender women and Indigenous women”

WATCH: Alexandria Ocasio-Cortez speaks at 2019 Women’s March in New York City






People of all ages bundled up and braved the cold, including one passionate 11-year-old, Etta Love. She said 51 per cent of sexual violence happens to youth under the age of 16 and wants to take action for change.


READ MORE:
‘Support your sisters’: Protest signs from Women’s Marches across Canada

“That’s me and my peers for the next few years,” she said. “If we’re old enough to be assaulted, then we’re old enough to be angry and be activists.”

The Women’s March began in January 2017, following the inauguration of Donald Trump.

Larder said she believes the grassroots movement can make a difference for all women.

“We’re really hoping to raise awareness for gender-based violence,” she said, “hopefully to advocate for legislation not only for Indigenous women, but all women in general.”

Due to the cold temperatures, the March route was altered from past years. Organizers said they have already begun planning for next year and invite anyone to join them.

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Some Quebec universities, CEGEPs miss deadline for sexual violence policies – Montreal

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In Quebec, several CEGEPs and two universities have failed to adopt a policy to prevent and fight sexual violence on campus by the Jan. 1 deadline set by the province.

The provincial government published a list of post-secondary institutions on Thursday that have complied with the measure, including Concordia University and John Abbott College.

Two Montreal universities and more than a dozen CEGEPs are notably absent from that list — including McGill University, the Université du Québec à Montréal (UQAM), Dawson College and Marianapolis College.

READ MORE: Quebec sexual assault bill focuses on campuses

Bill 151 was passed into law by the previous Liberal government in December 2017 following several high-profile sexual misconduct allegations in Quebec.

It requires all post-secondary institutions to adopt a policy to prevent sexual violence by Jan. 1, 2019 and implement it by September 2019. It has to be separate from the school’s other policies.

Under the law, they must also have formal complaint procedures, safety measures for social activities and support services in place.

Montreal universities working to catch up

Both McGill University and UQAM said on Friday their institutions are working toward adopting a new policy.

At McGill, the current rule, which was implemented in 2016, remains in place.

WATCH: Concordia and McGill react to Quebec’s new campus sexual assault bill






“Throughout the fall of 2018, it has been carefully reviewed through extensive consultation with our campus stakeholders to ensure that our revisions to the policy reflect both the requirements of Bill 151 and the needs and goals of the McGill community,” said associate provost Angela Campbell in a statement.

“These revisions to the policy will come to the senate and the Board of Governors for approval this semester. In the meantime, McGill’s current policy and the resources associated with it to prevent and fight sexual violence, remain active and in force.”

READ MORE: McGill professors back students, call for external investigation on misconduct allegations

UQAM spokesperson Jenny Desrochers said the French-language university’s new policy surrounding sexual violence will be adopted over the next few weeks.

“In the meantime, our policy against sexual harassment is still in effect,” she said.

‘Unacceptable’ says minister who put forth law

Quebec Liberal MNA and former minister for higher education Hélène David, who put forth Bill 151, expressed her disappointment about schools lagging behind the deadline.

On social media, she described the finding as “unacceptable.”

READ MORE: Quebec unanimously passes motion to prevent sexual assault against athletes

“The fight against sexual misconduct must be a priority,” she said.

David also called on Quebec Education Minister Jean-François Roberge to intervene. She said he should put more effort into ensuring all universities and CEGEPs adopt the policy without delay.

© 2019 Global News, a division of Corus Entertainment Inc.

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Toronto’s rising violence can’t be blamed on the decline of carding

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The new year had barely been rung in —12:35 a.m. — when there was a fight on Queen St. W., the victim taken to hospital in critical condition.

By the time this column is published, that man might be Toronto’s first homicide of 2019, blood splatter on a fresh page as the calendar flips. If not him, some other poor soul.

Across the city, violence struck here, there and everywhere on Jan. 1: A shooting, a stabbing, a broken bottle ground into a male’s face, a hit-and-run collision, several vicious kicks to the head.

Doubtless, as right-wing editorial writers sharpen their pencils, as tabloid columnists crank out vilifying copy, somebody will blame the chronic mayhem on law enforcement stripped of their investigative tools. To wit: the curtailment — not necessarily the end — of “carding,” as mandated by Regulation 58/16, introduced by the previous Liberal provincial government in 2016.

