Syrian Refugees in Ottawa: Health Promotion Needs

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Table of Contents

Introduction
The Current State of Primary Health of Refugees in Canada
Mental Health of Refugees
Chronic Illnesses
Caring For Children and Youths New in Canada
Implementing Global Proficiency in Health Professionals and Organizations
Role of Faith-Based Organizations in Promoting Health Needs
Conclusion
References

Introduction

Even though the number of migrants and refugees has increased dramatically in recent years, addressing their healthcare needs has received scant attention. Syrian refugees in Ottawa are among those who require health promotion services. This report gives an overview of the current understanding regarding migrant and refugee health issues and the scope to which different studies have addressed these issues. The information is directed to the Faith-Based organizations as they can take a significant role in helping the refugees meet these needs. Through peer-reviewed studies, it highlights the various tactics, strategies, rights, and services offered in multiple dominions. As a result, it will provide proof of achievements and trials and highlight areas that require additional effort, such as caring for the healthcare needs of youth and children who are new to Canada. This report will highlight the difficulties of neglected facets such as mental health and the crucial role of implementing global proficiency in health professionals and organizations that work with refugees.

The Current State of Primary Health of Refugees in Canada

It is vital to remember that Canada has a significant record of relocating escapees to comprehend Canada’s approach to Syrian refugees. Across the country, the federal government has continually financed relocation initiatives for shelter, orientation, linguistic, and occupation training (Lara 2021). Advocacy has become a particular power in Canada. CDRC (Canadian Doctors for Refugee Care) was established in 2012 as a nationwide support group to fight past government restrictions on genuine refugees’ and migrants’ healthcare. This support assembly staged ‘white coat’ complaints to persuade the authority to alter its unjust practice that was not supported by facts and excluded wellbeing and clearance organizations.

Collaboration between public and private health systems was another important aspect of the healthcare system. Collaboration with family doctors is now well established, based on previous refugee immunization, tuberculosis surveillance, and psychological services. Furthermore, public health promotes health equity in programs and policies, which helps to build a proactive health system. A universal health system, notwithstanding well-intentioned government legislation, does not constantly certify contact and worth for all. Treatment and prevention of diseases are hampered by a Medicare program that needs a complete pharmaceutical benefits program. Access to care for refugees is further hindered by additional hurdles, such as service charge payment plans for physicians. There are hurdles to exceptional care at the rank of healthcare practitioners, as many doctors are unprepared to handle the frequently specific issues that immigrants bring.

The administration’s appeals are not each time met with dogmatic drive and practical measures. In 2016, the newly elected administration delivered an electoral pledge to welcome 25 000 Syrian refugees (Gamalerio, 2018). However, several applicants are still waiting for Interim Federal Health (IFH) assistance for weeks or months. This waiting time is frequently a critical period in which they require the most effective chronic ailment administration. Without IFH, many immigrants delay seeking medical help until late in their illness, worsening their state and necessitating costly treatment afterwards. This condition is severe when children are affected, violating the United Nations Convention on the Child’s Rights. The reaction of the Canadian healthcare scheme to immigrants highlights the significance of collaborating with resettlement programs and maintaining an open line of communication between policymakers, physicians, and academics. The practical wellbeing settlement of migrants, which lingers currently, requires surroundings exposed to superlative practices, evidence-based initiatives, and teachings learned.

Mental Health of Refugees

Mental illness is a set of behaviors or thoughts that is diagnosable and treated. Only a tiny percentage of refugees might have mental health issues. However, a comprehensive analysis by Bazaid found that refugees to Canada have a higher incidence of post-traumatic anxiety disorder and depression (Bazaid, 2017). Refugee children have higher mental illnesses while being a migrant contributes to psychosis. Although just a small percentage of migrants will experience difficulties, they are a particularly vulnerable group to psychiatric problems or disorders, which can be complicated. Promoting mental health, building resilience, and preventing mental illness via good resettlement planning, education, and intervention on the socioeconomic health determinants are essential parts of a strong strategy. Assessments of mental disorders in refugee populations vary greatly, from 10 per cent to 40 per cent (Bazaid, 2017). This difference is partly due to changing social responses to different refugee groups; for example, in nations where migrants are not permitted to work, the risk of psychiatric illness is substantially higher.

