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American Poker Pros Move to Canada

Phil GalfondO Canada! Our home and native land!’ Yes, that might just be the call from one American online poker pro who has made the big decision to cross the border into the USA’s North American neighbour.
However, another Internet star doesn’t quite yet have the need to learn the Canadian national anthem after having his hopes dashed – for now – by that nation’s immigration authorities.
Several pros, including Olivier Busquet and four-time World Series of Poker (WSOP) bracelet winnerDaniel Negreanu, have travelled north following the US Department of Justice (DoJ) decision to shut down more than a few online poker websites – including PokerStars, Full Tilt Poker and Absolute Poker – back on April 15, or ‘Black Friday’ as that shocking day has now become known.
In the three-and-a-half months since that fateful day, there has been a steady stream of American online stars quitting the States to ensure that they can continue making a living from poker.
The latest to abandon the USA for Vancouver is Phil Galfond (‘OMGClayAiken’) after he quit New York, but another star, Daniel ‘Jungleman12’ Cates, has failed in his initial attempt to relocate to the beautiful British Columbia city.
Galfond – who won the WSOP $5,000 Pot-Limit Omaha with Rebuys event back in 2008 for $817,781 – took to microblogging website Twitter to announce his departure when writing: “To everyone asking, I moved to Canada to play.”
Of course, many poker insiders had predicted a mass exodus of American online pros following that dark spring day, but it really has been more of a trickle.
However, the high stakes star is not unduly worried about his future as he talked about his joy at once again being allowed to display his undoubted skills online, writing that he “was really happy to be back playing at @PokerStars”.
Galfond, who is known as ‘MrSweets28’ on PokerStars, added that the website have “been extremely helpful and responsive with getting everything set up again”, although he hasn’t had as much luck with PartyPoker.
The native of North Potomac in Maryland continued by posting that he had hoped “to start playing on @PartyPoker, but they’ve responded to 0 of my 3 e-mails over the past 3 days trying to verify my account”.
Still, it is almost certain that many other pros will look to follow in Galfond’s footsteps now that the WSOP in Las Vegas is over for another year.
However, for now, Cates won’t be among them, although that could all change very shortly…if he can sort out his visa problems.
Another Maryland native, Cates also ventured on to Twitter to report that he would be “leaving for Vancouver tomorrow, time to crush online again :)”.
But that post proved to be inaccurate as the 21-year-old – who is considered by many to be the best heads-up No-Limit Hold’em player in the world – was refused entry by the Canadian immigration authorities.
Cates, with his online cash earnings from PokerStars and Full Tilt sitting at about $7 million – including more than $5 million last year – later tweeted that, “in a ridiculous twist, I have been deported from Canada for being an illegal immigrant… Going to Seattle tomorrow to try to get temp visa”.
We will soon know if he has been successful, but he later followed up his second post with another that stated: “Apparently I need a visa to play poker for a living in Canada? Wtf? Anyone know about the immigration laws here?”
So, will Galfond and Cates open the floodgates for a poker player evacuation to Canada? Or will we see most remain in the USA in the hope that any future laws created by the American government will be stacked in their favour?
It is certainly a strange time for North American poker pros, that’s certain.

