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Physician Advocates Supporting Refugee Healthcare Headshot

If Doctors Don't Speak Up For Refugees' Health, Who Will?

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In a time of government austerity and popular opposition, we have grown accustomed to the sight of people taking to the streets. But physicians demonstrating en masse? Now that's not something you see every day! The action began on May 11, and it hasn't stopped yet.

That day, 90 physicians occupied the office of Conservative MP Joe Oliver in Toronto in response to proposed cuts to healthcare for refugees, and were joined by others taking action across the country.

These cuts to the Interim Federal Health Program (IFHP), will deny access to essential medicines for all refugees, and almost all healthcare for many. This means that diabetics will no longer receive insulin, while others will go without blood pressure medications. Those deemed to be from so-called "safe countries" will be denied care even in life-threatening situations such as heart attacks or suicide attempts. These cuts will lead to increased suffering, and possibly even death, for a population that is already vulnerable.

Physicians are often insulated from the hardships that patients face, with comfortable incomes and usually secure immigration status. At the same time, doctors witness the impact of bad public policy on the health of individual patients and their families. Over the past month, physicians have responded to these unjust cuts by penning op-eds and letters to newspapers, speaking to colleagues, contacting politicians, issuing a joint statement, together with multiple national professional health organizations, and a National Day of Action on June 18, all to demand the IFHP cuts be rescinded.

With these actions, physicians are following a long tradition of speaking up. Rudolph Virchow, a 19th century German physician, offered the wise words, "Physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction." Social determinants, like poverty and access to housing, effect a patient's health, and are themselves determined by the politics of the day. Medicine cannot be divorced from politics, and it is therefore our duty to advocate for the health of our patients, joining our voices to those from affected communities who have been fighting for justice for years.

The role of the physician as a health advocate has been recognized by the professional organizations charged with educating our future doctors, and internationally, schools such as the Latin American School of Medicine instill a core belief in social justice in their students. Just as responsible lawyers don't just practice within the confines of existing laws, instead choosing to challenge those that are unconstitutional or unjust, the physician's responsibility does not start and end inside the clinic walls.

On a day-to-day basis, advocacy may manifest as a phone call to a colleague to review a challenging health concern or it may mean tracking down a tardy pathology report. But sometimes, we recognize that to best serve our patient's health and well being, we must step outside the clinic walls and address the root causes of ill health. This can mean writing a letter, joining with others to engage in public protest or demonstrating alternatives to the status quo, often stepping outside our comfort zones.

Of course, not everyone believes physicians should venture outside of the hospital. Rob Ford, mayor of Toronto, famously said that "a doctor is there to be a doctor, not to advocate for the poor," and Jason Kenney, the Minister responsible for these cuts to refugee health services, accuses physicians of "grandstanding." Clearly, we have his attention. Physicians should take these attacks seriously. We need to show that it is indeed our professional duty to be advocates for marginalized communities and to call for justice alongside those directly affected by these cuts.

When physicians, health workers and community members take a stand on June 18, a National Day of Action, we stand in solidarity with those affected and fighting for the right to health for all refugees and refugee claimants. This is not and never has been about "political grandstanding." This is about some of the most vulnerable people in our society becoming even more so. We call on all health providers and community members to join us on June 18 to demand that our government prioritize the health and wellbeing of all people living in Canada, regardless of immigration status or country of origin, and to rescind these cuts to refugee healthcare.

Ritika Goel is a family physician and public health professional in Toronto.
Danyaal Raza is a family physician and Fellow in Global Health & Vulnerable Populations at the University of Toronto.
Michaela Beder is a fourth year Psychiatry resident with the University of Toronto.
Andrew Pinto is a family physician and Public Health and Preventive Medicine specialist in Toronto.