Examples of approved HSLs in Honduras

[Ange]

Please do not copy (plagiarize) this or any other approved hardship letter from this forum!!!

[Cynthia]

Resources for your extreme hardship/I-601 waiver packet:

Tips for Writing the HSL

Laurel Scott's Memo on the I-601

Some Supporting Document Tips

Help for HIV Waivers

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Approved HSL Courtesy of Member mariadelpilar via Tegucigalpa, Honduras

LETTER OF EXTREME HARDSHIP FOR PETITIONEE
IMMIGRANT VISA CASE CASE #XXXXXXXXXX

TABLE OF CONTENTS
MEDICAL REASON 2
RESPIRATORY PROBLEMS 5
FINANCIAL REASONS/CHILD CARE COSTS/POTENTIAL BURDEN TO SOCIETY 5MEDICAL INSURANCE 6
CHILDREN’S EDUCATION 6
INVESTMENT IN PERSONAL EDUCATION AND TEACHING CAREER 7
US VS. HONDURAS 7
ORICA VS. DENVER 8FAMILY 9
HUSBAND’S HISTORY 9
HUSBAND AS MY PARTNER AND A FATHER 9
MARRIAGE 10

June 2007.
US IMMIGRATION OFFICETEGUCIGALPA,
HONDURAS RE: PETITIONEE
Immigrant Visa Case CASE #XXXXXXXXXX

I, PETITIONER, declare under penalty of perjury, under the laws of the United States, that the forgoing is true and correct. My name is PETITIONER. I am the petitioner for my husband, PETITIONEE (WAC-##-###-#####)/NVC Immigrant Visa Case CASE #XXXXXXXXXX, whom I will hereon refer to as HUSBAND. The primary reason that I am asking for a Waiver of Extreme Hardship is because I need my husband, HUSBAND to be able to be with us in the United States to help take care of our daughter, DAUGHTER HUSBAND LAST NAME, who due to her prematurity and intraventricular hemorrhage is classified as a child with “special needs and developmental delays”, and our son, SON HUSBAND LAST NAME, an infant.

MEDICAL REASON
The main reason that I am asking for a Waiver of Extreme Hardship is because I need HUSBAND to be able to be here to help take care of our daughter, DAUGHTER HUSBAND LAST NAME, and administer her ongoing needs for physical therapy. On October 9, 2005, HUSBAND and I gave birth to DAUGHTER HUSBAND LAST NAME. DAUGHTER was born at 26 weeks (<28 is considered “extremely premature”) and only weighed 960 grams (considered Extremely Low Birth weight < 1000 g) around 2.2 lbs. Due to her prematurity, her lungs were not developed, and she was intubated within 2 minutes of life. Even with the intubation, her oxygen saturation was 30% initially and it took 15 minutes of CPR for her oxygen to come up to 70%. I can remember as if it were yesterday, having just given birth, my first time, with all the hopes and expectations, of hearing the baby’s first cry, instead replaced by an unforgettable memory of seeing a group of nurses feverishly resuscitating DAUGHTER as she laid there unresponsive. I knew it wasn’t good. I just prayed for the will of God. I remember Dr. X, a neonatologist from Children’s Hospital that was called that night, telling us that DAUGHTER had a 60% chance of survival. Once she was intubated and stabilized, the nurse who saved DAUGHTER began to explain to us all the tubes and machines to which she was hooked up, when she broke in tears and disappeared behind the curtains. I still don’t know why she cried, but all we knew is that we were thankful for all the efforts that she made in saving DAUGHTER’s life and that she didn’t give up. I wondered if she was overwhelmed with the effort it took to save DAUGHTER or if she knew the possible future for a child who had just gone through what DAUGHTER suffered. We are so thankful to that nurse, that DAUGHTER’s middle name is the name of her life saving nurse, Diane. DAUGHTER was transported hours from birth by Flight for Life to the NICU at the University of Colorado Hospital where she was hospitalized for close to three months (released January 2nd, 2006). Within a few days from birth, DAUGHTER was diagnosed as having an intraventricular hemorrhage grade III (a bleed in the ventricles of the brain). Dr. X, DAUGHTER’s doctor, explains an Intraventricular Hemorrhages as follows:

The internal structures of the brain in a preterm infant are at risk for hemorrhage. The bleeding is usually the result of a previous period of low blood flow, and occurs in the first four days of life. Diagnosis of the bleeding is performed with bedside ultrasound exams. The degree of bleeding is graded from 1 to 4. Grade 1 and 2 bleeds are small, and they do not increase the infant's risk of neurodevelopmental abnormalities, while 33% of the babies with grade 3 and 4 bleeds will suffer severe neurologic injury, and another 33% will suffer lesser deficits. The final neurologic complication in preterm babies is injury to the motor tracts in the brain called periventricular leukomalacia (PVL), which causes cerebral palsy-a movement disorder with spasms that can impair the ability to walk.

The intraventricular hemorrhage led to hydrocephalus (fluid in the ventricles of the brain). While in the hospital she suffered a great many obstacles: the closing of the Patent Ductus Arteriosis, Nectrotizing enterocolitis, etc., but the most significant and with potential long-term effects is the IVH Grade III . Her lungs were underdeveloped and she spent a significant amount of time on and off high frequency oscillating respirators and CPAP. When DAUGHTER came home she was still on oxygen. Her current diagnosis includes, Chronic Respiratory Disease (a.k.a. bronchopulmonary dysplasia (BPD)), arising in the Perinatal Period, and Developmental Delays among others . DAUGHTER received physical therapy throughout her ~3 month stay in the NICU and continues to receive physical therapy at home because her prematurity, lack of oxygen, and intraventricular hemorrhage are known to cause physical and other disabilities.

As a result of all of these complications, DAUGHTER is considered a child with “special needs and developmental delays”. According to the “Criteria for Determining Disability in Infants and Children: Low Birth Weight” , a report from the U.S. Social Security Administration, children with very low birth weight and very premature are at higher risk for:
• cerebral palsy and neurological disability
• abnormal cognitive development or mental retardation
• speech/language delay, hearing loss, behavioral disorders, and learning disabilities
• visual disability
• pulmonary disability
• growth impairment

A synopsis of the objective and findings of this report are below:“Objective:To determine whether specific factors or combination of factors alone or in addition to birth weight predict significant developmental disability in former premature infants and whether premature infants with such factors have long-term developmental disabilities.Main Results: We looked for evidence of association of very low birth weight (VLBW defined as <1500 grams) with six outcome conditions. The evidence of the literature overwhelmingly supports that the risk of cerebral palsy (CP) and major neurologic disability is increased among VLBW infants compared to full-term infants. The literature is consistent in demonstrating that risk of CP, major neurosensory and/or neurologic disability is inversely proportional to the degree of immaturity whether measured by gestational age or by birth weight.The evidence demonstrates that children who were born VLBW have significantly higher rates of cognitive abnormality in early childhood and a several-fold increased prevalence of IQ <70 as adults compared with children or adults who were born normal birth weight at term. There is evidence that even children who were apparently "well" VLBW infants during their neonatal course are also at significantly greater risk for both moderate and severe delay compared to larger birth weight groups. VLBW infants are at high risk for developing cognitive, neuromotor, and neurosensory disabilities including blindness and hearing loss. These disabilities in turn may lead to other disabilities in speech and language, behavior problems and learning disabilities affecting school performance. All of the above problems have been identified in disproportionate numbers in the VLBW infants.The studies provided strong evidence of increased incidence of speech and language delays in VLBW and extremely premature infants, and identified clinical factors associated with the increased incidence. Across all measures of short-term memory and language outcomes, preschool children who were born preterm performed at a lower level than children who were full-term counterparts. These deficits were independent of the general IQ.The evidence identified by this review clearly demonstrates that children born as VLBW infants, with or without retinopathy of prematurity (ROP), are at significantly increased risk of visual impairments and disability compared to children born full term. The risk of visual disability in VLBW infants varies inversely with gestational age.The studies reviewed indicate that VLBW infants with bronchopulmonary dysplasia (BPD) are at increased risk for long-term pulmonary disability. The greater the severity of BPD, the greater is the association with long-term pulmonary impairment and need for re-hospitalization.VLBW infants, with or without other conditions, are at high risk for poor growth during the first years of life due to acute neonatal illnesses, developmental delays, and chronic illnesses.Conclusions: Surviving premature infants often sustain multi-organ system complications that may persist beyond the first few years of life and frequently result in permanent impairments. Complications of even a single organ system may have a profound impact upon other organ systems. Biomedical determinants of disability in premature infants are often compounded by adverse determinants of social and psychological adaptation of these vulnerable children and their families.”

In the interest of not quoting the whole report, it needs to be read in is entirety and in parallel with DAUGHTER’s discharge report, as in almost every compounding factor individually analyzed, DAUGHTER has suffered it in combination with many of the other factors mentioned. The fact that DAUGHTER was extremely low birth weight and extremely premature, had low oxygen at birth, had an intraventricular hemorrhage grade III leading to hydrocephalus, and was on respirators and on oxygen for about the first 6 months of life, had a PDA, suffered necrotizing enterocolitis, had Hyaline Membrane Disease causing Chronic Lung Disease (Bronchopulmonary Dysplasia) etc. puts her at an even higher risk for all of the aforementioned issues according to the SSA report. In addition, this report states, “The long-term complications result in significantly increased tangible and intangible lifelong costs to the family and society for medical care as well as for ongoing ancillary health and educational services.”

You cannot imagine how difficult that in spite of all the love in the world, or even if you had all the money in the world, you can do nothing to change the reality that your lovely child could be afflicted with any one of the above impairments. However, there is something we can do to make sure that the outcomes are the best possible, by providing the best possible care by both of her parents and by doctors and other providers such as physical therapists, speech therapists, occupational therapists, and special educators, here in Denver, CO. Some of DAUGHTER’s past and current physical problems could point to DAUGHTER having cerebral palsy or some other neurological problems. For example, DAUGHTER demonstrated persistence in her ATNR (Asymmetrical Neck Tone Reflex) beyond the time that is normal, an indication of possible neurological problems. Currently, DAUGHTER appears to be walking on her tip toes a little more than normal, another early indicator of neurological problems, specifically a form of cerebral palsy known as diplegia, which is more common in premature babies . As a mother, it has been heart-sinking to wonder if a movement or action is an early indication of any of the above long term issues. Although the best prayer I know is to let God’s will be done, many times I pray to God to please give me whatever pain and suffering DAUGHTER has or will have, and to please spare her of any of these conditions. I teach high school, and I’ve had a number of students who suffer from cerebral palsy. I know many of the struggles that these students face, from being bound to a wheelchair, limited mobility, requiring assistance even for minor things such as going to the bathroom, to numerous surgeries made in the hopes of improve their quality of life, as many of them suffer chronic pain.

The most important reason that we need HUSBAND with us is so that he can take care of DAUGHTER and continue her physical therapy and upcoming speech and language development. We have a letter from DAUGHTER’s physical therapist detailing that HUSBAND has been taking care of DAUGHTER and been responsible for her home care physical therapy. This letter explains how important it is for DAUGHTER’s development for HUSBAND to continue her physical therapy to ensure the best possible outcomes for DAUGHTER. She is being seen by Dr. X, one of the most recognized neonatologists in Denver, who is the Director of the NICU at University Colorado Hospital and a doctor at the Special Care Clinic of Denver’s Children’s Hospital, ranked 7th in the United States, and recognized by his peers as one of the best doctors. We have a couple of letters from Dr. X asking for your consideration in this matter . We are very lucky and Dr. X and is the doctor for both of our children. In an article written by Dr. X, he answers the question of “What is the outcome for survivors of the intensive care nursery?” as follows:

Neurodevelopmental handicaps may occur in survivors of the intensive care nursery. These handicaps include cerebral palsy, which can be severe enough to prevent a child from walking, and cognitive deficits, which can be severe enough to prevent a child from learning to talk or read. Fortunately, deficits this severe occur in the minority of survivors, but others may have lesser deficits that cause delayed motor development, learning disabilities, and behavioral disorders, such as attention deficit disorder (hyperactivity).

The rates of abnormalities are higher in babies of lower gestational age at birth, particularly those born at 25 weeks or less. Although ROP rarely causes blindness, vision problems may still occur. The frequency of hearing loss is increased compared to term infants. The consequences of chronic lung disease are an increased rate of hospital readmission during the first two years of life, a continued oxygen need, and an increased incidence of asthma-like symptoms.

Finally, preterm infants are at an increased risk for poor weight gain, and they may require nutritional supplements or special formulas. Most premature infants who "graduate" from an intensive care nursery do quite well; however, coordinated follow-up to address all of their needs is of paramount importance.

We have a letter from Denver Options, the early intervention program provided by the Colorado Department of Education, regarding DAUGHTER’s participation in the program due to her special needs . Lastly, we have a letter from Denver Health Hospital Health Care Program, for children with Special Needs, which assisted in making sure we were being provided all the services to which DAUGHTER was entitled due to her condition.

RESPIRATORY PROBLEMS AND PHYSICAL THERAPY NEEDS REQUIRE HOME CARE

DAUGHTER’s lungs were underdeveloped at birth and as a result she is at a much higher risk for contracting illnesses, and being exposed to other children, particularly in a daycare setting, could put her at unnecessary risk. DAUGHTER’s few exposures to a sick person result in her getting sick and when she gets sick, it is difficult for her to breathe and eat or drink at the same time, and her nutrition is affected, a concern with premature children. After discussing our situation with doctors and consulting with support organizations about what other parents did in similar situations, we found out that the best care is given when children are taken care of at home by their families. To prevent the health risks of a day care setting, and even though it would be financially more lucrative to have both of us working and sending our children to day care, we have chosen to place DAUGHTER’s needs first, and made the decision to take care of DAUGHTER at home. I am a high school teacher and with my humble means of income have to provide for my whole family. Although I would prefer to be in the traditional maternal role at home taking care of DAUGHTER and SON, and HUSBAND would prefer the role of being the provider, as a family, we have to sacrifice and HUSBAND is taking care of DAUGHTER and SON while I go to work. Due to our limited finances, I ended up returning to work 2 weeks after labor with DAUGHTER and 3 weeks after labor with SON, so that we could afford to survive and continue our health insurance benefits. The physical therapy that DAUGHTER receives at home once a week needs to be carried out by HUSBAND with DAUGHTER continually. With the help of DAUGHTER’s physical therapist, HUSBAND challenges DAUGHTER with physical therapy every day so that there are no further physical delays in her development and to ensure the best possible outcomes for DAUGHTER. Because we have been able to do this so far, we are fortunate that DAUGHTER is progressing in her physical development. However, there are currently ongoing concerns with DAUGHTER’s physical development as many long-term problems may not be diagnosed until years to come and we are able to see what she is capable and not capable of doing. In addition, DAUGHTER is about to begin additional therapy for her speech and cognitive development.

FINANCIAL REASONS/CHILD CARE COSTS AND RISKS/POTENTIAL BURDEN TO SOCIETY

Without HUSBAND here to help take care of DAUGHTER and our other son, SON, I don’t see any possible solutions that will allow me to be financially solvent. I have always been able to provide for myself and my family, but this situation is going to force me to become a burden to society, and potentially lose my home, my career, health benefits, the health of my children and my own health, and my dignity. Below is a table that shows my monthly income and our monthly expenses.

Balance Deposit/Withdrawal
2400 ~2400 Monthly Direct Deposit from being a teacher Note: It costs me $701 monthly for medical insurance for myself and my children.1572.73 827.47 Mortgage 1360.73 212 Electric 1196.07 164.66 Auto Insurance 1170.17 25.90 Internet Service 1105.91 64.26 Cell Phone Service 1017.78 88.13 Home Phone/DirectTV 929.65 39.01 Water 229.65 700.00 Groceries (varies) 109.65 120.00 Gasoline (varies)

This does not include the $45 co-pays I have to pay for each of my children’s doctor’s appointments, clothes for my growing children, credit card balances, car maintenance, house maintenance, annual sewage bill, and any other extraordinary expenses.

The point of this above summary is to show that I have about $109 left each month. With that money I would have to pay for daycare for DAUGHTER and SON if HUSBAND was not here. I have been researching daycare places and they cost from $1600-1800 a month for the two children . I will have to choose to pay either for my home, food, or daycare. I cannot afford all three.

In addition, daycare would be a negligent option, as it has been made clear to me by doctors and service providers that it is not the optimal setting for a child like DAUGHTER. Doing so would place DAUGHTER at higher risk of contracting illnesses and is not the optimal setting for physical therapy and monitoring of her developmental progress. Whereas at home HUSBAND is able to focus on our two children, in a childcare setting, DAUGHTER would be one of 5 or more children being cared for and probably not as much attention will be given to her in all aspects in this setting. The best outcomes for DAUGHTER’s health are if she is taken care of in our home. In addition, with so many reports of negligence and child abuse even in day care settings, and with the special medical circumstances that DAUGHTER has, I would certainly be unsure of the quality of care and attention she would receive considering her ongoing physical therapy needs. The only way I can envision the best possible outcomes for DAUGHTER is for HUSBAND to take care of DAUGHTER and SON while I continue to go to work.


I could relieve myself of my financial obligation to pay my mortgage by attempting to sell my home. Unfortunately, Colorado is #1 in foreclosures and currently it is very difficult to sell a home. Actually, the mortgage payment I pay is less than what I used to pay for an apartment in this same neighborhood, so this option wouldn’t really help me pay for daycare.

MEDICAL INSURANCE

Currently through my job and at a cost of $701/month (please see EXHIBIT X), I have medical coverage for myself and my children. Because the cost of medical insurance is so high, so much of my paycheck goes to insurance. The good news is that my children and I can have the medical attention that they need, especially DAUGHTER, who needs special medical care.

Currently I have been diagnosed with having high cholesterol. I need ongoing care with that and possibly medication.

I am a strong person and I wouldn’t have gotten so far in life if I was not, but this situation is consuming me. Every waking moment I spend thinking about what we’re going to do. How am I going to handle going to work full time, coming home to take care of two infants, one with special needs, without the help of my husband. Every time we go to get into the car, we each take one of the babies. I cannot even envision how I am even going to be able to go grocery shopping by myself with the two babies. I’ve been suffering from insomnia. I cannot sleep well trying to figure out everything I need to put in place for the potential of survival and not losing everything I’ve worked for all my life. Currently, each morning, I wake up exhausted. My students and my school administrators are noticing there’s something wrong, as they can tell I’ve had little sleep or because for a second, I become overwhelmed with our potential separation and tears weld up in my eyes.

CHILDREN’S EDUCATION

If we were to move to Honduras to be together as a family, I doubt we would have access to the programs and services that are currently available for DAUGHTER here in the US and specifically in Colorado both in terms of health and education, and which are so important for her development. The programs that are available here in Colorado are specifically due to a mill levy tax passed in 2003. Currently, DAUGHTER is being served by Denver Options and Early Childhood Connections, an intervention program that serves children with “special needs and delays”. Through this program, DAUGHTER will receive physical therapy at home until at least 3 years of age. In addition, the schools in the United States have special education for children who need it. I have spoken with my husband regarding if services like these are available in Honduras, and from what he recalls, where he is from, most children with special needs, are not even sent to school. He is aware of a Teleton program that sounds like a fundraiser that helps families with children like DAUGHTER. I wouldn’t want to subject DAUGHTER to a charity-based program without guarantees of services that are critical to her development. With my background as a high school teacher, I know that children with special needs in the US are able to go on all the way through high school and sometimes even college, to help them be able to live, if possible, independent adult lives. I have a few students who have cerebral palsy and muscular dystrophy, and in spite of their disabilities, they have had an opportunity to develop their minds, which is so important for me as a teacher, and as a mother of a child who potentially might have disabilities. Although HUSBAND tells me that there is 1 good hospital that he knows of in Honduras, this is a private hospital and the services are for a high cost. Considering the unemployment rate is 27%+ in Honduras, I’m unsure if even if both of us were able to obtain work, that we could even afford DAUGHTER’s medical care and potential surgeries if she were to need them.

INVESTMENT IN PERSONAL EDUCATION AND TEACHING CAREER

I am a high school teacher and in order to be able to teach in Colorado, I had to become licensed and endorsed here in Colorado. That involved attending two years at Metropolitan State College in Denver, CO for my teacher licensure and passing a rather difficult Science Exam for the state of Colorado that allows me to teach here. It has taken a few years to transition from being a Probationary Teacher to obtaining a Professional Teacher’s License . I’m not sure what teaching requirements there are for Honduras; however, if I were to leave the Denver Public School district, I would lose my position and need to re-interview without any guarantee to future employment. A lot of teachers continue teaching in the district until retirement age because the years of longetivity are sometimes not counted in other districts and/or accumulate for the pension. Especially since I started teaching as a second career, I am way behind in salary to counterparts my same age who started teaching right out of college. Leaving my teaching position here, even temporarily will harm my chances of future employment in the district in which I so much desire to serve and my future earning potential as a teacher within the same district, Denver Public Schools.

In addition, I have begun taking courses towards my Master’s at the University of Colorado. If I don’t complete the coursework within a certain period of time, I will lose all the credits I have taken. Also, Denver Public Schools has an innovative compensation program, Pro-Comp that I would like to enroll in, but to do so I have to complete my master’s within a limited time frame . I have had a grant to attend graduate school, and if there is a lapse in my studies I will not be able to take advantage of this program.

