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Immigrant Health: A Plan to Improve Outcomes in Ottawa
When it comes to health care and health status, immigrants are at a significant disadvantage compared to Canadian-born individuals. So says a study that was released by St. Michael's Hospital (Toronto) and the Institute for Clinical and Evaluative Sciences on March 30th.
The conclusion reached by the study is that access to the health care system for immigrants has to do with more than just wait times. In fact, it has to do with a range of barriers including the inability to find a primary care doctor, language and/or cultural barriers, income, unstable housing and psychological/mental health issues.
The evidence provided by this study is very welcome, but the conclusions it came to are not news to the Executive Director of the Catholic Immigration Centre (CIC), Carl Nicholson.
"A number of years ago, " says Nicholson, "it became apparent that immigrants were arriving here pretty healthy, and within 5 years, that would not be the case. We also noticed that the health status of refugees needed special attention. Many of them come from conflict areas where poverty and a lack of services is the norm, and they can arrive here with a variety of problems including conditions that are simply not present in Canada."
While the problem is large - especially with the increasing number of immigrants to Canada and the critical role they will play in labour market replacement -- large scale change is challenging at the best of times, so CIC decided to start small.
In partnership with the Champlain Immigrant Health Network, CIC approached the Champlain Local Health Integration Network and proposed that they provide funding to set up a medical clinic for government sponsored refugees. The purpose of the clinic and its related health services - called "The Care Link Program" - was to facilitate the successful integration of refugees into the Ottawa community by linking them with geographically and/or culturally appropriate primary care practices such as family physicians, family health teams and community health centres. The Champlain LHIN said yes and, in 2008, the medical clinic opened at CIC's Reception House, a facility which helps government assisted refugees in their transition to life in Canada.
Two years later, the clinic is still operating and has dramatically improved the integration of government assisted refugees into the health care system.
Access for All Immigrants
Always looking for ways to improve immigrant settlement, CIC now wants to take the Reception House clinic to the next level and provide a range of integrative health care services not only to refugees, but to all Ottawa immigrants during their first year in Canada. These services would be provided at an Immigrant Wellness Centre located in CIC's main building at 219 Argyle Street.
"Not dealing with these issues is not an option," says Nicholson. "If we don't spend the money to better integrate immigrants into the system, it will end up costing us much more down the road when they start experiencing really serious health problems."
The space for the Wellness Centre is currently being developed and should be ready in November. Once complete, there will be enough room to offer a range of services including medical screening, linkage with a primary care provider, explanation of the structure and organization of the health system, and interpretation services. But the centre will also offer a variety of programs to help immigrants maintain their health, such as training and support in areas such as physical activity, healthy eating, recreation and sports, mental health programming, as well as health promotion and disease prevention.
Because of the work that has been done at the Reception House clinic, all of the professional partnerships CIC needs to make the Wellness Centre a reality are in place. Doctors and professionals from the University of Ottawa Faculty of Medicine and Institute of Population Health, the Bruyère Family Medicine Centre, and the Centretown, Sandy Hill and Somerset West Community Health Centres have all been involved in the clinic and continue to contribute to its success.
"All we need now," says Nicholson, "is the operating funding to make this dream a reality. What we need is financial partners who are willing to invest in the future of our country."
If you are interested in financially supporting CIC's Wellness Centre,
please contact firstname.lastname@example.org.
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Federal Funding Goes to Upgrade Bruyère Immigration Centre
By The Ottawa Citizen - February 2, 2010
OTTAWA - The Elisabeth Bruyère Centre for Immigrants will get $375,000 for renovations, Transport Minister John Baird announced Monday.
Run by the Catholic Immigration Centre, the Bruyère centre provides services and resources for new arrivals to the city. The renovation funds, to be matched by the immigration centre for a total of $750,000, will replace the Argyle Avenue building's elevator, waterproof the basement to prevent flooding, create more office space and update the HVAC system.
"This project will renovate the centre to ensure its sustainability and ability to continue to provide these important services, as well as new ones," said Baird, flanked by
Ottawa-area Tory MPs Pierre Poilievre and Royal Galipeau.
Carl Nicholson, executive director of the Catholic Immigration Centre, said the funds will also go toward creating a specialized wellness clinic at the centre.
Baird said that with more than 16,000 immigrants arriving in Ottawa annually, the immigration centre's efforts in the areas of health, education, housing and employment are needed.
The federal government's $375,000 contribution comes from its $4-billion infrastructure stimulus fund. The Elisabeth Bruyère Centre for Immigrants renovation project is one of about 1,800 across Ontario that have received $1.3 billion.
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Helping International Medical Doctors to use their Skills in Alternative Roles
Ali Abdulla came to Canada from Iraq in 2008 looking for a better life. He dreamt of practicing medicine in his new home - Canada, but very rapidly he learned what the reality is: an International Medical Doctor (IMD) faces significant barriers to obtaining a license to practice medicine in Canada. He realized it was going to be a long and challenging process with no certainty of licensure.
