Medical students’ initiative hopes to improve health-care services for Canadian refugees

Mother and child filling out a form while waitingThe Newcomer Health Hub covers a collection of unique services to meet the challenges faced by different newcomer populations and the health-care workers who serve them. (media_photos/Envato Elements)

By Cam Buchan

Facing the barriers of culture, language, and digital fluency, newcomers to Canada are prone to slipping through the cracks when it comes to accessing much needed health-care services. 

In response, the Newcomer Health Hub (NHH), an online resource developed by fourth-year medical students Lotus Alphonsus, Amalka De Silva, and Penelope Neocleous, provides critical information to close these gaps. These resources empower newcomers to take control of their health, and enable health-care workers to provide culturally competent care.

And now this unique service just got a boost thanks to two new projects undertaken by the team.

One initiative centres around providing much-needed clarity to the Interim Federal Health Program (IFHP). The IFHP provides health coverage for specific groups, including refugee claimants, until they become eligible for insurance. The group’s research has shown that the complexity of the program – especially regarding physician billing – is a barrier to health-care providers taking on IFHP patients.

A collection of resources and guidelines available via the Newcomer Health HubThe Hub provides evidence-based, culturally competent resources for newcomers and health-care providers. (supplied image)

The students are creating a simplified guideline for providers along with an outreach initiative that will raise awareness of the program and how it works, with the goal of increasing the number of newcomers accessing IFHP support.

They are also working with experts in the field to create guidelines for interviewing and examining the survivors of torture, as well as documenting those findings for medical-legal purposes. The students are also establishing a female genital mutilation workshop, enabling physicians to provide the specialized care these survivors need and deserve.

“Both our projects this year come from gaps that were identified by our team, health-care workers, community organizations and refugee groups,” said Alphonsus. “These two projects centre around health-care access concerns and educating health-care workers on topics that are not traditionally covered.

“It feels full circle to work with amazing organizations such as the Canadian Centre for Victims of Torture, an organization that my family and I have used,” she added.

Driven by a shared passion

The Newcomer Health Hub was born from the groups’ shared experiences and a passion to light the way for marginalized and underserviced groups.

“We each come from different newcomer populations, and are all children of immigrants or refugees,” said Alphonsus. “We’ve witnessed firsthand how inequity persists across different immigrant and refugee groups in Canada. Our shared experiences allowed the three of us to form an immediate bond, and channel our passion for equitable health care through this initiative.”

The three students began their training at Schulich Medicine & Dentistry during the COVID-19 pandemic. Within their small-group sessions online, they instantly bonded over their shared concern for refugees’ lack of access to much-needed services.

“During COVID-19, many of the resources that refugees, including our family members and friends, use just shut down,” said Alphonsus. “And the populations we serve – many of whom don’t speak English or have access to the Internet – weren’t able to transition to virtual services.”

But the group also saw beyond the pandemic to the increased needs that would come as a result of a lack of access to health-care support systems – such as depression, anxiety and loneliness.

“One population that had it especially hard were refugees who had experienced violence, such as human trafficking, where they were kept in enclosed spaces or not allowed to leave the house,” said DeSilva. The lockdowns experienced during the pandemic were especially triggering for this population, who thought they had escaped these conditions. “This group of people didn’t know how to use the Internet or didn’t have reliable access to it. And while we could meet our health-care provider or therapist on Zoom, that might not be an option for them.”

With the Newcomer Health Hub, the team has created a collection of unique services to meet the challenges faced by different newcomer populations and the health-care workers who serve them, all through the lens of community customs and experiences.

The goals of the initiative include reducing health-care disparities and advocating for newcomer populations, increasing awareness of the complex backgrounds and unique health-care challenges faced by newcomers, and supporting health-care providers with evidence based and anti-oppressive guidelines tailored to the needs of newcomers.

While still in its early stages, the Hub has logged more than 2,000 unique visitors and 10,000-page views. It’s also an important opportunity for Schulich Medicine students to gain experience providing culturally competent care for refugee and immigrant populations.

“We hope our outreach initiatives will allow us to work with refugees and immigrants more effectively, building further bridges and providing newcomers with the tools they need to take control of their own health,” said Neocleous.

Their medical school colleagues have been quick to help support the program, with approximately 50 medical and nursing students across Canada contributing to ongoing projects. The team is looking to expand the organization and encourages anyone interested to apply on their website.

“The goal is to have medical students come together as a collaborative force to address the health needs of populations that are the most silenced,” said Neocleous.


Sharing their stories

Lotus Alphonsus, Amalka De Silva and Penelope Neocleous connected in their first year of medical school over a shared passion for advocacy, especially concerning health-care inequities and the gaps in service and care between communities. With similar experiences growing up in Canada as the children of refugees and immigrants, they were highly motivated and equipped to launch the Newcomer Health Hub (NHH).

Here they share their personal stories:

Lotus AlphonsusLotus Alphonsus

Having witnessed the atrocities of genocide firsthand and the immense hardships my family faced as refugees, I know the devastating impact that war and displacement can have. The complex war-related traumas my parents experienced meant many family doctors were not comfortable taking them on as patients or felt they were out of their ‘scope.’ Having experience working over a decade with survivors of sexual assault, human trafficking, and torture, it was clear that large gaps in access, culturally competent and trauma-informed care existed. As a medical student, I am fueled by my passion to address health inequities and am driven to make a tangible difference in improving the well-being of underserved populations by working together with the community.

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Amalka De SilvaAmalka De Silva

My journey into the world of public health and equity started through my roots in a community struggling to navigate a complex health-care system. This pivotal experience drove me to pursue a Master of Public Health and continues to influence my path through medical school. Together with the NHH and the wider medical student community, I look forward to championing equity within our health-care system.

*****

Penelope NeocleousPenelope Neocleous

As the daughter of a refugee, I have always been drawn to advocacy work. Watching my family, and other newcomers to Canada, struggle to navigate the Canadian health-care system spurred me to pursue medicine as a career. I have explored similar inequities through my work as a member of Amnesty International, the OMSA Advocacy Portfolio, and the Schulich National Advocacy Committee, and the NHH is my next step in the fight for equitable health care.