New Canadian Media
Thursday, 15 October 2015 07:42

Health-care Options for the Uninsured

by Belén Febres-Cordero in Vancouver

As a signatory of the Universal Declaration of Human Rights, Canada acknowledges the right to adequate health care for all. However, uninsured individuals living in Canada still face barriers that limit their access to appropriate care.

According to Health For All, anywhere from 200,000 to 500,000 people are living without health insurance in Canada.

The reasons for the lack are diverse, including precarious immigration status, lost documents, and refused refugee claims. Also, Quebec, British Columbia, and Ontario have a three-month waiting period before newcomers get health insurance, while other provinces do not.

“This creates inequities in the access and the type of health care people receive across the country,” says Steve Barnes, director of policy of the Wellesley Institute.

Health-care options

Barnes explains that uninsured people in Canada have four main health-care options: community health centres, clinics and grassroots initiatives, hospitals receiving patients without insurance, and midwives.

Community health centres (CHCs)

CHCs – publicly funded health-care facilities currently located in all Canadian provinces and territories – are an option for people both with and without health insurance.

Since the cuts to the Interim Federal Health Program in 2012, many people have lost access to insurance.

Scott A. Wolfe, executive director of the Canadian Association of Community Health Centres, explains that the programs at each CHC vary because they respond to the priorities of the community.

“What unifies CHCs is that they offer a team-based approach to frontline health care that wraps services around the individual’s needs so that people get the right type of care from the right providers at the right time,” he says.

In this way, CHCs take a holistic approach to health based on the collaboration of different health practitioners, such as physicians, nurses, and therapists.

Patricia Dabiri, manager of the Multicultural Family Centre at REACH, explains that another characteristic of CHCs is that they also focus on the social and environmental factors related to health and well-being. “For this reason, CHCs have a greater range of services than other health-care institutions,” she says.

Wolfe explains that the 800 CHCs that currently exist in Canada have different services and programs focusing on removing barriers to access the health system, building better community capacity and improving individuals’ overall health and wellness.

He adds that since the cuts to the Interim Federal Health Program (IFHP) in 2012, many people have lost access to insurance, and CHCs are working to fill that gap.

“A major wave of people has presented at CHCs because they have been turned away from other institutions. CHCs do not always have the capacity or the funding to absorb this challenge,” Wolfe says.

Clinics and grassroots initiatives

Clinics for non-insured patients and grassroots initiatives are another option.

Byron Cruz co-funded the grassroots initiative Sanctuary Health in 2012 as a response to the IFHP cuts. “We started as a network to advocate for health care,” he says. Now they serve populations with a vulnerable immigration status through a network of health practitioners who volunteer to treat them.

The Health Network on Uninsured Clients, convened by the Wellesley Institute, is another network of collaboration among professionals addressing health for uninsured populations.

Clinics for uninsured clients are an option too. There are a variety across the country, such as the Non-Insured Walk-In Clinic (NIWIC) and the Canadian Centre for Refugee and Immigrant Health Care (CCRIHC). They offer medical treatment, support, and translation services, among others.

Hospitals

Cruz explains that sometimes people can only be treated in hospitals, and some across Canada treat uninsured patients. However, “because of the changes in immigration laws, there is confusion among health-care providers, and usually people are denied care even if they qualify for it,” he says.

Cruz also notes that the uninsured cannot always afford the costs. “Even if people eventually access primary care, they can rarely pay for treatment, laboratory tests, or medicines.” Wolfe draws attention to the need of finding alternatives, such as a national drug coverage program, to reduce these costs.

Midwives

Manavi Handa, a midwife and activist focusing on health care for marginalized populations, explains that uninsured pregnant women are particularly vulnerable because they cannot bridge from care.

People who do not access appropriate primary care may end up at the emergency department, where care cannot be denied.

Midwives are an option because their services are less expensive than that of other health professionals. Uninsured women in Ontario can access their services without cost because midwives in this province are publicly funded to provide care regardless of immigration or insurance status.

However, Handa says that there are some barriers. “For example, midwives are often at capacity. Also, newcomers may be unaware of their services.”  For this reason, Handa coordinates a group of midwives through NIWIC to connect uninsured pregnant women with appropriate care.