The correlation is dubious.

That is one of the findings contained in a 310-page doorstopper of a report by Justice Michael Tulloch, the Ontario Court of Appeal judge tasked with reviewing how the regulation has been applied throughout Ontario and its effectiveness.

Read more:

Will Toronto see fewer killings in 2019? A violent year ends with record totals — and questions

Carding — a subset of street checks — is a bust, the regulation unevenly implemented, with cops largely uncertain of when they can legally stop and query, leading some jurisdictions to completely abandon face-to-face encounters with the public even when they might have reasonable cause to question, as long as it’s not random or arbitrary but based on intelligence-led “articulable cause,” a “constellation of objectively discernible facts.”

The language is lawyerly dense, which is an intrinsic fault of the regulation, writes Tulloch; perceived as “being too complicated and hard to follow,” written for lawyers, not police officers or civilians. “Even lawyers who I have consulted with agree.”

Example: The regulation sets out information that a police officer must record in a “regulated interaction” — those encounters which fall under 58/16. Yet the required information does not include the location of the stop or the age or the race of the person stopped. “Only by inference later in the Regulation — when such information is required to be analyzed — does it become apparent that such information must be recorded in every stop encounter.”

I’ve spent hours poring over the report and am still not altogether certain I understand all its contents. Whose brilliant idea was it to release the thing at 3 p.m. on Dec. 31, the day before a statutory holiday, to be speed-read by reporters, by which time it was well nigh impossible to reach experts in the field who might provide illumination.

Somebody in the government decided to pull that trick. A Tory government which did not set Tulloch upon this year-long review and which could, if it chooses, ignore its numerous recommendations completely.

Tulloch’s core recommendation is blunt: Random carding has minuscule value as a law enforcement tool and should be sharply curbed where it’s still being practised, specifically because its iffy value is not worth the damage caused to individuals — particularly those in disproportionately scrutinized minority communities, Black, brown and Indigenous — to say nothing of heightening distrust between those segments and police.

“It is recommended that the practice of randomly stopping individuals to gather their identifying information for the creation of a database for intelligence purposes be discontinued.”

Purely random stops, absent any discernible subjective and objective reason for doing so, based on some vague “spidey sense”: Never.

“A widespread program of random street checks involves considerable time and effort for a police service,” Tulloch writes, “with little to no verifiable results on the level of crime or even arrests.”

Many cops will disagree. It is precisely the “spidey sense” that informs their policing instincts as front-line officers with intimate knowledge of a place, a neighbourhood, a scene that feels wrong. But that can’t be enough, Tulloch argues, because of either tacit or overt biases. Under the regulation, race is absolutely prohibited in forming any part of a police officer’s reason for attempting to collect someone’s identifying information — information which no individual is compelled to provide unless police are making inquiries into suspicious activities, investigating an offence that has been or may be about to be committed, or gathering information for intelligence purposes, circumstances wherein a suspect can be detained or arrested.

Simply creating a database containing information on tens of thousands of people who’ve committed no crime — the crux of random carding — is a misuse of resources, an invasion of civil rights and indefensible.

It has become to too easy and knee-jerk malevolent to draw a straight line between carding reduced and gun/gang activity increased in Toronto in 2018. In fact, the Toronto Police Service had voluntarily curtailed street checks since 2014. There was nevertheless a significant decrease in gun deaths between 2016 and 2017 before last year’s surge. Between 2016 and 2018, Tulloch points out, the number of shootings declined by a combined 40 per cent in some designated high-priority neighbourhoods with historically high incidences of poverty and crime. Nor did a steep decline in street checks prevent Toronto police from a 65 per cent increase in gun seizures from 2017 to 2018.

More broadly, Ontario experienced the greatest reductions in homicides, along with Saskatchewan, in 2017, the year that the regulation came into effect.

“Overall, it is difficult to see anything contained in the wording of the regulation or in its proper application that would cause a spike in gun crime or violent crime,” writes Tulloch.

