♪ >> Welcome to Canada Files.

I'm Valerie Pringle.

My guest today is Dr. Samantha Nutt.

Who is a humanitarian, a medical doctor and founder and president of War Child Canada and War Child USA.

She is also a staff physician at Women's College Hospital in Toronto.

Assistant professor of medicine at the University of Toronto.

And author of the book, Damned Nations .

She has lived a life of service, working in conflict zones around the world for almost 30 years.

>> Valerie: Hi Sam.

>> Samantha: Hi Valerie.

>> Let's go back almost 30 years when you were a recently-graduated family doctor interested in public health, women's rights.

You signed up to go with UNICEF to Somalia.

Told your parents you were going on safari.

>> I did.

It was the worst lie I ever told in my entire life.

>> How did being in Somalia change your life?

>> I got this opportunity to work with UNICEF in Somalia because I was doing my masters in public health.

But the research I was focusing on was the intersection between violence and women's health outcome.

So how is it that women who live with high degree of violence end up having a disproportionate number of health concerns over their lifetime and live very short lives.

So I was recruited for that reason.

I went into Somalia believing as a young physician that I had the skills and I would be useful in that kind of context.

It was right on the heels of the Rawandan genocide.

Most of the international agencies that were deployed to work in Somalia had left to go to Rawanda.

There was a second wave of famine that was gripping the country.

I arrived into an abyss of insecurity, human suffering, and starvation, thinking as this young doctor that I was somewhat invincible and prepared.

I was completely unprepared.

It left me with a kind of grief and rage that I think only people who have ever lived with war can fully recognize in themselves and others.

The pursuit of trying to do something to prevent that kind of outcome and atrocity, especially for women and girls.

That was really the moment that led me towards this particular mission.

In many ways, it was a shattering experience.

I never would have thought, looking back at how I was as a teenager, in high school or medical school.

If somebody had said, "Well someday you're going to be a war doctor, you know."

I never would have thought that would be true.

Yet almost 30 years later, here we are.

>> You've looked at this so many times and places in the world and say what seems like an obvious statement, "War is too high a price to pay."

And yet.

>> Yet it's getting worse.

We are facing right now in the world, the worst refuge and displacement crisis since World War II.

More than 115 million people have been forced from their homes as a result of conflict, violence, instability.

Also secondary to climate change within that.

The vast majority of those are civilians.

Eighty percent of them women and children.

So we are facing a catastrophic level of conflict in the world that is bringing us very close to a precipice.

From which it will be nearly impossible for us to recover.

Unless we're willing to invest in different outcomes that promote peace and security throughout the world.

Specifically for the most vulnerable, that is often women & children.

>> You've been in so many situations yourself.

Where, I guess, you're lucky to be alive.

>> I'm very lucky to be alive, yeah.

I've been in some very close calls.

More than my fair share of car ambushes where I was very lucky to have survived.

I've probably been threatened with sexual violence more times than it's possible to count in the course of doing this work.

Yet for me, I look at the extraordinary people that work with us, with War Child throughout the world.

We have more than 600 local staff.

99% of our staff throughout the world, including at the most senior level--country director, come from war-torn countries.

They're the ones building our programs, identifying the needs.

Responding to those growing demands for our services.

The only thing that they ask every day-- they're really putting their lives on the line, is that people like me, who have the opportunity to fundraise, speak and engage bigger audiences in the conversation.

That we get up and do that.

The work is hard, can be scary and life-threatening.

You have to be, even in the best of circumstances, extremely careful.

And sometimes-- there are no guarantees.

I've lost far too many of my own friends in the course of doing this work.

My attitude to this is, and I say this in my office all the time, there is a good possibility that someday this work will kill me.

Hopefully it's not today.

>> In North America, you say we sometimes feel so far away from that.

But one of the points you make over and over again is that North America is very involved in the form of the arms trade.

Canada's involved in the form of the arms trade.

It's something we can do something about.

People either don't know, don't pay attention or understand.

>> They don't and that is quite understandable.

Unless you're immersed in this kind of work all the time, you can feel as if you're a little disconnected from it.

