A healthcare professional with a passion for medicine, Yllka Spaho-Skilja has honed her education and training as a pharmacist to ensure patients take active ownership of their health through quality use of conventional and complementary medicine. She is also a small-business proprietor who co-owns the pharmacy where she practices.

This interview comes in recognition of International Women’s Day. In March of 2018, I did my first interview with the acclaimed soprano Ermonela Jaho, and since then I have talked to prominent women in the art world for each March issue. This point in time marks a full year of the global coronavirus pandemic since WHO announced it in March 2020. So, I am pleased to speak with a healthcare professional and proprietor such as yourself. Also this is my first interview with a member of our community in Canada. While we continue to fight the pandemic, in the course of the public health crisis, we (the public) have become increasingly aware and appreciative of the intense pressure on each sector of the healthcare system. What has it been like for you as a pharmacist, personally and professionally?

– It is my pleasure. Knowing the history of your prestigious newspaper; I feel really honoured and thank you for the opportunity given.

What an extraordinary year indeed; I cannot believe it has already been a year since everybody’s life literally changed overnight. It was a challenging year for sure; no one predicted the speed, severity, depth, and magnitude of the COVID-19 pandemic and I felt the challenges both personally and professionally. Looking back, it has been a year that taught me a lot; everyone’s mental, physical and emotional limits were tested; mine included. So this March 8th, even though there was no celebration as it used to, I felt blessed to be surrounded by such amazing, brave, compassionate women such as my sister and my friends and to have great role models in my life like my mother and mother-in-law. Reflecting on the profession I feel proud about the enormous role pharmacy has played in helping patients to navigate the unknown and face the realities of the pandemic; pharmacy professionals have certainly gone over and above during this public health crisis to ensure continuity of care and it does feel good to be part of it.

You mention the compassionate women and role models in your life. As you know, women are often asked how they balance family and work. How do you answer that?

– This question reminds me of an interesting essay I read some time ago written by Kate Ryder, founder, and CEO of Maven, a digital health care company, titled The question we ask every mom (but never dads). “I frequently get asked about ‘work-life balance,'” Ryder writes. “My husband, an executive at Google, who changes as many diapers as I do, never”. There’s clearly an overall expectation that the burden of domestic life falls primarily on women. That assumption starts young and I think we should change that. Encouraging both our daughters and our sons to think and imagine fully formed lives for themselves — lives that include a career and a family and all that both entail would be a good start.

On a personnel level I should say that I have an amazing husband; he and I support and push each other to succeed; we make a great team. It is not easy for sure; things you hold dear compete for your time but if you support and encourage each other you can make it work.

What can you share with the reader about your life as an Albanian immigrant in Canada? With a family, a startup and a career, do you find that your story relates to the Albanian community?

– For sure immigration is not easy; you are leaving all your life behind and moving to a new unknown country. I think it is one of the hardest decisions in a person’s lifetime. I also think there is no one immigrant life experience; it depends on who you are, on how prepared and knowledgeable you are, and also, on plain old luck.

Multiculturalism is a key part of the Canadian identity and that makes Canada an awesome place for new immigrants. I see Canada as a “mosaic “where people from all cultures live in harmony, while also maintaining their cultural heritage. Canada embraces immigrants and has one of the highest immigration rates per capita among developed nations. As an immigrant, you do feel welcomed, included, and treated fairly.

I see the Albanian-Canadian story as a success story. The majority of Albanians in Canada are professionals; this also due to the immigration process requirement, and you see this drive the community has to achieve and succeed. The community is growing and more and more members are succeeding and excelling. It seems like most of us have found our way to a place that lets us realize our full potential and that makes us happy.; after all, that’s why most people choose to immigrate in the first place; for a better life.

Your education, studying and training prepared and drove you to the next important step in your career. You founded SelectHealth Pharmacy with a mission of offering “comprehensive and integrated approach to health and wellness’ as stated. Can you explain your vision of an integrated approach to healthcare and how you got there? How has the community responded?