Currently, with my salary and HUSBAND here, we have enough to survive. I’m not sure that I would be able to do the same in Honduras as teacher or in any other job, considering their ~27% unemployment and the fact that I would be a foreigner trying to obtain a job in an already highly political and competitive market. I can’t imagine subjecting my children to such an unstable environment in which I may not be able to provide them what is necessary just for survival.

US VS. HONDURAS

The U.S. Department of State website contains the following information regarding Honduras.

CRIME: Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes. Fifty-three U.S. citizens have been murdered in Honduras since 1995, with a very significant recent increase, and most cases remain unresolved. Kidnapping of U.S. citizens has occurred in Honduras, including two incidents in 2006. Poverty, gangs, and low apprehension and conviction rates of criminals contribute to a high crime rate, including horrific acts of mass murder.

The thought that we might have to move to Honduras for us to be able to be together sounded very romantic before we had DAUGHTER with her special needs. Now, that I’m traveling down to Honduras for HUSBAND’s immigration visa interview, I’m a little bit scared to go there, even though I am a seasoned traveler and have even lived in other countries. In preparing for our travel to Honduras, I have read the reports from the CIA and travel.gov regarding Honduras. There are many concerns that I have starting with the crime, especially against US Citizens. Based on the above information, Honduras is not safe for US Citizens. United States Citizens are often victims of robberies, kidnappings and many other criminal activities. This would be an extremely dangerous place for our family.

MEDICAL FACILITIES: Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital. Ambulance services are limited in major cities and almost non-existent elsewhere. OTHER HEALTH INFORMATION: Mosquito-borne illnesses are an ongoing problem in Honduras. All persons traveling in Honduras, even for a brief visit, are at risk of contracting malaria. Take a prophylactic regimen best suited to your health profile. The country regularly suffers from outbreaks of dengue fever during the rainy season. Travelers should take precautions against being bitten by mosquitoes to reduce the chance of contracting such illnesses. Severe air pollution, which can aggravate or lead to respiratory problems, often occurs throughout the country during the dry season due in large part to widespread forest fires and agricultural burning. Because of DAUGHTER’s chronic respiratory disease, the severe air pollution could make DAUGHTER’s breathing worse. Also, it is stated that the medical facilities are nowhere at the level they are in the United States and with DAUGHTER’s continuing needs, I cannot in good conscience choose to live in Honduras when we have some of the best doctors and hospitals in the United States at our fingertips, and I need the best possible care for my children, especially DAUGHTER.

From the World Factbook on the CIA website it says:

“Honduras, the second poorest country in Central America and one of the poorest countries in the Western Hemisphere, with an extraordinarily unequal distribution of income and massive unemployment,…” The unemployment rate in Honduras is about 27.9% . The main reason my husband left his country was because his job situation was highly unstable whereby he may have a job for a few months and then be without a job for a while, and the salaries were very low. I’ve talked to HUSBAND about the idea of me finding a job in Honduras as a teacher, and he has told me that teaching positions are highly political, and that they require connections to be obtained.

ORICA VS. DENVER

The town where my husband is from, Orica, is 3 hours from the capital. If we were to move there it would be very risky for DAUGHTER’s health. Because of the nature of the farming community, the lack of modern appliances, the hygiene typical of the United States, my husband told me that as a child, he and all his cousins had parasites in his stomach, since the water is not treated to have the same quality as in the United States. Something simple such as brushing her teeth, or drinking some water, cannot be done without boiling the water, not even washing your hands is enough. There is no hospital in Orica. There is a village clinic, but nothing remotely close to a hospital. HUSBAND tells me that there is 1 ambulance, and if it is occupied, one must travel on your own to the capital of Tegucigalpa. Not too many families have cars, and the roads are all dirt roads.

I’m a very adventurous person, and I when I was single, the idea of going on a short trip to a place like Orica may have sounded like fun. However, now that I am a mother of two children, one of which is a special needs child, I have become a lot more conscientious of my responsibility and the consequences of my actions with respect to my children. I worry that they would get sick. I worry that the health care is not available, not proximal, or not up to par with the United States. I worry that hospitals are 3 hours away. I worry that I might not even be able to afford to buy a car in Honduras because we cannot find work.

In Orica, most of the people subsist in agriculture. My husband’s father was killed when he was 9, and HUSBAND, my husband, started working in the tomato fields. An adult working in the fields made 25 lempiras/day, children made half. For me, it is hard to believe that children would have to work to survive. I was surprised to hear that children are not required by law to go to school, and that sometimes parents have to make their children work just so they can survive. Although I am not opposed to a child learning the value of hard work, I wouldn’t choose the extreme of placing my children in a situation where they would have to work instead of going to school, just so we as a family could survive. However, if we were to live in Honduras, that might be our reality. I have seen pictures of parents and children in the city dump trying to scavenge for food or things along with the black crows. It is so sad. I can’t do this to my children.

FAMILY

I believe that children learn most of how to behave from what they learn from their own family. As a teacher, I can attest that a lot of my students suffer because their families are so busy just trying to survive, that they are not around to provide the character lessons that the children need to learn, and to provide them the love that they need to become healthy and caring citizens.

I know that if my husband were not here to inculcate his values and his love to my children, that my children will be detrimentally affected, much in the same way that children from single-parent homes are affected from the lack of the missing parent. I consider this extreme hardship, especially for a child with special needs who has a father that loves her and wants to care for her, to have to suffer this being apart from her father.

HUSBAND’S HISTORYHUSBAND’s father died when he was nine years old. His mother had 5 other children for which to provide, and since that age, as if it wasn’t enough to lose one’s father, HUSBAND took it upon himself to provide for himself. HUSBAND began working on the tomato fields on weekends trying to earn enough money to help him pay for his school expenses so that he wouldn’t be an additional burden to his mother. When HUSBAND came of age to attend high school, HUSBAND had to move to Tegucigalpa, Honduras, since there were no high schools in Orica at the time. Moving to Tegucigalpa involved extraordinary expenses, especially to an orphan who did not have a working father to provide for him and a mother who was struggling to survive. There HUSBAND worked so that he could afford to pay for a room to live in, food, and transportation costs of going to school and maintaining a job. Unfortunately, due to the high unemployment rate in the country, HUSBAND wasn’t able to make the money required to finish his schooling as was forced back home to Orica. There his family extended him help when they could by giving him jobs but it wasn’t enough for his survival and the growing desire to take some responsibility to help his mother with his younger sisters. HUSBAND, like many in his country, heard of others in his own village and around the country who risked everything to come to the United States with the hope of finding a job to send money back home to support their families. Since HUSBAND came to the United States in May of 2001, he put two of his younger sisters all the way through high school, something he wasn’t able to do for himself. As a teacher and a wife and a mother, I appreciate that he values education so much, yet it makes me so sad that no one was able to do this for HUSBAND, but that he was man enough to do it for his sisters. However noble his intentions, it does not excuse that he broke the laws of this great country by coming here illegally.

HUSBAND’s personal need is no excuse for his illegal entry in the United States. However, neither he nor I realized how grave and difficult our marriage would be and the effect on our children because of his perpetration. I have been a teacher at Denver Public Schools where many of the students who attended are illegal. With such a great number of undocumented students attending my school, I didn’t realize that it would be so difficult, for me, a US citizen, to be able to obtain residency for HUSBAND through the proper channels. Both HUSBAND and I were naïve about the difficulties we would face through this immigration process. After spending money on consultations with supposed immigration lawyers, they all told us different things: from the antiquated pardon where one could pay as a means of consequence to advising us to not leave the country for any reason. The stress of deciding what to do has been one of the most difficult challenges of my life. Because we consider our alliance to the United States a privilege, we acknowledge that HUSBAND should suffer some consequence for his actions. However, I think it is extreme and unusual hardship for DAUGHTER (and SON) with her critical brain development from age 0-3, to have to suffer permanently because we are trying to do the right thing by attending the immigration visa interview and applying for this waiver, in the hope that in the long term, HUSBAND will be there for DAUGHTER, my son, SON, and I. It has been especially a difficult decision in the face of potential immigration reform.

Both HUSBAND and I recognize that it is a privilege to be in this country and that anyone violating its laws should suffer consequences. It is for this reason, that in spite of knowing what is likely to happen in our situation, we are going ahead and honoring the interview that we are so lucky to have in the US Embassy in Tegucigalpa.

HUSBAND AS MY PARTNER AND A FATHER

HUSBAND has taught DAUGHTER all the vocabulary she knows. She can clap, kiss, hug, sit down on the chair and drink her bottle, give him things, lie down in her crib, walk, blink, blow her nose, say the word “ball”, say “Bye Betty” to our neighbor, among others. DAUGHTER is in love with her dad. It would be devastating for her development to lose him. HUSBAND is taking care of DAUGHTER and SON and in all his free moments is helping to fix our 1910 home in the case that we will have to rent it to someone else in an effort to preserve it as our property and not lose it to foreclosure if I end up not being able to pay for our mortgage.

HUSBAND takes care of the babies all the time. I cannot imagine what DAUGHTER will lose if HUSBAND isn’t here. Her development will be gravely affected. All the efforts we, and mostly HUSBAND, has made so far with DAUGHTER, could be frozen in time, and it kills me knowing that a child’s future depends so much on what happens from the age of 0-3. As it is right now, with each of us here, it is a struggle to take care of an infant and a toddler. Because DAUGHTER could have physical disabilities, physical activity is very important for her, so we allow her to walk about a lot, but this requires constant supervision.

MARRIAGEIt needs to be emphasized that by issuing an approval of an I-130, the United States government has formally and legally recognized the validity of our marriage. It is well documented that family unity is an important value unpinning the raison d´etre of the United States of America and that actions to assure family unity are part of the intent of the United States immigration law (for example, see Title 8, Chapter 12, Subchapter II, Part II, Section I, pp. 64 and 65). Although it is a function of the law to provide legal definition and recognition to this marriage between PETITIONEE and me, PETITIONER, it is clearly the intent of law to support the complex nature of marriage. In other words, in this and other genuine marriages there are multiple social, psychological, familial, economic, cultural, spiritual, etc. bonds, which are presumed by the law to exist conjointly with the legal presence of marriage. Support for these complex interacting marital bonds is a fundamental value of the larger society and a function of the law.

Because ours is a full and complete marriage with intense emotional, social, familial, economic and spiritual ties, the reciprocal bond between us must be granted great weight while evaluating what would happen to our family if HUSBAND were not admitted to the United States. My children and I will miss HUSBAND painfully. I am very anxious about our future because it depends upon my husband’s return. However, these are considered herein to be simply the backdrop of the fact that DAUGHTER is a special needs child, and that losing her father, even temporarily could gravely affect her development permanently. This I consider extreme and unusual hardship.

SUMMARY

DAUGHTER is a special needs child and her father, HUSBAND, is her primary caretaker. The primary reason we need HUSBAND here is so that he can continue to be the primary caretaker for DAUGHTER due to her ongoing physical and medical needs. DAUGHTER is a special needs child because of complications due to her prematurity, the most important of which was an IVH Grade III hemorrhage. Any time of separation from her father will be catastrophic for her development, as DAUGHTER is currently in the midst of the most critical time for her brain development.

If we were to move to Honduras, we would not have the medical, physical, and developmental services available to DAUGHTER here in the United States, specifically in Denver, CO. If we were to move to I could lose my career as a teacher. If we moved to Honduras, both my husband and I would also be faced with imminent unemployment and without the possibility of providing for ourselves and our children. These factors would make moving to Honduras with our children to be united as a family an incredibly risky and unstable situation that I would prefer to avoid at all costs. Because Honduras is economically depressed, has poor health care (by United States standards), is extremely dangerous, has bad air pollution, has limited educational opportunities for children with special needs and cannot provide the employment opportunities necessary for me to fulfill my dreams and maintain my standard of living, I cannot see moving to Honduras as a viable option. However, neither is it viable to stay in the United States without my husband.

If I stay in the United States, with my salary, I cannot afford to pay for day care, my home, and living expenses. I will forced to become a burden to society in order to take care of my children, and in doing so DAUGHTER and SON both will possibly be losing out in the most important time in my children’s brain development without the support and love of their father. If DAUGHTER, SON, and I were unable to live with HUSBAND, we would suffer great hardship in so many levels: physical, emotional, financial, and educational. This dilemma is tearing family and me apart.

Because our marriage is evidenced by our love and our children, I implore on you to consider my situation for the waiver of extreme hardship. If HUSBAND is not able to return I will lose everything….the possibility that DAUGHTER will receive the best care possible to ensure the best possible outcomes considering her special needs, I could lose my home and everything I have fought to hard to attain because I cannot afford to pay both for childcare, my mortgage and living expenses. I could lose the job that gives me some sense that I’m giving back something to the world, and most of all I would lose the support that I would need from my husband in physically and emotionally dealing with our current situation with DAUGHTER as well as any further complications that should arise in her health. While understanding the need for retribution for my husband’s illegal entry into these great United States, I humbly ask you for the greatest compassion that you can offer us under the law.


Sincerely,

PETITIONERAddress
Tel. (###) ###-####
Email: XXX@XXX.COM

[Cynthia]

Approved HSL Courtesy of Member catrachowife via Honduras

American Embassy , Honduras


To Whom It May Concern:
Let me begin by saying that my husband, xxxx, and I have been going through this whole process of getting his legal citizenship in the U.S. alone, without the help of a lawyer. For this reason, I must submit this addendum to our original I601 and hardship letter. Upon returning to the U.S. after xxxx ’s visa interview, I realized that I might not have included enough evidence to convince Homeland Security of my hardship without my husband here with me. Perhaps this was a blessing in disguise because since returning home alone without xxxx , I have realized that living without him is so much more difficult than I had even imagined. It is unbearable.
xxx and I met in May 2005. At the time, he was x and I was x. We both knew that we wanted families of our own, but just hadn’t met the right person yet. We both know that it was a miracle that we met. We were both in the exact right place, at the exact right time. Of course it would have been better had he been in the U.S. legally, we both knew that fate meant for us to meet. My family and friends adored xxx from the first time they met him too. We knew we were lucky to find each other, so we married and started trying to start our family. We went through a year of trying, and doubting, before finally conceiving. On April 15, 2007 we were blessed by the birth of our first child, xxxx. Five weeks later, xxxx had to leave his newborn daughter and I behind to return to xxxxx . It was the hardest thing we’ve ever had to do, but we know that it’s what needs to be done to gain his citizenship here in America .


During the two years since I met xxx, I have grown closer to him than anyone I’ve met before. We have been inseparable. I’m so lucky to have been able to marry my best friend. I am lost without him. Therefore, if indeed we are not granted this waiver, I will be forced to leave my home country in order to be with my husband, the father of my beautiful daughter. There will be no other option. I did not marry my husband only to live thousands of miles apart for ten years. For this reason, the majority of my hardship will be caused by my relocation to xxx , a third world country, as I’m sure you are aware.

HEALTH
Perhaps the most concerning issue related to health is my increased risk for clinical depression. The majority of the personal letters from my family and friends, which I am submitting as evidence, will attest to the fact that there is a strong tendency for depression in my family. My grandmother, mother, aunt and sister have all been on medication for depression and my aunt took her own life because she was struggling with depression. Although I have always feared that I would become victim to this disorder, I am now sure that I will be if xxx cannot return to us. I spent the first five weeks of my daughter’s life crying most of the time dreading xxx ’s departure for xxxx . I have not been able to fully enjoy having a child yet because of this situation. I have become short tempered and unable to deal with daily life like I could when I still had my husband with me. This is not only threatening my own health, but that of my infant daughter as well. I have seen my nephew grow up with his depressed mother and know that this situation is absolutely unacceptable. Our daughter needs me to be happy like I used to be, and that will only be possible when we are reunited with xxx .
Of lesser importance, but still relevant to my hardship I would suffer if xxx cannot return, is my diagnosis of Polycystic Ovarian Syndrome. This syndrome is the reason that I didn’t get pregnant before one year of trying. I ended up needing to take Metformin in order to become pregnant. The probability of needing further assistance to conceive in the future is very high. The availability in xxx of the medications, testing, and treatments, including numerous high-tech ultrasounds and infertility treatments, that I will likely need in the future is very questionable. Also, once I became pregnant, I developed gestational diabetes (GD). I will have an increased risk of developing GD in future pregnancies, as well as Type II Diabetes. These conditions require frequent blood sugar screening, diet and medication control, and possibly the need for insulin treatments. Please refer to the letter from Dr. xxx pertaining to this information (document A). The availability of these supplies and good health care in xxx is very doubtful, and the quality of care is definitely substandard compared to that in the U.S. According to the U.S. Department of State Consular Information Sheet, “support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in xxx � (document 15).

Also due to the poor health care available in xxx, our daughter xxx may suffer an extreme hardship. She failed to pass her hearing screen in the hospital in one ear. Since then, we have been in to see an audiologist. He is concerned due to a family history of preauricular pits in xxx ’s family. This many times indicates- hearing loss. Because of these factors, the audiologist has recommended that xxx have her hearing screened every 6 months for three years, and then every year after that. If she does indeed have hearing loss, her development will be adversely affected. The advanced screening equipment required to catch such hearing loss is very unlikely to be available in xxx . Please refer to the letter from Dr xxx regarding this issue (document B).
Last year by brother’s wife gave birth to a daughter who has Cystic Fibrosis (CF). This is a lethal disease that will cut my niece’s life expectancy short. She will probably only live into her 40’s, with excellent health care. I was unaware until the birth of my niece that I have a 25% chance that I am also a carrier of CF. If xxx is also a carrier, and should we have a child with CF in the future, their prognosis would be greatly reduced living in xxx with their substandard health care.
Another issue contributing to the hardship that I’ve been suffering is my father’s diagnosis of stage T3 bladder cancer. We found out that he had cancer in the week before xxx ’s visa interview in May. Since then, he has had surgery on his bladder and has weekly chemotherapy treatments. His health has deteriorated since his diagnosis. He is weaker and feels ill almost all of the time. Please see the enclosed letter from his doctor, as well as information I have included from the American Cancer Society regarding his diagnosis, prognosis and treatment options (see documents C and 1). He and my mom will need my assistance before he is done with all of his treatments, including at least one more surgery. If they are unable to get rid of the cancer, I will be needed daily to help with his care. This is causing an extreme hardship for me on many levels. I need my husband here in this time of uncertainty. When a person’s father is diagnosed with cancer at the age of 56, and has only a 38% chance of surviving five years, it is hard to deal with under normal circumstances. Now I am here alone without xxx to deal with this, trying to care for our infant daughter in the meantime. My parents had reassured me before xxx left that they would help care for xxx while I work. Now that my father is ill, that has become much more difficult for them to do. Not only do I not have my husband here for emotional support, he’s also not here to care for xxx so I can help out with my father.
To add to all of the other emotional health issues, my grandmother passed away on July 12, 2007 due to cancer. This has shaken what little strength I had left to make it here without my husband. Of course, he is there to console me on the phone, but I need him here. I need him to help me get through everything that is going on in my life. I can’t continue to do this alone.

FINANCIAL
Although I realize that financial reasons in and of themselves are not sufficient to prove an extreme hardship, they must be taken into consideration with everything else. Every time a new bill comes in the mail, I feel more and more like I just can’t do this anymore. It just adds to the hopelessness that I’ve been feeling since xxx left.
One financial consideration directly caused by xxx ’s absence is the cost of childcare. For one thing, quality childcare is not even available due to the fact that I work the night shift from 7pm to 7am. (Please see letter from my supervisor verifying this, document D.) I am unable to work a different shift at this time. I do not trust any stranger to care for our daughter in their home, especially at night. Therefore, I have been relying on family to care for xxx. While they have been very generous with their time, the cost of transporting xxx to relatives’ houses has become overwhelming. My parents live 2 ½ hours away from our home, and my sister, aunt and cousins who have helped once in awhile live in xxx which is 3 hours away. I have spent in 32 days $xxx on gasoline. (Please see the enclosed receipts that I have saved as evidence, document 11.) That is an unacceptable amount to be spending on gas! With Franklin here, we spend about $x a month on gas since I work only 3 blocks from home.

I feel obligated to financially support my husband now as well. I cannot stand the thought of him living in a third world country with no money. I have been sending him $xxxto $xxx every two weeks. (Please see copies of Western Union receipts, document 12.) He has been trying to find work in xxx , but jobs are hard to come by. The cost of communication has been high too. I have been buying calling cards for $x each, which only give me xx minutes at the most to talk with xxx . If I call directly on my cell phone, the call is xx per minute. It cost me $xx just to send some photos in the mail recently. Although it took him almost a month to receive his package, I was grateful it finally arrived in the mail as the mail system in xxx is not very reliable. Also, because I cannot stand the thought of not being with my husband even for the 6 months we will be waiting to hear about the waiver, we have the added expense of airfare to fly to xxx for our daughter and I. We will be taking a trip to xxx in August, which just cost us $xxx. This is the lowest airfare I could find from this part of the U.S. (please see document 2). This has been an added expense during a time when there just is no extra money to spare.

