Refugee Health Clinic scales back as demand outpaces support

The Record

Terry Pender The Record Mon., Nov. 28, 2022

KITCHENER — At a time when more refugees and newcomers than ever before are arriving in the region, a medical clinic that specializes in helping them has to cut back operations because of a lack of funding.

Beginning Jan. 1, the Refugee Health Clinic that operates on David Street in Kitchener in association with the McMaster School of Family Medicine will stop taking new patients, shift to a nurse-practitioner model and try to reduce its current patient roster of 500, said Dr. Neil Arya.

“I will be going in there about once a month, consulting a little bit,” said Arya, who founded the clinic in 2008.

Designed to handle about 200 government-assisted refugees a year and working closely with Reception House, the clinic aimed to treat newcomers, get them stabilized and transfer them to other family doctors in the region.

“We aren’t taking any new patients. It will just be the people that we have,” said Arya.

Hospital emergency rooms packed because of seasonal flu, respiratory syncytial virus (RSV) and COVID-19 will become even more crowded as refugees are sent there for medical help, he said.

“And we have seen chronic issues such as hepatitis B not being diagnosed in a timely fashion, with no screening among refugees, again leading to future negative consequences for the individual and health system,” said Arya. “It is going to worsen the crisis.”

Once the patient roster is down to 400, the clinic will try to take 50 refugees a year from Reception House, thanks to funds from the Immigration Partnership that will fund interpretation for family doctors taking high-risk patients, he said.

Originally, the clinic aimed to keep refugees on the roster for six months. It became harder to find them family doctors in the region, and the clinic’s caseload ballooned to far more than it was ever designed to handle.

“It became impossible to cope,” said Arya. “During the pandemic family doctors have felt overwhelmed.”

It is not just an issue for the Refugee Health Clinic. The entire system of primary care across the province is buckling under the strain of a pandemic, seasonal influenza and RSV, said Heather Montgomery, communications director at Reception House.

In the coming year about 750 government-assisted refugees are expected in Waterloo Region. That figure does not include Ukrainians fleeing the Russian invasion of their country.

“At Reception House we are seeing double to triple the number of people we would typically support in a year,” said Montgomery.

Refugees are among a much larger number of people who are having trouble accessing primary health care, said Montgomery.

The system-wide strain on primary care is happening as Ottawa increased immigration levels to 500,000 annually. Canada’s birth rate of 1.4 children for every woman is well below the 2.1 children needed to replace its population without immigration. So enhanced immigration is essential for continued economic growth in the future, the federal government says.

“Let’s be clear: this isn’t a health clinic issue, it is a health systems issue,” said Montgomery. “Specialized health clinics will never be able to absorb everyone coming to our community unless we can transition people to their own primary health providers.”

The federal and provincial government have to do better, she said.

“We need better connections between our federal immigration policy, and our provincial health policy,” said Montgomery. “What we are currently seeing in Ontario at least is a lack of investment in health care at the very time it needs to be bolstered and strengthened.”