In Chicago, Illinois, about 38% of the John Stroger Hospital’s palliative unit’s patients are foreign-born. On average, about 25 to 30 patients a year ask to return to their homelands. From 2005 to 2007, the Stroger team helped 57 patients, including naturalized citizens, legal immigrants, and undocumented persons. These people were returned to 23 countries, most commonly Mexico, Poland and the Philippines.
Each case is a race against time and half of those who ask to travel home are already too sick to do so. Dr. Catherine Deamant commented “For us, that’s morally upsetting. If we had seen them sooner, we could have helped.” Each request comes from the patient and no one is pressured to leave. These patients feel drawn to see their homeland, to die surrounded by family or to be buried on native soil. In fact, wanting to be buried overseas is a major incentive for patients who do not want to inflict financial burdens. “It’s more expensive for families to send their bodies home than for them to go alive,” said Dr. Deamant.
Patients are responsible for paying for the trips themselves but it is the doctors, nurses and social workers on the Stroger team who make the complex arrangements. They contact airlines and write letters assuring that patients are stable enough to travel, not contagious, and able to sit up and care for their own medical needs on board. They alert the airlines to patients whose appearance might raise a concern for contagious illness. They make sure that patients have someone to accompany them on the flight and care for them in their homeland. The Stroger team also arranges for ambulances, medications, medical record transfers, and oxygen, both in-flight and at airports during layovers. They arrange paperwork with so many embassies that “I think Dr. Mackie and Dr. Deamant are known in every consulate from Africa and Europe,” said Francisco Chaidez, a medical interpreter at Stroger.
Once contacted the consulate provides identification materials to allow undocumented immigrants to get through airport security; arranges follow-up medical care in Mexico and pays for airline tickets for indigent patients and an accompanying family member. If a patient has no family, the consulate sometimes even provides a flight companion. Air travel is arduous for seriously ill people but only two out of the several hundred patients the Stroger team has cleared for travel in nine years have suffered complications.
Dr. Sandra Frellsen, an attending physician commented, “You’re granting someone their dying wish, it’s a very powerful thing to be part of.”
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