All posts by Caroline Mercer

Undesirable: A Sick Immigrant’s Journey Home

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George Fry boarded a ship destined for Liverpool in the late summer of 1907. He had arrived in Alberta only a few months earlier. Red Deer, where he found work, was booming. The town had just become a divisional point for the Canadian Pacific Railway and was bracing for a wave of settlers. Fry, a bricklayer in his forties, wouldn’t be there to see it.

Fry had contracted syphilis more than fourteen years earlier and was facing deportation, according to archival material available online. The discovery of penicillin was still decades away, and Fry’s infection could have already spread to his internal organs and brain.

Cattle in Red Deer, Alberta. 1900-1910. Credit: Canada. Dept. of Mines and Resources / Library and Archives Canada / PA-021033.

“George Fry is suffering from syphilitis and dangerous to be at large. Do not delay deporting,” his immigration records warned.

Newcomers to Canada still face medical scrutiny today. However, a system overhaul could be coming. Immigration Minister Ahmed Hussen says he plans to announce changes to Canada’s medical inadmissibility policy in April, after calling it “out of step with Canadian values.”

The current policy allows the government to deny residency to people whose medical conditions could place excessive demand on Canada’s health care system. Advocates say it discriminates against people with disabilities.

Hon. Frank Oliver, minister of the interior from 1905 to 1911. Oliver developed the Immigration Act of 1906. Credit: Library and Archives Canada / PA-.

Fry’s fate might have been different had he arrived in Canada a year earlier. The Immigration Act of 1906 tightened restrictions on prohibited immigrants. Under the new act,  any immigrant who was “feeble-minded, an idiot, or an epileptic, or who is insane” was considered undesirable.

The physically unwell were also prohibited, including those “afflicted with a loathsome disease… which may become dangerous to the public health or widely disseminated.”

The immigrant’s journey itself was a source of sickness. Canadian port officers became used to dealing with immigrants who fell ill during their lengthy voyage on a crowded ship.

As legislation stiffened, the focus of medical examination shifted from immediate contagion to overall fitness. For Lisa Chilton, immigration historian at the University of Prince Edward Island, this change coincided with a growing interest in eugenics.

“Their sense of what was genetic included a lot of things that now a lot of us would say are more class based,” Chilton explained. She cited the once popular argument that African immigrants were genetically incapable of withstanding the Canadian winter.

“Certainly, a lot of the economic arguments were tinged with racism,” Chilton said.

George Fry was born in Wells, England with light brown hair and a medium complexion. He likely wouldn’t have faced the racism that Asian, African, and Irish immigrants did. However, his “loathsome disease” attracted a unique set of prejudices.

“The defectives of other countries are not merely a burden, whether able to be at large or requiring detention, but they are apt to perpetuate a criminal or otherwise defective population,” a Globe and Mail columnist argued in 1910.

Chilton believes that our mentality towards people with disabilities has changed significantly since George Fry’s time.

“There are opportunities to be inclusive in the workplace of people who in the early 20th century would have been seen as just a burden,” she said.

Passenger list of the SS Lake Champlain arriving in Québec on May 19, 1907. George Fry’s name is sixth from the bottom as “Geo. Fry.” Credit: Library and Archives Canada.

Fry was one of 2,296 immigrants deported for medical reasons between 1902 and 1913. The Immigration Act of 1906 made it easier to deport any immigrant who became a burden to society within two years of their arrival – a sort of probation period.

Fry was deported just five months after he arrived. On Aug. 30, 1907, he boarded the SS Lake Erie bound for Liverpool. A Canadian immigration officer overseas confirmed his arrival ten days later. He was said to be heading to London – returning to the wife he had left behind.

Document 1: Department of Citizenship and Immigration, Deportations, by Cause, Nationalities, and Provinces, from 1902-03 to 1949-50.

Document 2: Statement regarding George Fry, Department of the Interior, Immigration Branch

Featured Image: The SS Lake Champlain, on which George Fry first sailed from Liverpool to Quebec. 1911. Credit: Lamb, W.K / Library and Archives Canada / PA-143538.

Low-income Canadians less likely to get the flu shot

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Canada’s poorest seniors are 1.1 times less likely to get the flu shot than wealthy seniors. This inequality has persisted over time, but is shrinking as high-income seniors are getting the flu shot less often. Vaccination rates dropped 9% for Canada’s richest seniors between 2003-2013.

This flu season has been especially severe, with 53,898 cases to date, according to the Public Health Agency of Canada. That’s a 70% increase from the same time last year. Almost half of all cases reported this year are in adults 65 and older. Vaccination inequalities, and downward trends in vaccination among seniors, are concerning.