Canadian economy to slow as U.S. cuts spending: economists

Canada likely faces slower economic growth even if the United States manages to avoid default on its debt or a credit rating downgrade, economists said Wednesday.
Topics : 
McGill University , RBC Capital Markets ,Moody’sUnited States , Canada , Washington
The U.S. government’s need to cut spending by between US$2 trillion and US$4 trillion over a decade would delay its recovery and drag down Canada’s rebound because the two economies are so closely linked.
“The short-run effect of these changes is going to be to slow the recovery even further,” says Christopher Ragan, an associate economics professor at McGill University.
“But at the same time they need to put themselves onto a fiscal track that is credible and show they are not going to be hitting the debt wall.”
The U.S. government has been grappling since May with more than $14 trillion in debt – the borrowing ceiling set by Congress – and may not be able to pay its bills after Aug. 2.
That means Washington could be forced to cut its spending by almost half, threatening social security benefits, defence outlays, or even the wages of civil servants.
Ragan said a slower recovery by Canada’s largest trading partner would have a ripple effect on export sectors such as automotive and forest products that have been struggling to return to pre-recession levels of a few years ago.
“Our exports still have a way to go before they get back to a pre-crisis levels, so we’ve got a lot of recovery to go in the export sector and that’s going to slow it down.”
Sluggish growth in the United States cuts demand for many Canadian exports – from oil and gas, cars and auto parts to newsprint, lumber, fertilizer, industrial chemicals, metals and machinery.
That eventually leads to fewer jobs in those sectors and far slower growth than is healthy for the national economy.
A one per cent hit to U.S. growth translates into a 0.5 per cent drop in Canada, said RBC Capital Markets chief economist Craig Wright.
He said financial restraint could prompt forecasters to ratchet down their growth forecasts in both countries.
“It does leave the economy more vulnerable and any further bad news may be in and of itself not enough to knock the economy significantly lower but you start wondering about the cumulative effect of all these negative shocks when the economy is sort of struggling,” he said in an interview.
Potentially offsetting the decreases, however, could be a decision by corporations to spend their hordes of cash in the face of more financial certainty, he added.
Many believe U.S. politicians will eventually cobble together some sort of deal that avoids a default.
Prime Minister Stephen Harper said Wednesday that he was confident the U.S. government would find a way to deal with the situation and avert an economic disaster.
He called the situation in Canada “significantly” better than that south of the border but said Ottawa would remain vigilant and act as needed to mitigate any spillover effects.
“Part of the reason that the Americans are having such trouble dealing with this is that the U.S. debt and fiscal situation is extremely difficult,” Harper said in Brampton, Ont.
“It is very bad.”
Ragan said U.S. debt is not a crisis and levels are relatively lower than when Canada hit the debt wall in 1995.
Then Liberal finance minister Paul Martin tackled the problem by cutting $7 in spending for every $1 raised in taxes. But the impact on Canada’s economic growth was shielded because the American economy was booming.
As the world’s largest economy, the U.S. doesn’t have that advantage.
The impact of a potential default are unclear.
U.S. interest rates would spike in such a scenario but those in Canada may actually decrease. That’s because the Canadian dollar has soared in recent days – as the U.S. greenback weakened over the debt impasse – keeping downward pressure on Canadian rates.
The high Canadian dollar has squeezed the export sector and manufacturers in Central Canada. But if a U.S. economic slowdown cuts demand for energy, minerals and metals, it could drag down the loonie in the long term because of lower global commodity prices.
Wright said the worst case could be a U.S. recession, which would have a spillover effect in Canada.
More likely, a soft patch in the United States gets even softer for a bit longer, he said.
The United States may still face a downgrade even if a political deal is reached. Standard & Poor’s said it wants to see a commitment for $4 trillion in spending cuts.
The impact of that would be less significant than a default and would likely be short term since ratings agencies might provide targets the U.S. would have to meet to regain its top credit rating, said Ragan.
The situation could be in some ways similar to 1998 when Moody’s downgraded Japan’s sovereign rating, said a report by Barclays Capital Research.
“We believe fundamentals will drive assets rather than the ratings revision,” said the report.

    Canada Mortgage and Housing Corporation: Welcome to Canada!

