Posts Tagged ‘access to health care’

Foreign Girl Forever – Einat Fishbain

June 25, 2014 1 comment

Einat Fishbain

Lily Oudraogo was born in Tel Aviv, and that’s where she lived and died. Twenty-five difficult and insulting years on the margins of society, and beyond, reached an end on June 6, likely from complications of preeclampsia (a pregnancy-related condition involving high blood pressure, among other factors). Her younger son, Ben-El William, born less than a week earlier, is still in the neonatal department at Tel Aviv’s Ichilov Hospital. Her five-year-old son Michael is with friends from the local Ghanaian community who are trying to help. Francis, Lily’s partner for the past three years, wanders the halls of the hospital, fluctuating between courteous smiles at those offering consolation to spells of crying, anger, and helplessness. It is hard to imagine a sadder and more senseless end to the life of a woman who spent her entire life trying to survive in the land of her birth.


Lily was born in 1989, the second daughter of unauthorized migrant workers from Ghana who had arrived in Israel a few years earlier, leaving their older daughter in Ghana. Lily’s father died when she was young. Her mother remarried and had two boys, Samuel and Isaiah. During the large-scale deportation of migrant workers in the early 2000s, Lily’s step-father and brother Samuel were deported. Since then, the remaining members of the family tried to attain legal status in Israel. Despite two “one-time arrangements” in which the Ministry of Interior granted residency status to several hundred Israeli-born children of migrant workers, they were always left out. The reason: their mother entered Israel illegally.


Lily’s mother died last year and was buried in Emek Hefer in central Israel. Her younger brother was sent to a boarding school when he was young. Six months ago, Lily’s dream finally came true: her status in Israel was approved, and she was on her way to becoming a citizen of the place where she was born, the only country she had ever known. Legal status also ensured citizenship for Michael, and for the unborn child she had conceived with Francis, whom she had met in the meantime. For a moment it seemed their lives were starting to fall into place. But only for a moment.

My relationship with Lily is personal, so I write in the first person. We met for the first time when she was 8 and I was starting to report on migrant workers in Tel Aviv for the local newspaper Ha’Ir. The first daycare for “illegal” children I visited was that of Nana Ofoko, who taught children of varying ages in a small room near the Old Central Bus Station. Lily was one of three graduates; a happy girl who smiled a lot, she learned to read and write in English while the teacher took care of babies and played with younger children. The classes were new then; the system barely recognized these children.

When we met again she was twelve. We interviewed her for the Israeli television program “The Third Eye.” Her living conditions were tough, and she continued to fight for her place in her middle school class, for a musical future that she and her music teacher believed in, and for her older sister – whom she had never met – to come to Israel from Ghana so together they could open a small salon specializing in African braids.

We met for the last time nearly two years ago. I had heard that Lily’s mother was sick, and I came to her home on HaGdud Ha’Ivri Street in South Tel Aviv. Lily was 23-years-old, and the father of her three-year-old son, Michael, had been deported to Ghana and then disappeared. After all those years she had almost stopped believing she would ever get legal status in Israel. Her file was stuck somewhere in the Interior Ministry, and she had stopped making plans. She and her son lived in decrepit conditions, in a crowded apartment with no light, in a building inhabited by asylum seekers. Lily complained about them, the new foreigners. She understood that she was stuck somewhere in the middle.

In the meantime, Lily had been filmed for a documentary movie, “Last Stop,” directed by filmmaker Julie Shles, about life in Tel Aviv’s New Central Bus Station and its surroundings. Shles, completely dedicated to the heroes of her film, became part of Lily’s life, talked to her every few days even after the filming, and waited with her for the birth of her second son. Lily did not attend the premiere of the film at the DocAviv Film Festival last month. She said she had edema, that she wasn’t feeling well.

It’s Shles who called me and told me that Lily was hospitalized, and that there complications from the pregnancy. She said she was going to the hospital with the priest and promised to keep me update. Half an hour later she called again crying, finally able to say two words: “Lily died.”

The details I’ll provide are what we were able to ascertain that morning at Ichilov Hospital, in conversations with the medical staff who treated Lily since her hospitalization, and with the hospital’s director, Professor Gaby Barabash.

Lily came to Ichilov on Sunday evening, able to walk, but feeling very ill. She was 37 weeks pregnant. She was hospitalized immediately and diagnosed with preeclampsia that the medical staff deemed “something we’d never seen here” – apparently rare, and extremely severe. She delivered by caesarean section that night, and after the surgery her condition seemed good. Preeclampsia is supposed to resolve itself within five days after delivery, as its source is in the placenta, which is delivered with the baby. Francis described how they had looked at their baby boy together, and Lily had tried to figure out who he looked like. Less than 48 hours later her condition deteriorated, and she suffered from swelling around the brain. She was brain dead the next day. Her partner and other members of the community didn’t understand the medical staff’s hints, and continued to believe that Lily would soon be fine. But she wasn’t, and Friday morning her heart stopped beating.