But yes, the reality is we're currently spending more than $2 trillion globally on the military, basically.

On arms, military investments throughout the world.

You compare that to what we spend on international humanitarian assistance.

Making sure kids are vaccinated, have the chance to go to school.

In the most impoverished nations in the world.

That they have access to food, clean drinking water & shelter.

All these really important things that will lead to stronger, better societies over the long run.

That is a fraction--less than 1/12th of what we have in terms of military spending.

Canada's heavily invested in the arms trade.

We've had a $15 billion arms deal with Saudi Arabia for the last several years.

Which is one of the notoriously-despotic countries in the world that has been actively involved for years in the conflict in Yemen.

In which almost 400,000 people have died.

And other conflicts beyond that.

...I would certainly say there is a time and place for the military and defence spending.

To be able to legitimately defend the interests-- especially of civilians, human rights, good governance.

All these things are really important.

When we think about the balance--we invest disproportionately in the machinery of our own destruction at the expense of the very things that would make us safer and more prosperous in the long term.

>> You started War Child Canada in 1999-- sort of born of frustration.

From what you'd seen and you hadn't been at it that long.

What were you trying to do differently?

>> I had spent about 5 years working for, and alongside different international organizations.

Working for UN organizations, and we still do, to be clear.

War Child emerged from the gap that existed.

A lot of the organizations were focusing on the short term.

So they were thinking about how do you keep people alive.

Food, water, shelter, blankets, healthcare.

But then wars are never short-term.

They go on for years, in many cases for decades.

So if you're constantly relying on the distribution of short-term supplies.

And people are becoming more disengaged.

The funding levels decline.

It's dependent on this entire expatriate international staff and their expertise which they bring.

Then as the money starts to decline, they withdraw.

Or things become more insecure and they have to withdraw.

Then there's no capacity or resources left behind.

People don't have the resilience or skill to be able to look after themselves or their own communities.

As a public health doctor, we're trained to look at how you do the most with the least.

What kind of interventions can you scale and have the biggest impact?

What will be the most cost-effective?

When you look at things like the death of children under five, child mortality, one of the important predictors of the child mortality in the world is the child's mother's independent access to income and her education levels.

So if you think about how you bring the deaths of kids under 5 in really complex humanitarian environments down, you have to be invested in the education of women and girls, and the education of those children.

You have to be thinking about how can people earn an income so they are less dependent on all these external factors.

So trying to solve that problem and reconciling that frustration of short-term, are we really moving the dial forward?

That became the impetus behind War Child Canada.

>> And you thought, "I can change this, I can do this."

>> I was young, naive, had a lot of energy!

...there are times when I think if I'd known how hard it was going to be, would I still have done it?

It would have been a whole lot easier for me to have stuck with the path I was on.

Eventually have been... some UN dignitary in some other part of the world.

But I genuinely believe in the model of local engagement, and that change happens when it's being driven by people who come from those communities.

And that piece was being missed.

I also genuinely believe that you need long-term strategies.

That you solve the problem of war across a generation.

Not across 12 months, 2 years, not with 1 goat or chicken.

That's not going to do it.

As much as we love that on this side of the world.

We want quick fixes, easy answers, to feel good about it.

>> You've looked too--so much that whole issue of fundraising and people's attention span, their guilt, concept of charity.

What drives them and what works.

And usually it's not long-term engagement.

>> That's right.

So changing the thinking around that too has been, not just important to the organization, but to me.

That's one of the reasons why I'm out there speaking, advocating and writing all the time.

It's to at least inform people of what's most effective.

If you really want to make a lasting impact, you are far better off giving a smaller regular amount to an organization on a monthly basis than writing a cheque once and walking away.

Saying why aren't things getting any better in places like South Sudan.

Because education, as we all know, isn't a one-time investment.

You have to keep on investing in it.

In order to see those material gains and changes in people's lives.

The recovery from war, especially with the level of trauma, violence, abuse and exploitation that people endure.

You don't get over that with one session of play, or something along those lines.

It takes continuity, deep knowledge and understanding.

So people who want to really affect change, they want to be invested in an organization over a longer stretch of time.

