Existing literature on refugee health has often focused exclusively on either the post-arrival or pre-arrival experience. We believe the totality of each individual social identity should be acknowledged, including life prior to becoming a refugee. Thus, health status must be contextualized within pre-arrival health status and living conditions, health-care access, flight experiences, combined with postarrival status: a fluid journey-to-health arc. The following article offers a holistic view of refugee health as an outcome of the entirety of this journey captured in a series of in-depth interviews with long-term, established service providers in Hamilton, Ontario. Our findings illustrate the importance of viewing health issues within the context of time and space. Refugees embark on fragmented journeys, leading to multiple challenges for providers, such as limited case histories, the absence of documentation and cultural (in)competence in terms of practice. © The Author(s) 2018. Published by Oxford University Press. All rights reserved.

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