Public sexual-health clinics are another option for uninsured women. Among other services, these offer assessments for contraceptive methods, tests, and counselling. 

A combined effort

“The way in which we exclude some populations from health care is not benefitting anyone,” says Barnes. He explains that people who do not access appropriate primary care may end up at the emergency department, where care cannot be denied.

“The diseases patients present at that point are usually serious and expensive to treat, but could have been prevented if addressed on time.”

He concludes: “We need to combine our efforts to provide services, advocate, and promote changes in the institutions’ policies and the political system to continue improving the health of uninsured residents and of the Canadian population as a whole.”


While across Canada there are organizations that provide new immigrants with information about the Canadian health-care system, there is a growing number of newcomers who still don’t know about these resources. As such, this is the first of an occasional series by NewCanadianMedia.ca that will look into access to health care for immigrants.

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

 

Published in Health
Friday, 09 October 2015 12:05

Walk Your Way to Health

By Dr. George I. Traitses Can’t imagine slaving away in the gym for hours at a time, but know you need to do something to get in better shape and reduce your risk of disease? The simple act of walking is a good place to start, according to Dr. George Traitses. He promotes the power 

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Published in Health
Saturday, 26 September 2015 18:13

Their Bodies, Their Rules: Sex Ed in Ontario

by Rebecca Bromwich in Ottawa

You've probably seen some variation of the popular T-shirts that set out “Rules For Dating My Daughter.” They usually contain a number of threats towards anyone looking to court someone's children, but ultimately the key rule is “you can’t.”

This is supposed to be a way of jokingly protecting one’s children from advances by prospective suitors, and I laughed the first time I saw it. However, thinking about it further, I realized the T-shirt wasn't that amusing. In fact, these types of jokes have another effect entirely: they limit an adolescent's agency and freedom.

Ontario’s newly announced health and sexual education curriculum has been the subject of a great deal of debate. Protests have erupted across the province, as have “strikes,” during which some parents are keeping their kids home from school to object to the new curriculum.

These jokes limit an adolescent's agency and freedom.

These protests reflect the issue of who gets to make the rules for our youth. Debates and protests about Ontario's new sex education curriculum seem focused on what kids are taught and when, but more so on which group of adults is in control and who among them gets to make the rules.

The battle, which has become politicized with the strong opposition from Ontario’s PC Leader, is centred on whether parents or the government should have the authority to determine the best interests of the child.

Setting up discussions about what our children should learn in school as a battle between parents and the government misses a fundamental aspect of what is at stake — namely, the health, sexuality and self-expression of the province's youth.

It's not just parents, educators, governments and communities whose rights and powers are at stake when we talk about sexual health education for kids. Children have rights of their own.

When they are small, their chief sexual right is the right not to be abused. However, as they grow and develop, they acquire rights as sexual citizens.

Not just politics: children’s rights under Canadian law

Protesting against the current provincial government about the curriculum is a displaced effort. The notion that children have rights is not a concept based in Premier Kathleen Wynne’s personal agenda. It is a matter of law.

The discussion of sex and sexuality set out in Ontario’s new sexual and health education curriculum is more than a reflection of the values of a particular political party or community group. Rather, it reflects the language of and case law interpreting Section 15 of the Canadian Charter of Rights and Freedoms.

Protesting against the current provincial government about the curriculum is a displaced effort.

Children’s rights in this provision complement others in Canada’s Charter of Rights and Freedoms, which applies to children as well as adults. Under the Charter, children as well as their parents have rights to freedom of conscience and religion and to free expression. Equally as important is a child's right to become educated about things that will affect their bodies and their health.

Children’s rights under international law

Children’s rights are not a Canadian invention, but are set out in international law, as well as domestic provisions.

The rights of children, whatever their gender, sexuality, race or religion, are outlined in the United Nations Convention on the Rights of the Child (CRC). This convention was agreed upon by the vast majority of the world’s nations by multilateral international legal convention over 20 years ago.

