Nam Kiwanuka: You're listening to Mistreated. I'm Nam Kiwanuka. Cervical cancer is one of the most preventable cancers and yet systemic barriers exist to treat it effectively. For example, would it surprise you that prostate cancer receives more funding than three gynecological cancers combined? In 2019, the National Cancer Institute released a study that showed that of 18 different types of cancers, ovarian, cervical, and uterine cancer received the least amount of funding per life lost compared to prostate cancer. $1.8 million US went to prostate cancer. Not even 250,000 went to ovarian, cervical, and uterine cancer combined.

Nam Kiwanuka: Another barrier to prevention is early detection. Studies show that fear, shame, and anxiety are not uncommon when it comes to going to the gynecologist. In 2025, two women engineers from the Netherlands redesigned the speculum and called it the Lilium, which is made with soft plastic, unlike the traditional speculum made of metal. It's hard to believe that it took 180 years for researchers to redesign the device used for pap smears and other exams to something a little more comfortable.

Nam Kiwanuka: In an interview, one of the creators said this, "I've received a lot of emails from women who told me they actually don't go to the gynecologist because of this device, because they're scared, because they have a traumatic experience." The hope from these engineers is that with a more patientfriendly speculum, it will motivate more women and people with cervixes to get their health checkups. Now, I'm not drawing a direct link between uncomfortable examinations and poor funding to worse health outcomes. But recent data has shown that this preventable cancer is the quote fastest rising form of cancer in Canada. It's quote a silent national health crisis.

Nam Kiwanuka: According to the Government of Canada, rates of cervical cancer are higher among females residing in rural areas and lower income neighborhoods. Cervical cancer is the fourth most diagnosed cancer and fourth leading cause of cancer death among females worldwide. Because of this, in 2018, the World Health Organization, the WH, set out a global call to eliminate cervical cancer around the world by 2030. Canada joined this call to action and pledged to eliminate cervical cancer by 2040 through targets known as 909090. This means that 90% of 17year-olds would have received a vaccination by 2025. 90% of those eligible would be screened using an HPV test by 2030 and 90% of all individuals with a positive HPV test would have a follow-up plan by 2030.

Nam Kiwanuka: In a way, Canada is a leader here. The WHO only pledged to 90 7090, as in 70% of eligible people would be screened using an HPV test by 2030. Despite Canada's ambitious goals, in 2025, an estimated 1,650 Canadians were diagnosed with cervical cancer and 430 died from it. And a November 2025 report from the Canadian Cancer Society shows that cervical cancer rates in Canada, once steadily declining, have now plateaued, signaling that the country may be at risk of falling short of its goal to eliminate the disease by 2040. We're joined with two guests today. Michelle Haligan, director of the Canadian Partnership Against Cancer, and Nakia Leoon, a health equity researcher at the Institute for Better Health, Trillium Health Partners. Our guests couldn't name an exact reason as to why cervical cancer rates were changing for the worse, but we dive into what causes cervical cancer. We also discuss how prevention strategies fall short because of vaccine hesitancy, how underserved communities are at risk, and what jurisdictions around the world are on track to eliminate cervical cancer. They join me now.

Nam Kiwanuka: Uh thank you so much for joining us to talk about the rising rates of cervical cancer. Uh Michelle, could you please introduce yourself first?

Michelle Haligan: Thanks for having me, Na'am. I'm Michelle Haligan, director of prevention at the Canadian Partnership Against Cancer.

Nam Kiwanuka: And Nikia,

Nikia Leoon: hi. Um, I'm Nikil. I'm the health equity research lead from the Institute for Better Health at Trillium Health Partners in Missaga, Ontario.

Nam Kiwanuka: Um, well, in February, Michelle, a coalition of health advocacy groups went to Ottawa to speak about cervical cancer prevention and Dr. Shannon Salvador, the president of the Society of Gynecologic Oncology of Canada, said this quote, "We are here today because Canada is currently facing a silent national health crisis. The WHO, the World Health Organization, called on countries around the world to commit to eliminate cervical cancer and in 2020 launched the cervical cancer elimination initiative to eliminate it by 2030. Michelle, what was Canada's response to that call?

