KeepHealthCare.ORG – Regina Community Clinic breaks down health-care barriers for newcomers
Shortly after Dr. Razawa Maroof came to Regina in 1996 as a political refugee from Iraq, she was upset when a physician treated her as though she was untouchable.
On Maroof’s prenatal visits to the physician, and when she accompanied other newcomers to appointments, he was always gowned, masked and gloved and refrained from touching patients.
“I don’t know what he was thinking,” Maroof said. “Did he think everyone who comes to Canada has leprosy or has a bad infectious disease?”
She feels fortunate she spoke English when she arrived in Canada, unlike many newcomers who often have limited language ability, which is exacerbated by a lack of trained interpreters.
“The experience of seeing a physician in a different country who doesn’t speak your language is very overwhelming,” she said. “Imagine, you’re in a new country and you don’t know how to communicate.”
As a physician, she knew doctors typically don’t cover up when treating patients, so she was troubled by the physician’s approach to newcomers.
The dehumanizing experience stayed with her.
She was a gynecologist in Iraq for 10 years. After arriving in Canada, she worked hard to get accredited to practise medicine here and began working as a family doctor at the Regina Community Clinic in 2002.
Three years later, Maroof became determined to give back to the community she loves. With the collaboration of the Regina Community Clinic and Regina Open Door Society, she started seeing new government-sponsored refugees.
When she became a professor associated with the College of Medicine at the University of Saskatchewan in 2007, Maroof jumped at the opportunity to teach a new generation of physicians.
“There are a lot of health-care workers, including physicians, who aren’t familiar with taking care of immigrants and refugees,” Maroof said. “They aren’t aware of their culture and their religious beliefs … The (medical) residents are very happy to come here because they don’t see that different demographic of patient anywhere else in the city.”
When 650 Syrians came to Regina, demand for the clinic’s services was overwhelming. Staff struggled to care for the influx.
Mental health is a big issue for new Canadians, so the clinic hired another counsellor and got money from the provincial government so she could work with interpreters, Maroof said.
However, when demand outstripped the clinic’s ability to help all newcomers, staff matched patients with Regina doctors who spoke their languages and referred them to other community services.
Newcomers from more than 30 countries, including China, Somalia, Burma, Philippines, India and Bangladesh are directed to the Regina Immigrant Women Centre, where numerous free non-medical programs are offered to support their integration into the community.
Each group has special needs.
Many Burmese newcomers were born in refugee camps in the jungle.
“They never saw milk or ate cheese in their life and they weren’t ready to try it,” Maroof said. “When these families have a new baby, we do nutrition counselling and educate them about breastfeeding. We’re doing a good job of that.”
Under the federal Resettlement Assistance Program, government-assisted refugees receive immediate supports for their basic needs. Federal financial assistance is provided for up to one year after a refugee arrives in Canada, or until they can support themselves, whichever comes first.
Maroof points out newcomers’ challenges extend beyond a year.
“Mental problems start to surface and they need help,” she said. “I have a lot of patients that four or five years later, I diagnose them with mental illnesses because they’ve had challenges in life. It is very complex. We like to help all of the immigrants coming to the city, but we need a bigger centre, or more centres like our clinic, and more staff.”
Maroof observed patients feel uncomfortable going to the mental health clinic because they feel judged for seeking psychological care, and there’s no interpreter. Added to that, many don’t want their partners to know they need mental health services.
“If they say ‘I’m going to see a doctor at Regina Community Clinic,’ no one has to know they’re coming for counselling,” Maroof said. “Once a week, we had a psychiatrist on board that was seeing our patients with the help of an interpreter, but the provincial government is cutting our budget all the time.”
The clinic takes a team approach to treating patients’ physical and mental health.
Many refugees have chronic diseases, such as diabetes. To ensure diabetes hasn’t impacted their vision, patients are sent to optometrists, the nutritionist is consulted and the nurse practitioner educates them about managing the disease.
New immigrants get bloodwork and chest X-rays at the clinic, and public health nurses vaccinate them.
Language is a hurdle for many. Maroof is calling on the Saskatchewan Health Authority to provide translators, particularly at the city’s emergency departments and the General Hospital’s labour and delivery department.
The clinic sends interpreters with patients when they see specialists, but can no longer send translators to Regina’s ERs.
“Sometimes we have to call family members or friends to interpret for them, so it’s challenging,” Maroof said.
One of her patients is Ya Way. The 75-year-old man started seeing Maroof in 2009 when he arrived in Canada from Thailand with his wife, two sons, daughter and their families.
“It’s really great to live here,” Way said via interpreter Pusay Ly. “It’s good except for the cold weather.”
Regina is vastly different from the refugee camp, where Way had no job and couldn’t leave.
“Health care is good here,” he said. “We have everything, but the problem is the language. I came here in old age, so it’s hard to go to school to learn English.”
Ly was born in a village in the jungle and grew up in a refugee camp in Thailand where she taught.
She’s been in Canada since 2007. For the past five years she’s been translating for newcomers.
“We learned English as a subject (in Thailand), but when I came here I had interpreters from Open Door who took me to the hospital and bank and everywhere.”
To educate health-care professionals about refugees’ needs, Maroof speaks at conferences and gives presentations. She’s advocating for more resources and training for health-care workers, but there is no money.
“Although there’s challenges, they are part of our community — they’re working, going to school, going to university,” Maroof said. “I was one of them, I worked very hard and I’m encouraging other people to help.”