The language barrier can cause a lot of problems when it comes to refugees getting health care, but there are other obstacles as well.
Mei-Ling Wiedmeyer, a family physician who grew up in Columbia, but now works with refugees in Vancouver, Canada and is on the faculty of the North American Refugee Health Conference. She spoke with Health and Wealth about the other barriers to care, and how communities can get around them.
Could you talk about what some of those barriers typically are to accessing healthcare for new arrivals?
Just coming to a new place, and having to interact with a completely new system, but not necessarily having anyone there to guide you through the different steps in terms of what it takes to access a new system. So many people have come from places where they didn’t have to have insurance to access the healthcare system – they may have paid out of pocket and just went to the doctor when they needed to, or they may have had other types of systems that they used to access healthcare, or they may have been living in a refugee camp where there were just some clinics but they didn’t have regular healthcare access. So when they arrive here it can be very confusing to understand what insurance is and how to use it in order to access healthcare and how you can only use it in some places and not others. That can be really confusing.
When you have a new refugee or a new immigrant community, what are the critical pieces of building up an infrastructure to accommodate them, and make sure they can access healthcare?
So that has happened to us with a variety of different communities in the past, because as you can imagine, who arrives as refugees is determined at all these different geopolitical levels, so you can have these situations where suddenly you get a small group of people coming from a place where you may not have people locally that speak that language. So sometimes what we do is start out by using phone interpretation, so there’s lots of phone interpretation services that have an enormous span of languages because they can network people from all over the place. So that’s a start, and then starting to build relationships with the community as they start to get settled. Sometimes, trying to identify often younger people who have good capacity in English or just seem to be catching on very quickly, to help train them to learn some of these initial pieces, they end up kind of being the helpers. So, there’s that piece of it and then really enlisting all of the community agencies and other organizations that provide adjacent kind of support, so housing, access to food, access to social services and really trying to educate them on the refugee process, who this group of refugees is, what kind of situation they’re coming for and trying to problem-solve for the kinds of issues they might face and trying to be a little bit proactive in terms of how you can mediate between the people who have arrived and the people who are already here working and are used to working with people in one setting, to help them shift their mindset a little bit, to help accommodate some of the special needs of the people who are just arriving. I think there's some really incredible potential for small communities especially, when they really embrace a new group of people. Sometimes there have been really great small initiatives that have built up in small communities that have just really rallied around their new arrivals. So when that happens I think that can be really meaningful both for people who are coming as refugees and for their host communities.