Christmas! What a glorious time of the year! Carols, parties, lights, the smell of wonderful foods floating in the air. A time for celebration. But not if you are sick, and not if you are thousands of miles away from home.
For George, it was terrifying. He was far away from his home in Africa, sicker than he had ever been before. He had just learned his kidneys had failed! Permanently and without warning. He wasn’t even in this country legally. How was he going to pay for all this? Would he ever be well again? What about his dream of going to an American college?
I first learned about George while he was in ICU. I was told he was a student at Hampton University and Kenya in East Africa. I was looking forward to meeting him. My daughter had been to Kenya many times in her line of work, and I was eager to talk with him. I knew that since he was going to be a chronic patient I would have many opportunities to do so.
We were hopeful that he had health insurance through the school and that they would be willing to support his treatments while he was a student. Dialysis is not cheap, and without some kind of insurance, we were worried how would be able to handle the expense. I placed a call to the University, and to my surprise, was told they had no record of his being a student there.
When he was well enough to be transferred from ICU to the Dialysis unit for treatment, our social worker, Marilyn, and I began asking questions. We discovered that, in fact, George was not a student at the University and more than that, was not even in the country legally. He had come over with his brother the previous June with a goal of being admitted to the University and then being able to switch his tourist visa for a student visa.
We called a family conference. George’s family in America consisted of his brother who was also here illegally, and a cousin who was a student at the University. There was also a gentleman from Chesapeake, who had picked the boys up while they were hitchhiking and had taken on the responsibility of being their sponsor.
After much discussion, all agreed to find funding for George to stay in the country and attend school. We also notified the Immigration Bureau, who agreed to give us time before they mandated his return to Kenya.
At that time, my daughter worked for an international relief and development organization called World Vision. She was an expert on East Africa. I started with her. She told me that healthcare in Nairobi is very advanced and the best in Africa. People go there from all over the continent for care. At least that made us feel better if we had to send him home. She also said she was not aware of available funds for this kind of situation. She did give me contacts in other organizations who might be able to help. If there were funds available, these people would know. She also recommended that we contact the Kenyan Embassy.
The last thing she said was that most Kenyan families are not wealthy and those who manage to get the funds to send their children to school here, do it at great sacrifice. It was usually a once in a lifetime opportunity. After many hours of countless phone calls and exhausting every contact and resource we could find, it became clear that there was nothing we could do. At last Marilyn made contact with a nephrologist and a dialysis clinic in Nairobi. Both agreed to accept George as a patient if he came back to Kenya. Immigration was notified. George had to go home.
While this was going on, George had been discharged from the hospital and was coming in three times a week for treatments. Riverside Regional Medical Center graciously agreed to write off his hospital bill. When it became apparent there were no means to pay for treatments, the Renal Division did. After several more phone calls, the airline graciously agreed to reduce the price of his airfare to Kenya, and sponsors were found to pay for the ticket. Arrangements were made with Nairobi for his care.
The day he left was a sad one for all of us. We still wondered if there was not something more we could do, someone else we could call. Nursing is more than treating a disease process. It is making sick people well whether they are sick in body, mind or spirit. Maybe we did not have complete success, but we felt confident we did all that could be done. If there had been a way to keep him here, we would have found it. George had his last treatment just before he boarded the plane to fly home.
We hear from George periodically. He is still hopeful of coming back and going to school. The good news is that after only a couple months on dialysis in Kenya, he received a transplant and is doing very well. He has promised to come and visit when he finally comes back. We look forward to seeing him.
Janell Almquist, RN, CNN
Clinical Director, Renal Division, Riverside Health System
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