Immigrant left to die by starvation after Jesuit hospital decides care is too expensive

WASHINGTON, D.C., March 10, 2011 (LifeSiteNews.com) – A Rwandan immigrant who survived the genocide of 1994 has now had her life cut off by starvation and dehydration, reportedly because a U.S. hospital affiliated with Georgetown University decided that caring for the woman who lost her health insurance was too expensive.

The New York Times reports that Rachel Nyirahabiyambere, a 58-year-old grandmother and refugee from war-torn Rwanda, has been denied food and water since Feb. 19 after her feeding tube was removed.

“Now we are powerless spectators, just watching our mother die,” he said. “In our culture, we would never sentence a person to die from hunger.”

Unlike the Terri Schiavo case, every one of Nyirahabiyambere’s family members has been pleading for her right to live. Since last April, Nyirahabiyambere had been severely disabled after suffering a stroke. For eight months, she had been under the care of Georgetown University Hospital, a non-profit entity run by the MedStar Health Corporation and affiliated with the eponymous Catholic university.

But the Times reports that the hospital, frustrated by the woman’s lack of insurance and inability to pay her medical bills, sought a court in Alexandria, Virginia to appoint a guardian for Nyirahabiyambere who would take the grandmother off their hands, on the basis that the family would not make a decision.

The Times reports that Nyirahabiyambere’s sons – immigrants who fled the violence in Rwanda and earned their way from menial jobs to master’s degrees – lost control of their mother’s situation when Judge Nolan B. Dawkins of Alexandria Circuit Court appointed attorney Andrea Sloan as her guardian, despite an apparent conflict of interest: Sloan was the guardian recommended by the attorney for Georgetown University Hospital, even though the family had asked for an independent attorney to represent their mother’s interests.

The Times reports that Sloan then transferred the mother to a nursing home in Millersville, Maryland. The hospital then agreed to pay the costs of nursing home care – but the financial burden assumed by Georgetown University Hospital in that situation was also shortlived. Sloan made arrangements to put Nyirahabiyambere in hospice care and have her feeding tube withdrawn, leaving her to starve to death.

Sloan explained to the Times that the family did not have a right to consume hospital resources that might be allocated to others with better chances of recovery.

“Hospitals cannot afford to allow families the time to work through their grieving process by allowing the relatives to remain hospitalized until the family reaches the acceptance stage, if that ever happens,” Andrea Sloan told the Times in an e-mail. “Generically speaking, what gives any one family or person the right to control so many scarce health care resources in a situation where the prognosis is poor, and to the detriment of others who may actually benefit from them?”

The Times reports that one of Nyirahabiyambere sons protested in a letter to Sloan that “Ending someone’s life by hunger is morally wrong and unrecognized in the culture of the people of Rwanda.”

Sloan, however, responded that she was trying to understand “your culture” and asked flippantly, “Feeding tubes are not part of your culture, are they?”

She said that unless they could prove their mother would like to live “with a feeding tube, in diapers, with no communication with anyone and in a nursing home” that she would not reinstate the feeding tube.

The Times notes that Nyirahabiyambere, the wife of a Baptist minister, came to the United States after surviving the horrors of the Rwandan genocide and violence in refugee camps that divided her family, made her a widow, and forced her to survive in the jungle for a time. Her sons, who became U.S. citizens, brought her to America, where she found work that gave her health care benefits.

Nyirahabiyambere, however, lost her health insurance because she left her job to follow her oldest son to Virginia and help take care of his grandchildren. Generally, U.S. health insurance is employer-based, and not portable for an individual that switches jobs.

Georgetown University Hospital, which says on its website that they provide “physicial and spiritual comfort to patients and families in the Jesuit tradition of cura personalis – care of the person,” declined to tell the Times why they had washed their hands of Nyirahabiyambere’s case and omitted to intervene in Sloan’s course of action.

LifeSiteNews.com contacted the Maryland nursing home Wednesday where Nyirahabiyambere resided, but a spokeswoman said no one would be able to talk about her case, or even confirm if she were alive or dead.

