Illegals afraid to see a doctor. Appointments cancelled out of deportation fears. Health workers want Ottawa to issue moratorium May 23, 2006. 05:36 NICHOLAS KEUNG

Some Toronto doctors are calling on the federal government to ease up on deportations after recent high-profile removals appear to have spooked many illegal migrants into cancelling appointments at clinics serving the uninsured. “If they keep pushing these people further underground, it’s going to be not just a tragedy for these people’s health but a huge public health concern down the road,” for example during a flu epidemic, warns Dr. Meb Rashid, of Toronto’s Access Alliance Multicultural Community Health Centre. “This population is most vulnerable to infectious diseases such as typhoid, malaria, tuberculosis and HIV. If an epidemic breaks out, there’s no way we’d be able to control that.” He and other physicians working with illegal immigrants plan a news conference on Friday to demand that Ottawa put a moratorium on deportations to calm fears in the community.

While no firm statistics are available, clinics staffed by physician volunteers that help illegal migrants say they’ve noted a growing number of cancellations in the wake of several high-profile removals, some involving children at school, and rampant rumours about deportation round-ups in public places.

Though her pregnancy is considered high-risk, 35-year-old Viviane, an undocumented immigrant from Brazil, said she has stopped going to her doctor for prenatal care because her health risk doesn’t come close to her fear of “getting caught” by immigration authorities. Since word began swirling two months ago that Canada Border Services Agency was stepping up efforts to enforce deportation orders, the office cleaner, who is 21 weeks pregnant, has stayed locked inside her Dufferin St.-Davenport Rd. apartment and cancelled all her medical appointments, from regular checkups to genetic screening and blood tests.

“I’m afraid that Immigration would stop me on the street and send me back to Brazil. I had a very difficult pregnancy with my first child and I know I’m at high risk, but if I had to, I’d just have my second child at home,” says Viviane, who came to Canada in 2000 as a visitor and overstayed her visa. She’s not alone. There’s a growing perception among people living “underground” in Canada — an estimated 200,000 undocumented workers, plus dependants — that a harsh immigration crackdown is underway.

Rashid says most illegal migrants don’t distinguish health-care providers from other “authorities,” and the general fear of authorities has deterred many from coming for medical help, even when they’re in dire need. Undocumented migrants, most of whom have either overstayed a visitor’s visa and or put in a refugee claim that was rejected, are not covered under the Ontario Health Insurance Plan.

Doctors don’t turn them away, but will generally demand payment out of pocket.

Failed refugee claimants lose their health coverage if they stay to pursue an appeal or other alternative. Coincidentally, an article in last month’s Canadian Medical Association Journal highlighted lack of access to health care by immigrants and refugees. “That there is a great potential for health problems in this population is evident: many have left countries that have limited health care resources and where diseases such as tuberculosis may be endemic,” the report says.

Dr. Paul Caulford, the report’s author, says recent action by Border Services may further block the access of marginalized people to health care. And people with acute or chronic conditions, such as diabetes, are going to suffer most. If they’re not treated in a timely fashion, “it would lead to other avoidable health problems and it would be more dangerous for the patient and more expensive for the (health) system,” cautions Caulford, head of the Scarborough Hospital’s family medicine and community services department.

Caulford, who also runs the Urban Outreach Family Medicine Centre, says he’s talked with immigrant patients over the past several weeks who have been afraid to show for appointments or been adamant about not being referred to outside specialists or counsellors, but doctors and health officials don’t turn patients in. Sofia, 36, a failed refugee claimant from Argentina, over the past month cancelled three medical appointments for herself and her 8-year-old boy, who, along with a seizure disorder, was born with only one kidney and requires regular medical monitoring.

On top of the kidney problem, her son has begun wetting his bed as a result of stress from the threat of his family’s removal. More than a week ago, he developed a new infection and a high fever, but could only suffer silently at home. “I knew I should have taken him to a doctor, but sometimes fear and panic just paralyzes your judgment,” explains Sofia, an office cleaner who has been in Canada since 2001.