Services for Ukrainian refugees need urgent upgrade, doctors state in journal article

Article co-authored by Dr. Christina Greenaway, JGH expert on migrant health

The recent arrival of Ukrainian refugees in Canada has further underlined the urgent need for improvements to health care and social services for those fleeing traumatic situations, says a new analysis co-authored by Dr. Christina Greenaway, an expert on migrant health at the JGH and McGill University.

Since these refugees face socio-economic stresses and barriers to services so soon after they arrive, they are “more likely to transition to poor health than other immigrants,” says the article in the CMAJ (Canadian Medical Association Journal).

However, these negative factors “can be mitigated by supportive resettlement services,” writes Dr. Greenaway, an infectious diseases physician and researcher at the Centre for Clinical Epidemiology in the Lady Davis Institute at the JGH.

She and her co-authors are recommending stronger partnerships among policy-makers, healthcare administrators, practitioners and communities “to protect refugees and other migrants, promote their self-reliance and health, and build responsive health systems in host communities.”

The co-authors say they are aware the public healthcare system is straining under the burden of waves of refugees from Ukraine and Afghanistan, as well as the COVID-19 pandemic.

Therefore, they conclude, there is a strong need for “creative solutions” based on “an examination of current refugee health practices and programs.”

The article notes that among Ukrainian refugees, in particular:

• There is a high prevalence of chronic diseases, such as cardiovascular disease and diabetes.
• Tobacco use is common.
• Rates of mental illness are high. Even before the current conflict, it was estimated that about 33 per cent of Ukraine’s population had experienced mental illness.
• The risk of vaccine-preventable diseases, such as measles, polio and COVID-19, may be elevated due to a lack of access to vaccines in Ukraine and because of vaccine hesitancy.
• Rates of tuberculosis, viral hepatitis and HIV may be elevated, particularly in certain risk groups.

The Government of Canada has provided shelter for Ukrainians as part of a novel, three-year temporary visa program, known as the Canada-Ukraine Authorization for Emergency Travel. More than 112,000 people may eventually be accepted.

Unlike traditional refugee programs, this one can make shelter available more quickly and facilitate the rapid integration of newcomers into employment and education. However, some Ukrainian migrants could still be vulnerable because of limited settlement services and medical support.

Although Ukrainians who flee the war will be entitled to provincial health coverage during the three-year period, coverage varies across Canada. This will make it necessary for practitioners to determine whether the full range of services, including medication, is covered.