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. 


Upcoming Events

Workshop on Finding and Using Research Evidence

The McMaster Health Forum is pleased to announce that registration is now open for a five-day training workshop that will teach policymakers, stakeholders and researchers how to find and make use of research evidence in their work to reform, renew or strengthen health systems, and to get cost-effective programs, services and drugs to those who need them.

The winter session of the ‘Finding and Using Research Evidence to Inform Decision-making in Health Systems and Organizations’ workshop will be held from February 17-21 at McMaster University. Registration is open until January 31.

The training workshop offered by the McMaster Health Forum is a complement to the online version of the course, and is designed for those who wish to master the skills needed to find the most reliable research evidence and to use it to inform and influence decisions about how the various parts of a health system function.

The workshop will require participants to complete the online course before travelling to McMaster for five days of interactive workshops led by Forum Director John Lavis, who has conducted nearly 100 training workshops in more than 30 countries with health system policymakers, stakeholders and researchers, on a variety of topics. Lavis will be assisted by Kaelan Moat, Lead of Health Systems Evidence and Learning for the Forum.

The cost of the workshop (which includes the online course) is $2,480 (not including personal travel and accommodation expenses).

The finding and using research course was launched by the Forum early in 2014, and approximately 500 participants from a range of health system policy and stakeholder organizations (in addition to trainees interested in careers in health policy) have already completed the online course.

The workshop is now open for registration by individuals who wish to take it on their own. Download the registration form now.

The Forum is also interested in working with organizations whose staff could benefit from the online course alone, or in combination with the week-long training workshop. Organizations are invited to contact the Forum directly to discuss options, at

For more information on the McMaster Health Forum or its course offerings, visit


News from Student Subcommittee: Open Houses & Call for Applications

We are pleased to announce that more exciting opportunities are available with the McMaster Health Forum Student Subcommittee for the 2014-2015 academic year. This month, we will be recruiting one health literature coordinator and six general members to be a part of our dynamic team.

  1. Health Literature Coordinator (1 position): For students who have a keen knowledge of, or interest in, literature surrounding diverse current issues in local and international health, this position involves managing an online blog, coordinating regular roundtable discussions, and assisting with media updates for the subcommittee. This position requires excellent communication, organizational and interpersonal skills.
  2. General Member (6 positions): For students who have a keen knowledge of, or interest in, trending health topics and are looking to gain experience in leading and supporting event planning, this position requires strong organizational and interpersonal skills and the ability to work both individually and as part of a motivated team in a fast-paced, professional environment.

To apply, McMaster students can find the postings online on OSCARPlus. The deadline for applications is September 23rd at 4 p.m. A cover letter, resume and a skills matrix are needed to apply.  A copy of the skills matrix can be found here:

To find out more about the McMaster Health Forum and the positions listed, come visit the Forum at one of our two open house events on either September 8th or 10th from 5:30 to 7 p.m. We will be available to provide more details on the activities of the committee, including hosting publics talks, lectures, and workshops aimed at engaging students in discussions and action on pressing health issues. All students are welcome to attend the open houses to learn more about the work of the committee and the specific positions available for the 2014-15 academic year. The open houses will be held at the Forum’s offices on the fourth floor of Mills Memory Library, adjacent to the Lyons New Media Centre.

Alternatively, to find more information about the McMaster Health Forum, student subcommittee and coordinator positions, visit our website at or send an email to the subcommittee co-chairs at We look forward to meeting our new student subcommittee members in the coming weeks!

By Hark Randhawa, co-chair 2014-2015, McMaster Health Forum Student Subcommittee