The woman behind the Marie Stopes first abortion clinic in Ireland
Dawn Purvis says: ‘We want to concentrate on the men and women who need our services. They are our priority.
Looking out of the window’s from her new office, with its dramatic view of the Belfast skyline, Dawn Purvis says she never expected to be standing here.
The former leader of the Progressive Unionist party is the director of the city’s soon-to-be-open Marie Stopes clinic, which will offer abortion services in Northern Ireland for the first time. After consultation, and if medically eligible, clients with pregnancies of less than nine weeks’ gestation will be able to have nonsurgical terminations.
It is quiet in this room high above the city, yet Purvis expects that, in certain quarters, reaction to the centre will be vehement. In the minds of some, Purvis has done the unthinkable. But she is calm and ready for whatever lies ahead.
“I am pro-choice. I understand that there are people who are anti-choice. It may be on religious grounds; they may have strongly held moral views,” she says. “But I don’t understand their reasons for not allowing a woman to make up her own mind about her own body, in consultation with her doctor. It is down to the individual woman. It is always her choice.”
Purvis has come a long way from her early days as a fledgling member of the Progressive Unionists, a small left-wing political grouping linked to the Ulster Volunteer Force. Encouraged by her mentors, David Ervine and the former UVF leader Gusty Spence, Purvis rose quickly through the ranks of the party.
In 2007, after Ervine’s sudden death, she was made leader of the PUP. But her leadership was constantly tested by the violent insubordination of UVF elements, and in 2010, when members of the paramilitary group shot dead Bobby Moffett, a former loyalist prisoner, in daylight on Shankill Road, she had had enough. Purvis resigned from the party, saying that she could not defend the indefensible and that the UVF were more trouble than they were worth.
She stood as an independent in the Assembly elections of April 2011 but was unable to keep her seat.
Setting herself up as an independent consultant, she began working for Marie Stopes International, the UK provider of sexual and reproductive healthcare services, with a view to opening a clinic in Northern Ireland.
“I started preparing the ground, making contacts, consulting with people such as the FPA [the Family Planning Association, a sexual health charity]. If you’re going to invest time and resources in a new area, you also need to be sure that there’s a proven need for those services. For that, you need to look only at the number of women from Northern Ireland who go to England for abortions every week.”
In August of this year Purvis took on a full-time role at the purpose-built Marie Stopes clinic, which offers contraceptive options, HIV testing, STI testing and treatment, and ultrasound scanning, as well as medical abortion to anyone over 16.
As for the legal side, Purvis is confident that the clinic and its services are viable within existing laws. The Offences Against the Person Act of 1861, places a legislative restriction on abortion in Northern Ireland. The 1945 Criminal Justice (Northern Ireland) Act, which allows the abortion of a child “capable of being born alive” only where the mother’s life would be otherwise at risk, is also applicable.
The FPA has long fought for clear guidance for health professionals on terminating pregnancy. Last month the high court granted the FPA permission to challenge the government’s alleged failure to issue new guidelines on abortion.
Given the context of opposition to abortion among religious campaigners and politicians in Northern Ireland, isn’t Purvis concerned about challenges to the clinic’s position?
“I think there will be a mixed reaction. There are those who have been waiting a long time for what we are offering. Others will not be so welcoming; that’s to be expected. But we have taken legal advice, and we will be operating within the current legal framework: when the risk to a woman’s life is determined to be a permanent, long-term and serious threat to her physical or mental wellbeing. So it’s difficult to see where such a challenge could come from. Besides, those who oppose us are not our focus. We want to concentrate on the men and women who need our services. They are our priority.”
Nobody will be persuaded to have an abortion that they are unsure about. “It’s about choice, every step of the way,” says Purvis. “The full range of options – adoption, continuation of the pregnancy, termination – will be discussed, as well as the personal circumstances of the woman, her state of health and available family support. In the end it’s a decision about a woman’s health that she should make in conjunction with her doctor. That’s what we’re providing here.”
The site for the clinic has been chosen with the needs of women in mind. “We have deliberately chosen a multiuse, multitenant building on a busy street, with lots of footfall and access to good transport routes,” says Purvis. “In the event of protests we will be taking measures to reassure our clients, working with the management company that owns our premises and with the PSNI. There will be an ongoing assessment of our security needs. For us that is paramount.”
