GO TO CMA Home
GO TO Inside CMA
GO TO Advocacy and Communications
GO TO Member Services
GO TO Publications
GO TO Professional Development
GO TO Clinical Resources

GO TO What's New
GO TO Contact CMA
GO TO Web Site Search
GO TO Web Site Map


CMAJ
CMAJ - March 7, 2000JAMC - le 7 mars 2000

The Left Atrium · De l'Oreille Gauche

CMAJ 2000;162:676-9



The fruits of generosity

Strangers at the gate: the 'boat people's' first ten years in Canada
Morton Beiser
University of Toronto Press, Toronto, Buffalo and London; 1999
214 pp. $50 (cloth) ISBN 0-8020-4282-1
$17.95 (paper) ISBN 0-8020-8117-7


The arrival this past summer of successive groups of destitute Chinese in dilapidated boats off the coast of British Columbia helped reactivate recurrent public debate about Canada's refugee policy. As usual, the battlelines were drawn between compassion and fear: compassion for victims of tragedy and persecution, fear of undue burden on our social services and of the abuse of Canada's legendary generosity by unscrupulous traffickers. Morton Beiser's Strangers at the Gate is a welcome corrective to much of the ill-informed rhetoric that has dominated public discussion.

Beiser reviews the history and progress of the so-called "boat people" who escaped to Canada from Vietnam, Laos and Cambodia between 1979 and 1981. The backbone of the work is the author's longitudinal study of 1348 refugees who settled in Vancouver. Participants were interviewed in 1981, and again in 1983 and 1991, to track their adjustment to their new country.

This book is, however, more than simply a formal research presentation. Beiser's statistical findings are enriched and humanized by case histories. These personal stories are valuable reminders that many refugees who now subsist in Canada through often menial jobs were once successful professionals or wealthy businessmen before their home countries were torn apart by war or revolutionary politics. Take, for example, Li Wuchin, a janitor in a Vancouver church. Once a rich industrialist, he was divested of his factories, house and servants when the Communists took over Saigon in 1975. After a spell in a "re-education" camp he fled for his life through the jungles of Laos. At the Mekong River, which separates Laos from Thailand, he drew the gunfire of border guards so that his family might swim across the river unobserved.

Beiser falls squarely on the side of compassion in his recommendations for refugee policy. He argues that "privileged countries should go on admitting refugees because their kindness to strangers at the gate is an affirmation of humanitarianism." Moreover, the "moral and legal obligation [flows] one way — from Canada to the people we agreed to protect. Since they were admitted as refugees, Canada [has] no right to expect the Southeast Asians to contribute to the economy."

Nonetheless, much of Strangers at the Gate provides compelling evidence that the "cost of compassion may be less than many alarmists fear." After ten years in Canada, 86% of the refugees followed in Beiser's study had "successfully" integrated into Canadian society: that is, they had jobs, spoke some English and rated themselves as being in good or better health. They also boasted lower rates of unemployment, depression, substance abuse and use of social services compared with national averages.

Popular perceptions of the boat people's fate, however, fall considerably short of the refugees' actual accomplishments. A 1994 Gallup poll found that roughly half of all Canadians doubted the refugees were as likely to be working as other Canadians. Almost 40% thought the boat people were using more than their share of health and social services and that, in the long run, the decision to accept the Southeast Asian refugees had cost Canadian taxpayers too much.

Certainly, the refugees' achievements came not without struggle or cost. Two years after arrival, a mere 15% were considered "successful." Some, particularly men in the first year after their arrival, battled depression. Others grappled with the frustrations of underemployment, language barriers, discrimination and separation from family members who remained in Southeast Asia. Beiser depends largely on anecdotal evidence to illustrate the difficulties encountered by refugees and to buttress his entreaty that we do more to ease their way into our society. This raises an apparent contradiction, since his own research suggests that, as a group, the refugees are doing remarkably well. His recommendations are nonetheless eminently reasonable: he advocates more language training, easing of the restrictions on family reunification, and greater facilitation of appropriate employment.