Michelle Haligan: Yeah. So, in response, the Canadian Partnership Against Cancer worked with partners and patients across the nation to develop and launch Canada's own action plan to eliminate cervical cancer back in November of 2020, around the same time that the WHO uh launched its global strategy. And I'll say there's a little bit of a nuance between what the WHO has uh committed to and what Canada's committed to. uh we in Canada actually have a more ambitious plan because we're a bit further ahead um as a country. So we've actually committed to 90 9090 targets instead of what the WHO has committed to of 90 7090. That's because we've made a lot of progress. We have the tools available to us. Uh we have the HPV vaccine in school-based programs across this country. We have established organized cervical screening programs that need to make a switch towards HPV primary screening and we've got decent follow-up care in this country. And so it's really about closing equity gaps to get us to elimination by 2040.

Nam Kiwanuka: Uh you mentioned the HPV uh vaccine which we'll talk about in just in a few moments. Uh but AI I wanted you to maybe explain to us what cervical cancer is and what causes it.

Nikia Leoon: Sure. So that's a great question. And so before we talk about what cervical cancer is, we need to talk about where is the cervix?

Nam Kiwanuka: Where is the cervix? What does a cervix do? And why are we actually testing for cervical cancer?

Nikia Leoon: So the cervix is the best way to talk about it is that it's the doorway between your vagina vagina and the actual uterus. So it's that doorway. So if someone has a cervix, it opens up during menration, um opens up during childirth and it actually changes in consistency during ovulation as well. So the best thing I like to say is the cervix, if you touch the tip of your nose, it's it kind of feels like that. So that's what the cervix is and where it is. Now, why are we actually screening for cervical cancer? We're screening for cervical cancer because what can happen um is that folks can experience abnormalities in the actual cells of the cervix which can most often be caused by something called HPV uh which is a human papilloma virus. So I'm sure we'll talk about that a little bit more.

Nam Kiwanuka: Can you explain what that is?

Nikia Leoon: Yeah, sure. Sure.

Nikia Leoon: Absolutely. So um HPV is a sexually transmitted infection that can happen um to anyone at any time if they've had any type of sexual activity. So

Nam Kiwanuka: that's men and women.

Nikia Leoon: Exactly. So men and women as well. So if you've had any type of sexual activity, so oftentimes what happens is that people will think if I've had any type of sexual intercourse, that's it. However, when I say sexual activity, that could be anal, that could be vaginal or oral. So any type of sexual activity could lead to HPV, HPV is the most commonly acquired um STI in the world. And really?

Nam Kiwanuka: Yes. And I don't think I knew that.

Nikia Leoon: Oh, well there we are. So, it's the most commonly acquired STI and it's often for the majority of people who get HPV, it's symptomless. So, you can get HPV and have no symptoms whatsoever. So, that's one of the major reasons why on top of um you know um prevention, why you should actually be testing for um getting cervical cancer screening back

Nam Kiwanuka: because you want to catch it in time. You don't there's no

Nikia Leoon: Exactly. For most people who get it, there are no symptoms. for most people who get it, your body actually naturally clears HPV. So, you may have no symptoms for years and and be walking around with it. Um, the fact that it's preventable, um, I wanted to talk about the people that it it impacts because in 2025, an estimated 1,650 Canadians were diagnosed with cervical cancer and 430 died from the disease. And this is according to the Canadian Cancer Society. Those are people's family members uh people who uh hold up um uh the communities. Um cervical cancer is a cancer that is said to be preventable but yet people are still getting it. How can you prevent cervical cancer?

Nikia Leoon: So there is a number of ways that you can prevent cervical cancer. So one is HPV vaccination. So both men and women can actually get HPV vaccination. Um that's often done in the school system. So there's certain the certain number of of vaccine shots that uh uh you would get slated to do if and again I say if you do go to school in Canada. So if you're coming outside of the country, depending on where you're coming from, HPV vaccines and the vaccin the idea of getting vaccinated for HPV may be a brand new concept for you. Or if you are coming into the country, depending again on when you've come in, you may have only gotten the first dose,

Nam Kiwanuka: which can is is a good thing. However, it doesn't necessarily um you know protect you against the full spread of um certain types of HPV that can increase one's chance of getting cervical cancer if um you are exposed to it.

Nam Kiwanuka: Um what are you seeing in the communities that you work in?

Nikia Leoon: So that's a great question. So where I'm located which is in Peele region. So Peele region um refers to a region of Ontario that includes Missaga, Kaledan, and Bmpton. Uh we have over uh one of the most diverse communities in the country. So folks are coming from all over the world including uh India, the continent of Africa, the Caribbean and so on and so forth. So we've got a very diverse community. We speak over a hundred different languages. Over 60% of the community um identifies as racialized and not a lot of people are aware that preventative medicine is just as important as uh treatmentbased medica medicine. So by the time they're going in, you know, often more often than not, by the time they're going in to actually see a clinician, so that's a doctor or a nurse practitioner, they're often coming in with symptoms versus going in to actually get cervical cancer screening.

