The Breaking Point
For Sick Illegal Immigrants, No Relief Back Home
By KEVIN SACK
A decade after crossing illegally into the
Grady, a struggling charity hospital, had been absorbing multimillion-dollar losses for years because the dialysis clinic primarily served illegal immigrants who were not eligible for government insurance programs.
Hospital officials decided the losses were threatening Grady’s broader mission of serving the region’s indigent population. But before closing the clinic on Oct. 4, they offered to pay to relocate patients to their home countries or other states, and to provide dialysis for three transitional months.
Ms. Chavarria, 34, left quickly with her 8-year-old son, Jose Andres, an American citizen who had never been to
Her husband, Roberto Barajas, 37, and their 14-year-old son, Eduardo, remained in
In separate interviews, one in the farming
“I think about them all the time,” said Ms. Chavarria, whose raven hair falls past her waist. “It was the hardest thing to leave without them.”
Mr. Barajas, a stocky road paver, shielded his eyes with his hand. “You don’t know if you’ll be able to see each other again,” he said. “We had always been together, the four of us, and then suddenly they had to go.”
Like other patients repatriated by Grady this fall, Ms. Chavarria gambled that her chances would be better at home. The costs of dialysis and a possible kidney transplant would be considerably lower in
But it has not worked out that way.
On Dec. 22, she exhausted the 30 free dialysis sessions that Grady had provided at a gleaming private clinic in
Now Ms. Chavarria is dipping into money that Mr. Barajas and other relatives have raised in
The fund-raising proceeds — about $11,000, according to Mr. Barajas — had been earmarked to defray the $20,000 cost of a transplant. So it is a setback each time Ms. Chavarria has to withdraw $100 for a dialysis treatment.
Everywhere, it seems, there are roadblocks to affordable care. The dialysis unit at
On top of the cost, the preparations for a kidney transplant can take months. Ms. Chavarria’s brother, Roberto, her first volunteer, recently learned that his own kidneys might not be functioning properly, possibly ruling him out.
When Grady officials decided last summer to close the dialysis clinic for budgetary reasons, the board chairman, A. D. Correll, declared that “people are not going to die on the street because of these actions.” But that pledge may ignore the conditions that await patients who return to
Two Grady dialysis patients have died in
But one of the Grady patients who died in
“To have end-stage renal disease in
The health care dichotomy in
During her journeys for dialysis, and her three-and-a-half hours in the chair, Ms. Chavarria daydreams that her family might some day reunite. “I hope it’s soon, while things are all right,” she said, as the bus rolled past fields of cactus and maize.
But it is difficult to block out the grim realities. She knows that she may never be strong enough to cross the border again and that her continued treatment may depend on her husband’s ability to earn $11 an hour in
There are an estimated seven million illegal immigrants in the
Most of the 66 immigrants who were dislodged by the Grady clinic’s closing have stayed in
Ten to 13 of the patients appear to have returned to
Antonio Camron, 20, said he did not know what he would do after his Grady-sponsored treatments ended in late December. “I have very little time left,” he said.
The repatriation of most of the patients was carried out by MexCare, a
But six patients interviewed in
Matt Gove, a senior vice president at Grady, said the hospital had not been aware that MexCare was promising patients’ insurance coverage.
Residents of this farming village on the south
During the holidays, when the population of Ejido Modelo swells with homecoming immigrants, the rutted, unpaved streets are dotted with cars bearing
Mr. Barajas’s family came in waves. He said he made the first of his three illegal crossings at age 17 in 1989, shortly after meeting Ms. Chavarria at the soccer field in Ejido Modelo. They courted by telephone and mail, and he returned to marry her in the whitewashed village church. After Eduardo was born, she followed him back to
Their American dream was to save enough to build a three-bedroom house in Ejido Modelo, and then return home. But in February 2008, while working at an auto parts plant near
When it came time to leave, the family made the heartbreaking decision that Eduardo would remain in
Mr. Barajas and Ms. Chavarria said their tearful farewells at a McDonald’s restaurant at Grady, where her MexCare escort had suggested they meet. Mr. Barajas’s sister has moved in to their apartment to help care for Eduardo, but the emptiness remains.
“It’s hard to get home from work or some other place and not see her here,” Mr. Barajas said.
Ms. Chavarria is living with her 64-year-old mother, who welcomes each morning by baking tortillas over a wood fire. Other family members live in a compound of small brick houses surrounding a communal courtyard that is planted with citrus and poinsettias. Ms. Chavarria said she was happy to be with her extended family, but was “missing my own.”
She seems fatalistic about the chances for a reunion, in the house they have all but finished.
“I would want good things to happen,” Ms. Chavarria said, “but destiny is not in our hands.”
David Agren in