Caring for a newly arrived Syrian refugee family

Kevin Pottie; Christina Greenaway; Ghayda Hassan; Charles Hui; Laurence J. Kirmayer

doi:10.1503/cmaj.151422

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An Open Letter to Refugees From Canadian Medical Students
Koray Demir

Posted on: 31 May 2016
Refugees and public health concerns
Lawrence C. Loh, MD, MPH, CCFP, FRCPC, FACPM

Posted on: 22 February 2016

Posted on: (31 May 2016)
Page navigation anchor for An Open Letter to Refugees From Canadian Medical Students
An Open Letter to Refugees From Canadian Medical Students
Koray Demir, National Officer of Human Rights and Peace
As medical students, we are encouraged and inspired by physician leaders, including the authors of this piece, who are invested in the health of refugees. To add our voices to this conversation, over 500 of us from diverse backgrounds and medical students across the country have signed onto the attached open letter, reaffirming Canadian medical students' commitment to the health and wellbeing of refugees in our communiti...
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As medical students, we are encouraged and inspired by physician leaders, including the authors of this piece, who are invested in the health of refugees. To add our voices to this conversation, over 500 of us from diverse backgrounds and medical students across the country have signed onto the attached open letter, reaffirming Canadian medical students' commitment to the health and wellbeing of refugees in our communities.
--------
To our newly arrived friends and neighbours,
We, the undersigned, are medical students from around Canada. We work daily with patients in communities all over the country, and will soon be practicing physicians in Canada's hospitals and clinics. As our government prepares to welcome many refugees from areas of conflict, we would like to take a moment to say hello - and reaffirm our commitment to working hard for the wellbeing of you and your loved ones as you begin a new chapter of your lives.
For one, we understand that navigating the healthcare system of a completely new country will be challenging. Still, we hope that you will never hesitate to seek care for yourselves or your families should you need it. When we meet you, we pledge to be patient, understanding and empathetic, such that your experience in the Canadian healthcare system is as positive as possible.
We commit also to acknowledging the particular challenges that have been part of your lives prior to arriving in Canada. We will consider them carefully in speaking with you and in understanding how they may have shaped your health, and how we can play a part in helping you to move forward.
Our role as future physicians does not end at offering care in clinics and hospitals. When we see injustices and inequity in health, we are bound to advocate for better health on a broader level. We will use our voices to ensure that your physical and mental wellbeing are considered priorities for policymakers.
In particular, we understand that the conditions of your daily lives are the most important factors in determining the long-term health of you and your families. We will continue advocating for your access to adequate housing, education and employment, among other social factors that may influence your health.
In this vein, we will reject discriminatory or hateful rhetoric if it arises. Threats to your human rights and dignities are an offense to our core values as medical students and as Canadians. We will stand by you and defend your rights with conviction.
We are eager to do our part such that you feel comfortable, welcome and, most importantly - at home, here in Canada. We hope the years ahead bring you and your families happiness, and we look forward to sharing them with you as healthcare professionals, advocates for health and as neighbours in your communities.
From medical students around the country, welcome to Canada.
Signed, sincerely:
Name Medical Faculty Graduating Year
1. Abdelhakim Khellaf, McGill University 2019
2. Abdul Raheem, University of Alberta 2018
3. Abdulkarim Muhaseen, University of Toronto 2019
4. Adam Rocker, University of Ottawa 2019
5. Adam Stich, University of British Columbia 2019
6. Adriana Mejia-French, University of British Columbia 2016