Nam Kiwanuka: I want to come back to what you just said. Uh Michelle, I want to bring you back into this conversation and I wanted to share a quote from Dr. Sarah Keane, uh a gynecologic oncologist from Manitoba. She also spoke at that press conference I mentioned earlier. She said this, "Indigenous women are diagnosed at higher rates with more advanced disease and they experience worse outcomes. This is not due to biology. It is due to barriers, lack of access to screening resources, geographic isolation, systemic racism and healthcare, poverty, and the enduring impacts of colonial practice." She also added that in Manitoba, the data shows that 30 and 40 year olds are the fastest rising group of getting cervical cancer.

Nam Kiwanuka: you think of being in your 30s and you're in your 40s, the prime of your life, and then getting something like this. Uh Michelle, what needs to be done to address how cervical cancer is impacting some communities in more adverse ways?

Michelle Haligan: Yeah, thanks for that, Nan. I think one of the big things that we need to address in this country is that we have really limited standardized ethnicity and race-based data, including people's specific and self-governed data for First Nations Inuit Matei populations that will actually describe who is and is not vaccinated or be or being reached with screening programs or ends up with cervical cancer. makes it really difficult for those of us working in the health system to focus our finite resources on populations that need it the most. Um we we we're seeing those barriers in indigenous populations as well as other populations that are typically equity denied. Um and we need to address those issues um and work with these communities to make solutions that are going to make sense and bring more people in. This is about bringing people in.

Michelle Haligan: Um, I want to share a video from Dr. Salvador. Uh, I mentioned her at the very beginning of this conversation. Um, and she had this to say at the press conference. Let's take a listen. We are currently facing some major setbacks. There is a vaccination gap as our national HPV vaccination completion rate has stalled at 64%. This is far below the 90% target that is needed for elimination. We currently operate on a postal code lottery system for health care. And whether you receive the most sensitive screening technology, the HPV DNA test, currently depends on which province you live in and even where you are in some provinces. For years, there has been a health gender gap as too many women, particularly those in rural, indigenous, and underserved communities, are falling through the cracks of a fragmented system. Michelle, I wanted to get your thoughts on that clip.

Michelle Haligan: Yeah, so uh Dr. Salvador is pointing out many of the things that I think are outlined really well in Canada's action plan. Um we need to do better to improve uptake of the HPV vaccine. Um and there's many ways um that we suggest making that happen, including uh increasing awareness and acceptability of the vaccine across the country. um and in some places expanding access to that publicly funded vaccine uh beyond those school-based programs and Nikia Nikia described some of uh the issues related to that and I'd say working directly with partners to understand and implement tailored solutions that meet community needs. We've demonstrated doing that during the CO 19 pandemic. This is no different.

Michelle Haligan: The other piece that she spoke is needing to expedite efforts across the country to switch to HPV primary screening and HPV self-sreening. Um, and those those are fancy terms for just a new and better test than the test we currently have. Um, it's going to find HPV infections sooner. Um, and it's going to enable folks to uh seek care closer to home. Self-sampling opens up the ability to uh do a swab at home um and not have to actually show up to a clinic to do so if you want to. Um I would say all Canadian jurisdictions have plans to move towards uh cervical self screening. Um and many are already uh well underway BC being the first. Um, but I think what's important um, in this transition, and I know there's urgency to doing this, is that we need to think about it right from the start, we need to not miss more women and people with cervixes in this transition and do a better job of these screening programs.

Michelle Haligan: Making this test available at home is fantastic and is going to open up screening to even more folks, but we need to make sure if somebody receives a positive result, they have somewhere to go. Um, and so if you don't have a healthcare provider, where are we going to attach you in the system so that you can follow up on those results? And so I think that's an important piece to this transition that maybe sometimes is missed um when we're thinking about that health system change that needs to happen.

Nam Kiwanuka: Um, I wanted to follow up with what Michelle just said and also what Dr. Salvador mentioned in that clip around testing. Uh, PEI is leading Canada when it comes to decreasing cervical cancer. They started HPV testing, I believe, in 2023. NBC did as well in 2024. What is HPV testing and what's what makes it more accessible than a Pap test?