However, this should not obscure that many refugees will require assistance due to mental health issues or illnesses. Access to proper mental health interventions as soon as possible saves money by reducing the need for more expensive measures later on, such as inpatient. It is important to remember that over-treating and stigmatizing refugee populations are detrimental to their mental health needs. The emphasis should always be on building resilience and strengthening the ability of individuals, families, and communities to self-manage. One can derive refugee services from studies that have proven successful for other Canadian communities. Those in need of mental health services frequently suffer from common mental illnesses like depression that their primary care doctor can address if they have the necessary expertise and resources. Early intervention is critical, as is non-clinical staff training in understanding refugees’ potential mental health concerns and how to assist them in receiving care. Those with more severe or sophisticated mental health issues may require specialist mental health interventions.

The mental health approach to incoming immigrants in Canada should encourage people’s wellness and recognize refugee populations’ incredible resilience. The individual needs of refugees require special attention for the future to accomplish their wellness. Conrad contends in his study that pursuing well-being is essentially a moral goal, achieving a sense of goodness (Conrad, 1994). Canada can promote good health while reducing the effects of possible mental health problems by using a recovery strategy, working across sectors to establish comprehensive, coordinated, and affordable services and programs, and looking at the socioeconomic determinants of health. The Mental Health Commission of Canada is privileged to provide evidence-based information and best practices for an integrated mental health response to groups working toward a coordinated response for incoming refugees. MHCC has led research and supported mental health fairness for immigrant, refugee, ethno cultural, and racialized (IRER) populations since 2008 through its Diversity Task Group.

Canada seems to have the right individuals and a collection of healthcare guidelines founded on scientific data. What is needed is a political and institutional framework for connecting and supporting doctors, nurses, social workers who give treatment, settlement staff and communities who provide social support and a sense of belonging to new refugees. In Canada, mental health services are underfunded and can be a huge problem. Increased patient volume, service alignment to build new treatment plans, and the education and specialty of some physicians will all necessitate additional resources. Developing an equitable and acceptable response is conceivable and inexpensive, but it will take some investment. According to Unruh’s post on health in Canada, engaging in health sector infrastructural facilities, training, and keeping appropriate domestic health personnel would be critical in the end to building a robust health system (Unruh et al., 2021). MHCC is well-positioned to assist in resolving some of these difficulties, and we look forward to collaborating with relevant stakeholders and essential organizations to increase capacity and promote coordination.

Chronic Illnesses

Chronic health illnesses are common among Syrian refugees in Ottawa. Gruner discovered many discrepancies between the genders in his cross-sectional research of chronic diseases in government-assisted Syrian refugees, which had clinical and public health consequences (Pottie, Gruner & Magwood, 2018). Tobacco usage was incredibly high among male participants; culturally relevant and gender-specific initiatives may be necessary. Anemia was prevalent among female participants, most likely due to nutritional insufficiency, and has implications for primary care. In this investigation, the incidence of G6PD deficiency appeared low. The proportion of HBV and HCV contamination was modest, comparable to Canada’s. Iron-deficiency anemia is a common dietary condition globally, mainly affecting women and children of reproductive age. Other types of anemia can cohabit, depending on the patients’ diets, living environments, and genetic predispositions.

Tobacco use, which induces chronic illnesses, has established a societal norm in postwar Syria, where those who remain in Syria and refugees fleeing the conflict confront war-related pressures. Refugees are particularly vulnerable, although cigarette use and refugee status are poorly understood. However, cigarette use is typically higher among male participants in prevalence studies than in female ones. In Syria, Lebanon, and Jordan, women’s prevalence of cigarette and water-pipe use in social places was high. Primary care doctors and other healthcare providers helped newly arrived refugees to embrace or sustain healthy behaviors and preventive care measures. Understanding and adhering to chronic illness treatment requires a combination of cultural values, language, socioeconomic level, and health literacy. However, this help seems insufficient in helping these escapees stop those habits, and therefore, collaborating with a stakeholder will be of great importance.

