by SAMER ELATRASH

When Abdelkader Belaouni’s arm began to swell, he convinced himself it was because of bad sleeping posture. Then he felt it weighing down when he walked, and after a few weeks someone told Belaouni, who was blinded at a young age, that his arm was turning blue. A month went by before he called a doctor who had been providing him care for his diabetes.

“I didn’t want to bother my friends,” he says, referring to a network of supporters, including the MP for Pointe St-Charles, who have been campaigning to overturn his deportation order to his native Algeria. He has spent the past eight months living in a small room in the presbytery of St. Gabriel’s Church, which offered him sanctuary after his appeal to stay in Canada on compassionate grounds was rejected by the government. Belaouni considers himself fortunate, however, for the care he receives. Several doctors make sure his cabinet is stocked with pills he needs for the diabetes. But those familiar with his case worry, however, about the difficulties he’ll face if he finds himself in a critical condition.

“How do we go about dealing with the situation?” asks one doctor, who, like several others contacted for this article, requested anonymity out of concern of possible professional repercussions.

Sick and scared

Like many of the estimated 40,000 immigrants in Montreal whose requests to stay in Canada were refused, Belaouni relies on the compassion of doctors for medical treatment. He tells of a man he met in Montreal whom he had known in Algeria. Sometime after they met, the man called him and said he was losing his hearing. “He didn’t know what to do,” says Belaouni. “I told him about one doctor who could help him.” (Belaouni is expecting another decision from Immigration Canada today, Thursday, June 14, although he has not been making any plans to leave the church.)

Non-status immigrants always live in fear of being picked up by Immigration Canada. There has been at least one case of immigration agents being called on a patient in a Montreal hospital, say doctors who regularly treat non-status immigrants. Many avoid hospitals and clinics, scared they might be arrested or deciding they couldn’t afford the treatment anyway.

The result, says Dr. Marie Munoz with the Côte-des-Neiges CLSC, is that non-status immigrants can live with health problems that are easily preventable. “When there’s a chronic illness or issues of women’s health, like abortion and complications during pregnancy, it gets very difficult to treat these people,” she says.

Others have undiagnosed diseases that are only discovered in advanced stages. A doctor tells of a man taken to a detention centre for non-status immigrants in Laval, where it was discovered he had a serious case of diabetes.

“It’s a cost-benefit thing,” says Dr. Samir Shaheen-Hussain, a practitioner at the Montreal Children’s hospital. “Normally, if you have a chest pain, what’s the harm of going to emergency? But with these people it’s a whole different calculus. They try to delay treatment.”

Another problem is that patients may use contacts with pharmacists or nurses to treat the painful symptoms of a disease, but remain undiagnosed. Paul Caulford, a doctor at Scarborough Hospital who coordinates a Toronto volunteer clinic for non-status and uninsured immigrants, recalls a case of a woman who would show up at the emergency room complaining of severe pains, vomiting and dehydration. Doctors couldn’t detect symptoms of dehydration and would send her away. Apparently, Caulford says, her friend was a nurse who provided her with intravenous therapy, which palliated the symptoms of what turned out to be stomach cancer.

Paying in but shut out

“Non-status immigrants face almost insurmountable obstacles to getting health care,” says Caulford, whose volunteer clinic now attracts more than 20 doctors. “Most of them aren’t rolling in dough. They can’t often afford the bills, and when they do get billed it just pushes them further underground.”

In Montreal, some hospitals take an informal quota of non-status immigrants, usually those in labour, and often write up the treatments as losses, says one doctor here.

The difficulties faced by non-status immigrants in Canada disturb Caulford, who says the Canadian health system could afford to treat them. “We have 20 volunteers in the clinic,” he says. “Every one of them has a practice and a pretty decent life. They can afford to volunteer a night or two every month, and none of them are poorer for it.

“If you’re prepared to say health care is a defining Canadian value, it should be extended to all our residents,” he says. “These people work, they pay taxes, they do the jobs that no one wants. And their taxes go to support the health care we don’t give them access to.”