Calgary doctors help refugees connect with key Canadian health services

A unique online tool designed by University of Calgary researchers is helping refugees in Canada connect with key health care and settlement supports.

The Canadian Refugee Healthcare System Atlas provides information and links for 146 organizations across the country, including primary care clinics treating refugees, public health clinics and settlement services.

The Atlas, which is free and presents the information on a searchable map, is offered in a number of  languages, including English, French, Dari, Ukrainian and Arabic, with plans to include more.

"We took that information, put it on a map and made it available so people could search, by name or city, and find the resources in their city," said Dr. Gabriel Fabreau, project co-lead and an associate professor at the University of Calgary's O'Brien Institute for Public Health.

The idea came to Fabreau and his colleague, Dr. Annalee Coakley, as they worked in Calgary's refugee clinic and scrambled to deal with a rapid influx of Syrian refugees, which began in 2015.

"It became clear that no one really had a playbook, and the health system for Canada had not really been written down anywhere, despite having a 70-year history in Canada in being a global leader in refugee resettlement," said Fabreau.

The Atlas is designed to assist refugees, and those who help settle them, navigate a complex system involving different levels of government, agencies and health providers, and aims to fill some key gaps.

"It's incredibly difficult for our patients to navigate," said Coakley, co-director of Refugee Health YYC at the University of Calgary, noting the federal government handles immigration while health care falls under provincial jurisdiction.

"There is a lack of co-ordination between those two levels of government."

The doctors saw a need to compile accessible information in one place.

"We [were] trying to find a better way to integrate those things," added Fabreau.

The third iteration of the Atlas, which has grown in scope, launched in April. Coakley said she's already seeing the impact.

It's empowering refugees to find the specialized care they need, she said, and improving the transition of care.

"What the Atlas now allows [Immigration Refugees and Citizenship Canada] to do is to be able to reach out to the refugee heath providers in the destination city, to help them prepare for a medically complex new arrival."

Patient impact

Coakley recently treated two patients, in kidney failure, who required dialysis. The federal government worker was able to connect with the refugee clinic ahead of time so preparations could be made for their treatment. 

According to Coakley, this wasn't happening before.

In the past, she said, medically fragile refugees would often show up in the ER needing intense medical attention, and staff would have no prior notification.

"This map allows that co-ordinator to get a bird's-eye view of resources across the country," she said.

"That not only helps the patient themselves, but it also helps the system overall because you don't have somebody waiting in an emergency room. Things are planned and thought through and then they receive the necessary care. So it's efficient. It's cost saving. It's good health care for the patient."

Coakley said it also helps in cases of secondary migration, allowing health-care providers in one Canadian city connect refugees with the appropriate care in another city.

The Atlas also compiles detailed information, gathered from the organizations, including the types of care offered, patient populations served, and the health-care workforce.

Interactive migration data, including the type of refugee and displaced populations — such as asylum claimants, private and government sponsored refugees, and evacuees —  is also included to help providers and policymakers understand the trends and demand for services and plan for future surges.

The doctors presented their work to the World Health Organization in the fall.

They've since received more funding, allowing them to revamp the site.

According to Fabreau, they're now collaborating with the WHO and the UN Refugee Agency and hoping to expand the Atlas to become an international tool.

"That's the most exciting thing.… Finding out this Canadian-made innovation has the potential to help other people across the world."

"It's been 12 years in a row that [forced migration] has been growing. It's a global issue. No single country can do it on its own."