Caring For Children and Youths New in Canada

In various respects, the experiences of refugees may vary from those of other immigrants. In contrast to economic and family-class immigrants, refugees escaped their home countries due to afflictions, wars, or persecution. As a result, intense stress and trauma mark several refugee children and youth’s pre-migration experiences. Furthermore, even after fleeing conflict in their home country, individuals confront additional stress and suffering while in transit, particularly in refugee camps. For example, 79 per cent of Syrian refugee youngsters polled in a Turkish migrant camp had lost at least one close relative; 30% were harmed and 60% had watched someone else being physically abused (Langford, Powell & Bezanson, 2020). Mental health matters, mainly post-traumatic stress disorder (PTSD) and despair, are widespread among refugee children and teens.

Refugee youths are distinguished from other migrants by their forced migration encounter and higher risk of victimization, loss, and trauma. In a poll of Syrian refugee youngsters in a Turkish migrant camp, 45 per cent reported symptoms of PTSD, which is ten times greater than the global average (Pelek, 2018). According to Canadian research, traumas encountered before, between, and after migration result in more emotional disorders and difficulties with dynamic control and violent behavior (Maich, Somma & Hill, 2018). Other components of the settlement process for refugees and some other immigrants can be similar. All immigrant children and teens, for example, may face difficulty transitioning to a foreign culture, lifestyle, and educational system after landing in the relocation nation, and many may need to learn a new language. Even so, refugee adolescents often differ significantly from other immigrant youth. Resettled refugee youth, for example, are more likely to have had school disruptions and have low skills in the resettlement country’s language.

Traumatic pre-migration experiences, inadequate language competence, and other acculturative pressures can make it difficult for refugee adolescents to integrate socially. Bullying, hatred, and discrimination are common in the resettlement country’s educational system. Children and teenagers who have recently immigrated to Canada are diverse groups with health requirements comparable to and different from Canadian-born youngsters. It can be challenging, if not impossible, for newcomers to obtain culturally and linguistically appropriate health care. Clinicians frequently find themselves serving as patient advocates due to this service vacuum. Research on broad groups such as immigrant adolescents or even Syrian immigrants should be perceived with caution because it may overlook significant differences within communities, particularly between small and disadvantaged segments (Merritt & Pottie, 2020). In medical care, health practitioners should examine an adolescent’s period of stay in Canada and her immigration status or refugee status. Both indicators affect acculturation, migration, and resettlement experiences and highlight a family’s motives for moving.

Canada has launched the Caring for Children New to Canada site, a new, accessible, free, bilingual internet site open to everybody but geared toward health care workers who work with newcomer kids and teens. This website is the first in Canada to concentrate on the health issues of children and teens who are immigrants or refugees. It is accessible, easy to navigate, and content-rich, with links to the most relevant resources for multidisciplinary healthcare professionals dealing with this at-risk group of children and teens daily. The website’s primary purpose is to offer essential guidance, practice guidelines, clinical tools, exams, checklists, and access to social and government services. Equally important, the Canadian government hopes that this website will promote awareness of the distinctions and challenges of delivering treatment to this group, thereby optimizing care and eliminating health inequities. Because of the web-based nature, information may be examined, supplemented, and updated iteratively. End-users such as pediatricians, family physicians, and nurses have already begun to provide input, integrated into future website components.

The website’s creation has been a perfect representation of a transdisciplinary, cross-specialty information interpretation and transfer project that will potentially serve as a model for prospective information translation and sharing projects through the CPS or other networks. According to Durie’s research, most indigenous peoples in developed countries reside at the interface, meaning that they get informed by science and indigenous knowledge (Durie, 2004). The problem is to maintain the integrity of each belief system while inventing techniques that can include features of each and promote creativity, increased relevance, and new chances for knowledge generation. As a result, not everyone will be able to access the website developed to assist children and youth who are new to Canada.

Despite all the Canadian government’s efforts to take care of the kids and youths, more needs to be done by society. The community should provide for the specific needs of refugee families and children to improve their well-being while coping with life in the relocation society. These requirements may be distinct from those of other refugees seeking economic opportunity or family reunification. Psychological counselling, language instruction, and enhanced understanding of refugees’ issues in their resettlement towns and with the community organizations with whom they engage are examples of such demands. Welcoming, well-resourced communities aided the achievement of Polish migrants in Canada. More financing for amenities, training, and community development will guarantee that all refugees, irrespective of where they came from, are embraced into regions that can fulfil their requirements.