As explained in the CRC, children are entitled to be supported in ways that ensure their full development to enjoy responsible life in a free society. This includes rights to freedom of expression, to identity and to autonomy.

Adolescents, whatever the values held by their families, are subjects and agents. Children own their own bodies and they have legal rights. 

The interests of communities, as articulated by parents, community and religious leaders must be balanced against the rights of adolescents.

Yes, it’s sometimes difficult for any parent to accept that our children’s life choices are theirs, not ours. It’s a difficult journey to parent children who are subject to our influence, but not our control, who are subject to government regulation, but not government dictation in a free society. But this is the nature of the adventure. 

The rights and freedoms of children aren’t just dictated by a radical politician with whom you may not agree. They are the law, nationally and internationally, and must be respected as such.

Sexual health, sexual citizenship: their bodies, their rules

In the past, in Canada and elsewhere, too often have governments, educators, parents and communities all failed to recognize and protect the rights of children, especially girls. The bodies, wills and minds, of adolescents have not been well acknowledged by our laws and policies, as recent protests may suggest.

The interests of communities, as articulated by parents, community and religious leaders (who are not usually young, or children) must be balanced against the rights of adolescents to know and understand their own bodies, rights and responsibilities.

Yes, adults and legislators have roles to play in guiding and safeguarding children. However, kids have developed to become responsible enough to make up their own minds.

With this in mind, there is only one set of rules for dating my daughters (or sons) that is consistent with the Charter and the UN Convention on the Rights of the Child, and it's completely consistent with Ontario’s new sexual and health education curriculum as well:

“You don’t make the rules.

I don't make the rules.

She makes the rules.

Her body; her rules.”


Rebecca Bromwich is a mother of four and has been a lawyer in Ontario since 2003. She received her PhD from Carleton University's Department of Law and Legal Studies and joined the Faculty there the same year, in 2015. She also teaches at the University of Ottawa's Faculty of Law.

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

Published in Commentary
Saturday, 26 September 2015 16:56

Navigating Health Care as a Newcomer

by Lucy Slavianska in Toronto 

When Jasmine, a young engineer from Iran, arrived in Toronto, she immediately applied for the Ontario Health Insurance Plan (OHIP). 

She knew she had to wait three months to receive her health card, but since she was generally healthy, it didn’t occur to her to look for an alternative health insurance while waiting for OHIP. 

January, however, was extremely cold and just three weeks after Jasmine landed, she fell sick. She had a high fever and, due to acute laryngitis, lost her voice. Over-the-counter medicines didn’t work and she had to see a doctor. 

Her visit to a walk-in clinic, as well as her treatment, cost more than $200. “This was so expensive,” she says, “but it could have been worse.” 

Insufficient knowledge is one of the biggest barriers newcomers in Canada face when they seek medical help. Often, the mistakes they make can be prevented if they receive guidance and accurate information about the ways the Canadian health-care system works. 

To avoid unexpected high medical expenses during the first three months after arriving to Canada, Marwan Ismail, executive director at Polycultural Immigrant and Community Services, advises newcomers to buy travel insurance. 

“It is really important to be insured. Treatment is very expensive in Canada.”

“You go to the doctor,” he explains, “you pay, and then you send the claim to your travel insurance company, which will reimburse you.” 

This is something Ismail’s team at Polycultural underlines for many newcomers who don’t know how health insurance works. 

“It is really important to be insured,” Ismail continues. “Treatment is very expensive in Canada.” 

Ismail cites, for example, that elderly people can easily fall and have a fracture. If they need a surgery and have to stay in the hospital for two or three days, the bill could reach about $50 000. 

“Some newcomers think, ‘Why should I to pay $50 per month just to be insured?’ Well, $50 may save you $50 000 – you never know,” he says. 

Seeking help 

People who have no health coverage at all may be eligible for treatment at a community health centre, but these centres – depending on the location – often have extensive waiting lists and it may take several months to see a doctor. 

Not knowing where to seek medical attention, many newcomers go to the emergency departments at hospitals – even if their conditions are far from critical. 

The large number of new immigrants who go directly to the emergency departments has recently provoked discussions at Health Canada.