With the realization of how difficult it could be to become a licensed Canadian physician, Ali decided to look at other options. He started to think about how he could apply some of his skills, knowledge and experience to alternative or non-regulated work in the health care sector. It was this thinking that led him to the Career Transitions program for International Medical Doctors.
The Career Transitions program is delivered to IMDs by CIC in partnership with Skills for Change (Toronto), Settlement and Integration Services Organization (Hamilton) and LASI World Skills (Ottawa). It is funded by the Ministry of Citizenship and Immigration (Ontario) and by Citizenship and Immigration Canada.
Career Transitions was developed to provide focused training and employment assistance to unemployed or under-employed IMD in their search for positions in health care-related roles. "A number of years ago," says Ottawa-based Program Manager, Arber Zaplluzha, "we noticed that a large percentage of our clients who are internationally educated and trained doctors were having real difficulty finding meaningful work, and so we decided to create a program to give them the kind of knowledge they need to successfully integrate into the work force."
The program takes a practical approach to providing IMDs with the skills and knowledge they need to become employed. The workshops cover topics such as Canadian business culture, transferable skills, retraining possibilities, "Action Plans", and how to market themselves for employment. Career Transitions also includes an instructive workshop on writing résumés and cover letters and succeeding in job interviews. At the end of the program, IMDs receive a certificate of completion and ongoing support from the Career Transitions team with résumés and cover letters, interview preparation, job search and career guidance.
Ali Abdullah, now employed as a Clinical Research Coordinator, says "I gained so much from the Career Transitions Program. It really opened my eyes to the alternatives available to International Medical Doctors in Canada. Not only did I learn about the structure and organization of the health care system, but I also learned how to use my skills in different areas, how to present myself in my cover letter and résumé, and which websites would be most useful in my job search. The program allowed me to connect with other IMDs and to exchange tips and ideas. Most importantly, the program provided me with the support I needed to become employed."
Due to the success of the program in helping IMDs to transition into alternative careers, the funding was renewed by the provincial and federal governments in the Fall of 2009 for a period of three years. This new funding will allow CIC to offer the program and ongoing support to an additional 482 IMDs in Ottawa, Toronto and Hamilton. Following is a table illustrating program results for the first year of the new funding.
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A Day in the Life of the Settlement Department
By: Mohamed Dalmar, Settlement Manager
As the Annual General Meeting was approaching, I knew I will be asked, as other department managers, to highlight the accomplishments of the Settlement department during the past year. Usually, a very brief report is presented dealing mainly with statistics; the number clients served, the number of information sessions conducted, the number of meetings held and so on and so forth.
This year, an interesting idea came into my mind. I thought, why not pick a day and present the cases we have worked on in that day and, in that way, tell the stories of the real people behind the numbers. So, Wednesday, November 11 was the day I chose. It was Veteran's day when many offices were closed for the holiday and some workers were wondering why we were open. Here is the summary of the cases we saw that day:
- We helped three clients with sponsorship applications. Of the many services we provide, sponsorship of family members is the most frequently requested one. Not only do clients come to us asking for help in filling out the long and complex forms but they also require our advocacy in dealing with the excessively long and frustrating delays in family reunification. It is worth mentioning that, on that day, we had one case of a Group of Five sponsorship application. This is a program that allows for the sponsorship of refugees from overseas by a group of five or more Canadian citizens or permanent residents. Many clients use this program to sponsor their extended family members who happen to be refugees.
- We had three child tax benefit cases. Newcomers encounter delays in getting their fist cheque of the Child Tax Benefit because often they miss to report their world income or the income they made for the part of the year before they came to Canada. On the other hand, refugee claimants are not eligible for the Child Tax Benefit until they have been recognized as protected persons.
- We dealt with several refugee claimant cases. In one case, we helped a refugee claimant with obtaining a work permit. Refugee claimants also experience delays in getting their first work permit. First, they have to do a medical examination and wait for the report, then they have to apply for the work permit and wait for the authorization and finally they have to apply for a Social Insurance Number and again wait for the card. It may take the refugee claimants three to five months before they are legally authorized to work in Canada. In another case, we referred a newly arrived refugee claimant to Legal Aid Ontario to get help with legal representation. Another refugee claimant was referred to a psychiatrist for an evaluation. Refugees, as we know, often come with trauma having fled from countries where they have been imprisoned, tortured, or persecuted.