Influenza Immunization Rates in Canadian Seniors, by Income Level

Canada’s lowest-earning seniors are consistently less likely to get the flu shot compared with the country’s wealthiest seniors.
Source: Canadian Institute for Health Information, Trends in Income-Related Health Inequalities in Canada: Influenza Immunization for Seniors, 2016.

Vaccination rates among seniors of all income levels are marginally higher in Western Canada, according to the Canadian Institute for Health Information’s most recent data.

Flu activity is at peak levels in Eastern Canada, compared with the rest of the country, according to the Public Health Agency of Canada. Vaccination rates are especially low in Quebec and Newfoundland and Labrador, at 60.2% and 54.4% respectively.

Interestingly, this season’s flu shot is less than 20% effective against the most common strains, according to Eurosurveillance. This brings the relationship between geographical vaccination rates and flu activity into question.

Seniors living in Eastern Canada are less likely to be vaccinated than their counterparts in Western provinces.

Source: Canadian Institute for Health Information, Trends in Income-Related Health Inequalities in Canada: Influenza Immunization for Seniors, 2016.

Link to Excel Worksheet

New paramedic hires won’t keep pace with growing demand

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14 paramedics will be hired this year to support increased demand on the paramedic service.

These new hires follow 24 paramedics brought on in 2017. Since 2016, new recruits have cost the city an additional 13 per cent in salaries, according to an analysis of budget information the City of Ottawa has made available online.

Darryl Wilton, president of the Ottawa Paramedic Association, isn’t convinced this hiring strategy goes far enough.

“Those 24 paramedics and the 14 added this year, we know they’re not enough, because we can trend our increase in call volume,” Wilton said. “It is mathematically not enough paramedics to keep pace with call volume.”

Photo courtesy of Darryl Wilton, Ottawa Paramedic Association.

Wilton estimates that the paramedic service responded to roughly 140,000 calls in 2017. The five-year trend demonstrates a 17 per cent increase in calls, according to an analysis of the Ottawa Paramedic Service 2016 annual report.

Marc-Antoine Deschamps, paramedic superintendent, expects demand on the paramedic service will continue to rise.

“Ottawa’s a growing city, there’s more and more population,” Deschamps said. “They’re aging, they get sicker, and they require more and more of our services. That’s a pressure that’s being felt across our entire healthcare system.”

“If our call volume keeps increasing, we’ll need more paramedics to keep up,” Deschamps added.

Provincial and council approved mandates require that paramedics respond to life-threatening calls within 8 minutes, 75 per cent of the time. This target has not been met since 2015, according to a 2016 report.

Although the paramedic service hasn’t officially reported their response time figures for 2017, Coun. Riley Brockington, vice-chair of the City of Ottawa Community and Protective Service Committee, said mid-year reports suggested the 24 additional paramedics were having an “immediate impact” on response times.

“We have seen a direct correlation between investments in more staff and ambulance vehicles and their ability to get to people quickly,” Coun. Brockington said.

Coun. Brockington, who is an economist, acknowledges the possibility that factors other than the 24 new hires could explain the anecdotal reduction in response times. For example, weather or traffic changes could have helped ambulances get to their destinations faster.

“I think it’s fair to say that [it] is a reasonable conclusion,” he rationalised. “I point to other services across the province where there was an investment in staff and the response times almost immediately improved.”

Changes to another key metric are less encouraging. According to Coun. Brockington, the city ran out of ambulances 290 times in 2017, almost a daily occurrence. A “level zero,” is called when no ambulances are available to respond to a 911 call. Level zero alerts increased 13% since 2016, despite 24 new paramedic hires. There were 256 level zero alerts in 2016.

Photo courtesy of Darryl Wilton, Ottawa Paramedic Association.

Coun. Brockington clarified that code zero emergencies are a complicated metric that can’t be addressed through hiring alone. Instead, ambulance availability depends on the length of time it takes hospital emergency rooms to see patients – a figure largely outside of paramedic control.

“Until a nurse or doctor takes the patient, the paramedic has to stay there. Some are there for hours. When we have our paramedics waiting with patients in urgent care facilities or hospitals, there are times when there are no available ambulances.”

When asked what kind of investment would guarantee demand be met, Darryl Wilton replied, “Definitely more than what you’re seeing on the docket. Definitely more than 14.”

“I think what’s important is that we clearly indicate need, and then it becomes council’s decision as to whether or not they’re going to fund that need,” Wilton said.

Hiring for the new recruits has already begun. Deschamps expects the 14 new paramedics to hit the streets in July.