Purvis’s route to her current role as director of Marie Stopes Northern Ireland may have been circuitous, but it’s not as unlikely as it may first appear. “I grew up in the place I still live, Donegall Pass [in south Belfast]. As a child I heard women whispering about girls who had got into trouble, and I wondered what they had done that was so awful,” she says.
“When I got involved in politics, for me being pro-choice was part of my psyche, my political make-up. David Ervine was absolutely pro-choice; it was party policy. I was glad when I was elected, because it gave women a voice.
“I draw strength and motivation from helping the women and men who will walk through the doors of this centre. No shame, no embarrassment, just somewhere they can come where they will be treated with sensitivity and respect, and where they won’t be judged. I’m proud of that.
“You need to be true to yourself, true to your beliefs,” says Purvis. “I’m doing this because it’s the right thing to do and the right time to do it.”
Ireland’s cheese makers can now advertise their cheese as ban is lifted
The Broadcasting Authority of Ireland has granted an exemption for the advertising of cheeses
There was gratteee news for the cheese makers of Ireland who got their whey this morning when the Broadcasting Authority of Ireland (BAI) confirmed that when it comes to advertising cheeses on television, it has decided to let it brie.
Last March, the State’s broadcasting watchdog published a draft advertising code that proposed banning cheese advertising from children’s television because of its high fat content.
“You gouda be kidding,” was the response from the general public and the dairy farming lobby who feared the ban might be a feta accompli. The howls of outrage appear to have been heeded by the authority, however, which this morning published its revised code and exempted all cheese from the ban.
The authority said it had followed the Department of Health’s recommendation and exempted cheese from a new advertising system that is to come into effect in the middle of next year.
Under the new code, all commercial communications for food and drink that are deemed to be high in fat, sugar and salt will not be permitted in children’s programmes.
Restrictions to such foods will also apply to commercial adverts that are broadcast outside of children’s programmes but are directed at children. Ads will not be able to include celebrities or sports stars or cartoon characters.
Although cheese ads will be broadcast, they will have to include an on-screen message indicating the recommended maximum daily consumption limit.
BAI chief executive Michael O’Keeffe said cheese had been taken out of the nutrient profiling model because of “the health benefits and the economic and cultural significance of cheese in an Irish context”.
The big cheese at the Department of Communications, Pat Rabbitte, welcomed the decision. “This is a commonsense decision from the BAI and demonstrates that the consultation process has worked well,” the Minister said.
Food and Drink Industry Ireland (FDII), the Ibec group that represents the food sector, also welcomed the lifting of the ban, but said the newly published advertising code was based on flawed science and would have little impact on childhood obesity rates.
“The nutrition model in the code is simply copy and pasted from the UK, without any reference to valuable Irish research on the subject,” head of consumer foods Shane Dempsey said.
“The UK system is unscientific, out-of-date and based on the concept of a 100g measure rather than on the actual amount people eat. This means that foods such as dairy and cereal products, which are vitally important to Irish children’s diets, are classified as unhealthy.”
The big challenges in life of having a mentally ill parent
Chelsie Santoro has a beagle, a sparkly temporary tattoo fading from her neck and a dad who lives with mental illness.
“Say you had a dog and you’re not controlling it,” the 9-year-old Montreal girl says one afternoon during a quiet chat on the couch in her basement playroom.
“Well, it’s going to get out of hand and you’re going to be very frustrated about it. It’s the same thing about mental illness — that you have to control it to be happy.”
Chelsie’s father, Mike Santoro, has schizo-affective disorder, most easily explained as a combination of bipolar disorder and schizophrenia — dizzying highs and debilitating lows blended with a loss of contact with reality.
Most of the time the 44-year-old man, who promotes mental well-being through public speaking engagements and a website called Mike’s Story, is able to control his illness with prescription drugs and coping strategies.
But when he has to change his medication, notes wife Bonnie Parsons, she walks on eggshells. As for Chelsie, “(I) go with the flow,” she says of his bad days.
Still, Parsons, 42, who works in the main office of a high school, says she and Santoro started a family with eyes wide open to the challenges they would face with one parent having a severe mental illness.
