Lily has risked her life working on the frontlines in one of the most dangerous settings for COVID-19 deaths in the country: long-term care homes.
She says that she doesn’t think of it as dangerous and that she loves the work that she does. She actually transitioned from one-on-one care to long-term care during the coronavirus pandemic so she could help more people.
“Some of them think that once you reach a certain age, you don’t have (a reason to live),” Lily told Global News. “But for me, I always try to give them that — make sure they know that it’s not the end, being in a home.”
During the pandemic, essential workers like Lily are being called heroes. But despite caring for people on the frontlines of this health crisis, Lily herself doesn’t have access to healthcare.
She’s undocumented. We have changed her name to protect her identity as she fears deportation.
“You walk around in fear thinking, ‘Oh, today’s the day.’ You really have to try to put that behind you and get up, go to work, function,” she says. “It’s something that plays on your mind every single day — that you could be found out and lose everything you’re trying to get here.”
Because she works in long-term care in Toronto, one of the cities hardest hit by COVID-19, she should have been among some of the first people to receive the vaccine. To arrange shots, her employer sent out an email in January, asking staff for their provincial health card numbers — something she doesn’t have.
So she put it off, forced to make excuses for why she won’t be getting the shot alongside all of her colleagues. She says she knows she would be fired if her employer found out she has no status.
“Then what will be your position? You have no money. You have to live here, yet you can pay bills,” she says, exasperated by the thought of once again being put in that situation.
“I don’t want to take that chance.”
Despite assurances from federal and provincial governments that the vaccine will be available to everyone, regardless of immigration status, the reality on the ground is quite different.
There is fear and confusion. Advocates say the way provinces are approaching vaccination excludes and marginalizes migrant workers and undocumented people, despite those communities being some of the most at-risk.
The Migrant Rights Network, the country’s largest network of migrant-led groups, along with 270 other organizations, is calling on federal and provincial governments to ensure people have safe and dignified access to the vaccine, regardless of status.
The Migrant Rights Network says that across the country, it is already seeing people being denied the vaccine, according to Karen Cocq, an organizer for the network. Among the list of the organization’s demands are that the vaccine must be free, not require a health card or the collection of any identification or addresses, or information about immigration status.
The network is also asking for a guarantee that information collected will not be shared with immigration enforcement or police.
“Unless those concrete measures are taken to ensure that everyone has access in practice, the policy won’t matter,” Cocq says.
Advocates say migrants and undocumented people are being denied access to vaccine
Global News reached out to the ministries of health in Ontario, British Columbia and Quebec — provinces that have large numbers of migrants and undocumented people — to see what information someone must give in order to receive the vaccine.
All three provinces say that the vaccine will be free and that a health card will not be required to get it, though a card is asked for at almost every stage from making the appointment to showing up at the clinic for the shot.
When asked what information will be collected, all provinces required a full legal name, address or postal code, date of birth, and contact information.
In Ontario, if you do not have a health card you must bring “another form of a government issued-photo ID, such as a driver’s licence, passport, Status Card or other provincial health cards,” something undocumented people likely don’t have.
“That level of information would keep an undocumented person away,” says Dr. Paul Caulford, director of the Canadian Centre for Refugee and Immigrant Healthcare. He has been providing health care to migrants and undocumented people for more than two decades.
Although provinces have laws in place to protect health information, for undocumented workers, it’s not enough; the fear that information is being turned over to border services and of their possible deportation is too great.
When the coronavirus spread to Canada, Caulford says he knew it would be devastating to the population he treats.
In March 2020, he says six people with symptoms of COVID-19 showed up at the centre in Scarborough. He sent them to the hospital for treatment, but he says they were all turned away after they asked to pay for care but couldn’t.
Outraged by this, he says he started organizing with other advocacy groups to call on the federal and provincial governments to expand coverage to uninsured people.
“We posed the question to them: if you don’t treat everyone in your community and it’s a pandemic, you treat no one. Everyone is at risk.”
It worked. In March 2020, Ontario and a few other provinces temporarily expanded health insurance coverage to uninsured people for COVID-related treatment. Ontario even went a step further and provided access to the full health system. It was a win, but celebrations did not last long.