It may be true, however — and I wish that Tulloch had undertaken a deeper exploration of this area — that abandoning street checks has contributed to more flagrant gang activity in Toronto.

The argument pro random carding has become circular, says Tulloch. “Some police street checks were proper. The improper practice of random carding led to the Regulation. The Regulation led many police officers to not conduct any street checks, whether proper or not. The lack of any street checks at all might have encouraged some types of crime to increase. This increase in some crimes has led some people to argue that we should return to random carding. This assumes that it was the reduction of random street checks that caused the increase in some crimes, as opposed to the reduction of all street checks.

“The solution to these issues is not for police officers to fail to conduct street checks when it is prudent and appropriate to do so.”

Which means better understanding of the regulation, improved training and “supporting police officers who conduct proper street checks when there is a subsequent public complaint.”

Tulloch emphasizes that the regulation did not, does not, eliminate street checks. “Without any restriction, police officers can stop, question and ask people to identify themselves — if the officer reasonably suspects criminal activity.”

All that’s changed is that there has to be a good, justifiable or “articulable” reason for asking them to provide their identity.

“That is not an onerous requirement.”

Rosie DiManno is a columnist based in Toronto covering sports and current affairs. Follow her on Twitter: @rdimanno

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Toronto police chief on gun violence: ‘To think we can arrest our way out of this is a falsehood’

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“Not only did we have a high-profile homicide case to look after, we also had to respond to two mass casualty attacks that left a tremendous loss of life and lots of injuries for our citizens.’’

High-profile homicide case: A serial killer preying on the gay community, though Saunders had assured there was no such thing last December, despite tracking orders for the suspect obtained just days earlier, leading ultimately to the arrest of Bruce McArthur on Jan. 18.

Mass casualty attacks: The deliberate van rampage on north Yonge St. in April that killed 10 and injured 16, some critically; the lone shooter carnage on Danforth in July that killed two innocents and wounded 13.

“Two mass casualty incidents in such a short period of time,” said the chief, grimly, recalling a personal nadir for 2018. “I think that was a game-changer. It’s one thing when you’re dealing with gunplay. It’s another thing when you’re walking down the street and looking over your shoulder or you’re sitting in a restaurant with family and friends and the next thing…

“The general public really felt stung by the two mass casualties back to back and it’s still there.”

A year of ominous firsts for Toronto: An unprecedented 96 murders, 51 of them by gunfire; police had recorded 406 shootings as of Sunday. Mass carnage by disturbed individuals, the kind of extremist slaughter we believed, in our smug naïveté, only happened elsewhere.

So, yes, the statistics were skewed by two abnormal and deviant occurrences. But the shootings, my God the shootings.

“I’ve said earlier that most of our gun violence is street gang related and I stand by that. That’s not just Toronto, that’s all urban cities across North America. The street gang issue is our primary concern. Most people that are getting shot are people that are living a high-risk lifestyle, in conjunction with being associated to street gangs. That’s the root of the matter that we have to look at.

“The numbers are one thing. But people that are motivated to shoot other people I’ve got concerns with. If people think that it’s a matter of just arresting and all is well, that’s a far cry from the truth, a far cry from the right solution in today’s environment. You need to have the resources necessary, at the front end and the back end, and our enforcement piece in the middle in order to get this right.”

But what does getting it right mean, practically? Because there is widespread disagreement on where to stick the limited fingers — and the funds — in the dike.

Not carding — street checks which provided police officers with street intel yet was disproportionately borne by the city’s racialized communities and underprivileged neighbourhoods. The police board ended that, just as, three years ago, TAVIS (Toronto Anti-Violence Intervention Strategy) was disbanded.

“To think we can arrest our way out of this is a falsehood,” Saunders stated bluntly, when asked about the ramifications of ditching carding and TAVIS, which some believe has led directly to brazen violence and gangbangers laughing at police.

“Ninety per cent of these folks we arrest get out, will be out and will be continually released,” said Saunders, clearly a shot across the bow at the judicial bail system. He pointed to Project Patton — massive multi-jurisdiction raids in June that resulted in more than 1,000 charges against 75 accused and the largest weapons seizure in the city’s history. Yet most defendants cartwheeled right through bail court. “Some of those members that we arrested were people that were arrested in prior large-scale projects.”

