The day also focuses on taking action against bias, stereotypes and discrimination while working to achieve the equity and inclusion of everyone who identifies as a girl or woman.

This year’s international theme for the day is “Inspire Inclusion.”

We asked members of UM’s Rady Faculty of Health Sciences community to reflect on this theme in the context of the Rady Faculty.

Mikayla Hunter is a master’s student in community health sciences in the Max Rady College of Medicine and founding president of the Queer & Trans Graduate Student Group.

“I identify as a non-binary woman, which means that I identify both as a woman and as non-binary,” they said. “International Women’s Day should be inclusive of all women, including trans women, who experience immense discrimination. To inspire inclusion, we need to make sure that our efforts are anti-racist, anti-homophobic, anti-transphobic and anti-ableist.

“One change that comes to mind is the need to provide free menstrual products in washrooms on campus. Menstrual equity is essential to enabling women and non-binary folks to participate equally in their work and their studies.”

Dr. Diana Sanchez-Ramirez is an assistant professor of respiratory therapy in the College of Rehabilitation Sciences.

“The invaluable contributions made by women deserve proper recognition and should serve as a source of inspiration for girls,” she said.

“To inspire inclusion in the Rady Faculty of Health Sciences, all members of our faculty must refrain from perpetuating traditional gender biases and make active efforts to establish an inclusive environment where the contributions of every individual are valued and respected equally.

“Women across the Rady Faculty need to feel empowered and encouraged to express their opinions and actively engage in leadership roles.”

Rhonda Campbell is an Anishinaabe instructor in the College of Nursing who directs Mahkwa omushki kiim: Pathway to Indigenous Nursing Education (PINE), a unit that supports Indigenous students in obtaining their bachelor of nursing and becoming registered nurses.

“I’m encouraged by the work being done at the College of Nursing to address Calls to Action 23 and 24 made by the Truth and Reconciliation Commission [calling for more Indigenous professionals in health care, retention of Indigenous health workers in Indigenous communities, and cultural competency training for health-care professionals; and calling on medical and nursing schools to educate all students in Indigenous health],” she said.

“In terms of women’s equity and inclusion, we have women students in our PINE unit who have family responsibilities. They may be juggling part-time employment and childcare. We help them to access the financial, cultural and academic supports they need during their educational journey to become nurses.”

Dr. Anna Chudyk is an assistant professor in the College of Pharmacy.

“To me, ‘inspire inclusion’ calls for the purposeful co-creation of environments where all individuals who self-identify as women are supported to thrive to their full potential and achieve the goals and positions that matter to them,” she said.

“Those who self-identify as women in the Rady Faculty should have opportunities to weigh in, through methods such as town halls and surveys, on how Rady can ‘inspire inclusion.’ And Rady Faculty leadership should commit to working with them to transform the information gathered into timely and measurable change.”

Dr. Asmaa Haimeur is an assistant professor of restorative dentistry and director of equity, access and participation in the Dr. Gerald Niznick College of Dentistry.

“Inspiring inclusion means empowering women to speak up, to participate and to apply for leadership roles,” she said. “We must create welcoming and supportive learning and working environments where women can reach their full potential.

“We need to understand and work toward removing barriers that women still encounter daily; evaluate and improve upon policies and practices that affect women’s learning and working experiences; and establish or promote mentorship programs that support women in their career paths.”

Kimberley MacKay is director of undergraduate nursing programs in the College of Nursing.

“Inspiring inclusion means empowering women and gender-diverse folks, particularly BIPOC [Black, Indigenous and People of Colour] individuals, to pursue leadership roles,” she said.

“There is a need for leadership positions in the Rady Faculty that are designed for women from minority populations and gender-diverse folks to have a seat at the table where decisions are made. This would help to make decisions more inclusive and understanding of the needs of a broader community.

“To address gender inequalities, we need to ensure that we’re teaching the values of inclusion and diversity to our children right from the start.”

Alexa Pommer, a fourth-year bachelor of health sciences student, worked on the scoping review as a summer research assistant for Dr. Diana Sanchez-Ramirez, assistant professor in the college’s respiratory therapy department.

The virtual strategies identified from this review included diagnostic websites, online clinics and remote follow-up appointments to assess effectiveness of in-person visits. Results indicated these approaches can be useful to assess the causes of chronic cough, treat and track chronic cough symptoms.

Pommer, 21, was drawn to the project because of an interest in clinical research and respiratory diseases.

“My grandma had COPD and struggled with that for several years. I saw first-hand how that affected her, and how she was able to manage her condition a bit better with different interventions, medications and health-care professionals that worked with her,” she said.

