Canadian Doctors Speak Out for Refugee Health Care

Speakers left to right: Juan Carlos Chirgwin, Samir Shaheen-Hussain, Philip Berger and Janet Cleveland. Photo Brandon Johnston

Members of Canada’s medical community gathered at McGill on Saturday to discuss the federal government’s 2012 amendments to the Interim Federal Health Programme (IFHP), which changed the way refugee seekers qualify for health care within Canada.

The changes made it so that those in the process of seeking refugee status would receive no medication coverage or any supplemental services.

Additionally, those seeking status from countries considered by Canada to be ‘safe,’ such as Europe and Mexico, would receive very limited services. Only if their health posed a threat to public safety would they receive free treatment.

For example, a refugee from Mexico with an infectious disease that could potentially harm members of the public, would qualify for free health services. However, for other medical instances, such as a broken leg, they would be left unprotected.

The cuts were claimed, by the Conservative government, as a means discouraging ‘bogus’ refugee claims and on economic grounds.

Panelists at Saturday’s discussion disagreed.

“The federal government has lied continually for three years about [the amendments],” said Philip Berger, a University of Toronto medical professor and health rights activist. “Costs were absorbed by provincial governments and local hospitals,” Berger continued.

“Rather than treating people on the basis of their medical need, we are asked to treat them based on their legal status and where they were born,” Berger said.

The amendments were brought before a federal court which ruled against the changes, claiming they constituted “cruel and unusual treatment” and were in violation of the Canadian Charter of Human Rights. The decision has since been appealed by the federal government, and a temporary health program now exists.

Janet Cleveland, a psychologist and lawyer, cited an example of a women from Honduras who lost her child due to the amendments. The women was in the process of immigrating to Canada while being sponsored by her husband. Because she had no coverage, she was forced to neglect costly prenatal care. After having a miscarriage, she was stuck with a bill of $40,000 for the 10 day hospital stay she required afterwards.

“Absolutely preventable and absolutely avoidable, and that kind of thing goes on, unfortunately, not uncommonly,” Cleveland said of the case.

She went on to discuss how categorization under the program makes it difficult for doctors to assess what type of treatment they can administer to patients, who are categorized confusingly depending on the status of their claim.

“Most healthcare providers don’t understand migratory status […] and yet coverage is based around this,” Cleveland said.

“The context of budget cuts means that, in Quebec, the hospitals are much less generous […] everybody is trying to cut costs,” Cleveland said. “It amplifies the perception that we have scarce resources and we have to keep them for us, and not for ‘those people’ who are seen as being the Other,” she concluded.

The panelists also discussed Canada’s changing image as a country open to receiving refugees. Berger relayed a story of a trip to Hungary where he stayed in a town composed largely of Roma people. Canadian pamphlets discouraging immigration had been distributed around the town as an effort by the Canadian government to discourage migration of Roma people.

Since 2012, more than 3,000 Romas seeking refugee status in Canada have been paid by the federal government to abandon their claim and return home.

“What is Canada’s justification in deciding who’s allowed to come in? The reality is that Canada itself was founded on the genocide of native peoples, and that’s a reality that cannot be denied. We’re here on this land because native people were extinguished by very explicit acts,” said Samir Shaheen-Hussain, a pediatrician and health care activist who spoke at the panel.

“Two or three hundred years down the line, assuming humanity survives, people are going to be looking back at this time and saying ‘how could a society, how could a government, ever be pushing this idea?’” Shaheen-Hussain said. “The question is, what side of history are we going to be on?”

The daylong event was hosted by McGill’s Comparative Healthcare Systems Program and featured workshops revolving around refugees inside and outside of Canada.

Organizers claimed to have reached out to the federal government and doctors who support the health care amendments, however their attempts were denied and no supporters of the bill would speak at the event.