Essential home care-based and nursing home services are made possible largely through the cumulative efforts of immigrants and refugees.

When I arrived at the home of Rosemary Larking in March, a 71-year-old quadriplegic, I noticed she was struggling to breathe. As her regular personal care aide, I saw that the adaptor connecting her ventilator to the oxygen tank was broken. I immediately called her doctor for support.

But this was not business-as-usual, as the coronavirus pandemic had already disrupted normal workflow patterns, especially in health care facilities, and I wanted to avoid her being sent to one.

I activated her lifeline alarm for emergency assistance, but as soon as a paramedic arrived, her doctor called. He told us not to go the hospital’s emergency care department, noting that she is in a high-risk category for contracting COVID-19. He told me to contact the suppliers of her oxygen tank or her ventilator and get them to her home as soon as possible.

A mad dash of phone calls erupted as I tried to reach her suppliers and others in Massachusetts who could fix the problem. In the meantime, I carried Rosemary from her bed to her wheelchair, which seemed to ease her distress.

Four hours later, the ventilator supplier arrived with the replacement parts. As we settled in after the crisis, some of Rosemary’s neighbors stopped by to see how she was doing. They had seen the fire department paramedics wheeling a gurney into her apartment and then leaving with it empty, which confused them. I assured them that everything was fine, taking the precaution not to let them into the apartment, given her risk of exposure to the coronavirus.

It was an exhausting day, and when I went home that evening, it was not easy to decompress after the worry and panic. Whenever a chronically ill patient experiences a life-threatening crisis, every moment is critical.

This scenario is a familiar one, not just for me but for tens of thousands of immigrants who are working on the front lines as personal-care attendants and nursing assistants for patients just like Rosemary Larking. And it’s not only the elderly, but also for patients of all ages who live with disabilities and physical limitations of all types.

My colleagues and I are taking precautions to ensure we are not exposed to the virus so we can continue to provide critical services to our patients and clients. And demand for caregivers is skyrocketing. Elderly patients and those with limiting disabilities who have no family members nearby rely primarily on aides like me. We do everything from bathing them and helping them maintain good hygiene to preparing their meals and feeding them. They are vulnerable and rely on us to keep them safe and secure.

It’s a rigorous job, and the caregiving field has struggled to recruit young people. Many aides in nursing homes, assisted living centers, group homes, and hospital-affiliated centers are immigrants like me. I started working with Rosemary Larking three years ago, shortly after arriving in the United States from Uganda.

For many migrants, the field of caregiving offers immediate opportunities with minimal skill requirements. My background is as a journalist who has covered beats in numerous countries around the world. I never imagined myself in this position, but here I am. My patients, especially Rosemary Larking, have become my de facto family, and I’m grateful for the job.

The pandemic amplifies a point that policy makers should heed. Essential home care-based and nursing home services for patients, who are among the most vulnerable to the virus, are made possible largely through the cumulative efforts of immigrants and refugees who have come to the United States.

This crisis has brought much to light. One point that has received little recognition is the critical role immigrants play in the US health care system. Political leaders should acknowledge this and allow them to come here and work without fears of punitive actions or deportation.

Caregivers still have to fight to stay in the United States. As an occupational category, they are not among those professions or skills that are eligible for employment-related green cards. These visas go primarily to researchers, professors, engineers, or multinational managers, but not to caregivers. And this continues, despite the fact that there are more job openings for caregivers than there are for professors and researchers, especially during this time of crisis.

Rosemary Larking is not alone in her home. Her husband, Donald, 73, is frail after five strokes that have paralyzed his body’s right side. The Larkings are in the highest risk category for complications that could arise should either of them contract the virus. My colleagues and I are even more cautious now to keep them safe. It is a challenge, since they rely on several aides for their care. And many aides care for other patients just like the Larkings. It is a precarious situation. One broken link in the chain of front-line health care could cause a cascading health crisis for the most vulnerable groups during this pandemic. That is why even the smallest precautions matter every day.

Yasin Kakande is a TED Fellow and author of “Why We Are Coming.”

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