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June 26, 2014

Rally for Refugee Health Care

Reuel S. Amdur

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Is a sick child a bogus refugee? That was a question raised by Children's Hospital of Eastern Ontario (CHEO) pediatrician Dr. Tobey Audcent, on June 16, the third national day of action called by Canadian Doctors for Refugee Care. The event was a rally on Parliament Hill. Some 350 people gathered for the rally, including doctors, nurses, social workers, lawyers, and medical students. They were there to protest against the Harper government's cuts to health care for refugees and claimants.

Audcent referred to a report on billing at Toronto’s Hospital for Sick Children.  90% of bills to families of refugees and claimants were unpaid.  As a result, the charges had to be absorbed by the hospital and the province, in spite of the fact that costs for refugee care are a federal responsibility. 

Mado Mushimiyimana, a nurse who came to Canada as a refugee herself, noted that refugees and claimants ended up in hospital because they are denied access to care in the community.  Dr. Doug Gruner noted that Immigration Minister Chris Alexander claimed that eliminating coverage for these people would save$20 million.  He forgot to mention that these savings at the federal level will increase costs to provincial health care budgets, at a multiple of that $20 million.  Audcent asked how he could ask doctors and hospitals to refuse care to children with fractures, seizures, or appendicitis. 

First year medical student Hernan Franco came to Canada with his family ten years ago, coming from the United States where their refugee claim had been denied.  The family had fled Columbia, in the midst of guerilla conflict.  His parents needed medical care, which they received here.  Commenting about refugees, Franco said, “We are receiving them in their most vulnerable state.  We cannot ignore their health needs.  We have to remember that, just like me, they will one day contribute to and become active members of our society.  Let’s help them when they most need it.”

Dr. Alison Eyre, who practices at Ottawa’s Centretown Community Health Centre, pointed out that the Harper government’s termination of health coverage is a violation of the 195l UN Convention Relating to the Status of Refugees, of which Canada is a signatory.  It requires of Canada that we accord lawful refugees with coverage for “maternity, sickness, disability,” etc.  As NDP MP Paul Dewar noted, Harper continues to stonewall about the number of Syrian refugees that have been admitted to Canada (if any).  The ones who will come under private sponsorship—apparently most of them—will be ineligible for health coverage.  Dewar noted that there were also Liberal MP’s at the rally.

In addition to health care professionals, there were also lawyers.  Peter Showler, who co-chairs the Advisory Committee of the Canadian Association for Refugee Lawyers, reviewed the history and current status of refugee health care:

“For over 55 years, long before Canada signed the UN Refugee Convention, Canada provided basic health care for refugees under the Interim Federal Health Program.  We did it because it was the decent thing to do.  Refugees, newly arrived, often physically and psychologically  damaged by persecution or civil war, needed health care until they could establish themselves in Canada.  Hundreds of thousands of refugees have benefitted from the program.  Two years ago, the federal cabinet drastically slashed the program without consultation with the provinces, medical associations, or parliament.

“The government said the policy only applied to fraudulent refugees who were abusing the refugee system.  That is an out-and-out lie.  For example, for the 1400 Syrian refugees who will allegedly be resettled this year from the Middle East, only 200 are government assisted.  For the rest, people who have suffered civil war and refugee camps, their sponsors must find the money for medications and the many medical needs not covered by the government’s reduced standard of care.

“The government said that refugees had been getting ‘gold-plated’ health care, better than ordinary Canadians.  Another lie.  Under the IFHP program, refugees received basic health care, comparable to care provided for indigent Canadians on welfare.”

Showler spoke of the legal challenge to the government’s denial of health care for refugees and claimants.  Three refugees, the Canadian Association of Refugee Lawyers, and Canadian Doctors for Refugee Care, have filed in the Federal Court for a declaration that the cuts are violations of the Charter of Rights and Freedoms, constituting cruel and unusual treatment (section 12) and discriminatory (section 15), designating certain countries as “safe” when they are in fact not safe for some refugees.  As well, the cuts violate the international conventions on the rights of refugees and of children.

At the demonstration, information was distributed about people denied health care.  Here are some cases:

--A woman who had a heart attack in her country of origin presents in the hospital with worsening chest pain.  Told of the cost of the visit, the patient left without being seen.

--An eight year old child with a history of kidney disease who now has urinary symptoms cannot receive diagnostic care because the family has not been given medical coverage.  Such coverage can take a few weeks on arrival.

--A vomiting three year old has no insurance because her family comes from a country the government designates as safe.

--A refugee who was repeatedly raped before arriving in Canada has stomach pain, likely related to the assaults.  She must wait for health care coverage before medical assessment.

--A pregnant woman is turned away from her obstetrician at 36 weeks when she is found to be ineligible for refugee status.

On April 28, Stephen Harper, promoting his initiative for maternal and child health in the Third World, explained, “We don’t want to stand idly by while women and children around the world die for lack of things that are really very basic, inexpensive remedies that we take for granted.”  What about here in Canada?

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