For such long-term economic health of immigrant and migrant children, some regulations to overcome systemic hurdles are required and additional refugee-specific assistance efforts. Given the plethora of elements that impact migrants’ actual experiences, including factors relating to their encounters in their original place and their acceptance in the resettlement nation, authorities must look beyond refugee status when assessing arrivals’ needs. Kids who arrive as refugees may spend several years in the relocation nation, and their experiences would be affected by various structural factors, including their socioeconomic status and ethnicity. As a result, because refugees come from all over the world, their practical implementation will be contingent on policies that address their specific problems and requirements as refugees and policies that support inclusive practice for the economic gain of all immigrants, particularly racialized immigrants.

Furthermore, more sophisticated knowledge of how more significant societal circumstances influence refugees’ integration patterns contributes to the idea of refugees as a temporary rather than permanent category throughout time. It is critical for a nation such as Canada, whereby refugees acquire permanent residency, to recognize that their lives develop not simply as “refugees” but as persons who eventually contribute to society. Preventive measures are sensitive to the environment of the participants, according to Broholm’s research, since socially rooted conceptions of risk and health determine the view and implementation of preventive initiatives (Broholm-Jørgensen et al., 2019). Preventive measures should get tailored to each individual’s context-dependent needs rather than being administered systematically.

Implementing Global Proficiency in Health Professionals and Organizations

When people have different perspectives on health, illness, and healthcare, it can be challenging to provide care. Health literacy might be limited, and people may use several terminologies for the same ailment. Secondary prevention, mental health care, and self-management are all terms that are new to many people. Service users may lack knowledge of the healthcare systems of their host countries, making them more likely to miss appointments and attempt to receive treatments unlawfully. Disparities in health culture make it harder for health professionals to comprehend a patient’s symptoms, necessitating more time and effort to explain health issues, healthcare concepts, and health systems (Sá & Baeza, 2021). Some immigrants and asylum seekers had unrealistic expectations of health care and health professionals, which practitioners needed to address.

Cultural differences in gender roles, decision-making, societal taboos, and time orientation are all obstacles, with some healthcare providers expressing apprehension about doing particular clinical activities like physical examinations. Gaining a better understanding of the civilizations of escapees and asylum seekers is a critical component of cross-cultural care. Understanding disparities in principles, body language, health practices, and health presentations are part of this. Cultural awareness allows health providers to tailor their care to the needs of their patients. Some personal attributes in health workers, such as sensitivity, empathy, and cultural humility, have improved cross-cultural interactions.

Role of Faith-Based Organizations in Promoting Health Needs

Individuals assume that faith-based groups have more moral authority than non-faith-based organizations, allowing them to reframe humanitarian concerns and arguments concerning relief and support. They may have a wider reach because they can establish relationships with community religious groups “on the ground” before other international agencies arrive. FBOs’ capacity to anchor their activities in religion can help them gain clout in communities by allowing them to appeal to people’s moral responsibilities.

Faith-based groups are frequently respected and valued by government agencies and refugees. Because of this reliance and respect, they have contact with susceptible communities that other groups do not have, comprising uneven migrants and refugee children. Religious organizations can be proactive in resolving sensitive public health issues as well. In Iran, Muslim religious front-runners collaborated with the UNHCR to promote and distribute sex-based violence materials to Afghan refugees. Islamic leaders lent authenticity to exertions to assist females in overcoming societal humiliation and seeking assistance.

Next, religion-based organizations frequently have significant exposure to charitable linkages that may help provide health maintenance to underprivileged refugee societies. Most of these systems have doctors and nurses who have received training. These platforms enable religious organizations to perform time-consuming or resource-intensive treatments that would otherwise be out of reach for most health care providers. Volunteers, for example, take patients to medical centers and provide home health care services. These programs offer medical resources nearer to patients, which is especially important in rural areas where there are few doctors or clinics. Volunteers can help migrants who work long shifts by providing medical care during non-working hours. Some even provide childcare, providing migrants with greater alternatives when it comes to getting medical help. Faith-based groups are regularly used to disseminate health-related information and provide charity assistance. They provide basic health tests as well as health workshops and discussions.

