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Proposal by College of Physicians and Surgeons to have all circumcisions performed in medical clinics “cut off” before it could go anywhere

By BERNIE BELLAN It began with an emailed message sent out by Jewish Federation CEO Elaine Goldstine to members of the community on July 13.
In her message, Goldstine informed recipients that the College of Physicians and Surgeons of Manitoba had issued a draft proposal that, if accepted, would prevent any circumcisions from being performed anywhere other than in a “medical clinic”.

The proposal, however, did not include any specific reference to the Jewish tradition of “brit milah”, which has traditionally been performed in a home setting.
According to Goldstine, “If brought into force, this draft as it is currently worded would therefore make the performance of a brit milah by a physician outside of a medical clinic a violation of the College’s Standard of Practice.

 Even though the Draft Standard by the College has been in the public domain for approximately one month, the Jewish Federation was only made aware of its contents yesterday” (July 12).
Further, according to Goldstine, “

The Jewish Federation immediately reached out to the College of Physicians and Surgeons of Manitoba to discuss the matter. Based on those discussions, this was unintentional.”

Subsequent to Goldstine’s email to members of the Jewish community, the Winnipeg Council of Rabbis sent a letter to the College of Physicians and Surgeons, also indicating strident opposition to what was perceived as the College’s new policy governing circumcisions.
In the letter, which was penned by Rabbi Allan Finkel of Temple Shalom, the Council enumerated a number of points, all of which detailed the long history of circumcision within the Jewish community.

B’nai Brith Canada also joined in the opposition to the College’s proposal, noting that “If enacted, this would constitute a significant infringement on the important Jewish lifecycle event of brit milah. Jewish circumcisions are typically family events hosted in homes or synagogues, involving a celebratory meal, blessings and speeches. None of these can practically take place in a medical clinic or hospital.
“In correspondence with B’nai Brith, the CPSM has clarified that pursuant to Manitoba law, non-CPSM members can also perform ritual circumcisions and would not be bound by the proposed Standard of Practice. But the main mohel, or Jewish circumciser, in Manitoba is a CPSM member, and the mooted change would have the effect of preventing any future Manitoba mohel from performing traditional Jewish circumcisions while maintaining a medical practice, which is standard across Canada.
“There is no evidence that the CPSM specifically consulted the Jewish community about the proposed change, despite its obvious impact on Jewish life in Manitoba. It is also not clear what prompted the proposed restrictions, and B’nai Brith is not aware of equivalent strictures in any other province.”

A perusal of laws as they apply in other countries did not turn up any other jurisdictions which require that circumcisions be performed only within a medical clinic.
We wondered what may have led to the College of Physicians and Surgeons, perhaps unintentionally but with drastic implications nonetheless, wanting to regulate the practice of circumcision in a way that had never been ordered previously?

As background to the College’s apparent radical policy directive, Myron Love sent me a story that was originally reported by the CBC in December 2018. In that story a CBC journalist reported on two botched circumcisions that had been carried out by a Dr. Ejaz Ahmad. The CBC report noted that:
“Two boys almost bled to death from botched circumcisions performed by a now-suspended Winnipeg doctor.
“Dr. Ejaz Ahmad pleaded guilty to professional misconduct on Oct. 15 (2018) for performing circumcisions on

as many as 18 pediatric patients in 2016 and 2017, when he lacked the training and know-how to do the procedures.
“Several of his young patients ended up in the emergency room with complications.
” ‘It is disturbing any time a physician practises and performs procedures that they are not competent to do,’ said Dr. Anna Ziomek, CEO and registrar of the College of Physicians and Surgeons of Manitoba, in an interview Thursday.
“Among the complications, two boys were rushed to hospital with potentially life-threatening bleeds, one after a portion of his penis was amputated and the other with arterial bleeding.
“Other boys experienced complications like swelling, pain, embedded gauze from improper wound care, possible infections and disfigurement.
“At least one boy’s penis was left so deformed he required a revision surgery.
“Ahmad admitted to using an inappropriate technique and lacking knowledge, skill and judgment. He acknowledged he provided anesthetic at a ‘non-specific dose,’ used only alcohol swabs to sterilize the surgical site and did not suture after circumcision.”