There’s almost no doubt Lily suffered from preeclampsia in the weeks preceding the birth – complaints of swelling and migraines are common symptoms. It is unclear how rigorously her pregnancy was monitored. Lily was significantly overweight and apparently did not go to the doctor regularly.  Although it wasn’t classified as such, in light of her history, this was a high-risk pregnancy and should have been treated as such. When she arrived at the hospital, however, she didn’t even have documents or information regarding either this pregnancy or her previous pregnancy and delivery, which were also complicated – information that  could have assisted in understanding the risks.

Francis lashed out at the medical staff, which alerted Barabash, claiming that Lily had been neglected for 48 hours until the onset of edema. At present there is no proof of this. According to staff reports, initially she seemed fine. When things deteriorated she underwent a CT scan, received medication to treat the edema, and it was apparently reasonable to assume that the preeclampsia would subside.

During our last meeting Lily talked about her mother’s illness: “We had a lot of problems and misunderstandings about many issues, including her illness – we told her to go to the hospital many times and she didn’t want to. Because she doesn’t have citizenship, or because of money, she was afraid to take care of herself. We couldn’t deal with it all. Up until a year ago she still cleaned houses, until she couldn’t do it any more. Her situation is so bad now because she didn’t get medical treatment.”

As a kind of self-fulfilling prophecy, Lily, too, died from neglect. There is almost no doubt her death could have been prevented if the preeclampsia had been diagnosed and treated earlier.

Her body remained in the Intensive Care Unit until Pastor Combert, who also buried her mother, arrived. The priest entered the room and spoke to Lily in a mix of English and the Ghanaian language her family spoke about her mother, about her younger brother who grew up in boarding schools and his poor condition, and about Michael. Often in such moments one thinks about an eternal reunion between the dead and about protecting the living, but the priest’s words were beyond my comprehension.

Because such a short time had elapsed since she was granted formal status in Israel, Lily had not yet become a citizen, and it is unclear how this will affect her burial.* When the priest left the room he asked to delay the process until approvals arrived from close relatives in Ghana regarding her burial. Her brother Samuel, who was deported with his father, lives in Ghana, as does her older sister, about whom Lily dreamed her entire life and will never meet. The hospital refused to keep the body for more than two or three days, despite the Ghanaian community’s request.

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Francis, who broke down suddenly on the way to the elevator and cried until his eyes were red, does not yet know how he will raise a newborn baby, and Michael, on his own. In the meantime Shles has appealed for any possible assistance, and helps take care of Michael. Mesila, the Aid and Information Center for the Foreign Community run by the Municipality of Tel Aviv-Jaffa, knew Lily well and has promised to stand by the family and try to help.

The family that I met in 2000 – the mother, Lily, and her two younger brothers – quickly fell apart. One was deported, one is at a boarding school, and Lily grew apart from her mother, who died alone. Now Lily leaves behind a family whose chances of survival are not much better than those she faced. The awful cycle of neglect, life on the fringe of the margins, the law that determines who is eligible for (certain) treatment and who deserves nothing – all of these forces have now seized another victim. Is there a chance that Lily’s two children will not repeat their family story?

On a personal note, my relationship with Lily extended beyond normal work and symbolized much more for me than one girl’s story. I chose to conduct my last interview with her as my swan song before leaving my position as a writer for the newspaper Yedioth Ahronoth, and in my parting words I promised to stay in touch with her and Michael. By then I was used to writing about injustices and suffering and facing the system, but this case – of absolute alienation, just ten minutes from home – was over the edge. The tragic end, in her case, is painful in a way I find difficult to describe. There are moments when even those who make a living from words recognize their futility. Goodbye Lily. I hope you’re finally in a better place.

Einat Fishbain is an Israeli journalist and founder of The Hottest Place in Hell, a news site focusing on issues of social concern that was recently awarded the inaugural DIGIT prize for online journalism. Her work as a writer, editor, and producer for Israeli print and television media has garnered her multiple awards, including the award-winning column “The New Tel Avivians,” which first brought the lives of migrant workers to the attention of the Israeli public and was awarded the Sokolov Prize in 2000. She is also recipient of the Zchut Award (2010) for her work on the human rights of people with disabilities. This piece is slightly amended from a version that appeared at The Hottest Place in Hell.

* Update: Lily Oudraogo was finally laid to rest on June 20.

Translated by Orna Dickman.


Excerpt from the television documentary “Third Eye” (episode: “Lily”).