Nikia Leoon: Sure. So, so where we are in Ontario actually, we changed the testing rules in 20 in March of 2025. So, before you just do a pap test, uh most people are familiar with that if they've if they had

Nam Kiwanuka: it's horrible.

Nikia Leoon: Sorry. I mean, it's nice [laughter] to talk to your daughter, but it's not, you know, that that could be another that Yeah, that is that is another podcast show. I mean, to add on, but yes, it's not it's not the most comfortable of experiences and not the most comfortable of tests. So, so we we we know that putting it out there. Um but what has happened in Ontario has been the shift from pap testing which is you know what we just um where we've moved to HPV testing. Uh and the idea with HPV testing as Michelle was mentioning HPV testing right now in Ontario uh you have to go to a clinician. So that's a doctor nurse practitioner. So again you know this

Nam Kiwanuka: there's a family doctor shortage.

Nikia Leoon: Exactly. So that's you you read my mind. So, if you have a family doctor, most more likely than not, you could go to your family doctor and say, you know, I might have gotten a letter in the mail saying that I'm due for for my pap test and they do the test. But if you are unattached, meaning you don't actually have a family doctor, you're more likely than not having to go to a walk-in clinic. And depending on who's there, who's not, there's also an an issue with comfort level that the actual clinician, the nurse practitioner, the doctor has with doing the test. So depending on that comfort level, they they'll they'll do it, but they might be a little bit apprehensive around doing it even though that should be a part of their practice.

Nikia Leoon: Um, going back to, you know, what HPV testing is, as Michelle mentioned, it's a more sensitive test because we know that cervical cancer is largely the result of HPV and there's certain strains of HPV that can increase uh your chance of getting cervical cancer. what HPV testing is doing, it's testing for those particular strains of HPV. And it's doing that like using a more um refined test, meaning that that test looks for those particular markers um in that potential in that actual cell culture that the that the doctor or nurse is getting from the cervix. And then they're saying, "Okay, if I see this particular culture, we're going to do some follow-up tests and see if there's any abnormal cell growth or any type of issues that are happening." and then we'll kind of take it from there.

Nikia Leoon: However, let's say you know you get HPV testing done as of right now and your screening comes back clear. There's no um you know no HPV found in those in those actual um those cultures then with this new with the new rules that are in place you actually have to you get to wait five years for the next round of testing.

Nam Kiwanuka: So five a lot can happen in a year but five years.

Nikia Leoon: Yes. Five years. So it used to be um with pap testing it used to be every 3 years. Now it's switched to every 5 years because the test is a lot more accurate than the original pap test.

Nam Kiwanuka: So I imagine that also brings cost down for the government.

Nikia Leoon: Yes, it brings cost down. I mean, you know, government is government, but when we talk about HPV testing, we're really talking about the individual and the patient because as we just talked about, you know, it's not a it's not a fun test. So if we can increase the the length between getting testing done, we reduce that fear, that discomfort around getting testing. Um you know the test is a lot more accurate and again the testing the time between tests really are is dependent on the individual. So, if you have a family history of cervical cancer, if you have some sort of, you know, autoimmune disease or or any type of of thing that might have an impact on potential cell abnormalities of the cervix, that would be a conversation you'd have with your doctor or nurse practitioner. And they can shift the amount of time between screenings. But for most people, um, that time is every 5 years. They've also changed, um, how often, so what age you would start getting, um, your HPV testing done.

Nikia Leoon: [clears throat] again with pap testing it used to be you have to be at least 21 years of age having had any type of sexual activity having a cervix again important having a cervix now it's at least 25 years of age so the age range has shifted and the length between time to get HPV testing has shifted too

Nam Kiwanuka: um the [clears throat] society of gynecologic oncology of Canada has called for the immediate national shift to HPV self-colction swabs and kits because again I think sometimes when we have these conversations, we forget that there are people behind all of these numbers. Yes. Behind all of these statistics, all these families that are impacted by this devastating uh cancer. What do you say to policy makers that everybody across the country should have access to HPV um kits? We needed to have this yesterday and then that yesterday should have been yesterday. And then I see Michelle smiling. Um that yesterday should have been 5 years ago.

Nikia Leoon: So HPV self-sampling is not new. So HPV self-sampling has been done in various countries across the world. Australia is actually on, you know, on this goal to essentially eliminate.

Nam Kiwanuka: Exactly. So they're they're on track to do that.

