New arrivals are helping UBC students understand patient needs
For first-year medical student Baljeet Brar, an unexpected lesson in practising medicine came from an unlikely source — new Canadians who have sought refuge in B.C.
For the past six months, Brar has been assisting nurses at Vancouver’s Bridge Clinic with Iranian refugee families who have arrived in the Lower Mainland via Turkey.
“Even though many of the patients don’t speak English, and we communicate via a translator, I am amazed at how well we can express ourselves through gestures and facial expressions — and how much rapport we can build that way,” says Brar.
“I have learned so much about the art of medical history-taking. I have learned how to let the patients express what is important to them. I’m also better able to rephrase questions using simpler language.”
Each year, B.C. becomes the new home of approximately 2,000 refugees. The Bridge Clinic is one of their first stops. Here, after an initial screening, the newcomers are offered preventative and primary health care through the clinic. But due to the high costs of living, many refugees move on to other parts of B.C. and may not return beyond their first appointment.
“Few refugees speak English, some may be suffering from post-traumatic stress disorder and other psychological conditions, and family physicians can be reluctant to take on refugees as new patients,” says second-year medical student Nancy Yao. “I felt that if more medical students have experience interacting with refugees and gain a better understanding of the dynamics and issues around caring for them, they would be more willing to take them on as patients when they become family physicians.”
Last year, Yao founded the History Taking Project with New Refugee Families at UBC after learning about programs in Ontario and Newfoundland that sends medical students to observe initial care of refugees. She approached nurses at the Bridge Clinic and soon began shadowing them — and taking on patients herself.
“My first intake was with a family of five,” Yao recalls. “The father was Iraqi and the mother was East Indian. They had moved from Iraq to India and then to Canada, but only the eldest son spoke a little English.”
“I was struck by how dramatically their environments had changed and
yet they were eager to start school, to get on with life and move forward together as a family,” says Yao.
“It taught me how resilient people can be when faced with unfathomable adversity.”
An immigrant from China by way of Finland, Yao is no stranger to adapting to new environments and negotiating cultural differences. While there are similarities, Yao says providing care to refugees takes on added dimensions from those of immigrants.
“You place higher emphasis on basic needs — food and nutrition, for example – as well as issues that may be unique to this population — infectious diseases, psychological disorders and dental hygiene,” she says.
“I’ll never forget how excited some kids got over the prospect of having their own free toothbrushes,” she recalls. “For some of them, this was symbolic of the better life they were hopefully about to embark on in this new country.”
The Bridge Clinic currently only has capacity to take on two students at a time, once a week, but Yao is working with two other clinics in Metro Vancouver in hopes of expanding medical student participation. Until then, Yao and Brar are developing training material for their peers so they can share their knowledge and insight.
“It’s been amazing to meet some of the refugees who have lived through such difficult circumstances, but yet are ready to start fresh with hope,” says Brar.
“The experience has been invaluable,” says Yao. “And I have no doubt it will make me a better doctor and a better person.”
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