Who Are We?
Epistemic Marginalization: A Critique of How ‘Barriers to Access’ to Health Care are Framed in Discussions of Refugee Health in Canada
Paper Presentation in a Themed Session Fern Brunger
Our research presents a critique of how barriers to accessing health care experienced by refugee newcomers to Canada have been understood and framed. The literature on refugee health care experiences in Canada, similar to elsewhere, emphasizes logistical challenges, language barriers, and cultural (in)competence. Our study originally aimed to contribute to that literature. We conducted in-depth interviews with newcomer patients, patient advocates, interpreters, health care providers, and community support workers, to identify barriers to care. At one level, our findings reflected what has been reported in the literature. Participants emphasized logistical constraints, patient lack of familiarity with the healthcare system, cultural competency on the part of care providers, and interpretation difficulties. However, inviting patient perspectives on the meanings of those barriers, our findings challenge the current understanding of how barriers to accessing care are experienced. We identified missed opportunities in the way that barriers to accessing health care have been labelled and discussed in the literature: (1) logistical barriers have been linked to patient ‘knowledge deficits’ rather than being understood as a failure of the health care system itself; (2) cultural competency skills of providers have been considered solely in relation to explicit (“exotic”) cultural or religious practices; and (3) descriptions of language barriers inappropriately de-emphasize power differentials. Taken as a cluster, these point to the need for the established solutions for care – specifically, cultural competency training and attention to the social determinants of health – to be re-interpreted through reflection on the culture of the health care system itself.
Who Are the Latino People?: Migration and Identity in Mexico
Paper Presentation in a Themed Session Ilithya Guevara
For decades, Mexico has been a place for migrants. Due to the harsh economic situation in the countryside, many decided to move not only to the most prominent cities within the country's limits, but to our neighboring country where they’re looking for a “better life”. However, it’s also a transit spot for thousands of people from Central and South America who are on their way to the USA. And finally, it is the reception place for a lot of them. One of the elements that get touch by the mobility is the social identity as the people who are moving from one place to another travel with their cosmovision, so this is a case study of some of does people from Latin America who decided to stay in Mexico, and their struggle for finding a new home that let them be part of the community without losing their own identity and the perception from does who always consider them “the others”. Even though from a different perspective we’ll all be considered “latinos”, once that decision to move is done, they struggle every day to preserve those cultural differences that make them alien to the place while at the same time seeking to integrate into the daily routine. From a qualitative approach, it seeks to recover their experiences from the perspective they have of them.
