Response to Refugee Crisis Must Include Expanding Refugee Healthcare

The haunting image of Alan Kurdi’s lifeless body lying face down on a Turkish beach, and the subsequent revelation of the Kurdi family’s intention to seek asylum in Canada, have prompted many Canadians to ask what we can do as a country to help Syrian refugees. So far, our search for an answer has rarely moved past the issue of refugee resettlement as we continue to debate how many Syrian refugees we should admit, how soon and by which means.

This is unfortunate. While there is no question that refugee resettlement should be an important component of our collective action, our humanitarian response to the Syrian refugee crisis must go beyond this.

What is largely missing in the public discussion is an appreciation that refugees face extraordinary challenges throughout their migration process, including before and after their resettlement, and this equally demands our attention. One challenge in particular – access to proper healthcare – is critical, both for Syrian refugees remaining in the region and many of those who have arrived in Canada.

Lack of healthcare has dire consequences for the well-being of refugees and can also stand in the way of their integration into new environments.

For the four-million Syrian refugees living in the neighbouring countries, their access to healthcare has been severely hampered by the funding shortage facing aid agencies. Take this year as an example; as of June, the UN High Commission for Refugees and its partners have secured only 17 percent of the 369 million U.S. dollars needed for the health-related humanitarian initiatives in the region. As a result, UN-operated clinics in 10 of the 18 Iraqi districts have been forced to close. In Jordan, only half of the war-wounded have been able to access necessary nursing care. Refugees in Lebanon in need of certain life-saving treatments, including kidney dialysis, chemotherapy and care for extremely pre-term infants, have lost UN subsidies and must now find ways to pay for their medical costs privately.

Syrian refugees that arrive in Canada, those sponsored by private groups as well as those awaiting refugee status determination, also encounter barriers accessing medically necessary services owing to cuts to the federal refugee healthcare program since June 2012. Although the Federal Court ruled in July last year that these changes to refugee healthcare were cruel and unusual — and therefore unconstitutional — the government is now appealing the decision. Meanwhile, gaps in refugee healthcare coverage persist.

According to the current federal policy, most privately sponsored refugees and refugee claimants are entitled to neither supplemental benefits nor prescription drugs unless they are required to treat conditions that pose a threat to public health or public safety. As such, Syrian refugees injured in the war and in need of prostheses or mobility aids must pay for them out of pocket. Those seeking support for mental illness, which is common among refugees, receive no financial assistance when consulting a clinical psychologist or when requiring psychotropic drugs. Refugees living with chronic diseases like diabetes and hypertension must also shoulder the cost of their medications on their own. This latter point is especially salient in the context of Syrian refugees. In 2011, before the onset of the civil war, over three-quarter of all deaths in Syria were reportedly attributable to non-communicable diseases.

There are, however, immediate steps that the Canadian government can take to facilitate Syrian refugees’ access to healthcare — both abroad and here at home. As a country, we must boost our humanitarian aid to frontline organizations that work tirelessly to meet the needs of refugees in Syria and adjacent countries. The government’s recent announcement to match private donations made between now and the end of the year is a crucial first step, but with the refugee situation becoming protracted, we must commit to longer-term funding support.

Critically, at home, the federal government should discontinue its appeal of the Federal Court’s ruling and fully reverse the cuts to the refugee healthcare program in Canada.

These measures will not only attend to the basic needs of refugees, but also contribute to the success of Canada’s resettlement program. Restoring healthcare access will reduce the out-of-pocket healthcare costs of refugees and ease the financial burden of private refugee sponsors. Access to healthcare will also help maintain or even improve refugees’ well-being and sense of hope which can only help to encourage their active participation in the host community.

The protection of healthcare access for refugees must be a key element of Canada’s humanitarian response to the Syrian refugee crisis. We can’t start too soon.

YYChen_headshotY.Y. Brandon Chen is an Assistant Professor at the Faculty of Law, University of Ottawa. He is a member of University of Ottawa’s Centre for Health Law, Policy and Ethics.