Children growing up with a mentally ill parent, experts say, are vulnerable to an array of difficulties, including: low self-esteem, trouble with relationships, taking on adult responsibilities, guilt, poor communication skills, risky behaviours involving drugs, alcohol and sex, trouble fitting in or performing well at school, feelings of isolation and alienation due to stigma, and the disruption that comes with hospitalization of a parent or, in many cases, removal of the kids from the home.
They may also develop mental-health issues themselves, because of hereditary factors and the strain of growing up in a difficult environment.
And often these children fall through the cracks as health-care and social programs focus on the affected adults, offering few services to their children.
Statistics on the number of Canadian kids growing up with mentally ill parents are hard to come by, but an oft-repeated estimate is that one in five people will develop a mental illness at some point in their lifetime.
For an article published in Child and Adolescent Psychiatry and Mental Health in 2009, a group of Ontario-based researchers used data from the Canadian Community Health Survey to estimate there were 570,000 children under age 12 — about 12.1 per cent — who lived with parents who had mood, anxiety or substance-abuse disorders in the year leading up to the survey.
The study authors believed the real number was higher.
Chelsie understands that, in the summer, her dad cannot always accompany her and mom to the beach, because the heat aggravates the side effects of his medication.
Or that not every day is a good day to play that game in which he picks her up and swings her around, the one that makes her giggle.
Her dad remembers a time in the spring when he was preparing for a string of out-of-town presentations while Chelsie had the day off from school.
“It was like a pressure cooker,” Santoro says while sitting across from Bonnie at their kitchen table. “I was about to explode.”
“Chelsie, you realize Daddy’s having a bad day today,” Santoro recalls having told his daughter.
“Yes, Daddy,” she replied.
“She basically made me understand that it was okay to be the way I was that day,” Santoro says.
The couple says they strive to be open and honest with Chelsie.
“If she’s old enough to ask the question, she’s old enough to hear the answer,” Santoro argues.
Not every parent follows this approach.
To research how children perceive mental illness, Elaine Mordoch, an assistant professor of nursing at the University of Manitoba, interviewed 22 Canadian children and teens whose parents had a primary diagnosis of bipolar disorder, schizophrenia or depression and were receiving treatment.
One 9-year-old boy had overhead his family discussing his father’s condition and his inability to get life insurance — presumably in the event of suicide.
The child described mental illness in those terms.
“It’s not that fun, you don’t get life insurance,” said the boy, according to the 2010 article Mordoch wrote for the Journal of the Canadian Academy of Child and Adolescent Psychiatry. “That’s kinda (sic) bad thing, I think.”
The boy paused before asking a burning question.
“What’s life insurance?”
Susan Nathiel, a family therapist in Hamden, Conn., interviewed many women whose mothers had mental illness for her 2007 book Daughters of Madness, in which she chronicles in harrowing detail what happens to families without a support network or the honesty required to speak to children about mental illness.
“Young kids do pick up the vibes of strange things happening, and if they don’t have an explanation, they make up one,” Nathiel said in an interview with the Star. “The made-up one is usually a lot worse than what is actually happening.”
The list of things that Joanne Smith (no relation to this writer) was told while she was growing up is, in hindsight, heartbreakingly simple.
“Your mother is ill.”
“It’s not your fault.”
“This is what she has.”
“This is the treatment.
“Don’t worry: we’re going to take care of things.”
That last one makes her laugh.
Smith, a 61-year-old who lives in Montreal’s West Island, says it was painfully obvious her mother was extremely unwell years before she was eventually given a diagnosis of schizophrenia.
She managed to keep the house clean and rose early every morning to go to work, but the words coming out of her mouth could be gibberish, and Smith was astonished when relatives would nod as they listened to her as if nothing was wrong.
She drank most nights, as did Smith’s father, and they could be violent with each other.
Mom once showed up at Smith’s high school, telling the principal that students were trying to poison her daughter.
Smith left home at 15 to study at a convent in small village near Lancaster, Ont. Within a week, her mother broke down physically and mentally, spending six months at a mental hospital and finally getting a diagnosis and treatment.