    Canada Mortgage and Housing CorporationImage via Wikipedia

    OTTAWA, ONTARIO–(Marketwire – July 28, 2011) – You’ve made Canada your new home and are probably in the process of searching for a place of your own. Looking for a home can be a very exciting experience that can be both rewarding and challenging.
    As Canada’s national housing agency, Canada Mortgage and Housing Corporation (CMHC) has been providing Canadians – including new Canadians like you – with information and tools to help you make informed homeownership decisions.
    Canada’s population growth is becoming increasingly reliant upon immigration. In the 2006 Census, close to six million Canadians identified themselves as immigrants, representing about 20 per cent of the entire Canadian population.
    To help new Canadians make informed housing-related decisions and find safe, affordable homes for their families, Canada Mortgage and Housing Corporation has developed a multi-language one-stop online source for housing-related information. Visit CMHC at www.cmhc.ca/newcomers.
    CMHC wants to provide newcomers to Canada with relevant and culturally appropriate housing-related information. A wealth of information is available for newcomers in both official languages – English and French – as well as in Mandarin/Simplified Chinese, Arabic, Punjabi, Spanish, Tagalog and Urdu.
    This housing-related information is divided into three areas to make things simpler: Renting an apartment – for most newcomers, your first home will likely be a rented house or apartment. Renting a home should provide you with a safe place where you can begin to adjust to your new life in Canada. It can also give you the time to look for a home to buy without feeling pressured into making a quick decision; Buying a home – CMHC has created a series of guides and tools that take you through the home buying process; and Looking after your home – which will help guide you on how to take care of your home and prevent problems before they happen. Don’t forget to also check out the videos on buying, renting and renovating a home.
    For more information or for FREE information on other aspects of renting, buying and renovating a home in Canada, visit www.cmhc.ca/newcomers. For 65 years, Canada Mortgage and Housing Corporation has been Canada’s national housing agency and a source of objective, reliable housing expertise.

    Contact Information

    For story ideas or to access CMHC experts or expertise
    CMHC Media Relations – National Office
    (613) 748-2799


    40,000 immigrants to be admitted in Canada

    Posted at 07/28/2011 5:20 PM | Updated as of 07/28/2011 5:20 PM

    VANCOUVER – The Federal Government recently announced that it is increasing the number of immigrants to be admitted under the Provincial Nominee Program.

    Forty thousand immigrants under the Provincial Nominee category will be admitted in Canada this year, higher than the 36,000 provincial nominees welcomed in 2010.
    In a statement, Citizenship and Immigration Minister Jason Kenney made the announcement following the rapid growth in the Provincial Nominee program in the last few years.
    “Faster yung processing time. They delegate the assessment of the qualifications in a provincial level,” said immigration consultant, Aggie Roldan.
    Provincial Nominees are nominated by the respective provincial governments for permanent resident status in Canada. They are usually temporary workers or foreign students who meet the province’s economic needs.
    While Toronto, Montreal and Vancouver have attracted a large share of immigrants coming to this country, Manitoba, Alberta and Saskatchewan are the top provinces for the nominee programs.
    The Provincial Nominee Program is also an effective way to get workers quickly as applications are processed within a year.