But, here’s a crucial part of the story: “The circumcisions were performed at Ahmad’s private clinic.”
One wonders, therefore, how the College’s proposal to require that all circumcisions be performed within a medical clinic would have made any difference if a physician is not fully competent to perform those procedures, as was evidently the case with Dr. Ahmad?
Apparently the storm that resulted from the initial disclosure by Elaine Goldstine in her email to community members that the College was considering ordering that all circumcisions in future be performed within a medical clinic led to a quick reversal on the College’s part.
By Friday, July 16, the College had posted a notice on its website indicating a complete abandonment of its proposal. Here is what that notice said, in part:
“We recognize that as currently written, the standard would implicate a practicing CPSM (College of Physicians and Surgeons of Manitoba) member performing a male circumcision outside of an appropriate medical facility. That was not the intention in drafting the standard…

“The standard will be amended. The standard will not infringe on any human or religious rights and freedoms whatsoever. The role of CPSM is to protect the safety of the public, and we will continue to strive to achieve this through appropriate regulation of the medical profession.
“At a minimum, the working group will add an exemption in the standard for male circumcision performed in a religious ceremony or tradition, particularly respecting low-risk neonatal circumcisions…
“CPSM established a working group in 2020, tasked with developing a new standard of practice for performing specific procedures in office-based practice settings, including male circumcisions.
“The working group did not consult with the Jewish community in its early development of the draft Standard; however, that is precisely the purpose of the current public consultation, and we are grateful for the feedback received.”

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Long-time Winnipeg doctor and Israeli colleague make medical app available to general public

