Wednesday, June 27, 2012

Refugee Health Cuts

When I started this blog I was working with refugees for the first time. I was in South Africa and I watched as many refugee claimants struggled to get by in a highly xenophobic society where they faced barriers to accessing essentials such as food, health care, and employment. I will never forget the day when I had to bring two women to the hospital who had severe food poisoning after eating expired food from a shelter they were staying in that had no food or running water.

After returning to Canada from South Africa I was hired as an intern with the Halifax Refugee Clinic. The main focus of my internship was coordinating aspects of the Invisible Women/Concrete Barriers project which sought to help refugee claimant women and their children gain access to resources, including health care, in their community. As part of my work I followed up on research that had been conducted on the challenges facing refugee women in the community and became familiar with the Interim Federal Health Program, which is meant to provide supplementary health care services to refugee claimants and government assisted refugees. At the time in Nova Scotia, refugee claimants who were covered by the program were ineligible for provincial health care coverage which of course caused a number of problems. Fortunately at the time the coverage provided under IFH was enough for refugee claimants and government assisted refugees to access basic health care like seeing a physician and taking prescription medication.

Then I took a break from working with refugees, I worked with the government and I went to Uganada. Now I'm back in Canada and back working with refugees, but this time it's government assisted refugees. As part of my job I help to coordinate a weekly health clinic for newly arrived government assisted refugees and listen as the case workers around me try to find family doctors for their clients. I'm also already acutely aware of some of the health and psychological needs of our clients which require prescription medication,  special equipment and counseling all of which are covered for one year through the Interim Federal Health Program. In Ontario government assisted refugees and refugee claimants are immediately eligible for provincial health coverage.

On July 1, 2012 significant changes to the Interim Federal Health Program will take effect. The cost of prescription medication, medical equipment such as wheel chairs and walkers and services such as counseling will be cut, except in emergency situations. Even worse; if you're a refugee claimant from one of the designated countries of origin, which as of yet have not been identified, or your refugee claim is denied you will only have access to health care if your medical condition is deemed to be a health risk. 

Government Assisted Refugees (GARs) are individuals whose refugee claims have been approved by the International Organization on Migration or the United Nations High Commission on Refugees and who are approved for resettlement in a country such as Canada. They receive a travel loan and when they arrive in Canada they have permanent residence status. Many GARs have spent months or years living in a refugee camp. Many refugee camps do not have proper sanitation and residents do not have access to adequate nutrition which means that individuals arriving from camps may be suffering from malnutrition or water borne diseases and need prescription medication to treat these conditions. A smaller number of GARs are permanently disabled and need access to mobility devices or are chronically ill and need access to medications. Almost all of the individuals arriving in this category have little to no money, particularly if they have been living in camps and cannot afford to cover these costs.

Refugee claimants are often individuals who have fled their countries of origin very quickly. Although they have a variety of financial backgrounds many individuals in this category may face the same health concerns as GARs and may also have injuries or conditions requiring immediate medical intention, particularly if they came on a container ship. This category of refugee is less likely to have been living in a camp situation and does not have permanent residence status. They have less access to resources in their community to support them and face substantial uncertainty until a decision is made about their claim.

Both categories of refugees have significant mental health concerns resulting from trauma, torture and adjusting to a new culture and under the changes to IFH will not receive the support they need. I will never forget when one of the clients of the Halifax Refugee Clinic killed himself after he was deemed ineligible to make a claim because he could not face the prospect of returning to his country where he knew he would be tortured and killed for abandoning the army. 

Refugees living in provinces where they do not receive immediate provincial health care coverage may not even be able to access a family physician.

The government claims that through these cuts it expects to save over 20 million dollars a year. Critics say that the cuts will end up costing tax payers more because of an increase in emergency room visits and public health issues.

When questioned at a news conference by a doctor about the changes, Health Minister Joe Oliver said the government was undertaking the changes to make sure that all Canadians have equal access to healthcare If the Conservatives truly believe that all Canadians should have the same access to healthcare perhaps they should be providing coverage for prescription medication and counseling for everyone rather than cutting access to it for the people who need it most.

If you would like to get involved you should write to:

PM Harper

M.P. Jason Kenney, Minister of Citizenship and Immigration

M.P. Joe Oliver, Minister of Public Health

For more information or other ways to get involved:

 http://www.policyalternatives.ca/publications/commentary/federal-cuts-put-refugee-health-care-danger

http://www.youtube.com/watch?v=TQiSe00HOec

http://www.youtube.com/watch?v=75FmimeFnu8&feature=player_embedded

http://www.nursesunions.ca/news/canadian-doctors-refugee-care

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