    Immigrants need cash in hand and have to be prepared for tradeoffs, sacrifices

    MONTREAL – Newcomers to Canada, get ready: being mentally prepared to make sacrifices or tradeoffs when you arrive on these shores is very important, immigrants who have already made the jump told a recent Royal Bank poll.
    The survey found that 58 per cent of Chinese and South Asian immigrants who responded named emotional preparedness as the key for newcomers adjusting to life in Canada.
    A big part of that mental preparation is also the key for meeting financial challenges that can await immigrants, according to one recent arrival.
    “When anybody comes here, I think the requirement is that they must have $15,000 for immediate expenses,” said Ash Ghose, who came from India in 2004 and works in insurance at RBC (TSX:RY) in Toronto.
    “The first two or three months are fine, but if you do not have any source of income coming in after four or five months then the panic sets in.”
    Ghose, who trained as a mechanical engineer but notes that “all my life I have been a salesperson,” said he sold off everything he owned in India and came over with two suitcases and some paintings.
    “I built everything from scratch here, but that is something one has to be mentally prepared for.”
    The RBC poll also found that 47 per cent of immigrants surveyed conducted online research to understand more about life in Canada.
    Judy Sillito of the Edmonton Mennonite Centre for Newcomers said any research that can be done before arriving is helpful, but added that immigrants need an “openness to the unknown.” She also said immigrants aren’t always prepared for the sticker shock of living in Canada.
    “They get here and find out it’s not so easy to make a lot of money and have enough to live on, much less send a lot home,” said Sillito.
    “There’s absolutely no way to explain that to someone who hasn’t been in Canada.”
    She said another surprise for immigrants is finding out how much time new Canadians can spend at work.
    “When you come to a new country and you have to work and day job and a night job and do weekend work, it really takes a toll on the family,” said Sillito, whose organization serves 10,000 immigrants a year.
    Mikal Skuterud of the University of Waterloo said immigrants tend to be older and much more educated than Canadian-born workers, but they often have to take jobs that pay less than their education would imply they should earn.
    “Their unemployment rates are not that different from Canadian-born workers,” said Skuterud, assistant professor in the university’s department of economics.
    “They do get jobs and they get jobs quite quickly but they’re not very good jobs. They’re what immigrants refer to as ‘survival jobs.’ They appear to get stuck in these jobs. They have a very low propensity to move out of these jobs and get into the track or career they were trained for.”
    Statistics Canada’s 2006 census found that a recent male immigrant with a university degree earned $30,332 yearly, versus $44,545 for a Canadian-born man with a degree.
    Nick Noorani, a motivational speaker and consultant who helps immigrants integrate, said it’s essential to have the proper language skills, especially on the job. If you’re an immigrant and a sales manager, you need to have the same language skills as a Canadian-born sales manager, he said.
    Immigrants need to consider what other skills they have to find work, he said, adding his background was in advertising but he turned to publishing when he came to Canada.
    “You need to have a Plan B,” said Noorani, chief executive of Destination Canada Information Inc.
    “When we come here as immigrants we are so focused on, ‘This is what I used to do and I want to continue doing only that.’ That leads to a problem.”

    Canada’s new lustre in the world

    About 10 years ago, the American conservative magazine National Review ran an issue whose cover featured some Mounties with the word “WIMPS” printed across the page. The cover and the accompanying article by Jonah Goldberg, “Bomb Canada: The Case for War,” was a semi-satirical attack piece, taking Canada to task for its perceived anti-Americanism and lack of contribution on the world stage.
    Making fun of Canada has long been a U.S. national pastime. Recall the contest held by Michael Kinsley, then editor of the New Republic, to find the world’s most boring headline. The winner? “Worthwhile Canadian Initiative.” As recently as 2006, Goldberg, writing again about Canada, called us “arguably the most deluded” industrialized nation in the world” because “elite Canadians” think “being different than the U.S. and sucking up to the United Nations will buy them grace on the cheap.”
    Today, no one is laughing at the Great White North – especially Americans – and certainly no one would accuse the Harper government of kowtowing to the UN.
    As economic confidence south of the border plunges to a 15-year low and the debt-ceiling fiasco edges toward catastrophe, many U.S. experts are praising Canada as an attractive low-tax environment and a beacon for sound fiscal policy and good governance. The opportunities before us are immense – and the last to take note, as usual, are Canadians themselves. This week, for example, Canadian business titan Peter Munk said that Canada now has the same opportunity to do with the mining sector what Britain did with the financial sector at the turn of the last century – that is, to become its global centre.
    What’s most surprising about all the plaudits is that much of them are coming from the heretofore most critical corners – particularly from U.S. conservatives.
    Fred Barnes, editor of the Weekly Standard, recently took to the pages of the Wall Street Journal to argue that the government of Jean Chrétien set the example on how to right an economically failing ship: cut government spending and do not raise taxes. As Barnes noted, between 1995 and 1998 Canada turned a $36.6-billion deficit into a $3-billion surplus.
    (The Wall Street Journal was a fitting avenue for the article; in 1995 that newspaper ran an editorial suggesting that Canada was close to bankruptcy. Many credit the attention the editorial received for jolting Chrétien and then-finance minister Paul Martin into action.)
    Meanwhile, a surprising new article in Maclean’s notes that Canada is emerging as the go-to destination for the world’s wealthy. Tax specialists apparently now refer to Canada as the “Great White tax haven” and the “Switzerland of the North.” The inflow of high-net-worth individuals to our country (last year, 12,000 people moved here under a special immigration program for the wealthy) is giving Canada a net economic boost of roughly $2-billion a year – and the trend is likely to continue.
    The U.S. conservative movement is also looking to the Harper Conservatives for ideas. A consensus has emerged in the U.S. that Canada handled the 2008-2010 economic crisis better than any other western country, and conservatives there have been particularly impressed with the Harper government’s campaign strategies of microtargeting defined blocs of voters to broaden its support.
    At the moment, everything from our immigration laws to the GST is being praised by Americans as examples of good public policy.
    A quick pat on the back is more than deserved, and we should give credit to our successive national governments for the sound economic policies that have led us to this place. But we shouldn’t get caught up in self-congratulation either.
    It wasn’t that long ago that we were battling the brain drain (which has now effectively reversed direction) and paying $1.45 to buy a U.S. dollar.
    Canada seems to perform well when the global economy doesn’t. Europe and the U.S. are in the gutter, but we are holding our own. When things are going well elsewhere, Canada is perceived as an overregulator, and to a great extent that perception is true.
    Canada-enviers ought to tread carefully. They should look to Canada as a model in terms of outcome, not of process. In the past we have too often drifted into over-regulation of the economy. With the continuing emergence of the dynamic and risk-prone economies of the group known as BRIC (Brazil, Russia, India, China), this is not the time to take the safe route by turning to increased red tape, particularly in the U.S.
    We obviously have many challenges ahead of us, but let this international admiration remind us that things in Canada are going extremely well – though we have to work hard to hold on to our status as an enviable economy. That status is, for lack of a better term, worth something.
    Adam Daifallah is a partner at Hatley Strategies, a montreal public-affairs firm,and a lecturer at McGill University’s Department of North American Studies

