• Tatiana | The Costs of Fear

    Jacksonville, Florida


    "Everyone deserves the same basic right to health care. No one should be forced to choose between seeking medical care or possible deportation."

    Seeking healthcare is a daunting challenge, especially for those who are living in poverty or who are undocumented. “(Immigrants) come here and work hard, and just like everyone else they get sick. Everyone deserves the same basic right to health care. No one should be forced to choose between seeking medical care or possible deportation,” says Tatiana Ramirez.

    Tatiana is the Director of Patient Services at We Care Jacksonville, Inc. (dba WeCareJax) in Jacksonville, Florida. The mission of the nonprofit organization is to improve healthcare access by developing and coordinating a community-wide network of medical volunteers and donated healthcare services to compassionately care for the uninsured and underserved. These physicians and providers volunteer their time to see patients at no cost. WeCareJax accepts referrals for service from a dedicated network of free and charitable primary care clinics around Duval County.

    Yet despite WeCareJax’s mission, Tatiana says there is still initial apprehension by immigrant patients to engage their services. “For some, it is scary just to walk into a health center because there is a fear of what they can expect. Our very first goal is to make certain that every client that seeks our help understands that we are there to help them find treatment for their health care needs. Unfortunately, for some, the fear of their immigration status being discovered, or the medical services being considered a public charge forces them to choose to remain sick rather than seek medical care.”

    Tatiana recounts the plight of one such immigrant client who was living in Duval County. She had become so gravely ill that she was unable to continue working as a housekeeper. Despite her health deteriorating over the course of several years, she never sought medical treatment – feeling forced to live in the shadows of our healthcare system.

    “By the time she was referred to WeCareJax and was seeing our specialty provider, she was diagnosed with Stage 4, neuroendocrine cancer. She is now receiving care to treat her condition and continues to care for her two school-age children, who had gone for 10 years without receiving regular pediatric care themselves. If she had not been so fearful of seeking care due to her immigration status, her cancer could have been detected earlier, resulting in a better long-term outcome.”

    A point of frustration and heartbreak for Tatiana is knowing that many immigrant residents in the county opt to not seek help because of fear. “We often refer our clients to the University of Florida, which has a fantastic health care program funded by the city of Jacksonville for its indigent residents. However, some individuals - who have concerns about their immigration status - are afraid to utilize the program’s services. They fear that doing so will result in their application for a green card or citizenship being denied.”

    Tatiana explains that another consequence of immigrant residents not seeking initial medical care is the expensive option which they are forced to utilize once their health becomes critical. “Unfortunately, what happens more often is that these patients who have foregone seeking medical treatment for so long get to be so very sick. At that point, the resource of last resort is their local emergency room (E.R.). And the E.R. is a very expensive type of treatment for them to have to seek out.”

    Preventive care is a major issue for the uninsured. “The reality of the situation is that if we do not help provide care before their condition becomes critical, and these individuals are forced to go the E.R., then the cost of treating them will definitely be more expensive. This is something important to consider.”