Also, we were relying on xxx being able to return to the U.S. to work and help support our family. Now that we have a baby, there are the increased costs of her care, such as formula, diapers and everything else that goes into raising a child, as well as over $xxx in hospital and clinic bills. xxx and I will be unable to make any non-emergent appointments at the hospital or clinic until these balances are paid off (please see letters from the hospital and clinic regarding my balances, document 10). Because technically I make too much money to get any assistance, I am at a disadvantage to other mothers who are raising their children alone financially. I can’t even get help from xxx, an organization that provides formula a food to families with small children; my income is above their limit. I have nobody to help me when I just need $xxx for a can of formula to get xxx through to my next paycheck. We need xxx to return to help.
However, this will all be irrelevant if xxx is unable to return for ten years anyway. xxxand I will be forced to relocate to xxx to be with her father. This relocation will cause an even greater hardship for me and our daughter. Anyone who even visits xxx can see that the standard of living is tremendously below that of the U.S. The unemployment rate is 27.9% in xxx , compared to 4.8% in the U.S. Fifty-three percent of the population in xxx lives below the poverty line, compared to 12% in America (CIA, The World Factbook, document 7). The per capita income in xxx is only $xxx (document 14). If I am forced to move to xxx , I will only make a fraction of what I make as a registered nurse here in America . Even working for the U.S. Department of State in xxx , I would only make $xxx per year (document 4). According to SalaryExpert.com, the average nurse makes about $xxx per year in xxx (document 9). The few people I met personally in xxx who work as nurses state that they make approximately xxx per month in U.S. dollars. This would be fine if the cost of living were less in xxx than here in America . However, my personal experience has been that the majority of items cost the same in both countries, including gasoline, personal hygiene products and most foods. Also, please see the copies of my bills that I pay each month (document 5). I pay $xxx monthly for our mortgage, car, credit cards and school loan. This does not include other monthly expenses of phone, water, electric, food, gas, etc. My overall debt at this time is over $xxx. It is obvious that if I am forced to move to xxx, it would be impossible to pay all of these bills as well as have sufficient money for my family to survive in a third world country. I would lose our house and car and become delinquent on our credit cards, school loans, hospital bills and everything else I owe. I have already had to ask for a 6-month forbearance on one of my school loans and have bill collectors calling me several times a week. My federal Perkins school loan is in forgiveness right now because I am working as a registered nurse in the U.S. If I don’t continue working here as a RN for the next 3 years, I will end up having to pay back the remaining almost $xxx (see document 6). I would go from having perfect credit now to having to claim bankruptcy. My good credit history is an asset I have been working hard towards since I turned 18 years of age. It will only cause more stress to me and create more of a hardship for me if I have to give that up too.

EDUCATION
Of great concern is xzxx’s future education. If we have to relocate to xxx , her opportunities to succeed in school, and later in life in general, will be greatly reduced. The overall literacy rate in xxx is only 80%, compared to 99% in America (CIA, The World Factbook, document 7). According to the article on coutrystudies.us, “…a good education is still largely the privilege of the few who can afford to send their children to private institutions.� In fact, our children would only have an 8% chance of ever making it to college (document 8). Of course, we would not be able to afford these private institutions, so xxx would suffer greatly in xxx compared to here in the U.S. where good public schooling is the right of every child.
Also, it has always been my plan to eventually return to school for my Master’s Degree in nursing to advance my career opportunities. I would be able to make significantly more money as a nurse practitioner with this degree (see document 13). I am doubtful that there are any programs in xxx in which I could receive the degree to make this possible for me. I have always loved learning and the feeling of accomplishment when succeeding in my goals. A move to xxx would take this opportunity away from me and add to my hardship and feeling of depression.
SAFETY
According to the “Crime & Safety Report� on the OSAC website, safety is a big issue in xxx (document 3). They have “the lowest per capita ratio of police in Latin America .� Their homicide rate is more than five time higher than in New York City . Burglary is a daily threat, whether at home, driving, or walking in the streets. There is significant gang activity: “the gang problem in xxx is critical, and gang-related murders, carjackings and robberies are frequent.� The gangs are “heavily armed and have little value for life.� xxx ’s family lives in xxx, one of the most dangerous parts of xxx . This is most likely where we would live also if we need to relocate to the country. This is not the type of situation in which I would feel safe living, let alone raising a child in. Our lives would be in danger every day we live there.

On a lesser, but still important note, the prevalence of HIV/AIDS is three times higher in xxx than in the U.S (CIA, The World Factbook, document 7). Working as a nurse in xxx would put me at a greater risk of becoming infected through contact with contaminated blood. Also, road and traffic conditions are dangerous and life threatening. On my recent visit to xxx , I was amazed that we weren’t in an accident every time we went somewhere in a taxi or bus. With the substandard health care and lack of emergency vehicles in most areas, this becomes even more of a problem.

FAMILY
I realize that xxx ’s waiver will only be approved if it is proven that I will suffer an extreme hardship. Please take into consideration the family he has left behind here in the U.S. as well – my family. They all have so much love and concern for him. Everyone keeps asking when he will be able to return. This just adds to my feelings of depression, knowing that everyone else loves and misses him too. Please refer to documents E – R. Although a couple of the letters are a little lengthy, I ask that you take the time to read each one. Hopefully by reading all of these letters from my family and friends, it will be apparent how close I am to all of them and how concerned they are for my well-being, as well as for xxx . If I’m forced to leave the U.S. to be with my husband, I will suffer most due to the loss of my close contact with these people. We are a very close-knit family. I have strong family ties with my mom and dad, as well as two brothers, a sister, and their spouses, aunts and uncles, my remaining grandfather, cousins, nieces and a nephew. I have been a strong source of support for my mom and sister as they suffer with depression. Clearly I will not be the only American citizen suffering if xxx is not allowed to return to us. Knowing that my family is here missing me and living so far away from all of them will only add to my growing depression. I have no family or friends in xxx , but I will be forced to move there to be with my husband. When a woman marries a man, I believe with all my heart that she belongs at his side, no matter what.

PERSONAL CONSIDERATIONS
As much as I need to be with my husband, xxx needs her father. I will not have my daughter grow up only knowing her father in pictures and through occasional visits to xxx . She needs to know her loving father as she grows and develops.

I need xxx here for the emotional support he has always given me. I’m going through so many life changes right now, including the birth of our daughter, the transition into motherhood, finding out my father is suffering with cancer and could very possible die because of it, losing my beloved Grandmother. I need my husband here with me to get through this, and everything else that will come up along the years.

I have always been proud of my American citizenship. I feel lucky to have been born into something that so many people around the world are dying to have – freedom to live the way I want. But now that my husband has been taken away from me, I’m starting to wonder if it’s such a great thing. It will be a shame if I’m forced to leave this beautiful country in order to move to a third world country like xxx to be with my husband.

CONCLUSION
I ask for your mercy and consideration in this matter. xxx knows that he was wrong in entering the U.S. illegally. Now, more than ever, he wishes he had had the means to enter legally. We love each other dearly. We feel blessed to have met our soul mates and have been blessed with our beautiful daughter. We only want what is best for our family. We want to raise our children as proud American citizens. Please take into consideration everything and everyone that will be affected by your decision to approve or deny xxx ’s waiver. Please realize the very real and extreme hardships I am and will be suffering on a day to day basis if my husband is not allowed to return to us.

Thank-you for your time and consideration.

[Pinkpig]

Approved HSL Courtesy of Member Thernand via Honduras

American Embassy , Honduras

This is the message:

Would you please post
My approved hardship letter for Honduras

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AFFIDAVIT OF US CITIZEN NAME

RE: Waiver for Alien name, case #_________________________

I, USC name, being duly sworn, depose and say as follows:

I reside at_________________________________.
My mailing address is:_________________________.

I am submitting this affidavit requesting that you grant my husband,__________________, a waiver for being unlawfully present in the United States.

RELATIONSHIP HISTORY

_____________________ and I were married on ______________________. We lived together however, from November 2001 to November 2004 at which time ___________________ returned to Honduras for his interview at the consulate. I have two sons from a previous marriage, ___________age____________ and _______________ age_______________. Who see_____________ as if he were their biological father. ___________________has treated _______________and__________________ as if they were his own from the start of our relationship. _____and_____ have not seen their biological father since they were 5 and 3 years old. _________is their father in their eyes.

HARDSHIP TO USC

If my children and I had to leave Arkansas and go to Honduras to be with _, I would suffer extreme hardship. I know that the country of Honduras is very hostile to foreigners like me. I am fair-skinned and blonde, so everyone would know that I am not from Honduras. In addition, I can't communicate in Spanish, and I don't know how I could survive there. I know that Honduras has a lot of crime, including violence against women. When I was in Honduras with my husband for his interview at the U.S. Consulate, and when I came to see him in March of 2005, people would stare at me, and strange men and police officers on the street would grab me on my arm and on my private areas including my bottom and breasts, or make some remark about how light my hair was and touch my hair. Not only that, but everyone has a gun there. I was constantly afraid that men would attack me. When we were traveling on the road and the police would stop us, I would hide under a blanket in the back of the truck so
that they wouldn't see me and try to touch me. I couldn't even go outside to the outhouse to go to the bathroom without someone watching from the porch so that no one would try to attack me. There's also terrible abuse of children. Women and children are murdered all the time in Honduras. The police are corrupt and violent too and won't do anything to help people who are victims of crime, so if something happened to me or my children, I know that I would be helpless.

FAMILY TIES

I have extremely strong family ties to Arkansas and to the United States. I was born in Oklahoma, but I have lived my entire life between the towns of ______________and_____________Arkansas. I am the third ge4neration of my family to live in_______. My family is large and close-knit. Virtually all of my family lives within a 15-mile radius of where I live on a mountainside near__________, a small village in the Ozark Mountains in Arkansas. My grandfather bought the land on the mountain where my family and I live in 1955. I have two sons, ages ________and____________, who have lived all their lives with me in Arkansas and view_______, who is their step-father, as the only daddy they have ever known. _______wants to adopt the boys as his own when he can come back to us in the U.S. In addition, my mother and step-father, as well as my grandmother and two aunts, live next door to me. I have numerous aunts and uncles who also live on the mountain. My father and stepmother live nearby in
northwest Arkansas. I have five brothers and five sisters. All of my siblings except one live in Arkansas. I see my family everyday, and I can't imagine living ap0art from them. Many of us in my family go to the same church, the Liberty Baptist Church in a small town near the mountain where I live.

I have no family ties at all outside of the U.S. And certainly none in Honduras. The only home I have ever known is in ___________, Arkansas, and all but one of my immediate family lives in Arkansas. I can't communicate in Spanish and don't know how I would survive in a Spanish-Speaking country.

FANANCIAL

Since my husband ______________ departure in 2004, I have endured extreme financial hardship. _____________income contributed to a little over 50% of our family's total income. My current expenses are _____________ per month. While he resided here, we were partners and halved the expenses which were easily manageable. Without his income contribution I now am saddled with paying all of our expenses and that has decimated my finances. ______ presence here in the United States with me can therefore be deemed crucial. I work for ______________ ____________ _______ . My salary is very low for the expenses the expenses that we have. I am so poor that I don't even have any money to give my sons to buy a toy or a special snack. A couple of my friends will sometimes give the children a little cash so they can get a toy. My church runs a canned-food drive for me and my sons every month so that we have enough to eat. I can't even afford to pay all of my bills. My mother has had to loan me money
to make my bill payments, which makes me ashamed. See Exhibit___. However, my mother has a very little income and can't afford to keep helping me financially. I have no idea how my sons and I will continue to survive without my husband's financial support. Our situation will be especially terrible this winter. We use a wood-burning stove to heat our house during winter, but I have no money to pay for the wood and the wood-cutting this coming winter. My father and step-father are to ill to cut wood. Due to a bleeding ulcer that hemorrhaged, my father has no stomach, spleen, and only part of his pancreas and is completely disabled. My step-father is 75 years old and has had heart attaches in the past and required double by-pass and valve replacement surgery on his heart. Neither are able to help me. I'm afraid that our house will have no heat this winter. We are suffering and will continue to suffer extreme economic hardship, unless ___________ is granted his waiver and allowed to be
reunited with us here in the U.S. See Exhibit________. The rock work around the bottom of our trailer house is falling down and I have no one to fix it. See Exhibit ____. I can't afford to hire someone. There are other things that are falling apart also. One the end of our trailer where we had boards up around it as skirting till ___________- could finish the rock work, these have rotted and fallen down. See Exhibit____. This is the north end of our house and is letting in lots of cold air underneath. The gate to the barn is falling off its hinges. See Exhibit___. There is a tree that has broken off in the pond and needs to be pulled out. See Exhibit___. There are many things that are falling apart at our house. I can't afford to hire someone to do the maintenance. It is crucial that my husband be granted a waiver to come home to help with these things. My children are only _ and- years old and not big enough or know how to repair these things. Moreover, if I had to leave Arkansas,
I would have to sell off my house, farm and my few possessions at a loss. Our land is landlocked and __________is a small mountain community where few people want to live. Please, I pray that you will forgive my husband for his error in coming to the United States illegally. Please let him come home and be reunited with us here in the US.

CUSTODY DECREE

_____________in my second marriage. Previously I was married to _________________- and we separated in 1999 however, our divorce was final in November of 2000. My divorce decree from my ex husband, _______, explicitly forbids me from removing our two children_________and_____________ out of the state of Arkansas. See Exhibit it____. I cannot imagine having to leave my children in Arkansas to move to Honduras to be with my husband. This would be beyond an extreme hardship for me. They have not seen their biological father (_____) since ____________was _____ and _________was____ years old. _________is the only father they know. He is the one who has been there for them since they were small children. For me to move to Honduras and leave my children without a mother or father(alien) would be beyond an extreme hardship for _______and_________. Being separated from my children would also devastate me.

HEALTH

The terrible lack of medical care in Honduras would cause my sons and I extreme hardship. My younger son,______, who is ___ years old, suffers from Attention Deficit Hyperactivity Disorder (ADHD) and Asthma. ADHD is a chronic disorder that begin in childhood and sometimes last into adult life. Problems generally associated with ADHD include inattention, hyperactivity and impulsive behavior. They can affect nearly every aspect of life. Children and adults with ADHD often struggle with low self-esteem, troubled personal relationships and poor performance in school or at work. Currently psycho stimulant drugs are the most common treatment. However these drugs do not cure ADHD. Counseling, special accommodations in the classroom , and family and community support are other key parts of treatment. ______ is currently prescribed the medication Strattera by our family doctor every six months. His condition must be closely monitored to detect any deterioration and any possible side effects
from taking the medication that he needs to function in life. ______currently suffers from awful emotional outbursts and uncontrolled rage due to his "daddy's" (____________) absence. _____would not receive proper monitoring of this condition in Honduras which could result in more medical problems. It is imperative __________ receives adequate psychiatric care in the United States. See Exhibit____. Therefore, leaving________in the United States is not a viable option for _________USC name______________not is re-locating ______to Honduras. _________also has trouble with Asthma and has to keep an Albuterol inhaler close by at all times. Asthma is a breathing disorder that people can die from if not treated properly. The wood cook stoves in Honduras would cause many problems for his Asthma. See Exhibit____. In addition, I would fear for my own safety in Honduras. I recently went to the doctor with severe stomach pain. Because I don't have insurance, I couldn't do the expensive tests
that the doctors wanted to do. I know that if _____can come back to us and support us financially, I will be able to afford insurance and get the treatment I need here in the U.S.. My husband had insurance through his work when he was in the U.S. That covered me and my sons. When he left of Honduras, I lost my insurance. See Exhibit____. I know it's possible that I might have an ulcer or some other serious illness and tat in Honduras I wouldn't get the medical treatment that I would need. My family has a history of serious medical problems, including asthma, high blood pressure, diabetes, multiple sclerosis, and heart disease. See Exhibit____. I know that the chances are very good that I will contract one or more of these diseases. If I had to live in Honduras, where medical care is substandard, I fear that I wouldn't survive. My sons and I would suffer from extreme physical hardship if we had to move to Honduras.

INFECTIOUS DISEASES IN HONDURAS

People in Honduras die from infectious disease like Malaria, Influenza, Typhoid, Pneumonia, Bubonic Plague, and Tuberculosis. Honduras ranks eighth among Western Hemisphere countries with a high tuberculosis burden. According to the World Health Organization's Global Tuberculosis Control: WHO Report 2004. See Exhibit____ Alcoholism and drug addiction are other health concerns mentioned by the Ministry of Health. There is also a very rapid spread of acquired immune deficiency syndrome (AID'S). See Exhibit___ The life expectancy in Honduras is only 69.3 years in Honduras as compared to 77.71 years in the United States. The infant mortality rate is 25.8 in every 1000 births. Diseases such as Influenza, malaria, typhoid, and pneumonia, once believed to be under control, have returned in force because of lack of preventive measures. Population growth, the implementation of economic austerity measures by the government in the 1990's, and present lack of facilities seem to suggest that
public health services in Honduras are likely to remain inadequate in the near future. See Exhibit____

EMPLOYMENT IN HONDURAS

I have taken paraprofessional classes to meet the qualification of working as a teacher's aid in special education, so if I had to move to Honduras, all of my classes and preparation would be lost. I also have no training that would help me to find a job in Honduras. I know that since I can't communicate in Spanish, I would have little or no chance of getting a job. The unemployment rate is 28.5%. See Exhibit____.

SCHOOL IN HONDURAS

Son is also learning disabled and takes special education classes for reading, spelling and math. In Honduras, I know that there are no such special education classes for special needs children like my son. The public education system in Honduras remains poor. The ministry of Education suggest that Honduras suffers from widespread illiteracy (more than 40% of the total population and more than 80% in rural areas). Schools are not readily accessible. When they are accessible they consist of joint-grade instruction through only the 3rd grade. Schools are so understaffed they have up0 to 80 children in one classroom. Public education is only available to children from 7-14 years old in Honduras. Parents must pay for their children's schooling at this point. Most children only attend through the 3rd grade. See Exhibit___. If my son couldn't be treated for his ADHD and learning disabilities, I would honestly fear for his life in Honduras, where ____wouldn't receive the psychiatric and
educational care that he desperately needs. Where he could possibly be shunned for his disabilities. Not only can he not speak Spanish but he requires speech therapy to learn how to speak English correctly. This would not be available to him in Honduras. See Exhibit___. If we had to move to Honduras to be with _______ my children would not have the wonderful public schooling that is available to them in the United States. It would greatly decrease their chances of going to college and reduce their future standard of living.

COMMUNITY TIES

We have very strong community ties in our community. My children love to participate in pee-wee football program, however I was very worried that they would not get to participate this year due to finances, however my grandmother paid the entry fees for them so the could participate. See Exhibit___. We are also active in church. I grew up attending the Liberty Baptist Church near where we live. Now we attend as a family. While _was still in the US he attended with us. Over the years there I have taught Children's Church, Vacation Bible School, helped organize, make costumes and put on the Christmas plays, sang in the choir for the Adult Christmas cantata. We are now in the middle of preparation for the K-6th grade Easter Concert which ____________and ___________ will both participate in. Both of our children,____________and_____________, were Baptized this last August 21,2005. I am so proud of the decision they have made for Christ. I just wish _________ could have been here to share
in that moment. I pray that you will forgive him for his illegal presence in the U.S. And let him come home to be reunited with us as a Hardworki9ng, Christian Family.

DIET AND CONDITIONS IN HONDURAS

Poor food productivity and low incomes lead to a very low standard of living in the country side where illness and poor diets are endemic. Most rural population live in one or two room thatch roof huts built of adobe or sugarcane stalks and mud with dirt floors with no electricity or running water and only an outhouse for bathroom facilities. The Honduran diet is based on beans, rice tortillas, fried plantains, meat, potatoes, cream and cheese. The main crop is corn. The typical diet of the rural population consists of corn, the primary staple and most widely planted crop, made into tortillas, beans and the main source of protein, cassava, plantains, rice and coffee, with only occasional supplements of meat and fish. Meat is infrequent in most rural diets, as are green vegetables. Given the nature of the typical diet and the fact that food production has been insufficient for the countries needs, widespread malnutrition complicates the populations fragile health. See Exhibit___ I
also know that Hurricane Mitch devastated what little infrastructure Honduras had before the hurricane. The U.S. Government is still providing Honduran immigrants in this country with Temporary Protected Status so they can live in the U.S., so even the U.S. Government believes that living conditions in Honduras are bad for Hondurans. For an American like me, it would be a terrible hardship to live in such primitive, violent conditions. I would constantly fear for my life and that of my children if I had to live in Honduras with my husband.

SUMMERY

It would be an extreme hardship to me and to my sons to continue to be separated from ________. It would be beyond extreme hardship to have to move to Honduras, where I have not ties and where I would fear for my safety and that of my sons. For me, my love for ___________ is my life. I love him absolutely and can't imagine continuing my life here without him. He is a loving husband and father and needs to be here with his family. My sons and I desperately need his support and comfort. ______is very sorry for his bad judgment in coming to the United States illegally. I ask you to pleas forgive ________for his error and allow him to be reunited with us a a loving hardworking Christian Family.

Thank you,

[y14gemini]

Thanks for posting these!!

[wanaads]

I've bolded the parts of the letter that were highlighted by someone at the embassy. They did not return my first addendum to us, so I don't know what was highlighted there.



Note about the organization of the Exhibits: All exhibits are listed numerically in the order that they first appear in the letter. Exhibits containing evidence cited first in one place and then cited n a subsequent place following other Exhibits are listed under the original Exhibit number in the following manner: Exhibit 1 (original appearance in the letter); Exhibit 1.1 (second appearance in the letter); Exhibit 1.2 (third appearance in the letter) and so on this manner.

