Canadian Collaboration for Immigrant and Refugee Health Power of Sharing Newcomer Stories Program

 Abstract

Our Canadian Collaboration for Immigrant and Refugee Health (CCIRH) network, now known as the Power of Sharing Newcomer Stories program, formed with the CMAJ publication of our evidence-based guideline series on refugee and migrant health. This network provides a foundation for students for our international CCIRH refugee health service learning programs to address unmet refugee health needs. From 2017-2022, this has expanded to support students in 19 universities in Canada, Ireland and Lebanon. Our unique programs offer a transformative space for culturally and linguistically diverse young leaders.

Introduction

Our CCIRH Power of Sharing Newcomer Stories Case Study shows our transformative digital start up for new leaders in unmet Refugee and Global Health Research and Practice. With MSF, WHOCC, CIHR, and HealthCanada support, we have built a novel and internationally relevant emerging leader program and website complete with e-Learning and student outreach activities built on student-led Global Health Passport 2015 Alex Trebec Health Innovations Award. 

The field of refugee health first emerged as tropical medicine infectious disease screening focused on developing countries along with the International Organization for Migration medical screening. As the Campbell and Cochrane Equity Methods Group, we launched new initiatives to bring evidence-based principles, methods, and guidelines into the field of Refugee and Global Health. Our program offers open access e-Learning modules, community outreach activities, international summer institutes and academic publications that support the development of health equity research for new leaders for the field of Refugee and Global Health. Our recent students have become leaders of international refugee health organizations and have published a remarkable series of over 50 peer-reviewed health equity papers in the last 5 years.

Context

As complex immigrant and refugee migration increases worldwide, so too do the number of health professional students coming from immigrant and refugee families. We have responded to our students’ desire – often from lived experience - to support newly arriving refugee families. Many of these students are exceptional, but face barriers to health equity learning opportunities. 

Migrant unmet needs are our global mandate for inclusion and immersion programs/mentorship to support this emerging culturally and linguistically diverse health workforce. Building on community service learning principles, we provide students with the training necessary to positively impact refugee communities, giving meaningful service and reflective experiences. Our central role is to enable meaningful engagement, which we do using our selected student leaders and refugee community settlement partners. This ensures the students actively learn from the process and constantly reflect on their experiences. 

Such responsibility requires competent supervision and strong communication skills. With Red Cross and MSF field experience respectively, Dr. Douglas Gruner and Dr. Kevin Pottie are ideal mentors for the program. The CCIRH is also pleased to have been recently selected to join a series of technical WHO consultations between February and April 2023 to help define global research priorities in health and migration in line with WHO’s Triple Billion Targets: Addressing Health Emergencies, Promoting Healthier Populations, and Achieving Universal Health Coverage.

Engagement

From 2011 to 2022, our international academic research team led the formation of high impact evidence-based Syrian and Ukrainian guidelines for refugees and other migrants. In 2018, Kevin Pottie and Chris Greenaway also led the formation of ECDC guidelines for recent migrants to the EU and EEA. 

Our international foundation has helped inspire community service learning programs across 19 universities and counting. We engaged leaders from a variety of areas: Peter Tugwell from our Cochrane Equity Methods, Janet Hatcher Roberts from our WHO Collaborating Centre on Health Equity, Kevin Pottie from the MSF Association, and Douglas Gruner from the Red Cross. For immersion and inclusion at the local municipal levels, each program’s student leaders and medical advisors engage and partner with resettlement services, NGOs, interpreters, and local refugee physicians.

Our resources include prototype international medical graduate community interpreter training programs that support student engagement. Over the past 5 years, our network has trained and inspired over 500 students in community outreach programs with resettlement and NGO services. Our model relies on supporting student leaders who then train and support student participants in a train-the-trainers experiential service learning model.

Our program includes many students who come from migrant families, some of whom are refugees themselves. Newly arriving international medical graduates support advocacy, interpretation services, and research. Our health literacy programs work with refugee resettlement staff and community NGO representatives. Our medical advisors are refugee health physicians. Success stems from the fact most local medical leaders do not have the time to train and organize junior students. Our open access resources and mentorship help support local student leaders to work with medical advisors to overcome health care barriers for refugee populations. We have also found great success in conducting international summer institutes, and Doctors Without Borders helped us bring leaders from Lebanon and Syria. These institutes became the global scaling foundation for our program but were halted in 2020 due to COVID restrictions. We look forward to relaunching our international programs with the help of this Award.

Impact

Resettlement amidst language and cultural barriers is a major challenge for refugees, many of whom arrive without any local family members or any recent access to health or education services. Our student hosts welcome and work with families to address the many obstacles, both parties learning from the experience. The feedback from refugees has been overwhelmingly positive: they love the students and the program has helped them proactively prepare to link community doctors and programs, learn about healthcare, and make new friends. 

Students from Rwanda to Kenya to the USA have sent messages of gratitude, stating the eLearning has advanced their research and clinical positions. Our network of universities has directly supported service learning for over 500 students, building leaders for the emerging field of global health equity research and practice. Over the past 5 years, many of our students have gone on to lead more than 50 peer-reviewed publications and countless conference presentations. Many have won awards, scholarships, and gone on to take leadership positions with refugee organizations such as the North American Refugee Health Network. We have successfully scaled up to 19 universities with several others in the US, Germany, and France interested to start programs. We have also published two student-led curricular frameworks to support scaling. Our digital first model, combined with our international summer institutes, have provided us with an effective advocacy and scaling process. We are currently in the process of using our model to scale service learning for other vulnerable populations: over the last 2 years, we also began to apply our community service learning model to support the development of similar programs for the homeless, vulnerably housed, and frail elderly. Our next step is to work with WHO to scale our refugee health training programs globally.