By Muniyra Douglas
Transcribed by Fatima Husain
Every year thousands of immigrants and refugees migrate to Canada. Men, women and children, many of them from African nations seek to make this country their home.
However, Ontario is one of the few provinces that require a mandatory three-month waiting period for health care insurance for permanent residence. During this time these citizens do not have access to health or dental care.
In this VIBE TALKS interview, Correspondent Muniyra Douglas speaks with Dr Paul Caulford – Medical Director & Co-founder of the Canadian Centre for Refugee and Immigrant Healthcare. He also runs the Volunteer Clinic for Medically Uninsured Immigrants and Refugees.
Muniyra: What services or programs do you offer?
Dr. Caulford: Immigrants and refugees and undocumented persons and migrants who are in Canada residing here without access to medical care or access to Canadian Public Health care. Provincial Health Insurance or Interim Federal Health coverage. So they’re medically uninsured and have significant problems accessing health care. It’s barrier-free; we don’t have any restrictions on who we see other than people who are simply tourists in Canada. But we do see anyone else who’s not insured.
Muniyra: Can you explain the story of Tem*?
Dr. Caulford: Kim Tem was a classic example of that. He was caught in the three-month wait for Ontario Health Insurance Plan (OHIP). A lot of people think that: over Oh, it’s three month.s… Imagine if someone came to you and said to you: “Oh, well. We’re going to take away your healthcare for the next three months.” Yes, but my dad goes for heart check-ups; he had a heart attack. My mom’s pregnant, and her pregnancy care. She is going to will deliver in those three months. Or our child has asthma, what am I going to do? They’re wheezing and sick and they need help. So, a lot happens in three months. That’s one example of Tem’s category. But children and youth new to Canada are usually significantly vulnerable population exposing them to a lack of health insurance is very dangerous thing to do but it’s also shocking to us that Canada permits many thousands of children to reside here and go to school here, sit next to our children in class and when they’re sick they can’t get the care. We’ve put a report on our website; we’ve had a 34 per cent increase in children and youth new to Canada who are either medically uninsured or what we would call precariously insured where they can’t find the physician who is willing to take their Interim Federal health. So it’s a very significant growing problem and we think Canadians would generally probably don’t know about this. And we likely would be shocked to learn about how we’re treating many of our new Canadian children arrivals.
Muniyra: In your 2012 study you mentioned that 60% of your clients were women? Does this still hold true today?
Dr. Caulford: There is a lot of gender based vulnerability for women; refugees, immigrants and undocumented persons. And we know that there is actually more than 60 per cent of the patients we’re seeing at our clinic are women. In fact, the two biggest groups that we’re seeing at our Volunteer Medical Centre where the work is done by volunteer physicians because the patients have no ability to pay. The two largest groups are children and youth new to Canada and pregnant women. They account for almost 40 – 45 per cent of the people we see. And these are some of the most vulnerable individuals and within the child population we are regularly seeing those who are being, were either accessing for or actually treating for having Female Genital Mutilation and cutting done in their own country. So, women (excuse me) are quite vulnerable, in particular.
Muniyra: Is there currently anything being done to reconsider the mandatory waiting period
Dr. Caulford: Well, we’ve made efforts for the last twenty years to go to the government, show them the harm. There’s a group called OHIP for All – Healthcare for all who are lobbying the government now on the harm and the negative outcomes that are occurring in children and in their parents. So, there is an effort to eliminate the three-month wait for OHIP. But that is one of the many routes by which newcomers to Canada are left medically uninsured in Ontario and in Canada.
Muniyra: How can our listeners help?
Dr. Caulford: Our organisation, just to say, is a volunteer driven organisation. We are about 60 – 70 at any given time volunteer providers. We have physicians and we’re always in need of physicians who are licensed to practice in Canada who wish to volunteer their time to provide care to these groups. We are always in need of other equivalence of health type individuals with skills in those areas. So for example, we are in need of physiotherapists, we are in need of social workers, we are in need of mental health providers who can give counselling. Post-traumatic stress disorder is a significant issue within our population we serve. So, the website does provide an opportunity to offer your services on a volunteer basis.
Muniyra: Is there anything you’d like to leave with our listeners?
Dr. Caulford: The groups that we’re seeing more and more of now, almost on a weekly basis, someone who we would classify or at least consider to be the equivalent of the American Dreamers that we hear about in the States now. There’s a lot on the news that Canadians are hearing about the Dreamer population, that’s children and youth, brought here through no choice of their own in their immigration and now having been in the States for many years, that is their home and there is great discussion about whether they should be allowed to stay. In Canada, we see exactly the same phenomenon. So, Canada has, if you want to call them this; Dreamers, as well. Many children and youth who are now either adolescents or young adults who are in Canada and have known virtually no other home and who are denied access to healthcare, university and higher education. They go through high school because that’s something that there’s no Social Insurance Number needed for, no health card needed for, and no proof of any kind of permanent residence or status. And then when they’re 16 or so they find out when they go to get a job that they don’t have a Social Insurance Number. That they’re people in limbo. That they’re literally caught in the middle. And there are no provisions and there is not even any discussion now in Canada about what are the ethical approaches to this issue.
Canada is a nation that is going to, and is now requiring the vast majority of its people are going to be arriving from other places. Natural production of children is going to account for only one in five of the needs of the population growth, of the needs of this country in the next ten years. So, regardless of the fact of whether or not, it’s right or just a humanitarian thing to do; to provide them with healthcare as they progress in Canada – that’s given and they are not getting it. But really, why would we not be supporting this generation of young people wanting to build the Canada that their parents brought them to by offering the opportunity to advance their education, their skills development and prevent them from getting ill on their journey. So, I think that’s a conversation that Canada needs to start to have. And we need to start to have that quickly.
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*Editor’s Note: Tem was six year’s old when he immigrated to Canada. He arrived from Darfur, Western Sudan during the winter months. Two weeks later, Tem began having fevers and developed pneumonia. He was turned away from a Toronto Hospital due to lack of health coverage. His condition worsened over the following days at home. The team at the Volunteer Clinic treated Tem’s pneumonia. They also learned Tem had a serious heart condition requiring surgery. With the help of Toronto’s Hospital for Sick Children, they operated on Tem, free of charge. Tem is now 15 years old and a Canadian Citizen. (SOURCE: Canadian Centre for Refugee and Immigrant HealthCare)