Transcript
Transcript: Reflections by Dr. Samantha Nutt
[00:00:00 A series of images of people walking along busy urban streets; a Canadian flag flying on the side of a building; an aerial view of Parliament Hill and downtown Ottawa; the interior of a library; a view of Earth from space. Text on screen: Leadership; Policy; Governance; Innovation.]
[00:00:16 Text on screen: Review and Reflection; Produced by the Canada School of Public Service.]
Introduction: Public servants, thought leaders and experts from across Canada are reflecting on the ideas shaping public service – leadership, policy, governance, innovation and beyond. This is the Review and Reflection series, produced by the Canada School of Public Service.
[00:00:25 Dr. Samantha Nutt appears full screen.]
Taki Sarantakis (President of the Canada School of Public Service): Welcome back to the Canada School of Public Service, to our Review and Reflection Series. Today, as always, we have a wonderful treat for you. We have Dr. Samantha Nutt. Samantha, welcome.
[00:00:33 Text on screen: Dr. Samantha Nutt, Founder and President, War Child Canada/USA]
Dr. Samantha Nutt: Well, thank you very much, Taki.
Taki Sarantakis: So, where were you born, Samantha?
Dr. Samantha Nutt: I was born in Scarborough, Ontario at Scarborough General Hospital.
[00:00:44 A photo of cars driving on the highway in Scarborough is shown with the text: "© EelamStyleZ, CC BY-SA 4.0, via Wikimedia Commons".]
Taki Sarantakis: Oh my God, Scarberia.
Dr. Samantha Nutt: I know.
Taki Sarantakis: Did you grow up there too?
Dr. Samantha Nutt: I did, Finch and Victoria Park. Right on the margins.
Taki Sarantakis: Do you know how close we were to each other? I grew up in East York and I was like St. Clair and O'Connor.
Dr. Samantha Nutt: Okay, that was close actually.
Taki Sarantakis: So, that's pretty close, and a lot of my relatives were in Scarborough and they had restaurants and dry cleaners.
Dr. Samantha Nutt: Yeah, yeah. Well, my friends in that neighbourhood were all Greek (laughs).
Taki Sarantakis: Exactly. So, you ate very well.
Dr. Samantha Nutt: I did. Yeah, I did.
Taki Sarantakis: And tell us a little bit, what did your mom do? What did your dad do?
Dr. Samantha Nutt: So, my dad was a shoe designer and an artist, and he worked for Bata when I was a kid and then worked for himself from the time I was about 14 on.
[00:01:26 The Bata logo is shown with the text: "© Tomas.russek, CC BY-SA 4.0, via Wikimedia Commons".]
Dr. Samantha Nutt: And my mom was a stay-at-home mom, but they were both immigrants to Canada. My dad came over when he was in his mid-twenties and my mom came over with her family when she was a baby.
Taki Sarantakis: And immigrants from where?
Dr. Samantha Nutt: My mom was from Scotland, from Edinburgh, and my dad is from Northumberland, Northampton area of the U.K.
Taki Sarantakis: Wonderful, and a shoe designer.
Dr. Samantha Nutt: I know.
Taki Sarantakis: So, are we supposed to think like Jimmy Choo and Ralph Lauren.
Dr. Samantha Nutt: No, no, no, no, no.
Taki Sarantakis: What are we supposed to think?
Dr. Samantha Nutt: Mostly, I think, early on, he started off in fashion. In fact, his best friend growing up was Andrew Oldham, who went on to be the manager for the Rolling Stones.
[00:02:08 A photo of Andrew Oldham and Mick Jagger is shown with the text: "© Dcameron814., Public domain, via Wikimedia Commons".]
So, he was part of that whole swinging sixties London scene before he came in. So, I think he was doing high fashion then. But from the time I was a kid, he was doing more sports-related fashion. So, he did running shoes, all the Sesame Street shoes when I was a kid, all the children's stuff.
Taki Sarantakis: So, do you remember Mr. Dressup?
Dr. Samantha Nutt: Yeah.
Taki Sarantaki: And Casey and Finnegan and all those?
Dr. Samantha Nutt: And Polka Dot Door.
Taki Sarantakis: Toronto things from the era, the Gentle Giant, the Green Giant.