Pommer says virtual care has a “growing landscape” since the pandemic. She said it can benefit patients who face barriers in accessing care, such as those with mobility issues or living in rural areas.

“As far as we know, this is the first literature review to specifically look at the virtual assessment and management of chronic cough. We hope this might be valuable for informing clinical practice and further research,” she said.

Pommer began a four-month placement working with Sanchez-Ramirez in May, funded by a UM Undergraduate Research Award. The term was just extended into September to finish other projects she has been assisting with, including research into long COVID.

“One study has to do with the association between physical activity, cardiorespiratory responses and symptom exacerbation in patients with post-COVID syndrome. People were given wearable biometric technology – a smart watch and a smart shirt that they wore on a day-to-day basis – that tracked different physiological parameters, like heart rate, breath rate and sleep,” Pommer said.

Currently, they are working on a report based on an event in June that brought together 30 participants with long-COVID symptoms.

“We’re working on a report which will present the patient perspective about their experiences with long COVID – how they feel, what they have seen, their interactions with the health-care system and their perceived needs for the management of their condition,” Sanchez Ramirez said.

Pommer said after she completes her bachelor’s program in Spring 2025, she is looking at either studying medicine or public health.

“That’s where I’m at right now. I’m interested in a career that has an aspect of research within it,” she said.

“I am very grateful to be working under the supervision of Dr. Sanchez-Ramirez. This research position has been a great opportunity to learn and gain experience in an emerging field. The skills I’ve developed will serve me well in my future career.”

“We think children were kind of at a disadvantage from the start because of the vaccines being rolled out a bit later for them,” said Catherine Campos, who is entering her second year of the bachelor of respiratory therapy program at the College of Rehabilitation Sciences.

Campos and Samantha Prokopich, a second-year student in the Interdisciplinary Health Program, Rady Faculty of Health Sciences, worked this summer with Dr. Diana Sanchez-Ramirez, a researcher and assistant professor of respiratory therapy, on two projects looking into long COVID in children.

Long COVID is a condition that affects people beyond their initial COVID-19 infection. The most common symptoms of long COVID are fatigue, shortness of breath, muscle pain and difficulty concentrating.

The primary work was a systematic review of persistent long COVID effects on lung function, cardiorespiratory symptoms and fatigue in children and teenagers. The study identified 17 relevant articles published in several medical journals.

“We focused on the persistent effects of COVID after three months of their initial diagnosis. We looked at things like lung imaging, their function, cardiorespiratory symptoms, fatigue and their ability to return to school,” Campos said.

“With children, it could affect their respiratory system along with other organ systems, such as cardiovascular and neurological.”

She also noted that children are not as likely as adults to go to follow-up appointments following the acute phase of COVID.

“The research on children and adolescents is scarce, a lot of people are unsure if long COVID is something they are experiencing,” she said.

The second project Campos and Prokopich are involved in is a survey on the prevalence of long COVID in Manitoba. The survey is open to any Manitobans who wish to participate.

“The data are coming from health practitioners, respiratory therapists, all within health institutions. We’re trying to figure out if people are actually going to get help for long COVID or if it’s one of those things where they say, ‘I’ll just work through it and see what happens,’” Prokopich said.

The students both received an Undergraduate Research Award from the University of Manitoba for this summer research work. The award allows recipients to choose a professor to pair with whose work aligns with their interests.

“It just so happened that we were both really interested in (Sanchez-Ramirez’s) lab and COVID research,” Prokopich said.

“I have family who have kids that are currently going to middle schools and elementary schools, so having a chance to see how COVID is affecting people close to me was a really exciting opportunity.”

The systematic review took place over 16 weeks, starting in May and concluding in August. The survey will continue into the fall.

“We are hoping that this study, along with filling out the survey, helps people to openly discuss and identify symptoms that may be long COVID,” Campos said.

Long COVID is a condition that affects people beyond their initial COVID-19 infection. The most common symptoms of long COVID are fatigue, shortness of breath, muscle pain and difficulty concentrating. Emerging evidence suggests that 10 to 30 per cent of individuals who have had a COVID infection experience long-COVID symptoms. 

“Given the number of confirmed COVID-19 cases, it is likely that thousands of Manitobans are affected by long COVID,” said Dr. Patty Thille, administrative lead for the project.

“Emerging international guidance recommends that policy-makers address long COVID through a multidisciplinary approach, including interprofessional rehabilitation services.”

Rehabilitation interventions like supervised conditioning programs, respiratory training, developing strategies for living with cognitive symptoms, and mindfulness and cognitive behavioural therapy for mental health concerns are among the important components of long COVID recovery, Thille said.

