Undocumented Migrants in Canada: Dr. Caulford Reveals What the Public Needs to Know

Welcome to Canadian Health Equity and podcast tackling the hard truths about health care for refugees and asylum seekers. This podcast is brought to you by the Canadian Center for Refugee and Immigrant Healthcare, I'm Maggie John. In 2023, Canada welcomed close to 472,000 immigrants into this country. And in the last quarter of 2024 alone, 124,000 immigrants were permitted into Canada. While Canada's reputation of being a welcoming country to many has faced criticism, both at home and abroad, leading to tightening of the borders in this country. And drastic changes to immigration policies. There are many who will do anything to come into this country and even more will do anything to stay. Today, we'll hear the story of one such person. Our guest has asked to remain anonymous, so we will call him Marcus to protect his identity. He came to Canada in 2008, leaving his family and loved ones behind. And now lives in this country like many do as an undocumented worker. Marcus, thank you for joining us today. Thank you for our remaining. So tell me, why did you come to Canada first in 2008? Because in my country, the situation is very hard. We only with you, I try to work for the better opportunities, better life. That's why I come into here to Canada. When you came in 2008, Marcus, were you thinking of staying or did you just come to visit first? No, my tenderness is coming to world, it's coming to world. Because it's more hard to go to USA in that time, Canada is more easy just to use my passport or come in here. It was easier to come into Canada back in 2008. Yeah. So what did they ask you when you first came into the country? When you came to the airport or I'm assuming you flew into, did you fly into the country? Yes. And so what did they ask you? Well, I come in, I say tourist to know some plays, because my English is not good, but in that time I have zero English, right? I'm looking for somebody to help me, the same thing, immigration people to help me. The translation, I say, "I'm coming to see, I want to come into Niagara, Sanita, where I have a program, I have a hotel, everything." They say, "Okay, welcome to Canada." And you've never left? Yeah. You haven't left. So what did you hear about Canada when you were back home? What did you hear from people that would come to this country? I hear, I hear, it's like it's not my job, you can find job and you can work in. The purpose is to help my family too. It's not like coming to live here alone on my life, it's to help my family. I say, "Okay, if you go to say, "Yes, I'm hearing." As I hear, you have the opportunity to work, no need to just to clean the construction. How did you get into the country? How did you get here to Canada? No, the only thing you can come in is fly. Okay. Because from Mexico to here, it's only fly. And tell me about your family back home, who did you leave back home? Oh, my lie, I'm comerciante. I don't know what is the correct to work to an English like a seller on the street. That's my life, when I kids, my mom, my whole family to do it. That's what you used to do, used to sell on the street. Like a vendor, like a street. But who did you leave back home? What kind of family, your mother, your father, what relatives do you have back home? That time, I'm having a partner and no kids, but I have a partner, I have my mom, my brother. He had leukemia on that time, and then my sister, I have another brother. And my niece, how it kids do, the family make a big one, right? Yeah. So since 2008, you've been here in Canada, so you haven't had the opportunity to go home and see them? No. What is that like, Marcus, not being able to see your family? Ah, it's hard, it's very hard, but when I think about, I put in the balance where I can do more for my family. If you, I go back, okay, I am with my family, but now everybody's, what I want to do, I can do it now. So here, I have a little not too much, but I can do it, I did it for all my brothers passed away three years ago, but I need to send them money because it's very expensive to help to, to my brother, my father died too for my Kobe, I don't see nobody, but that's what I think. Where I can do it more, if you, I am here alone or with my family, cry all together. Yeah. So you said you lost your brother and your father, your father died as well? My father died, yeah, on the Kobe, with Kobe, while you were here in Canada. That must have been very hard to not be able to go back to see them. Yeah, that's, that's the more where I can feel in the saying, I want to say by my brother, I say by my camera, but it's not. Yeah. Now that you've been in Canada for so many years, what has life been like here? Do you, is it, do you have a good life? Are you enjoying it here in Canada? I have a diabetes, I'm sick sometimes, I come into the center to help me, help me to mars if it's not for this, my life is bad, but you have to help me to have a control. When I think it's not bad, it's not good, because okay, I can live, but you have to, too many people discriminate to you, abuse it to you, you want to work, don't pay it like that. You have to pay, you know, you have to quiet, don't say nothing because if you people know you are in the comments, they have a problem, they'll give you a job, it's