Bringing Children to the US

Bringing Patients to the United States for Medical Treatment

By: Dr Tom Brian- President and Founder of Send Hope

It always saddens my heart to see a person, in particular a child, not getting needed medical treatment.  Many times while members of groups are serving in other countries, they will be introduced to a person needing medical treatment.  Send Hope has helped bring numerous children with medical problems from Honduras and Mexico to the U. S. for treatment or helped them get treatment in their countries.  This article is written in hopes that it will help others facilitate getting the medical attention for needy people.

            Getting a patient to the U.S. can be difficult, time consuming, costly, and frustrating.  Before you tell someone you will help, you need to be totally committed to accomplishing the task.  However, it can be done, even though at times it will appear impossible.  Keep on pursuing the dream.

            Also, this article is written from the perspective of bringing a child from Honduras to the U.S., because that is the country in which I have the most experience.  Other countries may have different requirements and rules. 

Before you begin the process, it is important for the parent and/or the patient to be realistic about the final results of treatment.  Many people believe that if they can get treatment in the U.S. their medical condition will be totally corrected.  A bone infection can be cleaned and cleared up, but many times a joint has been destroyed resulting in a permanent limp.  A parent may expect a child to return perfectly normal and be disappointed with the results.  Be sure to communicate with the family that the patient will be better, but may not be as perfect as they would like.

The first question to ask the patient is, “Can this treatment be done in Honduras?”  Next you need to find out it they have seen a doctor for an evaluation.  If not, they need to be sent for an exam to answer two questions.  Again, “Can the treatment be done in Honduras?”  If treatment can be done at the medical school hospital, Hospital Escuela, in Tegucigalpa, or a hospital in one of the larger cities, then you should send the patient there.  Hospital Escuela does not charge for treatment.  Many people believe they will receive better treatment in the U. S., and sometimes this may be the case.  However, there are some excellent doctors and good hospitals in Honduras, and most of the time the patient will receive good treatment.  The second question that needs to be answered is, “Are there additional medical considerations other than the obvious?”  Most of the children Send Hope brings to the U.S. are for

orthopedic treatment, because the only hospital and doctor that I have found that will do treatment at no cost specializes in children’s orthopedics.  It would be a problem if a child who had come for orthopedic treatment were given a physical exam upon checking into the hospital, and a life-threatening heart problem is discovered.  The orthopedic hospital would have to refer the child to another hospital, and you, as the sponsor, would be responsible for payment.  If the heart condition is discovered in Honduras, you can address that problem first.  Have the doctor that they see in Honduras write a letter stating the diagnosis and that the treatment cannot be performed in Honduras.

If the patient is to be brought to the U.S., the first step is to find a doctor and a hospital willing to donate their services.  Many doctors will donate their time, but finding a hospital is more difficult.   It is also important that the hospital not receive federal money.  I will discuss this later.  Also, the U.S. Embassy website, found at the end of this article, states what documents are required to obtain a visa.

One very important thing is to have a contact person in Honduras who can receive and care for the patient in the capital city, Tegucigalpa, while they are getting their visas.   Some patients may be able to get their visas without help, but most will not be able to do this alone.  Equally important is someone to host the patient in the U.S.  This requires a very special person.  This person does not necessarily have to speak Spanish, but it does help.  This person not only has to have a desire to keep the patient, but also be realistic about the amount of time and attention a rehabilitating patient will require.  Many people want to help but do not realize how much time it takes to transport the patient to the multiple visits to the hospital, clean and bandage wounds, as well as cooking and cleaning for the patient.  This person should be identified before proceeding very far. 

                        If you are getting treatment for a child you will need to decide if a parent will travel to the U.S. with them.  Some groups never allow a parent to come with their child.  That may sound unreasonable to a lot of U.S. parents who would never think of allowing surgery on their child without being present.  However, there is some merit to this policy.  It has been my experience that children adapt very well to their surroundings, and most of the problems have been from the moms.  Sometimes a parent gets depressed from being home sick, not speaking the language, and differences in food, culture, etc.  They may also worry about other children left behind with a family member.  Normally we will consider the age of the child and bring a parent, usually the mother, if the child is less than 3 years of age. 