Application for Waiver of Grounds of Excludability (I-601)
Claim of Extreme Hardship on the U.S. Citizen Spouse

April 28, 2008

United States Consulate
Avenida La Paz
Tegucigalpa, Honduras

Dear Sir/Madam:

I, wanaads, a United States citizen, in support of an I-601 Waiver of Grounds of Excludability, on behalf of my husband, Mr. wanaads, submit this personal statement of extreme hardship. As family unity is an important American value and assurance of family unity is part of the intent of United States immigration law, I respectfully request the consideration of this waiver be undertaken bearing in mind the societal and legal support of the many social, psychological, familial, economic, cultural and spiritual bonds which are presumed by the law to exist collectively in a marriage.

If Mr. wanaads is not admitted to the United States I will suffer extreme and unbearable hardships. As we took solemn marriage vows before God, family and friends to live together as husband and wife, in spite of my very close relationships with my family and friends in the United States and my love for and desire to live in my country, I would feel deeply compelled to live with my husband in Honduras during his 10-year bar from re-entry into the U.S. However, I have outlined below how living in Honduras would gravely endanger my health and safety as well as that of our unborn child. It would cause me significant psychological damage, completely destroy my financial well-being, irreparably damage my career prospects and greatly strain my relationship with my family. Were I to stay in the United States without my husband, this would also cause me to suffer grave psychological damage, would leave me to raise my child alone without his or her father in our home and would cause me excessive financial strain and emotional distress due to my need to bear the costs of childcare and living expenses in the United States on my own as well as my inability to afford regular visits to Honduras so that we could attempt to keep our family bond strong during the long and agonizing separation.

I. FAMILY BACKGROUND

I met Mr. wanaads in January 2006 when I was volunteering for an English as a Second Language Program in which he was enrolled as a student (Exhibit 1). We began dating shortly thereafter and were soon inseparable. I found him to be the kindest, most pure-hearted and generous person I had ever known. He listened to me and took care of me in a way that I had never experienced – and made me laugh every single day. While I had been in long-term relationships in the past, I quickly fell in love and knew that Mr. wanaads was the man with whom I wanted to spend my life and start a family. Luckily for me, he felt the same. We were married on October 21, 2006 (Exhibit 2) and have been joyously happy with each other ever since. Almost immediately after our wedding – against the advice of several different attorneys who suggested we either do nothing or lie about my husband’s illegal presence – we began the process of adjusting Mr. wanaads’s immigration status on our own, as we knew it was imperative to a stable future together that we follow the law and do everything possible to move forward with getting him a visa that would allow us to legally live together in the United States. This past Christmas we were thrilled to find out that I was expecting our first child (Exhibit 3). However, our excitement and joy about becoming first-time parents has been greatly diminished by the understanding that Mr. wanaads would have to return to Honduras and might not be allowed to come home for 10 years. He will undoubtedly not be here for the birth of our child, something that causes me an immense amount of emotional pain and sadness. The thoughts of the bonding time and special moments he will miss during those precious early days and months of our child’s life are unbearable for me. I have now found myself beginning to dread what should be the happiest time in my life – the birth of my first child – because I will be unable to experience it with my husband.

II. HEALTH HARDSHIPS

A. Depression and Stress-Related Health Issues
Worrying about whether or not I will have to leave my country in order to live with my husband or live in the U.S. without him is already causing me an enormous amount of stress. I am experiencing insomnia and have only been getting 2-3 hours of sleep most nights for the past few months. On the nights I am able to fall asleep, I have recurring nightmares that I’ve lost my husband or that we are have been separated by force and I wake up sobbing and unable to get back to sleep. I feel extremely anxious, exhausted, helpless and, often, hopeless about our situation and have found myself having difficulties staying focused and engaged at work and unable to keep up with my relationships with even my closest friends. All of these are classic symptoms of depression as outlined by the National Institute of Mental Health (Exhibit 4, p. 1-2). The NIMH points out that depression interferes with a person’s “daily life and routine, such as going to work or school, taking care of children, and relationships with family and friends,� (Exhibit 4.1, p. 1).

I began seeing a psychoanalyst last summer for symptoms brought on by my excessive worry and feelings of powerlessness over our situation and what will happen to us. She diagnosed me with depression and recommended medication which I wanted to avoid if at all possible. I continued therapy until Mr. wanaads and I moved to Los Angeles in February 2008 (Exhibit 5). I have just begun treatment with a new psychologist in Los Angeles in an attempt to alleviate some of the symptoms of depression that I am experiencing even more acutely now as the separation from my husband draws near. But I am very worried that I will not have the time or money to continue treatment after our baby is born if my husband is not allowed to return and help out with childcare and expenses. This is causing me severe additional anxiety because I know I will be even more vulnerable to a much more severe and prolonged depression if I am either separated from my husband for a long period of time and forced to care for our child alone; or, if Mr. wanaads cannot return to the United States and I am forced to go to Honduras in order to keep my family intact. Needless to say, the trauma of having to move to Honduras, leaving behind the safety and stability of living in my country, as well as my family, my friends, enormous debt and all hope of advancing my career in the recruitment field would only exacerbate the problems I am already experiencing. And in Honduras I would be unable to seek the help of a professional psychoanalyst as I do not speak Spanish and would have no means to pay for it if I did.

My diagnosis of depression also leaves me at serious risk for experiencing postpartum depression (PPD) which often develops in the first six months after giving birth. The Mayo Clinic reports the following regarding PPD:

For women with postpartum depression, feelings such as sadness, anxiety and restlessness can be so strong that they interfere with daily tasks. Rarely, a more extreme form of depression known as postpartum psychosis can develop (Exhibit 6, p. 1).

Postpartum depression may appear to be the baby blues at first � but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to function. In addition to the signs and symptoms listed above, you may experience:

• Constant fatigue
• Lack of joy in life
• A sense of emotional numbness or failure
• Withdrawal from family and friends
• Lack of concern for yourself or your baby
• Excessive concern for your baby
• Less interest in sex
• Severe mood swings
• Impaired thinking or concentration
• Insomnia

With postpartum psychosis � a rare condition that develops within the first six weeks after delivery � the signs and symptoms are even more severe. In addition to the signs and symptoms listed above, you may experience:

• Fear of harming yourself or your baby
• Confusion and disorientation
• Hallucinations and delusions
• Paranoia

(Exhibit 6.1, p. 1-2)

Though there are many causes for PPD, emotional factors such as feeling that you have lost control over your life or that you are struggling for your sense of identity, as well as lifestyle factors such as financial problems and a lack of support from your partner can contribute (Exhibit 6.2, p. 2). I will be dealing with all of these factors whether I am in the United States without my husband or whether I’m forced to leave my home to live with him in Honduras. Either way, I will feel very much like I have no control over my life, as I am already experiencing; my identity will be in an extremely fragile state as I struggle to come to terms with the horrifically altered circumstances of my life; I will experience severe financial difficulties, likely being unable to pay my bills and support myself and our child; and my husband and I will either be forcibly separated by thousands of miles or living in a state of poverty in his mother’s home, where he will have to be the sole support for both of us as well as his mother, thus causing him to be absent from the home for extended periods of time to try to find work.
My risk of experiencing PPD is increased because I have a history of depression, both before and during my pregnancy; because I am experiencing unusually stressful events such as being separated from my husband during my pregnancy and the uncertainty of not knowing when or where we will be able to live together as a family again; and because of the strain being separated against our wishes has put on our otherwise strong, positive and supportive marriage, (Exhibit 6.3, p. 3).

Perhaps worst of all are the lasting negative effects PPD can have on our child. The Mayo Clinic reports that PPD “can interfere with mother-child bonding and cause family distress. Children of mothers with untreated postpartum depression are more likely to have behavioral problems, including sleeping and eating difficulties, temper tantrums and hyperactivity. Delays in language development are common as well,� (Exhibit 6.4, p. 4).

Even in an ideal situation PPD can be very serious and difficult to manage, but I am extremely fearful about my ability to deal with such a hormonal and psychological imbalance, on top of the anxiety and depression that I am already experiencing, without the support and care of my husband, as well as his help with our child during a time when I may be unable to care for him or her in the best way.

In addition to the depression that I am currently experiencing, as well as any PPD that I might experience, the possibility of living in the United States without Mr. wanaads for ten years and raising our child on my own, effectively making me a single mother, leaves me severely distressed. I grew up in a single parent household, and while I believe my mother did an excellent job raising my brother and me, I have always promised myself – and even shared this intention with friends and family at many points throughout my life – that I would never have a child unless I had a loving, responsible husband who I could trust to be committed and to participate fully in our child’s life. I have that in Mr. wanaads. He too was raised in a single parent household and we both have an intimate understanding of what we missed out on by not having our fathers in our lives. We want better for our child. And the idea that we might not be able to raise our child together, under one roof, with all the love that it deserves from both of us breaks my heart beyond words. The effects of growing up in a fatherless home are pervasive, grievous and enduring:

• Children in father-absent homes are five times more likely to be poor.
• Even after controlling for income, youths in father-absent households still had significantly higher odds of incarceration than those in mother-father families.
• A 2002 Department of Justice survey of 7,000 inmates revealed that 39% of jail inmates lived in mother-only households.
• Adolescents, particularly boys, in single-parent families were at higher risk of status, property and person delinquencies.
• A study of 13,986 women in prison showed that more than half grew up without their father.
• Even after controlling for community context, there is significantly more drug use among children who do not live with their mother and father.
• Being raised by a single mother raises the risk of teen pregnancy, marrying with less than a high school degree, and forming a marriage where both partners have less than a high school degree.
• Women whose parents separated between birth and six years old experienced twice the risk of early menstruation, more than four times the risk of early sexual intercourse, and two and a half times higher risk of early pregnancy when compared to women in intact families.
• Teens without fathers were twice as likely to be involved in early sexual activity and seven times more likely to get pregnant as an adolescent.
• In a study of 6,500 children from the ADDHEALTH database, father closeness was negatively correlated with the number of a child’s friends who smoke, drink, and smoke marijuana. Closeness was also correlated with a child’s use of alcohol, cigarettes, and hard drugs and was connected to family structure. Intact families ranked higher on father closeness than single-parent families.
• National Longitudinal Survey of Youth found that obese children are more likely to live in father-absent homes than are non-obese children.
• Fatherless children are twice as likely to drop out of school.
• Students living in father-absent homes are twice as likely to repeat a grade in school

(Exhibit 7, p. 1-5)

The anguish I feel about risks our child faces and what I personally know about what it will have to endure living without its father, leaves me deeply concerned about what will happen to my own psychological well-being if I feel that I have failed to provide the loving, safe, stable and complete home for my child that I have always promised myself I would. My self-worth and very identity as a loving mother are at stake. My family and friends have expressed concern about this as well and I remain at a loss for how to calm their fears, and my own, as I can feel my control over what happens to my child – and myself – slipping away from me (Exhibit 8).

B. Breast Calcifications
In April 2007, during a baseline mammogram, microcalcifications were spotted in my left breast (Exhibit 9). My doctor immediately recommended a biopsy of the tissue in that area (Exhibit 10) due to the increased risk of cancer with these types of calcifications (Exhibit 11, p 4; Exhibit 12). The biopsy results came back as benign, however, my doctor recommended that I return for a mammogram in six months and then annually beginning at age 40 in order to monitor the tissue in that area for possible cancerous cell mutations (Exhibit 13). The National Cancer Institute (NCI) recommends mammograms for women in their 40s every 1 to 2 years (Exhibit 14). I am only 37 years old. My need for ongoing, highly-specialized observation of these microcalcifications highlights my doctor’s concern about the increased risk of cancer these calcifications represent. In the United States, I have access to the best medical care in the world and a job that provides health insurance to cover the costs of monitoring and early treatment should these microcalcifications metastasize. This type of monitoring and level of care would not be available to me in Honduras, nor would I have means to pay for whatever care is available there.
However, if I was living in the United States without my husband and my microcalcifications metastasized, I would be deprived of his love and support during a time when I would need him most. Further, there would be no parent in our home to care for our child should I become seriously ill. This would cause me to suffer from severe additional stress that would surely make my recovery much more difficult. A National Institutes of Health (NIH) report on stress and disease states, “in situations of chronic stress your immune cells are less able to respond to an invader like a bacteria or virus,� (Exhibit 15, p. 2). It goes on to say that people experiencing chronic stress “show a prolonged healing time, a decreased ability of their immune systems to respond to vaccination, and an increased susceptibility to viral infections like the common cold,� (Exhibit 15.1, p. 2). Having a weakened immune system due to chronic stress while sick with, or even being treated for, breast cancer could easily render me completely disabled and unable to care for my child and myself, or even become fatal.

The stress I will experience if Mr. wanaads is not able to return to the U.S. can also have a negative effect on our child. In a study of the effects of stress on children, the NIH reports that “the children of parents with higher levels of chronic stress and psychiatric symptoms at enrollment had higher rates of total illness and illnesses with fever in the subsequent year,� (Exhibit 16, p. 1). Further, the study’s findings suggest that “chronic family stress may alter a child's developing immune system and have a detrimental effect on their health,� (Exhibit 16.1, p. 2). If I were to be diagnosed with breast cancer, either in the U.S. or in Honduras, having a child with an illness perhaps brought on or made worse by my own psychological and physiological state would only serve to increase my stress, ratcheting it up to an intolerable level and making it even more likely that chronic stress would make my recovery immensely more difficult.

C. Pregnancy over 35
As previously noted, I am 6 ½ months pregnant with my first child. While Mr. wanaads and I are overjoyed that we will soon be blessed with a child, I am over 35 and my pregnancy comes with several very serious risks both to me and our baby.

• Women over age 35 are about twice as likely as younger women to develop gestational diabetes. Women with gestational diabetes are more likely to have a very large baby who is at risk of injuries during delivery.
• Women in their late 30s were almost twice as likely, and women in their 40s nearly three times as likely, as younger women to have placenta previa. This can cause severe bleeding during delivery, which can endanger mother and baby.
• Women over age 40 were 40 percent more likely than younger women to deliver prematurely (before 37 weeks of pregnancy). Premature babies are at increased risk of health problems in the newborn period and of lasting disabilities.
• Women over age 40 are about twice as likely as women in their 20s to have a stillborn baby.

(Exhibit 17, p. 2)

Luckily, infant and maternal mortality rates in United States are among the lowest in the world at 7 deaths/1000 births for infants and 17 deaths/100,000 births for mothers (Exhibit 18, p. 1). I am grateful that I am currently able to receive such a high level of care should any of these problems develop. However, Mr. wanaads and I desperately want more children and, as noted, these risk factors increase with each passing year, making it dangerous to wait and agonizing not to. By age 40 the risk of having a child with birth defects increases to a 1-in-100 chance compared with a 1-in-400 chance at age 35. This increases to 1-in-30 by age 45; (Exhibit 17.1, p. 1) and the risk of miscarriage rises from 20% at ages 35-39 to 50% by ages 40-44, (Exhibit 17.2, p. 2).These risks require complex testing and evaluation; worrying about these risks and the possibility of suffering through them either in Honduras, where the state of medical care is sub-standard at best, with an infant mortality rate of 28 deaths/1000 births (Exhibit 19, p. 1) and the maternal mortality rate is 110 deaths/100,000 births; or in the United States without the love and support of my husband is causing me to suffer from severe stress which, as noted above, can severely weaken the immune system, therefore, increasing the likelihood of one or more of these risk factors developing into a very serious, possibly life-threatening complication.

D. Health conditions in Honduras
Based on my medical hardships listed above, living in Honduras would gravely affect my health due to the extremely poor health conditions and the sub-standard level of healthcare available there in comparison with the United States. The U.S. Department of State, Bureau of Consular Affairs states:

Medical care in Honduras varies greatly in quality and availability. Outside Tegucigalpa and San Pedro Sula, medical care is inadequate to address complex situations. Support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital. Ambulance services are limited in major cities and almost non-existent elsewhere. (Exhibit 20, p. 4)

Mr. wanaads’s mother, who we would be living with in Honduras should I have to go there to join my husband, does not have a car and lives in the rural pueblo of Pespire which has extremely limited medical facilities, capable only of giving the most basic first aid care and vaccinations. My husband tells me that the nearest hospital is in Valle, one and a half hours away from my mother-in-law’s home by bus, and the hospital in Tegucigalpa is 4-5 hours away by bus. In addition, doctors and hospitals expect immediate payment for health services (Exhibit 21, p. 5), so even if I were able to make it to the best doctor or hospital in the country for regular or, God forbid, emergency treatment for myself or my child, not only would neither be able to provide the standard of care I have grown up receiving but it’s very likely that I would not have the means to pay for treatment.

Based on the U.S. Department of State’s own assessment of medical conditions in areas outside of the major cities of Honduras, I would be unable to find adequate psychological treatment during what would surely be the most traumatic experience of my life; regular and accurate monitoring of my breast calcifications would be impossible, leaving me at grave risk for not being able to detect and/or treat breast cancer at an early stage; and the lack of adequate testing, monitoring and treatment facilities would make the risks involved with an already high-risk pregnancy unbearable, destroying my hopes of ever having another child.

Furthermore, health conditions in Honduras are among the worst in Latin America. Nearly a third of the population are without access to any health services (Exhibit 22, p. 6) and there only .57 physicians, 1.29 professional nurses, .21 dentists and .14 pharmacists per 1,000 population (Exhibit 23) in comparison with 2.56 physicians, 9.37 professional nurses, 1.63 dentists and .88 pharmacists per 1,000 population in the United States, (Exhibit 24). According to the Pan-American Health Organization, the prevalence of stunted growth in children is rising as children grow older and malnutrition affected 44.6% of the rural population, with the most serious nutritional problems in the western rural areas of the country – exactly where I would be living with our child – where the prevalence of chronic malnutrition was 59.5%, (Exhibit 22.1, p. 6). According to the World Health Organization, Honduras has the eighth highest incidence of tuberculosis in the Western Hemisphere, (Exhibit 25, p. 1). The CIA World Factbook lists the degree of risk for major infectious disease in Honduras, such as bacterial diarrhea, hepatitis A, typhoid fever, dengue fever, malaria and leptospirosis as high, (Exhibit 26, p. 4). Having lived in first-world countries my entire life, I am not at all accustomed to dealing with these kinds of risks, emotionally or physiologically. Couple these risks with a weakened immune system brought on by the depression and stress of being forced to leave my own country in order to live with my husband, as well as the sub-standard level of healthcare in Honduras, my inability to pay for anything beyond free public care, and the difficulties I will encounter just trying to reach a proper hospital, and the medical hardships I will be forced to endure are indeed extreme.

III. FINANCIAL HARDSHIPS

A. Student Loans and Childcare
I currently owe $xxx,xxx in federal student loans. I make monthly payments totaling $xxx. Based on my current payment amount and my current interest rate, I am not expected to pay off my loans until 2037, (Exhibit 27). If I have to leave the United States to live in Honduras with Mr. wanaads for ten years, I will have no means by which to make the payments on these loans. They will go into default and can never be discharged in a bankruptcy should I be forced into taking that route. Upon my return to the United States after ten years of not paying on these loans, the amounts I will owe will be astronomical and the damage to my credit would make it impossible for me to even rent an apartment and possibly even find a job. I will be financially destroyed and indentured for the rest of my life. In short, these debts that I owe to the United States government and promised to repay will never go away and will only grow exponentially larger if I do not continue to work in the United States so that I can continue to pay them down.

However, staying in the United States without my husband will leave me with no one to care for our child. If Mr. wanaads were able to return to the United States, we have decided that he would stay home with our child and work on a part-time basis in order to help relieve some of our expenses. In Los Angeles County, where I currently live, average rent for a two bedroom apartment is $1652 per month with an annual salary of $66,560 required to pay the average rent (Exhibit 28, p. 1) and the average monthly cost of childcare is $589-$895 per month for care of an infant and $542-623 per month for a four year old child, (Exhibit 29, p. 1). If Mr. wanaads is not allowed to return, my rent, childcare expenses and student loan payments will total more than my take home pay. Even if I cut out retirement and regular savings and all extraneous expenses, it will be impossible for me to make ends meet. I simply do not know how I will pay these essentials and still have money left for food, utilities and the ever-increasing gas costs.
Having to choose between going to Honduras and leaving all of this debt behind to mount up in my absence or stay in the United States without my husband and not be able to cover living expenses for myself and our baby will cause me to suffer an immeasurable amount of stress and hardship. I simply want to live a decent life with my family and be able to pay my bills. I cannot do these things without my husband

B. Work
I currently work as a researcher at an executive search firm. I make a base salary of $xx,xxx, plus overtime and an annual bonus, (Exhibit 30). My employer provides low-premium medical, dental, and vision insurance for me and Mr. wanaads. I am also able to participate in pre-tax flexible spending accounts for medical costs not covered by insurance, commuting, and dependent care services. In addition, I am provided with long and short-term disability insurance as well as life insurance (Exhibit 31).

