Navigating the Unique Healthcare Needs of Refugees

Transcription

1 Navigating the Unique Healthcare Needs of Refugees Friday, March 11, 2016 TCU Place Saskatoon, Saskatchewan in collaboration with the DIVISION OF SOCIAL ACCOUNTABILITY

2 Table of CONTENTS Conference Goals and Learning Objectives... 2 Continuing Professional Development Credits... 3 Conference Planning Committee... 3 Handout Information... 4 Conference Schedule Declaration of Potential Conflict of Interest... 8 Conference Floor Map... 9 Continuing Medical Education Fund... 9 Keynote Speakers Conference Speakers Coming Events Sponsors and Exhibitors CME Staff Contact Information Conference GOALS & OBJECTIVES CONFERENCE GOALS To inform health care professionals about existing clinical guidelines for refugee health To provide health care providers with resources and connections that will build their capacity to support the unique health needs of refugees LEARNING OBJECTIVES After attending this conference, participants will be able to: Improve Screening for Infectious Diseases Implement appropriate screening and assessment for mental disorders Discuss pathways to care Identify Specific Health Concerns of Refugee Women and Children Work effectively with interpreters in a healthcare setting Unique Medical Needs of Refugees... 2

3 Continuing Professional Development CREDITS Certificates will be made available for conference delegates to pick up at the Registration / Check-in Table in the lobby on Friday, March 11, 2016 The College of Family Physicians of Canada Mainpro (Maintenance of Proficiency) is the College of Family Physicians of Canada (CFPC) program designed to support and promote continuing professional development for family physicians. Physicians participating in Mainpro demonstrate a commitment to lifelong learning through completion and documentation of personal CPD. Unique Medical Needs of Refugees has been accredited by the Division of Continuing Medical Education, College of Medicine, University of Saskatchewan, for up to 7 Mainpro-M1 credits. The Royal College of Physicians and Surgeons of Canada Unique Medical Needs of Refugees is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification (MOC) Section 1 program of the Royal College of Physicians and Surgeons of Canada. Unique Medical Needs of Refugees is also accredited by the Division of Continuing Medical Education, College of Medicine, University of Saskatchewan, for up to 7 MOC Section 1 credit hours. American Medical Association Through an agreement between the Royal College of Physicians and Surgeons of Canada and the American Medical Association, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits. Information on the process to convert Royal College MOC credit to AMA credit can be found at Nurses and other Healthcare Professionals Participation in this conference may be included as part of the continuing education and competence programs established by individual professional associations. Conference PLANNING COMMITTEE Erin Wolfson University of Saskatchewan College of Medicine Staff Yvonne Blonde Saskatoon Health Region Family Physician Andrea Clinton Saskatoon Health Region Nurse Practitioner Andries Muller University of Saskatchewan Family Physician Mahli Brindamour Saskatoon Health Region Pediatrician Parviz Yazdani Private Practice - Saskatoon Dentist Unique Medical Needs of Refugees... 3

4 Join the CONVERSATION HANDOUTS POSTED ONLINE PDFs of the presentations provided by the speakers will be posted online following the conference. Please note presentations will only be available for 90 days. If you would like to obtain materials from a presentation that is not included in our online listing, please contact the presenter directly. To access the presentation PDFs posted online: resources/refugee_conference_2016_handouts/ refugee.php username: CMEMAR2016 password: REFUGEE2016 Like what you re learning? Tweet about it to your followers! Follow us on Please note: Presentations posted online may be abbreviated to ensure compliance with federal copyright legislation. Please call (306) or cme@usask.ca if you need assistance. EVALUATION The online evaluation gives you the opportunity to provide quality feedback to our speakers, organizing committee and CME staff and is an important component of conference accreditation. Evaluations will be ed to registered delegates on Friday, March 11, Please pass along your feedback to assist us in the planning and improving of future events. You do not need to complete the entire survey in one session, as responses will be saved and continued in subsequent entries. WI-FI ACCESS Wi-Fi access is available throughout the building: Username: cme Password: refugee2016 ROOM TEMPERATURE Room temperatures may vary periodically, so please dress in layers. While we try our best to accommodate everyone, this variant cannot be controlled. DISCLAIMER Continuing Medical Education is not responsible for any errors or omissions in information included in this booklet or on the handouts webpage. Unique Medical Needs of Refugees... 4