Dr. Gerald Minuk (left) and Dr. Daniel Iluz-Freundlich

By MYRON LOVE Seven years ago, Dr. Gerald Minuk, Canada’s first hepatologist (liver specialist), partnered with Israeli computer science student Daniel Iluz-Freundlich  in founding Refuah Solutions Ltd (RSL). Their goal was to create an app – which they called PI-enroll (“PI” stands for “Principal Investigator”), which was designed to be used by clinical trial investigators that would save them time and effort so they could be more personally involved in seeing their trial patients.
Last month, they released their second app, this time for patients. The app, called  Patient-empower, informs patients about clinical trials underway for their condition and helps them make an informed decision as to which trial best meets their specific needs and preferences.
“I was approaching retirement,” recalls Minuk, now Rady School of Medicine Professor Emeritus, who has been in practice in Winnipeg since 1987, and “I couldn’t see myself filling my days doing crossword puzzles or Sudoku.  I wanted to be able to continue contributing to medical research and patient care.”
It just so happened that, at the time, Minuk was introduced to an Israeli student, Daniel Iluz-Freundlich, who had just finished studying Computer Sciences at the University of Winnipeg. (Minuk notes that Iluz-Freundlich – on graduating – received the Gold Medal in Computer Science.)
“Daniel is an exceptionally talented young man,” Minuk says.  “So I tapped his computer programming skills to create our PI-enroll and subsequently, our Patient-empower apps.”
The friendship continued after Iluz-Freundlich returned to Israel in 2020 to begin medical school on a Phil and Elle Kives Scholarship, where he earned numerous honors. Iluz-Freundlich is currently an intensivist anesthesiologist at the Beilinson Hospital in Israel. Despite his new professional responsibilities, including caring for IDF forces wounded in Gaza– he has remained active with Refuah – as vice-president of the company.
Minuk adds that a dozen other senior professors of medicine also contributed to Refuah’s software design.  “Together,” he reports,  “the company represents 400+ years of clinical trial experience. That experience is being applied to identifying and addressing the major challenges investigators and patients face when conducting or participating in clinical trials.”`       
He adds that Refuah Solutions has established a truly global network with company personnel in San Diego, São Paulo, Mexico City, London, Barcelona, Nairobi and Delhi thus far.
According to Minuk,  the company has enjoyed worldwide success – with over 2,000 doctors in 40 countries and 50 drug companies signed on for the PI-enroll app. He attributes this success to the app’s impressive results. In a recent global clinical trial, Minuk reports,  within 3-6 months of implementing PI-enroll, investigator personal involvement increased by 60% and with that, patient enrolment increased by 80%, patient drop-outs decreased by 50% and there were 20% fewer protocol deviations (mistakes made). In addition, 90% of PIs rated the App 8 out of 10 in terms of usefulness.
He adds that one site that had not enrolled any patients for 12 months, subsequently became the trial’s leading enrolment site.
Regarding the newly released Patient-empower app,  Minuk notes that despite the many benefits patients derive from clinical trials including free and early access to new and often safer and more effective treatments, fewer than 10% of patients who would qualify for a clinical trial are ever invited to consider that option. “The problem,” he explains, “is that most Health Care Providers are either unaware of what clinical trials are underway in their area or if they are aware, don’t have the time to discuss the trials with their patients.”
Therefore, Minuk, Iluz-Freundlich and their team designed and recently released their second app – Patient-empower – which informs patients of what clinical trials are underway for their condition and empowers them to select the trial that prioritizes their needs over those of industry.
The platform, he explains, uses AI to generate concise, easy-to-understand summaries of clinical trials tailored to the patient’s location—city, state, country, or globally, depending on their preference. Each summary includes clear explanations of the patient eligibility criteria and key practical details, such as the likelihood of patients receiving a placebo, the number of required site visits, and other important practical considerations. It also suggests questions that patients should consider asking the investigator before they consent to enrolling. The trial information is presented in a shareable format to facilitate discussions with family, friends, and local healthcare providers—supporting both patient confidence and continuity of care.
Once a trial is selected, Minuk continues, Patient-empower provides the contact information for the trial investigator closest to the patient’s location, the trial’s sponsor and, where available, the world’s experts in the field.
The feature Minuk is most enthusiastic about is the “Recent Findings” page which keeps patients up to date on newly published clinical trial results and discoveries relevant to their condition. 
“Patient-empower is available to patients from internet venues (App Store or Google Play) or through NFP organizations, associations, societies and patient support group web-sites,” he adds. “Although only recently released, we have already attracted interest from the American Diabetes Association, the Alzheimer’s Society of America, the Canadian Liver Foundation, Colorectal Cancer Canada, the American Myasthenia Gravis Society and many others.”
“Overall, Patient-empower informs patients, and more informed patients benefit everyone involved. After all, it’s the patient’s health; their voice should be heard,” Minuk concludes.

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The South Seas come to the Asper Campus

Pacific Island dance team with members of the Sarah Sommer Chai Folk Ensemble

By MYRON LOVE On Thursday, July 24, about 150 members of our Jewish community got a chance to sample the dance and music of the South Pacific. The event was billed as “Beyachad Together – Celebrating Indigeneity, land, culture and identity.”

Sarah Sommer Chai Folk Ensemble

The program featured both the Sarah Sommer Chai Folk Ensemble dancers and Steinbach-based Island Breeze Manitoba – which describes itself as “a high energy live band & Pacific Island dance team featuring authentic outfits and dances from the islands of Hawaii, Tahiti, Fiji, Samoa and New Zealand.”

According to Dr. Ruth Ashrafi, Regional Director of B’nai Brith Canada in Manitoba, the evening’s performance was connected to  an Indigenous Peoples Conference that was held in Steinbach under the auspices of Island Breeze with participants from Canada, the United States (specifically Hawaii), Antigua and Bermuda in the Caribbean, South Africa, the Philippines, Japan, Australia, New Zealand and the South Pacific island countries of Fiji, Tonga, Samoa, the Solomon Islands and Tonga.   

