Someone asked about improving access to emergency services. I think that one of those things is addressing issues related to language barriers and also those related to culture as a social determinant of health.
Years ago, the Public Health Agency of Canada used to have racism subsumed under “culture” as a determinant of health. Now we realize that there are many more differences in terms of racism and culture as the determinants of health, so yes, it's very important in terms of being able to address culture. It's also important to address issues of racism, and also, for a lot of immigrants, to address system navigation: just knowing where to go and how to navigate the system.
Oftentimes, we think of language barriers in terms of, “You speak Arabic and you speak Arabic; just come together and you can interpret for each other, and voila, everything is all done.” Some of the research I have done tells us that there are complexities in terms of interpretation services. You know, one of the participants I interviewed, an immigrant service provider, talked about that. For example, if you have two interpreters, one from the Taliban tribe and one from the Pashtun tribe, and you bring them together and tell them to interpret for each other, there may be clashes in that, because you are bringing together the oppressor and the oppressed.
There also are delicate aspects in terms of gender-based violence. Sometimes you may want to match based on gender.
There are so many complexities in terms of culture and interpretation services, yet, without interpretation, it makes it so much more challenging to address the needs of immigrant populations in Canada.