Saying yes when everyone else said no

childern

Sheila Angeles-Han, a pediatric rheumatologist at Emory-Children’s Center and one of only 200 in the country, offered to treat Mireya without charge, a gesture that helped persuade the Bolivian government to let the child leave that country and come here for treatment.

During layovers in Bolivia, flight attendant June Rheingrover often volunteered in an orphanage near Santa Cruz.

There she met 9-year-old Mireya, always smiling and reaching for hugs, despite the polyarticular juvenile rheumatoid arthritis that affected her joints.

Rheingrover and life partner Patrick Norris, a pilot, decided to bring Mireya to the United States for treatment. This proved difficult, however, and two years passed with no entrance visa in sight. Meanwhile, Mireya’s condition deteriorated. She became wheelchair bound, weighed less than 40 pounds, and was in constant pain. She tried to keep smiling, but the spark was fading.

Desperate, Rheingrover began calling random people at Emory Healthcare for advice. A social worker passed the message along to pediatric rheumatologist Sheila Angeles-Han at Emory-Children’s Center, who immediately offered to treat the child without charge. Her offer helped persuade Bolivian courts to declare Rheingrover as Mireya’s legal guardian and to let the girl leave.

“Dr. Han said yes when everyone else said no,” says Rheingrover. “I am so grateful that people like her still exist in this weary world. She is my hero.”

Shortly after the first visit to Han, Mireya’s pain went away, and she stopped moaning in her sleep. With weekly steroid and methotrexate injections, she abandoned the wheelchair, first crawling, and then racing up the stairs of her new home. Her joints loosened and straightened. She grew to normal size. In regular visits to Han, she jumps nimbly up on the exam table, chattering happily in fluent English: “Look what I can do!”

Biologic therapy, used for immune disorders, now keeps the brakes on Mireya’s overly aggressive immune system, although earlier damage means she eventually will need joint replacement. While Rheingrover and Norris pay for the medicines Mireya requires, costs for care (totaling more than $45,000 thus far) are unreimbursed. But who could put a price on watching a bubbly Mireya leave for Disney World with her American “parents,” walking on her own.


   
   
 
 

In the past five years, Georgia children in poverty increased from 19.9% to 23.3%. Many children seen by Emory pediatricians have no health insurance, and their parents have no resources to pay for care. More than half are covered by Medicaid, which provides lower reimbursements for pediatric than for adult care. Even with insured patients, Emory pediatric specialists often spend much more to provide services than they ever get back—except for the satisfaction of knowing they are an essential part of the safety net for these vulnerable Georgians.

 





     
 

Emory pediatricians provide care in the following venues:

Outpatient:

  • Emory-Children's Center, the largest pediatric multispecialty group practice in Georgia (and a joint venture with Children's Healthcare of Atlanta) 

Inpatient:
Children's Healthcare of Atlanta

  • Children's at Egleston, 255 beds, Emory campus, staffed by Emory and community physicians, with Emory providing 80% of physician care 

  • Children's at Hughes Spalding, 24 beds, Grady Hospital campus, staffed by Emory and Morehouse medical schools and community physicians, with Emory providing 66% of physician care

  • Some Emory pediatric faculty also teach and have admitting privileges at Children's at Scottish Rite, 250 beds, located in north Atlanta

Emory University Hospital Midtown (high-risk pregnancy and neonatal intensive care)

 
     

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Community Benefits Report Cover 2011