Beiser also reminds us that good intentions can occasionally cause unintended harm. The Canadian government sponsored only a third of the 60 000 Southeast Asian refugees, while individuals and community groups sponsored the rest. It was tacitly assumed that the personal attention and often lavish generosity showered upon newcomers by private sponsors would help them integrate into Canadian society more rapidly than their government-sponsored compatriots. Beiser's study revealed otherwise. No difference in well-being was apparent between the two groups of refugees at any time after arrival. Indeed, the prevailing opinion among refugees was that government sponsorship was preferable. Non-Christians sponsored by Christian groups, actually had an increased risk of depression. One young woman explained that she became a Christian to please her church-based sponsors, despite their sincere disavowal of any intention to convert her. Ironically, the very altruism of sponsors became a source of frustration for the refugees, who felt unable to repay a substantial debt.

The encouraging record of Southeast Asian refugees in Canada stands as a dual testimony to those who rebuilt their lives after facing enormous adversity and to the nation that welcomed them. Strangers at the Gate reassures us that our generosity has been rewarded. Beiser's demonstration that it has cost so little to do so much good should bolster our willingness to welcome more refugees and to make their transition into Canadian society as painless as possible.

Michael Klompas
Class of 2000
Faculty of Medicine
University of Toronto

[Contents]


Room for a view
Going to America

What if one were to raise a child, but conceal from him the fact of his mortality? Would the child, secure in his kinship with eternity and free of the terrible knowledge that shackles the rest of us, become an Übermensch of sorts? Or would he, devoid of the discipline imposed by the weighty sands of time, fail to identify the things that really matter, fail to make choices, and ultimately fail to endow life with meaning?

These were the questions that troubled Adolfo de Nocte, an obscure professor of philosophy who, despite the originality of his research, will not be found in the annals of academe. De Nocte had misgivings about the ethics of pursuing his inquiry, but in the end persuaded himself that the benefits outweighed the risks. And so he concealed from his own son, Giovanni, any evidence, mention of, or reference to death.

There were few places so well suited to his experiment as Nocera Terinese, the Calabrian town where de Nocte lived. Nestled in one of the most remote regions of southern Italy, this little town with a population of barely 5000 afforded him uncommon control over the flow of death-related information to his son.

Of course, there were a few close calls over the years, the closest being when the professor lost his beloved wife. She died suddenly, without any anticipatory illness, and Giovanni, then eight years old, was simply told that his mother had gone to America.

"When will she come back?" he asked.

"Soon," his father answered, not knowing how else to answer without giving up the experiment.

The boy spent long hours on the doorstep of their house, waiting for his mother to return and repeating his question. After two years he stopped asking the question and no longer waited. De Nocte continued the experiment.

And yet, for all the effort he put into it, de Nocte's experiment was something of a disappointment to him. He loved his son and thought him special, but he knew that Giovanni was special only because he was his son. To the objective observer he was no more special than the boy next door. He was, in short, no Übermensch.


Art Explosion

Was it possible, de Nocte wondered, that we humans are indifferent to our own mortality? Or perhaps the experiment simply needed more time. Perhaps Giovanni would show signs of greatness once he reached manhood.

Alas, destiny put an end to the experiment in Giovanni's eighteenth year, on a rainy afternoon in Nardotti's hardware store. There, as Giovanni played cards with his father, Nardotti and Dottore Cotrolào, Nardotti dropped his cards, clutched his chest and fell to the floor.

"Come on Nardotti, your hand can't be all that bad," the professor said, convinced they were being treated to slapstick by the practical joker, Nardotti. A trickle of blood appearing from under Nardotti's forehead announced that this was not the case.

Dottore Cotrolào got down on the floor. He checked for evidence of respiration and for a pulse. Finding neither, he struck a match and held it close to Nardotti's right eye, which he held open.

Nothing.

The doctor blew out the match. Aware of the experiment and mindful that Giovanni was present, he simply shook his head.

Giovanni surveyed the scene before him. Professor de Nocte held his breath.

Giovanni looked at his father, then at the body of Nardotti, then back at his father.

"Nardotti's gone to America," he said. "We will never see him again."

De Nocte was flabbergasted. "What would make you say such a thing?"

Not without irritation in his voice, Giovanni replied: "Papa, if it were possible to return from America, wouldn't my mother have done so by now? She would never have left us alone like this." Then, without rancour, he asked, "Will we, too, go to America?"

Giovanni registered a barely discernable affirmative nod on the part of his tearful father.