Dr. Samantha Nutt: Yeah, the Friendly Giant, right?
Taki Sarantakis: The Friendly Giant.
Dr. Samantha Nutt: That's right, the Friendly Giant, and yeah, definitely Mister Rogers and the Polka Dot Door, for sure.
Taki Sarantakis: So, did you grow up your whole time in Toronto?
Dr. Samantha Nutt: No, the first six years of my life, I was born in Scarborough and then when I was about six months old, we moved to Africa because of my dad's job. So, we were based outside of Durban.
[00:03:03 A photo of Durban is shown.]
Dr. Samantha Nutt: And then, we came back when I was six.
[00:03:09 A photo of Toronto is shown.]
Dr. Samantha Nutt: And then, I was in Toronto mostly from the age of 6 to 17 but we did spend about half a year in Brazil, in São Paulo, where my father was working for a company called Sandak which made plastic sandals, when I was 13.
[00:03:15 A photo of São Paulo is shown.]
Dr. Samantha Nutt: So, it was a very interesting international way to grow up.
Taki Sarantakis: Who were some of your heroes as you were growing up?
Dr. Samantha Nutt: Most of my heroes were women who were doing amazing things, right? And women who had really compelling stories.
[00:03:44 The cover of the book The Diary of a Young Girl by Anne Frank is shown.]
Dr. Samantha Nutt: I read The Diary of Anne Frank when I was really young and found that profoundly moving, but I also loved Margaret Atwood.
[00:03:53 A photo of Margaret Atwood is shown with the text: "© Larry D. Moore, CC BY 4.0, via Wikimedia Commons".]
Dr. Samantha Nutt: I know I'm a total nerd. And actually, Margaret Atwood lives only a couple of blocks over from me now, and I sometimes see her in the neighbourhood and I'm a complete fangirl all the time because I remember reading all of her books, basically, growing up, The Handmaid's Tale and a number of others.
[00:04:08 The cover of the book The Handmaid's Tale by Margaret Atwood is shown.]
Dr. Samantha Nutt: And then, I was also a kid, right? So, you love all the Marvel comics and Aquaman and all those things too, right?
Taki Sarantakis: So, at some point, you started thinking about your profession. You ended up in probably the most noble profession, which is medicine. Did you always know? Did you have the bug from when you were little or is that something you grew into?
Dr. Samantha Nutt: No, I definitely didn't have the bug when I was little. Look, there's always that quintessential immigrant story, especially if your parents were artists, and it's like you need a solid job, right? We came to this country and sacrificed for you.
Taki Sarantakis: Even though we didn't know you.
Dr. Samantha Nutt: (laughs) That's right, even though they didn't know me, and there's that achievement-oriented track and pressure for sure, and especially, again, to have more financial and other stability than my parents had been able to have, not working in a sector like that. But no, actually, when I finished high school, I went on a scholarship to study drama and 19th century romantic English literature in the U.K., and my parents almost lost the will to live (laughs). It was just like, oh no, we raised her the wrong way, she's also going to struggle to find employment and be engaged in artistic pursuits for the rest of her life. But I think ultimately, even though I went on a different path, it certainly was great training and it's been useful.
Taki Sarantakis: As a little aside, tell us what your son is studying and what your reaction was?
Dr. Samantha Nutt: (laughs) He actually is in the School for Dramatic Arts at the University of Southern California in Los Angeles and he's doing a combined degree in the music industry. So, I always joke that the artistic gene skipped a generation because I can't even draw anything more sophisticated than a stick figure, and I wouldn't say I'm completely tone deaf but some people might (laughs). People who hear me do karaoke might tell you that.
Taki Sarantakis: So, now, you go to medical school, you graduate, you become kind of the apple of your parents' eye, you've got initials after your name. Tell us then what happened? Because you've not taken kind of, let's call it, the typical path of an M.D.
Dr. Samantha Nutt: It's interesting. I think my parents, one thing that was always wonderful is that they wanted me to make my own choices, and they always believed, and I think that was just how we were raised, right? In the eighties especially. It was very hands-off. Your parents didn't know where you were applying or what you were applying. It was just, okay, that sounds fine, but I was always interested, and I think partly because I did have those early formative experiences in different parts of the world and I was exposed to human rights violations and different ways of seeing the world and the challenges that people were facing, I was very interested in the intersection between health and human rights.
