Posted on 12/23/2005 10:55:07 PM PST by conservative cat
Health officials say they may have no other alternative
The tuberculosis eating at Ricardo’s lungs makes him a public health threat. His fear of being picked up by immigration authorities has sent him into hiding.
A hard-to-treat combination of medical problems left the young farmworker tired, without an appetite and, because of the tuberculosis, quarantined in a hotel room for weeks.
But last week, Ricardo, who is also an illegal immigrant, heard that Skagit County Public Health, which has treated him for months, might have reported him to U.S. Immigration and Customs Enforcement.
Ricardo has been deported to Mexico once before and said he doesn’t want to go again — especially now that he’s sick.
So he left his county-paid hotel room, where he was ordered to stay to avoid infecting family members with the highly contagious disease.
Ricardo did not want to reveal his last name to the Skagit Valley Herald, and privacy laws prevent the county from revealing his name. The newspaper verified through sources that Ricardo is the same man the county has been treating for TB.
Public Health Director Peter Browning said Monday the county hadn’t yet made a formal report to federal immigration officials. But the county department’s budget is strained, and Ricardo’s complex health problems have made it tough to make him noncontagious, Browning said. Browning said calling immigration may be the only option.
An immigration medical facility would give Ricardo the care he needs and take a huge financial burden off county public health, Browning said.
“We’re looking at our toughest financial year ever,” he said. “I don’t see where the money will come from if we have to continue to treat this man.”
Critics say even the suggestion of turning a patient over to immigration will destroy the health department’s credibility with Skagit County’s illegal immigrants, who make up a large proportion of its clients.
Rogelio Rojas, executive director for Sea Mar Community Health Centers, said he heard that the health department was considering calling immigration last Wednesday and called Browning to urge him against it.
Rojas said Browning told him he had already reported the patient, but Browning later told the Skagit Valley Herald that he only meant that he had talked to state health officials about the possibility.
Browning said he talked to state health officials on Nov. 16 about the possibility of getting the young man into a hospital run by federal immigration authorities in Tacoma. That facility treats illegal immigrants for contagious disease before they are deported.
Rojas said in his 27 years of working in community health, the possibility that a health department would report a client as an illegal immigrant is unprecedented and would be “a huge mistake.”
“The consequences may be substantial for the county,” Rojas said.
In a Monday letter to Gov. Christine Gregoire, Rojas wrote, “Mr. Browning has made it clear that Skagit County Public Health is willing to have people deported to save money, even at the risk of spreading infectious disease.
“Now it will be just about impossible to get undocumented people to come in for care, especially if they have an infectious disease,” the letter states.
Browning said an immigration officer has been leaving messages for him, but they haven’t spoken yet. What the county will do remains unclear.
The health threat
Skagit County Public Health has a responsibility to protect the health of all of the county’s residents, and one patient with contagious TB has the potential to expose many, Browning said.
“Unless we can get him well, he will continue to be a risk in our community,” he said.
Tuberculosis is caused by bacteria that usually attack the lungs, sometimes causing symptoms including weakness, weight loss, fever, night sweats, coughing, chest pain and coughing up blood, according to the U.S. Centers for Disease Control and Prevention.
The bacteria are spread from person to person through the air, when an infected person with active TB coughs or sneezes and people nearby breathe in the contaminated air.
Many people who get infected may not get sick, though. Some people have a latent TB infection that doesn’t cause symptoms and can’t be spread to others. Sometimes the latent TB becomes active later, if the bacteria manage to overcome the person’s immune system.
TB can kill if left untreated. Treatment can mean months or years of taking combinations of expensive drugs. People with latent TB infection also can be treated so they won’t develop the active disease.
Tuberculosis was once the leading cause of death in the United States. Cases have declined since the 1940s, but climbed again between 1985 and 1992. Renewed efforts to control it helped, but around 14,000 cases were reported in the United States in 2003.
Skagit County has seen a spike in TB cases this year, and several have been expensive to treat, Browning said.
Skagit County Public Health has seen six cases of active TB this year, said Sandi Paciotti, communicable disease nursing supervisor. The department records zero to three cases in a typical year, she said. Usually at least half of those involve foreign-born patients, she said.
The county’s 2005 budget for TB monitoring and treatment is $160,000, including staff time, medications and X-rays.
Browning said he estimates the county has already spent $16,000 on treatment and housing for Ricardo, and testing and treatment for others who may have been exposed by him. Because Ricardo’s case is hard to treat, that number could easily climb to $100,000 and higher, and there’s still no guarantee of making him noncontagious, Browning said.
Skagit County Public Health’s policy is not to ask patients about their immigration status, though it might be inferred, Browning said. He said other immigrants shouldn’t be afraid to come to the health department.
While it’s unclear what will happen with Ricardo’s case, Browning said the department has a history of caring for the immigrant population.
Three Spanish-speaking nurses work in the community to get people immunized and treated for disease. During the summer, nurses are sent to camps set up by Skagit County farmers to check on farmworkers housed there.
“We do a very good job of treating a tremendous amount of undocumented people in our community, and we have forever,” Browning said.
