Citizenship and Immigration Committee on May 1st, 2012

[David Matas]

If you say to people who are refugees from a country, who are fleeing human rights violations, “We don't want to protect you, we don't want you here, and we're trying to discourage you from coming”, that's saying we don't care about the violations in the country they come from.

[Rick Dykstra, Conservative, St. Catharines, ON]

Actually, that's incorrect, because the minute a person or a family achieves refugee status here in Canada, they would immediately be given permanent residency.

[David Matas]

No, they are not immediately given permanent residency. There's a five-year delay.

[Rick Dykstra, Conservative, St. Catharines, ON]

No, that's not true.

[David Matas]

It's a five-year delay from the date of the claim. Once designated foreign nationals are recognized, they do not get permanent residency under this bill.

[Rick Dykstra, Conservative, St. Catharines, ON]

What they get is the ability to be approved for refugee status. They have temporary...they have the five-year allowance to live here in the country. Then they are given PR residence and are allowed to achieve the goal, if they so wish, to bring their families here. Nothing stops their families from applying for that same refugee status as they have.

[David Matas]

If they are outside the country.

[Rick Dykstra, Conservative, St. Catharines, ON]

They can do it from their country of origin.

[David Matas]

If they are outside the country. What's more, because of the denial of travel documents during those five years, they can't even visit their family outside of Canada. It's a forced family separation.

[Rick Dykstra, Conservative, St. Catharines, ON]

So someone who flees their country of origin because of a risk of death should be allowed to go back.... You would advise those individuals to go back to their country of origin to face that same potential risk?

[David Matas]

No, but if they could travel, they could at least visit their family in another country.

[Rick Dykstra, Conservative, St. Catharines, ON]

Thanks.

Mr. Rashid, we haven't had a perspective with respect to health care at the table here. I wondered if you have had a chance to treat any of your patients at any of the detention facilities we have in the country.

[Dr. Meb Rashid]

No, I have never actually had the opportunity of working at a detention facility.

[Rick Dykstra, Conservative, St. Catharines, ON]

So your experience has been post.... When a refugee comes to you, generally speaking, it's when they have been approved as refugees.

[Dr. Meb Rashid]

I've worked with refugees at different points in their migration. I've certainly seen a lot of people at the point when they've arrived and put in a refugee claim. I have seen a lot of resettled refugees within the first couple days of arrival. I've had a smaller number of people who have been in detention for short periods of time.

[Rick Dykstra, Conservative, St. Catharines, ON]

Have any of those individuals acknowledged to you, from a health perspective, that they felt like they were in a prison, or that they felt that in their time in detention they were being treated fairly?

[Dr. Meb Rashid]

It's interesting you mention that. I had a patient, probably about three or four weeks ago, who had come from an African country. He was fleeing persecution. He hasn't had his hearing yet, but he has some very obvious evidence of violence that was perpetrated on him. He was in detention for just a month and came to see me. I asked him a few questions, and he certainly made a point of saying he was treated very well. People were kind. But it broke him. He wept as he told me the story. It wasn't because of what people were doing. It wasn't the food he was given or the conditions within detention. But he never expected to be put in detention here. That had happened in his country of origin. He was shocked that it had happened in Canada when he arrived.

[The Chair, Conservative, David Tilson]

Thank you, Dr. Rashid.

Ms. Sims.

[Jinny Sims, NDP, Newton—North Delta, BC]

Thank you to both of you for coming to make the presentations you did.

Under this new legislation, Bill C-31, we're talking about the potential for a detention for up to a year, and then over the next five years people not being able to have travel documents or to apply. That's very clear in the legislation at face value. If there is something else in the works, we certainly don't know about it.

Recently, you might have heard some announcements. It seems we have a government that has got into the habit of making proclamations, because those are ministerial orders or announcements. This bit was built into the budget, and it was the reduction in health care benefits to refugees. In light of that announcement, what kind of an impact, one way or another, do you think that would have on refugees arriving on our shores, and what kind of a case could be made for these refugees getting good health care benefits to have long-term benefits for Canada, for us as a society?