[00:07:22 A photo of a march against apartheid is shown with the text: "© Rob Bogaerts / Anefo, CC0, via Wikimedia Commons".]
Dr. Samantha Nutt: I marched against apartheid in South Africa when I was an undergraduate student. I was part of that Live Aid generation and was exposed to all of that. And so, even throughout my undergrad, I was very interested in human rights issues and I started to think about the intersection between health and human rights, and that was one of the reasons why I applied to medical school, and it was that passion, that conviction that ultimately led me after medical school to pursue public health and a scholarship program that I was on at the London School of Hygiene and Tropical Medicine.
[00:07:54 A photo of the London School of Hygiene and Tropical Medicine is shown with the text: "© Rob Bogaerts / Anefo, CC0, via Wikimedia Commons".]
Dr. Samantha Nutt: Where I did a Master's of Science in Public Health in Developing Countries.
[00:08:01 The UNICEF logo is shown with the text: "© Delehaye, CC0, via Wikimedia Commons".]
Dr. Samantha Nutt: And I was recruited by UNICEF to work in war torn Somalia as a volunteer during that experience because my thesis research was around violence and women's health and the intersectionality of that. And so, it wasn't a decision. I didn't go to medical school thinking I would become a war zone doctor or run an international NGO. I didn't even go to medical school thinking that I would be doing what I'm doing now on any level. It was just a series of incremental shifts in my perspective and the things that I was exposed to that led me to this place.
Taki Sarantakis: So, tell us now a little bit, you are the founder of an incredible little, well, it's not so little anymore, NGO called War Child Canada, also War Child USA.
[00:08:47 The War Child logo is shown.]
Taki Sarantakis: At one point, and we talked a little earlier, at one point, this organization that now operates around the world had one employee, or not even an employee, had one volunteer and that volunteer was you. Tell us a little bit about those early days.
Dr. Samantha Nutt: The early days were challenging. It's a really difficult thing to reconcile when you are really passionate about a cause and deeply believe in the mission and you can make sense of it and demonstrate the kind of impact and demonstrate the need, and yet for a lot of people who are not as immersed as you are in these issues, you don't necessarily have the personal experience or academic background, making the case for why this was necessary, what it would accomplish, what would make it different, was incredibly hard and there was this perception that what you're trying to build exists already, even though it did not. There were a lot of organizations that were heavily focused on short-term humanitarian interventions on food, water, shelter, blankets, the business of keeping people alive in difficult circumstances which is very necessary, but what was missing was an organization that was working in those environments to really foster and sustain peace and to build resiliency and to build better communities, and to create opportunities for people that would disrupt the cycle and this legacy of war and ultimately lead to more sustainability. So, creating the space for an organization that would focus on these things through education, through access to justice, through the protection of the rights of women and children, through economic development, convincing people of the primacy of that was very, very difficult. So, here we are.
Taki Sarantakis: So, you had this great idea, almost like an entrepreneur, you saw something that needed an organization to kind of fill in that vacuum. Tell us a little bit, what do you do when you're starting an international organization? Do you fundraise? Do you knock on doors? Do you cry? Do you laugh? Do you go to tuxedo-clad dinners? What's it like when you're starting off an organization like this?
Dr. Samantha Nutt: All of the above, except for the tuxedo-clad dinners because you're not being invited to those (laughs), not yet anyway. Look, the most important thing really is to have conversations, and it is to convince other people to join you in that effort so that you're not alone. And ideally, when those people come on board, they open up their networks and they create other opportunities for you. I didn't have any money. I didn't come from money. As you said, I was a volunteer staff of one with a cell phone and a backpack. I used my Aeroplan points that I had accumulated to fly to meetings and to do various things for quite a few years. But slowly, through persistence and through presence and through talking to other people who then become your anchor and your support network, they create other opportunities for you and we had some amazing, big yeses that came through after a couple of years of persistent badgering, but one of them was, I mentioned this earlier, one of them was Gord Downie and The Tragically Hip who did a huge launch event for us in Winnipeg at The Forks.
[00:12:16 A photo of Gord Downie is shown with the text: "© Ryan Merkley, CC BY 2.0, via Wikimedia Commons".]
