They may have crossed thousands of kilometres of ocean in dirty, rickety boats with minimal food, but the almost 600 Chinese adults and children who landed unannounced in BC last summer arrived in surprisingly good health.
Dr. Cheryl Anderson, medical director of the Bridge Health Clinic, a Vancouver centre for refugees and migrants, accompanied federal officials as they followed an elusive Chinese freighter - the third of 4 boatloads intercepted last summer - for 8 hours. In all, 190 people, including 23 minors, were found huddling on deck when Anderson and a paramedic climbed aboard, "eyeballing to see who looked weak, who looked sick." Only 6 of the migrants were mildly hypothermic.
The main concern was nutrition, because most of the passengers had been without food and water for up to 3 days. On some of the boats, water was in short supply from the start of the voyage. Officials speculate that the "enforcers" responsible for smuggling the migrants withheld water to intimidate them.
Although conditions in the ship's hold were appalling, most of the migrants, who claimed refugee status upon arrival, were in good health. Anderson assumes that this was because they were a pre-selected, healthy group: the "snakeheads" who smuggled the human cargo to Canada wanted to ensure they could recoup their investment by collecting money once the migrants started working.
Once on shore, the newest boat people were bused to Esquimalt, a navy base near Victoria, where they underwent health screening in a hastily converted gymnasium. Ray Mostowy, a psychiatric registered nurse, spent 14-hour days working with migrants from the last 3 boatloads. When he first met them, the Chinese "looked like they had come from a concentration camp. You could count their ribs from across the gym." Notably exempt from malnutrition because of their superior food supplies were the snakehead enforcers, who were in "extremely good shape." FIGURE
Figure. Mask-wearing Mounties escort illegal Chinese migrants to waiting buses in Esquimalt, BC.
Two people were sent to hospital - one for a bleeding ulcer and the other because of neurological symptoms. Another man was so severely hypothermic that medical staff "couldn't get a reading on the thermometer." He had lost 55 pounds on the journey and took 2 weeks to recover at the base. However, "if it hadn't been for malnutrition, dehydration and gastrointestinal problems, they would have been in excellent health," Mostowy said.
Six stations were set up to check the new arrivals, with screening done by military doctors, paramedics, and Mostowy. Many migrants had scabies, head lice and minor skin conditions. All received chest x-rays and physical examinations, and the women underwent pregnancy tests. By the time the fourth boatload arrived in September, screening for hepatitis B and syphilis had been introduced; 34% of those screened from that boat were found to be chronic carriers of hepatitis B. All migrants were screened for tuberculosis, but no active cases were found.
About 100 minors, most thought to be in their teens, were placed in the care of the BC Ministry of Children and Families. All adults are being held in custody - most in a Prince George, BC, prison - as they await immigration hearings. Others are in the Burnaby Women's Correctional Centre and in a minimum security institution in the Fraser Valley. The only exceptions are adults from the first boat, who were released to await an immigration hearing. Because most of them disappeared without a trace, all subsequent Chinese migrants were held in custody.
Anderson and her colleague, Dr. Elaine Wynne, have seen several of the minors at the Bridge Clinic. All have been vaccinated and screened for gastrointestinal parasites, with half of them receiving treatment.
Psychological stress aggravated by detention is common, say the doctors. Although many migrants were euphoric following their arrival, this often turned to anxiety after the expected freedom was not offered. With only essential and emergency care mandated for refugee claimants, Anderson and Wynne rely on detention centre nurses to screen for minor ailments. Physicians are contracted on a sessional or fee-for-service basis by Corrections Canada.
Some of the refugee claimants went on brief hunger strikes last November to protest their detention. Corrections Canada spokesperson Sheldon Green said the strikers were monitored constantly by medical staff.
Although it is difficult to arrive at a specific estimate for health care costs, the per diem charge to keep people in Corrections Canada facilities is about $200. Since the migrants fall under the Interim Federal Health Program, only emergency medical care is mandated. However, the cost of providing care for Kosovar refugees who arrived in Canada last spring and received full coverage is estimated to be about $2000 annually.