Community fights to preserve dialysis treatment

Bulletin: As we go to press, the dialysis patients have gotten another reprieve. The dialysis providers have agreed to continue treatment while a more long-term arrangement is negotiated.

Photo: Angela Flores

At a meeting chaired by DeKalb County Commissioner Larry Johnson on Aug. 31, officials from Grady Hospital, Emory University, Fresenius Medical Services and kidney care company DaVita stated that an agreement among them for extended care is almost completed and that the patients should keep their appointment schedules. Many of the terms being discussed were not revealed.

The Grady Coalition is going ahead with planned actions on Aug. 31 and Sept. 1 to underscore that health care is a human right for all.

Once again, poor immigrants suffering from kidney failure face a cutoff of their life-sustaining dialysis treatment. Grady Hospital had sent some 38 patients a letter informing them that Aug. 31 was the last day the cost of their treatments would be covered under a contract between the hospital and Fresenius, a for-profit business. Without dialysis three times a week, deadly toxins will build up in these patients’ bodies, bringing about imminent death.

This nightmare began a year ago, when the privatized corporate board of directors of Atlanta’s safety-net hospital ordered the closing of the outpatient dialysis clinic. With a closing date of Sept. 19, 2009, the patients were given three options — return to their home country; move to another state that provided funding for chronic care for kidney patients; or begin paying a private provider. A fourth option was raised — to wait until the patient’s toxin level was at dangerously high levels, and then go to an emergency room, be hospitalized until stable and then be sent home! Grady offered patients transportation money to leave the area.

In 2007, when the hospital was still a publicly operated facility, a similar attempt was made to shut the clinic down. Community opposition, organized by the Grady Coalition, prevented this attack on a life-or-death service needed by poor and uninsured people. In fact, the CEO who tried to ram through the closing was fired by the hospital’s board, which chastised him for undermining the hospital’s purpose.

Two years later, with the hospital privatized and a handful of influential business leaders now making decisions, the idea of eliminating the clinic resurfaced.

Once again, health care advocates, Grady doctors and nurses, students, faith leaders, elected officials, and the patients and their families organized press conferences and rallies in front of Grady Hospital. They crowded into board meeting rooms, where immigrant workers presented their stories of having lived and worked in the U.S. for years, of having children growing up in Atlanta and of the inaccessible or nonexistent dialysis facilities in countries such as Honduras, Ethiopia and Mexico.

Despite a temporary injunction and a lawsuit, the clinic was shut down on Oct. 4, 2009. The closure impacted 91 patients, more than half of them undocumented immigrants. However, as a result of all the pressure, including national media coverage, Grady agreed to cover the cost of treatment for 51 people at for-profit clinics operated by Fresenius Medical Services until Jan. 3. The other 40 were eligible for Medicaid coverage.

As that deadline approached, community pressure forced a continuation of care. After another cutoff date was set for February, it was discovered that Grady had in fact signed a contract with Fresenius to treat Grady patients until September. The public cat-and-mouse game was intended to panic these critically ill patients into agreeing to leave the state.

At the outset of this human crisis, board Chairperson “Pete” Correll, a former CEO of Georgia-Pacific and a major force in the corporate takeover of Grady, claimed, “We made a commitment. ... People are not going to die on the street because of these actions.” (New York Times, Nov. 20)

However, at least nine of the ousted patients have died in the months since the clinic closed, including 23-year-old Ariana Ríos Fernández, who died on Nov. 28 in Durango, Mexico. The mother of two returned to Mexico, where each dialysis treatment cost $118. Although her father sold everything he could and borrowed money, they could only afford two sessions a week. Her death was not tracked by Grady Hospital officials.

Members of the Grady Coalition are focusing on three key players in this unethical abandonment of ill patients — Emory University, whose medical students train at Grady and which opened three dialysis clinics within months of the shuttering of the Grady clinic; Fresenius Medical Services, a giant, highly profitable, multinational corporation with dozens of facilities throughout metro Atlanta; and Grady Hospital, whose CEO Michael Young received a $290,800 bonus on top of his $615,000 salary for cutting costs and bringing about a $34 million surplus in 2009. On Aug. 25 and Aug. 26, the Grady Coalition held demonstrations at Emory University, at a Fresenius facility and in front of Grady Hospital with signs declaring, “Don’t let them die!”

For months, efforts have been made by DeKalb County Commissioner Larry Johnson and community activists to gain agreement from Fresenius, Emory and other dialysis centers to provide pro bono care for these particular patients.

However, as critical as this short-term need is, the Grady Coalition also demands treatment for all those poor, uninsured and underinsured who are just being diagnosed with renal failure. What are they to do and where can they go when dialysis is a profit-making business? The corporate board claims that the mission of Grady Hospital to serve the poor is intact. Without outpatient dialysis care available, that is a death-causing lie.