"Good. I should like to see my mother again."

And in that moment de Nocte realized the futility of attempting his experiment anywhere but in a world without love.

Frederick Paola
Assistant Professor of Medicine
University of South Florida College of Medicine
Tampa, Fla.

[Contents]


Two thousand words

William James Topley /
National Archives of Canada / PA-010451
William James Topley /
National Archives of Canada / PA-010282

Women's and men's infirmaries, Hospital and Immigration Detention Centre, Quebec City, c. 1911(details). The child was born aboard ship.

[Contents]


Send us your regrets
"Experience," Oscar Wilde wrote, "is the name everyone gives to their mistakes." So let us have the benefit. Why not write about the things you've learned the hard way in medicine? How would you replay the scenes that weren't in the script? We welcome submissions of unpublished poetry, memoir and fiction for The Left Atrium. The writing should be candid, but patient confidentiality must be respected. A sense of humour never hurts, and anonymity is optional. In general, prose manuscripts should be limited to 1000 words and poems to 75 lines. We won't launder the truth, but neither will we hang you out to dry. Send us your regrets at todkia@cma.ca

[Contents]


Lifeworks
The art of being an Inuit woman

Who are the women of the Arctic? What trials do they endure? What joys do they reap? Inuit Woman: Life and Legend in Art, at the Beaverbrook Art Gallery in Fredericton until April 2, offers a glimpse into the female condition in the North.

Davidialuk Alasua Amittu, 1910­1976. Untitled (mythological bird), 1958. Stone; 43.4 × 38.2 × 16.2 cm. Collection of the Winnipeg Art Gallery. Three drawings and this sculpture show beings that are part bird, part woman. These are likely female shamans in the process of transforming into the form of their animal helping spirits.

The 35 carvings and 28 prints, on loan from the Winnipeg Art Gallery's Twomey Collection, explore the iconography of female roles in Inuit society. The "life" component of the exhibit depicts women engaged in traditional tasks. The implements of labour — e.g., the ulu, or woman's knife, and the kudlik, or stone lamp — take on a symbolic force, as does the wearing of the amautik, or mother's parka. The word amautik (from the Inuktitut word for "carry") refers to the pouch (amaut), in which babies are carried on their mother's back until they are two or three. This ingenious garment allows the child to be swung to the front for breastfeeding, and the large hood allows fresh air to filter down to the amaut.

The "life" works are wonderfully instructive, but equally interesting are the origin myths depicted in the "legend" component of the show. In the shamanic traditions of the Inuit, women are associated with the sea, the sun and birds. The sea spirit, Sedna, a sort of mermaid who gives birth to various sea creatures (or, in other versions, a new race of humans), is an archetype that recurs in numerous cultures. Several exquisite sculptures, including one by Juanisi Irqumia Kuanana, depict the fate of a bad mother transformed into a narwhal. The often violent stories behind these artworks usually relate to weather, luck or taboos; for example, The Story of Sun and Moon, as shown in a striking print by Luke Anguhadluq called Sunwoman, cautions against incest.

Darlene Coward Wight, curator of Inuit art at the Winnipeg Art Gallery, remarks on the power and strength conveyed in these works. Traditionally, she notes, Inuit women performed "essential roles ... in partnership with the men in their families. ... [I]n the modern society of today's north, women are moving into positions of political and social power on an equal footing with men."

Barbara Sibbald
Associate Editor
News and Features

[Contents]


The doctor's farewell

I know they came for her
late that night
after all the goodbyes, and all the tears
and another comforting doctor's words.
I know they came silently
wordlessly
gently settling her onto a bed with wheels
to carry her deep into that final night,
for anointing and grooming,
preparing her
while I flew thousands of miles
to see her one last time,
preparing myself
for her final rite of passage,
a celebration of her life
in words and tears.

We all comforted one another
gathering around her
one last time.

I know they came for her
but I've never felt this way before,
I've never had these images.
This time it was different,
this time
it was mother.

Catharine Dewar
Division of Rheumatology
Sunnybrook & Women's College
  Health Sciences Centre
Toronto, Ont.

Comments Send a letter to the editor
Envoyez une lettre à la rédaction

© 2000 Canadian Medical Association or its licensors