Seeing is Believing
Mes Amis & St Michael's Hospital
A local initiative provides eye clinics for Syrian refugees and brings communities together for health and safety
When Toronto medical student Tarek Bin Yameen volunteered with Mes Amis/The Clothing Drive he noticed many of the Syrian refugee arrivals were in poor health. As a former refugee from Yemen, he understood that refugees are focused foremost on survival. Going to a doctor is secondary. When he encountered a child with eye problems, he wondered how widespread the problem might be. Even though government-assisted refugees (GAR) in Canada could access eye exams through their health coverage, they were not.
Could a large, institutional sector be responsive to immediate and emerging refugee needs? It would take an inspiring idea, a group with deep links in the refugee community, a motivated volunteer and a disruptive healthcare innovator.
We wrote recently about Mes Amis (formerly The Clothing Drive) and how they leveraged technology and community to build a rapid and effective response to Syrian refugee needs. They’re at the core of this story about providing eye care to recent refugees. This time, their impact would not have been possible without the interest and action of some key healthcare providers in Toronto, Canada.
Bin Yameen approached one of his professors, Dr. Myrna Lichter, a teaching and practicing opthamologist at University of Toronto, working out of St. Michael’s Hospital.
An innovator committed to providing eye health services to vulnerable populations, Lichter was a receptive audience. She had done vision screening projects for homeless and women suffering domestic violence, going into shelters to set up “pop-up” eye clinics. Mes Amis was offering pop-up clothing services to refugees in local hotels. The connection and potential to work together was clear.
Mes Amis was well versed in nimble, pop-up style services, going to where lots of refugees were, and help them. Their strength was organizing and moving community volunteers to action. In late 2015, Bin Yameen saw an opportunity to connect his soon-to-be profession and network to his volunteer work at Mes Amis.
The original idea was to continue the successful pop-up approach, this time for eye clinics. COSTI, the local settlement agency responsible for GAR settlement, was already working with other agencies provide health services to refugees at the hotels where they stayed until moving to permanent housing. Access Alliance Multicultural Health Centre provided primary healthcare. Toronto Public Health provided onsite flu vaccination clinics, as well as urgent dental assessments.
Bin Yameen and Mahfouz thought an eye clinic was a logical addition. COSTI was interested, but the priority was to get refugees into private housing as quickly as possible. As well, bringing the eye screening equipment into a hotel space proved to be an issue.
The idea went on the back burner.
Canada’s health sector is a valued partner and advocate for refugees. For years, Canadian doctors have been strong advocates of health service interventions for refugees. Their advocacy work has had a deep impact. But, they have also created and built services to ensure that refugees can get the help they need. Through specialty clinics, or offering services not generally covered by Canada’s healthcare system (such as eye and dental care services), Canada’s health practitioners have traditionally worked with vulnerable populations.
As Syrian refugees arrived in Canada, the sector was actively reaching out to and providing service to them. Bin Yameen approached Dr. Lichter to see if they could offer something manageable, but impactful. A small pilot idea grew into a bigger idea after Lichter met with Mes Amis’ Mahfouz. In the summer of 2016, together they would pilot a eye clinic at the Islamic Institute of Toronto, a Scarborough (East Toronto) mosque.
Mes Amis arranged participants and translators. Bin Yameen encouraged many optometry students to volunteer. Lichter worked her network to bring equipment and 20 doctors to the mosque to create a pop-up clinic.
Their goal was not to simply screen, but also provide follow up care; good exams and follow up for all of the patients. Supervised by his professor and mentor, Bin Yameen organized logistics. Lichter reviewed every file to ensure that quality care was given to all refugees.
The pilot was successful. So, they expanded. In Fall 2016, they moved their screening to an eye clinic in Brampton, just outside of Toronto. Dr. Ike Ahmed (head of eye surgery at Trillium Health Centre in Peel) donated his Prism Eye Institute clinic space for free. Lichter worked her network to bring in over 40 eye health specialist and optometrist volunteers, among them some of Canada’s top eye health talent. Over 60 medical students, including optometry students and nurses volunteered, along with over 60 Arabic translators, and 20 general volunteers organized by Mes Amis.
Almost 350 Syrian refugees received eye care screening. The intervention was successful, not only in numbers, but also in impact. It also confirmed Bin Yameen’s suspicion, revealing the needs of this vulnerable population. Fifty percent of those screened needed follow-up treatment, and doctors detected more severe vision-loss conditions in some.
Learning, expanding, replicating
The partners achieved their goals of identifying those with urgent eye conditions and referring them onto appropriate services while also educating newcomers on the importance of accessing thorough and complete eye examinations.
Mes Amis and their health sector partners are not planning to stop there. Mahfouz says other Canadian cities are interested in replicating their success. Eye clinics will continue. Mes Amis is also looking at how they can replicate the pop-up experience with dental and mental health services for all refugees. Ultimately, they want to work with their collaborators to create a newcomer medical services program that can meet needs across the city and beyond.
Mes Amis and St. Michael’s Hospital, along with a wide network of health sector volunteers, have shown the impact of collaboration and innovation. They’ve created a pop-up service model that can be rolled out with any vulnerable population, anywhere in the world.
Making it Work for You:
- Volunteers may come for simple tasks and realize they have other skills, connections and experiences that they can bring to the table. And, when the do, the impact can be transformative. Be open to that.
- A collaboration of and formal groups to create something new means having a common vision, but leveraging each other’s unique strengths.
- The healthcare sector, while large and institutionalized, can be incredibly nimble. Community organizations should tap into individual healthcare actors with a track record of innovation. They can bring other healthcare actors to the table to be partners and champions of your work.