Excerpt from the documentary “Last Stop”, directed by Julie Shles. For more, click here.

Cite this: Fishbain, Einat. 2014. “Foreign Girl Forever.” AccessDenied: A Conversation on Unauthorized Im/migration and Health. Accessed [date] at  

Anthropology Afflicting the Comfortable: A Review of Seth Holmes’s “Fresh Fruit, Broken Bodies” – Rachel Stonecipher

March 17, 2014 1 comment

Rachel Stonecipher

Having cut my teeth in anthropology while living in the state of Texas, I am accustomed to trying to explain what, exactly, this discipline is. At Thanksgiving, distant family members ask me whether I have anything interesting to tell them about the dinosaurs. When I correct them and confess that I neither dig up artifacts (certainly not T-Rex) nor analyze crime scenes, but rather practice “cultural” anthropology, I watch their shoulders sink and eyes wander away.

Seth Holmes’ book Fresh Fruit, Broken Bodies[1] is here to change that, and in the best of directions. In a tight 200 pages, Holmes lays out a call to action for social scientists, practicing physicians, and average readers to identify and combat the structural violence perpetrated against migrant farmworkers. By accompanying his companions as they migrate, work, and seek health care, Holmes sheds light on the “ethnicity-citizenship hierarchy” that shapes the health outcomes of indigenous Triqui migrant workers on a farm in the Skagit Valley of Washington state. His goal is to perform a “critical and reflexively embodied anthropology” that will “confront the ways in which certain classes of people come to be written off or deemed less human” (40-44). The idea of reflexive embodiment is to think about one’s own ways of sensing the world – such as feeling pain, love, or success – in critical comparison to how others sensorially experience. Holmes is on a trail parallel to the recent ethnographic movement, led by Sarah Willen,[2] to interrogate the social inequality (re)produced when undocumented migrants come to embody their abject status. However, as I argue below, his approach is more akin to discourse analysis than Willen’s “critical phenomenology,” though it would be strengthened by more of the latter. Read more…

Defects in the Safety Net: When the Emergency Option is the Only Option – Sural Shah

February 27, 2014 Leave a comment

Sural Shah
Cambridge Health Alliance & Harvard School of Public Health

Ana, age 29, came to the clinic for a sore throat, her two energetic children in tow. While her kids darted around the clinic space, which was donated by a local academic medical center, I introduced myself as a volunteer physician and began asking about her medical history. As Ana moved from her chair to the exam table, she told me she had traveled from Mexico to the United States as a teenager and now was living here illegally, a familiar story among patients in the largely Latino and impoverished Philadelphia community our non-profit clinic[1] serves. Moving my stethoscope around her chest, I was surprised to hear a harsh murmur suggesting problems with the blood flow through her heart.  Read more…

Immigration Reform and Health Care: Leaving the Undocumented in the Breach – Lori Nessel

March 27, 2013 1 comment

Lori Nessel
Seton Hall University School of Law

Any effort at comprehensive immigration reform must also address the health care needs of millions of immigrants with long-standing ties to this country. Absent such reform, immigrants needing ongoing medical care will remain vulnerable to the unethical practice of de facto deportation by hospitals, which is fueled by a lack of government reimbursement or oversight of international discharges.

In fact, a recent study from the Center for Social Justice and New York Lawyers for the Public Interest cites hundreds of cases of forced or coerced medical deportations. Acting alone or in concert with private transportation companies, as my colleagues and I report, hospitals are functioning as unauthorized immigration officers and engaging in de facto deportation of seriously ill or injured immigrant patients directly from their hospital beds to their native countries.

Read more…

Reading Between the Lines: Need to Know’s “Crossing the Line” Suggests a Reexamination of the Border Patrol’s Culture – Rachel Stonecipher

January 24, 2013 Leave a comment

Rachel Stonecipher


In 2012, a series of PBS investigations into Border Patrol abuses corroborated years of humanitarian volunteers’ reports, finding that the agency’s institutional culture cultivates a climate of medical neglect – and sometimes outright harm – toward migrant detainees. In July 2012, the PBS show Need to Know aired the second installment of its U.S.-Mexico border series “Crossing the Line,” an investigation into abuses of migrants in Border Patrol custody. The program reported that agents in the Tucson Sector, the busiest of nine regional divisions of the Border Patrol on the U.S.-Mexico border, have been accused of thousands of physical, verbal, and sexual abuses against migrants who are usually deported before they can report the crimes. “Crossing the Line, part 2” focused on the problem of poor treatment during detention, while Part I addressed agents’ excessive use of force. In light of my own research with humanitarian volunteers,[1] the two programs prove the frequency and injuriousness of abuse. Although PBS stops short of claiming that the Border Patrol’s “war on illegal immigration” actually promotes harm against migrants, to some volunteers’ dismay (including my own), “Crossing the Line” effectively conveys that abuse is an institutional problem that takes direct and indirect forms – including impunity.