7. Adriano Mollica, University of Toronto 2019
8. Ahmad Mousa, University of Toronto 2019
9. Albert Vu, University of Alberta 2018
10. Alexa Clark, University of Ottawa 2016
11. Alexander Dodd, University of British Columbia 2018
12. Alexandra Dansen, University of Manitoba 2019
13. Alexandra Rice, University of British Columbia 2019
14. Alexandre Coutin, University of Toronto 2019
15. Alexandre McDougall, University of Western Ontario 2018
16. Alexandria Chen, University of Western Ontario 2018
17. Ali Damji, University of Toronto 2017
18. Alison Berzins, University of Western Ontario 2018
19. Alison Spurr, Dalhousie University 2018
20. Alison Sumner, University of Toronto 2019
21. Aliza Moledina , University of Ottawa 2016
22. Allison Clay, University of Western Ontario 2016
23. Allison Hudson, Dalhousie University 2018
24. Alvin Yang, University of Toronto 2019
25. Alysha Rasool, University of British Columbia 2017
26. Alyssa Archibald, University of Manitoba 2019
27. Aman Gera, University of Manitoba 2018
28. Amanda Dancsok, University of British Columbia 2017
29. Amanda Glenn, Dalhousie University 2019
30. Amanda Sauve, University of Western Ontario 2018
31. Amanda Whitten, University of Calgary 2017
33. Amina Allalou, University of Ottawa 2019
34. Amir Parsoei, University of Saskatchewan 2017
35. Amy Chung, The University of Ottawa 2018
36. Amy Cook, University of Alberta 2019
37. Amy Li, University of Calgary 2018
38. Amy Macdonald, Dalhousie University 2018
39. Amyna Fidai, University of Calgary 2018
40. Anam Irshad, University of Calgary 2017
41. Anand Lakhani, University of Toronto 2018
42. Andrea Kulyk, University of Manitoba 2018
43. Andrea Moir, University of Calgary 2018
44. Andrew Ajisebutu, University of Manitoba 2019
45. Angela Cung, University of Manitoba 2016
46. Anish Naidu, University of Western Ontario 2019
47. Ann Lin, University of British Columbia 2016
48. Anna McLean, Dalhousie Medical School 2019
49. Anna Mierzwa, University of Western Ontario 2018
50. Anna Schwalfenberg, University of Alberta 2017
51. Anne-Sara Briand, McGill University 2018
52. Anthony Bismar, Universite de Sherbrooke 2018
53. Anthony Emmott, University of British Columbia 2019
54. Anthony Wong , University of Calgary 2018
55. Ari Cuperfain, University of Toronto 2019
56. Arnav Agarwal, University of Toronto 2018
57. Aselin Weng, McGill University 2019
58. Ashley Tse, University of Alberta 2017
59. Ashley Yip, University of British Columbia 2018
60. Asma Amir Ali, Western University 2019
61. Ateshia Walker, University of British Columbia 2018
62. Austin Yan, University of Ottawa 2022
63. Ayan Dey, University of Toronto 2018
64. Ayesha Nazarali, University of Alberta 2019
65. Azalea Lehndorff, University of Calgary 2018
66. Bandeep Kaur, University of Western Ontario 2019
67. Ben Schwartzentruber, University of British Columbia 2017
68. Ben Sheppard, University of British Columbia 2017
69. Bernice Fonseka, University of Calgary 2018
70. Bethea Shute, University of Alberta 2018
71. Betty Wang, University of Alberta 2019
72. Blake Lerner, University of Manitoba 2019
73. Bogdan Beca, Dalhousie Medical School 2019
74. Bon Lam, University of Calgary 2018
75. Bonnie Liu, University of Saskatchewan 2019
76. Boris Virine, University of Western Ontario 2019
77. Brandon Evtushevski, University of British Columbia 2019
78. Brandon McIlmoyle, University of British Columbia 2019
79. Brandon Yau, University of British Columbia 2019
80. Breanne Carey, University of British Columbia 2016
81. Brendan Cassidy, University of Western Ontario 2019
82. Brendan M. Wong, University of Ottawa 2018
83. Brendon To, University of Calgary 2018
84. Brian Tran, McGill University 2019
85. Bridget Gibson, University of Calgary 2017
86. Brittany Boorman, University of British Columbia 2019
87. Brittany Gillis, Dalhousie University 2016
88. Brock Randolph, University of Alberta 2018
89. Brooke Edwards, University of Western Ontario 2019
90. Bruce Gao, University of Calgary 2018
91. Caitlin Lee, University of Alberta 2019
92. Caleb De Putter, University of British Columbia 2016
93. Camille Paradis, McGill University 2019
94. Carl Severson, University of Calgary 2017
95. Carly Yim, University of Alberta 2019
96. Carmen Wong, University of British Columbia 2019
97. Carolyn Wonneck, University of Manitoba 2018
