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Instead of supporting the Access without Fear resolution, city council referred the issue up the chain to higher orders of government responsible for immigration and refugee settlement services. While this may push these levels of government in a positive direction, the councillors who opposed the resolution seem to have missed an important point. The problems we identified were not problems with the province (which has in fact been quite approachable about providing health care coverage for precarious individuals needing it) or with the federal government. The problems we see are the fear of accessing local municipal services.

Many of our patients are working “under the table,” or in other vulnerable work situations, because of their immigration status. They may be afraid to access city policy assistance when they are victims of child or spousal abuse. They are afraid to report housing safety problems, or fire hazards, in their often impoverished housing situations for fear of repercussions. They may need emergency shelter, or paratransit services to access medical appointments. They may be afraid to register for public recreational or fitness services in the city for themselves or their children. They often face language barriers that make their situations even more vulnerable, but may be afraid to access public library language resources, programs or tutoring.

Even if they are not asked for their immigration status, and their status would not be reported, many of them suffer from post traumatic stress that leads them to fear calling attention to themselves, even if that fear is not grounded in reality. The fear is nevertheless very real for them, and countering it would be significantly aided by a formal public policy and educational approach from the city.