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Médecins du Monde
Migrants with precarious status:
challenges accessing health and social services
MÉDECINS DU MONDE
• Mission: Offer and promote access to healthcare for
vulnerable and excluded people, here and elsewhere...
MÉDECINS DU MONDE
• Our approach:
– Meet people in their own environment
– Most vulnerable of the vulnerable
– Basic quali...
MÉDECINS DU MONDE
• Our projects in Montreal:
– Psychological support for community workers
– Mobile clinic
– Clinic for m...
MÉDECINS DU MONDE
• Medical clinic for migrants with precarious status
without medical coverage :
– Why? Immigration statu...
MÉDECINS DU MONDE
• Some tables and figures
1
YEAR N of
appointements
N of people N seen by
doctors
N seen by
nurses
2013-...
MÉDECINS DU MONDE
• Some tables and figures from 2015-2016
1
SEX %
Women 74
Man 26
AGE %
14 and - 3
15-18 1
19-25 7
26-30 ...
MÉDECINS DU MONDE
• Some tables and figures from 2015-2016
1
IMMIGRATION STATUS %
Canadian citizen or permanent resident 3...
MÉDECINS DU MONDE
• Some tables and figures from 2015-2016
1
CONSULTATIONS MOTIVES N
Pregnancy 255
Osteo-articular 121
Car...
MÉDECINS DU MONDE
• Other numbers from 2015-2016
– Total number of people who have benefitted from the clinic: 3290
– Tota...
The Challenges
2
• When we opened the clinic
– How to find migrants with precarious statuses in Montréal?
– How are they g...
More challenges…
2
• Ethics: can we give partial care?
– Pregnant women
– Children
– People who need investigations/surger...
And more challenges…
2
• Elaborate partnerships
– Laboratories
– Imaging centers
– Other clinics
– Hospitals
– Specialists...
All this without recognization
2
• The population with whom we work don’t exist…
• If your situation isn’t recognized, you...
REEMA
2
• 28-year-old woman from North Africa
• Sponsored by her husband who has is a permanent resident
in Canada, curren...
AMANTINE
Amantine is 65 years old. Born in St-Vincent, she has been
living in Montreal for the past 25 years. At the time,...
SOCIAL BARRIERS
• No or difficult access to social benefits and public services
– Social welfare
– Child care benefits
– C...
JOSÉ
José is 37 years old. Born in Columbia, he has been living
in Montreal for the past 10 years. After his refugee claim...
OUR LIMITS
• Volunteer doctors
• Limited staff
• Complex medical situations needing medical equipement
for appropriate dia...
CONCLUSION
5
• Complex
• Multidisciplinary team
• Advocacy efforts
Questions ?
5
Migrants with precarious status: challenges accessing health and social services
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Migrants with precarious status: challenges accessing health and social services

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A presentation designed by Pénélope Boudreault for the 19th National Metropolis Conference held in Montreal from March 16 to March 18, 2017.

Publié dans : Santé & Médecine
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Migrants with precarious status: challenges accessing health and social services