too much to, that's why I make animals because I don't, I don't know, somebody say, oh, I don't have nothing like a hidden. But what you're saying is that life is hard because you, you're not able to get quality work because you're undocumented. That's one teen, another teen is my healthy, like I see the regular doctor, like I see more, I don't know, attention, I don't know, too many teens, you have to, it's not support, but you, you have to, you worry, there's a lot of worry. Yeah, yeah, too many teens, it's a, and the world you both know, you, you don't have papers, they say, you do it or get out, you have to do it. They take advantage. Yeah, too much, too much. Have you ever thought of getting your papers and becoming a permanent resident here in Canada? Applying for PR, applying for permanent residency? I don't. Why, why, why don't you want to? I want, I want, but I come in to see one lawyer, another, I forget, what it's called, the, many centers to help you, they say to me, you have only 20% to chance to stay here. Now I'm feeling like I'm free, no problems, because I don't have a problem with the police, with nobody. I can walk in good, but if you are going to apply for, uh, Humanity reasons, the, the Canada knows I'm here, but I don't have it. Canada already knows you're here, but they'll, they'll be more aware. But they're not looking for me. When you apply, they say, no, but bye, he's looking for you. Yeah. Is it, talk to me a little bit more about the challenges of finding work? You said people take advantage or they don't pay you well because they know that you're undocumented. So what kind of work do you do? And that happened when I tried to do a construction. Too many people say, okay, let's go to the job, you're working, you're working for one week, two weeks. And then when it's a day, pay, you say, I don't have money, do what, do whatever you want. I don't have money. You can wait. And then you can go to the police to say, hey, that guy don't pay me. And I know too many people, I don't tell you only my, my experience. I tell you about the many parents, the friends, the one friend, he is going to the police, the police say, okay, he's going to pay you, but you are arrested, you want back to home because you are here working, you know, now you can stay here. And obviously, you don't want to take the chance, yeah, you have to decide what chance you're going to take. That's why you say, okay, I'll be quiet. Or I fight him, why you can do it. So right now, you're working as a cleaner, correct? Yeah. And how much, do you mind me asking, Marcus, how much do you get paid for being a cleaner in Canada? It's the minimum salary. Minimum. Yeah. How do you live off of minimum salary? You have to learn it to live because it's a, to have a good friend sometimes, to help me like I come into the clinic, I don't pay too much, when they have a medicine to give me medicine. That's what I can do, I have a problem with my eyes now, the clinic helped me for this. So that's why I can't have my life here because I can't forget to my back home, I have to send money too. So you have to think about rent, you're thinking about food, you're thinking about your health, and you're also thinking about your family back home. All of that comes out of your minimum salary paycheck. Yeah. I try to do sometimes when I have extra jobs, you know, I can do something. But I don't, like that is maybe it's terrible for another people, but for me, it's help because I can do everything, I don't know what I do. What do you mean you can do everything, what do you mean I have to do everything, I have to send a little here, little money here, little, see, I need to share for all my my necessity. Tell me about your health first, when did you first come to the center? I think 2008, two, like after six months, something like that, when the clinic is in England, in London, in the army, I come in that time and that clinic. And what was wrong? Why did you go to the clinic back then? Because I come in because I don't have a medicine for six months, I don't take my pills. I need a prescription because here in Mexico, maybe you can buy everything, you go to the pharmacy, I need this, the song for you here, no, for everything you have, you need a prescription and control, right? And you have diabetes, is that what the medication was for? Yeah. Yeah. Okay. And so you'd gone six months without your medication? No, yeah, nothing. So somebody told, oh, you can go to this clinic to help you. And were they able to help you? Yeah. 100% and helped me to match. I also heard, you were saying that you almost lost your eyesight. Tell me about that because diabetes can lead to people losing their eyesight. Yeah, I started to blurry my eyes. I have a surgery there and there's a microphone when it's a coffee with a surgery tube. Now I need to injection every month, up to months, I need to injection for you. And I already know the answer to this, Marcus. But if you did not have the clinic to do these procedures to get your prescription, would you be able to afford to go to a normal doctor and get all of the prescription and the injections in your eyes and so forth? Would you be able to afford to get all of that health care? Anywhere else? Oh, no, I don't know. It would be expensive. Yeah. Yeah. It is. I paid for like one year, something