People from all parts of the world immigrate to the United States in search of freedom, prosperity, peace and a better life. However, individuals’ lives are often affected by unexpected accidents that can happen to anyone regardless of age, gender, wealth or nationality. Acquiring a permanent disability such as a spinal cord injury is devastating no matter who you are, but the difficulties are compounded if one is undocumented and not afforded the same rights as the citizenry.

Changing Statistics

According to statistics from the Spinal Cord Information Network (http://www.spinalcord.uab.edu/), in the past spinal cord injuries were most prevalent among young males between 16 and 30, with the average age of disability acquisition being 28.7 years. Among those injured between 1973 and 1979, 76.8 percent were Caucasian, 14.2 percent were African American, 6 percent were Hispanic, and 3 percent were from other racial/ethnic groups. Since 2000, the median age at the time of injury has gone up as the populace ages. New injuries now occur mostly to males at an average age of 38. Recent statistics on new injuries organized by ethnic group have also changed with 63 percent Caucasian, 22.7 percent African American, 11.8 percent Hispanic/Latino, and 2.4 percent from other racial/ethnic groups.

The national averages are different than the data for individuals served at Shepherd Center (http://www.shepherd.org/), a world-renowned catastrophic care hospital based in Atlanta, Georgia. According to Shepherd’s statistics, between 1999 and 2004, the hospital served an average of 821 new patients annually, only 26 of whom – or 3 percent of the total – were Hispanic/Latino.

Legal Status & Post-Trauma Care

Pete Anziano, director of the Spanish-speaking peer support group at Shepherd Center, provided information on his experience with the impact of spinal cord injuries on undocumented immigrants. According to Anziano, the major obstacle facing most undocumented immigrants who acquire spinal cord injuries in the United States is that once they are stabilized there is no comprehensive post-traumatic care option available.

“Only ‘emergency Medicaid’ is available to assist undocumented laborers…this means that what they get in terms of rehabilitation support is very limited. Spinal cord injury patient care and rehabilitation are very specialized. Someone with a new spinal cord injury must learn to care for their bodies in very precise ways,” says Anziano. “Unfortunately, our national healthcare system precludes many people from access to adequate care, and, shortcomings in care may result in premature death. That’s why facilities that provide specialized rehabilitation and care like Shepherd Center are so important.”

Most of the Latinos served by Shepherd Center are farm laborers or construction hands who were injured on the job. The typical stay at Shepherd Center for an undocumented person is only 6 to 8 weeks, depending on extent of the injury and whether one has access to workers’ compensation or some other kind of insurance. This is not a long time when considering that spinal cord injuries are permanent disabilities which affect most aspects of physical human functionality.

Three Injured Workers’ Stories

Three men in the Spanish-language peer support group at Shepherd Center agreed to share their stories and opinions on the needs of undocumented people who acquire spinal cord injuries. Antonio is a 24-year-old paraplegic who was injured four years ago. Diego is a 27-year-old T-3 paraplegic, injured 12 months ago, who can now walk using braces. Juan is a 37-year-old incomplete paraplegic who was injured four months ago. All three were injured while working construction jobs after coming to the United States as undocumented workers in search of a better life for their families.

Antonio and Juan were fortunate enough to have had workers’ compensation coverage at the time of their injuries to support their transition into life with a disability. Diego did not, and was essentially abandoned by his employer soon after his accident. Because of the workers’ compensation, Antonio and Juan were able to obtain wheelchairs, shower chairs, and other equipment they needed to help them live independently. Diego relied heavily on the kindness and support of the local Latino community for donated items to allow him to be independent. Because of the limited resources available to undocumented immigrants, local Latinos organize fundraisers to assist community members in need. This was a great help to Diego because he had nowhere to turn.

The men, who were accustomed to working hard to provide for themselves and their families, all expressed great difficulty with losing their mobility. Everything in post-injury was “a struggle,” including tasks like cooking, transferring into and out of their chairs, reaching objects, and utilizing public restrooms, which are meant to be accessible but often are not.

All three men say that Shepherd Center’s monthly Spanish-language peer support group is an integral part of their healing process. In addition to receiving emotional and psychological support through the group, classes at Shepherd Center teach them how to live as fully and functionally as possible. Therapeutic recreation activities allow them to take part in outings that involve them in the community.

In addition to struggling to secure financial resources to cover the high costs of transitioning to life with a disability, the greatest worry for undocumented immigrants injured in the United States is deportation. Often, the individuals’ countries of origin are far less accessible and not as advanced in disability awareness, disability rights, inclusion, and reintegration back into society.

Community Bridge Program
With funding from the Bernie Marcus Foundation, Shepherd Center established the Marcus Community Bridge Program that offers post-discharge client education, guidance and referral for individuals and their families following a catastrophic injury or illness. The program assists people domestically or abroad, and even follows individuals who return to their countries of origin to assist in making those environments as accessible as possible.

The program prepares the newly injured person for reintegration into society. Bridge staff work with the person and their family to create individualized plans to make the most of available resources and options, and can also work with the person’s doctor and community. Currently, 60 percent of Bridge clients reside in Georgia and 40 percent live out of state or abroad. The program places special emphasis on fostering independence by making the newly injured person a responsible partner in a team working to set individual goals.

Providing Support for Community Transition Abroad
The kinds of assistance extended to people in their countries of origin are fascinating. For one man who had been a farmer all his life, the ability to grow food in his home country was of utmost importance. He worried that he would not be able to sow and reap a harvest. To accommodate his needs, a waist-high planter system was built so the paraplegic man could sow and reap crops without having to bend over to work the land. An assistant from the Marcus Community Bridge Program traveled to the man’s home and built the accessible planters with him.

Another man resided in a rural area of Mexico, where there were no paved roads or surfaces on which to use a wheelchair. When he returned to Mexico after his injury, Marcus Community Bridge Program helped him learn how to use a horse as his main means of transportation. This solution worked well and brought him a level of freedom he never thought possible.

Other Services
Program staff also provide technical assistance via the Internet and toll-free hotlines to individuals, families and doctors on how to increase quality of health and life for individuals who may not be able to find specialized care in their countries of origin.

The program is offered free of charge to all newly-injured patients admitted to Shepherd Center for inpatient or day program rehabilitation. For more information about the Marcus Community Bridge Program call Tammy King at (404) 405-9827 or visit http://www.shepherd.org/patcare/spec/Bridge.asp.

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