Refugee Health Care: Ukraine

KEY POINTS

• Canada has launched a 3-year temporary visa pathway to shelter nationals fleeing from Ukraine, which may allow for more rapid approval and integration than regular refugee pathways, but may also leave gaps in access to essential medications and social and refugee protection services.
• Clinical considerations for practitioners caring for people fleeing conflict in Ukraine include screening for noncommunicable and infectious diseases, anticipating mental health conditions and offering available vaccinations as needed.
• Key gaps in the health system in Canada include lack of universal access to interpreters and lack of supports for coordination of care across health services; addressing these will require a multistakeholder approach and multisectoral partnerships.
• Health care providers and civil society should take a trauma-and violence-informed care approach when engaging with people fleeing the war in Ukraine.

The war in Ukraine has driven global counts of displaced people and refugees to an all-time high, with numbers expected to continue to increase as a result of global instability and the impacts of climate change. As of May 25, 2022, 8 million people were internally displaced from Ukraine and more than 6.6 million had fled the country. Most have entered neighbouring Eastern European countries, but Western European countries, the United States and Canada have also accepted people fleeing from Ukraine. Canada has granted 112,035 temporary visas for Ukrainians; 241,620 people have applied; and as of May 18, 2022, 32,201 had arrived. Refugees fleeing traumatic situations face socioeconomic stressors and barriers to services after arrival and are more likely to transition to poor health than other immigrants, but this can be mitigated by supportive resettlement services. Although Canada has a long history of welcoming and integrating refugee groups and other humanitarian migrants, the concurrent arrival of Ukranians displaced by the war and refugees from Afghanistan into health systems strained by COVID-19 requires an examination of current refugee health practices and programs and demands creative solutions. We outline clinical considerations for health providers caring for people displaced by the war in Ukraine, based on available evidence and guidance, and discuss how Canada can strengthen its measures to provide health care to currently arriving refugees and prepare for future refugee waves.

The war in Ukraine and refugee health care: considerations for health care providers in Canada via CMAJ.