I am a family physician and work at Access Alliance, a Community Health Centre (CHC) that provides multidisciplinary care to new immigrants and refugees. In addition to my rostered patients, I provide short-term medical care to newly arrived refugees at one of the Costi shelters in downtown Toronto, until they secure housing and are able to find a provider close to their new home.

My Thursday mornings involve seeing the newly arrived refugees and on Thursday afternoons, I see my rostered patients. Most of my patients do not speak English and I use the language services made available through the clinic. Here are examples of a day in my practice life:

In the morning:

• I met Ms. F, a 47-year-old female, who became visually impaired as a result of a bomb blast in Iraq while she was teaching at a university. She came to Canada with her 11-year-old son who has been her main caregiver and is missing out on a normal childhood. In addition to addressing her presenting complaint of biliary colic pain, I also order extensive blood work as she has not seen a physician in many years. I order an ultrasound and refer her to the ophthalmology clinic.

• I also see a 23-year-old male from Palestine, who came to Canada as he was being persecuted for being LGBTQ+, a 35-year-old female from Sudan who has been suffering from weight loss, insomnia, palpitations, weakness and infertility for many years and have not received any medical care and a 29-year-old pregnant female with late but uncertain gestation and no antenatal care. 

Prior to the patients leaving the shelter, I give them a copy of their medical records.

My afternoon involves meeting the following patients:

• A 67-year-old uninsured patient from Jamaica, who was working for cash cooking food for a retirement home, until she was diagnosed with adenocarcinoma of the endometrium. She was living in the basement of the retirement home but after she started treatment, she lost her job and home and is currently living in a shelter.

• Other patients include a 43 year-old female who works as a cleaner, sending money home to her son and extended family in Colombia, a 22 year-old uninsured male from Portugal, working in construction, who only comes in when he’s had a serious injury and unable to be compliant with treatments, as he is not able to take time off from his 7 am -7 pm work, a 67 year-old uninsured truck driver from Portugal, a 41 year-old transgender Iranian female, persecuted in Iran, and now struggling to cope in Canada with poor social support.

It is a privilege to work with newcomers and refugees and I have learned so much from their courage and hard work. I and my agency, Access Alliance, do whatever we can to support their medical and social needs.