Medicine and Migration in Minnesota

In this snowy city where once Norwegians and Swedes had their own hospitals, the 446-bed Hennepin County Medical Center (HCMC) currently spends $3 million on interpreters fluent in 50 languages to translate over 130,000 times a year. Minneapolis is home to the largest Somali community in the United States, some 35-40,000. The Twin Cities also have large Hmong and Latino communities, in addition to Liberian, Sudanese, Russian, and most recently Bhutanese immigrants. HCMC has adjusted its practice to better meet the needs of the diverse immigrant population it serves, a community that comprises 20% of its patient base. (Grady, Denise. “Foreign Ways and War Scars Test Hospital”)

Catering to its patient mix, HCMC’s obstetrics unit is now predominantly female, since Muslim women cannot have their children delivered by male doctors. Imams are often consulted prior to medical procedures, such as drawing blood during the month of Ramadan. No questions are asked about immigration status, and indigent patients are offered a sliding-scale fee, though not all can afford even this. Many of these immigrants are refugees from war-torn countries, and their medical care often includes the surgical removal of shrapnel and more difficult treatment of buried pain. Some 47% of women and 25% of men in the Somali community experienced torture (a number extremely high even for refugees), and their care necessarily includes counseling and holistic treatment. (Grady, Denise. “Foreign Ways and War Scars Test Hospital”)

HCMC’s dedication to its immigrant patient population is surely to be lauded. In an economic climate that has hospitals seriously worried about budgets, this Minneapolis hospital is noteworthy in its continued efforts to better serve its community. It is refreshing to see such a positive community response to the new challenges immigration brings; the impact of these efforts at integration and outreach can be seen in the faces of fellow passengers every time one steps on a bus or the Light Rail in this Silver City.

Amazing G(race)

In the movie Amazing Grace, William Wilberforce campaigns for decades trying to abolish the slave trade in Britain. After a lifetime’s work, he is finally successful when he legislates the Slave Trade Act of 1807 which requires all British ships to fly their colors at all times, even when delivering slaves to the Americas. When the British slave ships were prey to pirates, the profit was no longer there and the slave trade withered within two years.

Devastating incidents like Postville, IA, will continue in these United States as long as our nation’s borders are increasingly militarized, our citizens are more policed, and our businesses are not held accountable. If employers were made accountable, truly responsible for the lives and wellbeing of all their employees, they would cease recruiting and luring extralegal immigrants to come and remain within our borders without basic human rights.

Whatever your political leanings, President Bush’s 2004 speeches concerning Latinos and immigrants in general were truly inspiring. On one particular occasion, George W. Bush called the extralegal immigrants in the United States “Americans by choice.” Rather than demonizing or criminalizing them, like so many other political leaders, Bush seemed to be advocating for compassionate immigration reform, change which would restore dignity to the 12 million extralegals within the U.S. and give hope to all those praying for their names to turn up in the quota’s lottery.

Until we move away from a profit-driven market for extralegal workers and continue criminalizing human beings for migrating, we will continue reading headlines like the shocking one in Long Island this past week. Marcelo Lucero, after having lived in the United States for the past 16 yeasr after emigrating from Ecuador, was brutally beaten and stabbed to death on November 9. A mob of seven boys were picked up shortly afterwards, and they were quoted as having said, ““Let’s go find some Mexicans.” (NYTimes)

The Pew Hispanic Center states that 1 in 10 Latinos (legal and extralegal) report being questioned about their immigration status. Even though Minnesota has refused to allow local enforcement of federal immigration laws, effectively prohibiting local justice departments from asking about immigration status (MNAdvocates), the recent economic crisis has xenophobia aflame in the United States once more. As middle-class Americans feel the crunch, righteous indignation at seemingly untouchable “upper management” is being turned on the ultimate scapegoats, those people who have scant rights and little legitimacy in our society.

It is important to note that in times like this our nation is redefined. Throughout American history, our nation’s crises were opportunities for both positive reform and negative policy-making. From the ceding of civil rights under the guise of Patriotism to the institution of universalized welfare programs for the nation’s neediest, from progressive refugee policies to profiteering part-time worker arrangements like the Bracero Program, it in epochs like the current Economic Crisis of 2008 that America, and indeed the world itself, is re-imagined for better or worse. It is our duty to guide its refashioning into a place where all people have basic human dignity and are afforded rudimentary rights such as the right to migrate and to work without fear.

United States and Spain Square off on Amnesty

Visiting Spain with Rotary International, I was struck by the diametrically different way this country was constructed. In the United States, the basic premise is that if corporations and businesses succeed, then people will likewise be successful. As a result, corporations and big businesses get tax breaks with the idea that it will then trickle down to the general populace. Spain’s laws, however, are organized with a dipolar paradigm, that if people are satisfied then businesses will do well.

I traveled Spain with minimum insurance, knowing full well that if I were sick I would be treated for free because of their socialized health-care system. When asked about their country’s healthcare system and the resulting 50% taxes, every single Spaniard I met voiced the fact that this was the only fair way to do healthcare. Rich businessmen and down-and-out vagrants all said that it was only right to make sure everybody got their basic needs met, irregardless of their income.

Spanish legislation has taken this one step further by providing basic human rights and opportunities to all immigrants, whatever their legal status. Deportation doesn’t exist in Spain; instead, the emphasis is on integration. No country in the world has run more legalization programs than this European Union nation. Just a decade ago, a mere 2% of Spaniards were immigrants. That number has risen to nearly 10%. (New York Times, June 10, 2008)

The marvel is that Spain not only attracts immigrants but also provides for them and their family’s assimilation. Immigrants are provided free health insurance, and in the six legalization programs since 1985, all working immigrants were eligible to become legalized citizens. And the education system has been revamped to integrate these new immigrant families into Spanish society, even though two of the top five sending countries – Romania and Morocco – do not speak Castellano Spanish. ((New York Times, June 10, 2008)

Perhaps even more telling is the government’s rationale for these legalization programs. In the United States, Reagan was decried for his Immigration Reform and Control Act of 1986 because it provided amnesty to millions of extralegal working citizens. Syndicates and the general populace criticized Reagan by stating that amnesty only encourages more illegal immigration, although this has less to do with amnesty programs and more to do with overly restrictive quotas and demoralizing lottery systems. Spain’s reasons for their six legalization programs were, in part, to ensure that lawbreaking employers were not given a competitive edge. However, the major reason espoused by all government officials is social rather than economic. Jesús Caldera, who was labor minister during one of these legalization programs, stated in the New York Times yesterday that, “If you practice exclusion, you risk the future of your country. You risk terrorism, violence.”

From here in rural Minnesota, there is little I can do to actively oppose the border wall in la frontera, a border wall initially proposed to stop illegal immigration. But I can work to change public opinion, the prevailing nativist rhetoric, and ultimately the antiquated and criminalizing laws which produce illegal immigrants rather than facilitate legal migration. We all can.