Listening to different voices.

Grounded theory research provides the foundation for this case analy sis about listening to the voices of refugee immigrant women in order to improve access to health care. The authors share the case study of "Elena" (pseudonym), a Latin American refugee immigrant to Canada, and explore listening as an individual and collective intervention. The feeling of being degraded, ignored or dismissed by others has serious consequences for refugee immigrants to Canada. The authors recommend a social advocacy approach with both individual and collective strategies for responding to the lack of cultural sensitivity and genuine listening evidenced by Elena's case. Inclusive and partnership approaches, an "inequities imagination" and relational approaches to difference are required to loosen our thinking about what shapes refugee immigrant health. A critical cultural perspective asks that practitioners not only listen for history and context in individual practice, but also take those discoveries further to change policy and practice systemically.