more than one year, I paid the injection when it's a coffee. Not sure anymore, but I had to pay a hundred and fifty dollars for injection. Oh, what do you say to people in this country who say, you know, people should come through the legal way. They shouldn't come and say they're visiting the country and then stay. What would you say to people who say we, you know, this is the wrong way to come to Canada? When the people ask me, because many people think it's very easy, it's not, if you don't find the correct people, if you don't find in you in your way to the good people, it's very hard. I know if you want to Facebook, have many groups to the Mexicans and Toronto, many places you can read there. People asking for help, to rent or give me chances to leave because I don't have a home. So what I can say is I say, okay, I can help you stay with me, but it's too hard, it's not easy. You think about it because it's not a thing that all the time is changing. Maybe when I'm coming, it's more easy, but easy in one team because it's very hard because I don't speak English, nothing. So the communication is very hard, and then now you can use the translation, you have more tools to do it, many things. When I'm coming here, it's more hard. Only you take a bus, that time you have to see and the stop bus to the time, if you have to wait for 10, 20 minutes in the winter, you're freezing, now you just put it up, okay, it's coming in two minutes, you're freezing outside, and that time you have to freeze it. But what would you say, Marcus, to people who live here who say, you know, immigrants are coming in and they're not coming in the right way. They're coming in, pretending to be visitors and then staying past their time. What would you say to them about that? Okay, because it's two different people. When they you have a chance to apply for some job because you have it like an engineer, you have a one job, it's specific. And another people, you can show you, oh, I don't know, qualified job to looking for here, kind of that. If you say, I'm a cleaner, kind of say, no, I don't need it. So that's why the people say, okay, you have to lie because if you say the truth, I'm coming to looking for job or for better life because I know many people that have a life race in Mexico, you have to lie and they try to apply for refugee and they kind of say, no, you go back. And I know too many people that like the event stories and they say, go ahead, no problem. So it's two different people is if you have like an nurse, like you have it one, I don't know what is the word correct to work to say, but if you have one qualifications or you can apply, you work to see if you are qualified for that or no, but the more people, he can say, yes, I'm nurse and the counter, that's that's the two different people. The more people don't have it like one profession to show to Canada or Canada say, yes, go ahead, come. What would life be like if you were to go back to Mexico? I don't, be honest with you, I don't see my life back to Mexico. I see my life, you want to say, you have my mom to call my mom, but I don't want to, but what would your life be like if you had to go back, what would you end up doing? What would you do there? Be honest. I don't know. Now my life has changed. My mental has changed. I don't come in like a tinky when I start to come in here. Now I have another tinky, it's very different. I don't know. I don't know. And what would life be like for your family if you weren't able to send back money to them? What would life be like for them? It's maybe more hard, but my family still continue their life, everybody do their lives. But now if I back to my, when my family, I think it's not the same. Because everybody do their lives like I don't know, I'm here, I don't know where it is like everything changes, you know? But that's why I don't, I don't, I can say to you, oh, if you, I go back to Mexico, I want to do this and this, I don't know. It's been so long. It has been so long. Yeah. And then the first, I don't want. Yeah, of course, of course. Thank you so much, Marcus, for your time today. No, thank you to you for, I may hopefully again, I can do something for somebody else. I'm now joined by Dr. Paul Cofford, the co-founder of the Canadian Center for Refugee and Immigrant Healthcare. Thanks for joining us again, Dr. Cofford. My pleasure. So you have heard, you've heard Marcus's story. You know him very well, personally. How many people do you meet in your practice who, like Marcus, love this country and yet for one reason or the other, don't feel compelled to become permanent residents for one reason or the other? Well, it's a real mix. Maggie, it's interesting when I, when I listen to his, his words, I heard that. I see it on a fairly regular basis, but I also seem, I would say there are more who simply would very much like to have Canada accept them as a permanent resident or eventually as a citizen. Yeah. I think what I was hearing from Marcus is that he needs to bring more, this feeling of needing to bring more to the table, even though he is supporting our society in so many ways, but feeling like maybe he's not doing enough to get that sentiment. Yeah. That's a good observation. And it's interesting that you would pick up on that. I think he, he probably feels that his application would