By Paul Weinberg
TORONTO, Jul 2 2003 (IPS)

Canadian healthcare professionals need to be better trained to handle the stress, depression and even trauma experienced by immigrant and refugee women in an increasingly diverse Canadian society, says a Nigerian-born Canadian sociologist in a new report.

"Basically, what we are saying is that the health sector needs to be culturally sensitive, needs to be patient, literally give time to multicultural women, talking about their diseases and symptoms," said Francisca Isi Omorodion, the co-author of the study, ‘Women and Post Traumatic Stress Disorder: Moving Research to Policy’, and president of the Immigrant, Refugee and Visible Minority Women of Saskatchewan.

Funded by the Canadian government-supported Prairie Women’s Health Centre of Excellence, the research comprised detailed interviews with 36 people, including immigrant, refugee and women of colour, local health officials and health care professionals. All participated in focus groups in four major cities in the western Canadian province of Saskatchewan.

Canadian doctors should be spending more time talking with their patients, particularly immigrant and refugee women who may have experienced war and torture in their country of birth, Omorodion said in an interview.

She points to the current billing practice in Canada where doctors’ payments are based on the number of patients seen under a national publicly run and financed health care system.

"Doctors are not paid by the [amount of] time they spend with you, but how many patients they see," said Omorodion. "A doctor doesn’t want to spend two hours with a woman who is struggling with her English."

Omorodion focused specifically on the anecdotal experiences of newcomer women in the largely rural prairie province of Saskatchewan, which in recent years has started to receive immigrants and refugees – who normally would settle in the large urban multicultural centres of Toronto, Montreal or Vancouver upon arriving in Canada.

However, that is starting to change, says the Regina, Saskatchewan-based sociologist, as more newcomers are directed away by federal and provincial authorities towards other less diverse areas like Saskatchewan where the population is aging and shrinking. (Europeans of British, French and east European stock primarily settled the Canadian prairies).

Saskatchewan health professionals are sensitive to the mental health issues encountered by a significant indigenous or aboriginal population, which is growing quickly and will eventually reach majority status if current demographic trends continue, says Omorodion.

But she also urges Saskatchewan’s health professions to start paying attention to the personal hardships faced by immigrants and refugees now appearing in their midst.

"I have no qualms about (serving the needs of indigenous people). But they need to make their services more multicultural," said Omorodion.

While all immigrants and refugees regardless of gender face considerable adjustment in a new country that includes barriers of racism in jobs and housing, language differences, alien social and religious values and a reluctance by employers to recognise foreign professional credentials, women still encounter unique problems, according to the Saskatchewan study.

Men are the ones who usually make the decision to migrate to Canada and the women and children are obliged to follow, says Omorodion. "You (as a woman) don’t have a choice and so you are not prepared."

Furthermore, women are more likely to take any job to support their family, even if they are overqualified, than the men, who are likelier to be choosey, the sociologist reports.

When the man cannot earn a large enough income he might take out his personal frustration on his spouse and children, resulting sometimes in battering and domestic abuse, she says.

While Omorodion’s study concentrated on Saskatchewan, her analysis fits what other professionals serving immigrant and refugee women across Canada are also observing.

Rather than explore the "resettlement stress" experienced by the immigrant woman, doctors are more likely to prescribe anti-depressant medication, which may be a useful tool, but does not always resolve deeply rooted personal problems, says Gulshan Allibhai, a coordinator of cross-cultural initiatives at the Toronto branch of the Canadian Mental Health Association.

While this trend is starting to change with greater attention paid to the positive role of religious healers and traditional medicines by therapists in some communities, Allibhai would still give Canadian mental health professions a score of three out of 10 for the amount of sensitivity shown to newcomers.

"There is no word for mental health in many cultures," said Allibhai, who notes that Canadian healthcare providers often fail to appreciate that no clear distinction exists between physical and mental ailments in many cultures in Africa and Asia.

Stress, she continues, may be manifested in all kinds of physical ailments. "We must focus on the whole person."

At the same time, Allibhai adds, immigrants are less likely to commit suicide in their new country than members of the Canadian-born population.

"I agree with the person who gives (the Canadian mental health system) a three out of 10," said Debbie Douglas, the executive director for the Toronto-based Ontario Council of Agencies Serving Immigrants.

Immigrants and refugees are more likely to find social and community supports in the large multicultural centres like Toronto and Montreal where the chances of finding people similar to themselves in terms of culture, religion and language are greater than elsewhere in Canada, Douglas explains.

But at the same what is available for newcomer women in a city like Toronto is still largely piecemeal, continues Douglas.

"That is part of the frustration. There needs to be far better co-ordination of services, particularly mental health services. Some of the symptoms that people are presenting may be happening because of social issues and not because of medical issues. It is about medicalising people’s experiences (by Canadian health care professionals)," Douglas adds.

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