The mainstream media has convinced many to focus on burning police cruisers and shattered shop windows as the key images of the Toronto G20 Summit. What have largely been ignored are the chilling details of police violence on protesters and bystanders: both in terms of direct injuries on the streets and violence in detainment, the effects of which will be long-lasting.
What has also been neglected is the structural violence  that will result from the decisions made by the leaders who attended the G20 Summit; decisions that thousands came out to protest.
The Toronto Street Medics is an independent organization of volunteers with various levels of health training. We provided preventative health services and first aid to protesters and bystanders. Such support is not an apolitical act. We saw our actions as enabling others to exercise their right to dissent and we freely provided care to all. For many, this is linked to the principle that health is a human right. For others, this is tied to a commitment to social justice, seeing health as essential for political engagement.
We gave out water and sunscreen, but we also dealt with severe injuries. All of the serious injuries we treated were inflicted by the police. While violence against property received a great deal of coverage, violence against people -- broken bones, cracked heads and eyes filled with pepper spray - has yet to feature prominently in any mainstream media. Our teams of medics witnessed and treated people who had been struck in the head by police batons, had lacerations from police shields and had been trampled by police horses (See examples here, here, here and here).
Medics escorted several victims to nearby hospitals who were later diagnosed with concussions and fractures. Many others provided first aid, beyond the Toronto Street Medics; hence these reports are only a part of the bigger picture.
Street Medics faced barriers in many instances. We witnessed people being seriously injured behind police lines who could not be assisted. Our concern for these individuals is immense. Several medics were detained by police and intimidated, despite identifying themselves. Medical equipment, such as gauze, band aids and gloves, was confiscated. We were intimidated and made to feel that what we were doing was illegal. In fact, we were simply providing first-aid.
Further violence occurred in detention. We assisted a number of people upon their release who shared their experiences with us. People were denied basic necessities, including water, food and appropriate toilet facilities. Rights were denied, including prompt access to legal services. Access to health services, including to personal medications for chronic diseases, was curtailed. For the people we assisted, medications were not returned upon their release. People were forced to frantically seek new prescriptions and purchase medications, with at least one case of withdrawal from a medication occurring. Some experienced sexual violence while in detention and many have reported symptoms of anxiety and trauma (See here and here).
Like other organizations (see here and here), Toronto Street Medics is demanding an investigation into violent police action at these protests and conditions within the detention centre. An independent body must conduct this, one without any connection to the police or the Integrated Security Unit. Further, those still in detention, given the conditions and context of their imprisonment, should be released.
However, this is not enough. First, as a community, we must begin to recognize a pattern: the criminalization of dissent. Our hard fought rights to protest, to assemble and to be free from unlawful detention are being eroded. This process accelerated in the years following 9/11, under the auspices of the "War on Terrorism". Many of the police powers granted during that time have been retained and used to quell dissent. In fact, the term "terrorism" was applied to some of the demonstrators this past week.
Second, we must recognize that arbitrary arrest, detention and police violence are everyday occurrences for some, including Indigenous communities, people of colour, sex workers, the homeless and our community members with precarious status. We are collectively guilty of paying attention only when unusual suspects fall victim, such as the university student, the journalist or the bystander. Recommendations for change must address the violence that marginalized communities face daily.
Third, while over 900 people were being arrested in the streets by a security force that cost nearly $1 billion, the leaders of the world's largest economies collectively agreed to focus on austerity measures. "Growth-friendly plans to deliver fiscal sustainability" is code language for cutting social spending while lowering taxes for corporations and financial institutes. The impact of such policies on health care, education, job security and welfare will be devastating, particularly in communities in the Global South and marginalized communities here. This, as well as the undemocratic way such decisions are made, is what thousands were protesting over the past week. Yet their voices have been scarcely heard.
As health providers, we learn that making a diagnosis is about pattern-recognition. Here, that pattern is clear: violence against people in the streets, violence against people through economic policy. What is our proposed treatment? Transparent, democratic, participatory decision-making and action that prioritizes health, dignity and social justice ahead of economic growth. This weekend, we witnessed brutality, but we also saw individuals helping strangers and communities coming together. Another world is possible.
 "Structural violence" refers to the harm caused by social, economic and political systems and processes. Galtung J. Violence, peace and peace research. J Peace Res. 1969;6(3):167-191. P. Farmer. 2003. Pathologies of Power:Health,Human Rights and the New War on the Poor. Berkeley: University of California Press.
Andrew, Malika and Michaela are all resident physicians in Toronto. This article was written in conjunction with Alison Gorbould, Paul Harrison, Vanessa Lehan-Streisel, Abeer Majeed MD, Nanky Rai, Priya Raju MD, Sarah Reaburn, Alicia Ridge RN, Samir Shaheen-Hussain MD, Sophie Schoen RN, Katie Wolk, Mubarak Cheema, Ritika Goel MD, and Tomislav Svoboda MD for the Toronto Street Medics.
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