The large number of new immigrants who go directly to the emergency departments has recently provoked discussions at Health Canada. 

“There are newcomers who don’t know how to find family physicians; some don’t even understand what an appointment means,” says Nadia Sokhan, director of monitoring, reporting and partnerships at Polycultural. “But they easily learn what 911 is and can also go to the emergency.” 

Those who are not insured are often surprised with very high bills when they go to emergency. On the other hand, for those who have provincial coverage, their treatment costs much more to the government than if they had gone to family physicians or to walk-in clinics. 

“Each visit to the emergency department costs the Ministry of Health about $975,” Ismail explains. “Even if the person just has a cold, the hospitals would send the Ministry a $975 bill – while if the patient goes to a walk-in clinic or to a family doctor, it would be about $30. So it is very important to educate the newcomers and make them understand the importance of having family physicians – this is in the best interest to everyone.” 

Cultural sensitivities

Finding a family physician, however, can be challenging for newcomers. 

There are some immigrants who prefer to be treated by doctors who come from the same countries of origins, speak their language and understand their culture. 

Gender can also be an issue for newcomers from certain parts of the world – mainly the Middle East and South Asia Ismail says – as some would like to see a family doctor who is of the same gender.

For an immigrant living in a multicultural city like Toronto or Vancouver finding a family physician with the same cultural background is more likely, but even then the physician’s practice can be far from the place the immigrant lives. 

Gender can also be an issue for newcomers from certain parts of the world – mainly the Middle East and South Asia, Ismail says – as some would like to see a family doctor who is of the same gender. 

Some newcomers find family physicians by asking people from their ethnic communities. Others search online. 

In Ontario, for example, the website of the Ontario College of Physicians and Surgeons offers an “all doctors search” option with information about physicians’ genders, the languages they speak, the areas they practise and their training and qualifications.

Not all the listed physicians accept new patients though and some of them have waiting lists. While waiting, newcomers can still use the walk-in clinics and, if necessary, find interpreters to accompany them.


While across Canada there are organizations that provide new immigrants with information about the Canadian health-care system, there is a growing number of newcomers who still don’t know about these resources. As such, this is the first of an occasional series by NewCanadianMedia.ca that will look into access to health care for immigrants.

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

Published in Health

In the late 1960s Canadian psychotherapist Nathaniel Branden unintentionally sparked what would become the self-esteem movement when he published his international bestseller, “The Psychology of...

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Published in Health
Thursday, 17 September 2015 07:05

Youth Volunteers Support Chinatown Seniors

by Deanna Cheng in Vancouver

One outreach worker is creating a bilingual volunteer program because there's not enough support for Chinese seniors, especially those in Vancouver's Chinatown.

Chanel Ly, a 23-year-old outreach worker who is part of the Downtown Eastside SRO Collaborative, initiated the Youth for Chinese Seniors program because when she sees all these seniors – who are predominantly female – she thinks of her grandma. She cannot imagine not helping them out.

"I can't stand seeing seniors being neglected. It's disrespectful."

She points out that it's part of the Chinese cultural values to care for elders.

Ly will connect bilingual youth volunteers to seniors in the Strathcona area, the city's oldest neighbourhood.

Tasks for volunteers include translating legal documents, taking seniors to the doctor's office or the pharmacy, and informing seniors about their rights as tenants.

The biggest problem for Strathcona seniors is affordable housing.

One of the biggest challenges Ly faced while building this program from scratch was the amount of work required because there was no previous infrastructure, despite the demand for service that was culturally appropriate and in Chinese.

The program will run from this month to March next year, Ly says, because that's when grant funding ends.

"The goal is to improve the quality of life for Chinese seniors."

Addressing Chinese seniors’ challenges

The biggest problem for Strathcona seniors is affordable housing. With condo developments in the area, rents are going up and pushing out the original residents.

Vancouver activist Sid Chow Tan believes the Chinese benevolent and clan associations should contribute to Chinatown by providing their buildings and property for social housing. These associations, grouped either by provinces in China or last name "clans," were community centres.

