Courtney Bercan is community health nurse at a clinic in the Downtown Eastside of Vancouver
Years later, I still don’t want to think about it, let alone type it out. Three children, babies practically, dead before me. Their parents, dead beside them.
It has now been two years since I was on a Doctors Without Borders search and rescue vessel in the Mediterranean and it’s been a slow path, at times, to finding healing and peace for the things I saw and experienced there. As my life settled into a predictable rhythm, the memories started coming out of the blue and with intensity. They demanded attention. Normally, in Canada, the process of finding closure for a patient’s death, while not always easy, is not usually this difficult. There are mitigating thoughts and phrases to help you along the way:
Ruth Chiu is a medical student in the Class of 2018 at McMaster University
From 1975 to 1980, over two million Vietnamese, Laotian, and Cambodian refugees fled from Communist states to refugee camps across Asia and became known internationally as ‘Boat People.’1,2 In response to this crisis and under significant public pressure, the Canadian government accepted 60 000 Southeast Asians as government-assisted and privately sponsored refugees between 1979 and 1980.3
The exodus of Southeast Asian refugees was by no means the first of its kind in history. However, Canada’s response to this refugee crisis was unique in its magnitude from both a national and international perspective. Political drivers, such as the adoption of the more inclusive Immigration Act of 1976 and the recent election of Progressive Conservative Prime Minister Joe Clark after 16 years of Liberal rule, contributed to the unprecedented settlement of Southeast Asian refugees in Canada.4,5 Public interest in the crisis, heavily piqued by international news media, allowed for the success of the newly formalized private sponsorship program which supported two-thirds of the Boat People who settled in Canada.6,7...continue reading →
Sondos Zayed is a medical student in the Class of 2018 at McGill University
Raised in an impoverished household, Ms. K was married off at a young age to a man decades her senior. As the years passed, the abuse her husband inflicted upon her escalated until she began fearing for her life. She spent years saving money and meticulously planning her escape, though her departure also meant abandoning her family to the mercy of her husband’s wrath. She eventually sought refuge in Québec, Canada.
With no real proof of identity, she was imprisoned for months upon arrival. Once released, with neither connections nor funds, she was directed to the YMCA Residence (which in 2010 had come to an agreement with the ...continue reading →
Mandi Irwin is a family physician at the Nova Scotia Health Authority's Newcomer Health Clinic, in Halifax, NS
Elizabeth Munn is a medical student at Dalhousie University
Hamid Abdihalim is a medical student at Dalhousie University
Matthew Ta is a medical student at Dalhousie University
Human displacement as a consequence of war, natural disaster, civil conflict or political instability is not a new problem. The ongoing war in Syria has brought this issue into mainstream view recently. This and other protracted and escalating conflicts have resulted in the displacement of over 22.5 million refugees globally, as estimated by the United Nations High Commissioner for Refugees. In 2016 alone, almost 190,000 refugees were resettled in new countries around the world. This includes resettlement in Canada, which has welcomed over 25,000 refugees from Syria .
We often fail to appreciate that once refugees arrive in their countries of resettlement, they face substantial challenges ...continue reading →
Kirsten Patrick is Deputy Editor at CMAJ. She is currently attending the North American Primary Care Research Group (NAPCRG) annual meeting in Colorado Springs, CO.
In the plenary session on providing primary care for refugees, one of the speakers, Kim Griswold, shared an image, now familiar to many, that is designed to help people to understand the difference between equality and equity. It demonstrates how some people start off at a relative disadvantage and need extra help to be able to achieve or access things that more advantaged people are able to experience easily. This image, and similar ones, have been criticized by some social justice thinkers who point out that ...continue reading →
Kim Griswold is Associate Professor of Family Medicine, Psychiatry, and Public Health and Health Professions at Jacobs School of Medicine and Biomedical Sciences in Buffalo, New York. Dr Griswold will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.
Communities in every nation are faced with providing competent, equitable and culturally appropriate services for resettling refugees. Health centric disciplines are not enough to meet the challenges presented by these newly arriving populations, nor to alleviate the disparities they face – such as isolation, limited English proficiency, differences in patients’ attitudes and health literacy levels, and a lack of cultural awareness on the part of providers.
Health inequity can be defined as: “unjust differences in health between persons of different social groups.” ...continue reading →
Kevin Pottie is Associate Professor of Family Medicine and Epi & Community Medicine at the University of Ottawa, as well as co-Chair of the Canadian Collaboration for Immigrant and Refugee Health, and a family physician at the Immigrant Health Clinic of Ottawa, which he helped to found. Dr Pottie will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.
My residency training in Ottawa began with a wave of refugees from El Salvador and Guatemala. Most conflict-affected refugees - Somali, Sudanese, Congolese, Karen, Bhutanese, Colombian - come quietly and settle rapidly in our communities. And, even in instances when the media cover the arrival of large waves of refugees, such as the Vietnamese boat people or the recent Syrian war victims, the refugees themselves settle quietly in our communities.
In the early 1990s, it felt almost revolutionary to care for refugees. There were few primary care practitioners trained and ready to lead ...continue reading →
Fern R. Hauck is Professor of Family Medicine and Public Health Sciences at the University of Virginia. Dr Hauck will be speaking at the forthcoming North American Primary Care Research Group (NAPCRG) annual meeting.
The scope of the crisis is staggering! The number of people displaced by war, conflict or persecution has hit a record high—over 65 million with 21 million of these being refugees. Most face an uncertain future. Those who are resettled to a developed country are among the lucky ones. Nonetheless, they face many challenges in their new home, including accessing culturally sensitive health care.
My involvement with refugees began on the Thai-Cambodian border, where I spent a year providing primary health care to Cambodian refugees who were living in the largest border camp, having fled there after the Khmer Rouge were ousted after years of genocide. Moving to Charlottesville, Virginia, in 2000, I never expected to find that refugees were being resettled in this small city. ...continue reading →
David Benrimoh is a fourth year medical student at McGill University
Dr. Cécile Rousseau is a professorof psychiatry at McGill University, working with refugee and immigrant children
The Syrian Civil War has become the greatest humanitarian crisis since the Second World War, creating over 4 million refugees. These refugees have, in large part, taken up precarious temporary residence in countries such as Egypt, Jordan, Turkey, Iraq and Lebanon. They are unlikely to find permanent residence there because of local integration policies, and so are left to either wait until the conflict in their homeland is resolved, or to apply to attempt to resettle in another country. It must be understood that those living in refugee camps face difficult conditions: sexual violence, trafficking of women and children, and lack of access to healthcare and education.
Because of poor conditions and limited opportunities in camps, many refugees try and make the move to another country. We have all seen reports of refugees drowning by the hundreds while trying to cross the Mediterranean, and the EU has been paralyzed by indecision with respect to who should take how many refugees. Canada has committed to taking in 10,000 refugees by year’s end ...continue reading →
Nobody could have predicted the desperate state in Syria when the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Europe Conference for 2015 was awarded to the Turkish Family Medicine Organisation (TAHUD) a few years ago. Few could also have predicted that Turkey would be at the very centre of a mass exodus of people not seen in Europe since the Second World War. According to the UNHCR as of September 2015 the country now finds itself providing refuge to an estimated 2 million Syrians fleeing conflict and destitution. I have heard the current situation being described as a ‘stress test’ of the European values of solidarity and collegiality, ...continue reading →