98. Casey Wang, McGill University 2019
99. Catherine A Wassenaar, University of Western Ontario 2018
100. Catherine Hart, Dalhousie University 2018
101. Catherine Liu, Universite de Sherbrooke 2016
102. Ceilidh Kinlin, University of Calgary 2017
103. Ceinwen Pope, University of Ottawa 2018
104. Chaitanya Gandhi, University of Alberta 2019
105. Charissa Chen, University of Calgary 2016
106. Charles Yin, University of Western Ontario 2018
107. Charles-Antoine Barbeau-Meunier, Universite de Sherbrooke 2019
108. Charles-David Clayton, University of British Columbia 2019
109. Chelcie Soroka, Dalhousie Medical School 2016
110. Chelsea Hart, University of Northern British Columbia 2019
111. Cheryl Gascoyne, University of British Columbia 2019
112. Cheryl Young, University of Toronto 2018
113. Cheyenne Lawton, University of Saskatchewan 2017
114. Chloe LaBrie, University of Calgary 2018
115. Chris Harper, University of Toronto 2018
116. Chris Picheca, University of Calgary 2018
117. Christine M. Kennedy, University of Northern British Columbia 2018
118. Christine Patterson, University of Alberta 2019
119. Cindos Barakat, University of Western Ontario 2019
120. Cindy Zhu, University of Western Ontario 2018
121. Claire MacKinlay, University of British Columbia 2019
122. Clara Hong, University of British Columbia 2018
123. Clara Van Ommen, University of British Columbia 2019
124. Clara Westwell-Roper, University of British Columbia 2016
125. Claudel P-Desrosiers, Universite de Montreal 2018
126. Colin Maslink, University of Toronto 2019
127. Colin Siu, University of Alberta 2017
128. Colton Lewis, University of Alberta 2019
129. Connie Drewbrook, University of British Columbia 2017
130. Connor Dietz, University of British Columbia 2019
131. Connor Hawkins, University of British Columbia 2018
132. Connor McGuire, Dalhousie University 2019
133. Craig Olmstead, University of Western Ontario 2017
134. Cynthia Kong, University of British Columbia 2016
135. Cyrus Thomas, University of British Columbia 2019
136. Dan Cojocaru, University of British Columbia 2018
137. Daniela Keren, University of Calgary 2018
138. Danielle Murray, University of British Columbia 2018
139. Danielle Thordarson, University of Manitoba 2019
140. Danika Leung, University of Alberta 2017
141. Danny Aceytuno, University of Calgary 2018
142. Dave Lincoln, University of Calgary 2018
143. David Benrimoh, McGill University 2016
144. David Galiano, McGill University 2018
145. David Kishlyansky, University of Ottawa 2019
146. David Van de Vosse, University of British Columbia 2016
147. Deanna Lammers, University of Ottawa 2018
148. Deborah Isabel Reid, University of Ottawa 2018
149. Devin Hasanally, University of Manitoba 2018
150. Devin Masyk-Neumeier, University of British Columbia 2016
151. Dima Saab, University of Toronto 2019
152. Dorothy Yu, University of Manitoba 2018
153. Elise Van Brummelen, University of British Columbia 2018
154. Ellen Snyder, University of Ottawa 2016
155. Ellie MacBain, University of British Columbia 2019
156. Emily Macphail, University of Calgary 2017
157. Emily O'Reilly, Dalhousie Medical School 2019
158. Emily-Lauren Simms, University of Saskatchewan 2019
159. Emma Boyce, University of Calgary 2018
160. Emma Jackson, University of British Columbia 2019
161. Emma Mitchell, University of British Columbia 2019
162. Erfun Hatam, University of Western Ontario 2018
163. Eric Wong, University of British Columbia 2018
164. Erica Cleto, University of Western Ontario 2019
165. Erica Hoe, University of Western Ontario 2016
166. Erik Hopkins, University of Calgary 2017
167. Erin Campos, University of Western Ontario 2019
168. Erin Love, University of British Columbia 2017
169. Ernest Chan, University of Western Ontario 2017
170. Evan Ailon, University of Western Ontario 2016
171. Evan Batten, University of Toronto 2019
172. Fatima Mahdi, University of Calgary 2018
173. Fei Fei Shao, University of Western Ontario 2019
174. Frances Morin, University of British Columbia 2019
175. Franco Rizzuti, University of Calgary 2017
176. Gabriel Dmytryszyn, Universite de Manitoba 2019
177. Gabriel Lavoie, Universite de Montreal 2018
178. Galilee Thompson, University of Saskatchewan 2018
179. Gaya Narendran, University of Calgary 2018
180. Gayathri Narendran, University of Calgary 2018