Nikia Leoon: BC has done an amazing job with um implementing HPV self-sampling kits um to folks. There's other places within Canada that's that's starting to do that. um in Ontario uh Ontario Health has actually started to to push for um and actually implement HPV self-sampling testing sites across the province. And some of the work that I'm actually doing um within uh the work that I do with community is actually you know starting to to have that conversation particularly with black um identifying women in ple with the cervix because we know that as Michelle mentioned certain communities racialized equity denied groups tend to be underscreened and if we can offer people um a kit that they can take home or that can be mailed to them that they can do you know wherever whenever they want we can increase the rate of screening and we can save lives.

Nikia Leoon: Um Michelle, you were nodding.

Michelle Haligan: Agreed totally with the urgency behind this. We need to move to the HPV test now if we're going to eliminate cervical cancer um before 2040. Um and we need to do a good job at making sure that the public is aware that providers are aware of this shift and convince people to do this with us. This is about taking your own health into your own hands.

Michelle Haligan: Um I have a 12-year-old and uh she's in grade seven and I think that's the around the age when the HPV vaccine is offered and I believe in science. I we do talk about science a lot on this podcast but I was really kind of nervous uh about her getting that. And when we talk about the HPV um vaccine vaccine skeptism is on the rise. I hate using antivaxer. I feel like that's just so dismissive of a lot of communities who maybe not have the same uh relationship with healthcare and I think it also kind of uh just kind of denies why people are worried but it is on the rise around the world and vaccine rates are slipping not only in Canada but around the world. There's a lot of misinformation and disinformation around vaccines. Um, if this is what is being used across the country right now, how do you go about addressing that and convincing people to get vaccinated? Michelle, I want to ask you that question first.

Michelle Haligan: Yeah, that's the million-dollar question. Um, and if we had one single answer, I think we'd all be doing it. Um, you know, we are we are funding work right now across the country uh with public health partners, with indigenous partners to really address those gaps in HPV and HPV vaccine related education and awareness amongst parents and caregivers because those are the decision makers uh when this matters the most to help families make decisions about accepting that HPV vaccine for their children. And there, this could be as simple as more plain language, electronic consent forms and reminders. It can be about access to a trusted care provider or community champion to actually just have a discussion about vaccination, their concerns or questions about safety. It's not about being dismissive. And you're right on. It's not about creating labels. It's about just putting the right information out there in ways that folks can hear it and with people that they trust. And I think that's something else beyond misinformation, but just public distrust of public institutions and healthcare institutions is something else we have to overcome.

Nam Kiwanuka: Nikia,

Nikia Leoon: yeah, that's a great uh great points to add on to what's been said. You know, it's really important. So, I also work from something called a community-based participatory research perspective and it's really about embedding community and meeting people where they are. So, so it's one thing to write articles, it's one thing to write, you know, pamphlets out, but we really need to meet people with where they are to really understand where are those fears because ultimately, you know, at the core of, you know, apprehension around getting the HPV vaccine are fears, right? Like what is this going to do to my child? What is this going to do to me if I get it? They may have heard stories of, you know, a loved one or a friend or someone else in the community that received X vaccine and X happened to them. So, so those stories and those fears are things that we need to um connect with community to learn more around the origins of those fears and work with community to identify the best ways to engage in a respectful way in a way that matches the the cultural views of vaccination and then work to identify the best individuals to to share that information.

Nikia Leoon: And another thing that's come out of COVID and continues today is something called community ambassadors. So what happens uh within various communities and organizations is that um they'll reach out to folks that are trusted within communities. So that could be a pastor, that could be an imam, that could be anyone that's trusted within the community. They learn more about the community, you know, what the composition looks like, where the fair fears are, where there's room for opportunity to have to have positive and engaging discussions. And those community ambassadors learn, they build their knowledge base, and then they share information around things like HPV vaccinations and the vaccines with fellow community members. So they're not just empowering the ambassador, they're empowering people within the community to to share and share with other people.

Nam Kiwanuka: I love that because we actually when you live in societies, you are we each keep each other safe in a way, right? Um that's I love that. Uh we mentioned Australia, but Australia is on track to become the first country to eliminate cervical cancer by 2035. What are they doing that Canada should adopt? Uh Michelle,

Michelle Haligan: so Australia is lucky in in many ways that they have a national health system and that has really offered them standardized consistent approaches um with data um that they can access no matter where you are in that country. There's data available to be able to really drive their program operations. Uh in Canada, we have a bit of a different model. We have essentially 13 14 different health care systems going on all making their own respective decisions on when they'll do vaccines. Some are in grade seven. Other jurisdictions are at a different grade. Um as well as when they'll transition and make that shift to the HPV test. Um and so that puts us at a bit of a slower pace. we started after them and we also have to get over our own uh health system hurdles to make this a reality.

