We Can Do Better for Newcomers In Canada

When I worked for a community prenatal program in Calgary from 2006-2009, a large majority of my caseload was newcomers. I was privileged to have a supportive multi-disciplinary team to work with when providing care to pregnant newcomers from central and eastern Africa, the middle east such as Egypt, Syria, as well as Asian countries like China (among others). The value of using a translator either in person, or over the phone through a service called the Language Line which AHS has a subscription to for all staff was immeasurable.  I had access to multi-cultural support workers who were often from similar regions and understood the patient's culture, so were able to share knowledge of the culture with me to enhance our team's care. our program was unique, in this supportive culturally competent interdisciplinary team and I know this is not always the case, for example in a busy emergency room with demanding priorities. 

Building trust with a patient that does not speak the same language as you are often a barrier, however not an impossible task. In my opinion building trust starts with respect, and an understanding of how culture influences health. According to Caring for Kids New to Canada (2022) “[culture] affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experienced and expressed, where patients seek help, and the types of treatment patients prefer.”  This difference in perception of health can drastically affect how a treatment plan is adopted by a patient, or how health advice is understood. As the number of refugees and immigrants in Canada healthcare professionals across all disciplines will need to build more competency in providing unbiased, respectful and culturally appropriate care to patients. One example of how health care providers could expand their practice would be to read and discuss Caring for Kids New to Canada - Case Studies: Stories of children and youth new to Canada. These informative and realistic vignettes share valuable insight into the background stories that may not be visible or detectable unless a practitioner knows to dig a little deeper on their assessment. 

After working with such a talented team of multicultural support workers, translators, nurses, social workers and dietitians I was inspired to give back on a personal level to newcomers. I signed up at my local Immigrant Services office to be a host for a refugee new to Canada. I was matched with a young adult woman from Bhutan in 2009. She had just moved to Canada with her family (2 siblings and parents). As the only English-speaking person in her family, she quickly became the translator for many medical appointments that her family required for a variety of healthcare issues. Becoming fluent in health literacy surely influenced my friend, as she later became a Licensed Practical Nurse. Having had little to no health care in the refugee camp they lived in in Thailand for over ten years meant that each member of their family had severe deficits in their health. When they first arrived the mother of the family was completely non-verbal (even at home in their own language) and struggling with mental health. As a healthcare advocate for her family, the oldest daughter found programs, resources and supports for her mother, and all members of her family. I was completely shocked to get a call from my new friend not long after we met, sharing that her 17-year-old sister had been airlifted to Calgary in the STARS ambulance due to a brain aneurysm. Now in addition to learning a new culture, a new language, they were now needing to navigate the health care system. I cannot imagine the fear they must have had, and stress with community to Calgary while their youngest child had emergency surgery and then underwent months of recovery in a Calgary hospital. While they did receive excellent care for the brain injury, mental health, cardiovascular health and other medical issues, I believe a lot of the family's health and happiness was because their own family member filled the gaps of health care's cultural competency. According to Benbenishty et al., "cultural competence may involve inclusive skills where prior knowledge, effective communication skills, and sympathetic behaviour enables a person or a programme to work effectively by understanding, appreciating, and respecting differences and similarities in beliefs, values and practices within and between cultures empowering patients and fostering an environment where patients feel involved in their care and participate in clinical decisions" (2015, p. 807 This unique situation, where a family flourishes over  time, because of the resilience and commitment, as well as special abilities of one family member to bridge the gaps in healthcare, is an inspiring story, but not typical.  Seen in the photo below, the family continued to smile, and be grateful despite their challenges and health deficits.