    Read more:http://www.montrealgazette.com/news/Canada+lustre+world/5170300/story.html#ixzz1TOznvBZn

    Ten-year multiple-entry visa: better use of government resources and easier travel to Canada

    Toronto, July 20, 2011 — Improvements to make it easier to visit Canada are coming soon, announced the Honourable Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism. A new ten-year multiple-entry visa will make applying more efficient for applicants and better use government resources.
    “More applications and higher expectations mean that Citizenship and Immigration Canada needs a more responsive and flexible processing system,” said Minister Kenney.  “To achieve that, the Department is providing applicants and staff with the right tools to deliver on those expectations.”
    Citizens of certain countries require a visa to come to Canada temporarily. Currently, the maximum validity period of a multiple-entry visa is five years. However, increasingly, countries are issuing passports which are valid for ten years. In light of this, CIC is changing its policy for visa issuance. Where applicants apply for multiple-entry visas, they may now be issued to the maximum validity according to the length of the passport validity (up to ten years, minus one month).
    This practice, already recommended for parents and grandparents with sponsorships in process, may now be extended to other clientele, such as business visitors.
    As Canada is becoming a preferred destination for visitors and business travellers alike,CIC continues to balance the need to facilitate this travel while responsibly managing our borders. We will increasingly focus attention on applications with the greatest potential for threat and vulnerability, while streamlining low risk cases. Further limitations on validity may apply on a case-by-case basis.
    The ten-year visa will be an option available to more low-risk travellers who are citizens of visa-required countries. As of Monday, the technical changes needed to issue it were in place.