Caulford and other physicians say it took hospitals a long time to implement the new policy. For months, people without coverage were being turned away or asked to pay for care.
“We had to advocate and phone (the hospitals),” Caulford says. “(The provincial government) didn’t really blast on the loudspeakers that it was happening.”
“There was a policy announcement without a plan for implementation,” adds Dr. Dan Raza, chair of Canadian Doctors for Medicare and a family doctor at St. Michael’s Hospital. “We absolutely cannot make that same mistake again.”
They are on the frontlines
Let’s take a moment to look at the scale of the problem.
More than 1.6 million people in Canada are migrants, refugees, or undocumented, according to the Migrant Rights Network. That’s one in every 23 people.
They come here through Canada’s various temporary foreign worker programs, via study permits or without documentation at all. They work in various frontline industries, such as health care, delivery, cleaning, construction, farming, and warehousing.
“This isn’t something that’s in the cracks, in the margins, in the shadows. This is a core part of our economy,” says Fay Faraday, a labour and human rights lawyer and an assistant professor at Osgoode Law School.
“There are significant sectors in our economy that would grind to a halt and businesses that would shut down without undocumented labour.”
The pandemic has brought to light the importance of essential workers, whose often low-paid, precarious work has kept the country functioning. While these people have received thanks and praise, for those with temporary status or no status at all, the last year has been devastating.
Like many Canadians, migrants and undocumented people have lost their jobs during this crisis but unlike Canadians, they cannot access emergency financial aid.
Most temporary workers are here on what’s called an employer-specific work permit, meaning they can only work for one employer and only do the job assigned on the permit. If they lose their jobs, they lose their income, health care coverage, and can’t legally work anywhere else until they find a new employer willing to submit an application for a new work permit.
That process of finding a new job and getting a work permit can take anywhere from nine months to more than a year in normal times, explains Faraday, and now the pandemic has made that take even longer.
With many industries shuttered by the pandemic, finding an employer who is willing to do the necessary paperwork can be tough and government processing times have been delayed, meaning people are waiting longer for the benefits that come along with the permit, like health coverage.
In order to pay bills and make ends meet, people are often forced to take work in the meantime which results in them losing their status if the government finds out.
“So there is a growing number of people who are in very precarious circumstances and have lost status for reasons that are completely beyond their control,” Faraday says.
How to provide migrants and undocumented people safe access to the vaccine
The federal government says it knows that people are struggling due to job losses and service delays, but claims it has put policies in place to get migrants back to work, like extending windows of time for people to reapply for status and letting people work while permits are being processed.
For people in Canada without documentation at all, not having access to health care during a global health crisis has been beyond challenging.
Laura normally works as a residential cleaner but she lost her job because of the pandemic. She lives in Vancouver with her husband and their two children. We are not identifying her because she fears she could be deported.
Laura says the last year has been tough on her family. On top of struggling to pay rent, she has been terrified to get sick.
“It’s really scary for us to get the virus because we say, are we allowed to go to the hospital?” she says.
Now with the vaccine available, Laura says she wants to get it but is nervous to go to a clinic.
“I won’t feel comfortable giving my personal information,” she says. “I don’t know what they will do with it.”
There are past examples of hospitals providing information to border services. Six years ago, a Vancouver health agency reportedly referred information about patients to the Canada Border Services Agency (CBSA), though since then the practice has largely stopped.
Undocumented worker speaks out about barriers to access COVID-19 vaccines
This fear is deeply ingrained in these communities and the government isn’t doing any messaging to combat it, Caulford says.
“All the government needs to do is put out an announcement through the radio that if you happen to be undocumented, come to the vaccine centre, you’re safe. No data will be collected that will harm you,” he says.
He says he recently had a patient who almost went blind in one eye because he didn’t want to go to a hospital.
“That’s how frightened they are of accessing health care.”
Caulford started the Canadian Centre for Refugee and Immigrant Healthcare, a volunteer clinic in Scarborough, with some colleagues after witnessing an undocumented teenager almost die after being denied care in 1999.
