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Children who are refugees and who live with disabilities are among the most at-risk groups for marginalization due to compounded disadvantages from the intersection of risk factors such as refugee status and disability status. Despite their high risk, there is no systematic data collected on this group and scant literature on the topic contributing to a feeling of invisibility. The purpose of this study is to better understand the experiences of Syrian refugee families with children living with disabilities.

The authors conducted a narrative inquiry into the experiences of two Syrian refugee families with children living with disabilities. Narrative inquiry is a way to understand experience as a storied phenomenon.

In attending to the families’ stories of their experiences across time, place and social contexts, two narrative threads resonated across their experiences including waiting and a struggle for agency as well as disruption and continuity.

Narrative inquiry does not produce generalizable results but, rather, gives insight into the unique experiences of individuals.

To understand the complexities of the experience of a refugee family with a child living with disabilities, attending to their lived and told stories is essential.

Based on a case study in Hamilton, Ontario, Canada, the purpose of this paper is to explore the difficulties faced by local health care providers in the face of constantly evolving refugee policies, programs, and arrivals. In doing so, it illustrates the complications faced by service providers in providing care to refugee arrivals and how the diversity of arrivals challenges health care provision and ultimately the health and well-being of refugees.

A series of semi-structured, in-depth interviews with key service professionals in both the social service and health fields in Hamilton, Ontario, Canada, examined both health and health care issues.

Beyond challenges for service providers that have been previously flagged in the literature, including language barriers and the limited time that they have with their clients, analysis revealed that health care providers faced other challenges in providing care, with one challenge reflecting the difficulty of providing care and services to a diverse refugee population. A second challenge reflected the lack of knowledge associated with constantly evolving policies and programs. Both challenges potentially limit the abilities of care providers.

On-going changes to refugee and health care policy, along with the diversity of refugee arrivals, will continue to challenge providers. The challenge, therefore, for health care providers and policy makers alike is how to ensure adequate service provision for new arrivals.

The Federal government should do a better job in disseminating the impact of policy changes and should streamline programs. This is particularly relevant given limited budgets and resources, tri-partite government funding, short time-frames to prepare for new arrivals, inadequate background information, barriers/challenges or inequitable criteria for access to health and social services, while addressing an increasingly diverse and complex population.

The research reinforces the complexity of the needs and challenges faced by refugees when health is considered, and the difficulty in providing care to this group.

While there is a large refugee health literature, there is relatively little attention to the challenges and difficulties faced by service providers in addressing the health needs of the diverse refugee population, a topic that is particularly important given limited funding envelopes, shifting policies and programs, and a focus on clients (refugees). It is this latter piece – the challenges faced by providers in providing care to refugees – which this paper explores.

This review aims to examine the literature on refugees’ and asylum seekers’ resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context.

A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed.

In spite of the gaining popularity of the resilience lens, which emphasizes an individual’s ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees’ and asylum seekers’ mental health care.

Careful consideration of refugees’ and asylum seekers’ mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal.

This paper aims to discuss the barriers to preventative breast cancer screening (BCS) among Muslim Syrian refugee women in a Western Canadian Prairie city.

Situated within a larger mixed-method study aimed at identifying barriers and facilitators to breast cancer (BC) preventative practices, the authors interviewed three key informants to get an in-depth understanding of the cultural, religious and social factors affecting knowledge of BC and BCS practices among Muslim Syrian refugee women.

Qualitative findings confirm quantitative results revealing that knowledge about BC and cultural and religious barriers on gender might translate into poor health outcomes for Muslim Syrian refugee women in a Western Canadian city.

This research has limitations related to the sample size and the lack of generalizability to all refugee women. Results indicate the need to develop culturally tailored intervention programs to increase breast awareness and participation in breast-self-examination, clinical breast examination and mammography. The study has implications for health-care policy. Muslim Syrian refugee women need to be educated about BC upon arrival in Canada to counteract low participation rates, promote positive health outcomes and decrease potential costs to the health-care system.

Evidence on Muslim Syrian refugee women’s knowledge and beliefs on BC is sparse. This study addressed this gap by documenting a lack of knowledge and barriers to BCS among Muslim Syrian refugee women.

The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor.

Hermeneutic phenomenology was used to produce an integrated description sensitive to the lifeworlds of refugees who came from multiple cultural perspectives. Participants consisted of refugees from Iran, Afghanistan, Myanmar, Vietnam, and Latin America who arrived in Canada between 2005 and 2007. Texts for analysis came from first language focus group discussions and interviews with the interpreters for those groups.

The principal themes that emerged from the experience of barriers were “futility,” “dependence,” and “relevance.” Themes related to the experience of facilitators were “inclusion,” “congruence,” and “benefit to family.” These themes provide key messages about sources of patient decisions to seek or not seek care, not comply, attend irregularly, and not disclose symptoms, which can be used by doctors and other health providers to enhance care planning.

The factors that facilitate refugees’ access to a regular family doctor have implications for the development of culturally appropriate healthcare information, policies that support adequate interpreter services, and cultural sensitivity training for physicians.

