By Patricia H. Rich, MSW, ACSW, LCSW-C, DCSW
Throughout the history of the United States there has been a great deal of discussion about immigration. Currently the debate seems to focus on Hispanic workers and the effect that undocumented workers have on the economy. People come to the United States from other countries in an attempt to make their lives better, and it is assumed that it is the economic factors that motivate them to come and stay in the United States. Only occasionally do the humanitarian aspects of immigration get discussed. In my role as a social worker, I work with many undocumented women and men who wish to stay in this country to make their lives and the quality of life for the family members better.
Many come here to live and they wish to stay in this country to be able to stay alive. I work in an HIV/AIDS clinic and we have many undocumented clients. Some are Hispanic, but a larger percentage immigrates from Africa. Often, they come to this country on visitor’s visas, working visas, or to work as nannies for American families. Once here, they discover that they are HIV positive and come to our clinic for treatment.
Many clients remain in the U.S. even after their visas expire because of the quality of care they is superior to what they would receive if they returned to their home country. Many live in fear of their undocumented status being discovered and worry that they could be deported to their homeland where state-of-the-art HIV treatment is not available to them.
Because many are originally from countries in turmoil, they have the added problem of concern about their own personal safety. As our clients become healthy and physically able to work, they long to be in this country legally so that they can make a contribution to our society.
Many find themselves living in poverty because they are unable to find legal employment. Despite being worse off economically, they feel they have no choice but to try to earn a living in the United States. They feel that they must remain here in order to survive. Their lives literally depend on their staying here and receiving good HIV treatment.
I have seen the anguish that undocumented people experience emotionally because they are unable to return to their homeland for visits. They miss their country of origin and the important people in their lives that have remained there. They are denied the possibility of visiting sick relatives or attending funerals and other important ceremonies. If they leave the United States, they know that they are not able to return.
My job as a case manager is to help my clients navigate the complicated social services system and I do this in several ways:
- Helping clients find programs in the community that will help them live a more fulfilling life.
- Dispelling myths of the HIV disease process.
- Encouraging clients to stay on their medications and to take them properly.
- Counseling clients about safe sexual practices to help stem the spread of HIV infection.
- Helping clients who are depressed find mental health services.
Unfortunately, HIV patients still live with the problems of stigma and many African immigrants seem to experience this stigma to an even greater degree that people from other cultures. This issue sometimes results in their being reticent about obtaining treatment. We try to help dispel their fears and make them feel very comfortable in our clinic. Each day brings new challenges and with it many rewards.