181. Gisele Adam, University of British Columbia 2018
182. Golden Gao, University of British Columbia 2017
183. Greg Costello, University of British Columbia 2016
184. Gurinder Grewal, University of British Columbia 2016
185. Gurmeet Kaur Sohi, University of Manitoba 2018
186. Hailey McInnis, University of Calgary 2017
187. Haley Butcher, McGill University 2018
188. Hamzah Qureshi, University of Toronto 2016
189. Han Yan, University of Western Ontario 2017
190. Hao Li, University of Western Ontario 2016
191. Harjot Bedi, University of British Columbia 2018
192. Hayley Levinson, University of Calgary 2017
193. Heather O'Halloran, University of Toronto 2018
194. Helene Babakissa, Universite de Montreal 2018
195. Helene Morakis, Queen's University 2019
196. Henry Annan, Dalhousie University 2018
197. Ian Armstrong, University of Alberta 2016
198. Inas Slim, Universite de Montreal 2018
199. Ismat Ali, University of Calgary 2018
200. Izn Shahab, University of Saskatchewan 2019
201. Jacob Matthews, University of Western Ontario 2018
202. Jacqueline Bobyn, University of Calgary 2018
203. James B, University of Toronto 2019
204. James Fowler, Dalhousie University 2019
205. James Welke, University of Alberta 2018
206. Jamie Gregg, University of Alberta 2019
207. Janine Reid, University of British Columbia 2016
208. Jarad Plato, University of Northern British Columbia 2019
209. Jasleen Grewal, University of Western Ontario 2019
210. Jasmine Lo, University of British Columbia 2019
211. Jason Elzinga, University of Western Ontario 2019
212. Jeanette Pedersen, University of Calgary 2017
213. Jeanine McColl, University of Calgary 2017
214. Jeff Friesen, University of Western Ontario 2016
215. Jeff Gustafson, University of Western Ontario 2019
216. Jennifer Day, University of Calgary 2017
218. Jennifer Kirkpatrick, University of Manitoba 2019
219. Jennifer Zhang, Western University 2018
220. Jenny Guo, McGill University 2017
221. Jenny Peng, University of Ottawa 2018
222. Jenny Saunders, University of Calgary 2018
223. Jeremy Cepek, University of Western Ontario 2018
224. Jessica Bednarz, University of Manitoba 2018
225. Jessica Bryce, University of Western Ontario 2018
226. Jessica MacIntyre, Dalhousie University 2019
227. Jessica McLellan, University of Calgary 2017
228. Jessica Reiniger, University of Saskatchewan 2019
229. Jessica Siu, University of Western Ontario 2018
230. Jessica Tamura-Wells, University of Calgary 2017
231. Jodie Roberts, University of Calgary 2017
232. Joe Truong, University of Western Ontario 2019
233. Joel Mohr, University of British Columbia 2018
234. John White, University of Western Ontario 2019
235. John-Jose Nunez, University of British Columbia 2017
236. Johnathan Lau, University of Ottawa 2019
237. Jon Herriot, University of Saskatchewan 2016
238. Jonathan Fuller, University of Toronto 2019
239. Jordon Charlebois, University of Western Ontario 2016
240. Joseph Goody, University of British Columbia 2019
241. Josh Taylor, University of Ottawa 2019
242. Joshua Aquin, University of Manitoba 2018
243. Joshua Nicholas, University of Calgary 2018
244. Julia Wright, Dalhousie University 2019
245. Julianna Deutscher, University of Alberta 2018
246. Justin Neves, McMaster University 2016
247. Justin Tabah, McGill University 2018
248. Justine Hames , University of Alberta 2018
249. Justyne Morrow, University of British Columbia 2016
250. Karl Narvacan, University of Alberta 2019
251. Kate Knuff, University of British Columbia 2018
252. Kate Reilly, University of Western Ontario 2016
253. Katelyn Postnikoff, University of Saskatchewan 2018
254. Kathleen Deering, University of British Columbia 2019
255. Katie Girgulis, University of Alberta 2019
256. Kavithan Abbu, University of Manitoba 2018
257. Kay Fung, University of British Columbia 2016
258. Kayla Feragen, University of Calgary 2017
259. Kayla McGowan, University of British Columbia 2019
260. Kayla Simms, University of Ottawa 2017
261. Kaylynn Purdy, Northern Ontario School of Medicine 2018
262. Keely Hammond, University of British Columbia 2019
263. Keely Loewen, University of Manitoba 2018
264. Kelcie Lahey, University of Calgary 2018
265. Kelly Huang, University of British Columbia 2019
266. Kelly Lau, McGill University 2017
267. Kendell Pon, University of Saskatchewan 2018
