Showing posts with label CBC News. Show all posts
Showing posts with label CBC News. Show all posts

Immigrants' health woes focus of new guide

Photo of Tabaret Hall with the Desmarais Build...Image via WikipediaCanadian doctors now have their largest, most comprehensive reference guide yet to use in treating immigrants and refugees.
Compiled from global data, the 100-page report published Monday by the Canadian Medical Association Journal is the first of its kind and synthesizes results from 150 investigators.
The guidebook highlights medical problems that are common among immigrants and refugees but can easily get overlooked because they're not typical in the wider Canadian population.
Dr. Kevin Pottie of the University of Ottawa, and founding director of the Immigrant Health Clinic of Ottawa, co-authored the report that recommends migrants visit a doctor more than once a year.Dr. Kevin Pottie of the University of Ottawa, and founding director of the Immigrant Health Clinic of Ottawa, co-authored the report that recommends migrants visit a doctor more than once a year. (CBC) "Immigrants are coming from 150 countries," notes Dr. Kevin Pottie of the University of Ottawa, who co-authored the guidelines. "Some of them come as refugees, some under family class. So, there's a large diversity of needs and potential preventable and treatable illnesses [that] the average family doctor just isn't thinking about."
Pottie hopes to develop an international set of guidelines in terms of treating migrants.
"We need to see health as a human right, and small interventions are all that's needed for all immigrants," Pottie said in an interview with CBC News.
The guide, titled Evidence-based Clinical Guidelines for Immigrants and Refugees, instructs physicians on how to deal with the kind of health risks faced by the 357,000 annual migrants to Canada, including refugees, international students and migrant workers.
It says the post-arrival "healthy immigrant effect" is declining and recommends that doctors get their migrant patients to visit them more than once a year.
Specifically, certain immigrant groups suffer from higher incidences of some diseases compared with people born in Canada: Southeast Asians from stroke, Caribbeans from diabetes and all immigrant men from liver cancer.
Also, the report says many immigrants are susceptible to diseases that are often preventable through vaccines:
  • 30 to 50 per cent are susceptible to tetanus.
  • 32 to 54 per cent are susceptible to measles, mumps or rubella.
  • A significant number come from countries with chronic hepatitis B infections.
The guidelines recommend that:
  • All adults without immunization records be vaccinated against measles, mumps, rubella, diphtheria, whooping cough, tetanus and polio.
  • Adults and children from countries with chronic hepatitis B be screened and vaccinated.
  • Adolescents and adults from places where HIV is prevalent (i.e. greater than one per cent of the population) should be screened, with informed consent.
  • All immigrants greater than 35 years of age from areas of the world at high risk, which includes South Asia, Latin America and Africa, be screened for for Type 2 diabetes
  • All women of reproductive age and children aged one to four should be screened for iron-deficiency anemia.
  • All migrants should be checked for dental pain.

A time-saver for treatment

Pottie said the guidebook can be an effective tool for time-saving and inexpensive treatment. He cites the presence of intestinal parasites in some migrants. He said most doctors would probably find, on average, 12 parasites, and most doctors wouldn't know which ones to treat.
"We've discovered, through a detailed look at evidence, that virtually all these parasites will go away except for two: strongyloides and schistosoma, which are particular to Asia and Africa. So we're able to refine it to a simple blood test."
Dr. Meb Rashid runs a clinic inside a refugee centre in downtown Toronto, A family physician for 17 years, Rashid has worked mostly with refugees and immigrants for the past eight years. He applauds the guidebook, which will help doctors intervene faster when it comes to possible illnesses in their migrant patients.
"There are physicians in rural Canada who may be just starting to see some of these diseases, and I think these guidelines will be immensely helpful to those people," Rashid told CBC News. "It's well-organized and easy to reference."

Refugees at higher risk

The guidelines say it's important to distinguish whether a person came to Canada through voluntary or forced migration, as those who have been displaced against their will face the most significant health risks.
They say refugees have experienced "past exposure to harmful living conditions, violence and trauma," and note that many experience a rapid decline in health after arriving in Canada and need more care and attention to their medical needs.
New guidelines say it's important to find out whether a migrant to Canada has been forced to leave their homeland. Refugees suffer from more health problems.New guidelines say it's important to find out whether a migrant to Canada has been forced to leave their homeland. Refugees suffer from more health problems. (CBC) Refugees, of which Canada takes in 28,000 a year, are especially vulnerable to depression and other anxiety disorders, the guidelines say. The report recommends physicians use "culture brokers," and not anyone related to the refugee, to help with treatment and to monitor progress and address the social causes of the depression. It proposes "empathy, reassurance and advocacy" and cautions against pushing for "disclosure of traumatic events," which causes more harm than good.
The guidelines include a section on AIDS. It warns that while many HIV-positive migrants may already be aware of their status, they may not be knowledgeable about treatments.
The report warns that migrants may come from countries where there is a strong stigma against HIV-positive people. It counsels health professionals to inform patients of the "risks and benefits of treatment in a culturally and linguistically appropriate manner."

Tread carefully on condom issue: guidelines

On women's health, the guidelines say "culturally sensitive" contraceptive counselling should be offered to women who are or could be sexually active, and they should be given a choice as to what method they want to use. The guidebook underlines that condoms are often taboo in some cultures and seen as an indication of promiscuity, infidelity or having a sexually transmitted infection, so there needs to be careful explanation about their use.
As well, it says that females between ages nine and 26 years should be vaccinated against the human papillomavirus, or HPV.
Migrant and refugee women are also at greater of risk of violence from their husbands and complications connected to their pregnancies, including sexually transmitted infections, chronic pelvic infections, reproductive tract trauma and psychological trauma, the guide says.
It says doctors should be aware the women may be reluctant to talk about their health problems and also unaware of their rights and of the medical services available to them.