5 Conference Schedule March 11, 2016 TCU Place - Saskatoon MORNING SESSIONS TIME SESSION TITLE SESSION DESCRIPTION SPEAKER(S) LOCATION 0730 Registration / Continental Breakfast Centennial Hall 0800 Welcome and Opening Remarks Dr. Ryan Meili 0815 P1 - KEYNOTE: Caring for a Syrian Refugee Family Appreciate the role of Health Settlement though a series of stories Use cultural humility with evidence based guidelines Integrate and master health assessments guidelines for PTSD and infectious diseases Dr. Kevin Pottie 0900 P2 - KEYNOTE: Approach to a Refugee Child with Failure to Thrive Review the definition of failure to thrive (FTT) Discuss common infectious and non-infectious causes of FTT in a refugee child Discuss the screening of a refugee child with failure to thrive Dr. Anna Banerji 0945 P3 - KEYNOTE: Decreasing Health Disparities: Screening Newly Arrived Migrants for Infectious Diseases Review the epidemiology of selected infectious diseases in migrants Provide screening recommendations for infectious disease in migrants Discuss the rational for screening and vaccination strategies in migrants Dr. Chris Greenaway 1030 Nutrition Break / View Exhibits Centennial Lobby 1045 Panel Discussion The National & International Picture Discuss sustainable strategies in healthcare advocacy that have been deployed nationally and internationally to ensure the health and well-being of refugees Describe current and emerging medical concerns and opportunities in the Canadian, American and International refugee communities Dr. Banerji, Dr. Pottie, Dr. Greenaway, Dr. Polatin Moderated by: Dr. Ryan Meili Unique Medical Needs of Refugees... 5

6 Conference Schedule March 11, 2016 TCU Place - Saskatoon MORNING SESSIONS 1130 Short Presentations - (10 min each) 1. Interpreters: Essential Members of the Healthcare Team Immunizing Refugee Populations: Global to Local 3. Gender and Cultural Considerations when Working with Newcomers To understand the difference between translators and interpreters To understand the role, value and importance of interpreters in health care delivery To identify the risks of using family members, community volunteers and/or non-trained health care interpreters for clinical visits Identify strategies for effective communication when using an interpreter Explain the context of immunization programs internationally Identify barriers to immunization services among refugees Describe local public health follow-up for refugees and immigrants Discuss gender and cultural considerations when caring for refugees Identify approaches that create and enhance culturally respectful health care Lorna Knudson Karrie Hamond-Collins Andrea Clinton 1200 Lunch / View Exhibits Centennial Hall AFTERNOON SESSIONS March 11, 2016 TCU PLACE - Saskatoon TIME SESSION TITLE SESSION DESCRIPTION SPEAKER(S) LOCATION 1245 P4 - KEYNOTE: Considerations in Defining and Fulfilling the Mental Health Needs of Refugees 1330 Relocate to Concurrent Sessions 1345 A - Concurrent Sessions A1- Caring for Refugee Children: A Case-Based Approach Unique Medical Needs of Refugees... 6 To enable the health care provider to better understand the experiences and circumstances that may have affected the refugee patient To understand options for brief and more extensive screening of refugees for mental health problems To promote a better understanding of trauma focused therapies Review cases of chronic and infectious diseases commonly seen in refugee children Review the associated literature regarding managing these cases Dr. Peter Polatin Dr. Mahli Brindamour, Dr. Anna Banerji Centennial B