not be accepted. And although by being in the country for as long as he has, I mean, 18 or 17 years or something, it's almost an automatic that he would not automatic. But it's very strongly that, that, but that much time here and that much contribution that he's underestimating what he brings to the table in terms of what he's given this country. You have being on the front lines of very, very disagreeable, oftentimes very difficult jobs and that's so typical. And he doesn't see the, or doesn't appreciate the discussion. Maybe he feels illegal. Maybe he feels ashamed. Does he appreciate how much he's brought forward to Canada by doing those jobs that are a front line? And very vital. Yeah. So this country's prosperity, economy, gross domestic product, all the things that are now front and center in the tariff situation and in needing our marcuses of the world because more than four to five, given our anemic birth rate, more than four to five of the work is going to be done by people arriving from elsewhere, different places. The fear of the unknown, right? Like not knowing what the response will be. And what does he have to go through? What more oops? And I often liken it to some sort of fraternity hazing. You know, more of a hazing does, as he has to go through because he's already experienced the negativity, the remarks that he's heard the comments, he hears the news. He probably simply, and his English was so much better, but it still wasn't where it might need to be to touch the finer points of how he's feeling. And I know from Nester, and talking to him in the past, and when you said I know him personally, I know him a little bit that way now that he's supporting and feel strong enough to support the issue that he confronts in our country and bring it forward. But I think he's still a very shy and reserved and very fearful person to come forward. He doesn't probably think he's good enough. Now that side is very common that we hear from people they'd love to be. I think he'd welcome being Canadian. He just doesn't feel that we might feel that somehow he's good enough for he's jumped through all the hoops. Let's talk about the humanitarian side of Marcus's story, again, like many others. And I think from the aspect of how you met him through his health needs as well and being able to offer those services to someone who's in this country without documentation. But as we've underlined so many times and so many of the interviews we've had, and we've just said, these are people who have contributed and continued to contribute to our society. And yet still struggle to access basic healthcare. And in Marcus's situation, it comes to a dire situation of being able to keep his eyesight. Oh my god, yeah. Well, when he came in, I was leaving. And he was milling about the waiting area. And I could see he was nervous and he was unsure and wasn't quite sure what next. And I could see he was not quite himself and I didn't met him before. And I don't think he'd been before except maybe remotely in the past. I said, you know, so I can help you and what's up and introduce who I was as a physician there. And he said, he went with his hand over his eye. He said, I can't see out of this eye at all, I can't see you. So we took him in and I ended up staying and he had had a hemorrhage into his eye because he hadn't had adequate diabetic care in five years. He'd had a spot of it here and there, but it had been untreated. He couldn't afford it. He was afraid to seek out medical care. He was under the misconception that somehow seeking medical care would lead to your discovery here. And by authorities and you'd be reported and you'd be home. And of course, he'd come here because he was in such poverty back home. He couldn't afford to help his family and to pay for the family. That's such a common story, a poverty is a big driver of migration. So on a humanitarian level, you have someone in front of you who has a diabetic damage to his eye, which is going to lead to permanent blindness. And it's been sending warning signals for several months to him by bleeding and then stopping and bleeding and stopping. It was sometimes going to bleed so badly that he can't see forever. And so it's just a no question, there's no politics in that. He's in front of us, he's here. He has rights here, he's a human being here, he has human rights here. He has the same right to health care as you or I do exactly the same. And no bit of politics can change that. There was no question that we would treat him and we did and we continue to, but that's a different part of his story, but it's been going on now for a number of years. And interestingly, at the very time, he was having this happen to him. My own son was having this happen to him as a diabetic, a young man having blindness problems and difficulties for different reasons. But if I can, I just want to read something to you, if I might, from a paper published on the sort of question of whose responsibility is health care for Canada's undocumented workers. And I prefer workers to undocumented migrants because they've settled down. They're no longer migrants, they're workers. And Dwyer writes in one of his really wonderful articles, refugees, forcibly displaced, undocumented workers, all have a right to health care and healthy conditions. And the international