So they can start to see where they're having an impact.

And how they're having an impact.

>> When people say does aid work, what do you say?

>> 100%...aid works.

I've seen it.

I've seen people whose lives were disrupted and destroyed.

I've seen women in Afghanistan who were begging on the streets, functionally illiterate, within two years of being in our program, which costs about $1,000 per head.

These are all women--often female-headed households so their partners have been killed in the conflicts.

They're incredibly vulnerable.

Especially in an intensely-misogynistic society.

Where you can't just go and sell goods in the market.

After two years of literacy, numeracy, training and psychological support-- and we provided childcare and education for their kids.

So they could catch up on their learning.

They'd all been out of school.

These women were going through, starting their own businesses, having a revolving fund and and guaranteeing one other's-- they weren't loans, as much as pooled resources.

Look, they're not going to be massive entrepreneurs running billion dollar companies.

But they became women who were self-reliant.

And who understood the value of education.

Who went from being illiterate to making sure their children's education was prioritized.

Even five years later, when we followed up with them, their kids were still in school.

They weren't in school when they started.

That's the magic of aid when it's done in a way that is consistent.

The enemy of effective aid everywhere in the world is that it's too short-term and narrowly-focused.

It doesn't prioritize the real tools that people need.

To become self-reliant and to make their own choices.

>> You don't like the expression third world .

>> No.

>> And I always cringe when people say first world problems .

That whole concept of them and us.

>> I just look at it in the sense that we're all born into places that have certain advantages and disadvantages.

Closing those gaps is one of the most powerful things that we can do.

>> You've spent so much time with women.

I love some...you talk about a situation-- you're in Pakistan with a group of women.

>> Maybe refugees from Afghanistan.

>> Yes!

>> Ended up talking about sex.

>> Everywhere in the world, wherever you go.

>> One of them was about to be married.

They're asking you about your wedding night.

>> ...she says to me, "Was it like that for you the first time you had sex with your husband on your wedding night?"

I'm like oh, this is a really sensitive conversation.

We come from very different worlds.

Yeah look, it's amazing to me that--it's funny.

When I started doing this work, in fact even just recently.

I was at the UN peace-keeping compound in South Sudan in Malakal.

I'm pretty much the only female--there are three of us.

There are about 300 men-- in geo folks and soliders.

I thought, "How am I still so outnumbered doing this work?"

But when I started in Somalia, it was the same I was often the only woman.

People would think this is unusual.

I'd be going across borders with these various armed groups.

I'd walk in, in the middle of the night-- they're all sitting there with their weapons, drinking and smoking and everything else.

Sometimes they'd think I was a complete joke!

Which actually worked to my advantage.

Because they're like... pmmft, sure go ahead.

But the one advantage to being a woman is that I've had extraordinary access to women's stories and lives.

You sit together and everywhere in the world, no matter what, women talk.

They talk about the most intimate details of their lives.

It doesn't matter if you're in Afghanistan or Iraq with Yazidi women and girls, or Eastern Congo.

You put a bunch of women together and the stories come out.

If I were anything other than a woman doing this work, none of that would have been possible.

>> You tell a wonderful story in your book, Damned Nations, about a woman named Nadia.

>> This one afternoon I was visiting War Child's programming in West Darfur in Junaynah which has become the epicentre of this current crisis unfortunately.

We'd been running this literacy and numeracy program for women and girls in the evenings.

Which had become a safe place for them to be.

Because there's a significant amount of rape and sexual violence in the camp.

So they would come with their children.

It was safe, they were protected and they were learning at the same time.

I started talking to Nadia and she had her little baby boy right beside her on this mat.

She'd been attending every night for 3 months.

That frustration I've had from the moment I'd landed in Somalia where you see these programs in action.

But you think there's a part of you that can't let go to this idea of what's the point?

It's just so much bigger.

What's happening is so unjust.

And it's never going to get better.

You feel as if you're some kind of incomplete apology-- sometimes, for just the way the world is.

On that particular day, I started talking to Nadia.

She explained how she had been in her village, just given birth to this little boy and I'm the mom of a son.