Which might call into question the usefulness of such roust-out-of-bed raids. They certainly do disrupt gang activity and illegal weapons distribution, but only temporarily. Criminals reorganize, gangs reconstitute, the wheels of violence keep on turning.

And, it must be noted, the public by and large favours this type of interdiction. They see all those guns laid out on a display table at the cop shop and there’s a sense that something is being done. But it is not a sustainable solution to urban crime drenched in bloodshed, with innocents caught in the crossfire.

Repeatedly, Saunders advocated stronger community relationships and interlocking engagement — police, public, social agencies, partnerships.

“The enforcement piece plays an important part. I’m not here to say that it’s softer policing. I’m here to say that it’s smarter policing. There have to be agencies at the front end that prevent these young boys from shooting others. There’s a lot of funding that needs to be put in. Not grant funding; core funding, into the communities. Nobody’s ever, that I know of, born saying ‘I want to be a street gang member.’

“The enforcement piece is ours, and then the deterrent factor. When someone shoots someone, they’re going to jail. Developing the relationship piece is what’s critical, first and foremost.’’

This past year, 514 handguns taken off the street, 172 more than 2017. But the underlying factor is what seizes Saunders most. “What’s motivating people to use a gun to resolve issues? Those are things we can’t just do as an enforcement piece. It is necessary but it has to be streamlined, it has to be surgical, it has to be intelligence-led if we’re going to get it right.”

Distilled: “Arresting police is not a success story.”

Well, not so sure about that. We’ve had decades of trying to avert gang affiliation, keep young people off the criminal path via youth programs and precrisis intervention. Some community programs have worked better than others; there’s been precious little auditing of efficiency and always, always, more clamouring for funding. Yet the jails grow more crowded, the promise of opportunity shrivels, the lure of gangs enticing, distrust burgeoning.

“When we go into communities that don’t have the funding, that have no hope, that despair, 99 per cent of those members of the community are law-abiding,’’ Saunders emphasizes. “They care about their babies just like we all do. But at the same time, they have to deal with reality and they’re concerned for their safety.’’

The chief likened gangs to sports teams. “It’s not an individual sport. So when a member from Team A shoots a member from Team B in that particular neighbourhood, it makes it very hard for you as a mom or a dad to pick up the phone and say this is who did it and I saw everything. Because that one person gets apprehended but the rest of the team is still out there. There’s fear of retribution. I would like some methodology in which we can still get that information and translate it so we can make it into a courtroom somehow.”

Because people do call the cops, even in neighbourhoods with a long history of bitterness toward law enforcement. All levels of government, said Saunders, should examine procedures to ensure their safety in co-operating with police. “Our Criminal Code, I think it’s antiquated.”

Maybe so are our presumptions of criminality.

“I want to be candid. I don’t want to make this sound sexy. We take every single shooting seriously. If we have stronger relationships with the community, we have an opportunity to reduce that. But at the end of the day, when a young man takes a gun and shoots, there are different entities that are responsible for that. We are the aftermath of that. What is in front of that? What are the measuring tools to see whether or not things are successful?

“So to dump on me and say, what are you going to do about it? I’m going to educate the public and say if we’re going to do it right, it has to be collective. And I’m going to continue to deliver that message.”

He’ll be doing it, Saunders expects, with some 200 more officers hired by the beginning of 2020. He vows they will be deployed smart, where most needed — “district-focused.” And if the much-vaunted Toronto Police Service’s modernization plan continues as calculated, front-line officers won’t be wasting their time on low-grade call-outs that can deftly be handled by civilian employees, online and via an expanding roster of special constables to relieve the load on front-line cops.

Under that program, within its first 108 days this past year, special constables took on 23,000 calls, Saunders pointed out, amounting to 3,300 hours of police work, which simultaneously reduced the response time on urgent calls.

A city of 2.8 million people. Two million calls to police this past year. Five million “contact points” between police and the public.

“Throughout the year, despite everything that happened, our members have truly done outstanding things. They’ve rescued people from drowning in an elevator. They prevented suicides. They’ve rescued people and pets from freezing water. They brought shoes to homeless people. They’ve supported families by purchasing groceries. They’ve walked into gunfights, knife fights, saved lives and continued to make arrests when needed.”