7 Conference Schedule March 11, 2016 TCU PLACE - Saskatoon AFTERNOON SESSIONS TIME SESSION TITLE SESSION DESCRIPTION SPEAKER(S) LOCATION A2 - Treating Survivors of Torture A3 - Dental Health Care for Refugees: Navigating the Maze A4 - Assessing for Latent Tuberculosis 1430 Nutrition Break 1445 Concurrent Sessions - Repeat of 1345 Sessions 1530 Relocation to final Plenary 1545 Panel Discussion (Saskatchewan Perspective) Specific Medical Needs of Syrian Refugees To increase the awareness of health care providers of the relevant sequellae of the torture experience To provide an overview of holistic treatment components for the recovery of the torture survivor Discuss similarities and unique oral health conditions specific to adult and children who are refugees Implement improvements through a holistic, patient-based approach to coordinating patient needs between medical & dental offices Explain the genesis or exacerbation of oral health problems related to crisis in refugee camps Connect the role of oral health within the Canadian health care system Interpret TB epidemiology in Canada and Saskatchewan Assess patients for Latent TB applying risk stratification and indications for prophylaxis Recommend appropriate prophylaxis and referrals for surveillance in Saskatchewan Apply best practice through a case review of refugees and LTBI Describe relevant social and health services available at the local level for Syrian refugees in Saskatchewan Contrast what is unique about Syrian refugee patients vs. other refugee populations Apply combined information and insights from conference sessions specifically to the needs of the Syrian refugee community in Saskatchewan Outline various pathways to support the unique medical and social needs of Syrian refugees Dr. Peter B. Polatin Dr. Parviz Yazdani Dr. Kris Stewart Dr. Brindamour, Dr. Blonde, Melanie Baerg, Getachew Woldyesus, Lorna Knudson Moderated by: Dr. Edward Rooke West Room Centennial C 1645 Closing Remarks and Adjournment Dr. Andries Muller Unique Medical Needs of Refugees... 7

8 Declaration of Potential CONFLICT OF INTEREST KEYNOTE SPEAKER Kevin Pottie Anna Banerji Peter B. Polatin Christina Greenaway OTHER PRESENTERS Karrie Hammond-Collins *Andrea Clinton *Mahli Brindamour *Parviz Yazdani Kris Stewart Ryan Meili Edward Rooke Lorna Knudson Melanie Baerg Getachew Woldyesus PLANNING COMMITTEE Eric Wolfson Yvone Blonde Andries Muller Karen Conway Shalayne Hendriks Pam Seib *Planning Committee DISCLOSURE I am currently participating in or have participated in a clinical trial within the past two years. Company/Organization: Sanofi Pasteur Details: C Difficile Vaccine Trial completed in Sept 2015 DISCLOSURE I have received payment from a commercial organization (Including gifts or other consideration or in kind compensation) Company/Organization: Gilead, Merck, Abbvie Details: Speaker Fees I have received a grant(s) on an honorarium from a commercial organization Company/Organization: Gilead, Merck, Abbvie Details: HIV and HIV Program Support I am currently participating in or have participated in a clinical trial within the past two years. Company/Organization: Amber and Capia Details: HCV Phase 4 and HCV Chart Review DISCLOSURE Unique Medical Needs of Refugees... 8

9 Conference Floor Map: Centennial Hall Saskatchewan Medical Association CONTINUING MEDICAL EDUCATION FUND The Continuing Medical Education Fund assists physicians with the costs associated with continuing medical education courses and materials. Physicians may make one or more applications during a calendar year (January 1 to December 31) or may allow the funds to carry over for use in the following year. (i.e. a physician can bank one year s entitlement and claim for two years worth of entitlement in the subsequent year. The maximum carry-over period is one year.) Applications must be received by January 15 following the year in which the entitlement is due to expire. $3,000 is available for eligible CME activities in The SMA is encouraging physicians to use the extra portion of CME funding for activities related to improving leadership skills and strengthening abilities to lead system transformation. Please note that the typical processing time for CME applications is two weeks after they are received. If you would like to know what your CME balance is, please log onto the members side of the website by clicking the My SMA Member s Area button. Please contact the SMA office at , or sma@sma.sk.ca if you have any questions about the CME Fund. Unique Medical Needs of Refugees... 9

