Canada has long been recognized as a leading country in terms of its commitment to diversity, inclusivity, and social justice. From its reputation as a welcoming haven for refugees to its emphasis on multiculturalism and equality, Canada has often been held up as a shining example of a country that cares about its citizens and is open to helping everyone. Despite this positive image, some people argue that Canada's track record when it comes to these issues is not as exemplary as it may seem. There are concerns that Canada's reputation for being open and welcoming may not always be reflected in its policies and practices, and that there are some groups of people who are left behind or excluded from the benefits that are supposed to be available to all.

Canada's universal healthcare system is designed to provide access to healthcare services to all residents regardless of their immigration status. However, undocumented immigrants may face challenges in accessing these services due to a lack of official identification or the fear of deportation. As a result, many may resort to avoiding seeking medical care altogether or turning to emergency rooms, which can be more expensive and provide less comprehensive care. These undocumented immigrants in Canada face significant barriers to accessing healthcare, including limited eligibility for publicly funded healthcare and fear of deportation, which can have negative implications for their health outcomes and the public health system (Campbell, 2014).

Undocumented immigrants in Canada face numerous challenges when it comes to accessing healthcare. One of the most significant barriers is limited eligibility for publicly funded healthcare. While Canada's universal healthcare system is designed to provide access to healthcare services to all residents, including those who are undocumented, some services may not be covered or may require proof of identification or immigration status. As a result, undocumented immigrants may not have access to the full range of healthcare services that they need (Campbell, 2014).

Fear of deportation is a significant barrier for undocumented immigrants seeking healthcare in Canada. Many undocumented immigrants may avoid seeking healthcare services for fear of being reported to immigration authorities and deported, even when they need medical attention. This fear can be particularly pronounced for individuals who have had negative experiences with immigration authorities in the past, or who have heard stories of others being reported to authorities while accessing healthcare services. This fear of deportation can have serious implications for the health outcomes of undocumented immigrants (Campbell, 2014). Without regular check-ups and screenings, individuals may not receive the preventive care they need to detect and address health issues early on. This can lead to more serious health problems down the line, as they may be more likely to delay seeking medical attention until their condition has worsened, which can lead to poorer health outcomes and a greater burden on the healthcare system. Delayed treatment can also lead to higher healthcare costs in the long run, as more expensive treatments may be required to address the health issue once it has progressed (Campbell, 2014).

Language and cultural barriers can also pose significant challenges for undocumented immigrants seeking healthcare in Canada. Many undocumented immigrants may not speak English or French, the official languages of Canada, and may struggle to communicate effectively with healthcare providers. This can lead to misunderstandings, misdiagnoses, and inadequate treatment (Ruiz-Casares, 2014). Undocumented immigrants may also face cultural barriers when accessing healthcare services. The healthcare system in Canada may be different from what they are accustomed to in their home country, and they may not be familiar with the procedures, practices, and expectations of healthcare providers in Canada. This can make it difficult for them to navigate the system effectively and may prevent them from receiving the care they need. Moreover, undocumented immigrants may have distinct cultural beliefs and practices related to health and illness that may not be familiar to healthcare providers in Canada. This can create challenges in providing culturally sensitive and appropriate care that meets the needs and preferences of the patient (Ruiz-Casares, 2014). These language and cultural barriers can lead to poor health outcomes for undocumented immigrants. Misunderstandings and miscommunications can lead to incorrect diagnoses, inadequate treatment, and even medical errors. This can lead to more serious health issues in the long run, which can be more difficult and expensive to treat.

The COVID-19 pandemic has highlighted the importance of ensuring access to healthcare services for all individuals, regardless of their immigration status. The inability of undocumented immigrants to access healthcare services in Canada can have severe public health implications, given the highly infectious nature of COVID-19. Undocumented immigrants who are unable to access healthcare services or fear deportation may be more likely to avoid testing and treatment for COVID-19. This, in turn, can lead to undetected cases of the virus in the community, increasing the likelihood of transmission to others. Furthermore, these immigrants who continue to work or live in overcrowded conditions may be at higher risk of contracting and transmitting the virus, given the challenges of physical distancing in these settings.

In an interview with journalists from the Toronto Star, Lily stated “I’m not going to take the risk of sharing my information,” when asked why she did not get her COVID-19 vaccines (Kennedy, 2021). Lily, a personal support worker at a long-term-care home in Toronto, has been eligible to receive the COVID-19 vaccine since its rollout in December. However, as an undocumented immigrant, she has yet to receive the vaccine out of fear of losing her job or being deported (Kennedy, 2021). Lily, like many others in her situation, is concerned that disclosing her personal information to public health officials may lead to her employer or immigration authorities discovering her status and detaining or removing her from Canada. She explained that if she were confident her immigration status would not be disclosed, she would willingly get vaccinated. Unfortunately, this concern has left her in a state of anxiety, saying "I'm living in fear” (Kennedy, 2021). The impact of inadequate healthcare access for undocumented immigrants is not limited to COVID-19. Infectious diseases such as tuberculosis and sexually transmitted infections can have severe health consequences if left untreated in population groups with inadequate healthcare access.