– I have an experience of more than 10 years as a compound pharmacist and was lucky enough to work in one of the oldest and most prestigious compounding pharmacies in Canada. My experience as a compound pharmacist-led me to Integrative and Functional Medicine and as I advanced my knowledge in this field I realized that managing health issues and improving health and well-being needs to be done through more than pharmaceutical medicines alone. So I created this vision of how I wanted to practice and the best way to turn my vision into reality was through my own pharmacy; that’s how SelectHealth came to life. We are combining traditional pharmacy services with natural alternatives, and offer a full-service medical dispensary coupled with a broad range of natural and homeopathic remedies. There is a gap between conventional and complementary medicine and I want SelectHelath to serve as a bridge between the two. Our mission is to move away from the traditional prescription-centered community pharmacy model and offer a more personalized pharmacy experience that integrates conventional pharmacy with evidence-based complementary medicine; innovative products and also other services that improve the health and well-being of our patients; all in one place. For example, right now I am collaborating with a nutritionist, an osteopath, and also a reflexologist who offer their services at SelectHealth Pharmacy. The community has really embraced this approach and we have had very positive feedback so far.

Among issues related to the public health, one in particular is very troubling, namely the long lasting impact of the pandemic on mental health. You clearly focus on raising awareness on mental wellness as a cornerstone of overall health. Why is it important to approach this comprehensively? How do you address on the local level issues of anxiety, grief and uncertainty that have reached global proportions?

– There is no health without mental health; that is why it is so important to break the stigma and raise awareness. The fragility of mental health has never been more exposed than during the COVID-19 pandemic. We are living through unprecedented times and the impact the pandemic is having on mental health is enormous. We should remember that this is absolutely the time to lean on each other. Even if we can’t be close physically we need to stay close emotionally. I always advise my patient to stay in touch and reach out if they need support. I’ve been active through the pharmacy social media, shared suggestions to help support mental health and wellness at this time of uncertainty, and also put together and shared helpful resources with my patient. Pharmacists are the most accessible of the health professional group and this became evident during the pandemic; a lack of assess to physicians led patients to rely more on their pharmacist. I realized that I needed to do extra as a pharmacist and that’s what I did. I put the patients at the center of my care; listened and provided accurate information and tried to be an honest, reliable voice of reason. I focused on self-care strategies, often spoke to my patients about meditation and how to practice mindfulness; I followed up and provided referrals when someone was struggling.

The elderly are among the vulnerable segments of the population that have been negatively affected by the isolation related to the pandemic and other restrictions. You have prioritized their care and drawn attention to seniors in your postings. Can you talk more about this topic

– I think the elderly are facing the most threats and challenges at this time. The elderly population has been worst affected by both the virus and the lockdown measures and that is why I focused on our senior patients. I offered concierge service to them, delivering not only their prescriptions but also everything else they needed from the pharmacy such as vitamins, supplements, incontinence products, and even toothpaste. I tried to make some social connection upon delivery while practicing social distance; spending that extra time and having a chat meant everything to them. I would leave handwritten notes on the delivery package when no one was answering the door and that was really appreciated. I made phone calls and spend time to understand what was going on, especially with those affected by multiple conditions. I provided education on Pandemic and answered their questions. I produced information leaflets on Covid and spend a lot of time talking to them on the phone. I made a list of vulnerable patients and I would call them every 2 weeks to ask how they were doing and to check on their prescriptions. I was not easy but I am consistently being thanked and that gratitude makes it all worthwhile.

What are some of the pressing health issues facing the community at this time?

– Social isolation and loneliness have been associated with an increased risk of mental health issues but also chronic conditions such as cardiovascular disease and type 2 diabetes. Most physicians in the community adapted rapidly to virtual care which was approached positively by young people but not so much by seniors. Most of today’s seniors grew up in a culture of “hands-on” medicine and more needs to be done to protect them and adapt them to the new ways of providing healthcare.

It became noticeable people changed the way that they sought health care— and that it’s likely some people didn’t seek care when they may have needed to. A study conducted by the Canadian Institute of Health Information showed that across Canada, visits to emergency departments declined by almost 25,000 a day by April 2020 — that’s about half the usual volume of Canada’s emergency departments.