But has any of it made a difference to the quality of life in Toronto?

“Depends on who you ask.”

Rosie DiManno is a columnist based in Toronto covering sports and current affairs. Follow her on Twitter: @rdimanno

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St. Mike’s hospital trauma surgeons are using battlefield techniques to treat victims of gun violence

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“One major difference is that today, when someone comes in, we start to give them a blood transfusion very early on,” he said, noting that until just over a decade ago, these patients were immediately given saline IV fluids with blood to follow.

But a 2007 study, of which Rizoli was a contributing author, showed that trauma patients suffering from major hemorrhagic bleeding have much better outcomes if they are immediately given massive blood transfusions.

“They do much better if they get blood from the start,” he said.

Many of these survivors owe their lives to the health professionals such as Rizoli.

St. Mike’s — one of three trauma centres in the city — sees about one shooting victim a week and is able save approximately 80 per cent of them, Rizoli said.

The Star recently spent some time with a Rizoli and the team of trauma surgeons at the hospital to learn how they are trying to keep more of these patients alive.

Rizoli said it stands to reason that shooting victims are faring better today. The increase in gun violence sadly means trauma surgeons are getting much more experience in dealing with these patients.

These days, St. Mike’s averages about one victim of gun violence a week.

“During my training 25 years ago, gunshot wounds were uncommon and many Canadian surgeons had to train in the U.S. to gain experience in treating them. The growth in the number of victims to gun violence and the progression to more lethal weapons had been fortunately balanced by enormous advances in trauma science and practice,” Rizoli said.

Advancements have been made in research, technology, drugs hospital design, workflow, protocols and best practices, he noted.

Much of the learning has come from the battlefield.

“We have learned from wars that patients who have lost a lot of blood cannot clot appropriately,” Rizoli explained.

They suffer from what is known as “trauma-induced coagulopathy,” and if not treated quickly, it can lead to a patient bleeding to death.

“We give them blood, and tons of blood, to start with. Then we try to diagnose, as quickly as possible, exactly what is wrong with their coagulation,” Rizoli said.

They do this by using a piece of equipment, purchased by the hospital about five years ago, which quickly analyzes blood-clotting properties. Called ROTEM, short for rotational thromboelastometry, it guides health professionals in determining what blood products trauma patients require so that their blood clots properly.

St. Mike’s surgeons have recently begun to use another technique developed on the battlefield, this one to stop traumatic bleeding.

The minimally invasive procedure is known as REBOA, or Resuscitative Endovascular Balloon Occlusion of the Aorta. It involves running a catheter up the femoral artery and into the aorta. A balloon at the tip of the catheter is inflated, stopping the flow of blood.

The procedure can be done in the trauma bay. Previously, patients would have been moved to the opening room where their chests would be opened and aortas clamped. That took much longer, was more invasive and carried a higher risk of death.

Before using the new REBOA catheter on patients, St. Mike’s tested it out on a high-tech mannequin. The simulation served to educate those in the trauma program — including nurses, respiratory therapists and surgeons — on how it works.

“It’s like crash-testing a car. You wouldn’t drive a car if it hadn’t been crash-tested first. We do the same thing with new processes. We crash-test them and make sure they work like we anticipate they will,” said Dr. Andrew Petrosoniak.

He and colleague Dr. Chris Hicks are emergency physicians, trauma team leaders and simulation educators at St. Mike’s. Their work on simulation exercises has helped improve the workflow in trauma resuscitation care. It has also informed the design of a new trauma bay at the hospital, scheduled to open in 2019.

One of their exercises involved tracking the movements of three nurses treating a simulated trauma patient. It was videotaped and the movements of each nurse were followed, using an overlay tracing tool, with a different colour for each nurse.

The end result looked like colourful child’s scrawl to the untrained eye. But to Petrosoniak and Hicks, it revealed how the nurses lost time criss-crossing the trauma bay to get different pieces of equipment.

If the equipment needed was closer at hand, nurses would need to criss-cross the room and seconds could be saved. There would be less risk of nurses bumping into each other and dropping instruments.