Historically, most of the association buildings were community homes and bachelor suites for Chinese immigrants, a demographic regularly ignored by the government and institutions, Tan says. "It's sad to see space that used to house hundreds and hundreds of bachelors are now used for mahjong and ping-pong."

Another concern for seniors is health, says Ly. "Doctors are not always accessible. Drop-in clinics are not always available. Or opened only during certain hours."

Volunteers will help by accompanying seniors to the doctor's office and translate if needed.

"We want to fill in the gaps between the generations." - Chanel Ly, Downtown Eastside SRO Collaborative

Racism against Chinese seniors does happen at community centres, due to an unfounded belief that there's no such thing as poor Chinese people.

"There are poor Chinese," Tan said at a July event where bilingual volunteers and seniors met. "The Chinese poor doesn't want to be seen as poor. They just bear it."

Tan says they don't want to "lose face." In Chinese, the phrase means losing a combination of self-respect, honour and reputation.

Community survival

Despite the barriers they encounter, these seniors survive by banding together. "They're always self-sufficient and resourceful. They have their own networks," Ly says.

However, Mandarin-speaking seniors are even more marginalized, she says, because what little support there is, it's usually for Cantonese speakers.

Tan says the boomer generation couldn't leave Chinatown fast enough, but the "echo-boomers" came back. "They see something to save and protect. It's sacred ground to Chinese people.”

"It was where people organized to vote, worked to send money home," he says. "Now it's sullied by market forces, economic greed and political entitlement within the community."

Three in five Canadians say their families are not in a good position, financially or otherwise, to care for older family members requiring long-term health care.

Connecting generations

The program also promotes intergenerational interactions. Says Ly, "We want to fill in the gaps between the generations."

Ly started collecting volunteers before the summer and will have check-in meetings with youth once a month. At the moment, she has 15 dedicated volunteers lined up.

The online volunteer form is comprehensive, even asking for preferred pronouns. The program organizer says she wanted the volunteers to feel comfortable.

When asked if seniors – especially those with a traditional mindset – would be upset with transgender volunteers, Ly says the seniors might accept them.

She says they'll notice more that the volunteer is a young, Chinese-speaking person. They'll be grateful for the assistance, and would get to know them as human beings with good intentions.

Seniors’ health care: the numbers

A report titled "2015 National Report Card: Canadian Views on a National Seniors' Health Care Strategy" by Ipsos Reid Public Affairs for the Canadian Medical Association said seniors today represent 15 per cent of the population. In 1971, seniors only represented eight per cent of the population.

Three in five Canadians say their families are not in a good position, financially or otherwise, to care for older family members requiring long-term health care, the report said.

Respondents 55 years of age and older indicate they want more home care and community support to help seniors live at home longer as a key priority for the government.

Ninety per cent of Canadians surveyed believe we need a national strategy on seniors' health care that addresses the need for care provided at home and in hospitals, hospices and long-term care facilities, as well as end-of-life care.

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

Published in Health

by Belen Febres-Cordero in Vancouver

There has been an increased demand for midwifery in Canada over the past decade, with now over 1,300 midwives registered in Canada, while in 2005, there were just 500.

Alix Bacon, elected president of the Midwives Association of British Columbia (MABC), attributes this growth to the personalized care midwives offer to mothers and their families, as they provide continuous support during pregnancy, labour, birth, and up to six weeks afterwards.   

While midwifery’s continuity of care principle can be valuable for all mothers in Canada, Manavi Handa, a midwife and activist focusing on serving immigrant mothers, believes that this model can have particular benefits for women new to the country and its medical system.

For instance, Ali Moreno, an Ecuadorian woman who had her baby in Vancouver, is particularly happy she chose midwives as her health care providers.

“They take the time to get to know you, understand your background.”

“With doctors, the clock is always ticking,” Moreno explains. “Appointments with midwives last up to 45 minutes. They take the time to get to know you, understand your background, and take care of your emotional and physical wellbeing.”

However, Handa explains, newcomers may not necessarily consider this option when first looking for maternal care in Canada.

“People come here expecting modern healthcare and they don’t always associate midwifery with that because they don’t know how well trained we are or what we do,” she says.

What is a midwife?