10 Keynote SPEAKERS Dr. Christina Greenaway Dr. Christina Greenaway is an Associate Professor of Medicine at McGill University and an Associate member in the Department of Epidemiology, Biostatistics and Occupational Health. Her primary appointment is in the Division of Infectious Diseases and Laboratory Medicine at the Jewish General Hospital. She is a Principle Investigator at the Centre for Clinical Epidemiology at the Lady Davis Institute for Medical Research and staff physician at the JD Maclean Tropical Medicine Center at McGill. Her research program is focused on immigrant and refugee health issues and promoting health equity for this population. She has published several observational studies that have highlighted the increased burden of infectious disease borne by the immigrant population, including childhood vaccine preventable diseases, viral hepatitis and tuberculosis. She has used this data to inform public health policy by performing economic analyses and has shown that it is cost-effective to screen and vaccinate immigrants for varicella and hepatitis B. She has been a member of the Canadian Collaboration of Immigrant and Refugee Health (CCIRH) since Dr. Peter B. Polatin Dr. Peter Polatin is on the clinical faculty of the Harvard Program in Refugee Trauma, based in Boston. He is a past Professor of Psychiatry and Director of Global Mental Health at George Washington University School of Medicine in Washington, D.C., where he remains as a Clinical Professor of Global Mental Health, and has also been the Senior Health Advisor for the Dignity Institute Against Torture, located in Copenhagen Denmark. He has prior specialization in community and disaster mental health, pain management, clinical outcomes research, and addictionology. From 2007 to 2011 he functioned as a Health Program Manager for Dignity, working with partner NGOs in the developing world to construct, implement, and evaluate psychosocial and medical interventions to assist in the identification, assessment, and treatment of survivors of torture. Prior to this, he was an Associate Professor of Psychiatry and Anesthesiology/Pain Management at the University of Texas Southwestern Medical Center at Dallas, Texas, and Disaster Mental Health Consultant to Dallas County. In that capacity, he helped to coordinate the community mental health response in North Texas for evacuees from Hurricane Katrina, that devastated New Orleans in He received several prestigious awards, has authored, co-authored, or edited over 60 chapters, and peer review articles. He has recently returned to Dallas, where he practices pain medicine and coordinates functional restoration rehabilitation at the Productive Rehabilitation Institute of Dallas (PRIDE), and provides mental health consultation for refugees being serviced by the International Rescue Committee (IRC) of Dallas. He is also on the board of Nunca Mas, a human rights NGO based in Denmark, and is a Pain Management consultant for Paradigm Outcomes, a U.S. health service coordinating organization based in Walnut Creek, California. Unique Medical Needs of Refugees... 10