            Before the child and parent travel to Tegucigalpa to start the visa process, both the parent and the child will need to get their birth certificates.  A child traveling alone will also need a letter from a lawyer signed by both parents, if they are alive, stating that the child has permission to leave the country.  Both parents will need their identification card for this letter.  It is important to check the birth certificate, the letter from the lawyer, and the parents’ identification card to see that all names are spelled the same and all birthdates are the same on all documents.  Sometimes one parent spells the child’s name one way, and the other parent spells it another way.  Check these papers closely; it will save time later.

            Next the patient and both parents will need to travel to Tegucigalpa.  Here my contact person, Janna, meets them and takes them to the Ronald McDonald House or another place where they can stay at no cost.  There is a kitchen, and Janna brings them food so they can prepare their meals. 

            Next, the people applying for their visa need two passport photos to get their Honduran passport.  Getting a passport takes about 1-2 weeks, assuming that all the paperwork is in order.  While the patients wait on their passports three letters need to be sent to your contact person in Honduras.  One letter needs to be from the person sponsoring the patient stating that they will be financially and physically responsible for the patient while in the U.S.  This responsibility should not be taken lightly.  The child and parent could be in the U.S. from four weeks to a few years, and will probably need medical attention for minor illnesses, such as colds or the flu, and will probably need dental attention as well.  Before they arrive, try to get a medical doctor and a dentist who will donate their services. The sponsoring person may or may not be the person who houses and cares for the recovering patient.   The other two letters that need to be sent are:  (1) from the doctor in the U.S. and (2) from the hospital stating that they are donating their services.  The U.S. embassy will not approve the visa for a patient to be treated in a hospital that receives tax money from the U.S. government. 

Once their passport is in hand, Janna goes to Bank Atlantida and applies for an appointment with the U.S. embassy.  The cost is $100 for each person.  In 2-3 days the appointment is made, but it may be anywhere from a few days up to 4 weeks before the actual appointment.       

So, now the letters are in Honduras, the parent and/or patient have their passports, and an appointment date has been set.  All that is needed now is approval from the U.S. embassy.  The people in the embassy who make these decisions have a very difficult job.  Because so many people want to come to the U.S., and plan to stay, the embassy people must screen out fraudulent applications from legitimate ones.  They have many stories about people making dishonest claims.  The two things that concern them the most are: (1) that people return to Honduras and (2) that no U.S. tax money is spent on them.  Janna takes the people to the embassy with all the papers to help answer any U.S. related questions.  Once the visa is approved, a courier will deliver the passport and visa to you, or you can go to the courier office and pick up the passport.  You should make one last check to be sure all names and birthdates on the passport match those on the visa.  If they are not identical and the customs agent that checks the passport before you board the airplane notices this, then your patient may not be allowed to board the plane. 

            Transporting the patient to the U.S. will require purchasing a ticket, using air miles, or having tickets donated by an air line.  Both Continental and American Airlines have similar programs, Care Force and Miles for Kids respectively, by which they give tickets to a patient and one person traveling with a child.  It is necessary to wait until the visa is received before requesting the tickets from American, but may not be on Continental.  Also, Continental seems to be faster because American has to wait on a committee to meet to make the decision, which may take up to four weeks.  However if you have to buy food for the people for four weeks, you may be better off purchasing the tickets.   Also, Continental does not always have seats for a patient. Because of this Send Hope has not used these programs in some time, so this information may be out of date.  Call the airlines and ask.  (The contacts are at the end of this article.)  You may also check with Sol Air, TACA, and North West air lines to see if they will transport the patients. 

            You may also want to check with such organizations as: Healing the Children, The Ruth Paz Organization, and others who have been helping children for many years.

            Good luck with your endeavor, and do not let discouragement get the best of you. 

 Contacts:

American Airlines- Miles for Kids- Debbie Ryan 1-800-531-7921

Continental- Care Force- Melia Reed 281-360-5374

U.S. Embassy- usembassy.state.gov   this site will take you to the embassy homepage for any country. 

Send Hope- www.send-hope.org - Dr. Tom Brian 972-727-5001