Midwives are specialists in low-risk maternal and newborn healthcare.

The midwifery practice in Canada differs from practice abroad in several aspects, such as the number of births attended annually and the level of contact with mothers throughout their pregnancy.

In Canada, midwifery is managed by each individual province and territory and is currently regulated in nine. Services are publicly funded in all regulated locations.

Midwifery in Canada requires all practitioners to have a bachelor’s degree. Handa, who teaches at Ryerson University, explains that the seven midwifery programs in Canada have theoretical and practical components, including two years attending to mothers under the supervision of experienced midwives.

“We empower women to make the decisions that are appropriate for them.”

People trained abroad can practise midwifery in Canada by completing shorter bridging programs, making it an attractive option for new immigrants.

According to information provided by the Canadian Association of Midwives (CAM), midwives in Canada are registered primary healthcare professionals that are fully trained and have access to all the necessary equipment, diagnosis services, and select medications to provide women and their babies the care they need from pregnancy to postpartum.

However, midwifery understands pregnancy and birth as healthy and normal aspects of life, and as such, aims for the least amount of interventions possible.

“Technology is great if you need it, but medical intervention when you don’t need it can lead to other risks,” Handa explains.

This consideration, together with the continuous support they provide, results in lower rates of medical interventions and shorter hospital stays for women who engage the services of a midwife, according to data from the Association of Ontario Midwives (AOM).

Cultural sensitivity

Midwifery is guided by the informed choice principle, which encourages women to be active decision makers in the care they receive. Handa explains that this principle respects individuality.

“This is of particular importance to immigrants because they may have their own cultural beliefs. We empower women to make the decisions that are appropriate for them.”  

She adds that because women primarily practise midwifery, newcomers from countries where only women attend labour might feel more comfortable under their care.

For Moreno, this was an important component during her pregnancy in Canada.

“The fact that midwives are women makes you feel safe and understood. They know how you’re feeling because they probably went through something similar themselves,” she says.

Organizations also try to eliminate possibly language barriers for new Canadian mothers to be.  Ontario Midwives includes information in different languages, and MABC offers help finding midwives that speak languages other than English inside the province.

The benefits 

Another principle of midwifery that increases the number of options for mothers is choice of birthplace. According to CAM, “people might have the misconception that midwives only attend homebirths, but they can actually choose to have their babies at hospitals or birth centres too.”

In Ontario, these cost savings are increased because women can access midwives’ care for free, regardless of their immigration status.

Engaging a midwife can also be cost effective. A study of birth costs in B.C., published on July 2015, reports more than $2,300 savings per birth in the first postpartum month among women who planned a homebirth with a midwife compared to a hospital birth with a physician.

In Ontario, these cost savings are increased because women can access midwives’ care for free, regardless of their immigration status.

For women in provinces such as B.C. where uninsured individuals cannot have the services for free, Bacon explains that it would still be more affordable for them to seek care through a midwife than a physician and to have a homebirth instead of staying in hospital.  

What if complications arise?

In specific cases of high-risk pregnancies, each province has guidelines for midwives to consult with or refer women to other health specialists.

Midwives can also provide shared care or transfer the care at any point, if needed.  

“If a more serious complication arises, the most responsible care provider would become an obstetrician, but we would remain in a supportive role,” explains Bacon.

This was what happened in Ali’s case.

She initially planned to have a homebirth, but she had complications during labour.

“I decided to go to the hospital. Midwives, nurses, and doctors were all great,” she remembers. “They worked together and they helped me choose the safest option.”


Journalist Leah Bjornson, through the New Canadian Media mentorship program, mentored the writer of this article.

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

Published in Health
Friday, 11 September 2015 12:01

How to Live to 100+

50-year long study of Swedish men reveals specific factors that associate with extended longevity. By Dr. George I. Traitses For 50 years, Swedish researchers have followed the health of 855 Gothenburg men born in 1913. The first surveys were conducted in 1963, and now that the study is ending –232 of the subjects reached 80 

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Published in Health
Wednesday, 26 August 2015 11:48

Addressing Newcomer Maternity Health Concerns

by Belén Febres-Cordero (@BelenFebres) in Vancouver, British Columbia

Raquel Velásquez’s objective on her visit to a clinic was to have a prenatal check-up. Instead, the medical practitioner asked her if she was sure she wanted to keep her baby.