Their father decided he was incapable of caring for Smith’s two younger sisters on his own, so they were placed in separate foster homes.
For years, Smith says, she felt guilty about wanting to leave her chaotic home to have a better chance of graduating from high school, and thus sparking the series of events that tore her family apart.
Smith, who used to facilitate a support group for the adult children and siblings of people with mental illness at the Montreal community organization AMI Québec, uses the imagery of an octopus to describe how her dysfunctional childhood has affected her life as an adult.
Its tentacles wrapped around her relationships, her choice to go into information technology as a career, her ability to communicate, her low self-esteem and other things she is only beginning to realize — despite having spent thousands of dollars on years of therapy — now that she is retired and has more time to think about it.
“Being a child of someone who suffers from mental illness can run into all aspects of your life,” she says.
Early research into the impact parents with mental illness have on the well-being of their children focused on hereditary factors: what was the increased likelihood that a child whose mother or father had schizophrenia would develop the disorder too?
The debate of nature versus nurture still rages, as it does with much else, but since the true causes of mental illness remains unresolved, there has been an increasing focus on the psychosocial impact on the children of mentally ill parents.
Dr. Simon Davidson, a psychiatrist and chief of specialized mental health care for children and youth at the Children’s Hospital of Eastern Ontario and The Royal Ottawa Mental Health Care Centre, says the stress on the kids can manifest itself in a variety of ways.
“In some cases, you can see role reversals where the kids are really trying to take responsibility for the parents to make sure that they take their medications, that they get to their appointments on time and all that sort of stuff, often at a cost to their own personal development,” he notes.
“So, their schooling might suffer, their friendships might suffer, but the integrity of the family stays whole and these young people do a wonderful job well in excess of their years.
“Then you get others that just get so ticked off with everything and get themselves into high-risk situations. They maybe get into relationships inappropriately, they maybe try smoking and drugs and alcohol early, they may themselves have mental health problems.”
But Davidson observes that there are also some families with a mentally ill parent in which “the kids have a very normal developmental profile. Often in those family situations, the support network within the family, including from (the ill parent), is generally a whole lot better.”
Nursing professor Mordoch acknowledges that while working as an acute psychiatry nurse, she saw mentally ill parents at their worst as they arrived at the hospital in crisis. Later, when she became a researcher, she learned a lot from children who spoke of their love for their parents and stressed that they were capable of good things, too.
She chuckles as she recalls how one child put it: “It’s not 24-7, you know.”
“The children had the ability to see their parents holistically and to validate the contributions that the parent had made to their experience,” Mordoch says. “I was not really expecting that. I was expecting more tales of woe.”
Lily, 17, is fiercely loyal to her father, quick to emphasize how kind and loving he is before describing his decades-long struggle with addiction to alcohol and hard drugs and the mood disorder that has gone undiagnosed.
“My dad is a normal person, but exaggerated,” she says while sitting on a bench on the lakeshore boardwalk in her hometown of Burlington, Ont.
She chose not to use her real name to respect the privacy of her father.
“His good times are super-amazing and then his bad times are terrible and some of the issues that he has are overwhelming for him and for our family,” says Lily, who is now in her first year of university.
There is the backyard littered with projects that were very exciting when he started working on them.
Now, he cannot get out of bed to finish them.
There was the time last fall when he quit working — sold his company, even — without telling his wife.
Now, he is burning through money without explanation.
He has been to rehab three times in the past nine years.
Around Christmas last year, Lily found her father passed out in the living room.
She hid her discovery from her mother, fearing that letting her know would precipitate a marital breakdown that might make her father worse.
“Sometimes, I try and edit a bit so that he can stay safe and stay at home,” Lily says.
When it happened again the next day, Lily found the bottle of pills that he had overdosed on and realized she could no longer keep a secret that could turn deadly.
“I would like to have someone see me graduate or walk me down the aisle and I don’t really know if that’s going to happen,” she says. “He sometimes makes comments to that effect, that he does not want to be living a lot longer, and I don’t want to hear that. It’s kind of scary for me.”
Lily is keenly aware of the effect growing up with her father has had on her so far, and she sees it as both a negative and positive.
