PLUS: Video documentary to learn more about this CCFP Exam priority topic by Dr. Simon Moore MD CCFP FCFP, The Review Course Faculty
"I know why they're giving these things for free. It's because this country is so cold."
At the Calgary International Airport, a young girl with a big smile and a yellow hair tie chooses a toque and gloves from a bin.
She is entering Canada for the first time.
Her next stop could be to see you during your clinical rotations, or as a patient on your vSOOs or your SAMPs
POP QUIZ: 2.5 million Canadians are infected with Strongyloides. Do you know the treatments for Strongyloidiasis and Schistosomiasis from the guideline?
Read on for the answer…
Though the exam questions can seem simulated, this is a real girl. You can learn more about her, and refugees like her, by watching her story in the 30-minute National Film Board of Canada documentary 19 days (watch free here).
Even if you don't plan to work in an immigrant or refugee clinic you may come across a patient who is a newcomer to Canada, so be familiar with the Canadian Guidelines for Immigrants and Refugees.
The Canadian Collaboration for Immigrant and Refugee Health guidelines recommend that you consider the following key principles when caring for newcomers, in 4 key areas:
Infectious Diseases
If vaccine records are missing, vaccinate against measles, mumps, and rubella (MMR), as well as diphtheria, tetanus, pertussis, and polio (DTaP).
Screen for hepatitis B and varicella antibodies if they meet high-risk criteria listed in the guideline.
Screen for TB, HIV, and Hepatitis C if at high risk.
Do not conduct routine Malaria screening (but do test if they are symptomatic.)
Test for STRONGYLOIDES in refugees from South Asia and Africa. Know the treatment: ivermectin.
Test for SCHISTOSOMIASIS in refugees from Africa. Know the treatment: praziquantel.
Women’s HealthDiscuss contraception, vaccination (e.g. Human papillomavirus), and cervical cancer screening for your patients if they are at risk.
Chronic & Noncommunicable DiseasesScreen your patients for diabetes, iron-deficiency anemia (highest risk are women and children), dental disease, and vision health
Mental Health, Physical & Emotional MaltreatmentBe aware of the mental health challenges that newcomers may face, including anxiety, depression, and post-traumatic stress disorder (PTSD). Provide referrals to mental health resources as needed. Of note, the guidelines recommend screening for depression but not inquiring about trauma in asymptomatic patients.
At The Review Course we also provide some additional clinic tools and Canadian resources that go beyond these guidelines to make sure you are providing the most comprehensive, evidence-based care for your patients. Knowing these tools can help impress your vSOO patients.
With this knowledge, plus watching the documentary about newcomers taking their first steps in Canada, you’ll be even more prepared to understand and assist with their unique needs.
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