Navigating the healthcare system is a daunting task. For Canada’s refugee population, however, palliative care access comes with additional barriers. Issues of inadequate healthcare in transit, inability to access provincial health insurance, communication issues, unstable housing, and the weight of one’s trauma leaves refugees seeking health services lost and overwhelmed. That is where GPS Health Navigators, a not-for-profit organization dedicated to providing palliative care access to refugees, comes in. In this interview, project manager Vilma Oliveros sheds light on how this organization offers resources and support for the under-served refugee population.
Lexa Frail (LF): Could you tell us a bit about GPS Health Navigators?
Vilma Oliveros (VO): GPS Health Navigators is a not-for-profit organization working out of the Greater Toronto-Hamilton area. We were founded by McMaster University palliative care doctors, Dr. Priya Gupta and Dr. Humaira Saeed, who did research on how often refugee palliative care patients were accessing support services. This opened their eyes to this issue and inspired them to prevent refugees from falling through the cracks of our system.
Our aim is to provide palliative care for refugee claimants who don't have provincial insurance yet. Despite being covered by federal insurance, refugees have a lot of barriers accessing the same community support and home care services that people with provincial health care have.
LF: What are the biggest challenges facing refugees in need of palliative care?
³Õ°¿:ÌýThere are two different types of refugees: convention refugees and refugee claimants. Convention refugees come as protected persons because they are under the international agency that protects refugees (UNCHR), and they can access their provincial insurance almost immediately.
Refugee claimants are people who get to Canada and submit a claim once they land here. If their claim is accepted upon arrival, they get federal insurance through the , but they still need to go through a whole process until they are deemed protected persons. Right now, that process takes around 29 months. If they get sick during that waiting period, they cannot access provincial insurance.
Usually, refugees have more health issues than the general population because they don’t have access to proper health care during transit. When they finally seek treatment in Canada, an illness that’s treatable for someone with healthcare access becomes life-threatening. For example, a diabetic refugee without proper care could reach a point where it's impacting other organs. This is true for all untreated progressive diseases, like cancer.
When refugees first get here, they don’t know where to go. They’re in the middle of a new place with no support or guidance. Even if the services are out there, they don’t know how to find them. That’s the first barrier. Then, there’s the communication barrier. How do they ask for the right support if they don’t speak the language? Even if you are born here, navigating the system is difficult. So, for refugees coming from a totally different background, with no experience navigating the system, it’s like climbing Mount Everest. They end up going to the emergency room and staying hospitalized longer than someone with provincial insurance would.
Home care for palliative patients requires a team and resources: personal support workers, visiting doctors and nurses, equipment, and medication. Provincial health insurance and agencies provide all of that. Without that insurance, refugee patients are discharged without support. That’s where we come in to fill the gap. We guide hospital staff to make appropriate referrals so that refugee patients can access the services they need.
LF: What services are you providing—and working on providing—to help fill the gap?
³Õ°¿:ÌýOur service aims to connect refugees living with life limiting illnesses to palliative supports in the community—medical support, homecare support, and social support. Our team of physicians and nurse navigators coordinate services and these supports for our refugee patients. We also guide the health care providers involved in the care through the process of registering with the Blue Cross, the agency that runs the Interim Federal Health Plan so they can provide care. When a referral comes in, our palliative doctor and nurse navigator completes a comprehensive home care assessment of the patient. We then set the patient up with home care and social supports and ensure they are connected with the local palliative care team to help patients stay home. We have built numerous partnerships with smaller nursing agencies, pharmacies, occupational therapists, suppliers, and community organizations so that the navigators can make referrals to these agencies for patients to then be set up with the right supports at home.
Unfortunately, the Interim Federal Health Plan is not easy to navigate. We provide guidelines for our health care providers to make it easier for them to register under the system and know how to provide care in a timely manner. We are also developing a toolkit for hospices so they can also provide support services to the refugee population.
In our context, most of the referrals for hospices come from Ontario Health at Home, which cannot be accessed without provincial insurance. We are trying to bridge that gap by supporting hospices in taking refugee patients and by providing support in the community. One of the biggest barriers to care access is making sure peoples’ basic needs are met. Refugees might be getting treatment or support for their illness when they go to the hospital, but once they're out there, they also need food and housing. So, we make sure that other services in the community step up and provide those services. We have referred the patients to community centers, food banks, transitional housing, and other support services in the community that can fill those gaps. The goal is to support them holistically because they are impacted by all those systemic barriers.
On top of that, this is a population profoundly affected by grief and trauma. We train our providers in trauma-informed care, because grief and loss are part of the refugee experience. They might come from countries that were at war. Along with the loss of family, these people have left everything behind: their jobs, their houses, their friends, and their lives. Then, they’re diagnosed with a life-threatening illness, and they don’t have anyone to talk to. We try to help them through all of that.
LF: What are the best ways for healthcare workers to support refugees seeking palliative care services?
VO: I would say the first step would be to educate yourselves in the services available in your area. You can always reach out to us if you don’t know where to start. Our goal is for teams everywhere in Canada to replicate our work. If you're interested, we can come out and provide training and education for this purpose. We can also guide you through registering with the Interim Federal Health Plan. More people advocating for the refugee population leads to better support services for them.
LF: Is there anything else you'd like to add?
³Õ°¿:ÌýThis work is very personal. My family and I came as refugees 16 years ago, and I know how isolating and terrifying it can be to be in a new place. I can't even imagine having to go through the illness journey and grief process alone. This work is really needed. So, try to learn about other people's disadvantages, build self-awareness, reflect on your privilege, and try to use your power to support those who need it and find your passion, because that's what's brought me to the palliative world. Through that, I've met incredible people along the way who have restored my faith in humanity. My team and the love and the care that they bring to the community is just inspiring. I am really grateful for this opportunity, and we're here for people who want to do this work.
Challenges with healthcare access for refugees continue to arise. Starting May 1, 2026, Immigration, Refugees and Citizenship Canada (IRCC) will require co-payments of 30% for for those covered under the IFHP. Home care services are considered supplemental, creating yet another barrier for refugees. Now, more than ever, the support of GPS Health Navigators and similar organizations is needed. For more information on this critical work, visit the GPS Health Navigators .