My brother’s keeper- Healthcare in Trump’s America

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I recently heard a story from a colleague about a patient that he admitted who refused admission for a potentially fatal illness because he was afraid he will be arrested and deported.  This incident happened during the Obama presidency that happened to have deported close to 3 million immigrants during the 8 years in office.  ICE (Immigration and Citizenship Enforcement) reports suggest that the exact number deported in the Obama era was 2,749,706; an average of 343,713 immigrants per year.  The Department of Homeland Security however still restricts enforcement from so called sensitive locations such as schools, places of worship, hospitals, and public demonstrations and rallies to allow undocumented immigrants easy access to those sites and services.  The problem that we face today with immigration policy is not the policy itself but the publicity associated with the enforcements.  As a physician I am focused on addressing the healthcare needs of all my patients irrespective of their immigration status. Unfortunately most undocumented migrants do not know and cannot be expected to trust us if they begin to feel that the whole nation is out to get them.

ICE REMOVALS IN OBAMA ERA – Source: Immigration Policy Institute

It is clear that the publicity related to the enforcement of our current administrations immigration policy can be harmful and may have unintended consequences on the health of our immigrants.  The current public nature of these policies is not all the fault of the Trump administration though.  The public nature of current enforcement is a relic of the election era utterances and pronouncement which continues to this day. A recent Pew Research survey suggest that numbers of undocumented immigrants in the United States has stabilized. As at 2014 a large majority (66%) of these immigrant are long term immigrants who have been in the United States for 10 years or more.

Most of the immigrants in the US today are people with very strong social and economic ties to the United States and removing them from this country could have a significant economic impact on this country.  The health needs of these undocumented migrants unfortunately are the responsibility of the US government.  This may sound like a damning statement to some individuals but if you consider healthcare in its totality with the inclusion of communicable diseases we realize that creating an environment that makes our visitors as I would call them from now on unwanted can have a significant impact on the health of all Americans.

Our current leadership may have come into power with strong support from some evangelical Christian groups. Franklin Graham the son of Billy Graham in his speech at the inauguration of President Trump is reported to have said that Trump won the election by the hand of God. There is no way that anyone can challenge that because Franklin Graham most probably is basing his pronouncement on a personal message that he received from God.  I however have a very public message from the Bible Matthew 25 verses 34 – 40 34 “Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. 35 For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, 36 I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’ 37 “Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? 38 When did we see you a stranger and invite you in, or needing clothes and clothe you? 39 When did we see you sick or in prison and go to visit you?’ 40 “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ (The Bible New International Version).


This is what the bible says; unfortunately the man chosen by the hand of God if I should believe Franklin Graham is singing a totally different tune.  I guess I can only blame God for all the fear and hatred that we see and hear about nowadays.

I certainly do not have the ear of President Trump so I do not believe what I have to say on these issues matters at all. I am just a lowly doctor and teacher trying to ensure that my patients believe they have unfettered access to my services and the services that other healthcare providers provide. These people that we call illegal immigrants are our neighbors, friends, uncles, aunties, brothers, sisters and co-workers. They pick the grapes and tomatoes that we eat. They clean our yards and sometimes they actually help build some of the information systems gadgets that enables us go to cities and towns we have never visit yet freely navigate these places.

Today, in America we hear about our visitors getting shot just because they did not look or act American enough. In this environment nobody can feel safe because we can never guess what the stranger on the street thinks of us.  This is America a country of immigrants and nobody should be made to feel unsafe or unwanted just by virtue of how they look, talk or act. My message to everyone especially to some Trump supporters who believe the United States is for only whites is; “ Please remember we are all immigrants the only difference is a matter of time”   We all need to feel safe and secure in this land and some of the xenophobic rhetoric must be toned down to ensure the safety of all of us living in this country citizens and visitors.

By Leonard Sowah a physician in Baltimore, Maryland


A physician providing primary medical care to patients across the lifespan

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