The group includes nine faculty members from the College of Rehabilitation Sciences, joined by one from community health sciences in the Max Rady College of Medicine and a PhD student in the Applied Health Sciences program.

PhD student Brenda Tittlemier works part time as a best practice coordinator at the Health Sciences Centre and was asked to take part to provide a health-care worker perspective.

“It is very exciting that some early research is showing that rehabilitation can help people with long COVID improve their function, and as such, rehabilitation for long COVID should be available to all Manitobans within our health-care system,” Tittlemier said.

Two group members, Dr. Sandra Webber and Dr. Diana Sanchez-Ramirez, have published papers on long COVID over the last few months. The group is also supported by two research staff, one of whom is also a master’s trainee.

Thille, an assistant professor of physical therapy, said long-COVID patients may be referred to rehabilitation programs that are not designed to meet their needs, as there are few existing programs for long COVID.

“To meet the demand of long-COVID clients, there was a big influx of referrals to the WRHA (Winnipeg Regional Health Authority) pulmonary rehabilitation program. While that may help people in the Winnipeg region with lung and breathing problems, it can’t help with the extreme fatigue some experience after exertion,” she said. “Many people with long COVID are not eligible for this and other existing rehabilitation programs, leaving them without any rehabilitation services at all.”

From July to October 2021, the group conducted an environmental scan to learn about long-COVID management across Manitoba, Canada and other countries with similar health systems. They found that Alberta, and Saskatchewan are the only provinces to currently have long-COVID frameworks in place, and only BC has an interdisciplinary care network for long COVID care.

They noted several provinces plan to manage long-COVID patients through existing systems, but that Manitoba lacks the capacity to do so due to consistently high demand of publicly-financed rehabilitation programs for people with non-COVID rehabilitation needs.

They also identified major gaps in Manitoba, including accessible community-based interprofessional care and services for youth and children.

“Rehabilitation programs specifically for people with long-COVID are being developed but are not yet funded,” Thille said.

The group is now meeting with Manitoba provincial health system leaders to facilitate efforts to support people living with long-COVID in Manitoba.  Among their recommendations are for decision-makers to ensure dedicated resources and funding specific to long-COVID patients, and that provincial health authorities coordinate to improve access to rehabilitation specialists with proper referrals.

Read the full report.

It was clear that respiratory distress was one of the main causes of hospitalization and death among patients with COVID-19. So Sanchez-Ramirez immediately turned her attention to a study of its effects on people with respiratory illnesses, such as chronic obstructive pulmonary disease (COPD).

“I was concerned about what would happen among people who already have lung disease or are at increased risk for developing it, such as smokers,” she says.

The study, published by the Journal of Respiratory Medicine in July 2020, used a systematic search of literature related to patients with COVID-19 between Jan. 1 and April 15, 2020. “We found that people with COPD are more prone to severe outcomes if they catch COVID, so we’d like to protect them while keeping them safe at home.”

Sanchez-Ramirez is currently focused on assessing the long-term impact of the virus and improving rehabilitation for post-COVID-19 patients, many of whom have continuing symptoms, including fatigue, shortness of breath and chronic cough.

In collaboration with an international research team, she recently published a review of activities of daily living in post-COVID-19 patients and completed another study exploring the long-term effects of the illness.

One of her studies explores the use of virtual platforms and portable devices to engage patients who have interstitial lung diseases (diseases that cause lung scarring and breathing difficulty) in a home exercise program. The devices include spirometers for measuring the amount of air a patient can exhale.

“We can provide patients with basic devices, and assess and supervise them virtually,” the professor says. “But we still need to determine the safety and cost benefits of delivering this at-home program.”

On another project, she will use “smart shirts” that can track multiple cardiorespiratory variables.

Sanchez-Ramirez was born in Colombia, where she earned a bachelor’s degree in physical therapy, and later obtained joint Erasmus Mundus master of public health and PhD degrees supported by the European Union.

She moved to Canada in 2014 for post-doctoral training at the University of Alberta’s Injury Prevention Centre. In 2017, she joined UM as a research director for the continuing professional development program in medicine before moving into her current position.

Her research program aims to find ways to enhance quality of life and participation among people with respiratory diseases. She is particularly interested in helping patients in vulnerable populations, including older adults, Indigenous people, immigrants and those in remote areas.

In a way, she notes, the pandemic has helped move her research forward unexpectedly, particularly in bringing pulmonary rehab to those who had limited access before.

“We knew we needed to explore virtual options, but with COVID we were forced to do it quickly,” she says. “There was an opportunity to be creative, but it also led to identifying knowledge gaps and needs, such as the need to individualize assessment and monitor exercise capacity virtually.”