Dr. Samantha Nutt: And then, the other big one was Denise Donlon who was the head of MuchMusic at the time, and I went in and had a meeting with her, and she said, great, let's do this, and it's a very funny story because she said, we're going to do a bunch of PSAs and we have all these artists that come through. So, Ricky Martin will do a PSA and the Foo Fighters will do a PSA and Beck will do a PSA and David Bowie will do a PSA, and I remember leaving the meeting, and I'm a doctor and I'm thinking, she can't be talking about prostate-specific antigens, can she? Because it sounds like I've done a lot of rectal exams. That's really all I know (laughs).
Taki Sarantakis: But they were public service announcements.
Dr. Samantha Nutt: Public service announcements. I had to call a friend of mine, Justin Poy, whose mom was Senator Vivienne Poy. And so, I had to call him and go, Justin, what's a PSA? Because in my world, it means something very different. He still laughs about it (laughs).
Taki Sarantakis: So, now, you're doing kind of two things, right?. Number one, you're doing medicine and you're going into war zones, which we'll talk about in a moment, but you're also building an organization at the same time. Did you find that challenging? Did you find it invigorating? Did you find it like you were doing trade-offs or were they complementary?
Dr. Samantha Nutt: I think when you're young, you don't necessarily feel the exhaustion in the same way. But yeah, I used to work emergency shifts. I used to work clinical shifts to be able to sustain myself and pay the bills and pay the rent. And then, the international stuff that I was doing was, at the time, certainly unpaid and just trying to make it go.
Taki Sarantakis: So, it was kind of like your hobby?
Dr. Samantha Nutt: Well, no, it wasn't so much a hobby. I was trying to build an organization and then you submit for funding for interns.
Taki Sarantakis: So, it was a side of a desk.
Dr. Samantha Nutt: Yeah. Well, actually, I would say the clinical piece was the side of the desk, the clinical piece made the other things go, but I did find that when I was able to get small grants and things, it was to hire summer students, to hire interns. And so, for a very long time, it would be me and people who were maybe five years younger than I was, and they would come on board and we would just try to make it work. But then, slowly, you'd start to demonstrate success and the more persistent you are and present you are, you start to build trust. And then, people began to invest in us and that's what made a difference. Young people especially did see some of those PSAs. They did see The Tragically Hip show. We started to make some documentaries that aired on MuchMusic that were financed by the various film and television funds that were available, and that really put us on the map and that raised the money that we then needed to be able to begin the programing side, very small, very incremental at first, mostly through funding of local partner organizations that we worked with. And then, we started to build our own presence up.
Taki Sarantakis: Yeah. Now, you and your colleagues, you go into areas of, is it fair to say largely kind of when a state has failed, a war zone, a famine, a coup, a failed coup, etc.? Tell us a little bit about the first two, three, four times you found yourself in that environment. You're a kid growing up in Scarborough in Toronto, and all of a sudden, you're in the Congo, you're in Sierra Leone, you're in Afghanistan. Tell us a little bit about that.
Dr. Samantha Nutt: Well, nothing, first of all, prepares you to be in a war zone. And I think that honestly, it's one of those things that if you think about it too much, you probably wouldn't do it in the first place. And for better or for worse, my first experience in a war zone was in Somalia during the mid-90s, during the famine.
[00:16:28 Photos of women and children in Somalia is shown with the text: "The U.S. National Archives, Public Domain, via NARA & DVIDS Public Domain Archive".]
Dr. Samantha Nutt: It was the second wave of famine to grip the country, and I was, as I mentioned, recruited by UNICEF because my thesis work was very much aligned. They were doing a major review, right on the heels of the Rwandan genocide, of the operations in Somalia that was right after the troops were withdrawn, that were deployed during Operation Restore Hope.
[00:16:50 A photo of women and children in Somalia is shown with the text: "National Archives at College Park – Still Pictures, Public domain, via Wikimedia Commons".]
