Come next week, Hodan Ali will be left with no choice but to turn patients away at her Hughson Street South medical clinic.
Ali is a registered nurse and opened the Hamilton Centre for Newcomer Health in November 2011. She treats many refugees and because of a new policy, she will no longer be able to help with their medical needs.
“It puts health care providers in a really unethical position,” Ali said.
As of June 30, the Canadian government is suspending funding that covers health care for refugees.
There are two groups affected by the cuts. One group is government sponsored refugees, who are funded, but not for dental, vision and prescription drug coverage.
Then, there are refugees who are not government sponsored and will be cut off entirely. The only ailments that will continue to be covered are those that pose a public health risk like tuberculosis.
“Without medicine and access to a hospital, some of them could be dead within weeks,” said Dr. Tim O'Shea, faculty at McMaster's school of medicine. “That's our ultimate fear. It's not hard to imagine people dying from this.”
While this new policy will affect refugees all across Canada, Hamilton will surely feel the impact. Many refugees settle here because of the low cost of living, Ali said.
At the newcomer's clinic, about 700 patients have come in since they opened in late 2011. About 40-50 patients come in weekly, and that's just her clinic.
Refugee patients O'Shea has seen “can't understand why this change is happening. A lot of them have been through so much, and they see this as another terrible thing,” he said.
Refugees have an increased need for health care because of conditions in their home countries, Ali said.
“They have fled war zones,” Ali said. “Children have suffered from malnutrition, there are tropical medicine issues, parasites, infections, people who have never been medically screened before.”
Ali emphasizes the need for mental health care is huge. Refugees who left war-torn countries have witnessed killings and some problems simply can't be dealt with yet.
“Refugees are patients who have been through horrific experiences and psychological traumas they can't even address right now,” O'Shea said.
These services as well as basic preventative health care, like regular check-ups or an antibiotics prescription for a sore throat, will be denied for refugees.
“They are going to end up in the [emergency room] if there is no prevention,” Ali said, adding this is not cost-effective for the government.
O'Shea said doctors like himself have been prescribing medication now for the next few weeks.
After that the patients won't likely be able to pay for it. Heath care costs are “astronomical,” Ali said, and refugees don't have status to work in Canada.
July 2 will be Ali's first day operating her clinic after the policy change. She said her front-line employees will have the most difficult time - they are the ones who have to tell patients they no longer can be treated. But, she can feel it, too. Her family fled Somalia for Canada in 1991 during the civil war.
“Being someone who came here as a refugee, I became a nurse to help people,” she said. “We all are heart-sick.”
Ali said she plans to document how many patients she's turning away and hope that might awaken the policymakers, she said.
“We understand the government has made up their mind,” Ali said. “Now, we're just looking for some leniency and compassion.”