Raquel was also encouraged to reconsider her decision at two other health facilities she attended afterwards. “They thought I was too young to be a mother, but they knew nothing about my culture or religion,” she explains.

Navigating a health system where patients’ backgrounds are not fully considered is one of the obstacles that women face when expecting a child abroad.

Irene Santos, who was a pediatrician for 29 years in Mexico, explains that further difficulties may include not knowing the language, the culture, or how the system operates. “Not being a permanent resident and lacking networks of support are also common challenges,” she adds.

Ángela Hiraldo remembers yearning to return to the Dominican Republic when first learning about her pregnancy: “I didn’t have access to the health system and I didn’t know how it worked. When you come to another country, there are so many things you need to do but there is no one to show you the way.”

“With the CCHB, I feel that my time is valued because she listens to me and understands what I need; we can talk in my own language, and we explain everything to the doctor together.” - Ángela Hiraldo, immigrant mother

Voces Maternas

To help others going through similar situations, Raquel and her team started Voces Maternas (Maternal Voices).

Voces Maternas is one of the programs of Umbrella Multicultural Health Co-op, a member-driven, not-for-profit organization that offers medical services to immigrants facing barriers to accessing health care in British Columbia. Financially sustained by the Vancouver Foundation, Voces Maternas delivers free pre- and post-natal support to immigrant women, their children and partners.  

The Cross-Cultural Health Broker (CCHB) is one of its crucial components. CCHBs are bi-cultural and bilingual health workers with medical degrees, and extensive knowledge of both the community with whom they work and the Canadian health system.

Irene, Voces Maternas’ CCHB, indicates that the goal is to become a bridge between the patient and the medical services in Canada by helping newcomers understand and navigate the health system, and by being an interpreter and translator – in both linguistic and cultural terms – between the patient and the doctor.

“With the CCHB, I feel that my time is valued because she listens to me and understands what I need; we can talk in my own language, and we explain everything to the doctor together,” Ángela says.

Moreover, the CCHB gives workshops that provide immigrant families with information about pregnancy, birth and post-partum so that they feel empowered to take decisions according to their own set of beliefs.

“We don’t try to impose ideologies, areas of interest, or methodologies. We talk about different options so that people can choose what works best for them,” Raquel explains. As a result, they provide a safe and non-judgemental meeting space for parents to connect and support each other.

“Sometimes people can’t access the services they’d like to because they learn about them when it’s too late. We assist them so that they can know their options and choose from them on time." - Raquel Velásquez, Voces Maternas

Resources for maternity health: an urgent need

Voces Maternas currently focuses on Latin American women, but it aims to include other communities in the future.

Other projects of Umbrella – such as the Umbrella Mobile Clinic, the Pediatric Health Outreach Program and the Many Faces of Diabetes Program – offer services in several languages and work with communities from different parts of the world.  

In an email to New Canadian Media, British Columbia’s Ministry of Health states that “we recognize newcomers may face challenges in accessing health care services, which is why we continue to introduce services aimed at this population,” some of which include the Bridge Clinic, the Global Family Care Clinic, the New Canadian Clinic, and the Newcomer Women’s Health Clinic.  

Similar services are available in other provinces. For example, the Multicultural Health Brokers Co-operative, which functions in Edmonton, Alberta, offers diverse programs where multicultural health brokers provide support to 22 cultural and linguistic communities. 

Both Raquel and Ángela recognize the urgent need to provide more information about the existing maternity health options in British Columbia.

“Sometimes people can’t access the services they’d like to because they learn about them when it’s too late. We assist them so that they can know their options and choose from them on time,” Raquel explains.

Immigrant health: a combined effort

Newcomers can also visit the WelcomeBC webpage to know more about B.C. health services, or the Government of Canada's Health page to learn about health services across Canada. For more support, they can access the Immigrant Services Society of British Columbia or the Community Airport Newcomers Network.  