268. Khue-Tu Nguyen, University of British Columbia 2018
269. Kia Dullemond, University of British Columbia 2019
270. Kiersten Amos, Dalhousie University 2019
271. Kim Kaspy, McGill University 2016
272. Kinjal Patel, University of Alberta 2019
273. Kiran Rikhraj, University of British Columbia 2019
274. Kirsten Marr, University of Calgary 2017
275. Kit Moran, Dalhousie University 2019
276. Koray Demir, McGill University 2018
277. Kristin Burles, University of Alberta 2017
278. Kristyn Kurio, University of Alberta 2016
279. Kriti Kumar, University of Western Ontario 2019
280. Kyla Adams, University of British Columbia 2018
281. Kyla Barrie, University of Manitoba 2018
282. Kyle Ng, University of Ottawa 2018
283. Lahoud Touma, McGill University 2018
284. Laura Faulkner, Dalhousie University 2019
285. Lauren Crosby, University of Western Ontario 2019
286. Lauren G, University of Calgary 2018
287. Lauren Kan, University of British Columbia 2019
288. Lauren Standerwick, University of Calgary 2018
289. Lawrence Yau, University of Ottawa 2018
290. Leah Sinai, University of Western Ontario 2019
291. Leandra Wellmeier, University of Calgary 2018
292. Lebei Pi, University of Toronto 2017
293. Lee Bauer, University of British Columbia 2019
294. Leora Day, University of Toronto 2016
295. Lerly Luo, University of British Columbia 2019
296. Lidiya Luzhna, University of Calgary 2018
297. Lina Cadili, University of Calgary 2018
299. Linda Liu, University of Calgary 2017
300. Linda Zhang, University of British Columbia 2019
301. Lisa Pinto , Memorial University 2016
302. Lisa Wang, University of Saskatchewan 2018
304. Luke Wiseman, Dalhousie University 2019
305. Lydia Gindy, University of Manitoba 2018
306. Lydia Schramm, University of Calgary 2018
307. Madalena Dearden, University of Alberta 2017
308. Maddison Bibby, University of Toronto 2019
309. Maggie Siu, University of Western Ontario 2016
310. Magnus Bein, McGill University 2019
311. Majd Mustafa, University of British Columbia 2015
312. Marc Sonntag, University of Calgary 2017
313. Marcus Cunningham, University of Calgary 2018
314. Marguerite Heyns, University of Calgary 2017
316. Marie-Faye Galarneau, Universite de Montreal 2018
317. Marie-Rachelle Felizaire, McGill University 2019
318. Mark Levitan, University of Ottawa 2019
319. Mark Woo, McGill University 2018
320. Marlise Sovka, University of British Columbia 2018
321. Mary Elrick, University of British Columbia 2018
322. Mary Koziol, McGill University 2018
323. Mary Lynn Beaulieu, University of Saskatchewan 2019
324. Maryam Eslami, University of British Columbia 2018
325. Mattan Lustgarten, University of Toronto 2018
326. Matthew Kochan, University of Manitoba 2019
327. Matthew McAdam, University of British Columbia 2019
328. Matthew Van Otterloo, University of Manitoba 2019
329. Maxime Leroux-La Pierre, Universite de Montreal 2016
330. Maxine Aird, Universite de Montreal 2018
331. Megan Blades, University of Calgary 2016
332. Megan Ruth, University of Calgary 2017
333. Meghan Plotnick, Dalhousie University 2019
334. Melissa Govindaraju, University of Ottawa 2019
335. Melissa Ng, University of British Columbia 2017
336. Meri Kieksi, University of Calgary 2017
337. Michael Gritti, University of Toronto 2019
338. Michael Multan, University of Calgary 2018
339. Michael Rizzuto, University of British Columbia 2019
340. Michael Wong, University of Alberta 2016
341. Michael-Anthony Ferrato , University of Western Ontario 2019
342. Michelle Giles, University of Alberta 2018
343. Mieke Heyns, University of Calgary 2018
344. Miles Hunter, University of Calgary 2017
345. Mimi He, University of British Columbia 2016
346. Mitchell Elliott, University of Toronto 2019
347. Mitchell Webb, University of British Columbia 2016
348. Mohammad Pannu, University of Manitoba 2017
349. Mona Maleki, University of British Colombia 2019
350. Monica McKeown, University of British Columbia 2019
351. Monique Marguerie, University of British Columbia 2018
352. Montana Johnston, University of Manitoba 2018
353. Munaha Mostofa, Dalhousie University 2019
354. My-Linh Ma, McGill University 2016
355. Naomi Macrae, University of British Columbia 2017
356. Natalia Binczyk, University of Alberta 2019
357. Nathan Stefani, University of British Columbia 2017
358. Nathan Toh, University of British Columbia 2018
