New Canadian Clinic a lifeline for refugees
At the New Canadian Clinic in Burnaby, health care workers don't just diagnose ailments and write prescriptions, they're charged with keeping in mind the bigger picture of their patients' lives.
That's because these are not ordinary patients at the clinic. They're all government-assisted refugees who come with a whole raft of needs not normally served at mainstream medical offices.
The Burnaby clinic (there's a sister clinic in Surrey) at 7315 Edmonds St. serves just over 500 patients who hail mostly from Middle Eastern countries such as Iran, Afghanistan and Iraq, and from African countries, such as Somalia, said the clinic's nurse practitioner, Ranjit Lehal.
Many simply don't understand how the health care system works.
Lehal, along with a primary care nurse and a general practitioner physician one day a week, not only provide regular medical care, but they have to ensure interpreters are on hand for those who can't speak English. They also have to make sure interpreters are present when such patients see specialists.
Then they have to do follow-up calls to make sure patients understand how to take their medicines, and even remind them of appointments since some are not familiar with the Western calendar or may never have used a calendar at all. Lehal noted that some patients may be illiterate, further complicating matters.
The clinic started about five years ago and is meant to be a transitional service with the hope that patients will eventually be discharged into the regular health system, said Lehal.
"I can't imagine this service not existing, to be honest."
Some patients deal with mental health issues related to trauma they may have experienced, both physical and psychological, from the war-torn countries they left. Many arrive dealing with malnutrition, and the lack of medical services in their native countries. Some also arrive with infectious diseases, such as tuberculosis, hepatitis, HIV and parasites, as a result of living in cramped quarters in refugee camps and a lack of proper water sanitation.
Without the clinic, Lehal said, the patients would likely go to hospital emergency wards for minor illnesses, and they risk being misdiagnosed due to the language barriers.
But just as important for clinic staff, in addition to the patients' health, is their living situations and settlement process.
If they see a specialist, they might be prescribed medicines they can't afford. If they're on social assistance, staff help them complete forms to cover some of the costs, or find samples or lower-cost alternatives. If a patient has blood sugar issues, but they can't afford food, staff work with settlement workers to deal with the situation.
"All the stuff we're saying goes out the window if they can't afford it."
Clinic staff also teach patients about health prevention through procedures such as breast and pap exams. "The whole notion of preventing illness versus treating illness is quite new" for the patients, Lehal said.
Much of their work is to make sure they understand what specialists have told them and to go over their treatment. "Often they'll say, 'I don't remember."
For Muzhda Ghulamsakhi, from Afghanistan, who brought in her two-year-old daughter Kausar Abdul Ahad for a recent exam, the clinic is a standby for her family.
"Doctor help for me. No doctor here I go to emergency. ... Interpreter here, everything," she said. If she had to go elsewhere, "something maybe wrong, maybe I don't understand English."
Lehal summed up the clinic's role as "we're the coordinator of their care." It meets a "critical need in the community" thanks to its approach.
"We need to look at more than just what is medically wrong with them ... the settlement process and what is happening with them in a life context."