Improving immigrant health is a combined effort. According to the email from B.C.’s Ministry of Health, “though we strive to offer comprehensive services to new British Columbians, non-profit organizations providing further education and resources are certainly a valuable addition to the system of care.”

In addition, Umbrella highlights the need for people to actively look for information and get involved. Ángela is pleased she did: “I feel empowered thanks to Voces Maternas, not only because I know more, but also because of the bonds I created.”

Raquel adds that “if we surround ourselves with people that support us, we also feed the circle by empowering other mothers to enjoy their experience.” She believes in the proverb that says that raising a child takes a village, “and we want to be that village for immigrant parents living in Canada.”

This content was developed exclusively for New Canadian Media and can be re-published with appropriate attribution. For syndication rights, please write to publisher@newcanadianmedia.ca

Published in Health

by Selina Chignall

The results of the Canadian Medial Association’s report card on health care shows Canadians strongly believe in the need for a national strategy for seniors’ health.

According to the report, released today, 90 per cent of those polled said there needs to be a national strategy for seniors care — which should include support in home, hospice, hospital and long-term care facilities and with end of life care.

The survey also found that 67 per cent of Canadians believe the “federal government has an important role to play in developing a national seniors’ care strategy.”

More than 80 per cent of those polled say if the provincial and federal governments cannot agree to a national strategy, they believe the costs for providing care for the elderly will fall on younger members of the family.

“We will just not have enough money to care about anyone.”

With no additional funding on health care expenditures for seniors between 2000 and 2011, CMA President Dr. Chris Simpson said the health care system will become completely unable to care for seniors.

“We will just not have enough money to care about anyone.”

Provinces and feds need to work together

Access to quality seniors’ care is cause for concern as the average life expectancy in Canada is 81 years. And when the last of the baby boomer cohort reaches the age of 65, seniors could represent a quarter of the population.

Whoever wins this election, a majority of Canadians say they will need to respond to this demographic shift, and it will require cooperation among the federal, provincial and municipal governments.

“The fact that it’s a messy discussion and these are difficult issues simply can’t be an excuse for not cooperating with other levels of government … Canadians expect the feds and provinces to work on this,” Simpson said.

Despite jurisdictional limitations — as hospitals and doctors are provincial responsibilities — Simpson said the federal government could include health infrastructure in the Build Canada Fund and create tax credits for caregivers to stay at home.

“We want people to think about where the parties stand on health when they cast their ballot.”

Simpson says he was disappointed the issue of health care wasn’t raised in the first national leaders debate, and the lack of discussion about it during this campaign. Canadians should think critically about the parties platforms on health care when they go to vote.

“We want people to think about where the parties stand on health when they cast their ballot.”

Simpson points to New Brunswick, where 25 per cent of the hospital beds are filled with seniors waiting for placements in long-term care facilities. “That’s the future for the rest of the country whose aging population is following behind.”

Last week in British Columbia, Liberal Leader Justin Trudeau pledged to invest an additional $190 million to expand the Employment Insurance compassionate-care benefit. He promised to extend the benefit to those taking care of seriously ill family members and greater flexibility to caregivers if they need to take time off work.

Currently, the benefit is only available to those who can prove their loved one is at risk of dying within six months. Because of the strict time frame to qualify for benefits, Trudeau said “too often, folks are forced to leave their jobs and drain their personal savings to provide essential care.”

His pledge to extend these benefits is a small step in addressing seniors care, which Simpson says “is not something you can fix overnight. It takes planning and good will … if we can’t even agree that we need a plan then we are in really big trouble.”


Published in partnership with iPolitics.ca.

Published in Health

Poll Question

Do you agree with the new immigration levels for 2017?

Yes - 30.8%
No - 46.2%
Don't know - 23.1%
The voting for this poll has ended on: %05 %b %2016 - %21:%Dec

Featured Quote

The honest truth is there is still reluctance around immigration policy... When we want to talk about immigration and we say we want to bring more immigrants in because it's good for the economy, we still get pushback.

-- Canada's economic development minister Navdeep Bains at a Public Policy Forum economic summit

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