Read more…

Flouting International Law: Violating the Human Rights of Asylum Seekers, Including Victims of Torture and Human Trafficking, in and en route to Israel – Laurie Lijnders

August 30, 2012 Leave a comment

Laurie Lijnders
Physicians for Human Rights-Israel

My 15-year-old brother Habtom disappeared after he was released from an underground cell in the trafficking compound of Abu Khalid, where he was tortured for three months until we paid US$35,000 for his release, a young Eritrean woman told me during a visit to her home in a Tel Aviv suburb. Habtom, who fled forced military conscription and institutionalized slavery in Eritrea, was kidnapped in April 2012 from Shagarab refugee camp in Eastern Sudan by Rishyada tribesmen. Through a well-organized network of human traffickers operating in Eritrea, Ethiopia, Sudan, Egypt, and Israel, he was transferred to the northern Sinai desert, near the Egyptian border with Israel.

The Israeli Ministry of Interior estimates that 60,000 African asylum seekers, mainly from Eritrea and Sudan, have arrived in Israel in recent years via the country’s southern border. According to Israeli human rights organizations, arriving asylum seekers face serious rights violations on both sides of the border.

Read more…

Narrowing Our Moral Community of Concern: A Critique of Canada’s New Refugee Policies – Ben Langer

July 24, 2012 1 comment

Ben Langer
Western University School of Medicine and Dentistry

The doctors of Canada are angry. Last May in Toronto, a group of 90 physicians clad in white coats and scrubs occupied the office of a high-ranking member of the Canadian Parliament. Since then, physicians have consistently interrupted press conferences held by Conservative members of Parliament to protest cuts to the country’s Interim Federal Health Program (IFHP), which since 1957 has provided basic health care to refugees and asylum seekers.

Under the new policy, many refugees will receive care only in “urgent and necessary” cases or if their illness is deemed a threat to public health. Ironically, these cuts came into effect on the July 1st celebration of Canada Day, when this nation of immigrants and refugees celebrates its independence and its core values of generosity, openness, and multiculturalism.

Photo: Doctors for Refugee Care

Read more…

“Doing No Harm” in an Age of Medical Repatriations: Challenges and Opportunities for Health Professionals – Juliana Morris

June 20, 2012 1 comment

Juliana Morris
Harvard Medical School

How often do doctors cause harm to their patients when they discharge them from the hospital? For a sizeable group of immigrant patients who are “discharged” to their countries of origin each year, the answer may be: more often than not. The story of Quelino Ojeda Jimenez, an immigrant from Oaxaca, Mexico, who became quadriplegic after a fall at his roofing job in Chicago, Illinois, is case in point.

Read more…

Conceptions of Reciprocity: The Navarro Transplant Case, Organ Allocation and Undocumented Immigrants – Emily Avera

May 14, 2012 1 comment

Emily Avera

Organ donors give the gift of life, but the sheer volume of patients hoping for transplants far outstrips donor generosity. How should we make decisions to ensure the equitable distribution of a limited supply of organs? In a system that depends on the goodwill of donors and public trust, this question becomes further complicated when undocumented immigrants seek transplants – especially in the United States, where undocumented immigrants consent to donate organs more often than they receive them. In light of this fact, should citizenship be a substantial consideration? Or should allocation decisions be made according to a claim of reciprocity – i.e., that individuals or groups who are willing to donate are more entitled to receive organs than others?

Read more…

When the Ward is Your Mooring: The Human and Economic Costs of Long-Term Acute Care for Undocumented Immigrants in the U.S. – Nora Kenworthy

January 16, 2012 Leave a comment

Nora Kenworthy

recent New York Times article by John Leland recounted the lengthy medical history of Raymond Fok, an uninsured and undocumented immigrant who ended up marooned at New York City’s Downtown Hospital for 19 months after surviving a stroke. Although suffering from chronic health problems, including kidney failure, and initially in need of acute care, Mr. Fok remained in the hospital long after his initial emergency because he had no other place to go.

Without insurance or public benefits, numerous immigrants in the U.S. find similar fates in public hospitals, learning that without chronic or community-based services to assist them in recovery, they cannot be discharged. Rather than qualifying for a home health aide, or getting transferred to a nursing home, Mr. Fok’s status left him in the expensive care of an already cash-strapped public hospital. As Leland writes: “Mr. Fok’s immigration status never kept him from receiving treatment, but it helped make sure that his care would be delivered in the most expensive setting possible and in a place no one wants to spend more time than necessary.” Read more…


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