Pacific Island dance team


 “The conference organizers contacted B’nai Brith Canada,” Ashrafi reported.  “They wanted to bring greetings to the Jewish community, as the indigenous people of the Land of Israel, and celebrate indigeneity together through dance and music.
 “Their support in these difficult times is heartwarming.”
 
 In her opening remarks as emcee for the evening, Ashrafi noted that “it is a great honour for the Jewish community to welcome so many indigenous guests from all over the world.”
 She then related the story and miracle of Chanukah and connected it to the experience shared by many indigenous nations around the world.
“They have been told that their religion is wrong, their traditions are not sophisticated,” she pointed out, “just as the Jews of that time were told by the Greek rulers that our religion was wrong and our traditions were outdated.
“Here in Canada, the First Nations were forced into Residential Schools to learn Canadian ways. The manner in which they were taught in these schools was abusive and horrific. Many children died, and many more were scarred for life.
“As with the Maccabbees,” she continued, “courageous individuals have stood up and fought for rights of their indigenous brothers and sisters. They had to overcome a lot of resistance and other obstacles. Indigenous peoples are still over-represented in the Canadian prison system and social services.
 “The story of Chanukah tells us that it is okay to be different from the majority culture,” she said, and “that special and unique traditions are important and worth preserving.
 “The story of Chanukah also teaches us that fighting for our rights is not easy,” Ashrafi added. “We may be a tiny minority and the other side may be much more numerous, better organized and equipped. But if we take the first step, like deciding to use that little jar of oil (that burned in the Temple for weight days even though there was only a day’s supply), we will be helped along the way.”
 
 
“We put the Menorah in our front window,” she noted, “so that the light is shining into the dark winter nights. We want to share the story of the Chanukah miracle and we want to bring light into a world that has still so much darkness in it.”
Ashrafi’s words were followed by greetings from David Harper, a former Manitoba Keewatinowi Okimakanak Grand Chief who spoke glowingly of his visit to Israel in  2014.
“Our faith teaches us that the People of Israel are the people of the Bible and we must bless them and pray for them,” he said.  “My people have a lot to learn from the people of Israel about healing the land.”
Next, Ashrafi introduced Pastor Roger Armbruster whom, she described, as the man behind the vision for the evening.  Armbruster, a strong Christian Zionist supporter of Israel, is the founder of Canada Awakening Ministries.
 
She said of Armbruster that “it is a privilege to be his friend. I have learned so much from you.”
 
 According to Armbruster’s bio on the Canada Awakening Ministries website, “his life has been dedicated to a ministry of reconciliation, and of building bridges between cultures, nations, denominations and generations. He sees cross-cultural reconciliation as a key to making disciples of all nations, and in seeing God’s House become a House of Prayer for all nations.
 
“As director of Canada Awakening Ministries, he is a leader in facilitating Native-Non-native reconciliation, and in restoring the indigenous peoples of the land to reflect that part of God’s image that He has deposited in them in their sounds, songs, praise and dances.”
 
Armbruster attended the Inaugural World Christian Gathering of Indigenous People in New Zealand in November 1996 as well as gatherings in Rapid City, South Dakota, in 1998, northern Sweden in 2005, and Israel in 2008.  In his remarks, he noted that he has visited Israel numerous times over the years – often leading tour groups representing  Canadian Inuit, Greenlandic Inuit and Manitoba First Nations at the northern ends of the earth, along with Maori, Fijians and Samoans from the southern ends of the earth – back to the City of Jerusalem from where the original gospel message first came. 
“In Israel,” Armbruster said, “these Indigenous People have shared their language, their culture and their faith with both Jewish and Palestinian audiences alike.  In one Israeli community, they even shared a message that brought hope to a joint audience of some 500 people that included both Jews and Arabs coming together.”
The dance part of the program was emceed by Isi Masi of Island Breezes. The musical program included several Hawaiian dances, including a rousing foot-stomping number,followed by performances featuring Hawaiian song and gentle movement.  The final part of the island dances concluded with a brief Maori war chant.
(The Maori are the indigenous people of New Zealand.)
The final part of the program included several high octave dances by our own – always outstanding – Sarah Sommer Chai Folk Ensemble, with all the performers singing “We Shall Overcome” and the audience invited to join in a round of Israel dancing. 

