Blog #4: The Lost Little Puzzle Piece

Imagine this; a small group of 10-15 people from different ethnic minorities cramped in a room with a built in kitchen. These people are cooking together, sharing their food, and learning how to make foods from the Canadian cuisine. Yet, half of these people are not fluent in English and cannot communicate their ideas in a clear manner. This is my perception of a community kitchen. So if someone asked me if I were to provide funding or donations to the establishment of such a place, I would out rightly say “No!”.

You may wonder why I hold such cynical views about a community effort that is clearly working towards creating a more accepting environment for newly immigrated individuals in which they can feel empowered and socially supported. These efforts are honorably trying to target the determinant of health of “Social Environments” which has a huge role in allowing new immigrants to become integrated into the Canadian culture and be able to navigate through the health care system in a well manner. Hence, as a future health practitioner, I should be warmer to the idea of community health kitchens.

However, I am not saying that they should not exist; I just do not “believe” in them per se. As an immigrant myself, I initially felt that holding on to my culture from back home assisted me in having a gradual transition into the Canadian society.  Although this transition was slow, I was content with the fact that I had held on to certain parts of my ethnic norms for some time before trading them in for Canadian ones. One of the major components of this ethnicity was food. Food tied me and my family to our country of origin and all of our memories from it. Yes, we were ecstatic that we were in Canada and  part of a much safer and developed society, but the main reason we came here was due to the acceptance of multiculturism in Canada, not for assimilation into unfamiliar cultures and their ethnicities.

Perhaps my reasons for being skeptical about the effectiveness of such programs is due to the fact that we as Canadians are still struggling to combat health disparities, poverty, and the problem of accessibility to healthcare resources. Hence it just makes more sense to me that funding goes into health promotion and public health programs which are more needed. Then again, need depends on the individual. Maybe some people enjoy such programs and find that it helps them integrate and adjust into the Canadian society more efficiently. Yes, this may be true, but are these small scale community kitchens ensuring that their participants are having adequate access to ingredients? Do they even having the means to purchase food? What about language skills which will improve their access to all services in general? One of the participant who shared his ethnic cuisine with the group, required the help of a family member just to communicate a preference of food. This made me think, would it not be better to fund large scale programs that are targeted to the overall improvement of immigrants adjustment into the society? Such programs could include kitchens like these but also provide people with workshops that helps improve their overall lifestyle (i.e. helping them overcome language barriers).

I do understand that every step towards better health counts but I still stand by my point that if funding must be provided to community health programs, it should be reserved for those which are multifunctional, because frankly, community kitchens alone seem like a sad missing puzzle piece which a kid had thrown under the sofa.

Hunting for Treasure

Last month, a conversation with a friend revealed that she was experiencing mental trauma. My first instinct was to advise her to pay a visit to her doctor’s office and explain the condition which had clearly started to affect her physical health. My fellow Nutrition students would know that this recommendation was based on 3 years of studying the professional practice of health sciences. Our professor have relentlessly placed great emphasis on the responsibility that the health practitioners hold (or should hold) to redirect their patients into the right direction in order to seek the appropriate health services.

My friend (let’s call her X), followed my advice and told me that her doctor (who is of similar culture and religion as X) referred her to the Shaw Clinic at York Central hospital, which specializes in psychiatric treatment. That was all fine and dandy, right up until her doctor told her that the referral entitled her to seek help for “anxiety and depression”. Unfortunately, that was not what my friend was looking for. She needed specialized counseling over issues that had little to do with anxiety or depression. However, according to her doctor, those issues weren't being covered by the Shaw clinic. Hence, X was disappointed because despite mustering up the courage to communicate her issues with a complete stranger (even if it was her family doctor), the appropriate help seemed unattainable. Yet, the disappointment did not end here, the doctor also told her that this referral was adequate enough for only one visit. After her initial visit, the health practitioners at the clinic would charge a fee per any additional sessions.