Ricardo’s story
Ricardo is a thin, shy 25-year-old who speaks little English. The Skagit Valley Herald interviewed him at a location arranged by an intermediary.
Assisted by a translator, he said he was born in Guerrero, on Mexico’s Pacific Coast. He was raised by his grandfather in a small town with no electricity or running water.
He said he first came to Mount Vernon several years ago.
Working the fields in Guerrero from dawn to sunset, Ricardo said he earned about $30 a week. In the fields of Skagit County, he could earn more than $30 per day.
Last year, Ricardo said, authorities came to the trailer park where he was living. He was deported to Tijuana. He stayed there and worked cleaning houses in exchange for food.
After about seven months, his sister and a friend in Skagit County sent him enough money to return. He took a bus to Nogales, on the border with Arizona. He paid immigrant smugglers, known as coyotes, $2,000 to bring him back to Skagit County.
Ricardo said he and 12 others ran for half an hour to cross the border. They were taken in a van to a trailer where they could eat and bathe. Then Ricardo was driven in a car to Skagit County.
He said he arrived in late July and moved in with his sister and brother-in-law and their three children, the youngest of whom is an infant. He got a job right away cutting cabbage.
Ricardo said he started to feel sick in Tijuana but thought it was something he ate. A couple of weeks after starting his job here, he started to feel tired and his throat felt sore. He went to the Sea Mar Community Health Clinic and was given some pills, which made him feel better for a while.
But he was soon sick again, coughing, tired and with no appetite. A friend took him to the county health department, where tests showed he had active tuberculosis.
Ricardo said he hasn’t worked since that day. He was in the hospital for a while, and he spent many weeks in a hotel room, paid for by the health department, to protect his sister’s young children from being exposed to TB.
County nurses brought him medicine, and his sister brought him food once a day, he said.
Eventually, tests showed Ricardo was no longer contagious. He was told to go home. But after a couple of weeks, Ricardo said, the whites of his eyes became yellow. Tests showed that his liver was not handling his medications well, and he had to stop taking them.
Around Nov. 14, tests showed his TB was contagious again. He was told to go back to the hotel.
But since he heard last week that health department officials were considering calling immigration about him, he has been too scared to stay in the hotel.
Roger Capron of the ecumenical migrant-outreach group Tierra Nueva said the family came to staff there Wednesday night, afraid to go home.
“They fear that they may be under surveillance,” Capron said.
Some who work with immigrants say irrevocable damage has been done to the county’s and the state’s public health mission.
“I think it has statewide impact, quite frankly,” Rojas said.
Capron said he wonders how many other people will avoid medical treatment because they’re afraid of being turned over to immigration.
“You’re just kind of closing the health doors on a lot of people who need it,” he said.
Browning said he rejects the idea that this one incident could undo all that effort.
“I’d hate to see anyone suggest that one case could unravel a very successful program,” he said.
I know an illegal in santa barbara, california spread TB to a bunch of children. These problems should not even be happening.
Jus' LUVed the article and photo with an obviously grinning "Ricardo" in a Playboy cap!
Nam Vet
This is classified as bio-terrorism, knowingly speading a disease and refusing, nor seeking treatment for their illness.
Just spreading the diseases Americans don't want to spread...
and potentially spreading active TB to anyone/everyone else who handles, even breathes near, much less eats, that cabbage.
Surley the medical costs alone of bringing all these ILLEGAL aliens up to American standards would be more than just sending them all home tomorrow, eh Secretary Chertoff?
Still too expensive and impractical?
Another reason why there used to be institutions for people with TB, places where they were, literally, prevented from leaving and those who visited and worked in and with them were closely monitored.
That was how we got infectious TB in this country under control and it was by forcing people with it into isolation while they were then treated.
Now we'll have to do that all over again but the "public health" dollars are now stretched far more severely due to other deadly and infectious diseases and other illness.
Another reason why legal immigration is so necesssary and illegal alien problem has to be contained.
Now we pay for their treatment and help them hide from the Border Patrol. This guy should have been reported to La Migra the minute they diagnosed him and sent home with a 30 day supply of meds.
If he comes back again, he should be incarcerated.
L
Great! Then send them home!
Great...
Nice...sliding backwards into the abyss of the third world, thanks to our worthless leaders and the greed of a few of our fellow citizens.
Throw all the county officials in jail for harboring criminals.
Put the officials into a jail cell with the TB aliens.
exactly, let dear old ricardo live in the halls of congress. why was he put into a hotel, didnt that put the other hotel guests at risk, i mean if cigarette smoke kills from miles away like the libs always tell us, surely tb germs can migrate too. btw, not one guest checking into the motel room was told a tb patient is staying here too. sue the federal govt for endangering citizens, if im on that jury, i triple the award.
With friends like this, who needs enemies.
It's better than just plain old TB this new virulent strain
is far worse...and pretty much incurable...
Americans get to keep it forever....at least as a low grade infection compromising immune systems everywhere...
Illegal aliens.. the ultimate incubators for the ultimate in anti-American bio terrorism.
imo
Nah, not forever. We will on the other hand get to spend untold billions in research for the cure, or it WILL wipe us out! Blackbird.
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