Roger Walter loved animals when he was growing up on the tropical Micronesian island of Chuuk, before moving to snow-covered to New Jersey and then to the drizzly Northwest.
“I loved dogs especially,” he said. “But when I came here I jokingly say,‘I don’t like dogs anymore. I see how much people spend on health insurance for their pets. If I had all that wealth, to get insurance for my dog, I would do that for one person. Or two.’”
Walter leans on a crumb-covered table at the cafeteria of Multnomah University, where he’s preparing to begin his custodial shift. His lunch cools.
Walter has health insurance through his work at the school. His wife qualifies for insurance through her employer, too. Three of their four children were born in the United States, and the kids are covered by Medicaid.
But Walter’s eldest is 17 - a young woman now. And his “auntie,” who cared for his wife as a child, is growing old. Both women need to see a doctor. But unlike the rest of their family, because of their birthplace, neither qualifies for health insurance.
Instead they worry. And they wait.
Portland is home to one of nation’s largest communities from Palau, Federated States of Micronesia and the Marshall Islands, nations that hold agreements with United States called Compacts of Free Association.
In exchange for allowing the United States military to occupy their land and water, the Islanders were promised security for health and environmental damages. Their island waters were the site of thousands of nuclear bomb detonations after World War II.
The agreement allows COFA citizens to live, work and go to school in the United States. But they’re barred, if hard times hit, from receiving public assistance.
“Our people work. We pay our taxes,” he says. “The government would spend less money to allow us insurance than for the emergency fees. At least we could be advised by a doctor.”
Walter’s daughter, Thursday, is a senior at Parkrose High School. She wants to be a pediatrician, or maybe a nurse. But she hasn’t had a routine checkup in six years. And despite being 17, she’s never had the annual exam that most women begin with puberty.
“When she gets sick we usually take her to urgent care,” Walter explains. “She’s a young woman. She’s strong. But there’s always a fear of something going wrong. I feel that almost every day with Auntie.”
Walter’s family has spent a lot of time in emergency rooms because his aunt, 71-year-old Ywikiko Santiago, has severe untreated asthma.
They constantly apply for free samples of the drug that stabilizes her. When they receive a supply they try to ration it out.
“There are times when she can’t get medicine,” he says. “When she’s out, we try not to call 911 when she’s wheezing. But when she passes out, then we call.”
The ambulance has been called to the family’s northeast Portland apartment at least five times.
“There are times when they resuscitate her after she’s turned purple,” he says. “I said, ‘there must be a reason you keep coming back.’”
The medics give her oxygen and take her to the hospital, where she remains until she’s stable - sometimes one day and sometimes three.
Her medical bills have added up. They owe nearly $100,000 now but when collection agencies call he just tells them the truth: She’s in her 70s. She doesn't work. She has Alzheimer's disease. And she doesn't speak English.
“I want to say what it’s like living in the house with her,” he says. “My shoulders are down. There’s no hope. There's a constant worry, knowing there’s nothing I can do other than wait until it gets worse so we can call 911.”
Read the new Health Department report: "Health Disparities among Pacific Islanders in Multnomah County"