As fewer people sought care for significant or common concerns. There was also an increase in delayed or deferred care such as a drop in planned surgeries or initial home care screening assessments. The biggest challenge is that we don’t yet have the full picture of the impact.

What are you most proud in your career? How important is your affiliation with Institute of Integrative Medicine and American Academy of Anti-Aging Medicine?

– Definitely creating SelectHealth and working towards turning my vision into reality. Leaving a comfortable, well-paid job and taking the risk of opening a business right in the middle of a lockdown was for sure risky but I believe nothing is impossible if you love what you do. I do love my profession, helping people achieve their health goals, making even a small difference in how my patients feel; listen to, inspire, and empower them to take control of their health and enjoy greater vitality, safely and sustainably. I believe in this vision and am sure the best is yet to come.

I am a member of The American Academy of Anti-Aging Medicine (A4M) and The Institute of Integrative Medicine, which are global leaders for continuing medical education in longevity medicine, metabolic resilience, and whole-person care. They provide an advanced network of continuing medical education opportunities including traditional CME events, intensives curriculum-based courses, university-level certification programs, in-depth workshops, and more. They lead and inspire practitioners to rediscover their passion for medicine and patients to take active ownership of their health.

Telemedicine (virtual) has been a helpful method in the time of the pandemic. Some believe that it will grow even more. What do you see as its benefits and downside?

– The increase in virtual care offered people unprecedented new ways to safely access their health care providers. Virtual care offers a convenient and cost-effective and time-saving way to see your doctor without having to leave your home and essentially eliminates the need to drive to appointments, take time off work, find childcare, etc. However, what is the quality of these appointments and of patient-provider interactions? This still needs to be analyzed. Older generations are not as open to using these services. They struggle more with technology since they don’t use it as frequently, so they don’t understand how to use virtual health services as easily. Virtual care is here to stay and we must continue to change and move forward with virtual healthcare initiatives while protecting the elderly. Their needs are greater and they must be kept safe.

We should embrace these changes in healthcare without losing sight of those who need it the most but find it the hardest.

Immigrants deal with numerous issues as they settle in the new country, such as cultural identity. I was impressed to read your position on preserving Albanian traditions and language while being accepting of assimilation? Did

I understand it right and can you tell me more about it?

– When you make the decision to move to a new country you should try your best to fit in with the mainstream society. That doesn’t mean you should forget your roots and where you come from. That is your identity and strong roots produce beautiful leaves.

In Ontario, the province I live, the month of November is proclaimed as Albanian Heritage Month; the Province of Ontario recognizes the meaningful contributions immigrants have made in building Ontario’s communities and the social, economic, political, and cultural achievements of Albanian-Canadians throughout the province. This is an amazing opportunity to remember, celebrate and educate future generations about our rich history.

I am very proud of my Albanian heritage, our language; our history, our rich folkloric traditions and try to preserve and transmit as much as I can to my kids because that is who they also are. And I always remind them of Dr. Seuss’s quote “Be who you are and say what you feel because those who mind don’t matter and those who matter don’t mind.”

On the topic of our heritage, as you know, over a century ago the founders of the Pan-Albanian Federation of America Vatra united around the mission of preserving the Albanian culture and promoting national interests. It was as relevant then as it is nowadays.

– Absolutely, Vatra has a legacy and is unified with the Albanian-American history. The mission might change with time but the values remain the same.

What have been some of the hardest fights for you getting to where you are? What do you wish to see change in the future for the young generation of Albanians?

– I would single out opening a business right in the middle of a lockdown. Yet I am a strong believer of the law of affinity so instead of focusing on my hard times, I focus on my blessings, I give thanks, and try to channel attention and energy towards gratitude, love, and trust. All things are possible when you believe.

Most of the young generation in Albania sees a future elsewhere and I wish for this to change in the future; for the country to prosper and give to the new generation all the opportunities, support, and space they deserve. I believe the next generation is different; they’re more confident, more optimistic, and have the potential to create a better future for the country. But in order for them to do so, the government has to urgently invest in them and I really hope that happens before it’s too late.

Thank you for the interview! Good luck!

Note: The interview was published in the March Issue of Dielli. This is an edited version.