A Day of Seeking Healthcare for the Undocumented and Uninsured

Seeing a doctor is Sisyphean task for those without citizenship in the US.
A Day In the Life of the Undocumented and Uninsured
Photo credit: Samantha Bloom

If you are one of the estimated 11 million undocumented immigrants living in the US, chances are the doctor’s office is not a familiar scene. From dire economic resources to language barriers and a crippling fear of deportation, immigrants face many hurdles to receive basic medical care in this country. Not only are approximately 40 percent of undocumented immigrants uninsured, but various clinics across the US have also reported a downturn in immigrants seeking appointments since the Trump administration took office. The national immigration debate is much more than a contentious battle to “fix” a broken system— for many, it’s a matter of life or death.


Carolina Ramirez is currently living that reality. When Ramirez fled Honduras for the United States in 2016, it took her one month to cross the border and several encounters with human smugglers, known as coyotes, who put her life at risk. Like many immigrants, she left her country behind in an effort to escape gang violence, as well as to seek medical care. Her right foot has been severely infected due to a growing ulcer that has been brewing in her skin for years. Ramirez had hoped that American doctors could provide the care she wasn’t able to find in Honduras, but she is still awaiting a diagnosis.

Ramirez’s ordeal is now in its second year. She has attempted to get a diagnosis from four different clinics in New York—all of which have failed to follow up with results. Ramirez is convinced this long waiting period is due to a “lack of urgency” that looms over patients who don’t carry enough money or papers. A visit to the doctor means a routine trip for many of us—but in Ramirez’s case, it entails hours of commutes, an anxiety driven by her inability to communicate in English, and an overshadowing fear of both rejection and reveal of her undocumented status. Ramirez’s foot infection has now severely limited her mobility and rendered her unable to work. To her, this is a scenario that seemed plausible in Honduras, but not in the United States.

For Ramirez, accessing healthcare is a daily struggle that is reflective of the experience of millions of undocumented immigrants living without insurance. We spent a day with Ramirez, following her to the doctor's office to document the hurdles she faces in an attempt to live the life she sought when she came to the US.

House in the dark an orange window

Photo credit: Samantha Bloom

Ramirez lives in upstate New York, roughly three hours from her doctor’s office in Manhattan. At 5:30 AM, with the sun still tucked away, her window was the only one radiating light on her block. Her appointment was scheduled for 10 AM.

Man coming down the stairs

Stepping into Ramirez’s house, we were reminded of how detached from reality the term “immigrant” has become. In the home exists the familiarity of a typical life, regardless of citizenship status—the smell of a home, rumbling kitchen noises, kids running down the stairs. These are the moments of normalcy she once yearned for.

Santa Biblia

Ramirez’s home holds an abundance of religious relics. She often retreats to her Bible in search of answers. Although her situation has led Ramirez to question her own self-worth, she relies on God to justify her reality. Almost every sentence she speaks ends with a “ si Dios quiere” (if it’s God’s Will).

Man looking in the rearview mirror

Photo credit: Samantha Bloom

“Back there [Honduras], one thinks that in the United States you can have access to the best doctors. One thinks,” Ramirez says as her son drives her to the local train station. On each side of her windows are acres of farm that have replaced the coffee plantations she woke up to every day back in Honduras.

Woman walking up the stairs

Ramirez is accompanied by at least one of her kids during every visit to a medical clinic. Since she doesn’t speak English and cannot afford a $38 Metro North round-trip ticket, her kids help her navigate a system that is foreign and inaccessible to her. Not only do they serve as translators, they also provide the emotional support she needs every time she succumbs to despair.

Conductor taking train tickets

Blending into the morning rush, Ramirez and her children try to avoid the crowds by sitting in the furthest seats possible. They all doze off—her daughter and son work night shifts in restaurants—lulled by the gentle rocking of the train. In between stops and loud announcements, Ramirez reminds us that not too long ago there was an ICE raid in the Hudson Valley, just miles away from where we’re at. “I try and not get scared by news like that,” she says.

Crowding at the train station

Once Ramirez sets foot in New York City’s Grand Central, among thousands of morning commuters, she continues to keep her head down as she crosses the station. Timidly looking away, Ramirez focuses on making her way to the yellow cabs stationed outside. Everywhere she looks, effortless strides crisscross all around her as she slowly limps forward. From afar, this serves as a reminder for me of the long, arduous journey it took her to come to the US, and the painful ways in which this trek has not ended.

When we arrived to the clinic for Ramirez’s 10 AM appointment, the attendant looked at Ramirez’s family and said, Your Doctor didn’t come in today. We can’t see you. We’ll see you next Tuesday.” What struck me most was that, rather than feeling disappointed, Ramirez accepted this rejection and didn’t contest it, as if dismissal was part of her norm.

Many hours, one sunrise, one car ride, one train ride, and a taxi cab later, and Ramirez had nothing to show for it. This is just one day out of two years of the same routine of seeking help, with different outcomes that lead to no concrete answers. Throughout the day, we witnessed an expression of cautious optimism turn into a sense of hopelessness that has now become a feature on Ramirez’s face. It lives in her stare, in the way she talks, and in the pain of her walk.

Ramirez is still awaiting a diagnosis, and millions of other immigrants across the country are also dancing in this familiar lingering limbo. It’s an uncertainty that plagues even the most joyous of moments and lingers as a dark cloud over their heads. But, just like Ramirez, they continue on—still driven by that initial hope this country promised them.

Follow Paola Ramos on Twitter. Photos By Samantha Bloom.

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