We engaged in a dialogue with Christopher Nkambwe (she/her), founder of and Chief Executive Officer at The African Centre for Refugees in Ontario-Canada, a non-profit organization that supports the holistic care and post-arrival integration needs of African refugees, particularly those who are from the LGBTQIA+ community. The Centre came into existence out of Nkambwe’s personal experiences as a refugee trying to navigate the system.
The Centre is also one of the partners for co-designing referral pathways with DET OHT’s Interprofessional Primary Care Team (IPCT)* project. During our conversation, Nkambwe highlighted the unique experiences of the African and Caribbean LGBTQIA+ refugees that shape their care needs and the challenges they face in accessing holistic care and integration support upon arrival.
Tell us a bit about the African Centre for Refugees in Ontario-Canada and how your work as a social services/newcomer settlement organization intersects with health care.
Christopher Nkambwe: It is a non-profit organization that supports LGBTQIA+ refugees from Africa and the Caribbean. Our goals are to empower these individuals to thrive in the new environment and connect them to opportunities that enable resilience.
From the moment they arrive in Canada, we provide humanitarian assistance to help them integrate into Canadian society. The programs and services at our Centre bridge gaps in accessing shelter and housing, health and community care, legal aid, and newcomer settlement supports.
Additionally, the Centre plays an active role in partnering with organizations like The 519 and The Neighbourhood Group, which offer programs on employment and capacity building to prepare our clients for their job search.
Based on your own journey and the experiences of the African LGBTQIA+ refugees you have worked with, what patterns or recurring struggles have emerged when it comes to accessing health and community care?
Christopher Nkambwe: One of the ongoing challenges is the lack of clear information for the refugees and newcomers on where to access health and community care services. Many of these services have long wait times – sometimes several months – making it difficult for them to receive timely support for urgent care needs.
Another major challenge is adapting to a new environment. Many refugees from African and Caribbean regions have experienced traumatic journeys and have unique care needs. The lengthy and complex health and community care processes – from initial access to seeing a doctor – can be overwhelming and negatively impacts their mental health.
Even when they do gain access to services, there are additional barriers. Many refugees cannot seek health care without proper identification, documentation, or a health card. At the Centre, we work closely with partner organizations to help bridge this gap and support African and Caribbean LGBTQIA+ refugees who either lack health care coverage or are in the process of filing their documentation.
Fear of opening up is another significant struggle. In Africa, many of these individuals have been unable to access gender-affirming care. As a result, when they arrive in Canada, they often carry the fear of discrimination with them. Even after spending hours, days, or weeks with a care provider, many still find it difficult to share personal details about their health, including HIV status and other conditions.
To address these challenges, we seek case workers who can guide our clients through the available services, help them navigate the system, and provide education on the care process.
How does the African Centre for Refugees build a sense of home and community for African LGBTQIA+ refugees?
Christopher Nkambwe: Our organization provides culturally centred support and services, ensuring that refugees feel a sense of belonging. Besides the Centre being led by an African transgender refugee, many of our staff members have lived experiences similar to those of our clients.
Our volunteers come from diverse African countries, including Kenya, Uganda, Ethiopia, and Tanzania. To create a deeper sense of connection, we match clients with volunteers from the same country whenever possible. For example, a refugee from Kenya would be paired with a Kenyan volunteer, allowing them to communicate in their first language and share cultural experiences. It is an opportunity to offer empathetic support centred on a strong sense of community.
Additionally, the Centre has hosted the Annual National Conference for Newcomers in Canada for the past three years. This event brings together over 500 African newcomers each year, offering a space to connect, share experiences, and access services from various service providers who participate in the conference.
This year’s conference will be held on October 18, and we will share more details about the participation process as the date approaches.
What changes do you think are necessary to create more equitable, culturally safe, and trauma-informed care environments for these communities?
Christopher Nkambwe: It is important to engage with and include newcomers at the strategic planning tables and policy decision making for inclusive care environments. For example, the Interprofessional Primary Care Team (IPCT) project has actively involved African refugees, using their lived experiences to shape primary care pathways. Through the Centre’s participation, our team has been able to provide more timely and effective access to care for our clients.
Additionally, health and community care workers need proper orientation on the unique experiences and care needs of African LGBTQIA+ refugees. They should be equipped with cultural sensitivity training, tools, and resources to engage with these clients with cultural sensitivity, guide them effectively, and help them navigate the system.
To create safer and more accessible care environments, it is also crucial for hospitals, urgent care centers, and community clinics to build strong partnerships with organizations like the African Centre for Refugees. These collaborations help remove accessibility barriers and ensure refugee communities receive the support they need.
How has collaborating on the IPCT project influenced your work and the goals of the African Centre for Refugees in supporting these clients?
Christopher Nkambwe: The IPCT project has significantly enhanced the visibility of our Centre and its programs and services. As a result, more of our clients now have access to healthcare tailored to their needs, particularly family doctors.
Since the project launched four months ago, it has strengthened our outreach efforts within the community. Now, members of the African refugees’ community are aware that we refer clients to Sherbourne Health for primary care. Without this connection, many of these clients would face months or even years of waiting due to a lack of access to family physicians. During the waiting period, their mental health would suffer the most.
*The IPCT project is a primary care initiative of DET OHT, aiming to enhance access and attachment to interprofessional, team-based primary care for individuals in Downtown East Toronto experiencing significant financial and social barriers. These populations include people experiencing housing insecurity, 2SLGBTQIA+ community, refugees, people with disabilities, and individuals who use drugs. The project places a specific emphasis on addressing the unique needs of Indigenous and Black communities.
Currently in its implementation phase, the four primary care providers are collaborating closely with their referring community partner organizations to establish a strong foundation for success.
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