    Canada is the Third Best Place to Start a Business in the World

    …according to the World Bank‘s Ease of Doing Business Index.
    Canada also ranked third in the closing a business category and ranked fifth for protecting investors.
    The World Bank’s Doing Business project provides objective measures of business regulations for local firms in 183 economies and selected cities at the subnational level.
    According to the detailed data on starting a business, starting a business in Canada requires only one procedure, it takes on average five days to register a firm, and the cost, as calculated in percentage of income per capita, is 0.4 percent.
    Compare these figures to a country such as Greece, where starting a business requires 15 procedures, it takes 19 days to start a business, and costs 20.7 percent of income per capita, and we look really good.
    The worst place to start a business in terms of jumping through hoops is Equatorial Guinea where an astounding 20 procedures are necessary to start a business. And if you have any thought of starting a business in Suriname, you better get started; it takes 694 days, just short of two years, to get one started there. The Democratic Republic of Congo is the most expensive country to start a business; it costs 735.1 percent of income per capita to set one up.
    And where is it easier to start a business than in Canada? New Zealand ranked number one, followed by Australia.
    Overall, Canada came in seventh for ease of doing business, following Singapore, Hong Kong, New Zealand, the United Kingdom, the United States and Denmark – perhaps because of our low scores on enforcing contracts and trading across borders.
    By Susan Ward, about.com guide


    Each immigrant costs Canada $450 per year: report

    Description: A train of Vancouver's Skytrain (...Image via Wikipedia

    By: Jon Woodward, ctvbc.ca
    Date: Tuesday Jul. 26, 2011 9:49 AM PT
    A team of B.C. economists has cut a conservative think-tank’s estimate of the cost of immigration down to size.
    Two months after the Fraser Instituteestimated that each immigrant on average costs the Canadian government $6,051 per year – a total cost of as much as $23 billion – Mohsen Javdani and Krishna Pendakur of Metropolis British Columbiatook another look at their numbers.
    Using a wider sample size of immigrants, correcting calculation errors, and using data where it was available rather than estimates, the pair found a far lower annual cost of about $450 per immigrant, or about $2 billion per year.
    “We find that there’s a significant fiscal effect of immigration,” Javdani said. “But we do not conclude that immigrants are a burden to the Canadian economy.”
    Javdani added Canada needs to find programs that benefit new arrivals to improve immigrants’ labour market potential and performance, which would inject money into the Canadian economy.
    The authors are both economists at Simon Fraser University.
    Taxes vs. benefits
    Both studies attempted to figure out whether immigrants fully pay for in taxes the public services that they use, like health care or education.
    The Fraser Institute’s study was an attempt to gauge whether our system should move to select for would-be immigrants who already have job offers, according to co-author Patrick Grady.
    “Canada has to develop a much better system of assessing immigrants coming in,” Grady told CTV News in a phone interview. “They can’t seem to tell if a person is going to be able to find a job at a good salary or if they’ll find employment at their profession and skill.”
    The Fraser Institute study looked at immigrants arriving after 1987 – about 4 million people – and compared them to average Canadians in the same time frame. The result was a report sharply critical of immigration.
    It recommended that Canada only allow immigrants with employment lined up, and keep citizenship only if the immigrants hang onto their jobs.
    The Metropolis study, which was given to CTV News before it is to be publicly released, at first set out to correct calculation errors in the Fraser Institute report, which it said were “apparently typographic in origin.” Corrected calculations reduced the difference to $5,473.
    Where the Fraser Institute estimated property taxes paid by immigrants – 72 per cent of the Canadian average — the Metropolis team dug up data on immigrant households to find they actually pay about 96 per cent of the Canadian average.
    “We prefer data to guesses,” the report noted dryly.
    The pair also widened their sample size, going back to 1970, which would capture more immigrants in their prime earning years.
    “If you look at the longer term, these immigrants are going to contribute through earning higher incomes and paying higher taxes,” said author Javdani.
    That change reduced the estimated cost to $2,470 per immigrant, the report said.
    Instead of comparing the immigrants to the average Canadian – which would include immigrants as well – the Metropolis study compared the immigrants to the Canadian-born, and found immigrants took $554 less in benefits.
    They also ignored “public good” government expenditures that are less directly related to the size of the population, such as national defence – a difference of $,1692 per immigrant.
    The end result was a much lower annual total cost of $450 per immigrant – about seven per cent of the Fraser Institute figure, and a very different conclusion, said Javdani.
    Immigrants tend to be poorer
    Javdani said the lesson is that immigrants tend to be poorer than Canadians, and that means we need programs that can help them succeed.
    Kanako Heinrichs runs Queensberry Flower Company located in Granville SkyTrain Station. She said when she came from Japan in 2007 with her new Canadian husband, it was difficult to get a job.
    “Most immigrants can relate to that,” she said, adding that the hardest part was bouncing around through low-paying, dead-end jobs. “It’s tough.”
    She contacted immigrant services agency SUCCESS, and they helped her develop an idea of bringing a Tokyo-style flower shop into a subway station. The project has been a huge success, to the point that she is opening another shop in the Yaletown subway station, which will employ more people.
    “Everybody has a different background. In my case, I brought what I know very well over here,” she said. “That’s what immigrants can do. Brand new ideas, brand new products, new concepts that make the city more exciting.”
    Javdani said her story is a good example of how difficult it is to filter immigrants. “If you limit settlement in Canada to the people who have a job offer, you limit opportunities that immigration may bring,” he said.
    SUCCESS CEO Thomas Tam said the $450 per immigrant is an investment that pays off in the connections that immigrants make with the world, and the ideas and opportunities they bring Canada.
    “We see thousands of immigrants, they settle down, they find a job, some create jobs for other people,” he said.
    Grady of the Fraser Institute said the institute stands by its report, with some corrections that he said don’t dramatically change the final cost.
    He rejected the Metropolis team’s choice to go farther back than 1987, because immigrants from before that time largely came from developed countries. Since then, a court decision has required the government to accept applications from all over the world.
    “Canadian taxpayers are going to be subsidizing future generations of immigrants if they keep coming at the rate they’re coming. It’s going to exacerbate the problems that we’re going to get with respect to the aging of the population, and it’s not going to solve the problem,” Grady said.