359. Nathan Turner, University of Alberta 2018
360. Nelson Chow, University of Western Ontario 2019
361. Nicholas, University of Western Ontario 2018
362. Nick Sajko, Dalhousie University 2019
363. Nicola Smith, McGill University 2018
364. Nicole Hong, University of British Columbia 2018
365. Nicole Mensik, University of Alberta 2017
366. Niko MacLellan, Dalhousie Medical School 2019
367. Nima Omid-Fard, University of British Columbia 2019
368. Nina Nguyen, Universite de Sherbrooke 2016
369. Nolan Lee, University of British Columbia 2019
370. Noren Khamis, University of British Columbia 2018
371. North de Pencier, University of Western Ontario 2019
372. Obaidullah Khan, University of Western Ontario 2019
373. Omar Abdel-Razek, University of Ottawa 2016
374. Omar Zghal, University of Western Ontario 2017
375. Osama Jarkas, University Of Manitoba 2018
376. Osman Raza, University of Ottawa 2019
377. Paige Durling, University of Calgary 2018
378. Paige Williams, University of Western Ontario 2019
379. Parnian Riaz, University of Alberta 2018
380. Parveen Brar, University of Calgary 2018
381. Patrick Hemmons, University of British Columbia 2018
382. Paul Dolinar, University of Western Ontario 2018
383. Pavitra Patel, University of Manitoba 2019
384. Paymon Azizi, University of Toronto 2019
385. Peter Cordell, University of Western Ontario 2016
386. Qadeem Salehmohamed, University of British Columbia 2019
387. Rachel Boyle, Dalhousie Medical School 2019
388. Rachel Loebach, University of Western Ontario 2018
389. Radhika Singh, University of Alberta 2019
390. Rameeshay Mubasher, University of Toronto 2019
391. Rameez Imtiaz, University of Ottawa 2018
392. Rami Elzayat, University of Manitoba 2019
393. Raymond Li, Memorial University 2016
394. Razvan Purza, University of Manitoba 2016
395. Rebecca Buttar, University of Calgary 2018
396. Rebecca MacLean-Angus, University of British Columbia 2019
397. Rebecca Manion, University of Calgary 2018
398. Rebecca Manion, University of Calgary 2018
399. Rebecca Shalansky, University of British Columbia 2017
400. Renee Crawley, University of Alberta 2019
401. Rikesh Parekh, University of Calgary 2017
402. Risa Namsechi, University of Alberta 2017
403. Rob Bobotsis, University of Western Ontario 2018
404. Rob Pintwala, University of Western Ontario 2018
405. Robbie Sparrow, University of Western Ontario 2019
406. Robert Dunfield, Dalhousie University -- New Brunswick 2019
407. Robert Nathan, University of British Columbia 2019
408. Robin Krug, Western University 2018
409. Robin Whitty, University of British Columbia 2018
410. Rosalinda Knight, Dalhousie University - New Brunswick 2019
411. Ruth Habte, University of Manitoba 2019
412. Ryan Henrie, University of Manitoba 2018
413. Ryan Leigh, University of Calgary 2017
414. Ryan Uy, University of British Columbia 2018
415. Saba Balvardi, McGill University 2018
416. Saba Samet, University of Toronto 2019
417. Sadie Kutz, University of Calgary 2018
418. Saleh Fadel, University of Ottawa 2018
419. Sam Fineblit, University of Manitoba 2017
420. Samantha Cheuk, University of Calgary 2018
422. Samantha Kinley, McGill University 2019
423. Samuel Harder, University of British Columbia 2019
424. Samuel Merrifield, Northern Ontario School of Medicine 2017
425. Sandra Botros, Schulich School of Medicine 2019
426. Sara Lynskey, University of British Columbia 2017
427. Sara Matyas, University of Manitoba 2018
428. Sarah Archer, University of Saskatchewan 2016
429. Sarah Bryson, Dalhousie University 2019
430. Sarah Cho, University of Toronto 2018
431. Sarah Graham, University of Saskatchewan 2016
432. Sarah Hanafi, University of Alberta 2018
433. Sarah Pallotta, McGill University 2018
434. Sarah Tremaine, Dalhousie University 2019
435. Scott Belyea, University of Calgary 2018
436. Scott Haslam, Dalhousie University 2019
437. Scott Laing, University of Western Ontario 2017
438. Sean Andrea, University of Calgary 2018
439. Sebastian Browne, University of British Columbia 2018
440. Shandel Riedlinger, University of British Columbia 2019
441. Sharon Feng, University of Alberta 2018
442. Shauna Regan, University of Alberta 2019
443. Shekoofeh Saboktakis, University of Manitoba 2019
444. Shoghi Nikoo, University of Calgary 2017
445. Shreya Jalali, University of Ottawa 2019
446. Shriya Deshmukh, McGill University 2022
