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Crossroads Clinic: Supporting refugee women in accessing healthcare

March 4, 2019

By Dr. Meb Rashid

Dr. Meb Rashid
Dr. Meb Rashid

In 2011, the Crossroads Clinic was founded at Women’s College Hospital to provide healthcare to newly arrived refugees in Toronto. The goal was to connect refugees to primary healthcare early in their migration trajectory to ensure that their health concerns were met and they could connect to the Canadian healthcare system.

Many of our patients have endured horrific journeys—and during these journeys, gender matters. Gender matters pre-migration, when women often do not have access to education and the labour force in the same way that men do. Many also do not have access to primary healthcare in their country of origin. Gender matters post-migration, when the burden of child-rearing often falls disproportionally upon women, thus making it more difficult for them to access English language classes and employment. And gender matters because, unfortunately too often, women have been exposed to intimate partner violence, incarceration and sexual assault.

Despite enduring such horrific trauma, so many of the women we see arrive with a tremendous sense of optimism and a desire to rebuild their lives. They are intent on overcoming their trauma and moving forward. Yet these challenges can be overwhelming. Some women have limited English proficiency and others struggle with the myriad of tasks that have to be undertaken upon arrival—finding a home, learning to navigate transit, preparing for winter, among many others. Some women are separated from their partners or children and struggle with social isolation. Almost universally, the women we see are living in poverty. Many have to wait between one to two years for their refugee hearing, not knowing what the future will hold. And, of course, the degradation of trauma is never far away—manifesting in nightmares, anxiety and depression. 

As such, we have come to realize the importance of cultivating a safe and secure environment for our patients. We recognize that many women, at least initially, will struggle with putting their lives back together. Many will not be at their best. Any missed appointments or unfilled prescriptions are interpreted in this light. Affirming a woman’s skills and capacities helps to rebuild their sense of self at a time where, even for the most educated and successful, their skills may not be acknowledged in Canada. Creating a safe environment helps to make a space where women feel comfortable raising their health issues.

Despite the obstacles that challenge refugee women—the terror and degradation they face pre-arrival, and the poverty and stigmatization they now endure on arrival—our patients show a remarkable ability to not only survive, but to thrive in Canada. Research shows that, if followed long enough, refugees actually do very well in Canada. This is echoed in our experience at the Crossroads Clinic. Women often struggle upon arrival, but each one, even among the most traumatized, tends to move forward and put her life back to together. It is a testimony to human resilience. At the Crossroads Clinic, we feel privileged to be able to share, in some small way, in this incredibly journey of so many immensely resourceful women.

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