covenant of economic, social and cultural rights, it's the United Nations organization recognizes and quotes the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. And he goes on to say that human beings, by virtue of their inherent worth and dignity as human beings, have this right to health care. And it certainly goes much further than that for Marcus. And I think that's the core condition that, or the core argument, sorry, that we need to bring a human rights perspective to refugees. Much of the immigration question today circles around PRs and immigrants and visa students, et cetera. And refugees, there is a no choice, a no brainer, they have to escape, they have to leave. It may well be poverty, it may be persecution, war, et cetera. And we're a nation whose long history of that and have been built by that. So I don't think that the humanitarian situation is something that should be lost on us. And I think you're underlining the global conversation about this, right? I mean, this has been brought up to the UN and they are holding Canada to account when it comes to the rights of access to health care for the undocumented workers, you're absolutely right, immigrants, refugees that are calling this country home, who have consciously made the decision. And this is a global conversation where the UN is also challenging our country to say, you need to do better. Maggie, it's interesting, you know, if you think about how if we had let him, and he would have lost his vision, if I'm going to say this, if the center wasn't there for him. And it would be something that no human being should be subject to. The United Nations calls having pain over five out of a 10 scale, as they label it as being abuse by anybody who doesn't try to help that. Imagine a physician being labeled as abusive because they're not trying to help that. And that would treat Marcus like no human being should be treated. That's the real crux of the humanitarian. And about the issue of the United Nations calling up Canada, Marcus did allude to that. It's very interesting. He commented about his words were something like, and I think they were, if he didn't want to do the job, because he was working, and he really didn't have any rights as a worker, as you or I would in a situation, because he does have rights, but doesn't know what they are. But if he, he said that his boss said to him, if you don't want to work the hours and the pay that I'm telling you, you're going to work, well, you can just say what you want and you'll be gone. And that word could mean you'd be gone from the job because I have many other people. But to me, it meant what the United Nations is talking about with Canada is that our foreign worker, our migrant worker programs or situations, because they're not really programs. Some of them are a breeding ground for modern day slavery. And when you hear modern day slavery, you say, what the heck is modern day slavery? Because for me in conversation with people who had family histories of slavery, they talked about the ownership aspect of slavery. And they had difficulty necessarily wondering or thinking, did migrant workers, undocumented workers have that level of slavery and that there was this boss of his applying that very level. I own you. I own you, Marcus. And if you just, and I've heard this numerous times in our work, and that to me does mean we have a major problem in how we are accepting the work of undocumented workers. They're not being by the majority of them removed or taken away, but they're allowed to continue to do work that other Canadians won't necessarily do because it's too dangerous. They won't pick fields of fruit when there's pesticides around. They're not going to be running to do that. And I think also, I think they're aspects to ownership, but also aspects of, as you said, I don't have any rights, so I can't say, I can't advocate for myself, and I can't bring anybody else in who can advocate for me because, you know what, there are thousands behind me who would love this job, which is what I got from the sentiment from Marcus and others that I've spoken to as if you don't want to do this, if you don't want to, you know, pick vegetables with all the pesticides, all of the things that we get undocumented workers to do in our country, there are thousands behind you who will take your place. And so there's a sense of, well, I guess I have to do it instead of saying, no, but I do have rights, and even knowing what rights they have absolutely is a part of the fear, I think we hear from those like Marcus who are struggling. So I guess to wrap up, Dr. Crawford, how do you, how do you communicate that? How do you communicate that to your clients that their voice matters in this country? And also I'm going to add on top of that, how do you also communicate that to Canadians who have some perpetuated this narrative that these undocumented workers don't have a voice or shouldn't have a voice? We let them know that no one's illegal, we let them, we try to give them a sense that this is a home for them, that we're trustworthy, that they can speak to us about what their anxieties and concerns and dreams and goals are, that if their goal is to become a Canadian PR documented, have some form of acceptance and status in Canada that we're here to help them. We offer now a program