- A Somali family of ten members came to our doors with large suitcases. As we do the needs assessment, we realize that they are Government Assisted Refugees (GARs). These are refugees sponsored by the federal government and supported by the same for one year under the Resettlement Assistance Program (RAP). Their destination was Gatineau, Quebec, but they moved from there after spending only one night at the temporary accommodation provided to them. They moved because they wanted to be closer to the large Somali community in Ottawa where they can find social support. Cases like this present a challenge for us. Refugees, like this family, are not eligible for the City of Ottawa shelters because they fall under RAP. They cannot be accommodated at our Reception House because they have abandoned their assigned housing. They cannot rent their own apartment because they have no financial resources, and it will take two to three weeks for Citizenship and Immigration Canada (CIC) to transfer their files and start issuing cheques for them. What to do in the meantime? We fed the family and escorted them back to Gatineau, their original destination. Our housing worker, who accompanied them, met with CIC officers in Gatineau and asked them to support the family temporarily until we find a solution for them. Later on, CIC agreed to let the family relocate to Ottawa and be accommodated at our Reception House and within a week, the family was placed into permanent housing.
- A woman who is a live-in caregiver came to our office visibly shocked and frightened. She ran away from the home of her employer allegedly because of exploitation and abuse. Fear and desperation were apparent on her face. She was crying: "please help me, please help me". She was worried because she did not know what would happen to her: where she will find food, shelter and financial support, and what would happen to her immigration status. It took us some time to comfort the client and make her feel safe. We, then, fed her and referred her to a shelter for abused women. We are also working with her on her employment and immigration issues. It is common knowledge that live-in caregivers can be subject to abuse including long hours of work, unpaid salaries, no week-end rest, passport confiscation and other kinds of maltreatment.
- One counsellor attended an Ottawa Food Bank meeting. This was the Ottawa Food Bank open forum information summary. Representatives from 36 agencies attended to hear presentations about Food for All, a project that addresses food issues in Ottawa. We are an Ottawa Food Bank member agency. The Ottawa Food Bank generously allowed us to be a member agency and distribute food to clients with urgent needs. That is why we were able to feed some of the clients of that day.
- Our counsellor who is placed at the Vanier Community Service Centre organized a workshop on "against prejudice" with 25 participants. This is part of a series of workshops that are facilitated by Jewish Family Services and funded by CIC. Another staff member held citizenship classes for 6 newcomers, with literacy and language challenges, at Queen of Angels Continuing Education Centre. In all, 10 counsellors provide settlement services at 12 off-site locations throughout the city of Ottawa.
- One counsellor attended a meeting with Children's Aid Society (CAS) workers, a family lawyer, and two parents whose children were taken into care by CAS. Our counsellor was involved in this case because the parents were his clients and he wanted to make sure that they get the support and advocacy they needed. One of the issues dealt with in that meeting was to place the children into a foster family that shares same Ethno-cultural origin as well as providing parenting classes for the two parents.
- A counsellor was writing the second letter to a Canadian Visa Office overseas on behalf of her client. This was the second reminder letting the Visa office know that the client's dependents have not yet received the permanent resident application package. The client in question came to Canada in August 2006 for training. After he completed the training in December 2006, he applied for refugee protection because he was afraid to go back home for fear of persecution. In April 2008, he was accepted as a protected person. It took him five months to raise the money for paying the processing fee; and in September 2008, he was able to submit his application for permanent residence in Canada. He included his wife and four children who are outside Canada in his application. He was very lucky to obtain his permanent residence status in July 2009, but his wife and four children were not. As of today, November 11, 2009, they have not yet received the application forms from the Visa office. This means that it will take several more years for the family to reunite.
- On that day, a counsellor was contacting the Social Housing Registry to follow up with her client's application for subsidized housing, but the office was closed for the holiday. The client in question came to Canada in May 2002 as a GAR. From the beginning it was clear that he had some mental health issues. By August 2002, he was charged with spousal assault and a restraining order was issued preventing him from seeing his wife and his children. Since that time, he could not maintain stable and permanent housing, being in shelters on and off and moving from one province to another. At present, he is staying with a friend who is himself suffering from mental health problems. We are trying to help him get Ottawa Community Housing as fast as possible, but the Registry refused to put him on a priority list since he is not technically a homeless person (not in a shelter). The problem is that the client does not want to stay in any shelter. He has been at Salvation Army before and developed a phobia about shelters. The client has been referred to the Canadian Mental Health Association.
- Three temporary foreign workers came to our office and asked information on how to apply for permanent residence in Canada as Skilled Workers. One of them complained about spousal abuse and needed emotional support. Nowadays, we receive more clients who are temporary foreign workers.
- A U.S.A. citizen, who is a permanent resident of Canada, needed help with the application for a Permanent Resident (PR) card. The client was landed in 1972. He has been outside Canada for many years and apparently he does not meet the residency requirement. He is lucky because, as a U.S.A. citizen, he could return to Canada with his American Passport and without a PR card. Right now, we have a client who is stranded in Kenya because he does not have a PR card and he cannot get one as he does not meet the residence requirement.
- The volunteer lawyer, on duty that day, saw nine clients; seven needed legal advice while two needed certification of documents. A sick single mother was escorted to a doctor's appointment and was helped with interpretation. We received three e-mails from outside Canada seeking information on how to immigrate to Canada.
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