11 Conference SPEAKERS Dr. Kevin Pottie Dr. Kevin Pottie is an Associate Professor and practicing physician in the Departments of Family Medicine, Epidemiology & Community Medicine, and Scientist at the Bruyere Research Institute, University of Ottawa, Canada. He is a member of the WHO Guideline Review Committee, Canadian Task Force on Preventive Health Care and the GRADE Methods Working Group. In 2011, he published the Canadian Immigrant Health Guidelines, an internationally unique evidence based series covering intestinal parasites, malaria, TB, posttraumatic stress disorder, child maltreatment, and other topics relevant for primary care. In 2013, he won the Geeta Gupta Equity and Diversity Award for outstanding national achievements and leadership for minority and under-served populations. He has published over 100 peer review papers and chapters including Migrant Health in Oxford Bibliographies and the Canadian Pediatric Society s new on-line resource: Caring for Kids New to Canada. He also is an avid Nordic skier, juggler, cyclist and birdwatcher. Dr. Anna Banerji Dr. Anna Banerji is a paediatric infectious and tropical disease specialist. She has trained in Toronto, Ottawa, Montreal, and Harvard University, where she completed her MPH in International Health. In 2007 she created the Immigrant Health and Infectious Disease Clinic. In 2009, she created the Canadian Refugee Health Conference which evolved to become the North American Refugee Health Conference, the largest global refugee health conference. In 2014, she created the Indigenous Health Conference: Challenging Health Inequities, which was a call to action. She is currently working on the IHC: Towards Health and Reconciliation. She was a member of the Canadian Paediatric Society First Nations, Inuit, and Metis Committee, where she wrote the statement on injury prevention and scabies. She is currently writing the paper on Food Security and Malnutrition for Indigenous Children and Youth in Canada. She uses a human rights framework for her work, research, education and is often an advocate for vulnerable populations. Her research on lower respiratory tract infection among Inuit children has resulted in changes to the Canadian Paediatric Society guidelines. Dr. Banerji has travelled extensively around the world, including work in Haiti after the earthquake. She has won several awards including the Promising Graduate from the Harvard School of Public Health in 2003, and the University of Toronto Educational Excellence for Community Care Award in In January 2012, she was inducted into the Order of Ontario. Karrie Hammond-Collins Karrie is originally from Montreal, where she studied Nursing at McGill University. She then completed her Master s of Public Health at the University of Saskatchewan, after which she began working as the Supervisor and Immunization Coordinator for public health services with Prairie North Health Region. She currently works there as Manager of Public Health Services, and oversees a variety of programs. Since January, Karrie has been involved with the Syrian Refugee Clinic operating in Saskatoon, supporting the work of Saskatoon Health Region s Population and Public Health Department. Andrea Clinton Andrea is a Nurse Practitioner with the Saskatoon Health Region. She works at West Winds Primary Health Centre, and has been supporting newcomers since the doors opened in Prior to that, she had many years of experience working in isolated northern communities in many areas of Canada. Dr. Mahli Brindamour Dr. Mahli Brindamour is a general paediatrician at the University of Saskatchewan. She has a special interest in caring for refugee children and underserved populations. She serves on the board of the North American Society of Refugee Healthcare Providers. She completed her medical degree at the Université de Montréal, and her paediatric residency at the University of Saskatchewan. Unique Medical Needs of Refugees... 11

12 Conference SPEAKERS Dr. Parviz Yazdani Dr. Parviz Yazdani moved to Canada as a refugee with his family in A graduate of the University of Saskatchewan College of Dentistry, he takes particular interest in the dental and oral healthcare needs of underprivileged and under serviced population of Saskatchewan and works with various NGO s internationally. He maintains private practice clinics in Saskatoon, and is the managing director of Saskatoon West Dental, the outreach clinic of the College of Dentistry. He has been working with new immigrant patients for the last few years. In his spare time, he likes experimenting with food, travels extensively and is passionate about film and soccer. Dr. Kris Stewart Dr. Kris Stewart is an internal medicine physician and the clinical lead for TB Prevention and Control of Saskatchewan. He conducts TB clinics in Saskatoon, Prince Albert and Pelican Narrows. He is also co-director and founder of SIDCN and SHARE, HIV and HCV research and service organizations in Saskatchewan. Dr Stewart conducts clinics in HIV and HCV in Saskatoon and at 6 other sites in northern Saskatchewan satellite clinics as well as continues to practice internal medicine in hospitals within Saskatoon Health Region. Melanie Baerg Melanie Baerg is the Immigrant and Refugee Health Coordinator at Global Gathering Place, a settlement agency in Saskatoon. Melanie holds a Bachelors Degree in International Development Studies and a Masters in Social Work. She has a passion for social justice and has extensive experience working with and advocating for marginalized populations both internationally and locally, including immigrants and refugees. As part of the PATH (Providing Access to Healthcare) program at Global Gathering Place, Melanie has been working directly with Syrian refugee families in Saskatoon, assisting them in accessing appropriate health services and familiarizing them with our healthcare system. She is a member of the Refugee Health Collaborative in Saskatoon and is currently involved in the coordination of the Syrian Refugee Health Clinic. Lorna Knudson Lorna Knudson was appointed Executive Director of the Regina Community Clinic in April 2012 after serving as the clinic s Director of Operations for four years. Prior to coming to the clinic, Lorna worked as an organizational development consultant, adult educator and management trainer in the private, public and co-operative sectors. Lorna is passionate about refugee care and works closely with the interpreters at the Regina Community Clinic. Dr. Yvonne Blonde Dr. Yvonne Blonde is a Family Physician in the Department of Family Medicine and in the Department of Community Health & Epidemiology. She has completed a postgraduate Global Health Fellowship. Her areas of interest lie in vulnerable population health including refugee/immigrant health, HIV primary care and indigenous health. Getachew Woldyesus Getachew Woldyesus is Manager of Settlement Family and Community Services at the Regina Open Door Society and the president of Saskatchewan Association of Settlement and Integration Agencies (SAISIA). Getachew is an accredited Settlement Practitioner in the provinces of Saskatchewan and Alberta. He also holds a Bachelor of Social Work Degree (BSW), and Masters of Social Work Degree (MSW) from the University of Regina. As part of his studies, he conducted several research projects in the area of immigration including: Temporary Workers Program, Canada Seasonal Agricultural Program, and Refugee Protection in Canada. Getachew is a former refugee from Ethiopia. He has been with the Regina Open Door Society since As part of his duties, he provides settlement services to newcomers and has done community development work to develop a welcoming and supportive community for immigrants in the city of Regina. He also provided cross-cultural presentations to organizations, employers, and other members of the Regina Community. Unique Medical Needs of Refugees... 12