If I leave my job in order to live with Mr. wanaads in Honduras, I will leave behind all of these benefits for both Mr. wanaads and me, as well as for our child, and will find my job prospects in Pespire to be extremely limited if not non-existent with an unemployment rate of 27.8% and 50.7% of the country living below the poverty line, (Exhibit 26.1, p. 7). The U.S. Department of State reports that the majority of women in Honduras work in low-status, low-paying, informal occupations without legal protection. Equal rights, equal pay and protection against sexual harassment are all guaranteed by law but are ineffectively enforced. In addition, cultural attitudes limit the career opportunities available to women in formal occupations, (Exhibit 32, p. 9-10). Even finding a minimum wage level job would not provide me or my child with a decent standard of living, (Exhibit 32.1, p. 16). Developing any kind of decent paying career in Honduras will surely be even more difficult for me as I am older, from a different culture and do not speak Spanish. This will not only be devastating to me financially, but emotionally and spiritually as well. I am a hard-working person and take great pride in my career and independence. Without the ability to support myself and our child, my self-worth will be utterly destroyed. Further, a ten-year absence from the American job market and the recruitment field will render moot all of the work I have put toward building a career here in the United States and leave me unable to support myself and our child upon my return, leaving me to depend on relatives, if possible, or even the state, if necessary.

However, staying in the United States and continuing to work toward a long-term career with my company will leave me unable to support our baby and myself alone as I outlined above. I desperately need the stability of my current job but I cannot make enough money there to make ends meet without my husband’s help.

C. Retirement Savings
My company also allows me the opportunity to save for retirement in a 401(k). I invest 6% of every paycheck into my 401(k) (roughly $xxx per month) and currently have a balance of $xx,xxx (note: $x,xxx of this amount is currently in a rollover IRA that is in the process of being rolled into my 401(k)), (Exhibit 33). My company matches 50% of every dollar I invest in my 401(k) up to 6% of my eligible income but in order to take advantage of this tremendous benefit and receive 100% vesting, I must stay with the company for six years, (Exhibit 31.1). Otherwise, I walk away from all the money that my company would have matched on my behalf. By the end of the six years, this will be tens of thousands of dollars in retirement savings that I will leave on the table if I am forced to quit my job in order to live in Honduras with my husband, not to mention at least $xx,xxx of my own contributions that I will not have the opportunity to make over the ten year period that I would be gone. Moreover, these amounts do not even take into consideration normal increases in value based on the average rate of return on the investments I have allocated for my 401(k) account.

Moving to Honduras will also put my future Social Security benefits in jeopardy as I will no longer be able to contribute to the system. Social Security benefits are based on taxable earnings on an annual basis. The Social Security Administration estimates benefit amounts using average earnings over my working lifetime and assumes that I will continue to work in the United States and to make about the same salary as I have in recent years. At my current earning rate, at age 62 my monthly benefit payment would be about $x,xxx. If I continue working until age 67, my monthly benefit payment would increase to $x,xxx, (Exhibit 34, p. 2). If I stop working in the United States and no longer contribute a 401(k) or to the Social Security system, this level of benefits will not be available to me and will put my retirement finances in serious jeopardy.

IV. PERSONAL HARDSHIPS

A. Family Ties in U.S.
My entire family lives in the United States. I am extremely close to my mother and brother and recently reconnected with many members of my extended family. In fact, Mr. wanaads and I recently moved from Virginia to California in order to be closer to my family, (Exhibit 35). We have lived with my mother for the past few months and I will be looking for an apartment nearby in the next several weeks so that I can be close to her while I await the decision on this waiver. I have absolutely no ties to Honduras and do not know a single person in that country. I have never even met my husband’s family and, while I am sure they are nice people, they could never serve as a substitute for my own. Not being able to talk to and visit my family regularly would cause me to feel desperately isolated and severely depressed. I rely and depend on them for guidance and support and view them as the touchstones in my life. The thought of my family not being a regular part of our child’s life is one that I can barely allow to enter my mind. I cannot imagine what it would do to my mother’s mental health and well-being if I were to leave the country with her only grandchild in order to live with my husband. Being forced to choose between my family in the United States and my husband in Honduras would put me in an impossible situation. I made a solemn vow to be with my husband for the rest of my life and desperately want to honor that vow, but I would be severely traumatized if I had to leave my family knowing that I would not have the means to visit on any kind of regular basis, (Exhibit 36).

B. U.S. Citizen
In addition to the trauma I would suffer if forced to leave my family behind is the severe distress I would suffer if I had to leave the United States. I love my country dearly and have never wanted to live anywhere else. I was born on a United States Army Base in Augsburg, Germany and moved to the United States when I was four years old. I vividly remember marveling at how everyone spoke the same language as me. I instantly felt as though I was home and immediately developed a great love and respect for my country. It is of the utmost importance to me that our child be raised in the United States and have a complete and intimate understanding of American values and what our country stands for. If I am, in essence, exiled from my home in order to be able to live as a family with my husband in Honduras, I would be absolutely lost and completely devastated. This can only be equaled by the loss and devastation I will experience if I stay in the U.S. without Mr. wanaads for ten years. I simply do not know how I can make this choice without destroying myself.

C. Loss of independence
I have supported myself and lived on my own for 15 years before I met my Mr. wanaads. I am an extremely independent woman. I am a city girl with strong opinions; I speak my mind; I’m fairly set in my ways and I take great pride in being able to take care of myself. Living in a small, rural, Honduran pueblo, in a two room house with my mother-in-law, without knowing anyone or even speaking the language will render me entirely dependent upon my husband in nearly every aspect of my life – from the smallest things such as what I ate to much more far-reaching issues such as child-rearing decisions. I will, most surely, experience a loss of independence if I stay in the U.S. without Mr. wanaads as well, due to my inability to support myself and our child. Either decision will cause me extreme psychological damage, greatly injure my self-identity and would, undoubtedly, throw me into a deep depression which would surely have negative repercussions for our baby.
V. SPECIAL FACTORS

A. Language Barrier
Honduras is a Spanish-speaking country. I do not speak Spanish. I took French in high school and college (Exhibit 37) and I cannot communicate in Spanish beyond the most basic, “Hello, how are you?� conversation level. It would be extremely difficult for me to socialize and assimilate into Honduran society, and it would be virtually impossible for me to find work without Spanish speaking, reading and writing abilities. This would cause me to suffer from feelings of unbearable isolation and depression.

B. Social Conditions in Honduras
1. Crime - The U.S. Department of State wrote in October 2007, “Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes.� The Embassy notice goes on to say that carjackings and kidnappings are common along Honduran roads, (Exhibit 20.1, p. 3). The Overseas Advisory Council writes, “Violence and crime are integral parts of life in Honduras. Gang activity…is prevalent throughout Honduras. The police have the basic skills to address violence and crime, but lack the level of manpower, training, equipment and other resources to adequately control it. Honduras has the lowest per capita ratio of police in Latin America,� (Exhibit 20.1, p. 1). The report also notes that Honduran police are ineffective at deterring crime, slow to respond to crimes in progress and mediocre at apprehending suspects once a crime has been committed (Exhibit 21.2, p. 5). Violence against women is also widespread and laws are ineffectively enforced. Not even 4% of reported rapes resulted in convictions in 2006, (Exhibit 32.2, p. 9). Corruption is also a serious problem, with “courts, prosecutors, and police…susceptible to bribery and influence,� (Exhibit 21.3, p. 5). “Security forces were suspected of direct involvement in unlawful and arbitrary killings… [including] killings of youths and children by vigilante groups,� (Exhibit 32.3, p. 1). I am a typical American woman, accustomed to my safety and freedoms, voicing my opinion, and speaking up when I see an injustice. If I had to live in Honduras, these core aspects of my personality would either put me, my husband, our child and possibly even his family in danger or would be frightened out of me, changing an essential part of who I am. Mr. wanaads has said that he doesn’t even want me and our baby to visit, much less to live there out of fear for our safety. And my fears for his safety while he remains in Honduras have manifested in horribly upsetting nightmares on a regular basis.

2. Education – The Inter-American Development Bank reports that the average level of education for Honduran adults is 4.74 years; the illiteracy rate for those over 15 years old is 27.3 %, nearly twice the rate for the rest of Latin America; and more than a fifth of Honduran adults have had no schooling at all, (Exhibit 22.2, p. 5). Education is free, universal and compulsory only through the age of 13, but a 2006 study estimated that less than 14% of children between 5-12 years old did not receive any schooling that year, and a 2002 report stated that only half of Honduran children reached the sixth grade, (Exhibit 32.4, p. 10). Education is a top priority in my family and is of the utmost importance to me when it comes to raising our child. I have already shown the educational risks he or she faces without Mr. wanaads living in our home here in the U.S. But how will I ensure that our child is properly educated if it must spend its childhood in Honduras? How far behind the other children will he or she be when we are all finally able to return to the U.S. together? These questions and my lack of acceptable answers to them harass me on a daily basis.

VI. GOOD CHARACTER AND ADMISSABILITY OF ALIEN

Mr. wanaads is a hard working, family-oriented man with strong religious and moral values. He presents no danger whatsoever to the interests of the United States of America and hopes only to be a contributing member of American society. If given the opportunity to return, Mr. wanaads will respect all laws of the United States and, in fact, plans to study to be a firefighter once he returns in order to give back to the country that has given him so much.

VII. SUMMARY

Obviously, I will miss Mr. wanaads painfully during the separation we must endure while waiting for the decision on this waiver. Being separated from one’s spouse is an unnatural state and one that causes severe distress for anyone, particularly a pregnant woman. I am already living in a state of extreme anxiousness about our future and that of the child that we will soon have because it all depends upon whether Mr. wanaads will be allowed to immigrate to the United States to live with us. However, the pain and anxiousness I am already experiencing are simply the backdrop to the other, previously listed hardships that, individually and when combined and interacting, are undoubtedly severe. Though the enormous strain of worrying about the outcome of this decision and being separated from Mr. wanaads constitute very powerful hardships on me, the other hardships on top of these culminate in me being potentially and actually subjected to extreme and unusual hardship.

These additional hardships include my health issues, including depression and the enormous amount of stress that this situation has brought on; microcalcifications in my breast that signal an increased risk of breast cancer and need to be closely monitored; the risks involved with my current pregnancy, as well as any subsequent pregnancies, at an advanced maternal age and the need for specialized pre-natal monitoring and care during and after the birth. Moreover, if I move to Honduras in order to live with my husband, I will lose my career, income, health insurance and self-identity and would be unable to honor my debts, the bulk of which are owed on federal student loans. I will also be living in grave danger and fear for my life due to the extremely sub-standard healthcare system as well as the enormous crime problems in Honduras, including murders, rapes, kidnappings of Americans and a high incidence of violence against women. These factors combined with my strong emotional bonds with my family and friends in the United States would make it impossible for me to move to Honduras without great risk to my psychological well-being. The thought of being forced into the decision about whether to leave everything and everyone I have ever known in order to honor my marriage vows and live with Mr. wanaads is weighing heavily on my psychological state and ability to function normally. I am feeling torn into two very distinct halves and can only be made whole by reuniting Mr. wanaads with me in the United States.

In short, if Mr. wanaads is not admitted to the United States of America, I would be placed in the midst of an impossible dilemma: choosing between my husband, the love of my life and father of my child, and my country and all that it holds, including my family, friends and everything I have ever known. But moving to Honduras would set into motion emotional, social, and medical forces that could prove permanently damaging to my physical, psychological and financial well-being. By staying in the U.S. without my husband, I would be setting into motion many of the same forces just in a different context. Simply put, I would be placed squarely between my marital bond, my country, my family, my health and safety and that of our child, and my financial obligations in the United States. The repercussions of either decision constitute an extreme hardship on me.

Based on the circumstances I have outlined above, I respectfully request that you take into consideration the extreme hardships I will endure if I have to live in Honduras in order to be with my husband or in the United States without him and that you allow this application for a Waiver of Excludability and grant Mr. wanaads the privilege of joining me and our baby in the United States of America.

I appreciate your time and attention in this matter.

Respectfully,


Wanaads


Exhibit 1 – Evidence of Mr. wanaads’ enrollment in English classes
Exhibit 2 – Marriage license
Exhibit 3 – Midwife letter stating I was 24.5 weeks pregnant
Exhibit 4 - National Institute of Mental Health info on depression
Exhibit 5 – Letter from psychoanalyst
Exhibit 6 – Mayo Clinic info on postpartum depression
Exhibit 7 – National Fatherhood Initiative data on effects of father absence
Exhibit 8 – Letters from friends
Exhibit 9 – Mammogram results
Exhibit 10 – Dr. recommendation for biopsy
Exhibit 11 – National Cancer Inst. info on breast calcifications
Exhibit 12 – Health Center Network info on breast calcifications
Exhibit 13 – Biopsy results and recommendations
Exhibit 14 – National Cancer Inst. mammogram recommendations
Exhibit 15 – National Inst. of Health report on stress and disease
Exhibit 16 – National Inst. of Health report on chronic family stress and illness in children
Exhibit 17 – March of Dimes info on pregnancy after 35
Exhibit 18 – WHO info on infant and maternal mortality in US
Exhibit 19 - WHO info on infant and maternal mortality in Honduras
Exhibit 20 – US Dept. of State Country Report on Honduras
Exhibit 21 – OSAC Honduras Crime and Safety Report 2008
Exhibit 22 – INS Resource Info Center Honduras Hardship Considerations
Exhibit 23 – WHO Core Health Indicators for Honduras
Exhibit 24 - WHO Core Health Indicators for US
Exhibit 25 – USAID Tuberculosis Profile – Honduras
Exhibit 26 – CIA World Factbook Honduras
Exhibit 27 – Student loan documentation
Exhibit 28 – City of LA Housing Dept. doc on State of Housing in LA
Exhibit 29 – NACCRRA doc 2008 Child Care in CA
Exhibit 30 – Letter fro HR with salary info
Exhibit 31 – Benefits info from employee handbook
Exhibit 32 – US Dept. of State Country Report on Human Rights Practices – Honduras
Exhibit 33 – 401(k) account statement
Exhibit 34 – Social Security statement
Exhibit 35 – Change of address confirmation from USPS
Exhibit 36 – Letters from family
Exhibit 37 – College transcripts showing that I took French



Addendum to Application for Waiver of Grounds of Excludability (I-601)
Claim of Extreme Hardship on the U.S. Citizen Spouse

November 13, 2008

U.S. Citizenship and Immigration Services
DEPARTMENT OF HOMELAND SECURITY
Tegucigalpa Sub Office
United States Consulate
Avenida La Paz
Tegucigalpa, Honduras

Dear Sir/Madam:

I am writing this addendum to my original waiver application because circumstances with regard to my health and financial hardships have changed significantly since I completed the original application in April. I respectfully request that you please take these additional facts into consideration when adjudicating the application for my husband’s waiver.

I. HEALTH HARDSHIPS
On August 13, 2008 I gave birth to our daughter, Isabella, by emergency Cesarean section (Exhibit 1). I had planned a natural birth but failed to progress after over 48 hours of labor. I was eventually given medication to induce stronger contractions. Soon after my baby went into distress. After a few hours on the medication, Isabella’s heart rate dropped dramatically and I was rushed into an operating room for what my nurse was calling a “crash C-section.� It turned out that Isabella had the umbilical cord wrapped around her neck several times and shortly after they began giving me the medication, I suffered a placental abruption, wherein my placenta tore away from my uterus causing internal bleeding and putting both me and the baby in grave danger (Exhibit 2). Upon her delivery, Isabella was immediately taken away for observation and I was not able to see her for several hours after she was born. It was the single most traumatic event of my life and still causes me great sorrow and distress every time I think about it. I was terrified and desperately in need of my husband’s strong and calming presence. And our daughter deserved to have at least one of her parents with her as she entered the world.

My doctor has informed me that should I have another child, which I am certainly hoping for, I am at increased risk for another placental abruption. I have the option of trying for another natural birth with additional monitoring during labor or another Cesarean section (Exhibit 1.1). Neither of these options are things I want to go through without my husband by my side or, worse, in Honduras with sub-standard medical care. I am convinced that had I been in Honduras when I went into labor with Isabella, one or both of us would not have made it. The thought of this shakes me to my core.

Additionally, at Isabella’s first doctor visit, 10 days after her birth, her pediatrician noticed a heart murmur and referred us to a pediatric cardiologist. Thankfully, the cardiologist diagnosed it as an innocent murmur but if it persists, or if her pediatrician notices any changes, she will require follow-up care from a specialist (Exhibit 3). This is care Isabella would need to receive in the United States, as far as I’m concerned, as it is here that I have the appropriate medical insurance to cover any condition she may have or develop and, most importantly, it is here that she can receive the best medical care in the world. Yet, should this waiver be denied, this still leaves me with the impossible choice between staying here without Mr. wanaads or going to Honduras to unite our family but putting us at potentially great risk.

The stress of dealing with Isabella’s traumatic birth and worrying for several weeks about a potential heart problem, not to mention raising a newborn alone has taken a great toll on me. While I am, of course, overjoyed to have our daughter here with me, healthy and thriving, my stress level and utter loneliness without my husband is at a fever pitch. I know I need to take good care of myself for our daughter’s sake but I am often unable to eat or sleep and I find it difficult to leave the house. I have become extremely withdrawn and spend nearly all of my days at home alone with Isabella, only leaving when I have to. Every moment of joy I experience with her is bittersweet because it is a moment that her father will never have. I continue to worry about what affect my stress will have on our daughter and how I will pull myself out of it when it comes time to return to work.

I was given 12 weeks of maternity leave from my company and was supposed to return to work on October 27, 2008. However, I did not feel anywhere near being emotionally ready to return and took an additional 6 weeks off at 55% of my pay through California’s Paid Family Leave program (Exhibit 4). Though this decrease in my pay will surely add to my financial distress, I did not see any way I could return to work as the end of my company paid leave drew near. This has created a difficult catch-22 for me, as the stress of worrying about our finances often leaves me as debilitated as worrying about when or if we will all be together again.

II. FINANCIAL HARDSHIPS
With regards to our finances, I unfortunately had to withdraw $x,xxx from Rollover IRA in June in order to pay for medical expenses which my insurance did not cover (Exhibit 5; Exhibit 6). I intended to pay the full amount back in order to avoid any tax penalty but was only able to replace half the amount that I withdrew (Exhibit 7). This will, of course, end up costing me quite a bit when I do our taxes next year as we will be taxed on the $x,xxx as income and pay an additional 10% penalty.

I am also now facing having to pay for childcare once I return to work in December. After a very extensive search, I found someone who I trust to look after Isabella who charges $xx per hour, which was on the lower end of the average for all the people I met with (Exhibit 8). At this rate, I cannot afford her full-time and I’m hoping that my mother will be able to help out a couple days a week but I cannot count on that. I believe I mentioned in my original letter that our plan was for Mr. wanaads to stay home with the baby during the day and take on a part-time job at night to help out with expenses. Not having him here to help raise our daughter is not only emotionally wrenching for me on a daily basis but it is going to put me in an impossible financial bind. I simply do not know how I am going to manage this on my own.

The other two major expenses I am currently incurring are living expenses for Mr. wanaads and phone cards so that we can stay in touch regularly to keep our bond strong. Mr. wanaads has been unable to find consistent work in Honduras and I have been sending him money on a regular basis, totaling $x,xxx so far (Exhibit 9). The phone cards have totaled about $xxx since he returned to Honduras in April (Exhibit 9.1). I am extremely concerned that I will not be able to sustain either of these expenses much longer. What will happen to us? How can I leave my husband in another country without money to eat or to live on? What kind of emotional strain will it put on us both if we are not able to communicate on a regular basis? I have to return to work in a few weeks but how can I afford to pay someone else to take care of my baby while I’m working? I lay awake every night asking these questions and watch the sun come up without any answers.

Simply put, I need my husband back here with me in order to help care for and raise our daughter and to contribute to our household expenses. And considering he has been unable to find work in Honduras, we would likely be destitute if Isabella and I went to live with him there while waiting out the 10-year bar.

I realize this letter is much more emotional than the one I wrote back in April but the fact of the matter is that I am now living my life without my husband, raising our daughter alone and the pain and sense of impending disaster is more excruciating than I could have imagined. I can hardly think logically right now and feel as though I am only raw emotion. As I write this it is 6 months to the day since DHS received our waiver application. We were optimistic and thought he would be home by now. Our daughter is 3 months old today and has never seen her father. She has thus far lived her whole life without knowing his voice, his smell, his face or his touch. I pray that she can feel his love. My mom and brother were so concerned about how I am handling this separation that they bought Isabella and I tickets to go visit Mr. wanaads later this month. Of course, I am thrilled that he and Isabella will finally get to meet but I am filled with dread when I think about the moment when we will have to get back on the plane to return to the United States without him. I am pleading with you to please, please allow Mr. wanaads to return to us in the United States. I am desperately afraid for our future without him.

Respectfully,


wanaads

Exhibit 1 – Letter from OB/GYN
Exhibit 2 – NIH info on placental abrubtion
Exhibit 3 – Letter fro pediatric cardiologist
Exhibit 4 – Info from CA EDD on PFMLA pay
Exhibit 5 – Medical bills
Exhibit 6 – Bank statement showing withdrawal
Exhibit 7 - Bank statement showing deposit
Exhibit 8 – letter from babysitter
Exhibit 9 – Bank statements showing ATM withdrawals and phone card purchases



Addendum to Application for Waiver of Grounds of Excludability (I-601)
Claim of Extreme Hardship on the U.S. Citizen Spouse

January 14, 2009

U.S. Citizenship and Immigration Services
DEPARTMENT OF HOMELAND SECURITY
Tegucigalpa Sub Office
United States Consulate
Avenida La Paz
Tegucigalpa, Honduras

Dear Sir/Madam:

I am writing this second addendum to my original waiver application because circumstances with regard to my health and financial hardships have changed significantly since I completed the original application in April and the first addendum I wrote in November, which I have attached for your convenience. I respectfully request that you please take these additional facts into consideration when adjudicating the application for my husband’s waiver.

