Key Takeaways
- Sanctuary Health began as a grassroots response to refugees and migrants being denied health care because of their immigration status.
- Founders Byron Cruz and Ingrid Mendez created the Bridge Clinic in 1994 to provide care regardless of status, later expanding to mobile clinics and community‑based cooperatives.
- Policy changes—Harper’s cuts to the Interim Federal Health Program, the rise of “access without fear” municipal policies, and recent federal immigration tightening—have repeatedly reshaped the group’s work.
- Today Sanctuary Health focuses on advocacy, connecting people to clinics like REACH and Watari, and running pop‑up health services while preparing for a possible increase in undocumented migrants.
- Personal stories, such as Eloina Alberto’s experience receiving maternity care through Sanctuary Health, illustrate the organization’s vital role in filling gaps left by the formal health‑care system.
Origins and Early Challenges
Eloina Alberto arrived in British Columbia from Mexico about ten years ago, pregnant and without coverage under the BC Medical Services Plan. Having worked as a nurse, she knew she needed proper prenatal care but feared the cost—stories from her community warned of bills exceeding $10,000 for childbirth and the risk that seeking hospital treatment could trigger immigration enforcement. Her anxiety led her to reach out to Sanctuary Health, a grassroots network that helped her secure a safe delivery at BC Women’s Hospital without questions about her status. Alberto’s experience reflects the precarious situation faced by many migrants who lack health insurance yet cannot afford to go without care.
Founding of Sanctuary Health and the Bridge Clinic
Byron Cruz and Ingrid Mendez, both refugees from Guatemala’s civil war, settled in Vancouver in the early 1990s and began outreach work in the Downtown Eastside. They observed that refugees, despite being eligible for the Interim Federal Health Program, often faced rejected claims or bureaucratic hurdles that blocked access to doctors. In 1994, a coalition of Canadian and refugee‑trained doctors proposed a clinic that would serve anyone regardless of immigration status. The result was the Bridge Clinic, opened on the third floor of Mount St. Joseph Hospital. Cruz described it as a perfect community model: clinicians could treat patients without fear of reporting them to immigration authorities, and the clinic quickly became a hub for newly arrived migrants seeking care and networking opportunities.
Expansion and Community Projects
Building on the Bridge Clinic’s success, Cruz and Mendez helped establish the B.C. Multicultural Health Services Society, which later launched a mobile health‑clinic project in the Fraser Valley. Volunteer staff set up weekly clinics out of an RV in an Abbotsford Value Village parking lot, eventually evolving into the Umbrella Multicultural Health Co‑op in New Westminster. These initiatives aimed to keep control of care in community hands rather than leaving it to health authorities that could impose restrictive policies. Simultaneously, Cruz continued his outreach on the streets, distributing condoms, advocating for safe injection sites, and supporting recent migrants who faced hardship, laying the groundwork for a broader migrant‑health network.
Policy Shifts and the Access Without Fear Movement
The early 2000s brought renewed challenges. When the Vancouver Health Board became the Vancouver/Richmond Health Board and later Vancouver Coastal Health, it assumed operation of the Bridge Clinic and introduced stricter patient‑acceptance criteria. Though the clinic remained open, the new oversight meant that people without status could lose access, and the authority never instituted a formal ban on contacting the Canada Border Services Agency (CBSA). Concurrently, federal cuts under Stephen Harper’s government to the Interim Federal Health Program left thousands of refugees unable to pay for care, prompting community forums that gave birth to Sanctuary Health as a collective advocacy and treatment group. Around the same time, municipal “sanctuary city” policies emerged: Toronto led in 2013, Vancouver followed in 2016 with an “access without fear” pledge, and Fraser Health adopted a policy prohibiting CBSA contact without patient consent. While Vancouver Coastal Health reduced such contacts, it never codified the prohibition, leaving a lingering risk for undocumented patients.
Current Role and Advocacy
As clinics like REACH Community Health Centre and Watari Counselling and Support Services began offering explicit “access without fear” services, Sanctuary Health’s role shifted from direct care provision to advocacy and navigation. The group now helps migrants locate safe providers, accompanies them to appointments, and acts as interpreters. Eloina Alberto, having benefited from the organization’s support, now works as a community outreach worker, fielding dozens of calls each week from people with precarious status. Karina Villada, a longtime outreach co‑ordinator with the Migrant Workers’ Centre, echoes this commitment, stating they will try to help in any way they can. Sanctuary Health also supports pop‑up vaccination and minor‑care clinics, aiming to reactivate the direct‑service model that had lapsed during years of focusing on policy work.
Impact of Recent Immigration Policies
The federal government’s recent immigration tightening has heightened Sanctuary Health’s urgency. In March 2024, the Strengthening Canada’s Immigration System and Borders Act tightened asylum‑claim requirements, and the government capped immigration numbers, reducing study permits by 35 % and cutting 20,000 temporary foreign worker positions. Advocates at MOSAIC estimate that up to 1.6 million migrants could see their work or study permits expire this year, potentially swelling the undocumented population. Concurrently, the Interim Federal Health Program will soon require co‑payments for medicines and supplementary services, further straining refugees’ access. A stark illustration occurred in January when a construction worker, Francisco Barahona, sought treatment at a Surrey hospital, was reported to CBSA, and now faces deportation alongside mounting medical bills. Cruz likens the current climate to the Harper‑era cuts that originally spurred Sanctuary Health’s formation, warning that the organization must be ready for a worsening scenario.
Future Outlook and Ongoing Efforts
Looking ahead, Sanctuary Health plans to resume monthly pop‑up clinics offering sexually transmitted infection testing, sports massages for injured workers, tetanus shots, and cervical cancer screenings—services Alberto hopes will mirror the support she once received. The group is also working to reactivate its network of doctors, nurses, midwives, and doulas who previously provided off‑the‑books care, recognizing that trust and accessibility remain essential for migrants who fear revealing their status. By combining advocacy, direct outreach, and partnerships with clinics that have adopted “access without fear” policies, Sanctuary Health aims to continue filling the gaps left by formal health‑care and immigration systems, ensuring that care remains a right, not a privilege tied to paperwork.
Conclusion
From Eloina Alberto’s anxious pregnancy to the decades‑long crusade of Byron Cruz and Ingrid Mendez, Sanctuary Health has evolved from a modest clinic into a vital lifeline for migrants navigating British Columbia’s health‑care landscape. Its story underscores how policy shifts—both restrictive and protective—directly affect the ability of vulnerable populations to receive care. As Canada’s immigration framework tightens once more, the organization’s blend of grassroots advocacy, community‑based clinics, and partnership‑building will be crucial in safeguarding the health and dignity of countless migrants who call B.C. home.