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Meet Francis Sanchez, 36, smart and good natured, a nice guy from the Dominican countryside. He was the kid his family hoped to send to college, but money was tight, so he went to work on the local hardscrabble back-country farms. He sprayed a lot of pesticides and herbicides, and before turning 25 he was on dialysis with kidney failure. With a lot of support from his Dominican and American friends, in 2017 Francis became one of the few Dominicans fortunate enough to receive a kidney transplant.
The transplant surgery gave Francis the possibility of having a future, but marked the beginning of a new struggle for survival. Transplant recipients are committed to a lifetime regimen of antirejection drugs, constant testing, and dealing with a series of infections and other complications of the transplant. Government insurance has covered most of his doctors’ and hopital costs, but not medications. The government is formally committed to providing the antirejection drugs, which cost far more than the typical Dominican income. But during the pandemic the supply chains collapsed, throwing the transplant recipients into the private marketplace, and often into the illicit black market. Francis managed to survive, again with a lot of help from his friends. But since then, Public Health has rarely had all the high-cost medications Francis needs, and it’s been a day-to-day scramble to somehow pay for those he needs to keep his transplanted kidney.
Francis can’t do heavy work, and for the last several years he’s been back in college, finally getting the education that will prepare him for a better paying job that includes good health insurance. This year he completed his bachelor’s degree in computer science, and is job hunting as well as continuing his studies. The Dominican job market is extremely tight, especially for new graduates with little work experience, and so far nothing suitable has turned up.
Now Francis is once again facing a financial and medical crisis. Public Health is increasingly falling short of providing the anti-rejection medications he needs. His subsidized health insurance will cover the medications, but is now requiring that he pay next year’s copayment before September 20th It’s about $500, a small fraction of the cost of the medications, but Francis doesn’t have it, and he is turning to his supporters to cover the cost. Everything helps, even small donations, and time is running out.