Michelle Haligan: I I'll say one other thing about the work in Australia is they really did do uh community engagement with indigenous communities in Australia in a really wholesome way um in rolling out uh their program that by the way also includes self-sreening. Um and we're also seeing early data from there that I think over 50% of folks are now actually requesting self-sreening. And so anyone that says that it's not what people want and people prefer having their provider do it, we're starting to see real data that this can be health in your own hands.

Nam Kiwanuka: Um I know there's been a call for a national uh women's health strategy to maybe this will be under that umbrella. Um but what do you think Nikia?

Nikia Leoon: Yes. [laughter]

Nam Kiwanuka: Did I say it close enough to the mic? Yes.

Nikia Leoon: Are we done? That's [laughter] a wrap. That's a wrap. Uh I definitely agree with that. Uh the other thing just touching back on what Michelle said around data. So um you know I did my PhD in the social behavioral health sciences stream at Dalana at the University of Toronto and one thing that was grilled within us is data data data data. And I always say if you don't count you don't count. But who counts how they count and when they count are just as important as the data and the counting.

Nikia Leoon: So, as Michelle mentioned, you know, we've basically got little islands of health care, you know, across the the country. So, we don't have a consistency in how we're collecting data. And if we don't have that consistency, we can't we can say, right, definitively, oh, like for example, within Ontario, we know that racialized populations, we know that folks um from the 2s LGBTQIA plus populations are not getting screened. They're underscreened. But we can't definitively say that in Manitoba. they can probably say that, but we can't say that because we don't have access to that data in the way that they do. So, without that kind of that that thread of consistent data across the across the country and across, you know, Canada, and we don't have race-based data, it's going to take a lot longer for us in Ontario, much less Canada, to really say we need to do this right now, even though we need to do this right now.

Nam Kiwanuka: Um, [laughter] like the young people say, make it make sense.

Nikia Leoon: Yes, exactly. Um, we had a guest on uh the podcast earlier in the season, uh, Dr. Michelle Cohen, who said that you measure what you treasure, right? And if you don't have the data, then you can't really try to you can't get the solutions that you need, right? Um, this has been really a great conversation. I've learned so much. Uh, do you have any final thoughts? Michelle, I'll start with you.

Michelle Haligan: This is the first time that we're going to eliminate a cancer ever in this world, in this country. We've got the tools in Canada. We just need to get them in place and make this happen.

Nam Kiwanuka: And Nikia,

Nikia Leoon: sure. Community matters in every aspect of your health and well-being. And community matters in tackling how we get to eliminating cervical cancer within our generation.

Nam Kiwanuka: Thank you both so much. We appreciate your time.

Nam Kiwanuka: This was Mistreated. Thanks for listening. You can follow our show wherever you download your podcast so that you can get notified each time a new episode is available. We would love to hear your feedback. You can write me an email at mistreatedodcast@tvo.org or reach out to me on social media. We have a YouTube comment from our episode on Ella's Danlo syndrome. Chris writes, "My youngest daughter was recently diagnosed with HEDS, which is hyper Ella's Danlo syndrome. She has cranial cervical instability. She had a fall at work with a whiplash type accident. She slipped, landed on her elbows, her head snapped back, then she fell the rest of the way and hit her head. A month later, she was having signs of POTS. She would lay her head on the table at work and not be able to speak. She began having donia, nerve issues, seizures. Her throat closes and she uses her fingers to pry open the muscles in the center front of her neck to be able to breathe when her throat closes up. I can go on. She is in the US and is awaiting results of a medical hearing in hopes of getting her social security disability. Her accident was just over three years ago. She is only 22. I am her brokenhearted mother. Chris, thank you so much for sharing that with us. We're so sorry for what your family is going through and send you the best and your daughter.

Nam Kiwanuka: This week's episode was produced by Shantel Domer, Tiff Lamb and me. Edited by Colin Kish, digital shorts by Ariana Longley. Camera work by Max Dussy. Teleprompting by Christy [music] Mloud. Production support from Jonathan Hallowell and TVO's digital media services team. Lori F is the executive producer of digital. [music] Stacy Dantis is acting vice president programming and content. Thanks so much for listening.