She heard the Janjaweed militias and people screaming.

Her mother, father and husband yelled at her to go and hide.

Behind their family farm which she did.

With her baby, trying to keep him quiet.

The Janjaweed militias ended up executing all of her family members.

Set fire to her farm.

She was one of only a dozen women and children who survived this attack.

She walked for days to get to this camp.

As I'm sitting there talking to her, knowing that she'd been in that program three months, she was completely illiterate when she started.

Like all the girls in her village.

I said to her, "Nadia, after everything you've been through, has any of this actually helped you?"

It was one of the most profound moments that I've experienced doing this work.

And a very powerful reminder of why it matters.

She was sitting on this mat, leans forward and just wrote her name in the sand.

She said, "Now that I know how to write my own name, I'm going to learn how to write my son's name."

I thought that's it.

We all just need a reason to put one foot in front of the other.

We all need to aspire to a better day.

Sometimes they're elusive but if we can invest in that-- that sense of it's possible that it will get better.

...It changes people's lives.

>> How do you cope, sleep, unsee what you've seen.

>> You don't unsee it.

And thank God actually.

>> You bear witness.

>> You'd have to be a kind of callous sociopath to unsee it.

I think you get to this point, which for me was very early on, where you can't go back.

You can only go forward.

The only thing that drives you forward is this realization that you are able to make an impact.

You end up--it's this weird space and paradox.

Where...sometimes you feel like you can't live with it but you also can't live without it.

That it is the thing that haunts you but it is the thing that sets you free.

The thing...that makes it make sense.

You can only understand, contextualize and rationalize the suffering, horror and abuse.

The nights of shelling, visions of gunfire and the occasional nightmares which I will sometimes have.

...some very serious ones coming out of South Sudan recently.

The only way you can push through those is when you see tremendous hope, opportunity and change that comes out of what you're doing.

That's the stuff that makes you brave.

Because I'm not brave.

But I'm working with a bunch of people who are extraordinarily brave.

And if all they need me to do is get my ass out of bed, even if I've had a nightmare, a bad night's sleep or think I'm tired and jet lagged, they're not asking for very much.

It's the least I can do.

>> And yet it's been quite a life and a real journey.

I wonder how you explain and see your life of service.

>> It's been a privilege.

I can't imagine...look.

It's the most extraordinary thing in the world, to be able to do a job that is your passion, commitment that aligns with your values as a human being.

Puts you at the front-line of some of the most intimate moments of people's lives.

That's true being a doctor.

It's especially true being a war doctor.

I've seen parts of the world and met people--it's irreplaceable.

So when I think about my life, I think wow.

It's been amazing.

As much as I've had really difficult scary moments, I also think in a way, it's been extraordinarily liberating.

Because it teaches you to prioritize things very differently.

I live my life, as hard as the war zone stuff is, with extraordinary energy and joy.

I'm one of the people--if it's a dance party, I'm all in!

You know?

I'll go for nine hours.

That's how I love...my family, my friends.

You have to be all in because every second is precious.

There's nothing that brings you closer to that realization than being confronted by what happens when it's stolen from you.

>> The final question we ask is, what does being Canadian mean to you?

>> Everything.

What an extraordinarily gift we have.

We are--as a Canadian, we live in a society that isn't perfect, certainly.

Our history is deeply imperfect.

There's a lot that we have to reconcile.

But at the same time, we can send our children to school, with a degree of confidence that they won't experience horrific sexual violence or be murdered on the way there.

We don't fall asleep, as millions of people do throughout the world, listening to the staccato of automatic gunfire.

Feeling the deep vibrations of those bombs in the darkest of night.

And wondering if we'll be next.

Or how we're ever going to keep our children safe in that context.

I've lived some of that.

I know what that feels like.

Every time I land here back in Canada, and I can close my eyes and that is not my reality, I am so thankful and grateful to call myself a Canadian.

>> Well, Godspeed to you, Dr. Nutt.

>> Thank you.

>> [Valerie)}: Your work's amazing.

>> Thank you and for doing this.

I appreciate it.

>> We'll be back next week with another episode of Canada Files.

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