Refugee Health

Refugees have health needs that are unique when compared with the general Canadian population. They suffer from medical problems that are not found in Canada, like strongyloides and schistosomiasis. They have higher rates of some medical issues, like viral illnesses and anemia. There are more physical disabilities and chronic injuries in this population because of war and other exposure to violence. And mental illness and distress are common in this population due to past traumas. The refugee health practitioner must be familiar with diagnosis and treatment of these issues.

As well, there are administrative challenges involved in refugee health care. Often, refugees do not speak English or French when they arrive in Canada, so interpreters are retained to assist in communication. Further, they don’t always receive orientation to our health care system before they arrive, so educating them about Canadian health care culture allows them to succeed in that area as they integrate into life here. Unlike in general Canadian practice, where provincial health care coverage is relatively straightforward, there is a complicated tiered system of coverage for refugees. Many physicians and institutions do not understand this complexity, so it is not uncommon for refugees to be turned away from care they need.

As a result, refugees require a health care approach that is not common in general family practice. Their health provider must be familiar with their unique social, settlement, and judicial needs because of their impact on health. Similarly, in order to go to school, get a job, and contribute to society – which is the ultimate goal of most refugees – health must be addressed and optimized. Because of all the factors affecting health, their care can be complicated, and requires experience beyond the usual medical model.

Refugee medicine, like geriatrics and sports medicine, is an emerging discipline within family medicine. Refugee health providers must draw on specialized medical knowledge and use skills, like cross-cultural communication techniques, that are rarely used in other areas of family medicine. They must have knowledge of issues specific to refugees, such as their health insurance, and they must be able to work with others who provide settlement and community integration services. This work is done best in specialized, multidisciplinary centres.