    Immigrants’ health woes focus of new guide

    Photo of Tabaret Hall with the Desmarais Build...Image via WikipediaCanadian doctors now have their largest, most comprehensive reference guide yet to use in treating immigrants and refugees.
    Compiled from global data, the 100-page report published Monday by the Canadian Medical Association Journal is the first of its kind and synthesizes results from 150 investigators.
    The guidebook highlights medical problems that are common among immigrants and refugees but can easily get overlooked because they’re not typical in the wider Canadian population.
    Dr. Kevin Pottie of the University of Ottawa, and founding director of the Immigrant Health Clinic of Ottawa, co-authored the report that recommends migrants visit a doctor more than once a year.Dr. Kevin Pottie of the University of Ottawa, and founding director of the Immigrant Health Clinic of Ottawa, co-authored the report that recommends migrants visit a doctor more than once a year. (CBC) “Immigrants are coming from 150 countries,” notes Dr. Kevin Pottie of the University of Ottawa, who co-authored the guidelines. “Some of them come as refugees, some under family class. So, there’s a large diversity of needs and potential preventable and treatable illnesses [that] the average family doctor just isn’t thinking about.”
    Pottie hopes to develop an international set of guidelines in terms of treating migrants.
    “We need to see health as a human right, and small interventions are all that’s needed for all immigrants,” Pottie said in an interview with CBC News.
    The guide, titled Evidence-based Clinical Guidelines for Immigrants and Refugees, instructs physicians on how to deal with the kind of health risks faced by the 357,000 annual migrants to Canada, including refugees, international students and migrant workers.
    It says the post-arrival “healthy immigrant effect” is declining and recommends that doctors get their migrant patients to visit them more than once a year.
    Specifically, certain immigrant groups suffer from higher incidences of some diseases compared with people born in Canada: Southeast Asians from stroke, Caribbeans from diabetes and all immigrant men from liver cancer.
    Also, the report says many immigrants are susceptible to diseases that are often preventable through vaccines:

    • 30 to 50 per cent are susceptible to tetanus.
    • 32 to 54 per cent are susceptible to measles, mumps or rubella.
    • A significant number come from countries with chronic hepatitis B infections.

