Community fights to preserve dialysis treatment
Published Sep 2, 2010 8:16 PM
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
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
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,
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
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.
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