Dr. Samantha Nutt: And the entire health infrastructure had completely crumbled. I mean, there was no functioning state. Somalia was the quintessential failed state at that moment in time, and I applied for this position because I felt that I would potentially be useful, that there was an alignment with the work that I was doing, that it would help UNICEF with their overall maternal and child health strategy and planning, and help them raise money, they were submitting this report to the UN Security Council, but I really didn't know completely what I was getting myself into. And yet, that experience fundamentally changed my view of the world, it changed my view of humanitarian assistance, and I would say it put the wheels in motion for where I am now in the sense that from that moment forward, all I saw were missed opportunities. I saw a system that was dangerously disconnected from the local population, where most of the expertise was external, that would chase the next crisis when it came up, where donor dollars would dry up when the media went home. And so, trying to address that gap and seeing what was working and what was not working became the impetus behind the creation of War Child Canada. So, it was a series of events that led to this. Was it growing up in Scarborough? Was it spending time in Africa as a kid? Was it being in Brazil as a teenager? All of these formative experiences? I think it was all of those things. But ultimately, I ended up precisely where I was supposed to be.
Taki Sarantakis: Yeah. Now, I think all of us have a certain admiration for doctors and nurses and people in the medical profession because it seems to somebody like me from the outside that they kind of run towards danger. That's their first inclination. A lot of us, our inclination is to kind of run away from danger. Were you always somebody that kind of ran towards the danger?
Dr. Samantha Nutt: I would say that I was always scrappy. I was the kid in the playground, if there was a bully that was picking on someone, and I'm not a big person, I say I'm 5'4", I'm kind of a little shy of 5'4", but I was always the one that would just get in there and try to make it right, even if I was the one in the end that would end up pummeled or have her bike stolen or whatever was going to happen. So, yeah, I wouldn't say I run towards the danger. I take my security very, very seriously. And as an organization, we obviously take our security very seriously. There have been instances where I have been caught, where the front line ended up right on top of me in those moments, car ambushes and other things like that. But in general, I think that doctors, you have this instinct to try to help and to preserve human life, and you don't necessarily appreciate or fully realize the threats to yourself in that. I wouldn't say it's an out-of-body experience but I would say that the drive, it takes over and some of that, when you start off, is an act of choice but then it becomes instinctive.
Taki Sarantakis: And I think a lot of us when we see stuff like this, we grew up at roughly the same time, is it like M*A*S*H? What's it like?
Dr. Samantha Nutt: Well, I'm a public health doctor, so you don't want me anywhere near an O.R. That's for sure (laughs). But yeah, it can be like that. It can be intense. When I landed in Somalia, the very first meeting I had with this Belgian guy, Jean, who was the head of operations there in Baidoa, which was the epicentre of the famine, 300,000 people had lost their lives, and we're in the middle of our security briefing, and he's got a walkie-talkie on the table, and suddenly, you hear gunfire and eruptions from the walkie-talkie and he has to pause the briefing to speak to some folks from a different non-governmental organization, and they're in the process of explaining that they fired their security team a few days prior because there had been some incidents, and now the security team had come back with a whole bunch of militia folks and they were shooting at the building and trying to extort them for payment and more money and other things that were going on. And so, you're very quickly and easily confronted by the insecurity in those situations but you always have to remember, and I do very much so, that to be in that situation and to not have choice and to not have access and to not have opportunity and to not have the luxury, and it really is a luxury, of a Canadian passport, that is so many orders of magnitude more devastating and risky. And so, you can't be in that situation and say, am I in danger, am I at risk? Because it feels incredibly self-indulgent, because it is.
Taki Sarantakis: Now, you mentioned the Canadian passport. Is it a particular benefit? And if so, is it a particular benefit that you're Canadian, that your organization is Canadian? Do you come in under the auspices, metaphorically speaking, of the Canadian flag?
Dr. Samantha Nutt: I think that the Canadian identity still is very strong throughout the world. I think that it has taken some hits, our cuts to our aid spending, the fact that we have never ourselves achieved the target that was set by Lester B. Pearson of 0.7% of our national wealth in 1969.
[00:22:44 A photo of a document from Lester B. Pearson is shown, in which highlighted text reads: "Total aid should amount to 1% of GNP, and official aid, .70% of GNP by 1975".]