She openly admits to acting out and engaging in risky behaviour when things are tough at home, including smoking “a lot of pot” — she is happier now that she has stopped — and having to be hospitalized with alcohol poisoning after drinking too much on a trip overseas with a student group a couple of years ago.
“That was kind of a kick in the pants for me,” Lily says, remembering telling herself that yes, there were consequences to her behaviour and that they pointed in the direction of her father.
She believes she is blessed for learning so many hard lessons so young.
“When I was 12, my mother used to call me her little 40-year-old. I’ve always been the one that talks to the adults and a bit mature for my age and that’s just another thing that has allowed me to deal with it a lot better. I think it’s a good thing.
“I just think that kids are tougher than everyone thinks,” Lily continues. “If I tell my story to one of my friends, I get the pity look . . . but when I think about my story myself, I don’t have a lot of sadness.”
Diabetes foot ulcer link to early death
New study findings.
A major new study has found a link between diabetes-related foot ulcers and premature death.
According to the findings, among people with diabetes, those who go on to develop foot ulcers have a ‘considerably higher risk’ of dying prematurely compared to those who do not develop the foot ailment.
An estimated 191,000 people in Ireland have diabetes and one in six of these will develop a foot ulcer in their lifetime. It is already known that if an ulcerated foot becomes infected or if the blood supply becomes seriously impaired, amputation may be necessary.
However, this latest study reveals an even more worrying potential consequence.
Scientists in London looked at almost 18,000 people with diabetes, 3,095 of whom had been diagnosed with a foot ulcer.
They found a higher death rate among those with ulcers. In fact, among this group, there were an extra 58 deaths per 1,000 people every year.
The team also looked at eight other international studies, which had been published between 2006 and 2011. Participants in these studies were monitored for between two and 10 years.
These results showed that those with foot ulcers tended to have more heart-related risk factors, such as high blood pressure. They were also more likely to die from heart disease.
“Our research, which is the largest and therefore most reliable study to date, shows that people with diabetes who have foot ulcers are at considerably higher risk of an earlier death compared to those patients without,” explained study co-lead, Robert Hinchliffe, of St George’s, University of London.
He added that the reasons for this ‘are not entirely clear’.
The team said that these results emphasise the importance of good foot screening, as well as extra monitoring of the heart health of those who have already been diagnosed with foot ulcers.
Details of these findings are published in the medical journal, Diabetologia.
Three medical groups unite behind Ireland’s Children’s Hospital proposal
A number of medical groups have come together to support proposals to build the new National Children’s Hospital on the Connolly Campus.
Connolly Hospital in Blanchardstown, Beaumont Hospital and the Royal College of Surgeons in Ireland say this is the best option.
They say they have the capacity to deliver a fully comprehensive range of medical facilities on site.
The two hospitals will shortly operate as a single provider, giving them 1,100 beds.
Some Irish public service workers ‘earned up to 18.9% more’ than the private sector
Some public sector workers have earned up to a sixth more than people employed with private firms, it emerged today.
Official figures showed the pay gap varied from 6.1% to 18.9% in 2010 after qualifications, service and age are considered.
The largest gap was among those on the lowest incomes but it decreased as workers in both sectors earned more, according to the National Employment Survey 2009 and 2010 from the CSO.
“Overall, the summary results show that, on average, public sector employees had higher educational attainment, longer service, were older, and were more likely to be in professional jobs than their counterparts in the private sector,” the CSO said.
The study also revealed the gender pay gap was less in the public sector, with men earning an average 12% an hour more than woman hourly women, compared to a 21% gap in the private sector.
But statisticians warned the analysis does not compare similar jobs between the public and private sectors.
For example, gardaí and soldiers are found exclusively within the public sector, while jobs in accommodation, food services or construction are only in the private sector, it added.
The Irish Congress of Trade Unions later said that the data confirmed the need to avoid simplistic analysis and highlighted the problem in making comparisons between sectors.
General secretary David Begg said: “The new earnings data from the Central Statistics Office illustrated the difficulties in making straight like-for-like comparisons, especially as these often feed into stereotypes and caricatures that are of no help whatsoever to working people.
“The key issue was not possible pay differentials, but the collapse of demand in the economy, the lack of job creation measures and the failure of austerity to deliver a solution to the crisis.”
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