Bobby Schinder of the Terri Schiavo Life and Hope Network told LSN that he was trying to establish contact with the family, but admitted that at this late stage there might be little that could be done.

Rachel Nyirahabiyambere, a legal immigrant from Rwanda, has been in a persistent vegetative state since having a massive stroke (suffered severe brain damagez) in April.

Because Mrs Nyirahabiyambere, who is Rwandan and has legal permanent resident status, has been in the U.S. for less than five years she is not eligible for the Medicaid coverage that would have paid for her to live indefinitely with a feeding tube in a nursing home.

On Feb. 19, Nyirahabiyambere’s feeding tube was removed on the order of her court-appointed guardian. Her six adult children — including two U.S. citizens — vehemently opposed that decision. But they were helpless to block it after Georgetown University Medical Center, frustrated in its efforts to discharge Nyirahabiyambere after she had spent eight costly months there without insurance, sought a guardian to make decisions that the family would not make.

When Jerome Ndayishimiye entered the overheated room at the nursing home where his 58-year-old mother lay under a tightly tucked blanket, he quickly closed the curtains around her bed and turned on her boom box so that a melodic Rwandan song enveloped them.

Sloan explained to the Times that the family did not have a right to consume hospital resources that might be allocated to others with better chances of recovery.

Sloan, however, responded that she was trying to understand “your culture” and asked flippantly, “Feeding tubes are not part of your culture, are they?”

Ms. Nyirahabiyambere was uninsured. The guardian wrote: “Hospitals cannot afford to allow families the time to work through their grieving process by allowing the relatives to remain hospitalized until the family reaches the acceptance stage, if that ever happens . . . . Generically speaking, what gives any one family or person the right to control so many scarce health care resources in a situation where the prognosis is poor, and to the detriment of others who may actually benefit from them?”

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It was by the staff.

It usually occurred at night. It was more neglect than violence, at least as far as what I saw.

During the day everything was neat and orderly, patients were attended to properly. Mostly because visitors or family members came and went regularly.

However at night, patients calls went unheeded. some moaned or screamed all night. Sometimes the odor of old urine and feces filled the air in the hallway and into my room.

One night I asked a nurse about one lady down the hall about her crying and pleads for help for over two hours and why nobody helped her. She said she only waited “attention.” Unable to ignore her crys and despite my condition, being attached to several I.V's and on crutches(I could barely stand by myself)I dragged my I.V pole and made my way down the hall, leaning against the wall to rest occasionally until I reched the room where the crying emitted and before I peered in the door the stench was so strong it almost choked me.

The old woman who had a stroke or something left her in a childlike state, had been left sitting in a visitor's chair and she had “relieved” herself. A brown liquid drained down her legs and puddled at her feet.

I got back into my room and repeatedly hit my buzzer until a nurse arrived. I told the "nurse' about what I witnessed and said she needed to be cleaned up. She told me, in a huffy tone, it was none of my concern and they were “busy” that night. They were “busy” laughing and having a grand old time joking at the nurse's station.

This went on almost every night I was there. To this day I feel ashamed I didn't get up and investigate earlier. I hope to G_d that if I was in that condition somebody else would answer my calls for help alot sooner than I did..

I'll never go back to a nursing nor will I ever send any of my loved ones to one.

About four yrs ago I had heart attack and open heart surgery..due to complications I was on ventilator and stayed in hospital for 30 days. (this was well known & respected hospital in Atlanta)....I was so weak I couldn’t do anything for myself for long time but eventually they got me up one day in one of those recliner type chairs. I spent the entire night there with no-one checking on me even though I kept buzzing for the nurse. The next day when the shift changed the nurse said “oh good...they got you up for the day”.When I said I was there all night she acted like she didn’t believe me. Many a night I would buzz for nurse or actually call out for help if I got twisted in bed and couldn’t move etc.....no-one came. One night one of my daughters said she would spend the night to help me...she happened to mention this to the lady walking the hall who was in room next to me. Her response “well, good..I hear her calling for help all the time”....
And this is before Obamacare sets in!! Heaven help us...particularly we seniors who already are getting short-changed from Medicare........

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