447. Sidney Morrison, University of British Columbia 2018
448. Sierra de Ciutiis, University of Northern British Columbia 2015
449. Simon Christie, University of Manitoba 2019
450. Solveig Nilson, University of Calgary 2016
451. Sonam Shah, University of Toronto 2018
452. Sonya Swift, Dalhousie University 2018
454. Sophie Bourgeois, University of Calgary 2017
455. Sophie Harrison, University of Northern British Columbia 2017
456. Stephanee Ophey, University of Manitoba 2018
457. Stephanie Rogers, University of Western Ontario 2019
458. Stephen Woo, University of Western Ontario 2018
459. Steve Liu, University of Calgary 2015
460. Steven Slobodian, University of Calgary 2017
461. Stone Li, University of Alberta 2019
462. Stuart Hartsook, University of British Columbia 2019
463. Sumaiya Ahmed, University of Ottawa 2019
464. Sunny Lee, University of Saskatchewan 2019
465. Sureni Gomis, University of Saskatchewan 2019
466. Susan Luong, University of British Columbia 2018
467. Susan McLellan, University of Saskatchewan 2019
468. Susan Telencoe, University of Manitoba 2018
469. Sydney Todorovich, University of Western Ontario 2018
470. Tamara Ibrahim, McGill University 2017
471. Tammy Nighswander, University of Calgary 2017
472. Tammy Wong, University of Western Ontario 2018
473. Tanya MacDonell, University of British Columbia 2019
474. Tara D'Ignazio, Universite de Montreal 2018
475. Tara Hilton, University of Ottawa 2018
476. Taran Main, University of British Columbia 2019
477. Tarun Rahman, University of Ottawa 2018
478. Tavis Apramian, University of Western Ontario 2019
479. Taylor Davis, University of Saskatchewan 2019
480. Thane Smith, University of Calgary 2018
482. Thomas Hedley, University of Manitoba 2018
483. Tianna Koreman, University of Western Ontario 2019
484. Timothy Chung, University of Toronto 2018
485. Tina Binesh, University of Toronto 2019
486. Tina Chiang, University of British Columbia 2017
487. Tinya Lin, University of Western Ontario 2016
488. TJ Henderson, University of Western Ontario 2018
489. Torey Lau, University of British Columbia 2019
490. Tori Henderson, University of Northern British Columbia 2019
491. Tracy Leach, University of Saskatchewan 2019
492. Trevor Peterson, University of Manitoba 2019
493. Tyler d'Entremont, Dalhousie University 2016
494. Umair Sajid, University of Alberta 2019
495. Vanessa Giesbrecht, University of Calgary 2017
496. Vanessa Montagliani, University of British Columbia 2019
497. Victoria Brzozowski, University of Western Ontario 2019
498. Victoria Pho, University of British Columbia 2017
499. Victoria Smith, Dalhousie University 2018
500. Vitaliy Chernenko, University of British Columbia 2019
501. Vivian Jia, University of Alberta 2016
502. Wade Coutinho, University of Alberta 2019
503. Wade Walters, University of Calgary 2018
504. Waleed S. Ahmed, University of Toronto 2018
505. Warren Koo, University of British Columbia 2019
506. Wendy Marina Davis, University of British Columbia 2017
507. Wenzhen Zuo, Universite de Montreal 2018
508. William Lin, University of Toronto 2018
509. Wynn Tran, University of British Columbia 2018
510. Yalda Karimi, University of Western Ontario 2019
511. Yara Abou-Hamde, University of Western Ontario 2019
512. Yasi Xiao, McGill University 2018
513. Yasmeen Mansoor, University of British Columbia 2019
514. Yi-Hong Shao, McGill University 2019
515. Yimeng Wang, Western University 2019
516. Youn Tae Chung, University of Manitoba 2019
517. Yuhao Wu, University of British Columbia 2019
518. Zara Zalnieriunas, University of Western Ontario 2018
519. Zoe Polsky, University of Calgary 2018
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (22 February 2016)
Page navigation anchor for Refugees and public health concerns
Refugees and public health concerns
Lawrence C. Loh, MD, MPH, CCFP, FRCPC, FACPM, Associate Medical Officer of Health
Pottie and co-authors are to be commended for their timely and helpful Decisions piece on providing care to a Syrian refugee family. As those affected by the worst humanitarian crisis of our time make their way to our shores, our focus should give some measure towards promoting and preserving health beyond solely treating infirmities, and understanding the complex interplay between public health and primary care. In that...