In Canada, healthcare is primarily provided through publicly funded healthcare systems administered by each province or territory. However, eligibility for publicly funded healthcare services is limited to Canadian citizens, permanent residents, and some individuals with specific immigration statuses, such as refugees and asylum seekers. Undocumented immigrants, who do not have legal status in Canada, are generally not eligible for publicly funded healthcare services, with some exceptions depending on the province or territory. Despite the limitations on eligibility for publicly funded healthcare services, undocumented immigrants in Canada still have access to some healthcare services (Mursal, 2022). For example, the Ontario government has implemented the Interim Federal Health Care Program (IFHP) to address the barriers that undocumented immigrants face in accessing healthcare services. The program provides a limited range of services, including primary care, emergency care, and some specialist services, to individuals who are not eligible for OHIP (Ontario Health Insurance Plan), such as undocumented immigrants. Under the IFHP, healthcare providers are reimbursed for providing care to eligible individuals, regardless of their immigration status (Mursal, 2022). This program is intended to ensure that individuals who do not have OHIP coverage can access essential healthcare services without facing financial barriers. However, some have criticized the program for being too limited in its scope, as it does not cover all healthcare services, such as prescription drugs and laboratory tests. Additionally, the program requires individuals to disclose their immigration status, which could deter some from seeking healthcare services for fear of deportation and legal action(Mursal, 2022).

Several community-based organizations and clinics provide healthcare services to undocumented immigrants, often with the support of private donations and volunteers. These organizations operate independently from the public healthcare system and provide services such as primary care, mental health services, and support for victims of violence and abuse (Mursal, 2022). While these alternative healthcare services and the IFHP are good steps towards addressing the healthcare needs of undocumented immigrants in Ontario, they are not a substitute for access to publicly funded healthcare services, which provide more comprehensive and consistent care.

The article "I was undocumented in Canada for 13 years. Now I fight for others like me" posted on CBC News by Luisa Ortiz-Garza is a personal account of her experience as an undocumented immigrant in Canada and her journey to becoming an advocate for immigrant rights (Garza, 2023). The author describes her struggles as an undocumented immigrant, including the barriers to accessing healthcare, education, and employment. She also highlights the constant fear of deportation that she and other undocumented immigrants face (Garza, 2023).

Luisa stated, “In 2013, our second child was born. I had to work as a cleaner right up to three days before the delivery to afford the thousands of dollars we needed to pay hospital fees. At the time of the birth, the anesthesiologist stood outside the door and refused to enter until we paid him in cash. We did not even get a receipt.” (Garza, 2023)

This highlights the financial burden that healthcare can pose to those without proper documentation or access to healthcare services. In this case, Luisa had to work up to the last moment before delivery to afford the hospital fees, and even then, she was forced to pay the anesthesiologist in cash without receiving a receipt which shows the potential for them to be taken advantage of by healthcare providers.

Luisa gives a second example, “When my husband had an accident at work in 2013 while using a circular saw, his co-workers wanted to call an ambulance, but he refused even though he almost lost his fingers. On his way to the hospital in the taxi, he had to ignore his pain to focus on what to say to the doctors. If the accident was reported, questions about his status might have arisen. That’s why he said that he was working on a project at home and paid the hospital costs in installments for over a year.” (Garza, 2023)

This quote shows the fear and hesitation that undocumented immigrants may feel when seeking medical care. The husband had an accident at work that required immediate medical attention, but he was afraid to report the accident due to his undocumented status. This fear and hesitation can lead to individuals avoiding medical care altogether, leading to potential health risks and complications.

Overall, undocumented immigrants face numerous challenges in accessing healthcare services in Canada, including fear of deportation, lack of legal status, and financial barriers. To address these challenges and improve healthcare access for this vulnerable population, policymakers and healthcare providers can implement a range of recommendations. These may include developing policies and legal frameworks that protect undocumented immigrants' privacy and ensure their access to essential healthcare services, increasing funding for community-based initiatives and programs, such as mobile clinics and outreach programs, and promoting awareness and advocacy for the healthcare needs of undocumented immigrants. By addressing these issues and working towards more equitable healthcare access, Canada can ensure that all residents, regardless of their immigration status, receive the care and support they need to lead healthy and productive lives.

References:

Campbell, R. M., Klei, A. G., Hodges, B. D., Fisman, D., & Kitto, S. (2014). A Comparison of Health Access Between Permanent Residents, Undocumented Immigrants and Refugee Claimants in Toronto, Canada. Journal of Immigrant and Minority Health, 16(1), 165–176. https://doi.org/10.1007/s10903-012-9740-1.

Garza, L. (2023, April 8). First person | I was undocumented in Canada for 13 years | CBC News. CBC News. Retrieved April 10, 2023, from https://www.cbc.ca/news/canada/first-person-undocumented-1.6801857

Kennedy, B. (2021, March 24). 'I'm living in fear': Undocumented workers worry that getting the covid-19 vaccine could lead to unwanted immigration woes. thestar.com. Retrieved April 10, 2023, from https://www.thestar.com/news/gta/2021/03/24/im-living-in-fear-undocumented-workers-w orry-that-getting-the-covid-19-vaccine-could-lead-to-unwanted-immigration-woes.html

Mursal, A., & Dong, W. (2022). Should Canada Pay for Refugee Healthcare? A Social Justice Analysis of the Interim Federal Health Program (IFHP). Journal of Immigrant & Refugee Studies, ahead-of-print(ahead-of-print), 1–14. https://doi.org/10.1080/15562948.2022.2128492

Ruiz-Casares, M., Rousseau, C., Derluyn, I., Watters, C., & Crépeau, F. (2010). Right and access to healthcare for undocumented children: Addressing the gap between international conventions and disparate implementations in North America and Europe. Social Science & Medicine (1982), 70(2), 329–336. https://doi.org/10.1016/j.socscimed.2009.10.013