I. HEALTH HARDSHIPS

A. Depression
As I noted in my first addendum, I gave birth to our daughter, Isabella, on August 13, 2008 under difficult and traumatic circumstances. The depression and stress that I was experiencing before and during my pregnancy have not abated but have grown worse during my postpartum period, particularly since we visited Mr. wanaads in Honduras in November. Reuniting with him even for just a week and seeing him with our daughter was wonderful, but since we returned I’m experiencing depressive symptoms more acutely than ever. I’m including a letter written by my psychologist to my insurance company outlining the issues she’s been treating me for during the past 10 months. (Exhibit 1.)

Having been to Honduras twice now and seeing exactly where and how we would live should I be forced to move there with Isabella to wait out Mr. wanaads’ 10-year bar leaves me nearly paralyzed with fear about our future. I mentioned in my original letter that we would live with my mother-in-law in the town of Pespire. She actually lives in a one-room wooden cabin in the mountain village of Las Crucitas. She is clearly one of the poorer residents in the village, as she does not have any cows or even corn, as many others in the area do. She has just a few chickens and often relies on the charity of nearby relatives for food. There is absolutely no work there for Mr. wanaads or for me. He has spent some time in Tegucigalpa looking for work during the past 8 months with no luck. He currently helps neighbors in Las Crucitas in exchange for food. If Isabella and I lived there permanently, I do not think there would be enough to go around. I don’t know how we would keep ourselves and our daughter regularly fed, much less clothed, educated, healthy and all of the other normal things that are almost a given living here in the United States. In addition to my fear about the impoverished state we would surely be living in is my overarching fear about raising my daughter in Honduras when she has every right to all the benefits and privileges of growing up in the US. All of the statistics and facts I included in my original letter are still current and relevant with regards to health, medical care, education and crime in Honduras. I am literally panic-stricken when I think of Isabella spending her childhood years in Las Crucitas and find myself more torn than ever about what will happen to us if Mr. wanaads is not allowed to return to the US. I believe with all my heart that our family is sacred and needs to be together but I agonize over whether moving to Honduras would be fair to our daughter.

Seeing how Mr. wanaads is living and knowing that this is the fate that awaits Isabella and me if he is not allowed to return to us has made me sad beyond words. And as the days pass living here without him, watching our daughter grow more and more into an alert and aware child without her father, I am filled with a sense of despair. My friends and family have expressed serious concern about my ability to take care of Isabella when I am in this state (Exhibit 2). My worry about the effect of my mental state on Isabella in both the short and long-term only serves to exacerbate the extreme pain and despair that I am already feeling. As noted in Exhibits 5 and 6 in my original letter, children of depressed mothers are at increased risk for both mental and physical disorders. This weighs on me heavily and I am beginning to wonder how much longer I can care for her on my own. I am experiencing several symptoms of postpartum depression including a sense of failure for bringing Isabella into a situation where both of her parents are absent from her daily life. With Mr. wanaads in Honduras and me out of the house 50-60 hours a week due to work and my commute and crying and depressed when I am home, this is hardly the life I wanted to provide for my child.

I am also experiencing significant insomnia, often getting only 2-3 hours of sleep a night. I lay awake every night missing and worrying about Mr. wanaads and stressing about money and my family’s future. During the day, I often feel as though I’m walking around in a haze, unable to connect with the people around me. It is taking a toll on my work performance and, with recent layoffs at my company and rapidly rising unemployment in the U.S. and California in particular (Exhibit 3, page 1), I’m extremely worried about my job security if I am not able to get a handle on my depression. My boss has already arned me about my diminished performance (Exhibit 4). I’m barely able to eat and have lost a considerable amount of weight, weighing less than my pre-pregnancy weight since November. These are all symptoms of postpartum depression as outlined in Exhibit 6 of my original letter.

In addition to these depressive symptoms, I continue to have an extremely high level of stress. I have been living with my mother since I returned to California in February as I have been unable to save money for moving costs and rent. Though I have been very grateful that my mom was willing to help me out in this way, she was working out of town during most of this time, leaving me to care for Isabella on my own for al but 5-10 days a month. I have felt extremely isolated and frustrated to the point of being scared at time while learning how to care for Isabella. I have also experienced a loss of identity and independence. As I noted in my original letter, I had previously supported myself and lived on my own for 15 years. Being back in my mother’s home, not being able to fully support myself and Isabella and feeling completely alone has caused me to feel great anguish and shame. And now, sadly, my mother has been laid off from her job (Exhibit 5) and is finding herself unable to pay the full rent on her apartment Due to the financial hardships listed below as well as in my original letter and my first addendum, I am unable to contribute to our household expenses. I am in agony over my inability to help my mom and, of course, scared to death that she, Isabella n I will be out on the streets soon.

I am simply in constant state of stress and depression. I am worried about my husband, my daughter, my mom, my job, my bills, my health, my living situation. I have no relief in any corner of my life and due to my insomnia am not even able to rest my mind and body at night.

Though I might still be experiencing some of these symptoms if Mr. wanaads were able to return, having the love and support of my husband on a daily basis, knowing that we did the right thing to get him here legally, and simply having him by my side raising our daughter together and having my family reunited here in my home, the United States, would certainly alleviate a great portion of the stress and depression I am currently experiencing.

B. Breastfeeding Problems
I chose to breastfed Isabella for several reasons, most importantly because I believe it is healthier for her than formula and it is also considerably less expensive, eve after factoring in the cost of a breast pump and other accessories needed to continue breastfeeding after returning to work (Exhibit 6). Unfortunately, shortly after Isabella was born, I experienced problems feeding her and suffered fro plugged ducts and bleeding nipples. My doctor recommended that I see a lactation consultant, which I did (Exhibit 7). She gave me advice about how to clear up the plugged ducts as well as how to position Isabella to avoid continued problems. As a result of these problems so early after her birth, I feel that Isabella and I had trouble bonding. The stress of caring for a newborn alone was difficult enough but due to these problems, my stress was greatly increased because I was never sure if she was getting enough to eat and felt that I had failed her at the one thing that was supposed to come most naturally to me. She is what is considered to be a fussy baby and had colic for several months. I can’t help but feel that this is at least partially due to the nursing problems and the lack of bonding because of them. While I only experienced plugged ducts a few times since then, milk production on my right side has never returned to normal and Isabella often has trouble feeding from that side. I continue to worry that I am not adequately providing for her and that she experiences frustration when she feeds, this interfering with what should be bonding time for us both. I have considered switching to formula just to be sure she’s getting enough to eat but, honestly, I just cannot afford it. She will be starting on solids soon and I can only hope and pray that the difficulties we’ve had with nursing do not cause her to have additional feeding issues and that we can overcome the rough start. Though taking care of her properly is becoming increasingly difficult as the stress I am under compounds.

C. Pregnancy over 35
Though I noted the circumstances of Isabella’s birth in my first addendum, it bears repeating that Mr. wanaads and I would like to have more children. However, as I am now nearly 39 years old, I am at significantly increased risk for problems during pregnancy and/or delivery due to my advanced maternal age (as outlined in my original letter) as well as the fact that I experienced complications during Isabella’s delivery. The choice between an elective Caesarian section, which can pose serious risks to both me and the baby, or a regular labor which my doctor says would require additional monitoring (as noted in my first addendum) is one that I would not want to face in Honduras, particularly when I know we would not have money to pay for the best medical care available there.

I have excellent medical insurance here in the United States and when Isabella was born, we were fortunate enough to be cared for by an excellent staff of doctors, nurses and midwives at Cedars Sinai hospital, one of the best in the nation. Knowing that I am at highly increased risk for complications with a subsequent pregnancy is frightening enough, but going through it even at the best hospital in Honduras, where care is sub-standard, I don’t speak the language and I would not have money to pay for the best possible care is something I can’t even bear to think about. Thus, I believe a move to Honduras would mean the end of my dream to expand our family. I simply could not bear the risks.

Mr. wanaads missed the latter part of my pregnancy with Isabella and, of course, her birth. One of the only things that kept me going was the belief that we would, hopefully, one day be able to experience those precious moments in a couple’s life together with another child. If Mr. wanaads is not able to return to the US for 10 years and I stay, it will be too late for me to have more children. And as I explained above, the risks of a subsequent pregnancy and labor in Honduras given the state in which we would be living are, I feel, too great. The thought that Mr. wanaads and I will not be able to have more children, something we’ve talked about since we met, leaved me despondent and overwrought.

II. FINANCIAL HARDSHIPS

A. Childcare Expenses
I outlined several of the additional financial hardships I am currently facing in my first addendum. There have been a few significant changes since I wrote it. Most importantly, as I mentioned above, my mother was laid off in December. Though she was gone most of the time due to work travel, she did work from home several days a month, thus allowing her to help out with caring for Isabella when I returned to work and relieving me of the additional childcare expense. She has since taken a temporary, lower paying teaching position that requires her to work full-time away from home. Therefore, I need full-time childcare. As noted in Exhibit 8 in my first addendum, my babysitter charges $xx per hour. Including my commute, Isabella is usually with her approximately 50 hours a week, costing me $xxx per week or $x,xxx per month. As noted in my original letter, I make $xx,xxx per year, bringing home approximately $xxxx per month. Of course, as I mentioned in my original letter, I also have other bills to pay, most notably $xxx per month for my federal student loans. I also have to pay car insurance and a phone bill as well as daily expenses such as gas and food. And I now have the additional expense of doctor co-pays, clothes and accessories for Isabella. I use cloth diapers through a diaper service because it is cheaper than disposables but still costs $xx per month (Exhibit 8). Just the childcare costs, student loans and diapers are $x,xxx – more than I bring home with absolutely nothing left to even pay for gas to get me to work. In short, these childcare costs are simply unsustainable for me. As I mentioned in both previous letters, if Mr. wanaads were able to return, he would take care of Isabella during the day and work a part-time job some nights or on the weekends to help with expenses. In the meantime, I’m looking for a more affordable childcare solution but have yet to find anyone willing to accept less than what I’m currently paying. But I certainly do not want to bargain shop for childcare and I am beginning to question whether it’s worthwhile for me to work at all given the enormity of this expense.

Additionally, I have been unable to send money to Mr. wanaads since my mother lost her job due to the increased childcare expenses and can only talk to him a few times a week for just a few minutes in order to save money on phone cards. This, of course, causes me tremendous worry about whether he has money for food and deprives me of the benefit of regular communication with him at a time when I need him the most. I have a total of $x,xxx in unpaid medical bills stacking up (Exhibit 9). I still owe the IRS $x,xxx for our 2007 taxes (Exhibit 10) and will surely owe money in taxes due to the IRA distribution I was unable to repay last year (as noted in my first addendum). I am in dire financial straits in spite of the fact that I make a decent living. If Mr. wanaads were here, we could eliminate the childcare expenses altogether. Our daughter would be in the care of one of her parents every day and we would at least be able to get by. At the rate I’m going now without his help, financial disaster is literally weeks away for me, if not days. I will very soon be faced with the decision to either pay the babysitter or pay all the rest of the bills. Add to this the situation with my mother’s lay off and potential eviction from her apartment and we are very near destitute. I have no answer as to how to solve this problem other than to allow Mr. wanaads to return. My going to Honduras would only deepen my financial problems as I would be unable to work (as noted in my original letter). Unemployment in Honduras is at an incredible 27.8% (Exhibit 11, page 8). Mr. wanaads tried regularly to find work in Tegucigalpa to no avail. As awful as the living conditions are at his mother’s home, it is at least a free place to stay and the neighbors and relatives are kind enough to provide some food to them. At least for the time being, I have a good job here in the United States and make enough money to support my family if it were intact. But with Mr. wanaads gone, I simply am not making it. I need him back.


III. SUMMARY

I have tried to outline here and in my first addendum how my circumstances have changed for the worse since I wrote my original letter. Mr. wanaads and I have been blessed with a beautiful baby girl but raising her on my own and living without my husband has proved to be more difficult and painful than I could have imagined before she was born. I am now experiencing ever worsening symptoms of depression and am worried about my daughter’s welfare as well as my own. My job is potentially in danger due to my inability to concentrate and socialize on the most basic level and I am developing a full-blown paranoia about the possibility of having to live in Honduras in order to reunite my family permanently. In addition to all of this, I am on the brink of financial ruin due to childcare costs that could be completely eliminated if my husband were able to return.

Taking into account the hardships outlined in my original letter, my first addendum and this second addendum, they are, individually and when combined and interacting, undoubtedly severe. Though the enormous strain of worrying about the outcome of this decision, being separated from Mr. wanaads and raising our daughter alone constitute very powerful hardships on me, the other hardships on top of these culminate in me being potentially and actually subjected to extreme and unusual hardship.

Based on the circumstances I have outlined above, I respectfully request that you take into consideration the extreme hardships I will endure if I have to live in Honduras in order to be with my husband or in the United States without him and that you allow this application for a Waiver of Excludability and grant Mr. wanaads the privilege of joining me and Isabella in the United States of America.

I appreciate your time and attention in this matter.

Respectfully,


wanaads


Exhibit 1 – Letter from current psychologist
Exhibit 2 – Letters from family and friends
Exhibit 3 – CA EDD Press Release on current unemployment rates
Exhibit 4 – Letter from boss
Exhibit 5 – Mom’s termination letter
Exhibit 6 – Receipts for breastfeeding supplies
Exhibit 7 – Bill from lactation consultant
Exhibit 8 – Diaper service bill
Exhibit 9 – Medical bills
Exhibit 10 – Tax bill
Exhibit 11 – CIA World Factbook

[Jardinera]

Download the original attachment

Mr. Klame1983

Husband of U.S. Citizen, Klame1983

Case Number: TGG200*******

I-601 Application for

Waiver of Grounds of Inadmissibility

Table of Contents

TAB 1. Form I-601 Application for Waiver of Grounds of Inadmissibility;

TAB 2. Updated Form G-325A for Mr. Klame1983;

TAB 3. Personal statement of Extreme Hardship by applicant Mr. Klame1983 U.S. Citizen
Wife, Klame1983;

TAB 4. Photos of Mr. and Mrs. Klame1983 with family;

TAB 5. Medical records, *********, M.D., diagnosing Klame1983's Bipolar
Disorder;

TAB 6. Letter, **********, M.D., discussing Klame1983's Bipolar/Manic
Depressive Disorder;

TAB 7. Article, Bipolar Disorder. National Institute of mental Health (USA),
Available at: <www.nimh.nih.gov>;

TAB 8. Article, Mental Health and Mental Health Care in Latin America. World
Psychiatric Association, available at: <www.pubmedcentral.nih.gov>;

TAB 9. Copy of Medical Insurance Card;

TAB 10. Letter, ************, M.D., discussing Klame's PCOS (Polycystic Ovarian
Syndrome);

TAB 11. FAQ, Polycystic Ovary Syndrome (PCOS), U.S. Department of Health and Human
Services, Office on Women’s Health, available at: <www.4women.gov>;

TAB 12. Medical records, *********, M.D., diagnosing Klame1983's Cervical Dysplasia;

TAB 13. Article, Cervical Dysplasia (precancerous changes of the cervix), Medline Plus,
U.S. National Library of Medicine, available at: < www.nlm.nih.gov>;

TAB 14. Country Conditions, Honduras – Medical Facilities and Health Information and
Medical Insurance, U.S. Department of State, available at:
<www.travel.state.gov>;

TAB 15. Diploma, Bachelor of Arts Degree; *****University, *******, Texas;

TAB 16. (LSAT) Law School Admission Test admission ticket for the exam of December 6,
2008;

TAB 17. Letter from ******* *****, Executive Director of ******** (employer of Mrs. Klame193);



TAB 18. Letter from ***** ****** LMSW, M.Div. Co-Founder: The ********, ***
I*********, agency of the *********************,
(employer of Klame1983);

TAB 19. Letter from attorney **** *****, Chair of The _________
Board of Advisors, agency of the ************
detailing Klame1983's value to the organization and to the *******,
Texas community;

TAB 20. Account Statements, ************ and ********* showing
student loan debt totaling $*****;

TAB 21. - Letter of Support from family members ***** and ********, Klame1983's
parents and Mr. Klame1983's parents-in-law, with proof of their LPR status in the
U.S.;
- Letter of Support from family member *******, sister of Klame1983, sister-in-
law of Mr. Klame1983, with proof of her U.S. Citizenship;
- Letter of Support from family member *********, sister of Klame1983, sister- in-
law of Mr. Klame1983, with proof of her U.S. Citizenship;

TAB 22. - Letter of Support from Pastor **********, former pastor of (name of church)
and friend of Klame1983 detailing the value she is to the
American society;
- Letter of Support from ************, lecturer B******* University and
friend of Mr. and Mrs. Klame1983;

TAB 23. Letter of Support from Pastor ********, (name of church)
detailing Klame1983's involvement in the community and the
need for her husband’s support;

TAB 24. Letter of Support from ********, Board Member, Community Race Relations
Coalition, detailing Klame1983's value to the ********, Texas community;

TAB 25. Statement from applicant, Mr. Klame1983.




October 29, 2008
United States Embassy, Visa Unit
Av. La Paz, Apartado Postal 3453
Tegucigalpa, Honduras
Via Hand Delivery at Scheduled Interview Date/Time
RE: Immigrant Visa Case of Mr. Klame1983
Case Number: TGG200*******
I-601 Waiver of Inadmissibility

Dear Sir or Madam:



I, Klame1983, in support of my husband ***********, I-601 Waiver of Inadmissibility, write this letter with high hopes that it will be approved and my husband will be granted admission to the United States of America.
I met (husband) on March 27, 2004 when I was a sophomore at ****** University. I worked tutoring in a middle school and one of the students I tutored introduced us, as she felt we were perfect for each other. To my amazement, that 12 year-old girl was correct. We started dating five days after we met and got engaged two months afterwards. Shortly after my graduation, we got married on June 17, 2006 in my home-town of *******, New Mexico (See Exhibit 4).

I could not imagine my life without (husband). My husband and I are very close, and although I would suffer extremely by not being physically with him, I will suffer even more severely in other areas. This extreme hardship would be reflected in the following areas: Health, Education, Employment, Finances, Family and Community ties, Safety, as well as other personal considerations. As I will further go into detail, I would not be able to move to Honduras to be with him; however, I need him in the U.S. with me. Please carefully consider a favorable decision on this case.





I. Health
I absolutely need to remain in the U.S. and need my husband to continue living with me in order to continue treatment for my Bipolar Disorder, Polycystic Ovarian Syndrome and Cervical Dysplasia.

A. Psychiatric Health

Since early childhood, I have been aware that psychiatric health problems have been evident in my mother’s side of the family. I know both of my grandparents and one aunt suffered from Clinical Depression and other Psychotic Disorders. I never met my maternal grandfather, as he died as a consequence of his severe mental disorders.



While I was a senior at ****** University in 2005, I was unfortunately diagnosed with Bipolar Disorder, also known as Manic-Depressive Disorder. I was placed under the care of psychiatrist, Dr. ******** and put on a medication called Lamictal (See Exhibit 5). I was treated with psychotherapy and with medication throughout the remaining of my senior year. Having access to top quality psychotherapy and medication was indeed of great benefit to me, as my symptoms were put under control and I began to live a normal life. However, shortly after graduating from college; in the summer of 2006, I was not able to afford medical insurance, and as a result, I had to stop my treatment. Without treatment, my symptoms returned even more severely from 2005.



In late 2007, my husband and I returned to live in ******* TX, where I began a new job with great medical insurance, so I began to receive treatment again from a new psychiatrist, Dr. ******** (See Exhibit 6). Due to the break I had in treatment, Dr. ********** doubled the dose of Lamictal I had been taking in 2005-2006, increasing it to 150mg. Once again, the medication regulated my symptoms, and I was able to live a productive life.



Bipolar Disorder is a mental illness that affects a person’s entire life. According to the National Institute of Mental Health, (See Exhibit 7) Bipolar Disorder is a “brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide… Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life”. Without proper treatment, this illness can have major consequences such as hospitalization and even suicide.



Thank God, my husband has always been with me, both physically and emotionally, to help me go on with the every day activities and to overcome the problems Bipolar Disorder brings. Mr. Klame1983 is a wonderful husband who truly understands this disorder. When there are days that I am on the depressive side, I have an extremely difficult time waking up in the morning and getting ready for work. Patiently and caringly, he motivates me to get up by saying positive and encouraging words. He makes me breakfast every morning to help relieve some stress I may be feeling. Also, he always helps me stay well by doing everything he can to help me avoid stressful situations. He always has something positive that always seems to brighten up my day. His tender care is what truly motivates me to keep getting treated.



According to Dr. *********, “If Ms. Klame1983 has to remain separated from her husband she also risks losing her support system (which for patients with Bipolar spectrum illness is quite important in managing their illness)”. Consequently, losing my immediate support, being my husband, there is a high probability that my illness will worsen. The inevitable separation that I will have to endure throughout this immigration process will certainly be a major stress event.



