Injured, Yet Uninsured

Injured, Yet Uninsured

Immigrants struggle to adapt to U.S health system.

A single day can change the course of a person’s life. For Nelson, an undocumented immigrant living in Herndon, it was June 2, 2006.

The 39-year-old day laborer who settled in the Herndon area after arriving from El Salvador in February of 2005 was walking down the street to his former home on Blackthorne Square in Herndon. It had been a rough morning for Nelson, having not found any work yet for the week at the center.

But things quickly seemed to be turning around when he walked past a woman in front of a home on his street packing up some luggage to the back of her truck. When she signalled Nelson and his friend over to her house to help her stack and secure her belongings, the two jumped at the opportunity to make a few extra dollars.

While Nelson was strapping down the loose suitcases with a bungee cord, his temporary employer reached down and pulled at one of the linked cords a few inches from his face. With a quick, sharp twang, the two tightly notched hooks separated and the bungee cord ripped back.

"In that moment, I didn't feel anything, it was just like a quick hit to the face," said Nelson. "I stepped back, and all of a sudden I felt my head start to hurt and my body was getting very hot."

THE METAL HOOK of the bungee cord, stretched taught over the suitcases, had flown up and whipped Nelson directly in his left eye, tearing into his cornea and pulling out more than half of his eye.

His friend worked to comfort Nelson, who had gone into a daze. The paramedics arrived and took Nelson to Inova Loudoun Hospital.

"I just prayed to God that it wasn't something life-threatening," said Nelson. "I couldn't move, I couldn't see. I just remember the paramedics telling me to count to 10."

After nearly two days of intensive medical care, Nelson survived the initial injury and was able to keep what remained of his now non-functioning eye. What would follow would be more than six months of recovery and an attempt to navigate the labyrinth of alternative medical care options for the uninsured in the United States.

As he was not a legal resident of the United States, he did not qualify for government medical assistance or disability payments. The woman who had asked him for his help had left town, and she was not returning the phone messages that he left to her cellular phone, asking him to contact her. With approximately $15,000 already owed to the hospital for his brief stay and anti-infection medication, Nelson couldn't afford any more assistance without outside financial help.

He was not able to work in his condition. The regular monthly remittances that Nelson had been sending to his wife and 11-year-old son in El Salvador ended. He would soon be finding it difficult to pay for his rent and basic food necessities.

THROUGH THE HELP of his friend Martin Rios, assistant director of the Herndon Official Workers Center, paired with a large donation from his former construction boss in Centreville and the help of various local free clinics and charities, Nelson was able to pull himself up and restart his life.

A few months ago, he received a prosthetic eye to fit over his wound and he has once again started to earn enough money to sustain himself.

"I survived because of people like Martin, people like [my former boss], people from the churches and people who work in the community with workers," said Nelson. Still, without a steady job, due largely because of his residency status, he has not yet had the ability to afford to pay off his medical bills.

And Nelson now must deal with another major obstacle in his life and his ability to provide for himself and his family.

His body still adjusting to the prosthetic eye which has left him with constant headaches. As his work cannot be overly physical, he has been limited to finding jobs as a painter. He still does not know what long-term effects or infections could come as a result of his injury.

"Having both eyes, it's something that you need for your life, it's something that a normal person has," Nelson said. "I'll never be a normal person again."

NELSON'S CASE is not unique in the regional day labor community.

Every year, thousands of workers in the region are injured in some capacity while working in day labor positions and virtually all of them are uninsured, according to Rios. Typically, all but the most extreme cases go unreported, he added.

"Unfortunately the kind of job that workers not only at the [Herndon day labor] center but immigrants in general get are jobs that have a high risk of personal injury," said Rios.

That problem is compounded by the lack of access to public health safety nets and familiarity of the American health system due to the fact that many workers are not legal U.S. residents, said Jennifer Montgomery, executive director of the Loudoun Community Free Clinic. The clinic, which helped Nelson find treatment last year, works occasionally with workers recovering from injuries such as hernias and broken ribs.

"If you or I are injured on the job doing these things, we would be paid compensation until we can recover and continue our work," said Montgomery. "These folks don't have that luxury and at the same time they are expected to support families."

"A lot of times this can just lead to their injuries becoming exacerbated as they try and continue to work when in most cases they really shouldn't."

And when it does get to the point where it is unbearable, the workers show up to the emergency room and are saddled with large expenses that they cannot afford to pay, Rios added.

MOST OF THESE immigrant workers who do not have access to the health care they need, especially those without legal residency status, are forced to look to the non-profit sector for help, according to Fiorella Izquierdo a community worker with the Hispanic Committee of Northern Virginia. But those options are often inconsistent in quantity, she said.

"The amount of access to the services [in the non-profit sector] doesn't depend as much on the number of workers who need it but rather what they can afford," said Izquierdo. "And that can vary greatly from one year to the next." She added that her organization helps about five "seriously" injured day laborers each month.

Getting information available to the immigrant worker community and increasing salaries so workers can afford insurance are the only ways to improve the region-wide immigrant health care access crisis, Izquierdo and Rios said.

"The best thing to improve this is to work to get these people legal [residency status]," said Izquierdo. "As residents, they will have more access to better pay, to the jobs that will provide them with insurance, to the social programs."

"If we cannot come upon a solution to increase the information out there and get more people the help they need," Rios said, "we're not going to be able to improve our lives and continue moving forward."