Western professor creates guide to help practitioners provide better care for refugees and migrants

Western professor Dr. Kevin Pottie co-authored a curriculum framework that aims to help create socially accountable and prepared healthcare practitioners.  

"The world is getting smaller. Global migration will only continue to increase. And so our practitioners need to be ready for this," said Pottie.

He said medical schools need to be more effective at producing future clinicians who can handle people from around the world.

Pottie worked with Douglas Gruner, a professor at the University of Ottawa, and other researchers to create a curriculum guide for treating refugees and migrants that can be implemented in medical schools, nursing and pharmacy programs.

Canada has resettled 16,000 Afghan refugees fleeing the Taliban, and plans to bring in a total of 40,000 Afghans. The federal government has also planned to take in an unlimited number of Ukrainians fleeing from the war. 

Trauma and violence informed care 

The guide suggests a trauma and violence informed care approach to treating refugees. 

 "So when we approach people, we try not to trigger their past trauma and if we don't trigger it and we make someone feel safe, a lot of those trauma memories are not necessarily a problem. Sometimes people just move forward," he said. 

He said if the trauma would have be brought up again it would be in the context of special therapy. 

Screening for diseases

Students would also learn evidence-based guidelines for treating refugees, such as screening for rare tropical diseases. 

Pottie said that the guidelines have been eliminating a lot of rare diseases practitioners used to worry about, because through research it's been shown that most of the diseases will not necessarily travel with the person who is migrating. He said a lot of those diseases are related to living conditions, which, if improved, may not be an issue in the new country. 

Behind the framework is the idea that people can get the care they need, Pottie said. 

"We're actually looking at people that have had difficult circumstances that might have had to forcibly travel," he said. 

"But these are actually human beings first. And these human beings want to contribute. So we just want to make sure that they stay healthy so they can contribute." 

Language barriers

Carly MacArthur, the communication officer for the London & Middlesex Local Immigration Partnership (LMLIP) said the curriculum framework is important. 

"It's very great work, and it's absolutely needed," she said.

The LMLIP works to help to connect immigrants with the services they need. Their own research found that language barriers pose a challenge for newcomers, which could be mitigated by access to healthcare interpreters. 

She said a lot of medical terms are difficult to understand even for people who speak English as a first language. 

"There's often difficulty communicating the healthcare concerns they're [immigrants are] having and understanding the recommendations or tests that are needed from the doctors end," she said.

McArthur said this can lead to challenges in the quality of care patients receive. She said an immigrant may bring another person with them to help discuss their healthcare concerns, and if their concerns are more personal in nature, it may lead to problems such as not wanting to fully disclose their issues. 

Pottie, the co-author of the curriculum framework, also said the framework aims to make it clear that working with interpreters is a skill, and if practitioners do it properly they will be much more efficient. 

He hopes that the framework will be implemented in all medical school curricula, and internationally in practitioner training programs.