Dr. Samantha Nutt: And have fallen very far short of that and over the next four years will fall even shorter of that with cutbacks that have been proposed and promised to our aid spending. I mean, this is money that people rely on to stay alive in very difficult circumstances, places where states have failed, where their governments have failed, and where they're under attack. And so, I think that Canada's reputation as a democracy, as a society that values inclusion, that protects and promotes human rights, that is compassionate and empathetic, that has strong social programs, all of these things are deeply valued and admired by people throughout the world. And so, when you present yourself as a Canadian, you are not presenting yourself, particularly when you're talking about Africa or the Middle East, with the historical colonial baggage and intrusive foreign policy and history of exploitation and abuse that other nations, certainly they carry those reputations, European countries, American. And so, that definitely helps. There is this sense that Canada is something to be admired and that Canadians are trustworthy in that context. That isn't to diminish our own complicated history of colonialism and our need for Indigenous reconciliation, for sure. But still, within those environments, Canada is among the best of the best.
Taki Sarantakis: Now, we're sitting here, we're having this conversation in kind of the first half of 2026. Kind of the zeitgeist is very different now vis-à-vis aid and security. We are very much now in the world of security first, security trumps everything. To the extent we talk about targets of GDP, we talk about targets on the other side of GDP. Tell us what you think the relationship is between kind of aid and security, if I can call it that.
Dr. Samantha Nutt: Aid and security are completely and inextricably linked. And when we cut aid, we do ourselves and this world a monumental disservice that will only make the world more insecure, and the threats to our existence, to our values, to our democracy, to human rights throughout the world will be heavily and perhaps irrevocably compromised as a result of that. There is no question of that. When you look at, for example, and I'm not talking about emergency humanitarian assistance, the business of keeping people alive. There are times when that is completely necessary. But when you look at who has the advantage in a lawless environment, it is armed factions that are able to easily recruit young men because they are the only employer in town and there is no other economic opportunity for these young people and because they have been displaced and abused and there are no schools, there's no educational system, there's no employment opportunities for them. And so, what else are they going to do if they want to provide for themselves, provide for their families, and feel safe and secure? Which means that you do have groups like ISIS or Daesh or the Taliban or others or the Janjaweed or the rebels operating in Eastern Congo or the Mai-Mai militia groups, who can then move in and exploit those desperations and weaknesses, right? Aid, inextricably, when it's done well, it is a barrier, it is protective against those kinds of outcomes, and it is woefully naive to believe that any conflict anywhere in the world can be contained by borders, particularly in places where those borders are not even really recognized or acknowledged as credible.
So, the more that we allow, as a global community, to have societies and to have generations that are raised on ideology, on grievance, on poverty, on violence, where they are forced to witness their loved ones being gunned down, murdered in genocidal atrocities throughout the world, that makes us all insecure and we cannot shoot or bomb our way back to safer societies in that context because there will always be another wave. There will always be someone else waiting in the wings. The only way that we protect ourselves through that is by creating safe and secure environments that allow people to envision a different future and to create opportunities for themselves where they are living and to not develop this sense that they have been forgotten or that their loved ones are being treated in an expedient fashion because it serves our own economic interests, and that's the problem, and that's the problem when it comes to the balance between defence and humanitarian spending. We spend 12 times globally, in terms of annual military spending, what we spend on international humanitarian aid, and let's be clear on what that is, on making sure that children in the most vulnerable parts of the world have the right to go to school, have access to clean drinking water, can feed themselves, and can grow up without a degree of violence and abuse and trauma, and it's shameful. It's shameful.
Taki Sarantakis: And clearly, your passion for the subject is coming through and that passion has helped build the War Child Canada, War Child USA into what it is today. So, what is it today? We started with one 5'4" young lady with a backpack and a cell phone. What is it today?
Dr. Samantha Nutt: Why I do what I do?
Taki Sarantakis: No, what is War Child Canada today?
Dr. Samantha Nutt: What is War Child Canada today? It's amazing. So, we have worked in over a dozen countries throughout the world. We're active in more than seven different war torn regions.
[00:29:13 Photos of children in classrooms around the world are shown with the text: "© PeterBuenosAires, CC BY-SA 4.0, via Wikimedia Commons".]