[Dr. Meb Rashid]

Maybe I can fill that one in. I think the announcement that came out last week has been shattering for a lot of us clinicians who work with refugee populations.

It's hard for me to understand the motivations for it, but it seems like it's been presented as a deterrent for people to come. I can't help but see it framed as targeting the Hungarian Roma. They certainly are the largest group of people we're seeing. There is a lot of cardiopulmonary disease in that population, from what I'm seeing, so certainly the health care costs are high.

What's interesting for me with that particular population is that the folks I've seen have arrived with full bags of medications they pour on the counter and a multitude of different diagnoses. I don't think they had struggles getting health care back home, and I can't speak to the quality of health care, but I don't see that as a draw factor for this population.

What I'm worried about, and I know this will happen after the June 30 date...there are people who are diabetics and hypertensives who will stop taking their medication and will end up in emergency rooms, hopefully without horrible outcomes. I don't think the cost savings are going to be as high as the $20 million that's been projected. I think it could be devastating. We have pregnant women in our practice who are going to lose their care. I'm not sure what they'll do. We have kids who are sick in our practice who won't have a place to turn to.

[Jinny Sims, NDP, Newton—North Delta, BC]

Thank you.

They could end up delivering on street corners or anywhere else. We've had that happen before.

One of the other things I would like you to respond to is the kind of impact it's going to have on asylum seekers who are not coming from, let's say, well-to-do homes. Some of these asylum seekers have been on the run for a long time. Some have already been relocated to one, two, three countries, or they're onto their third country. They're leaving very difficult positions behind. Undernourishment is often an issue. Psychiatric trauma is often an issue.

What kind of a health impact is it going to have on them when we incarcerate them as soon as they land—these are irregular arrivals—on our shores?

[Dr. Meb Rashid]

We've looked at this particular issue with respect to the evidence that exists, and I think you're going to have a couple of speakers presenting tomorrow who will formally present some of the literature that's available on detention in refugees.

I just worked with a resident and produced a paper that's in the process of being published in Canadian Family Physician journal. There are a number of studies that come from places like Australia, some from the States, and some from Europe, which have shown that there are mental health impacts of putting people in detention—and perhaps it's not startling. I think even under ideal circumstances, having someone who does not have the freedom to walk the streets and can't go outside does have an impact, particularly on people who have faced trauma. The extent of the duress seems to be correlated with the length of time in duration. Some interesting small studies have come out of Australia that have actually looked at people who are in the community and a similar group of people who are in detention and have found the rates of mental health issues are much higher, although the cohorts were quite similar.

Yes, I think absolutely there is a concern that we might be re-traumatizing people who have already demonstrated they are quite vulnerable.

[Jinny Sims, NDP, Newton—North Delta, BC]

This could be one of those examples of a penny wise and a pound foolish, when you look at the long-term effects on our economic well-being.

Mr. Matas, I think you very eloquently drew attention to the disconnect that exists right now. On the one hand, we're a country that is very articulate about defending human rights. Yet we're in the process of signing all kinds of agreements with countries where we know there are some very serious violations of human rights.

At the same time that we want to project ourselves as great defenders of human rights, and we have been, we're saying to people fleeing very difficult circumstances—and I'm not going to list them all again—that once you land on our shores, if you arrive by plane and you're fortunate enough to have enough money or somebody can pay for your airfare, we will treat you one way. But if you land on our shores and you come in a group, then we're going to put you in prison. We're going to create this two-tiered system that makes you a victim once again.

I don't see imprisoning people who are looking for asylum as a way of deterring smugglers. The smugglers will move on; they will become more sophisticated. But what message does this legislation send to people who are desperate around the world and are looking for a safe haven?

[The Chair, Conservative, David Tilson]

Thank you. We'll have to do that in another round.

Mr. Trudeau.

[Jinny Sims, NDP, Newton—North Delta, BC]

Could he make a quick response to that?