13 UPCOMING EVENTS Neonatal Resuscitation Program Provider Course... April 9, Saskatoon, Saskatchewan Saskatchewan Psychiatric Association Conference... April 15-16, Regina, Saskatchewan S.T.A.B.L.E Assessment & Stabilization Care of Sick Newborns... April 16-17, Yorkton, Saskatchewan Practical Orthopedics What To Do, When To Refer... May 13-14, Saskatoon, Saskatchewan Best Practices in Intrapartum Care... May 26-27, Regina, Saskatchewan Fetal Health Surveillance... May 28, Regina, Saskatchewan Drug Therapy Annual Conference... June 3-4, Saskatoon, Saskatchewan SEMAC VIII- Saskatchewan Emergency Medicine Annual Conference...October 14-15, 2016 Regina, SK PMCMP - Practical Management of Common Medical Problems...December 2-3, 2016 Saskatoon, SK ONLINE COURSES HIPA Privacy & Security Manual - create your customized manual to ensure HIPA compliance in your practice The Role of the Practitioner in Indigenous Wellness... March 1 - May 31, (continuous intake)... Launched on-line March 1, 2016 Refer to the CME website regularly for updates. Contact Us: Phone: cme@usask.ca For Online Course Inquiries Contact: Dan Mittleholtz Phone: dan.mittelholtz@usask.ca Unique Medical Needs of Refugees... 13

14 Exhibitor RECOGNITION WE GRATEFULLY ACKNOWLEDGE YOUR SUPPORT Saskatchewan Cancer Agency Early Detection Programs SHIRP - Saskatchewan Health Information Resources Program Saskatchewan Intercultural Association Thank you for attending Unique Medical Needs of Refugees. We hope your experience was enjoyable and your learning needs were met. Please check our website for information: for up-to-date information! Unique Medical Needs of Refugees... 14

15 Staff Contacts Dr. Andries Muller Assistant Dean, Division Head Phone: (306) Mark Brown Manager Administration Phone: (306) Karen Conway Coordinator, Education Phone: (306) Shalayne Hendriks Lead Clerical Assistant Phone: (306) Roxanne Laforge Coordinator, Perinatal Education Program Phone: (306) Heather Stenerson Coordinator, Educational Research Phone: (306) Daniel Mittelholtz Educational Program Designer Phone: (306) Pam Seib Clerical Assistant Phone: (306) Planning a Continuing Medical Education Event? We can help! The College of Medicine, University of Saskatchewan, is a strong supporter of outreach education for all physicians in Saskatchewan. Continuing Medical Education Division College of Medicine University of Saskatchewan Rm 5643 Royal University Hospital Box RPO University Saskatoon SK S7N 4J8 cme@usask.ca Phone: (306) Fax: (306) Office Hours: 8:30am - 4:30pm Monday - Friday Unique Medical Needs of Refugees... 15