“So now we understand where they’re moving and we can improve their efficiency,” Petrosoniak said. “The whole point of efficiency is to get the care faster. If you are thinking about gunshot wound patients, time matters significantly.”

Hicks said the information has also been used in the design of the new trauma bay to show how much room is needed around each bed.

The pair have also worked on creating a new “massive transfusion protocol.” They examined steps taken by everyone involved in the transfusing large amounts of blood into trauma patients.

That includes, as an example, porters charged with picking up blood from the blood bank at the other end of the hospital and carrying it over to the trauma bay.

Petrosoniak and Hicks realized seconds could be lost by waiting for an elevator, so now porters must take the stairs. As well porters must announce themselves when entering the trauma bay instead of waiting to be noticed.

Through changes such as this, delivery time for blood has been cut by 12.5 per cent to nine minutes.

“In the past you might have been waiting for blood,” Hicks said, citing research showing that every minute blood is delayed results in a 5 per cent increase in mortality.

Trauma surgeons at St. Mike’s are also working to reduce the need for their services by campaigning to reduce access to guns. Two surgeons with much to say on this happened to be on duty the night of the Danforth shooting in July. Drs. Najma Ahmed and Bernard Lawless say that the Danforth shooting prompted them to increase their activism.

“I think there is greater public awareness that this is a public health crisis. I think there is also greater awareness that guns can be lethal beyond just crimes. They are very often used in adolescent suicide in Canada,” Ahmed said.

This past fall, she helped draft a position statement, calling for limited civilian access to firearms, and then assisted in getting endorsements for it from medical associations, including the Trauma Association of Canada and the Canadian Association of General Surgeons.

She and Lawless have also been lobbying politicians to take steps to crack down on gun violence.

“Dr. Ahmed and I have been contacting decision-makers at all levels,” Lawless said. “It’s going to take political fortitude to make change. When you look at this from a common sense perspective, it’s really not a difficult issue.”

Calling gun violence a “disease,” Ahmed said it makes perfect sense for physicians to be involved in trying to eradicate it.

“It has its own risk factors and own epidemiology, its preventable strategy,” she said.

Lawless said the profession has a long history in working on injury prevention: “Trauma surgeons have long played a role in injury prevention, whether it’s around seatbelt use, drinking and driving, and even working with engineers on how cars and roads are designed.”

Rizoli said diseases can be eradicated and points to smallpox as an example.

“No one should be injured by a disease that is completely preventable. No one in Canada should he a victim of gun violence. There could come a time when this could end.”

Theresa Boyle is a Toronto-based reporter covering health. Follow her on Twitter: @theresaboyle

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Alberta yellow vest protests lack violence seen in Paris, but anti-immigration anger simmers

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Four people were killed, hundreds injured and streets were littered with flaming cars and broken glass as thousands clad in yellow vests partook in violent protests in France in recent weeks against a planned increase to the fuel tax.

The protest movement has now spread across the globe, but in Alberta, which may be Canada’s centre of anti-carbon-tax discontent, the yellow vest protests Saturday were free from physical violence.

« We are Canadian, we’re not anywhere close to that kind of radical, » said Allison Prentice, who was clad in a yellow vest at the Calgary protest. « I’m proud to be here and represent people who care about Canadians first. »

The burning anger, which seemed to be lit by multiple fuses, still meant threats of violence were on the lips of some attendees who linked frustration over economic woes caused by low oil prices to the country’s immigration policies.

In Calgary, more than 100 protesters, some accompanied by dogs also decked out in yellow vests, chanted « No Trudeau. No Trudeau » outside of city hall. Some yelled « String him up, » others yelled « traitor. »

« They hate our country and they hate our way of life, » yelled one speaker through a megaphone, to cheers and whistles, not specifying who « they » are.

Calgary police said the rally was peaceful and no protesters were arrested.

Yellow vest protesters, including Rudy the corgi, waved signs and chanted ‘No Trudeau’ outside Calgary’s city hall Saturday. (Helen Pike/CBC)

Edmonton also saw a large protest, with about 150 people marching from the Legislature to Churchill Square, carrying signs, some reading « No Global Climate Pact. Suicide. »

Multiple posts on Canada’s yellow jackets Facebook page called for more drastic action.