Canada's population growth slows

Pie chart of the area of provinces and territo...Image via Wikipedia
Canada's population rose slightly from the start of the year to April 1, with Alberta registering the fastest increase and Ontario reporting its slowest first-quarter growth in 15 years, according to Statistics Canada.
But while the national total hit 34,349,200, the growth in population was lower, at 70,800, than the increase of about 85,200 for the first quarter of 2010, the federal agency reported Wednesday.
The slowdown was mainly due to a decline in net migration — the difference between the number of arrivals and departures — in the first quarter of 2011, at 49,500 compared to 58,100 in the same period in 2010.
Jonathan Chagnon, a demographer with Statistics Canada and one of the authors of Wednesday's report, told CBC News that the country's population growth has been slowing the past few quarters, but warns that an accurate picture can only be reflected over the full year.
One factor that may be reflecting the first-quarter 2011 slowdown compared to the previous year's period is that from January to the end of March, 2010, Canada took in its highest number of immigrants in years. The 49,500 in this latest reporting period may just be a matter of the country moving to a more regular level, he added in an interview from Ottawa.
Alberta's population reached 3,758,200, an increase of about 15,500 compared to the year-earlier quarter, and the highest-quarter increase since 2006. But the province also had its lowest net migration, at 3,600, for a first quarter since 2004.
The only province in Atlantic Canada with a population increase was Prince Edward Island, by nearly 400 to 143,800. P.E.I. also welcomed the most immigrants (500), relative to its population, compared to the rest of Canada. Newfoundland and Labrador's population fell by 700 to 508,400 as of April 1, partly the result of 500 people moving to other provinces.
On April 1, Nova Scotia's population was estimated at 942,300, a drop of nearly 1,100 over Jan. 1, with about 1,000 people reportedly moving to other provinces.
New Brunswick’s population, estimated at 753,000, changed little in this year’s first quarter compared to the year-ago period.

Ontario's immigration levels dip

In Central Canada, Ontario had 28,400 new residents as of April 1, the lowest number since 1996, mainly because the province received only 20,100 immigrants, its lowest first-quarter level since 1998.
Part of the reason for Ontario's lower immigration levels may be that other provinces "are trying to attract more immigrants," Chagnon said.
Quebec’s population rose by 14,600 to 7,957,600, with only 900 people leaving to settle in other provinces, the lowest number since 2005.
Other first-quarter findings in other regions compared to the same year-ago period:
  • Manitoba: Population increased by just over 2,700 to 1,246,400. Reported it’s highest inflow of immigrants since 1972, at 2,800 people.
  • Saskatchewan: Population rose by about 1,900, to about 1,054,000.
  • British Columbia: Population rose by 9,200, to about 4,563,300, the slowest increase for a first quarter since 2005.
  • The three territories: Their population remained relatively unchanged. Yukon’s was estimated at 34,400, Northwest Territories at 43,500, Nunavut at 33,400.


Refugee claimants entering Quebec from U.S.

Royal Canadian Mounted PoliceImage by Robert of Fairfax via Flickr
A legal loophole has would-be refugees in the U.S. coming into Canada through the Quebec border, CBC News has learned.
"Sometimes we get half a dozen of them on a shift, and then you're a week without getting any, said RCMP Sgt. Christian Dubois. "And then, all of a sudden, 'boom.'"
Dubois said since the new RCMP border patrol started, more than half of their time is being spent on would-be refugees.
RCMP Insp. Marc Lacasse said there have been 64 arrests in just two months along the 140 kilometres of the Quebec-Vermont border, representing a 400 per cent increase over the same time period last year.
With immigration laws tightening in the U.S., increasing numbers of people have simply given up on ever getting permanent residency. Spot checks by American authorities have them worried about being caught and deported.
Lacasse believes that people are taking advantage of a loophole created by a document signed between Canada and the U.S. called the Canada-U.S. Safe Third Country Agreement.
Under the agreement, if a person that is already in the U.S. tries to move further north into Canada to claim refugee status, they will be turned back because both countries are considered safe. But the agreement only applies at organized crossings. Those determined to enter are now simply walking across through the bush.
"Our belief is there are organizations that are trying to use those areas to basically direct people to come over to Canada and gain refugee status," said Lacasse. "Contrary to a point of entry [where] they would be turned back."
Immigration lawyer David Cohen said that once a refugee gets away from an organized border crossing and enters Canada through the brush, Canada is obligated to process them.
"There's no surprise and in fact it was absolutely predictable … and was predicted," he said
"People avoid the Canadian port of entry and somehow make their way into Canada and make the refugee claim," Cohen said.
It's difficult to stop would-be refugees because there are more unprotected roads leading to the Quebec border than that of any other province.
Border services has also confirmed it will close or reduce hours for at least five entry points in Quebec alone, potentially increasing the number of unguarded roads.


Read more: http://www.cbc.ca/canada/story/2010/11/30/refugee-border-canada.html#ixzz17wOzV8ZH
 
 http://www.cbc.ca/video/player.html?category=News&zone=canada&site=cbc.news.ca&clipid=1675345025
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