Religion-based organizations usually have considerable knowledge of and link with immigrant communities, enabling culturally and linguistically relevant treatment easier to give. They frequently serve as “cultural brokers” among immigrant communities and healthcare providers. Migrants’ views toward health diagnosis and counseling are frequently shaped by cultural and religious norms. When medical advice is given from the viewpoint of the host nation, it may be insensitive to migrants’ cultural and religious origins. Some advice may even be in direct opposition to cultural or religious teachings and practices. Faith-based organizations are crucial in boosting community consciousness of migrant health concerns. They frequently lobby government officials in support of migrant groups. Nearly 250 church leaders, for example, signed a statement to ICE in April 2018 criticizing the imprisonment of pregnant immigrant mothers (Rayes, Karnouk, Churbaji, Walther & Bajbouj, 2021). Faith-based organizations can raise awareness of the needs and problems of migrant communities by taking such steps.

Conclusion

Migration has evolved into an organizational occurrence of the 21st century, imposing that policymakers break free from the immobility model, acknowledge the full range of motives for relocation, and inspect the results for various parts, with repercussions for scheduling, accounting, and enactment. Within the health field, the necessities of refugees must be met in the area of global settlements that nations have signed, acknowledging the fundamental human rights of all people and the importance of this theory in the formulation and construction of guidelines and programs at the international, nationwide, and local regions. Collaboration between community, governmental groups, and faith-based organizations is crucial to the growth and monitoring of outreach programs to enhance refugee health in Canada.

References

Bazaid, K. (2017). Syrian Refugees in Canada: Clinical experience in mental health care. European Psychiatry, 41(S1), S620-S620.

Broholm-Jørgensen, M., Kamstrup-Larsen, N., Guassora, A., Reventlow, S., Dalton, S., & Tjørnhøj-Thomsen, T. (2019). ‘It can’t do any harm’: A qualitative exploration of accounts of participation in preventive health checks. Health, Risk &Amp; Society, 21(1-2), 57-73.

Conrad, P. (1994). Wellness as a virtue: Morality and the pursuit of health. Culture, Medicine and Psychiatry, 18(3), 385-401.

Durie, M. (2004). Understanding health and illness: Research at the interface between science and indigenous knowledge. International Journal of Epidemiology, 33(5), 1138-1143.

Gamalerio, M. (2018). Not Welcome Anymore: The Effect of Electoral Incentives on the Reception of Refugees. SSRN Electronic Journal.

Langford, R., Powell, A., & Bezanson, K. (2020). Imagining a caring early childhood education and care system in Canada: A thought experiment. International Journal of Care and Caring, 4(1), 109-115.

Lara, A. (2021). Advocacy for asylum seekers at U.S. border: Psychiatrists’ role in promoting justice. Psychiatric News, 56(5).

Maich, K., Somma, M., & Hill, R. (2018). Canadian school programs for students with emotional/behavioral disorders: A Decade of programs, policies, and practice. Emotional and Behavioral Difficulties, 23(4), 441-456.

Merritt, K., & Pottie, K. (2020). Caring for refugees and asylum seekers in Canada: Early experiences and comprehensive global health training for medical students. Canadian Medical Education Journal.

Pelek, D. (2018). Syrian Refugees as Seasonal Migrant Workers: Re-Construction of Unequal Power Relations in Turkish Agriculture. Journal of Refugee Studies, 32(4), 605-629.

Pottie, K., Gruner, D., & Magwood, O. (2018). Canada’s response to refugees at the primary health care level. Public Health Research &Amp; Practice, 28(1).

Rayes, D., Karnouk, C., Churbaji, D., Walther, L., & Bajbouj, M. (2021). Faith-Based Coping among Arabic-Speaking Refugees Seeking Mental Health Services in Berlin, Germany: An Exploratory Qualitative Study. Frontiers in Psychiatry, 12.

Sá, F., & Baeza, F. (2021). Mental health care for refugees and the need for cultural competence training in mental health professionals. Brazilian Journal of Psychiatry, 43(2), 223-224.

Unruh, L., Allin, S., Marchildon, G., Burke, S., Barry, S., & Siersbaek, R. et al. (2021). A comparison of 2020 health policy responses to the COVID-19 pandemic in Canada, Ireland, the United Kingdom and the United States of America. Health Policy.

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