As per Dr. ******* letter, “Individuals with Bipolar Disorder risk relapse even with appropriate and aggressive monitoring of their medication. A patient who travels to a country such as Honduras, which would not likely have the sophistication and treatment of mental illness as this country, risks decompensation and destabilization. I do not specifically know about the state of psychiatry in Honduras but I suspect that it lags behind the current treatment strategies available in the United States, perhaps by several decades”.



According to the Official Journal of the World Psychiatric Association (WPA), (See Exhibit 8) “human mental resources in Latin America are very scarce. The estimated figures of 1.6 psychiatrist, 2.7 psychiatric nurse, 2.8 psychologists, and 1.9 social workers per 100,000 are far below those of Europe or the US… needless to say, insurance coverage is minimal… their (mental health professionals) training takes place in insufficient facilities with limited teaching staffs, scarce equipment, and loose monitorization by academic centers or governmental agencies”. These observations only confirm Dr. ********* comments. Therefore, it is evident that I would not be able to move to Honduras without losing access to excellent medical care and risking decompensation as per the comments above.



My current job provides excellent medical insurance that helps me to be able to afford my treatment (See Exhibit 9). Likewise, I need my husband to be with me in the U.S. so he can provide me with the support and attention I need. There have truly been times in which my Bipolar Disorder has taken a turn for the worse, but thankfully having my husband by my side, as well as having access to excellent medical care and medication, my disorder has been controlled. It would undoubtedly cause me extreme suffering if I had to move to Honduras or remain in the U.S. without him.





B. Polycystic Ovarian Syndrome
Recently, in May 2008, I was diagnosed by Dr. *********** with Polycystic Ovarian Syndrome (PCOS) (See Exhibit 10). According to the U.S. Department of Health and Human Services, Office on Women’s Health, “polycystic ovary syndrome (PCOS) is a health problem that can affect a woman’s menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance” (See Exhibit 11).


As per Dr. ******** letter, “Mrs. Klame1983 has a condition known as PCOS which requires treatment and monitoring that I believe would be best handled in the US. It renders her susceptible to diabetes, infertility, as well as hypertension”. I am currently taking medication for this condition. Since my diagnosis, Dr. ******** has prescribed a medication called Metformin, as well as oral contraceptive hormones. As per Dr. ******** letter, this medication must continue to be monitored.



It is in mine and my husband’s best interest that I continue receiving this treatment, as even with treatment, the risk of infertility is very high. Both ****** and I have always wanted to have children of our own; however, if I relocated to be with him in Honduras, I would have to suspend my treatment, increasing more the chances of never being able to get pregnant. We have been married for two and a half years, and although we would love to have children, we have not done so because we want to establish ourselves first; however, even if we decided to have children now, it would be extremely difficult to do so, as per this condition.





C. Cervical Dysplasia
In March 2007, I was diagnosed with Cervical Dysplasia, also known precancerous changes of the cervix as well as abnormal cervical cells/low grade squamous intraepithelial lesion (LSIL) (See Exhibit 12). According to the U.S National Library of Medicine and the National Institutes of Health, “cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Although this is not cancer, this is considered a precancerous condition” (See Exhibit 13).

It is necessary to have “consistent follow-up, usually every 3-6 months or as recommended by their provider” for this type of abnormality, “without treatment, 30-50% of cases of severe cervical dysplasia may lead to invasive cancer. The risk of cancer is lower for mild dysplasia” (See Exhibit 13). Although I was diagnosed with mild dysplasia and for the moment its presence is not evident, it must continue to be observed as, “the condition may return” (See Exhibit 13) even after having normal test results. Moving to Honduras would result in not having access to excellent medical care to maintain the observation of it.



In conclusion, as per the U.S. Department of State “support staff facilities and necessary equipment and supplies are not up to U.S. standards anywhere in Honduras. Facilities for advanced surgical procedures are not available. Wide areas of the country, including the popular tourist areas of the Bay Islands, do not have a general surgery hospital” (See Exhibit 14 Pg. 3). I would not be able to move to Honduras due to the lack of advanced health care. It is extremely important that I treat all of my illnesses. I take medication daily for them, as without it, the conditions would have devastating effects. I need my husband, Mr. Klame1983, by my side as I need a strong support network. He is the only family that I have in the city we live in. I consider health care to be the most important part of a person’s life.





II. Education
I must remain in the United States to carry out my goal of attending law school. I need my husband by my side in order to have the emotional and financial support.



My family and I emigrated to the U.S. from Mexico when I was five years old. My parents’ dream was for me to receive the best education possible. During grade school, I was an excellent student and I graduated high school in May 2002 with honors and ranked third in the graduating class. I then received a full-scholarship from a private foundation to attend the University of my choice. My dream was to attend ******* University. With great pride, I was the first to attend and graduate from college from my immediate and extended family. In May 2006, I graduated with a Bachelor of Arts degree in International Studies and Spanish (See Exhibit 15).
Although I have achieved an important academic goal, my life-long goal has been to attend law school. I am currently registered to take the Law School Admissions Test (LSAT) on December 6, 2008 (See Exhibit 16) and I plan to start law school the fall semester of 2009.



I cannot move to Honduras because I must continue pursuing a professional degree. Likewise, I desperately need my husband by my side in the U.S. to provide me with the emotional and financial support. It would be highly impossible for me to attend law school without my husband as I would not have the emotional, mental and financial stability to study. I would have to remain working full-time to support myself if he were not here. My husband has always been very supportive of my educational goals. He is my number one fan, always supporting and motivating me more than anyone else. I need to further my education in order to be able to provide my family a better future.





III. Employment
I deeply care about the American society. Most of my jobs have been in the non-profit sector; working diligently and caringly to help those that are in unfortunate situations. I absolutely love making a difference in my community, no matter in what the type of work it is. I currently hold two jobs in non-profit organizations.



I am currently employed part-time by ******* ******** **** as a Housing Counselor (See Exhibit 17). The focus of this non-profit organization is to revitalize communities through economic and housing development. As a housing counselor, my role is to mediate between different entities such as the client, the local government, and mortgage lenders, to help low-to-median income families achieve their goal of homeownership. My position requires special and on-going training, as it is an industry that is frequently changing. I am required to attend national trainings frequently so I can receive continuing education on the mortgage business. My job is very specific to the U.S., but even more so to my community. Honduras’s housing industry is completely different than that of the U.S. I would not be able to keep working in this industry there, as my training is irrelevant in any other country. The knowledge that I have in the housing industry of the U.S. would not be a marketable job skill in Honduras.



I have also recently started working full-time as Program Manager at the ************ (See Exhibits 18 & 19). This organization is a faith-based, non-profit organization which provides holistic services to immigrants; legal and social services. We empower immigrants to be active agents in changing their lives and assimilating into the American society. I accepted this job largely due because it is an excellent avenue to my preparation for law school. I have recently applied for full accreditation from the Board of Immigration Appeals. Once the accreditation is granted, I will be able to represent individuals in cases before the United States Citizenship and Immigration Services (USCIS) as well as the Executive Office for Immigration Review (EOIR). As **********, attorney and chair of this organization states, “Ms. Klame1983's extensive knowledge of U.S. immigration law will not be a marketable job skill in Honduras” (See Exhibit 19).

Inevitably, relocating to Honduras would cause me to lose both jobs. I have worked very diligently to gain experience in both careers. They are jobs that I love working in; however, these job skills are not marketable in any other country. My husband, as in every area of my life, has been very supportive of me taking on both jobs. I work approximately 65 hours a week, but with his help, I am able to be productive in both my professional and personal life.





IV. Financial
As I learned in a Latin American Studies class in my undergraduate education, Honduras is one of the poorest countries in Latin America. As you know since I perceive you must be living in Honduras, the employment opportunities there are not very good. I have absolutely no idea what I could work in if I had to live there. Although I did receive a full-scholarship to pay for my undergraduate education, my parents were unable to provide me with financial support; therefore, I had to resort to student loans to cover other expenses not covered by the scholarship. I currently owe $***** in federal and private student loans (See Exhibit 20). It would be impossible for me to pay back these loans if I had to live in Honduras, due to the lack of resources. Furthermore; mine and my husband’s goal is to purchase a home in the United States. We have not done so due to many current uncertainties, such as this immigration situation, as well as me continuing my education in law school. It would be very difficult to make a good living in Honduras, causing me severe hardships.





V. Family & Community Ties
More importantly, my entire family lives in the U.S. Despite the physical distance between us, I am very close to my parents and sisters, as well as my extended family (See Exhibit 21). I speak with both of my sisters and parents numerous times a day and visit them every few weeks. I have never gone more than one month without seeing them even though they live more than 400 miles away. My husband, Mr. Klame1983 plays a major role in my family’s life. For example, my younger sister got pregnant earlier this year. She is single, 22 years-old, and a senior in college. Mr. Klame1983 has helped her accept this unexpected pregnancy in means of moral and economic support. Both my husband and I have helped her with living expenses and paid for numerous items for the baby’s arrival. My parents, as well as my youngest sister are very close to him. He is not a son-in-law to my parents, but really as a son. My parents only have 3 daughters, so him coming into their lives is as if he is a new son to them. Mr. Klame1983's generous heart is always moved to help any of my family members. I have an 87 year-old ill grandfather and every time we go visit him in New Mexico, Mr. Klame1983 either pays his groceries or gives him money. It would break my heart to leave my family in the U.S. and part to Honduras. It would ultimately cause me severe suffering, as it would them as well. They have all grown to love Mr. Klame1983, as he loves them. If the family were to be divided due to geographical distance, all involved would suffer extremely. I have no family or friends in Honduras. All of my family and friends live in the United States (See Exhibits 22).


I am also very involved in the community. Aside from both of my jobs in the non-profit sector, I also volunteer weekly. I teach a civics/ESL class every Tuesday night to adult immigrants interested in learning more about their new country (See Exhibit 23). Also, I am a member of ************ Church. I have been attending there since my freshman year in college, making it almost a total of six years (See Exhibit 23). I am also a member of the Community Race Relations Coalition (See Exhibit 24). I volunteer many hours a month to raise awareness of issues different races have. I primarily volunteer with the immigration committee of this coalition, since most of my knowledge deals with immigrant issues.



My family and community are very important in my life. My entire life revolves around them. I would lose all the close relationships I have build with my community as well as with my family if I were to move to Honduras. I need to remain in the United States with the company of my husband in order to continue serving those in need in my community, but more importantly so I can remain in close proximity from my family. As you can see in the letters from my family and other community leaders, my presence is greatly appreciated and needed. Not only would I suffer extreme hardship, but so would they as I am also a very important of their lives.





VI. Safety
As per the U.S. Department of State, “Crime is endemic in Honduras and requires a high degree of caution by U.S. visitors and residents alike. U.S. citizens have been the victims of a wide range of crimes, including murder, kidnapping, rape, assault, and property crimes” (See Exhibit 14 Pg.2). I would not feel as safe in Honduras as I do in the United States.





VII. Good Character of Applicant Mr. Klame1983
Although I am aware the extreme hardship must be proved for the U.S. citizen, I would like to mention the good character of my husband. He is sibling number 11 of 14. At the age of 12 his mother passed away and his father abandoned the family. Since then, he has had to provide for himself. He grew up alone and in extreme poverty. Although he did not have a family’s support, he continued to attend school. He studied English in Honduras and is now completely fluent in the language. He has also taken on the task of receiving his GED and has now passed 4 of the 5 required exams to obtain his certificate. If he is allowed to return to the U.S., he plans on pursuing a college education in the medical field. My husband is a wonderful human being and very admirable. He regrets the way in which he came to the U.S., especially because he was unaware of the consequences it would have on his future wife (See Exhibit 25). Mr. Klame1983 would be an excellent asset to the American community.





Conclusion
In conclusion, it is of the upmost importance that my husband’s I-601 Waiver of Inadmissibility be granted so he can return to live with me in the United States of America. Although I emigrated from Mexico when I was five years old, the U.S. is the country that I consider to be my home. My entire life is in the U.S. My medical conditions can only be treated in the U.S. without putting my life at risk. I have received all of my education in this country, and plan on furthering it here as well. I have absolutely no family or friends in Honduras. All of my family lives in the U.S. As I have been able to prove, I am a valuable asset to my community and I have worked very hard to overcome many obstacles to obtain the education, jobs, and leadership positions I now have. I urge you to please approve this waiver. I am unable to move to Honduras. I need my husband to live with me in this great nation. We have many goals for our future, but all of those goals require living together in the United States. Thank you for considering my request.

[jeialeigh]

I truly believe that this letter was one of the deciding factor's for the adjudicator (well, this and the NASTY pics I sent of huge holes in my leg, wound vac therapy, maggot therapy - gross right!!). A picture in this instance was worth a thousand words, but anyway - Without this I'm not sure we would have had such a positive outcome. I included this letter w/ the original packet and used it during my multiple expedite requests to several ppl.

I just wanted to share this with others. The medical issues here are likely not applicable to anyone here, or at least very very few so I feel fine w/ sharing this information as a guide for what to request from your doctors. I have bolded/underlined/italicized the parts I felt were vital to this letter and that really strengthened our arguments. PM me if you have any questions...

Oh and mods feel free to move this to a more appropriate section, but it's not often ppl actually share their evidence - only a title or description thereof. So I wasn't sure where it should go!


November 23, 2009
To Whom It May Concern
RE: JEIALEIGH

JEIALEIGH has been treated in this office for over 10 years because of genetic, congenital conditions involving
both her knees. She has an increased Q angle of both knees which predisposes her to chronic, recurrent patella dislocations.

The right patella dislocation was so significant that it required a realignment procedure approximately eight years ago which had done a good job in terms of aligning her patella without dislocations until roughly one year ago when she presented with recurrence of right patella (knee cap) dislocations.

A confounding problem, however, is the fact that her left knee approximately one year ago began having recurrent dislocations as well. The left knee until this time had no surgical treatment. Because the left knee had a series of relatively new dislocations, however, it was decided that a realignment procedure to the left knee would be required as well.

In April 2009, JEIALEIGH underwent a soft tissue patella alignment procedure on the left knee. Unfortunately
through a series of unforeseen circumstances, the patient had postop complications which included but were not limited to a large three-cm diameter area of full-thickness tissue necrosis on the inferolateral aspect of the knee. This required frequent dressing changes and local wound care including wound vacuum techniques. The patient continued having multiple infections requiring multiple drainage procedures to the soft tissue of the ipsilateral left knee. Eventually several months ago she underwent skin grafting which, for the most part, has done okay with respect to her wound coverage. However, she has still developed recurrent soft tissue abscesses which require drainage in the office. Additional work up recently has included MRI scan which demonstrated soft tissue abscesses as well as possible patella osteomyelitis and possible patella fractures as a consequence thereof.

During the rehabilitation from her latest procedure in April 2009, her husband was instructed to assist her in dressing changes as well as to provide the technical requirements to attend to a wound vacuuming procedure. The patient was seen in the office on a weekly basis essentially since April 2009 for local wound debridement as well as incision and drainage of multiple soft tissue abscesses to the left knee which has required local dressing care on a daily basis as well.

Her husband was instrumental in his initial treatment of her obvious wound complications. However, his absence during the later stages of her left knee wound care has been obvious. She has required wound vacuum procedures, multiple open drainages of abscesses, all of which required local care to the left knee which is difficult for her to reach let alone perform the technical necessities of her wound care.

The patient recently consulted an Infectious Disease specialist, and he will place her on a PICC line, because she will require IV antibiotic treatment for at least six weeks to combat whatever infectious process may be in her subcutaneous tissue possibly fed by osteomyelitis from her left patella. In addition to the local knee wound, she will also require maintenance of the PICC line on a daily basis while she undergoes multiple antibiotic doses for the six week treatment plan.

The immediate future for JEIALEIGH may well involve removing part if not all the left patella. In doing so she will be in a non-weight bearing status on that left knee for approximately 12 weeks followed thereafter by another eight weeks of physical therapy to the left knee.

Further we have not yet addressed the recurrent dislocations in her right knee which had the soft tissue procedure approximately eight years ago. The right knee treatment will involve a tibial tubercle transfer whereby the distal attachment of her patella tendon onto the tibia will be transferred medially and superiorly so as to realign the patella while at the same time reducing patellofemoral stresses. This will involve, of course, 12 weeks of non-weight bearing on the right knee as well as several more months thereafter of physical therapy for range of motion.

It is easy to foresee this patient being on crutches and in a non-bi-pedal ambulatory status for at least the next year or longer.

Aside from that particular hardship, she will also require local wound care to the left knee in spite of surgical patellectomy. All the while, of course, she will be receiving some form of IV antibiotic therapy on a daily basis at home requiring close monitoring and treatment of her PICC line access for her IV antibiotic. Additionally, the patient holds down a full-time job. Her transportation will be significantly limited by her inability to use her legs during the driving process. The patient also is currently the only caregiver to her daughter who is under six years old and requires constant attention and care. This patient obviously cannot perform these tasks alone. She has limited resources with respect to being able to pay for transportation, nursing care as well as the rehabilitation necessary over the next year or greater as we treat her knees to improve her life and ability to function as a mother and breadwinner for her family. It is a great hardship to her, and she does require the presence of her husband who prior to his absence was instrumental in her care, treatment, rehabilitation, and transportation in addition to participating in the care of their child.

DR B!!!!!!!!!!!!!!!!!! Every time I read that I am amazed at how good this letter is!!! BTW - his office is expected to receive an 'Edible Bouquet' on Monday!!!

[jeialeigh]

I agree - my ortho kicks so much butt it's not even funny. I LOVE THAT MAN!! And he is such an awesome doctor. He has the lowest post-op infection rate in the area so he was clearly distressed when this happened, to me of all people. He's been taking care of my knees since I was 15 and I'm now 29 so we've known each other for quite some time. And, he absolutely LOVES my daughter. She gets little presents like 'skeleton maps' and reflex hammers etc almost each time we go in. She has even helped the nurse give Mommy and X-RAY... but I digress...

He charged me NOTHING for this letter. I realize that many of us aren't so lucky, but I also wrote him a little letter explaining exactly what it needed to say w/ regard to the importance of hubby's presence, post-op difficulties, etc.

I still sit here utterly AMAZED that we got an expedite especially considering all we overcame w/ regard to hubby's past. No CDC waiver, a psych eval (which hubby admitted he had the Dr almost in tears going through the pics, etc.).

IDK - perhaps it was the picture with a 3 inch diameter hole in my leg showing my tendons covered w/ MAGGOTS eeeekkkkkk that got the job done. Maybe they thought "OMG are those maggots?! This woman has got to be CRAZY to do that we've gotta send her husband home before she comes down here with those MAGGOTS!!"

Anyway - I digressed again back to the point! - I think that most docs have no idea what to write for this type of letter. I did get a few not so good letters, but even the letter I got from my eye doctor included that "w/out proper treatment patient will lose vision permanently, she may be treated w/ XXXx drug for # of weeks, etc."

It's important to know what you need BEFORE you ask your drs for letters. They're busy and this isn't a common request so be as specific as possible about what you want when u request.

I hope this can help those of you requesting drs letters. Oh, and I'll definitely tell him that you all think he ROCKS as much as I do!! He'll get a kick out of that!!

[jeialeigh]

Ok, I've done my best here to get this letter posted in the original formatting. For the most part this is correct w/ respect to the letter, but I cannot get the evidence lists in because I formatted them using tabs. So if you'd like to see more realistic formatting of the letter, see the link in my siggy where the letter and list are posted as close to the original as possible.

Regarding my evidence, I presented each piece in chronological order. I purged irrelevant portions of evidence and highlighted the important portions. In order to present evidence in this order I split medical records for each facility so that specific hardship evidence from each facility was presented in the appropriate section. I didn't do an overall evidence TOC; instead I did a TOC for each section (1.0, 2.0, etc) on a BLUE sheet of card stock to separate specific section's evidence. I also used a post-it sticky to label each piece of evidence (1.1a, 1.1b, 1.1c, etc.).

I think contrary to the approach of some I decided in favor of a longer letter that would fully explain my various hardships. I put myself in the adjudicator's place and though - would I really want to flip back and forth between letter and evidence to figure out unfamiliar terms, conditions, etc.?? Since my medical hardships aren't fairly common I spent considerable time explaining medical terms, conditions etc to make the letter easier to get through. Overall the letter was about 14 pages 1.15 spaced at a 12 pt font. BUT - we were approved so I guess it worked in our instance.







