For patients of the Crossroads Clinic, stepping through the clinic’s doors is a milestone in what is often a long and arduous journey. Most of its patients are newly arrived refugees or refugee claimants from around the world who are trying to access care while learning to navigate an unfamiliar health care and social system. 

First opened in 2011, Crossroads is Toronto’s first hospital-based refugee health clinic. In the 15 years that have since passed, the team has witnessed significant changes both to the refugee health care landscape and within the walls of the clinic itself. 

“There were only three of us when the clinic first opened,” says Dr. Meb Rashid founder and medical director of the Crossroads Refugee Clinic. “I was there four days a week, alongside our full-time nurse practitioner and our receptionist.” 

Today, the Crossroads team has more than doubled in size and grown into a multi-disciplinary team that includes a social worker, nurse practitioners, physicians, a medical secretary and a peer navigator.  

“We know that refugees do really well in Canada given the opportunity," says Dr. Rashid. “The vast majority of people we see, despite the horrible trauma they’ve endured, are able to put their lives back together. Their major concerns are getting a job, accessing social services, putting their kids in school and figuring out how to navigate winter.” 

In fact, it was in observing the difficulties experienced by patients in accessing health care services as well as essential community and social resources that inspired the clinic’s new Peer Navigator pilot program. After meticulous community consultation, the Peer Navigator Role was established in May 2022.  

“During consultation, patients emphasized the challenges in physically navigating a new city, particularly when they don’t speak English,” describes Dr. Vanessa Redditt, a family physician with Crossroads and the clinical lead for the Peer Navigator Program. “This helped us to advocate for the peer navigator role to include accompaniment and support activities outside of the hospital.” 

Semhar Musael, the clinic’s first Peer Navigator, arrived in Canada just five years ago. In her new role with the Crossroads Clinic, Musael guides patients through their health care journey and beyond. Fluent in Amharic and Tigrinya, languages often spoken in the Ethiopian and Eritrean regions, she often finds herself helping her patients – many of whom cannot read or write in English – navigate the settlement process, access housing or childcare services, among many other things. 

“I understood the struggles people were going through while trying to navigate a new health care system. As someone who was educated and could speak English, it was still hard for me,” Musael shares. “Knowing I wanted to serve my community while using my professional background and life experience, when I saw this job, it was like it was written for me.” 

Together with the patient and their primary care provider, she identifies what priorities patients have and what types of support they need. That support can take many forms. Musael may accompany patients to appointments, help them complete registration, immigration or referral forms, connect them with housing or child-care services, or help them navigate phone systems and community resources. Often, the most important part of the role is simply being present to listen and offer reassurance. 

One patient, a 46-year-old single mother of two teenagers, had metastatic colon cancer and had just learned her cancer had returned. She began missing appointments and was hesitant to continue treatment. 

“After speaking with her, doing emotional checkups, and really helping her through some tough situations, she eventually continued her chemotherapy treatments,” remembers Musael. “One day after one of her treatments, she came by, unannounced to visit me at the hospital. She told me I was her angel, and that she just wanted a hug. She said she wouldn’t have been able to do this without me.” 

For many patients, language barriers remain one of the biggest obstacles to receiving care. 

“The need for high quality interpretation in health care is critical for us as doctors to be able to complete our work,” says Dr. Meb Rashid, founder and medical director of the Crossroads Clinic. “We are fortunate to have access to over 160 languages through our interpretation services here. It’s something refugee health providers are fighting for more broadly across the country – unfortunately access to well-trained health interpreters is limited.” 

With more than 1000 yearly interactions between Musael and Crossroads patients, the Peer Navigator Program has helped thousands of newly arrived refugees navigate social and economic issues in their new lives in Toronto.  Women’s College Hospital is now evaluating the program’s impact and exploring opportunities to expand the model to other clinics across the hospital. 

“This program adds great, tangible value to newcomers in Ontario,” says Dr. Redditt. “ This program goes a long way in improving refugee health – our dream is that it will only get bigger and better in the long-term.”