Health Information – Ukrainian Arrivals

Ukrainians traveling to Manitoba under the federal Canada-Ukraine Authorization for Emergency Travel (CUAET) program are eligible for health-care coverage.

Coverage takes effect on the date they arrive in Manitoba. Arrivals need to complete a Manitoba Health Registration Form and will receive a Manitoba Health card with a 9-digit identification number for each family member.

Individuals and families will need a copy of their identity documents, their visa (both work or visitor visas are accepted) and a Manitoba address.

Support is available to Ukrainians needing help when registering for health coverage.

Learn more at Manitoba For Ukraine.

Providers please note: In cases where treatment cannot wait for the issuance of a health card, Manitoba Health is asking providers to “treat and hold” paper work for billing submission. 

While most Ukrainian arrivals will receive a Manitoba Health Card within days of their arrival and registration, some individuals may require access to health services before their health card arrives. Manitoba is committed to ensuring barrier-free access to health services for these individuals and families.

If health-care providers and/or clinics have Ukrainian arrivals presenting for care without a Manitoba Health Card, health services should be provided. If the individual/family has not yet registered for a Manitoba Health card, please direct them to do so by:

• Emailing Insured Benefits at insuredben@gov.mb.ca; or
• Going to the Reception Centre at 1715 Wellington Avenue; or
• Going to the Manitoba Health office at 300 Carlton St. in Winnipeg.
• Online form is available here: Registration Form.pdf (manitoba4ukraine.ca).

Providers please note: In cases where treatment cannot wait for the issuance of a health card, Manitoba Health is asking providers to “treat and hold” paper work for billing submission. Further direction will be provided as soon as it is available.

Basic dental, optical, prescription drugs and health-related supplies or equipment not provided by other programs may be eligible for coverage through Manitoba Employment and Income Assistance.

Visit Manitoba4Ukraine for more information.

COVID-19 Vaccination

• As of February 23, 2022, vaccination coverage in Ukraine was 35 per cent complete dose; 1.5 per cent booster dose.
• In the event you/your clinic see a Ukrainian arrival who is not fully vaccinated, follow your usual process/approach for offering vaccination.  

Routine Vaccinations

• Information on publicly available vaccination in Manitoba and routine schedule is found here.
• Review vaccination records and provide primary series and boosters as required. Polio and measles are a priority.
• In the absence of official vaccine documentation, consider the individual unvaccinated.

Polio vaccination

• A polio outbreak (circulating vaccine-derived poliovirus type 2) was confirmed in Ukraine in 2021; a nationwide polio vaccination campaign was underway in February 2022.
• Administer one dose of inactivated poliovirus vaccine (IPV) to each migrant, regardless of vaccination status.
• Consider testing stool samples from children under five (5) years if symptoms are suggestive of polio. Specimens should be sent in viral transport media to Cadham Provincial Laboratory (CPL) using a CPL requisition indicating Viral Testing for poliovirus.

Measles Vaccination

• Measles continues to circulate in Ukraine where vaccination coverage falls below the desired 95% population threshold at 82%.
• Review vaccination records and provide MMR as per routine schedule; in the absence of official vaccine documentation, consider the individual unvaccinated.
• Prioritize children under age seven (7) who may have missed a routine vaccination.

Cited rates of tuberculosis incidence are higher than in Canada, ranging from 73-77/100,000 during 2014-2019 (compare to Canadian rate of 4.7/100,000).

Active tuberculosis disease identification

• As part of the Immigration Medical Examination (section below) a chest x-ray will be performed and will provide screening for active TB shortly after arrival for all migrants except those aged 10 and under.
• Active tuberculosis disease can develop months after initial infection.  On go forward basis maintain low threshold of suspicion for tuberculosis in any Ukrainian patient who presents with new symptoms consistent with active TB disease and test appropriately:
• Respiratory disease – Sputum for AFB & culture and chest radiology
• Tuberculosis can also develop anywhere in the body – consider TB disease for any unexplained chronic complaint +/- unexplained fever, weight loss, night sweats—consultation with specialist is advised
• Tuberculosis disease should be treated by specialist in TB care (in Manitoba: Adult Respirology or Pediatric Infectious Disease)

Latent tuberculosis infection (LTBI)

The Canadian Tuberculosis Standards 8th edition conditionally recommends screening for latent disease in those from countries where incidence is >50/100,000 in those of any age who have co-morbidities with high risk of progression from LTBI to active disease and in those <65 years of age at other levels of risk

• Consider testing for LTBI by tuberculin skin testing in all <65 years
• Consider testing for LTBI by tuberculin skin testing in >65 years of age with high risk conditions for progression to active TB where risk of TB disease outweighs risk of LTBI treatment side effects;
• LTBI is best treated by specialist in TB care (in Manitoba: Adult Respirology or Pediatric Infectious Disease)—adults in Winnipeg with LTBI can also be referred to certain primary care clinics familiar with LTBI care: Referral Form.

Links

• Tuberculosis information for health care providers in Manitoba
• Canadian Tuberculosis Standards 8th Edition

Generally, before migrating to Canada, individuals require an immigration medical examination (IME). This application requirement has been waived for individuals coming to Canada under CUAET, but must be completed within 90 days of arrival in Canada.

All travelers will be provided with an information sheet related to this requirement at point of entry. The IME can only be performed by panel physicians identified by IRCC.

Mental Health and Psychosocial Support

• Providers are asked to watch for signs and symptoms of mental health concerns, including PTSD and depression, as well as other chronic mental health conditions and presentations within the Ukrainian arrival population.
• The Mental Health and Wellness Resource Finder provides a number of mental health, wellness and addictions supports and resources.
• Ukrainian arrivals mental health and addictions fact sheet for service providers
  • Adults | French
  • Children & Youth | French

Non-Communicable Diseases

Continuity of care for chronic disease is likely to be a challenge for patients displaced by the conflict in Ukraine.

• Recommend screening for chronic diseases as appropriate based on age and risk factors as per usual practice. Assess medication needs, as supply may have been disrupted.

Reproductive Health:

Assess women for contraceptive needs, pregnancy, and prenatal care as appropriate.

A reception centre has been opened to support Ukrainian refugees upon arrival in Winnipeg.

The centre is located at 1715 Wellington Avenue, Winnipeg at the Best Western Plus Winnipeg Airport Hotel. The Centre includes resources to connect new arrivals with a number of resources including mental health services, prescription refills, managing a chronic condition, or vaccinations (including COVID-19 vaccines.)

Public health nurses are on site and language access/interpreter services (see above) are available to support access to health services and information in Ukrainian, Russian and other languages.

Shared Health Language Access Interpreter Services employs trained, accredited interpreters who provide services in many languages, including Ukrainian and Russian. Interpreter Services are available 24/7, either face-to-face, remotely (video conference, conference call) or on-demand over-the-phone (through an external third-party contracted agency).

Language Access Interpreter Services are provided at no cost to publicly funded health services such as hospitals, community health services, CancerCare Manitoba, or fee-for-service physicians working in the Winnipeg Health Region. Services are available on a cost recovery basis to other health service delivery organizations in Manitoba.

To request an interpreter call: 204-788-8585 (available 24/7), or fax your request to the Language Access Interpreter Services office. Fax request forms can be found at: https://professionals.wrha.mb.ca/old/professionals/language/request-form.php.

A listing of Winnipeg-based resources for Ukrainian refugees is available here: ukrainian-resources-eng.pdf.

For more information, please visit: https://professionals.wrha.mb.ca/old/professionals/language.