Immigrant and Refugee Services for Health Care in British Columbia and Nova Scotia

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There are many reasons for people to leave their home countries. Canada is appealing to some for its health care system, job opportunities, or for a change of scenery. In some cases, however, individuals flee from danger in their countries and seek refuge. Canada is a popular country to seek asylum and the numbers of refugees coming to Canada has been increasing over the years. The Government of Canada (2019) reports that the number of asylum claims in Canada has increased from 23,870 in 2016 to 55,035 in 2018. With the increase in individuals seeking refuge, it is important to look at the resources available to those new to Canada. Bailee, a fellow MHST 601 student and I explored programs and services available in our provinces, British Columbia and Nova Scotia.

In Nova Scotia, there are a few resources for those planning to immigrate or seek refuge, as well as those who have already arrived. These include Nova Scotia Immigration, Nova Scotia Start and the Immigrant Services Association of Nova Scotia (ISANS). ISANS is the main organization that assists newcomers. It is the largest immigrant-serving agency in Atlantic Canada with a diverse staff representing more than 64 countries. This organization offers assistance with the following categories:

• getting settled

• learning English

• finding employment

• establishing a business

• connecting with the community

(ISANS, 2019)

Navigating the healthcare system in a new country can be daunting. In an effort to help immigrants and refugees understand Nova Scotia healthcare and get in contact with necessary health professionals, ISANS Immigrant Health staff meet with families soon after they arrive in the province. During this meeting they assess healthcare needs and provide support for those with challenges accessing services and resources. This assessment includes:

• “orientation to the Canadian health care system, Interim Federal Health Program and Nova Scotia Health Card coverage, patient rights and other services and supports

• links to the Newcomer Refugee Health Clinic for primary healthcare screening and services

• referrals to dentist, ophthalmologist and other specialized health services in the community

• individual case-management

• problem solving and advocacy for access to specialized services and coverage”

(ISANS, 2018, para. 5)

For those with more complex needs such as a disability, there are additional support services which include the following:

• “needs and risk assessments

• referrals to appropriate services

• information and orientation for public and private healthcare services

• information about federal, provincial and community resources and supports

• individualized support to help you with medical appointments and health information, community navigation, self-advocacy

• access to specialized supports associated with federal and provincial health and wellness programs (e.g. Interim Federal Health, Departments of Health and Wellness and Community Services)”

(ISANS, 2018, para. 8)

My area of expertise is dental hygiene and I am a proud provider and supervisor of dental hygiene care at Dalhousie University’s Immigrant Oral Health Outreach Clinic. This program is funded by Green Shield Canada, a company that works to improve access to health care for uninsured or under-insured Canadians. In 2017 Bell C. Dalhousie University’s communications officer for the Dean’s Office, wrote that through the assessment of refugee patients entering the clinic, it was found that 53% of recent immigrants to the province, and 85% of a Nepali refugee group, had untreated decay, compared to 20% of Canadian adults. It is clear that oral health care is needed for this vulnerable population, and this clinic allows individuals to receive necessary preventative and restorative dental work; it is also a valuable learning experience for the dental and dental hygiene students.

In British Columbia, there are a multitude of websites for refugees to read through for information on topics such as getting settled in BC, finding work, learning English, and exploring entrepreneurship. ISS of BC and MOSIAC BC are two more generic websites for immigrants and refugees that provide information on many topics. ISS of BC has a page dedicated to how to obtain health care in BC and mental health resources. Welcome BC has a page on their website specific for refugees and asylum seekers that provides an overview of what they need to know when they arrive to BC.

Specific to health care, there are several resources for health care providers so they can better care for refugees, as well as resources for refugees and their families. Refugee Health Vancouver is a website with extensive information for health care providers that provides them with knowledge they may need to best support refugees and resources to give patients in their own language. It is important to equip health care providers with the necessary information so they can best support this growing population of people. In addition, the Immigrant and Refugee Mental Health Project offers online training, tools and resources to settlement, social and health service professionals working with immigrants and refugees. The South Island Division of Family Practice has a page on their website dedicated to physicians who are caring for refugees.

Some resources for refugees include a healthy eating guide developed by MOISAIC BC and BC Salmon Farmers Association, AMSSA website that lists resources for immigrants about health care in BC and Canada, BC midwives website that lists information about getting a midwife if you are a refugee or an immigrant, and Success BC that has a document of curated resources that have been translated to Arabic. These are just a few of the many resources I found. In addition, Rainbow Refugee (n.d.) is a "Vancouver based community group that supports people seeking refugee protection in Canada because of persecution based on sexual orientation, gender identity, gender expression (SOGIE) or HIV status" (para. 1). BC Women's Hospital has information on their website about navigating the health system in BC.

Unfortunately, what was obvious through this search is that there are many different websites that provide information but not all of it is in one location. It would be beneficial if one of the main organizations, such as ISS of BC, MOSAIC or Welcome BC, collated all the resources in one section so they are easier to find and access.

A unique aspect about Nova Scotia that differs from BC is they have a Refugee Health Clinic in Halifax (Nova Scotia Health Authority, 2015). The Refugee Health Clinic "provides refugees and their families with primary and preventative health services during their initial integration into the Halifax area" (Nova Scotia Health Authority, 2015, para. 2).

Another unique support that Nova Scotia has for immigrants and refugees is an orientation to the health care system provincially and federally, provided by Immigrant Health staff (ISANS, 2018). This is currently not offered in B.C.

Some similarities between BC and Nova Scotia are the provincial immigrant and refugee societies (Immigrant Services Society of BC and Immigrant Services Association of Nova Scotia) that provide many different types of support. In terms of health care, the provinces have different approaches with refugees but overall are working to support them in many facets when they arrive in the province. Nova Scotia does a good job at having someone there to guide the refugees through the health care system and BC could improve in this area.

References:

Bell, C. (2017, September 15). More clinics and more care for immigrants and refugees. Retrieved July 9, 2019, from https://www.dal.ca/news/2017/09/15/more-clinics-and-more-care-for-immigrants-and-refugees.html

Government of Canada. (2019, June 14). Asylum Claims by Year. Retrieved July 9, 2019, from https://www.canada.ca/en/immigration-refugees-citizenship/services/refugees/asylum-claims/asylum-claims-2019.html

Immigrant Services Association of Nova Scotia (ISANS). (2019, July 02). Immigrant Services Association of Nova Scotia (ISANS). Retrieved July 9, 2019, from https://www.isans.ca/

Immigrant Services Association of Nova Scotia (ISANS). (2018, July 16). Refugee Support. Retrieved July 12, 2019, from https://www.isans.ca/get-settled/refugee-support/#immigrant-health

Nova Scotia Health Authority. (2015). Refugee Health Clinic "life-changing." Retrieved from https://www.nshealth.ca/news/refugee-health-clinic-life-changing

Rainbow Refugee. (2000). About Rainbow Refugee. Retrieved from https://www.rainbowrefugee.com/about-us