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Pottie and co-authors are to be commended for their timely and helpful Decisions piece on providing care to a Syrian refugee family. As those affected by the worst humanitarian crisis of our time make their way to our shores, our focus should give some measure towards promoting and preserving health beyond solely treating infirmities, and understanding the complex interplay between public health and primary care. In that vein, a few points in the article stand out to me.
Firstly, concerning tuberculosis, the authors state that a chest radiograph is used to rule out active pulmonary tuberculosis (TB) and discusses screening for latent TB in a separate section later on in the paper. No mention is made, however, of federally-mandated TB medical surveillance. While the merits of this practice are heavily debated, (1) the screening chest x-ray is presently also used to identify refugees with inactive TB that would need to report to public health for medical surveillance upon landing. These patients undergo clinical and public health assessments soon upon arrival, and, if deemed necessary, undergo TB follow-up for up to a two-year time period.(2,3)
A second recommendation put forward by the authors is to not offer routine HIV testing on arrival. This is at odds with guidance from the Public Health Agency of Canada, which recommended that the consideration and discussion of HIV testing be made a component of periodic routine medical care, given the potential benefits demonstrated through early detection. (4)
Finally, and most importantly, I found it noteworthy that an early paragraph saw the authors qualitatively discuss trends of scabies, head lice, measles, leishmaniasis and louse-borne fever in this refugee population with the opening statement that "No major public health concerns have been reported thus far [in this population]."
This statement poses several issues. Firstly, it significantly narrows the communicable disease control scope of public health. Not soon after this paragraph, the authors note that only around 50% of Syrian children have received primary series vaccines (diphtheria, pertussis, tetanus and polio.) As the authors are doubtless aware, vaccination is a cornerstone of communicable disease control and low rates are of significant public health concern, especially if they fall below the threshold required to maintain herd immunity.
The second more critical point is that we must remember that public health's remit is far more than communicable disease alone. When considering a broader determinants of health framework, one easily recognizes that incoming Syrian refugees face significant public health concerns, such as potential barriers to accessing shelter, employment, and social support as well as cultural and language barriers that may impact community integration, education and personal health habits.
To distill potential public health responses work around the refugee crisis to a sundry list of diseases is to ignore the important role that broad, wrap-around health and social services must play in integrating this community into their new home and ensuring that they remain both physically and mentally healthy.
REFERENCES
1. Khan K, Hirji MM, Miniota J, Hu W, Wang J, Gardam M, Rawal S, Ellis E, Chan A, Creatore MI, Rea E. Domestic impact of tuberculosis screening among new immigrants to Ontario, Canada. CMAJ. 2015 Nov 3;187(16):E473-81. doi: 10.1503/cmaj.150011. Epub 2015 Sep 28.
2. Immigration, Refugees, and Citizenship Canada. Medical Surveillance. Available at: http://www.cic.gc.ca/english/resources/tools/medic/surveillance/surveillance.asp (Accessed February 22, 2016)
3. Toronto Public Health. Tuberculosis (TB) Medical Surveillance for Newcomers. Available at: http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=acd12f763c322410VgnVCM10000071d60f89RCRD&vgnextchannel=833b2f763c322410VgnVCM10000071d60f89RCRD (Accessed February 22, 2016)
4. Public Health Agency of Canada. Human immunodeficiency virus (HIV) testing and screening guide. Available at: http://www.phac-aspc.gc.ca/aids -sida/guide/hivstg-vihgdd-eng.php#a (Accessed February 22, 2016)
Conflict of Interest:
None declared
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Competing Interests: None declared.