Dr. Samantha Nutt: We work with a million children, roughly between 600,000 and a million children and their families, every single year. Any given year, we have between 1500+ staff throughout the world, 99.9% of whom come from war zones, who are designing the programs, leading them, giving back to their communities. Here in North America, we have 25 staff all working towards the same goal. And again, our focus is always on addressing those systemic challenges. So, we're really well-known for our catch-up learning throughout the world. It's called Accelerated Learning, ALP programs. And so, kids who have been out of school, in some cases for six to ten years, can do two years over one year. We properly train the teachers. Then, they can be integrated back into the school system and get back on track. The ones that are not really eligible to go back to school, we still do youth entrepreneurship and skills training and micro-financing. We do a lot of food security work. We do a lot of legal protection of women and children. We're a registered law firm in Uganda which is the largest refugee-hosting country in Africa, and we were, we still are, a registered law firm in Afghanistan, but since the Taliban takeover, that's obviously become a much more problematic process.
Taki Sarantakis: So, you're an operating entity now. You're a multinational.
Dr. Samantha Nutt: We're an operating entity, yeah. I mean, it's still always hard because there are a lot of places where we should be and we are not. We are one of the only organizations, Canadian organizations, directly implementing in Darfur, Sudan, when that war hit a couple of years ago. We are still operational in Sudan but finding the resources to be able to do that has been very challenging. It's always hard. We're always being pulled in a million different directions, especially right now when the world is on fire. And so, we are constrained. We're constrained by what we can do, whether it's finance or whether it's security.
Taki Sarantakis: Let's shift now to your academic training proper. Let's talk a little bit about public health. So, we have gone through, in Canada in the last little while, several important kind of public health events. Kind of the crowning one obviously was COVID-19 but before that, we've had kind of variations, on SARS and avian flu and listeria and things like that. Tell us a little bit how you see the public health universe in 2026, because it seems to me, as you mentioned earlier, a lot of these things, they're not really subject to being contained by borders, and the world is not necessarily as nice, as kind, as safe as we would like it to be. What do you see as kind of the public health landscape in the next little while, outside of war zones. Let's talk about Toronto, Canada, North America, Europe.
Dr. Samantha Nutt: Public health is one of those invisible things that we take for granted until something happens, a crisis happens, like COVID for example. And then, these systems that seemed external, that seemed kind of redundant, that had faced cutbacks for years, all of a sudden become so instrumental to people's very survival, right? It's something that we need to continuously invest in, and I think that the pandemic in particular has created the kind of skeptical, cynical climate that is ultimately quite destructive to public health in the long-term. And we need to remember, public health has become so politicized, particularly in the United States but here in Canada as well, it has become so politicized around vaccines, around surveillance, monitoring, disease, all this kind of stuff, information-sharing even. There are a lot of governments throughout the world that don't want to share information because they're worried about a whole bunch of different things, accountability, blame, etc., intervention, foreign intervention. And yet, at the same time, we need that to stay safe and we need that to keep people fundamentally alive.
And public health, by definition, is really about, what can we do? What systems and structures do we need? What basic minimum interventions do we need, whether we're talking about coordinating the drinking water or fluoride, that kind of thing, to be able to sustain life and promote health and well-being? That's fundamentally what it is. And so, why it has become so politicized is something that I find quite alarming, and we're paying the price for that, right? Children who are not being vaccinated for measles, either at all or even according to the schedule, now are seeing the resurgence of a disease that had been almost, it hadn't been eradicated but certainly the impact of it had been dramatically diminished, and I work on the other side of that in different war torn environments where I see children who have lost their vision, who have got permanent cognitive deficits as a result of having faced measles, and those are the ones who survived. So, public health is necessary, it is a luxury that we often take for granted, and I worry that within this current context, we are dismantling one of the most important systems that is needed for our very survival.
Taki Sarantakis: You also work in our health care system proper. You are at Women's College Hospital.
Dr. Samantha Nutt: I'm at Women's College Hospital.
[00:34:57 A photo of Women's College Hospital is shown with the text: "© Dillan Payne, CC BY-SA 4.0, via Wikimedia Commons".]
Taki Sarantakis: Talk to us a little bit about the state of health care as you see it from the inside right now in Canada.