“We’d hoped we’d be out of business in one year after we told everybody what we found in 1999 and we’re here 23 years later and it’s worse,” he says.
He’s now on a mission to get vaccines to the centre’s patients. For weeks, he has been wading through layers of bureaucracy in order to set up the centre’s own pop-up vaccine clinic. He’s hopeful to have it up and running soon.
“There will be phone calls to thousands of people to say, come in, and give them a heads up and address the vaccine hesitancy. But we’re not going to collect your information. And they’ve come to trust this place,” he says.
It’s important work, but the clinic is small and he says resources are limited. He’s frustrated by the lack of action from the federal government and says, “we’re here because of bad policy.”
“After all these years, they’ve still continued to let these people fend for themselves and be lost,” Caulford says. “It’s a form of apartheid health care because it’s a highly racialized population. Ninety-five per cent of our patients are persons of colour and visible minorities.”
After more than 20 years of pleading with the government, he says if this crisis does not bring awareness to the limitations of Canada’s health care system, he doesn’t know what will.
“Every morning, I wake up being grateful I’m in Canada, but often every night, I go to bed thinking about where we’ve let human beings in far less fortunate circumstances than ours down.”
For Laura, getting the vaccine would mean she would be able to return to work and better support their two children during this crisis.
“It’s necessary for everybody,” she says. “I don’t want to be out of that just because of my status.”
Last summer, after three migrant farm workers from Mexico died from COVID-19, Prime Minister Justin Trudeau acknowledged the conditions that have left migrants and undocumented workers vulnerable to the virus.
“We know there are many issues, from living conditions to the fact that temporary foreign workers are tied individually to companies or employers, to various challenges around labour standards,” he said last June. “We can even look at things like pathways towards citizenship, which would give people more rights.”
Cocq from the Migrant Rights Network says it’s telling that the government recognizes the solution to the problem and yet refuses to act.
“The government has clearly recognized that permanent residency is what will give people access to the equality that they are demanding they deserve. But it’s only for some and not for others,” Cocq says.
As part of Canada’s economic recovery from the pandemic, the Trudeau government plans to accept 1.2 million newcomers to Canada over the next three years. The government says the 401,000 immigrants it would accept this year is the highest since 1913.
Immigration Minister Marco Mendicino declined our request for an interview, but in a statement, his spokesperson Alexander Cohen says the government is “seizing the opportunity to engage those immigrants who are already here, but without permanent status.”
The government has created one new initiative called the “Guardian Angels” program, which would allow people without permanent status and who worked in healthcare during the first wave of the pandemic to apply for permanent residency. But the requirements for eligibility are very narrow.
Yet Mendicino says he’d like for it to be more broad in scope.
“We’ll deliver on our plan by making the most of the talent already within our borders. Their status may be temporary, but their contributions are lasting,” Cohen says in a statement.
“There are workers who are doing front-line dangerous work during the pandemic, throughout the economy. All of them are essential. All of them should have status,” Faraday says.
Advocates say the government’s decision to create “pathways to permanent residency” leaves people exploitable.
“We’ve created a system that very predictably puts them at a disadvantage and imposes human suffering unnecessarily, but in a way that is functional for other people who profit from it,” Faraday says. “That is not a basis on which to build an economy. That is a basis on building exploitation.”
Lily came to Canada on a temporary work permit seven years ago and has been working diligently ever since, navigating the onerous government system and various programs in order to get permanent status and reunite with three kids and grandkids.
“That was the goal back in 2014, but now it’s 2021 and I am undocumented. I have no rights, no status,” she says.
She lost status last January after her last employer failed to properly complete the paperwork that she needed to get a new work permit and renew her status.
Even she doesn’t qualify for the government’s new program — despite doing a front-line job that many would consider makes her a hero.
“Hero? I don’t know. I just go to work. I’m just hoping that the federal government will see that we all need the vaccines. We all need status. We all need permanent residency.
“The ones who are here, we are here already. We work. We pay taxes. So why don’t you just try and meet us halfway?”
See this and other original stories about our world on The New Reality airing Saturday nights on Global TV, and online.