Refugee Talk: Cuts, Costs and Conflicts in Care

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On July 4th 2014, after two years of relentless advocacy efforts by numerous citizen and professional groups across the country, Court Justice Anne Mactavish ruled that the Interim Federal Health Program (IFHP) cuts “shock[ed] the conscience and outrage[d] our standards of decency” by subjecting particularly vulnerable groups, such as pregnant women and children, to “cruel and unusual treatment”. Moving forward, Justice Mactavish gave the federal government four months to respond to the ruling and to reinstate refugee healthcare coverage. To all those involved in advocacy efforts related to cuts to refugee healthcare, this marked a significant achievement in providing equitable access to critical healthcare services to some of the most disadvantaged members within our communities. Interestingly, the timing of the talk was well placed, as on the same day, the federal government announced that refugee health would be reinstated across the country with revised guidelines the next day.

On November 4th 2014, McMaster students participated in a discussion with Dr. Andrea Hunter, an Assistant Clinical Professor of Pediatrics at McMaster University, and Gabrielle Inglis, a third year medical student at McMaster and co-founder of the Health Advocacy for Refugees Program (HARP). Dr. Hunter and Gabrielle discussed the advocacy efforts leading up to the court ruling and the challenges associated with providing healthcare to refugee populations. Through their stories, Dr. Hunter and Gabrielle gave students the opportunity to explore perspectives in healthcare advocacy in today’s political climate.

Throughout the evening, both Dr. Hunter and Gabrielle stressed the importance of viewing healthcare advocacy as an all-encompassing term used to describe a diverse range of efforts targeted at improving quality and access to care. It was interesting to hear the many ways in which advocacy efforts were being carried out on both a micro and macro scale. For example, in an effort to provide quality care, Dr. Hunter consistently advocates on behalf of newcomer patients facing language barriers by requesting access to skilled interpreters at the healthcare institutions with which she works. Along the same lines, Gabrielle helped students realize that their advocacy efforts could take on any form, the most common being education and awareness of emerging issues within both our local and global communities.

Subsequently, Dr. Hunter and Gabrielle directed the conversation towards collaborative, large-scale advocacy efforts, citing the coordinated national response to oppose the IFHP cuts as an example. A recurring theme woven into the conversation was the importance of forming sustainable and multidisciplinary partnerships that draw from and capitalize on strengths, skills and resources of each partner. Drawing on her experiences with HARP, Gabrielle highlighted the role of student advocacy groups in mobilizing young professionals and arousing mass awareness about refugee healthcare cuts in educational institutions across the country. Dr. Hunter attributed part of the success of the campaign to integrated efforts of Canadian Doctors for Refugee Care (CDRC) and the Canadian Association of Refugee Lawyers (CARL). The CDRC was critical in formulating an evidence-informed campaign to raise public awareness about the issue. This effort was complemented by the CARL, who provided legal expertise and resources that were instrumental in translating the awareness generated by the advocacy efforts into tangible outcomes by challenging the legality of the cuts in a formal application in Federal Court. The series events leading up to Court Justice Anne Mactavish’s ruling are summarized in the figure below.

It was a pleasure to hear from two inspiring individuals who have had firsthand experience in instigating change through local and national advocacy efforts. The changes brought about by the campaign will not only affect current refugees, but will also have implications for future refugees seeking protection in Canada. Their involvement provoked us to re-examine our own capacities to spur change within our communities.

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Figure 1. A timeline mapping out some of the major advocacy activities and political events that occurred from the onset to the reversal of the Interim Federal Health Program cuts.

By Jenny Hoang, Multimedia Specialist, and Haniya Khan, Logistics Coordinator. 



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