  1. 1. Médecins du Monde Migrants with precarious status: challenges accessing health and social services
  2. 2. MÉDECINS DU MONDE • Mission: Offer and promote access to healthcare for vulnerable and excluded people, here and elsewhere. • Vision: A world where health is recognized as a real human right. • 14 delegation around the world: in Canada since 1999. 1
  3. 3. MÉDECINS DU MONDE • Our approach: – Meet people in their own environment – Most vulnerable of the vulnerable – Basic quality health services within a context of limited resources – Complementary to the public healthcare system – Understanding root causes of precarious situations – Advocacy 1
  4. 4. MÉDECINS DU MONDE • Our projects in Montreal: – Psychological support for community workers – Mobile clinic – Clinic for migrants with precarious status 1
  5. 5. MÉDECINS DU MONDE • Medical clinic for migrants with precarious status without medical coverage : – Why? Immigration status must not be an obstacle to access health care. – For whom? Women, men and children (0-12) who have an immigration background and do not have access to medical coverage. – How and by whom? – 2 clinics without appointment/week – 2 to 3 clinics with appointment/week – Professionals involved: nurses, social workers, volunteer doctors and psychologists – Partnerships – Outreach 1
  6. 6. MÉDECINS DU MONDE • Some tables and figures 1 YEAR N of appointements N of people N seen by doctors N seen by nurses 2013-2014 665 537 451 372 2014-2015 865 681 528 509 2015-2016 1002 795 639 555
  7. 7. MÉDECINS DU MONDE • Some tables and figures from 2015-2016 1 SEX % Women 74 Man 26 AGE % 14 and - 3 15-18 1 19-25 7 26-30 19 31-40 31 41-50 13 51-64 18 65 and + 9
  8. 8. MÉDECINS DU MONDE • Some tables and figures from 2015-2016 1 IMMIGRATION STATUS % Canadian citizen or permanent resident 3 Temporary residency visa 45 Particular situations giving a right to stay 15 Refugee claimants 1 Non status 36 Doesn’t know 0,6
  9. 9. MÉDECINS DU MONDE • Some tables and figures from 2015-2016 1 CONSULTATIONS MOTIVES N Pregnancy 255 Osteo-articular 121 Cardiovascular 118 Eyes 102 STBI 91 Digestive system 84 Metabolic, nutritional or endocrine 76 Mental health 38 General health 34 Neurology 34 Respiratory 29 Vaccination for VHA and VHB 24 Blood, system haematological/ immunological 22
  10. 10. MÉDECINS DU MONDE • Other numbers from 2015-2016 – Total number of people who have benefitted from the clinic: 3290 – Total number of people met at the clinic: 393 – Total number of nurses follow-ups: 1875 – Total number of STBI screening: 409 – Total number of people who received social support: 403 – Total number of hours given by the psychologist intern: 104 – Total number of people reached through our outreach program: 2216 1
  11. 11. The Challenges 2 • When we opened the clinic – How to find migrants with precarious statuses in Montréal? – How are they going to find us? – How to promote our services? – Are authorities a risk for our patients? • Now: – MdM specialities: front line health care services – But how to deal with chronic deseases? – Access to labs/special exams/speciality care
  12. 12. More challenges… 2 • Ethics: can we give partial care? – Pregnant women – Children – People who need investigations/surgeries – People with cancer/chronic deseases – Need of expensive treatments • Medication: – We can prescribe, but they canno’t afford it – They take half the prescription/one day out of two/stop when they have no more money/etc.
  13. 13. And more challenges… 2 • Elaborate partnerships – Laboratories – Imaging centers – Other clinics – Hospitals – Specialists (physio./ostéo./psychiatry, …) • Work with volunteers – Doctors – Nurses – Social workers – Students – Population
  14. 14. All this without recognization 2 • The population with whom we work don’t exist… • If your situation isn’t recognized, you have no services and there is no money for appropriate services… • THAT IS Médecins du Monde’s reality!!! – We have to knock on foundations doors – Our founding is not recurent – We depend on donations and voluntary work – Rigth now, we have to cut services…and staff…
  15. 15. REEMA 2 • 28-year-old woman from North Africa • Sponsored by her husband who has is a permanent resident in Canada, currently awaiting approval of the sponsorship claim. • Arrived here 4 months ago with a visitor visa. • No RAMQ, very few financial means • 3 months pregnant – Presents to ER for severe symptoms related to pregnancy – Needs pregnancy follow-up
  16. 16. AMANTINE Amantine is 65 years old. Born in St-Vincent, she has been living in Montreal for the past 25 years. At the time, she had come at the border as a tourist. No immigration process was ever started. She has been living in the same appartment for 20 years and working as a housekeeper. She makes approximately 600$ per month. She has a 14 year old daughter who was born in Canada. Amantine raised her daughter as a single mother. She comes to Médecins du Monde because she has been feeling dizzy and having very intense headaches. – No access to medical coverage – No access to social benefits or public services – No access to medical coverage for her daughter – Difficult access to community services (food banks, etc.) 4
  17. 17. SOCIAL BARRIERS • No or difficult access to social benefits and public services – Social welfare – Child care benefits – CSST – RAMQ: care and medication – ETC. • Difficult access to community services – Food banks – French or English classes – Help with employement search – ETC. • Governemental subsidized daycare: depends on the parent’s immigration status • Right to work: depends on your immigration status • Regularisation of immigration situation: $$$ 4
  18. 18. JOSÉ José is 37 years old. Born in Columbia, he has been living in Montreal for the past 10 years. After his refugee claim was refused, he decided not to leave the country because he considered that going back to Columbia was worse than staying underground in Canada. Since then, José has been working in a factory. Paid 6$ per hour, he can sometimes work for 30 hours straight. In the past few months, José has been feeling extremly tired and unwell. Unable to identify the problem, he decides to come at Médecins du Monde where he meets a volunteer doctor and a nurse. After a STBI screening test, he is diagnosted as HIV +. – Limits of Médecins du Monde 4
  19. 19. OUR LIMITS • Volunteer doctors • Limited staff • Complex medical situations needing medical equipement for appropriate diagnosis that we do not have • Very serious medical situations needing very expensive medication or interventions (EX: HIV, HVC, cancer, etc.) • Little support from general population • No governmental funding for the clinic 4
  20. 20. CONCLUSION 5 • Complex • Multidisciplinary team • Advocacy efforts
  21. 21. Questions ? 5

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