Dr. Samantha Nutt: We're hitting all the hot button issues (laughs). Look, I've been doing medicine long enough that I've seen some fairly significant changes that are quite worrisome, to be honest. For example, I do clinic one day a week roughly or it's spread out over two days, and all of the electronic medical records, the digitization, all of these kinds of things were brought in ostensibly to make that job easier, to allow for more forward-facing patient care. It has done the complete opposite. It is a disconnected, dysfunctional system that produces a massive digital footprint that requires multiple levels of sign-off and that ends up taking doctors away from front-line patient care and more towards this kind of drowning in digital paperwork. One referral that used to be a singular process, you fill out a form, you send it in, you got a note back from the specialist, that alone results in a dozen, 12 to 17 various touch points that you then have to sign off on that have nothing to do with patient care, and that also, frankly, doctors are not compensated for and so then they become more cynical and it becomes harder to find a family doctor.
On top of that, generations, and this started when I was in medical school, of cutbacks to the number of spots in medical school programs because every doctor that gets added to the system is billing the system. And so, it's easier to save costs by not adding more doctors to the system, but that's reached a bottleneck now. With demographic shifts, people are aging and people cannot find doctors, and the financial models don't incentivize physicians to take on more complex patients, elderly patients, more complex care. So, it's hard. I'm very frustrated about the state of health care. I think you've got great people on the front lines doing as much as they possibly can, but even making this system work is so much harder than it was, to get somebody treated on time, to get them seen by a specialist, to even find a specialist who will see them. A process that used to take days can now take weeks or months, and you're playing with people's lives.
Taki Sarantakis: And I think most Canadians would exactly echo what you said, which is when you finally do get somebody on the front line, they are amazing, amazing, the doctors, the nurses, everybody, but it's the kind of getting there. I know it's a complicated answer but you kind of implied that we're drowning in bureaucracy. Are we drowning in bureaucracy?
Dr. Samantha Nutt: On the medical side, I would say we're drowning in the technological advances that were put into place with the best of intentions but that have created an extraordinary bureaucratic burden that I think was not fully appreciated at the time, especially because the system is so disconnected, even within medicine. For example, you as a patient, you do not have a complete copy of all of your reports and all of your results. It doesn't follow you. It is attached to whatever system you have integrated with. So, it sits with your family doctor who may be on one system, maybe on a Telus PSS system. But then, if you go to a different hospital, you get seen and they have a different system altogether. That system doesn't communicate with the system. You can communicate with it through three different logins and this and that and try to find and transfer, and you don't have 20 minutes to sit and hunt for these results when you're sitting there looking at a person. So, yeah, that's part of the problem.
Taki Sarantakis: And our audience knows that well because we talk about that in different contexts, most specifically about information even within the Government of Canada, that one department does this, another department does that, a third department does a third way. You got a little pin on your left lapel. Talk to us about that little pin.
Dr. Samantha Nutt: Well, this, I was very honoured to receive the Order of Canada.
Taki Sarantakis: Can you tell us roughly how old you were, if you don't mind?
Dr. Samantha Nutt: 40, I think.
Taki Sarantakis: That's pretty young for an Order.
Dr. Samantha Nutt: 39, maybe.
Taki Sarantakis: 39. Talk to us about the phone call.
Dr. Samantha Nutt: It's wonderful when you find out. They call you and they tell you that they're putting out an announcement and your name is going to be in the newspaper, and it's great. It was a wonderful thing to do. My dad passed away about eight years ago and it was a wonderful thing to be able to do while he was still alive. It meant a lot to him to be there for that. It meant a lot to me as well. So, it's nice. I'm a very proud Canadian, and there's nothing that makes you prouder of this country and understand what a great privilege it is than to be in some of the environments that I have been in. I wake up every day knowing how lucky we are. I look out over the Canadian Shield and the Canadian landscape and meet with Canadians right across the country, and the fact that we live with relative peace and security, the fact that our democracy, despite its flaws, still functions, the fact that our public service still functions and is recognized as the gold standard, it truly is, throughout the world, these are things that are worth fighting for and they're things that are worth protecting. And so, when you get a little pin like this, you're just reminded of what it means to exist in service of this great country that we have. And gosh, you just have to look at what's going on to the south of us to realize that we should never take this for granted.
Taki Sarantakis: Dr. Samantha Nutt, fellow of the Royal Society of Canada, Order of Canada, medical doctor, founder of War Child Canada, War Child USA, maybe most importantly, daughter of immigrants that done good. Thank you so much for spending this time with us today.
Dr. Samantha Nutt: Well, thank you for having me.
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