through the North Pine Foundation's investment in our clinic for five years and I've started a program, excuse me, called Launch and Launch is designed to open eyes and doors and ears and knowledge in those in our community, those many thousands and there's millions in Canada who are uninsured, in limbo, in a health system that's anything but universal to them, doing very difficult jobs and we open, we say we know that you don't have the same chance I have by accident of birth, by circumstances of economic world geopolitical crises and issues and that you don't have given your position here the same opportunity for social progress, for growth, for their children or in school often so they're getting education and we try to bring out in them that we offer an opportunity for them to have knowledge and not just listen to the rumors in the hearsay and the misperceptions and the myths that are out there that if they come for a doctor's appointment they'll be found out that if they don't have any rights and so we offer an educational sessions on a regular basis now because of this grant and we also have a legal option for them to speak without fee to somebody in the legal profession, a lawyer, a paralegal who's knowledgeable and will give them the facts and then in fact that's you know that's one of the reasons we started this podcast was so that those very people who are the least or the most disadvantaged, the most unserved, unserved would be able to in a safe place say well I might like to follow, follow this path and maybe I could pay a little bit every so often to be able to get an application in and then we help with the applications. So we've actually taken a proactive approach to opening the subject with them that their social progress to us, their equality, health equity, social equity matters to us as health provider. As far as the side to your question I think it was that the perceptions and that get perpetuated and get bred into us like is they're taking their taking my jobs? Well are they? Well they'll we'll see you in the fields then with them too bad you weren't there ahead of them they wouldn't have had to come or they wouldn't you know so we try to break those down through whatever means we have our social media platform interviews that we have done with with media things such as this podcast the myths are a long list of Maggie you know the plastic one would be well they you know they broke the law when they came here well neither Marcus nor who you'll you you'll hear in the next interview final interview with Marcia neither of them broke their law and that's the majority of people coming here they didn't break any law they came here at a visa and Marcia you'll see how to work visa and then fell through these gaping cracks in the system and the tragedy that ensued for that dear family and the other thing is well they let's say they did break the law let's say one of the people who got smuggled in because there are some who come in that way they don't know they don't understand there might be a way and there's less of a way now with the hardening of our migration system if they did break the law there's a whole bunch of Canadians who've broken the law like the drug dealer on the corner outside of my hospital who comes in with a stab wound from a deal gone bad warning us to fix it and of course we fix it would we say to him oh no you were breaking the law we're not going to treat you but we say that to Marcus and no he didn't break the law even and so that's just a simple example of many misperceptions which we don't have time to go into today so I'm sorry for droning on a bit but they're we just keep fighting back against them and it's not changed much on this front because it's still as you'll hear from Marcia happening you know take the take for a minute the visa student who comes in and pays handsomely for university or college and then after five years and has kept that that system of education and the higher education system afloat and we're now seeing that they've cut back on those students that many of those universities and colleges are closing courses letting go professors dumbing down their programs that was kept alive by people with student visas who also worked here doing delivery jobs whatever they could support themselves and support Canada at the same time the myth is that somehow these people are bad and then all they do is ask whether they can stay and then they have to fill in forms and they often get turned down but meanwhile they were keeping afloat much of our university and higher academic system it's another myth no I think this is good context and also again we hope that our listeners gain another perspective on this issue that continues to evolve not just in our country but on our continent as we watch it just you know unfold in different different ways thank you so much doctor offered for your time today really appreciate your insight well thank you for listening to Canadian Health Equity this podcast is brought to you by the Canadian Center for Refugee and Immigrant Healthcare located in Scarborough Ontario this series is produced by lead podcasting and partnership with Change Made Studios I'm Maggie John for more information about accessing support from the center or for ways you can support their initiatives visit www.healthequity.ca