Tziscao: Emigration and Health Care Access

Doña Ilaria’s head hurts. She’s had this problem for eight years, she tells me. When she’s having a relatively good day, it’s not so bad. But every eight or fifteen days, it gets really bad and she’s bedridden.

What’s worse, doña Ilaria’s heart hurts as well. Her two sons are have been off in the United States, working in the fields there the past three years. She misses them and she also worries that the authorities are going to catch them and put them in prison.

The irony is that doña Ilaria’s health problem was the main reason her sons took the decision to go work in the U.S. in the first place. They wanted to earn money for her to buy pills and go see the doctor in the city. And there efforts have proved successful in some respects. Ilaria feels better most of the time, and she has been able to see a specialist in the city.

However, things have been changing for the family. Currently, the boys in the U.S. are out of work and are no longer sending money. Ilaria has had to stop seeing the specialist. When she was still seeing him, he recommended that she undergo a surgery to help alleviate her pain, however there is no way the family is going to be able to come up with the money to pay for the surgery, especially now that there’s less work for them in the U.S.

So, with doña Ilaria’s sons return home any time soon? Most likely not, she tells me. They had actually been thinking about returning home fairly soon, but a new health problem has arisen in the family. One of the sons of her eldest migrant son, her grandson Javier, has just recently been diagnosed with Hepatitis. The family still doesn’t know which type of Hepatitis because they didn’t have the money to pay for the blood test, but the symptoms he’s expressing fairly clearly suggest that it is one of the types. Now, doña Ilaria’s sons feel the need to stay in the U.S. longer in the hopes of finding some work so they send money for medicines for Javier. They would like to come home for a bit and then return to work in the U.S., but the border crossing is so costly and dangerous, they don’t want to risk having to go through that again.

So “así es,” as they say in Spanish; that’s the way it is. Even as someone who’s thought a lot about access to health care in the United States, hearing this story opens up my thinking a whole new dimension of the definition of “barriers to health care.” In an effort to access health services, this family has taken on the strategy of international migration, a strategy that brings along with it familial separation, sadness, and emotional stress as its side effects.