Previous research documents barriers such as lack of language access, differences in health beliefs, and lack of knowledge about western healthcare systems. However, little is known about how refugees experience these barriers, nor how they overcome them. This study contributes a rich and deeper understanding of how refugees experience these barriers and elucidates factors that facilitate their process of obtaining a regular family doctor.

Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The MUN MED Gateway Project is a medical student initiative in partnership with a refugee settlement agency that provides access to and continuity of health care for new refugees, while offering medical students exposure to cross-cultural health care. This paper aims to report on the first six years of the project.

Here the paper reports on: client patient uptake and demographics, health concerns identified through the project, and physician uptake and rates of patient-physician matches.

Results demonstrate that the project integrates refugees into the health care system and facilitates access to medical care. Moreover, it provides learning opportunities for students to practice cross-cultural health care, with high engagement of medical students and high satisfaction by family physicians involved.

Research has shown that student run medical clinics may provide less than optimum care to marginalized patients. Transient staff, lack of continuity of care, and limited budgets are some challenges. The MUN MED Gateway Project is markedly different. It connects patients with the mainstream medical system. In a context of family physician shortage, this student-run clinic project provides access to medical care for newly arrived refugees in a way that is effective, efficient, and sustainable.

The purpose of this paper is to examine support needs of African refugee new parents in Canada, and identifies support preferences that may enhance the mental health of refugee parents and children.

In all, 72 refugee new parents from Zimbabwe (n=36) and Sudan (n=36) participated in individual interviews. All had a child aged four months to five years born in Canada. Refugee new parents completed standardized measures on social support resources and support seeking as a coping strategy. Four group interviews (n=30) with refugee new parents were subsequently conducted. In addition, two group interviews (n=30) were held with service providers and policy influencers.

Separated from their traditional family and cultural supports, refugee new parents reported isolation and loneliness. They lacked support during pregnancy, birth, and postpartum and had limited interactions with people from similar cultural backgrounds. Refugees required support to access services and overcome barriers such as language, complex systems, and limited financial resources. Support preferences included emotional and information support from peers from their cultural community and culturally sensitive service providers.

Psychometric evaluation of the quantitative measures with the two specific populations included in this study had not been conducted, although these measures have been used with ethnically diverse populations by other researchers.

The study findings can inform culturally appropriate health professional practice, program and policy development.

The study bridges gaps in research examining support needs and support intervention preferences of African refugee new parents.

Social isolation and loneliness are global issues experienced by many seniors, especially immigrant and refugee seniors. Guided by the five-stage methodological framework proposed by Arksey and O’Malley and more recently Levac, Colquhoun and O’Brien, the purpose of this paper is to explore the existing literature on social isolation and loneliness among immigrant and refugee seniors in Canada.

The authors conducted a literature search of several databases including: PubMed; MEDLINE; CINAHL; Web of Science; HealthStar Ovid; PschyInfo Ovid; Social Services Abstracts; AgeLine; Public Health Database, Google Scholar and Cochrane Library. In total, 17 articles met the inclusion criteria.

Based on the current literature five themes related to social isolation and loneliness emerged: loss; living arrangements; dependency; barriers and challenges; and family conflict.

Given the increasing demographic of aging immigrants in Canada, it is useful to highlight existing knowledge on social isolation and loneliness to facilitate research, policy and programs to support this growing population.

The population is aging around the world and it is also becoming increasingly diverse particularly in the high-income country context. Understanding and addressing social isolation is important for immigrant and refugee seniors, given the sociocultural and other differences.

Social isolation is a waste of human resource and value created by seniors in the communities.

The paper makes a unique contribution by focusing on immigrant and refugee seniors.

Refugees integrate less successfully than other immigrants. Pre-migration stress, mental disorder and lack of human capital are the most popular explanations, but these propositions have received little empirical testing. The current study of Sri Lankan Tamils in Toronto, Canada, examines the respective contributions of pre-migration adversity, human capital, mental health and social resources in predicting integration. The paper aims to discuss these issues.

Participants are a probability sample of 1,603 Sri Lankan Tamils living in Toronto, Canada. The team, with a community advisory council, developed structured interviews containing information about pre- and post-migration stressors, coping strategies, and family, community, and institutional support. The questionnaire included the World Health Organization Composite International Diagnostic Interview module for post-traumatic stress disorder (PTSD). Interviews were translated, back-translated and administered by bilingual interviewers.

Two dimensions of integration emerged from a factor analysis of integration-related items: economic and psychosocial. Hierarchical multiple regression analyses revealed that PTSD militated against refugee economic integration, whereas pre-migration adversity (but not PTSD) compromised psychosocial integration. On both measures, increasing length of residence in Canada, and gender (male) were predictors of good integration, whereas age at arrival had an inverse relationship with integration. Religiosity had a positive effect on psychosocial integration but a negative effect on economic. Favourable perceptions of the health care system predicted economic integration and non-family support predicted psychosocial integration.

Results underline the importance of studying integration as a multifaceted phenomenon, help explain why refugees integrate less successfully than other immigrants, and highlight the importance of including mental health and mental health-related issues in integration discourse.