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Israeli-born realtor believes in paying it forward

By MYRON LOVE When Hofit Yanev and her husband, Stefan, first arrived in Winnipeg in May 2013, they knew no one here.
 
“We were looking for a safer environment in which to raise our children,” she recalls. “We thought that would be Canada, and Winnipeg seemed to be the most welcoming Jewish community.”
 
Despite not knowing anybody, on their first morning in our community they found that someone had left a challah on their doorstep. That was a small kindness that she has never forgotten. She is a strong believer in paying it forward. Ever since then, she notes, she has made sure to greet newcomers in our community with a challah.
 
Helping others – whether to buy and sell their homes or manage their money – is a principal focus of the thriving career she has built up here as a real estate agent and insurance adviser.
 
Sales has always been Hofit Yanev’s strong suit. Originally from Holon (near Tel Aviv), she began her sales career right after her army duty. Her first venture was selling Dead Sea and hair care products. (Some readers may remember the kiosks that used to be set up at some Winnipeg shopping centres some years back.) She worked a year in Chicago and four years in Miami before returning to Israel, where she met and married Stefan.
 
Soon after settling in Winnipeg, Hofit found work in sales, initially for an HVAC company (while Stefan became a long-distance truck driver and now operates Excellence Fences and Decks). “As I was doing very well in sales for this company,” she recounts, “after taking time following the birth of our third child, I decided to try selling houses.”
 
She secured her real estate license and went to work. After 18 months of trying, she was still struggling to make a go of it.
 
“I lacked experience,” she recalls. “I reached a point where I was ready to give up and go back to selling HVAC products.”
 
However, on what she thought would be her last day, she received two calls that revitalized her hopes. In quick succession, she recounts, she got a call from a former customer who wanted her to sell his house and a new customer who wanted her help in selling his house and buying another.
 
“I took it as a sign from God,” she says.
 
Today, eight years later, Yanev, working under the eXp Realty banner, oversees an operation with over 20 agents—nine of whom are on her team and the others working under her in the eXp umbrella.
 
“I achieved my dream,” she notes, “and I want to help others – either those looking to buy a home or fellow realtors starting out – to realize their dreams as well.”
 
She notes that she strives to understand what her clients’ needs are and provide the right homes for them. She reports that 70% of her real estate clients are members of our Jewish community. She deals with commercial as well as residential properties and adds that she also helps clients with long- and short-term rentals as well as car rentals.
 
About a year ago, she notes, she added another entry to her resumé – that of insurance adviser. “As a realtor, I could see how some people are struggling financially,” she says. “I wanted to help.”
 
As an insurance adviser, she works with single mothers, seniors, and others plagued by financial difficulty. “I advise clients on how to get out of financial trouble, how to save 10% of their net income, and build their savings.”
 
She makes it clear that she keeps a distinct separation between her real estate clients and her insurance clients.
 
Now, you would think that an individual working two careers – with five kids to raise (all of whom are enrolled in Jewish educational programs) – would have her hands full. Nonetheless, Yanev has a third avocation – that of a social events planner for fellow Israelis in Winnipeg and other Hebrew speakers.
 
“For the past six years,” she reports, “I have been producing five programs a year in our community for Hebrew speakers. No one else was doing it, and I felt that it was important for Israelis here to be able to connect with each other.”
 
She adds that the family-oriented programs have been “super successful.” “We have had as many as 300 people at some of our programs.”
 
Yanev believes that her success story can inspire other newcomers to Winnipeg. “If you are prepared to work hard, you can achieve your dream,” she says.
 
She also expresses gratitude to our Jewish community. “We have found the community here to be welcoming and supportive,” she says. “It is thanks to you that we have been successful. This really is friendly Manitoba.”

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