Volunteer clinics swamped
Refugees desperate after Ottawa cuts health care
Alittle United Nations of patients, some pushing strollers, started filing in half an hour before the first Thursday evening appointment. Soon, all 16 seats were filled in the waiting area of a modest health clinic tucked behind a Scarborough plaza.
There was a 59-year-old man from Jamaica anxious about an enlarged prostate; a 5-year-old boy from Nigeria with a gastrointestinal problem; and a willowy 2-year-old from Hungary with an ear infection and suspected urosepsis.
They were here because all have been shunned by other clinics because of the refugee papers they carry — and the confusion over what and who is covered under the federal government’s new restrictions on health care coverage for refugees that began June 29.
Both the Scarborough Community Volunteer Clinic and Muslim Welfare Centre Clinic — the city’s two mainstays for uninsured patients — have reported an influx of refugee patients as a result of the cuts.
At the Scarborough clinic at Markham and Ellesmere Rds., which opens for only four hours two evenings a week and is staffed mostly by volunteer doctors and nurses, the patient load has more than doubled, from 10 to more than 25 per shift.
At the volunteer-run welfare clinic, which operates for three hours, three times a month, the monthly patient volume has doubled from 25 to 50.
“Not only do we have an increased workload, people coming in now are definitely sicker,” public health nurse Jennifer D’Andrade said.
“A lot of the patients have a chronic condition, like hypertension and diabetes. They run out of medications and are scrambling for help,” said D’Andrade, at the Scarborough clinic.
A spokesperson for Immigration Minister Jason Kenney maintains that any refugee claimant in Canada currently receives the same access to health care as any Canadian taxpayer gets through their provincial health care.
“The changes ensure bona fide refugees continue to receive comprehensive health coverage, while illegal immigrants and failed asylum seekers from safe, democratic countries no longer receive health insurance that is superior to what is generally available to taxpaying Canadians,” said Alexis Pavlich.
But Dr. Paul Caulford, who operates the Scarborough clinic with seven other family doctors, attributes the surge in traffic — and panic — to a growing number of refugees turned away by regular clinics and hospitals.
“Our clinic is at a sustainability crisis point. Everybody is under the gun here and we are swamped. Some nights, it’s being crowd control,” said Caulford, grabbing a patient’s charts from a nurse before running from one examination room to another.
This evening, the clinic was fresh out of the children’s antibiotics donated by drug companies, Caulford said. He signed a note to the neighbouring pharmacy, pleading with them to give the Hungarian boy with an ear infection his medicine and bill it to the clinic later. The money would have to come out of the clinic’s piggy bank — replenished by public donations. It’s the fund staff also draw on to get diagnostic tests for patients: blood tests, MRIs and ultrasounds.
In July, Anna Elumah’s 2-year-old daughter, Monique, fell at the shelter where the Nigerian refugee family was staying. The girl was sent to the emergency department at Rouge Valley Centennial Hospital to get her eyebrow stitched up.
Elumah, whose older daughter died from female genital mutilation and says she fled to Canada to avoid having it forced on her younger daughter, was told to go to a community clinic to have the stitches removed after five days. “We went to a clinic on Morningside. They looked at my paper and said, ‘It’s no good anymore. Go somewhere else,’ ” recalled Elumah, who also was suffering from a headache after she ran out of her medication for high blood pressure. Her caseworker referred her to the Scarborough clinic, where she receives free drugs for her hypertension and asthma inhalers for her 8-year-old son, Davids. Dr. Berton Ung, who volunteers at the clinic once a month, said physicians now have to call a number to check if a procedure or a patient is covered by the refugee health plan, run by Blue Cross on behalf of the government. In the past, someone was either covered or not, but now all medical conditions as simple as a sore throat are coded. A patient could be eligible for treatment for one thing but not another. Some clinics try to avoid the hassles of not getting paid by turning refugee patients away. “Many patients are denied because the codes are not found or it’s not considered a threat to public health,” Ung said. Ung recently had a high-risk pregnant patient seeking an abortion but he was unable to send her to a specialist because the consultation alone would cost $800, an amount the refugee woman couldn’t afford. “These people are very vulnerable,” Ung said. “They are not here by choice. They need proper care.”