The Canadian Centre for Immigrant and Refugee Healthcare

While the majority of the population has access to healthcare services funded by the Ontario Health Insurance Plan (OHIP), this is not always the case. There is a growing number of individuals across Ontario that do not have access to publicly funded healthcare. This includes people in the three month OHIP wait period, temporary visa holders, some refugees, and undocumented residents. If not for centres such as the Canadian Centre for Refugee and Immigrant Healthcare, these individuals would slip through the cracks of the healthcare system. “Where care matters more than a card” is the slogan of the Canadian Centre for Refugee and Immigrant Healthcare, a volunteer-based centre in Scarborough that provides healthcare indiscriminately to patients without questioning their immigration status or ability to pay.

Since its inception in 1999, the Canadian Centre for Refugee and Immigrant Healthcare has served an estimated 25,000 people across the Greater Toronto Area, drawing residents from neighbouring regions as far as Brampton and Hamilton. The centre was the response to a near casualty that revealed a pressing community need. In 1999, 18-year-old refugee, Aisha, experienced a medical crisis. Without OHIP coverage, she was denied healthcare by the Emergency room. Some hours later, Aisha collapsed. She received a $5,000 bill for the treatment she received in the ER, a debt which made it impossible for her to continue her studies. In response to this incident, the Canadian Centre for Refugee and Immigrant Healthcare was born, founded by public health nurse, Jennifer D’Andrade, and Family Physician, Dr. Paul Caulford.

“We need to establish that it is an issue that goes against our core values as Canadians.”

Aisha’s story is not unique. There are hundreds of thousands living in the GTA that are ineligible for insured services, and the Canadian Centre for Refugee and Immigrant Healthcare continues to treat these patients. The question remains, why is this population still uninsured, 18 years after the centre has been established. Board Member and Clinic Coordinator, Sumathy Rahunathan, pinpoints lack of awareness as a key reason. “Young adults should advocate for this cause,” says Rahunathan. The lack of national statistics and documentation about the population they serve means that it is extremely difficult to make a case.  “We need to establish that it is an issue that goes against our core values as Canadians.”

Photo of a check-up room in the centre

The centre, operating out of a two-story church rectory, serves as a part-time walk-in clinic providing free healthcare to the uninsured every Tuesday and Thursday. It has made distinct progress in the 18 years since its inception, now housing a number of clinics, including a medical clinic, a dental clinic, pediatric services, diagnostic imaging programs, chiropractic services, and a foot care clinic, with a diabetes clinic on the way. As the organization continues to expand and treat an increasing number of patients, it stands by the principle that there are no boundaries in the right to access healthcare.

The work done at the Canadian Centre for Refugee and Immigrant Healthcare has had a profound impact on the healthcare system. Since 1999, over $20 million has been saved for Canada’s healthcare system – enough to provide 150,000 patients with a family doctor for a year. Moreover, the centre has documented over 40,000 medical and dental visits, and treatment of 13,000 refugees from over 120 countries of origin. It has also sparked the idea for similar clinics across the GTA to treat the medically uninsured. Welcome Medical Clinic is one such clinic that opened in Mississauga, based on the model of healthcare used by the Canadian Centre for Refugee and Immigrant Healthcare. In 2016, the Canadian Centre for Refugee and Immigrant Healthcare received the Rotary District 7070 Wilf Wilkinson Peace Award in recognition of its effort to promote equitable healthcare.

“Moreover, the centre has documented over 40,000 medical and dental visits, and treatment of 13,000 refugees from over 120 countries of origin.”

Given its notable impact, it may be surprising that the centre contains few paid staff members. Currently, there are only three part-time staff working at the centre. In addition, government funding is limited to the amount needed for diagnostics and lab tests. How is the shortfall covered? The centre contains volunteer teams of family doctors, dentists, nurses, and other healthcare providers that provide more than a million dollars in direct medical and dental care each year without charge. Funding remains an issue for the centre, comments Rahunathan, especially so since the number of patients has increased while core funding from the government has stayed the same. Without funding, the centre has not been able to develop its capacity for research, health promotion, and volunteer coordination.

When asked where they hope to be in the future, Rahunathan is optimistic that the centre will continue to grow to meet the needs of the population they serve. The plan to create a diabetes clinic has already been set into motion. “Ideally, we will not have to exist further down the road” she states. “At some point, we hope that the government will sponsor healthcare to meet the needs of this population.”  

Photo of Sumathy Rahunathan and Dr. Paul Caulford

By Saamiyah Ali-Mohammed 

Saamiyah Ali-Mohammed is a South-Asian Community Ambassador with the Regional Diversity Roundtable and a Masters of Public Health graduate from McMaster University. Saamiyah believes that health inequities, systemic barriers that are largely preventable, are an area of opportunity for aspiring health innovators such as herself. She has extensive experience working with marginalized communities in various nonprofit and governmental organizations. Saamiyah has been published in The Journal of Social Work and Rehabilitation and Life Rattle Publications. She has also presented her research findings at the Toronto Public Health Convention 2017. In her spare time, Saamiyah enjoys writing poetry and creative nonfiction.
This article is an “Equity in the City” feature, a Health & Science event that sheds light on health centres that cater to marginalized populations in the City of Toronto, Canada.

Please note that opinions expressed are the author’s own. They do not necessarily reflect the views and values of The Blank Page.