Category Archives: Newcomer Health Matters

Let’s build pathways to good jobs, starting from our workplaces.

By Yogendra B. Shakya (Senior Research Scientist), Axelle Janczur (Executive Director),  and Cliff Ledwos (Director, Primary Health Care), Access Alliance

Bad jobs are making us sick_JPEGAccess Alliance has created an info-graphic poster titled “Bad Jobs are making us Sick.” The poster highlights the rise in insecure, precarious types of jobs in Canada and the damaging health impacts that result. According to World Health Organization, “insecure jobs harm health, even more than unemployment.”  Click this link to download info-graphic or visit Continue reading Let’s build pathways to good jobs, starting from our workplaces.

Non-insured walk in clinic: addressing the needs of an under-serviced population

sikeeka NIWICSideeka Narayan (BScN, MPH) is a Registered Nurse with Access Alliance. She has played a pivotal role in coordinating the non-insured walk in clinic (NIWIC) since its opening in March 2012. Her research interests revolve around primary care, access to healthcare and refugee health. 


It is midway through a Friday morning when I step into the nurse’s room at Access Alliance on College, and there to meet me is Registered Nurse Sideeka Narayan. I had first heard of her work through an article on the midwifery services provided at the Non Insured Walk In Clinic (NIWIC) for pregnant patients in need of pre-natal care and delivery services. Sitting across from her in this sun-lit room expecting to hear more of the same, she cuts right away to emphasizing the clinic’s significance in its admittance of all undocumented, non-insured peoples in Toronto in dire need of health services.

Situated at AccessPoint on Jane, the clinic, which opened in March 2012, sees the majority of its patients coming from the West end of Yonge street, within the city of Toronto. However, nobody is turned away if they fit the eligibility criteria; namely, having no form of health insurance, without immigration status and lacking a primary care provider.

“At the NIWIC, many of our walk-in patients are refugee claimants who have been rejected by the Canadian immigration system and are flagged for deportation,” says Narayan.

“When it first opened, the clinic’s main objective was to provide primary care to the non-status and non-insured, a population marginalized in Toronto and greater Canada. They face barriers in accessing primary healthcare services. Community Health Centres (CHCs) are an essential point of service for this group. By partnering with them, we are better equipped to provide the right service at the right time and address access barriers, so these patients don’t end up in the Emergency department.”

Access Alliance MHCS along with the six other partnering CHCs (Unison, LAMP, Black Creek, Davenport-Perth, Stonegate and Rexdale) helps to coordinate and streamline the referral process by absorbing NIWIC patients with complex, chronic and/or unmanaged conditions. According to Narayan, the clients are from a highly vulnerable population group with backgrounds of complex medical and social situations, face language barriers, experience domestic abuse and live in fear of deportation. Since its conception, the demand for the NIWIC’s services have peaked. Recent-most figures from June 2013 to May 2014 revealed that 375 non-insured clients used its services, and is expected to only get busier.

“The success of working in this partnership model is that all stakeholders, from the nurses and volunteer midwives, to the partner CHCs, are advocating on behalf of the patients to address the needs of an under-serviced population,” states Narayan.

Success stories include an HIV-positive pre-natal patient whom the NIWIC connected to an interdisciplinary pre-natal care team specialized in HIV/AIDS who were able to provide appropriate resources and timely care to ensure a healthy delivery. In another case, an elderly, long term smoker was diagnosed with complex peripheral heart disease through the NIWIC, and was subsequently referred to a wound care specialist and vascular surgeon, and post-op offered ongoing primary care services at a partner CHC.

Narayan admits the trickiest part is connecting the medically complex patients to healthcare providers for ongoing care, due to their lack of healthcare insurance and precarious living circumstances. However, with the help of Access Alliance and similar organizations, hundreds within this extremely vulnerable population are provided access to essential healthcare services. The numbers of avoided ED visits speak for themselves.

Written by Yohani Mendis

NIWIC fact sheet for service providers can be found here.

What We Can Do To Improve Healthcare Quality: #1 Addressing Gender Inequity

Harlon DaveyBy Harlon Davey, first published in A Patient Voice, June 2,  2014

As healthcare evolves, there will be surveys to identify gaps in the system where a patient is at harm. Data will be collected to ensure that our healthcare machine marches towards patient-centric. Data will be analyzed to identify where we are not being universal in our healthcare, which by my definition is what patient-centric should be.  All inclusive.

Data will generate results which then lead to recommendations based on the collective data of healthcare consumers. In order for the data to be relevant, for healthcare to hit the target of patient-centricity, it must be accurate. Accuracy is improved when we include all.

How many times have you filled out a form while waiting to see a Doctor, Specialist, or seek any kind of therapy?  Imagine that if every time you filled out a form and one of the first questions provides only two answers and you answer to neither.  Imagine what that it must feel like to be reminded every time you access healthcare that you are not on the list.  That you are invisible. Excluded. How would that make you feel?


When any personal information is solicited from a consumer of healthcare and the individual is asked to identify their gender, we must include options for those that do not identify as male or female. We are excluding a community that does not have a place to put their check mark. That’s not a very nice thing to do. A human being’s data is not being truly captured and any analysis then becomes inaccurate and services and programs are not designed to respond to and reflect the needs of the community.

I myself do not have the answer as to what the third of fourth or however many boxes it takes to INCLUDE ALL, however, I would encourage consultation and consensus with the trans community – and I apologize if trans is not reflective of community standards – it’s what I am familiar with at this moment, but I am not an expert. Consult the community, they are the experts, and come to consensus on options for gender so that all can be included.

This is an easy thing to do.  If you, in your capacity, design, print, distribute or collate patient information which asks consumers to identify their gender or you are in the position of filling out a form and observe this discrepancy I encourage you to please speak with, make a phone call or send an e-mail to the person whose job responsibility includes designing forms so that they will follow best practices and amend the template by September 1, 2014 (chosen arbitrarily as a starting point, I always figure back to school time is a good time to start learning lessons and making change).

To be treated with dignity. It’s your right as a patient.

If you work in healthcare it is your duty to provide it.

It’s the right thing to do.


Harlon Davey blogs about gaps in our healthcare system to bring about awareness and change, and to elevate the voice of the patient. 

For more information about LGBTQ+ and Trans health, visit the Rainbow Health Ontario website.