    The guidelines recommend that:

    • All adults without immunization records be vaccinated against measles, mumps, rubella, diphtheria, whooping cough, tetanus and polio.
    • Adults and children from countries with chronic hepatitis B be screened and vaccinated.
    • Adolescents and adults from places where HIV is prevalent (i.e. greater than one per cent of the population) should be screened, with informed consent.
    • All immigrants greater than 35 years of age from areas of the world at high risk, which includes South Asia, Latin America and Africa, be screened for for Type 2 diabetes
    • All women of reproductive age and children aged one to four should be screened for iron-deficiency anemia.
    • All migrants should be checked for dental pain.

    A time-saver for treatment

    Pottie said the guidebook can be an effective tool for time-saving and inexpensive treatment. He cites the presence of intestinal parasites in some migrants. He said most doctors would probably find, on average, 12 parasites, and most doctors wouldn’t know which ones to treat.
    “We’ve discovered, through a detailed look at evidence, that virtually all these parasites will go away except for two: strongyloides and schistosoma, which are particular to Asia and Africa. So we’re able to refine it to a simple blood test.”
    Dr. Meb Rashid runs a clinic inside a refugee centre in downtown Toronto, A family physician for 17 years, Rashid has worked mostly with refugees and immigrants for the past eight years. He applauds the guidebook, which will help doctors intervene faster when it comes to possible illnesses in their migrant patients.
    “There are physicians in rural Canada who may be just starting to see some of these diseases, and I think these guidelines will be immensely helpful to those people,” Rashid told CBC News. “It’s well-organized and easy to reference.”

    Refugees at higher risk

    The guidelines say it’s important to distinguish whether a person came to Canada through voluntary or forced migration, as those who have been displaced against their will face the most significant health risks.
    They say refugees have experienced “past exposure to harmful living conditions, violence and trauma,” and note that many experience a rapid decline in health after arriving in Canada and need more care and attention to their medical needs.
    New guidelines say it's important to find out whether a migrant to Canada has been forced to leave their homeland. Refugees suffer from more health problems.New guidelines say it’s important to find out whether a migrant to Canada has been forced to leave their homeland. Refugees suffer from more health problems. (CBC) Refugees, of which Canada takes in 28,000 a year, are especially vulnerable to depression and other anxiety disorders, the guidelines say. The report recommends physicians use “culture brokers,” and not anyone related to the refugee, to help with treatment and to monitor progress and address the social causes of the depression. It proposes “empathy, reassurance and advocacy” and cautions against pushing for “disclosure of traumatic events,” which causes more harm than good.
    The guidelines include a section on AIDS. It warns that while many HIV-positive migrants may already be aware of their status, they may not be knowledgeable about treatments.
    The report warns that migrants may come from countries where there is a strong stigma against HIV-positive people. It counsels health professionals to inform patients of the “risks and benefits of treatment in a culturally and linguistically appropriate manner.”

    Tread carefully on condom issue: guidelines

    On women’s health, the guidelines say “culturally sensitive” contraceptive counselling should be offered to women who are or could be sexually active, and they should be given a choice as to what method they want to use. The guidebook underlines that condoms are often taboo in some cultures and seen as an indication of promiscuity, infidelity or having a sexually transmitted infection, so there needs to be careful explanation about their use.
    As well, it says that females between ages nine and 26 years should be vaccinated against the human papillomavirus, or HPV.
    Migrant and refugee women are also at greater of risk of violence from their husbands and complications connected to their pregnancies, including sexually transmitted infections, chronic pelvic infections, reproductive tract trauma and psychological trauma, the guide says.
    It says doctors should be aware the women may be reluctant to talk about their health problems and also unaware of their rights and of the medical services available to them.

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