("Source: https://www.euractiv.com/section/justice-home-affairs/opinion/violence-against-refugee-women-is-often-ignored/").
Immigrants and refugees are included as vulnerable population in every country they migrate to. According to the article published in the Canadian Medical Association Journal (CMAJ) by Caulford and Vali in 2016; out of 17 million people migrating worldwide,10 million included refugees. The medically uninsured immigrants and refugees are an escalating problem within Canada as well as other countries. In the year 2004, 204000 landed immigrants and 31000 refugees arrived at Canada. Out of these landed immigrants and refugees, some were denied access to health insurance plans while the others had a lengthy delay to access the healthcare insurance. In this blog, I will be discussing about the pressing problem of healthcare issues for refugees in Canada. I will also be sharing solutions that can be implemented to enhance the healthcare services of this vulnerable population.
Refugees are people who leave their countries due to unfortunate situations such as war and threats they experience in their native countries. They often depart from their homeland in a short notice of time without being mentally prepared. Also, most of these refugees arrive from the refugee camps set up in their native countries. During this process of migrating, refugees experience situations of separation from close family members and loved ones while some of them have go through torture inflicted in the war zone of their respective countries. Many refugees also end up losing their materialistic possessions such as wealth, jewelry, home etc. The sense of belonging to their homeland and the comfort of living in their homes is lost during the process of migration. Thus, a higher proportion of refugees tend to suffer from poor health status compared to immigrants who come willingly to Canada. As per Statistics Canada, in the year 2005, it has been reported that refugees experience greater physical, emotional and dental problems than immigrants and the remaining Canadian population.
In addition to the above-mentioned unfortunate emotions they experience while migrating, there are also a lot of barriers and challenges they witness while accessing healthcare services upon their arrival. In the journal article named, "Barriers to care: The Challenges for Canadian Refugees and their Health Care Providers,” Mckeary and Newbold (2010) mentioned that it has been observed that the challenges for refugee population included being unfamiliar with the Canadian healthcare system, having troubles navigating through the system and at the same time being uncomfortable to access healthcare from providers because of a lack of cultural connection.
Now let’s look at the statistical research conducted on refugees in terms of access to Canadian healthcare services by McKeary and Newbold in the year 2010. The table below clearly outlines the associated percentage of numerous problems experienced by refugees to access healthcare from 2005 onward.
The data accumulated in the table above has been gathered from a national level study conducted by Statistics Canada’s Longitudinal Survey of Immigrants to Canada that recorded data on the refugee population from the year 2005. The data gathered demonstrated that there was a decline from six months to three years post arrival of refugees in terms of accessing health care and problems associated with it. The reason for this decline could be that the problems faced by refugees diminished in the consecutive years or some of them they gave up on accessing and understanding the Canadian healthcare system. While analyzing the data of the problems to access healthcare by refugees listed in the table above, language has been observed as the most prominent issue accounting for 37.5 % of problems post six months of the landing of refugees. Some of the difficulties confronted by refugees such as not knowing where to go and finding the healthcare costs to be expensive disappeared post two years of arrival mainly due to them getting access to healthcare insurance plans. However, the two years of waiting period is a lengthy time to attain a health insurance plan and thus it may have added stress and caused poor health within this population. Another key issue noted was that the waiting list was getting higher and the inability to see a general physician also increased. This could be due to lack of sufficient funds possessed by refugees to bear the transportation cost and day-care cost for their children so that they can consult a physician for their health needs.
In Canada, every province is making efforts to improve the health needs of refugees. The province I reside which is Ontario, there is an Ontario Temporary Health Program (OTHP) for refugee claimants controlled by third party provider named Medavie Blue Cross. This program was designed in January 2014 to address the discrepancy in healthcare coverage for refugees and to provide them with short term healthcare coverage for services in Ontario. Similarly, other provinces such as Quebec, Nova Scotia etc. have their own programs and services designed to aid refugees with their health concerns (Refugee Health Survey, 2015). For a detailed look on healthcare strategies implemented by each province for refugees you can check this link to refugee health survey conducted by Canadian Council of Refugees.
Analyzing the refugee health and their associated problems, has made it clear that majority of the refugee’s experience language barriers such as inability to communicate clearly in English or French. This makes the process of navigating through the healthcare extremely tedious, frustrating and difficult for them. The solution to address the language barrier has already been addressed by providing interpreters, however provincial health plans do not cover the cost of hiring a translator and most of the community health centers and social service agencies require to reshuffle their budget to accommodate one. The solution to find a budget for these language translators is crucial to be able to serve the vulnerable refugee population. The strategies that have been implemented so far to assist refugees to avail healthcare services include not just creating increased funding for translators but also enhancing community health centers and programs that can provide them the additional support and resources needed. It is also vital to create additional employment and housing opportunities for refugees as unemployment, lack of shelter and associated poverty impacts their physical and mental health. Finally, attempts to deliver healthcare in a culturally sensitive manner is essential to strengthen the relationship between the patient and the provider. A greater understanding of the refugee backgrounds, history, associated trauma and respecting their cultural differences can play a significant role in enhancing the delivery of healthcare services to this vulnerable population type.
REFERENCES
Caulford, P., & Vali, Y. (2006, April 25). Providing health care to medically uninsured immigrants and refugees. Retrieved from http://www.cmaj.ca/content/174/9/1253
Mckeary, M., & Newbold, B. (2010). Barriers to Care: The Challenges for Canadian Refugees and their Health Care Providers. Journal of Refugee Studies,23(4), 523-545. doi:10.1093/jrs/feq038
Ministry of Health. (n.d.). Ontario Temporary Health Program for Refugee Claimants. Retrieved from http://www.health.gov.on.ca/en/pro/programs/othp/
Refugee health survey by province and by category. (n.d.). Retrieved from https://ccrweb.ca/en/refugee-health-survey-2015
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