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Cuts to refugee health care endanger patients' lives

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Across the street from the Immigration and Refugee Board of Canada's offices in downtown Toronto, Meb Rashid stood before a crowd of almost 400 health care professionals and their allies on Monday with a message for Minister of Citizenship and Immigration Chris Alexander and the Prime Minister on behalf of Canadian Doctors for Refugee Care.

"We are not going away," said Dr. Rashid, co-founder of Canadian Doctors for Refugee Care.

"As long as cynical politicians use vulnerable groups such as refugees for sound bites and cheap political points we will continue to demand change." 

Click here to see more photos from Monday's action in Toronto.

On Monday, health care professionals in 17 cities across the country held their third National Day of Action to oppose the cuts to refugee health care imposed by the Conservatives two years ago.

In April 2012, the federal government announced a series of sweeping changes to the Interim Federal Health (IFH) program that came into effect two months later.

The previous IFH program provided access to medical care, diagnostic services and laboratory testing very similar to what is provided by provincial health plans. It also provided access to medications, emergency dental care and vision care similar to what is available to people on provincial social assistance plans.

On June 30, all refugees (excluding government assisted refugees) lost access to medication coverage, vision and dental care through IFH. Refugee claimants that originated from countries the Minister felt should not be producing refugees lost access to all health care services except conditions deemed a public health concern or public security risk.

"We are demanding this government reverse the cuts to refugee health insurance," said Dr. Rashid. 

"No Mr. Alexander, we are not going away. We'll continue to speak out for those who have endured horrible atrocities like the woman I saw recently who was incarcerated and gang raped because her husband was involved in politics."

Because of the cuts to refugee health care, when Dr. Rashid first saw her he couldn't even conduct essential tests to determine if she had contracted HIV or whether she was pregnant.

"Or the woman who sat crying in front of me because she'd lost everything after fleeing Afghanistan," said Dr. Rashid. 

"Her crime is that she was intent on having her young daughter go to school."

Dr. Rashid recounted other stories of pregnant refugees turned away from care and sick children showing up in emergency departments who would have been treated earlier, if not for the cuts.

"We know that the system is so incomprehensible that even those refugees that have valid insurance are being denied care," he said.

"This program makes no sense. It's costly, inhumane and cruel."

Last month, said Dr. Sandy Buchman who is a Past President of the Ontario College of Family Physicians, a 72-year-old woman with a large cancerous tumour on her abdomen and back wasn't eligible for any cancer treatments or medications.

"She had no money whatsoever," said Dr. Buchman who was forced to scrounge medical supplies and medication just to deal with her wounds and pain in order to give her a peaceful, comfortable and dignified death.

"This is one of my practical challenges but there are many more."

Almost 40 University of Toronto medical students organized Monday's cross country actions, including second year student Emily Stewart.

Stewart recounted the story of a 22-year-old who fled to Canada to after she was forced into the sex trade. 

Shortly after arriving in Canada, the woman realized she was pregnant but unable to obtain STI (sexually transmitted infections) testing or prenatal testing until her refugee application paperwork was completed and the Board determined which category of refugee she belonged to.

Sadly, her case is not unique. And often these cases aren't restricted to the health of the individual.

"Some of those are threats to public health," said Dr. David McKeown, Toronto's Medical Officer of Health. "Conditions like TB and Hepatitis need to be diagnosed and treated early for all of our sakes."

In 2012 when the first National Day of Action was held, Vanessa Wright, a nurse practitioner at Crossroads Refugee Health Clinic in Women's College Hospital, never thought she and her colleagues would still be fighting to reverse the cuts to refugee health care two years later.

"Welcoming people into Canada and denying them the necessary health care they need is unjust," said Wright.

Three months ago, Wright gave birth to a baby boy. She's participated in and valued many community and provincial programs.

"It has been the most beautiful time of my life," she said. "And it makes me so disheartened to think that the IFH program cuts has potential for new mothers and new babies to not be part of this community."

Now an obstetrician, Dr. Tatiana Freire-Lizama arrived in Canada as a refugee when she was a young girl forty one years ago, after the military putsch led by General Augusto Pinochet removed the leftist (and democratically elected) President Salvador Allende. 

At the time, her mother was working in a public access clinic as a physician. She was forced into hiding with Tatiana and her two other children for several months. Eventually, the family was granted refugee status in Canada.

But shortly after they arrived, the eldest daughter woke up one night with a high fever and blood oozing from her ear. Without hesitation, Tatiana's family was able to get the medical attention and medication she needed to make a full recovery.

"But imagine today without health coverage," said Dr. Freire-Lizama. "Imagine the same family in a strange country with no English, no resources trying to decide what to do with a sick child in the middle of the night."

It's for that reason that Dr. Freire-Lizama was distressed that Canada is "turning its back on some of the neediest people on earth."

Dr. Freire-Lizama acknowledged that what happened in her home country of Chile in 1973 continues to happen today in other countries around the world.

"And our country is now taking in fewer refugees than ever," she said. "We are speaking about them as illegals. As phonies." 

After the Conservatives cut health coverage to refugees, Ontario introduced a new program on January 1 that provided refugee claimants with access to primary care and urgent hospital services as well as medication coverage regardless of their refugee status.

"I've expressed our government's disappointment with the Ontario government's recent decision to reinstate health care benefits to all asylum seekers and even rejected refugee claimants," said Minister Alexander at a January press conference.

"Simply arriving on our shores and claiming hardships isn't good enough. This isn't a self-selection bonanza, or a social program buffet."

Dr. Freire-Lizama responded on Monday with a strong message for the Minister.

"He ought to be ashamed," she said.

"We will not be convinced that caring for the sick and pregnant women is somehow irresponsible. I question the legitimacy of our federal government when it denies basic human rights and tries to strip us of our basic responsibility."

Dr. Paul Caulford also had some powerful words for the Minister.

"Single handedly with Mr. Kenney and then followed up by Minister Alexander, we are seeing the birth of a new poverty in Canada," said Dr. Cauflord.

"We are seeing the birth of health poverty."

Caulford said his Scarborough Community Volunteer Clinic almost went out of business after 14 years in operation.

"Overwhelmed by an unprecedented surge since 2012 that has just barely tipped down a bit," he said. 


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