In the past, there have been many stories about what happens to foreigners who get sick or injured while visiting this US. Specifically, when the patient is an uninsured foreign worker, hospitals are often left with no good options for setting up follow up care for the patient who will have long-term needs. This process of helping these patient return home has been referred to as "Medical Deportation" by some, and is harshly criticized by many. Our experience with these patients and the hospitals that care for them has been only positive and heart-warming.
In some situations, returning the patient to his/her home country is the best option... for the hospital AND the patient. Many of these patients came to the US to earn money, which they used to support their family in their home country. Once they have a chronic medical condition, they may be unable to earn a living for themselves or take care of their families. They often lack local financial and social support and are literally alone.
Returning these patients to their home countries is often the most humane and satisfying option for these patients....if done correctly.
In our role, we have had the opportunity to work with some of the most noble and caring case mangers imaginable. Their motivations are pure. They want what is best for the patient, and then justify their plan to hospital administrators using financial as well as moral arguments.
So, what is the "right" way to send a patient home? First, the patient has to want to go home. Once a patient realizes that he/she will no longer be able to work and may never see his/her home country, friends and family again, he/she is frequently eager to go home. If they have local family, the family needs to be on board as well.
Next, it is important to insure that the patient will have access to appropriate care in their home country. Case mangers work with assistance companies and local family in the home country to set up home care, dialysis, rehab, and any other long-term care the patient needs.
Travel documents must be in order. Patients must have permission to leave the US and obtain valid travel documents, which allow them entry into their home countries. For patient who may have entered the US through unauthorized channels, or who have lost/expired passports and visas, this can be a time consuming and arduous step.
Lastly, the patient must be transported home is a safe and medically safe manner.
As long as hospitals and case managers consider the above points and go through this process, they are to be commended, not criticized for going above and beyond to do what is best for this unique group of patients.
Every time we help one of these patients get home, we are rewarded with stories of how the patients were received by their family and friends as returning heroes. Our medical escorts tell us stories of kisses, weeping, and patients who immediately experience dramatic physical and mental improvements upon arriving home; family and patients who are profoundly grateful for everything that has been done for them. When we retrieve these patients from hospitals, they are sent off with hugs, gifts and even tears from the hospital staff who have become attached to them and only want what is best for these unfortunate patients.
Nurses and case managers chose their fields because they want to take care of people and want to do what is right. They are not motivated by the financial interests of the hospitals. They see themselves as protectors of these patients and we have never been in a situation where we felt that the clinical staff was not 100% comfortable with the idea of retuning a patient to his/her home country. The people who know these patients best, the ones who care for them 24/7 are best positioned to evaluate the best options for these patients; medical repatriation is frequently this best option and should be embraced.