Fortunately, the doctor sensed X’s disappointment and asked her if she knew about the division of her local mosque which specializes in providing counseling for people dealing with similar issues.  X told me that this information helped her relax but she still remained skeptical in regards to this “division’s” existence and credibility. So she asked me if I had known about this facility in our local mosque.

I did not.

So why didn’t I? I had been to that mosque countless times. The health care freak within me would have spotted the marketing campaign for such facilities from a mile away! Was it even “advertised”? Community health centers such as the ones located within this massive mosque are clearly a great way to cater in religiously/culturally-sensitive care. People from the community have quick and easy access to it and they can explore solutions to problems which health practitioners of other backgrounds may not be able to understand. With such an immense amount of funding, donations, time, volunteer-ism, and knowledge of experts going into these sorts of establishments, it is only reasonable that its existence should be made known on a substantial scale. Perhaps there has been a shift from the lack of accessibility of such resources to the lack of promotion of the available resources.

Thousands of immigrants and refugees from varying origins are pouring into Canada every year. As human beings, we share similar mental and physiological health issues, however the ways to deal with them must be tailored to our diverse needs. Community health centers are an amazing phenomenon which can provide such immigrants with a greater fit of health care.  However, searching for them shouldn’t turn into a treasure hunt for people who may already be having troubles accessing the basic resources.  The facet of publicity that lies within the notion of accessibility must not be ignored.

The Burst Bubble

Upon landing in Canada we thought; “Life has never been better!”. Who would have thought that education could be free? Back home even going to kindergarten cost an arm and a leg! What about healthcare, you ask? If you were lucky enough to find a Doctor for your kidney transplant, his fee to perform the surgery would be enough to cover the purchase of a third kidney for spare use! So how could we “pay” for a blood test here just by a simple swipe of a plastic card? It all seemed absurd yet amazing at the same time.

Of course, at the time, I was young and did not understand the tax system, however, when I did grow up, the small percentage I paid on top  of my purchases seemed like a minor price to pay for all the resources to which we had a freedom of access. Yet, I also started noticing people complaining about high taxes not measuring up to these promised resources.. Obviously, upon hearing these statements such as; “I waited with high fever in the emergency room for three hours!”, the patriot in me was confused as to why people negated the advantages of the system and voiced their opinions so loudly on its shortcomings.

Then, a time came when loved one of mine needed prompt medical help. We automatically relied on the healthcare system to guide us to the best specialist. However when the family doctor told us that the earliest appointment available was 2 months later, we were literally in a state of shock. Needless to say, the family member traveled back to my home country on an urgent basis and obtained the medical help he needed. The cost of a 22 hours flight and medical fees accumulated to an amount which would have been better spent in obtaining private health care in Canada. The problem was that there was no such thing available.

I regularly see more and more people migrating back to their countries to acquire timely health care access. In my opinion, the problem does not lie in gaining access to the primary level of health care. We have sources such as family doctors, walk-in clinics, TeleHealth, all of which are strong channels which can provide us with the proper means to attain specialized help (if needed). However, the number of specialized clinicians in Canada is not growing as fast as the expansion of the Canadian population. From personal experience, most of the students of Life Sciences who aspire to enter into Medical School show great pessimism towards practice in Canada. Many of them migrate to the United States in order to successfully obtain the rights to practice. The health practitioners which are immigrating into Canada face the challenge of not having proper medical education that is up to the Canadian standards. Many of them falter under the stress of countless obstacles and re-evaluation procedures that they either change professions or settle for jobs which are a waste of their specialization.

Health care reform is an idea that is worth commending. However, some of the problems with the “status quo” are related to lack of accessibility. Hence, if health care reform is placing an emphasis on cohesion with “other levels of care” (i.e. hospitals and specialist care), the need for expansion of these services is also mandatory. We health practitioners need to keep up with the ever-growing population of Canada and its needs. International practitioners should also be encouraged and given the chance to practice. These small steps would bring us from treading on the path of mere hope, to change.