Mayor pushes AHS on closure of specialized clinic
Council hears treatment has suffered since specialized clinic ‘closed down’
Edmonton’s mayor plans to write a letter to health officials after city council heard concerns that health care for refugees in the city is suffering since a specialized clinic closed last year.
Alberta Health Services (AHS) says the clinic for government-assisted refugees was never closed — its services were just “transitioned and enhanced.” But council, after hearing about the issue at a recent committee meeting, voted Tuesday to seek more details.
“If best practice is to have a clinic … and ours has been closed down, we want to understand from the province if they have a strategy,” Mayor Don Iveson said after council endorsed the move to write a letter Tuesday. “We want to have assurance that refugee health is going to be looked after equitably.”
Edmonton once had a physician-staffed health clinic for government-assisted refugees called the New Canadians Clinic, supported by AHS funding and hosted by Catholic Social Services (CSS). The clinic operated since 2007 at the agency’s Reception House, where newcomers are initially housed after they arrive at the airport, said Kathryn Friesen of CSS. At least one physician worked from the clinic every Friday before the transition.
Last year, the clinic’s services were “transitioned” to the AHSrun East Edmonton Health Clinic, where the team can perform weekly intake assessments and connect refugees with family physicians, AHS spokeswoman Kirsten Goruk said.
But Rhianna Charchuk, a specialist at the Alberta Association of Immigrant Serving Agencies who addressed council’s community services committee last week, said the new care model is poor.
“It’s not refugee-centred health care,” she said. “Doing the testing here and then sending them off somewhere else isn’t ideal care. The best practice is all-around care.”
After the transition, Friesen said AHS did offer to send a nurse to Reception House up to twice per week, but CSS declined — after the transition, there was no longer an on-site co-ordinator to organize would-be appointments with the nurse.
Refugees should have the equivalent of an intensive-care unit that offers services beyond triage and initial assessments, with a dedicated physician prepared to offer care and followup appointments for another year, Dr. Stan Houston, a professor of infectious diseases at the University of Alberta, said in an interview last week.
Major centres in Canada typically run these types of clinics, he said. An ideal refugee-dedicated clinic could address trauma, exotic disease, tuberculosis, mental health, and have cultural and language competency, Houston said.
At the East Edmonton Health Clinic, refugees receive initial health assessments, referrals and immunizations from a New Canadians registered nurse, Goruk said.
The team is able to determine the need for less urgent and chronic health concerns, as well as refer pregnant women to prenatal programs. A nurse practitioner is also available to treat and prescribe patients.
Moving from an intake clinic to a family physician is “perhaps not a huge obstacle” for refugee families, but Houston thinks the system could cause certain health problems to be missed.
“You can’t just pick a room in your ward and put up a sign that says ‘ICU,’ ” he added. “If you have a Somali or Congolese family coming into your clinic, they don’t fit into a 15-minute appointment time.”
Houston and Charchuk were each involved with the New Canadians Clinic through a community refugee health coalition.
Since the move, the East Edmonton Health Clinic has helped 513 people, feedback has been positive, and “people are grateful for the support and care they have received,” Goruk said.
But this feedback, Houston said, “tells me nothing.” Proper shortterm indicators of success would include emergency room visit numbers, because refugees who come to emergency departments with unique health concerns can possibly be misdiagnosed.
Other indicators would include whether refugees are receiving appropriate followup appointments, pap smears and other standard medical tests.
Houston said he and other researchers at the U of A’s School of Public Health, as well as the University of Calgary, are hoping to secure funding to research the longterm care of refugees in Alberta.