« Look at France today. After four weeks of burning the cities, the French government cut the carbon tax. So what do we want? 90 years or four weeks until something changes? » wrote Robb Kerr on the group’s page. « If you want to crush a government, you have to play their game … You want to see them jump? Then burn down City Hall. »

The protests were jointly against the provincial and federal carbon taxes, and Canada’s plan to endorse the United Nations’ migration pact, which outlines objectives for treating global migrants humanely and efficiently.

Yellow-vest-clad protesters hold signs outside Calgary’s city hall on Saturday. (Helen Pike/CBC)

« I’m here for primarily the fact that I know many people who barely get by month to month, so until we can take care of our own, I’m concerned that the money we don’t have are going to people that don’t have the right to have it, before our own, » said Prentice.

Attendee Peter Lebrun said he feared the non-legally-binding UN Global Compact on Migration would harm the country.

« I think that opens up a lot of possibilities that would prove to be negative to Canada as a whole, » said Lebrun, another attendee at the Calgary rally.

Members of Soldiers of Odin were also in attendance in Edmonton and Calgary. The anti-immigration group was founded in 2015 in Finland by a white supremacist.

Members of anti-immigration group Soldiers of Odin, which was founded in Finland by a white supremacist, attended Saturday’s yellow vests rally in Edmonton. (Scott Neufeld/CBC)

Stephen Garvey, the founder of National Citizens Alliance, a Calgary-based anti-immigration political party, and one of the organizers of the Edmonton rally, said the sentiments expressed at the events have been building over some time.

« There’s massive censorship of media, » said Garvey. « This is un-Canadian … Canada has to be about the Canadian people. It can’t be about people sold out to some globalist agenda to the U.S., in Ottawa. »

Speakers at both rallies decried the media, saying there hasn’t been enough attention paid to their cause.

« There’s no media outlet here today. The Liberals bought CBC. They’re not coming, » said one protester in a Facebook live video of the Calgary event. 

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Family of Toronto van attack victim launches foundation to end violence against women

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The family of a woman killed in the Toronto van attack has launched a foundation in her name to help women suffering from violence and abuse.

Anne Marie D’Amico was among the 10 people killed in the van attack that struck Toronto’s north end in April.

The Anne Marie D’Amico Foundation was launched on Dec. 3, which would have been D’Amico’s 31st birthday.

Following her death, D’Amico’s friends and family described her as a cheerful, friendly person and a dedicated volunteer.

« I think her spirit is something that’s going to live on, » her brother Nick D’Amico told CBC Radio’s Here and Now this week. « That was really what we were trying to capture here. »

In its mission to end violence and abuse against women, the foundation will begin by raising money for the North York Women’s Shelter, which is in the process of building a new facility.

Foundation is ‘grounding point’ for family

« It’s appropriate for the kind of situation that happened to my daughter, » said Rocco D’Amico, Anne Marie’s father.

« Rather than sprinkling our hard work throughout various organizations, we’ve decided to focus on this particular organization, » he said. « They do great work. »

The foundation is hoping to raise $3 million for the new facility.

There are also plans to host an annual fundraiser, called the Turtle Project, on D’Amico’s birthday. The event will feature entertainment and stories from survivors of abuse.

« Just having this foundation as a bit of a cornerstone, a bit of a grounding point for us, has really kind of brought us through a lot of the darkness, » Nick D’Amico said.

« This will be what I’m going to be doing for the rest of my life, » Rocco D’Amico added.

Alek Minassian, 26, of Richmond Hill, Ont., is facing 10 counts of first-degree murder and 16 counts of attempted murder in connection to the attack.

His trial is scheduled to begin in February 2020.

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Liberals double spending to tackle gender-based violence to $50M

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The Liberal government is more than doubling spending this year to tackle gender-based violence.

Today, Status of Women Minister Maryam Monsef announced $50 million to fund 60 projects across Canada that support underserved groups such as Indigenous women, immigrants and LGBT organizations.

In the era of the #MeToo and #TimesUp movements, federal funding was developed with women’s leaders who asked for more money over a longer timeframe to meet a growing demand for services.

« Gender-based violence must not be tolerated, and we will continue to work with survivors, community partners, the private sector and other orders of government to end gender-based violence in all of its forms, » Monsef said in a statement.

Funding will also go to projects that assist seniors, women living in northern, rural and remote communities, and people with disabilities.

Monsef made the announcement in Halifax, where she highlighted three projects:

  • The Antigonish Women’s Resource Centre to provide rural and remote residents more access to culturally relevant services.
  • The Sexual Assault Services Association and Avalon Sexual Assault Centre to identify and address gaps such as a lack of information, interpretation, or culturally appropriate programs.
  • The Nova Scotia Advisory Council on the Status of Women to provide culturally appropriate services, safe spaces and improve the health of survivors.

The funding is part of Ottawa’s strategy to prevent gender-based violence, help survivors and strengthen the legal system.

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More jail time won’t stop violence against Indigenous women, advocates say

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A Saskatchewan senator wants to stop violence against Indigenous women, but some say her plan could make things worse.

« I’m not sure this is the answer, » said Catherine Latimer, executive director of the John Howard Society of Canada.

Senator Lillian Dyck is proposing harsher sentences for those who commit violent crimes such as sexual assault, manslaughter or murder against Indigenous women.

« We are more likely to be victims of violence…there is no doubt we are more vulnerable, » said Dyck, Canada’s first female senator of First Nations descent.

Under Dyck’s bill, which has already been approved by the senate, an offender could face more prison time if the victim is Indigenous and female.

If you want to prevent violence, you have to actually focus on prevention, not on these suppression tactics.– Stan Tuinukuafe, president of STR8UP

She said Indigenous women face far higher rates of violence than anyone else, citing the research of the ongoing National Inquiry into Missing and Murdered Indigenous Women and Girls, as well as her own analysis.

Dyck said Indigenous women are not valued by society or by the justice system and called her bill one possible solution.

‘This will not help’: advocate

The bill isn’t sitting well with Latimer and others.

According to Dyck’s study, 66 per cent of the offenders she’s targeting are Indigenous men. Locking them up for longer periods of time, in jails and penitentiaries already overflowing with Indigenous people, is a bad idea, critics say.

« Is giving Indigenous men longer prison sentences the answer? This will not help, » said Stan Tuinukuafe, president of Saskatoon-based STR8UP, which works on the street and in prisons to help people leave gangs.

Latimer and Tuinukuafe say the bill will not attack the cause of the violence and injustice. Family supports, addictions treatment and job training would be a much better investment than warehousing Indigenous men in prison, they say.

« If you want to prevent violence, you have to actually focus on prevention, not on these suppression tactics, » Tuinukuafe said.

Bill contradicts Indigenous sentencing principles, advocates

They said this bill could also create a legal mess.

They say it could contradict decades-long efforts to educate the courts about residential school trauma and racism faced by Indigenous offenders.

Canada’s criminal code now instructs judges to consider « all available sanctions, other than imprisonment… with particular attention to the circumstances of Aboriginal offenders. »

A Gladue report, evaluate an Indigenous offender’s background, can be requested in court. Gladue reports emerged from a 1999 case involving an Indigenous woman convicted of manslaughter in the stabbing death of her husband. Judges are instructed to emphasize restorative and community justice.

The Calls to Action of the recent Truth and Reconciliation Commission of Canada challenge all levels of government to « commit to eliminating the overrepresentation of Aboriginal people in custody over the next decade. »

Indigenous female victims should be top priority: Dyck

Dyck agreed there are too many Indigenous people in Canada’s prisons, but said many have forgotten about protection and justice for vulnerable Indigenous women who are victimized. Those victims should be the top priority, she said.

She said judges and many others are starting to agree that the system has tipped too far in the other direction.

« The judges are now saying, ‘Why am I giving him special consideration when she’s just as Aboriginal as the offender? Does she not deserve the same level of consideration?' » Dyck said.

Dyck said the bill is necessary to protect Indigenous women, no matter the race of the perpetrator. She said she’s open to amendments, and hopes it will spark a national conversation on the issue.

The bill has been introduced in the House of Commons. Dyck said she is confident it will eventually pass.

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