US Citizenship and Immigration Services
c/o US Embassy in Honduras Visa Unit
Avenida La Paz
Apartado Postal 3453
Tegucigalpa, Honduras

RE: MR JEIALEIGH
Case # XXXXXXXXX
I-601 Waiver of Grounds of Excludability

Consulate Official,

I, JEIALEIGH submit this letter in support of an I-601 Application for Wavier of Grounds of Excludability for my husband MR JEIALEIGH. If my husband is not granted permission to enter the United States, I would be compelled by our strong matrimonial bond and the well-being of our family to relocate myself and our daughter to Honduras in spite of the extreme hardship I would face in doing so. I have learned of the last several years that my family is stronger together than apart, yet relocation to Honduras would result in an inability to access the medical care necessary for my numerous serious medical conditions, the loss of my employment and benefits, the endangerment of my and my family’s safety, the inability to provide quality education to our children, and the insecurity of our financial future.
My husband and I met in April of 2003 and within 3 months we both new we would be together forever. We were engaged in December 2003 just prior to my graduation from college. We were married in April of 2005 and our daughter LITTLE GIRL was born in August of 2005. We have truly been together for better or for worse and I could not ask for a better partner in life. He is a wonderful father and husband. Without his support I would not have been able to survive a move to Florida for 6 months of unpaid internships, enter a 2 year graduate program and complete it within 1 year, survive a devastating year where we both struggled to make ends meet financially, recover from a serious surgery, and many other things. We have truly been tested the last several months because of complex complications following a recent surgery. To date I am still trying to recover physically and mentally from the results of these complications and am preparing for a second surgery scheduled for December 29, 2009 followed by a long and difficult recovery and I need my husband with me now more than ever.
The remainder of this letter details the extreme hardships I would face if I were compelled by my marital bond to relocate to Honduras for the duration of the 10 year ban presently in effect for my husbands illegal presence in the United States.

Section 1 – Medical Concerns

1.1 Background Information
Due to the severity of my existing medical conditions, I require easy access to regular and emergent medical care. Individuals without medical insurance coverage in Honduras are often required to pay for services up-front and are more likely to receive substandard medical care (Exhibit 1.1a). In order to facilitate medical treatment in Honduras, I would need to purchase international medical insurance coverage. Research into international health insurance revealed my annual premiums would likely be between $1750 and $3733 (Exhibit 1.1b). The United States Department of State (DOS) reports Honduras as one of the poorest countries in the Western Hemisphere with a per capita GDP (gross domestic product) of only $1635 annually, which is less than what I earn in one month at my current place of employment (Exhibit 1.1c). Given this low earning potential in Honduras, I would be unable to purchase international health insurance or afford the up-front medical care expenses needed for treatment thus would have extreme difficulty getting treatment for my medical conditions. In addition to the issue of affordability, Honduras’ lack of adequate medical care facilities, equipment and supplies and the inability to perform advanced surgical procedures anywhere in the country also poses a serious risk to my continued health. I have several serious medical hardships including recurrent bilateral knee dislocations, pyelonephritis, eye infections, and the threat of infectious disease outlined below that could prove debilitating or even life-threatening without prompt and adequate medical care. This inability to receive proper medical care represents an extreme hardship if I were forced to relocate to Honduras for the duration of the ten year ban presently in effect.

1.2 Recurrent Knee Dislocations
I suffer from recurrent bilateral patella dislocations, more commonly referred to as bilateral knee dislocations. Patella dislocation occurs when the triangle-shaped bony covering of the knee moves or slides out of place usually toward the outside of the leg (Exhibit 1.2a). Knee dislocations, while somewhat rare, are considered one of the most serious knee injuries due to the extreme traumas normally involved in dislocations and the possible need for limb amputation due to neurovascular damage (Exhibit 1.2b). There are two causes of patellar instability: post-traumatic instability occurring as a result of significant damage sustained during an initial dislocation or developmental instability caused by a structural abnormality in the knee joint formation itself (Exhibit 1.2c). Each dislocation stretches and/or tears the ligaments and tendons that help to ensure the patella’s correct tracking and increases its instability. Surgical intervention is sometimes necessary to repair damage sustained during a dislocation or to attempt to prevent further dislocations by attempting to realign any structural abnormalities that predispose patients to recurrent knee dislocations.
I have endured 9 knee dislocations/subluxations (dislocations with spontaneous reduction of the patella), 2 reparative, and 2 realignment knee surgeries in the past 15 years of my life. These dislocations began at the age of 14 and have continued until my most recent dislocation of my right knee in September of 2008 (Exhibit 1.2d, 1.2e, 1.2f, 1.2g, 1.2h, 1.2i). Although sports or automobile accidents account for most all of this type of injury, all of but 1 of my dislocations have occurred during while simply walking. The one exception occurred when I swung a softball bat during my physical education class while in high school. It should be noted that many of my dislocations have occurred within months of each other and on three occasions I have suffered multiple dislocations of the same or both knees within little more than a month’s time.

1.3 – Previous Knee Surgeries
In 1995, I underwent arthroscopic surgery on my left knee to repair damage sustained during an initial dislocation. The first dislocation of my left knee did sufficient damage to warrant surgical repair. My orthopedist at the time, Dr. XXX, noted “severe shag (fissuring of cartilage beneath kneecap that resembles shag carpeting)” and “a large amount of chondromalacia (degeneration of cartilage under the kneecap)” and that “one could see that the patella did sit out laterally” (Exhibit 1.3a, 1.3b). Dr. XXX also noted that performing a lateral release, the simplest procedure used to improve patellar tracking and reduce the outward pull of the knee cap, was not likely to give me much advantage. Over the next five years I suffered many other dislocations that further increased my knees’ instability to the point that my knee caps just barely lie within the bony groove of the knee joint. The knees were so unstable that I could manually dislocate them simply by pressing the knee cap toward the side of my knees. Because of the high degree of reoccurrence, my then orthopedist Dr. XXX believed that more drastic measures should be taken to stabilize my knees.
In August of 2000, Dr. XXX performed a soft tissue reconstruction of my right knee (Exhibit 1.3c). In essence, Dr. XXX tightened the soft connective tissue on the inner side of my knee joint and using the excess tissue fashioned a ‘sling’ for my knee cap by stretching this removed tissue around the knee cap then re-attaching it to my thigh muscle (Exhibit 1.3d). This was an ‘open’ surgery, meaning that the knee joint was accessed via an approximately 8 inch long incision, much like those for total knee replacements. Following this surgery I was not allowed to put any weight at all on the affected leg and had to wear a full leg immobilizer for 6 weeks. For the next 6 weeks I was allowed to put partial weight on the affected leg and graduated to a hinged leg brace that would allow incremental movement. I also began physical therapy 3 times a week for 6 weeks to assist with regaining my range of motion (or bend) and strength that was lost during the initial 6 weeks following surgery (see Exhibit 1.2h in Medical Concerns – Recurrent Dislocations). Because I was not allowed to bend my knee or put any weight on the affected leg, I required a great deal of assistance during my recovery. I was unable to get in and out of bed, use the restroom, dress, or bathe myself unassisted for more than 2 months following surgery. During the first six weeks following the surgery, I could not be left alone for any lengthy period of time due to my inability to care for myself. Because the surgery was on my right knee, I was not able to drive myself at all the first 6 weeks and it was eight weeks following surgery that my doctor released me to drive. During this time I had to depend on others to take me to my doctor’s appointments and physical therapy sessions.
This realignment surgery allowed my right knee to remain dislocation free for 8 years. My left knee however, continued to dislocate many more times and in September 2008 my right knee (which had been previously surgically repaired) dislocated again (see Exhibit 1.2i in Medical Concerns – Recurrent Dislocations). This single dislocation essentially reversed all of the surgical reparations that had previously been performed. Because of this and the high degree of continued instability and dislocation of my left knee Dr. XXXX recommended that we move forward with a soft tissue realignment of my left knee followed by a bone realignment procedure on my right knee. In April of 2009, I underwent a soft tissue realignment surgery on my left knee. Unlike my first reconstructive surgery, my recovery from this surgery has been fraught with complications detailed in the following section.

1.4 – Post-Surgical Complications
As of mid-November 2009 I am still recovering from the reconstructive surgery of my left knee that occurred in April of 2009 (Exhibit 1.4a). I have endured numerous in-office and inpatient procedures, and wound therapies to attempt to resolve the complications that resulted from the surgery (Exhibit 1.4b). At my doctor and wound specialist’s requests I began to document my recovery process with pictures which I have included in Exhibit 1.4c. I have included these pictures in hopes that a better understanding of my complex medical situation and the extreme pain and discomfort I have endured for the past 7 months.
Although the specific cause has not been identified, surgical implement contamination and the malfunction of a specific piece of equipment were both factors in my post-surgical complications. During surgery, Dr. XXX placed a drain in my knee joint that was supposed to allow for the removal of blood and fluid from the joint. For some reason, the drain did not function properly and my knee joint and surrounding areas filled with blood and fluid to the extent that it restricted blood flow to the area and caused tissue necrosis (death). To alleviate this pressure Dr. XXX performed an excruciating in-office surgical procedure on 5/4/2009 to make two small openings around the joint and manually express the blood which had congealed into blood clots. The pain from this procedure was almost unbearable despite pain medications and local anesthesia. Another incision and drainage procedure was performed on 5/11/2009 which again involved manually expressing blood clots and joint fluid and was extremely painful.
To compound the issue of tissue necrosis, cultures taken during both incision and drainage procedures revealed an infection caused by a ‘bizarre bacteria’ which lead Dr. XXX to suspect contamination of some surgical tools, likely stitches that were used during the surgery. I was placed on antibiotics to treat this infection. On 5/21/2009, after noting that the skin and tissue necrosis was worsening, debrided (removed) a nickel-sized area of skin and tissue directly over the patella tendon. The following week I began 24 hour a day Wound VAC (vacuum assisted closure) therapy in attempts to granulate (fill in with new tissue) the wound bed and promote skin regeneration to cover the wound (Exhibit 1.4d). Over the next month 3 more wound debridements were performed on 6/4/2009, 6/12/2009, and 6/18/2009 because necrotic tissue was still present and the size of the wound continued to enlarge. After 6 weeks of wound vacuum therapy with little improvement, Dr. XXX and my wound therapist, XXX, RN, decided that medical maggot debridement therapy would be a good option for me to speed the removal of necrotic tissues in and around the wound bed (Exhibit 1.4e). On 7/15/2009 I began 36 hours of maggot therapy. The maggot therapy was extremely uncomfortable, both physically and psychologically, but was very helpful in removing the necrotic tissue in and around the wound. Unfortunately, acute symptoms of infection including swelling, redness and heat in the joint area, and swollen lymph glands in my inner thigh returned only a matter of days following this debridement therapy. Because of the fear of a possible septic knee, I was admitted into the hospital on 7/28/2009 by my primary care physician, Dr. XXX (Exhibit 1.4f).
On 7/29/2009 I underwent an arthroscopic debridement and irrigation of my left knee wound performed by Dr. XXX (Exhibit 1.4g). Cultures were taken of the wound and I remained in the hospital under IV antibiotic treatment until the cultures had returned and the doctor’s felt I was out of immediate danger of a septic knee. I was discharged from the hospital on 8/1/2009 under orders to continue oral antibiotic treatment for 30 days (Exhibit 1.4h). All appeared to progress well and I underwent a split-thickness skin graft performed by Dr. XXX on 8/20/2009, the day after my husband left the country for Honduras (Exhibit 1.4i). I remained on antibiotic treatment for 2 weeks following the skin graft procedure, but almost immediately following the discontinuation of antibiotics signs of infection returned and have continued intermittently since that time (Exhibit 1.4k). On 9/15/2009 I underwent another in-office procedure, a mini-arthrotomy, and my knee was again cultured and I began antibiotic treatment yet again on 9/18/2009 (Exhibit 1.3g). The results on the cultures taken on 9/15/2009 showed no infection of the joint fluid and Dr. XXX concluded that the joint itself was well but the soft tissue surrounding my knee had abscessed and that I was receiving proper treatment. However, in mid-October symptoms of infection again began to present and I returned to my orthopedist and was again placed on antibiotic treatment. Because of his concern over the continued existence of infection Dr. XXX referred me to an infectious disease specialist.

1.5 Continued Post-Surgical Recovery
On November 9, 2009 I consulted with Dr. XXX, an Infectious Disease Specialist regarding the ongoing infection that oral antibiotics had up until now been unable to completely clear (Exhibit 1.5a). Dr. XXX referred me for Magnetic Resonance Imaging (MRI) on November 11, 2009 to evaluate possible causes of this recurrent non-healing infection. The results of the MRI revealed significant infection of the soft tissue surrounding the joint and that the patella had fractured likely as a result of osteomyelitis (Exhibit 1.5b). Osteomyelitis is an infection of the bone that is quite serious and must be treated with IV antibiotics for long periods time (Exhibit 1.5c) Peripherally inserted central catheter (PICC) lines are to administer IV antibiotics over a long period of time (Exhibit 1.5d). A PICC line is a small tube inserted into a vein in the arm and threaded through the artery until reaching the heart (Exhibit 1.5e). My PICC line was put in on 11/20/2009, exactly 7 months to the day after my surgery and 3 months to the day after my husband’s departure for Honduras (Exhibit 1.5f). Because the use of PICC lines is quite complicated and there is a high risk of infection, home health services are typically arranged to teach patients and their caregivers about the proper care and use of PICC lines. To treat my osteomyelitis, Dr. XXX ordered a minimum of 6 weeks of IV ceftriaxone (Rocephin®) to be administered via the PICC line and rifampin to be administered orally (Exhibit 1.5g, 1.5h). Due to the placement of the PICC line insertion point it is usually necessary for a caregiver to administer the medications. I however, have no one that can regularly assist me with administering my medications, making treatments more difficult. XXX Home Health will check my status weekly and will assist me with sterile dressing changes and blood draws which will be tested for further infection or other indications of complications with the PICC line (Exhibit 1.5i). Because the insertion point dressing and the drainage incisions made by Dr. XXX cannot get wet, I will again be forced to take a daily sponge bath. With enough time, the IV antibiotics should clear the infection in my knee although more than the minimum of 6 weeks of treatment may be necessary to accomplish this and removal of the infected knee cap will be required.

1.6 Patellectomy
In order to successfully clear the infection and prevent further damage Dr. XXX has advised me that a patellectomy (surgical removal of the kneecap) will be necessary (Exhibit 1.6a, 1.6b). By removing the fractured and infected bone, my prognosis is much improved and the IV antibiotic treatment will likely succeed in eliminating the infection. Approximately 4 weeks after beginning IV antibiotic treatment I will undergo the surgery to remove my damaged kneecap. Removal of the kneecap is an extremely delicate procedure since soft tissue, ligaments, and tendons must all be severed from the kneecap then sewn back together so that I can retain the function of my knee. This procedure is not without its risks and complications including muscle loss, the inability to fully extend the affected leg, and a vulnerable joint space which the patella once shielded (Exhibit 1.6c). In an effort to mitigate the issue of ‘laxity’ of the tendon and increase the likelihood of a fully functioning joint, Dr. XXX will place me in a straight leg immobilizer for xxxx weeks. During this time I will not be able to bear any weight on the affected leg and will have to use a walker and/or crutches while walking and “will need assistance with all daily activities”. Hopefully, the xxx weeks of inactivity will allow the tissues to tighten and once physical therapy begins they will slowly be stretched back out to a functional length. Recovery from this procedure is long and arduous and could take many months, even up to a year for full and total recovery (Exhibit 1.6d).

1.7 Necessity of Spousal Support during Recoveries
I do not know how I could have endured the last 7 months without the love and support of my husband and I cannot foresee a successful recovery from my exiting infection and upcoming surgery without the same. He refused to leave me alone in the hospital so he stayed each night with me there in case I needed him. He gave me a sponge bath daily for almost 4 months. During early recovery I could not even make it to the bathroom and had to use a toilet chair placed in my bedroom directly beside my bed. I was in such pain that he had to literally lift me out of the bed and place me on the chair; I could not even use my walker to get out of bed and move one foot to the chair. As time progressed he assisted me with wound care and bandage changes including changing my wound vacuum dressings. He cleaned me up multiple times after I had urinated and defecated on myself because some of the medication I was taking made bladder and bowel control virtually impossible. He held my hand at night when the pain was so extreme that I could not sleep. He literally spent hours a day assisting me because I was unable to perform even the most basic daily tasks without his help. He did all this while at the same time caring for our young daughter and our household.
In the past 3 months since his departure for Honduras, my condition has deteriorated. Although I am slightly more able to perform limited daily tasks, I continue to wear a leg immobilizer and cane for support when standing or walking. My husband is the only means of support I have readily and reliably available to assist me and the recent worsening of my condition has meant that I have had to resort to receiving assistance from my 4 year old daughter to do something as simple as putting on my shoes. She has even had to help me with bathing on some occasions because the pain and physical limitations made it impossible to clean myself. It may seem trivial to some, but the fact that I must rely on the help of my small child to do something as simple as putting on a pair of socks and shoes causes me great distress. She is of the age when our roles should be reversed and I should be putting on her shoes and helping her get a bath. I cannot continue to rely on my daughter for help, especially now that I have the added burden of IV antibiotic treatment and a complex surgery in the near future.
Although my mother does live in the area, she is available for assistance very rarely because she already has the burden of the care of my elderly grandmother and disabled uncle. My grandmother suffered from a hip fracture a year ago and just recently underwent another surgery on her hip. Because of her advanced age and fragility, she cannot be left alone for long periods of time and requires daily help with bathing and meal preparation. She is very prone to falls; twice my husband has caught her as they were walking out in her yard. She is also beginning so suffer from some of the symptoms of dementia including memory loss and she is no longer able to drive herself to the store or to her doctor’s appointments. My uncle underwent a cervical fusion operation 6 months ago and he also suffers from osteomyelitis of the bones in his spine for which he is being treated. His condition is extremely painful, so much in fact that even the act of getting out of bed is excrutiating. Due to the recent and sudden death of his wife, my mother is the only person able to care for him. Add to this the fact that my mother works full time and she must care for both her mother and brother each day after work and it is understandable why she simply cannot bear the added burden of my and my daughter’s care. In fact, she is under so much stress that her own health has begun to decline. Recently she was diagnosed with hypertension which can be attributed to the extra pressure she is under to care for so many.
Over the next weeks and months I will need extensive assistance not only with daily tasks but also administering medications, dressing changes, and physical therapy. I will be unable to drive for several weeks following my surgery and will have to depend on someone to drive me to doctors’ and therapy appointments and to work once I am able to return to work and to drive my daughter to school each day. It is imperative that my husband’s waiver be approved and he be allowed to return to the United States to care for me and our daughter during this difficult time.

1.8 – Pyelonephritis
Multiple times in the last decade I have suffered from acute pyelonephritis, an infection of the kidneys (Exhibit 1.8a, 1.8b, 1.8c, 1.8d, 1.8e, 1.8f, 1.8g, and 1.8h). These infections usually present fairly quickly and I develop a high fever (usually in excess of 102° and in one case more than 105°) and debilitating back pain. In my case, I usually do not present any of the typical urination symptoms of painful urination or increased urinary frequency or urgency which are often the precursors of a full onset kidney infection (Exhibit 1.8a). Instead, I present acutely with back pain, high fever, and nausea which signal an active kidney infection. If left untreated for long, I run the risk of severe complications and even kidney failure which can be fatal (Exhibit 1.8a). It is vital that I obtain prompt medical treatment once the symptoms of the infection begin to present themselves. In order to effectively diagnose and treat the infection a urine culture must be taken to identify the specific bacteria causing the infection. It is important to identify the specific bacteria because bacteria may only be susceptible to certain antibiotics.
In February of 2000, I sought care in the emergency room at XXX in XXX, California for a suspected kidney infection (Exhibit 1.8c). There I was diagnosed and treated with an oral antibiotic and released early the next morning. Within 24 hours of release, my temperature spiked to over 105° and I returned to the hospital and was admitted for treatment of pyelonephritis including intravenous (IV) fluids and antibiotics (Exhibit 1.8d, 1.8e, 1.8f). Had I not sought medical attention right away, I ran the risk of permanently damaging my kidneys and possibly going in to renal failure which can be fatal.
My most recent kidney infection in 2007 was treated with oral levofloxacin antibiotics for 10 days (Exhibit 1.8h). Levofloxacin, more commonly known as Levaquin®, is typically a very effective broad spectrum antibiotic used to treat pyelonephritis, but it is also extremely expensive costing roughly $15 per pill (Exhibit 1.8i, 1.8j). Individuals like myself, those with a history of recurrent pyelonephritis, have a higher risk of recurrence and with each recurrence have a higher risk of irreversible damage that could lead to chronic kidney infections or kidney disease. If I were forced to relocate to Honduras for the duration of the 10 year bar, the possibility of irreparable kidney damage or even death from kidney failure because of my inability to receive proper medical care represent an extreme hardship.

1.9 – Herpetic Eye Infections
I suffer from recurrent herpetic eye infections also known as herpes simplex virus (HSV) keratitis (Exhibit 1.9a). My initial outbreak occurred at the very young age of two and subsequent outbreaks have continued into my adult life (Exhibit 1.9b, 1.9c, 1.9d). HSV keratitis is caused by Type I HSV (HSV-1) which is responsible for orofacial and ocular infections. HSV keratitis outbreaks can be triggered by stress, illness, and sun exposure, all of which I am subjected to both in the United States and in Honduras, albeit more so in Honduras (Exhibit 1.9a). According to my life-long ophthalmologist Dr. XXX, “if left untreated, permanent corneal damage can occur with permanent loss of vision” (Exhibit 1.9e). Due to past outbreaks, I have permanent scarring on my right cornea (Exhibit 1.9e). Because of this, I will never attain ideal vision in this eye despite the use of corrective lenses. It is imperative in the event of an outbreak that I receive prompt diagnosis and treatment to prevent any further scaring. Treatment consists of the use of “Viroptic® drops as well as possible steroid drops” and “treatment durations could vary between 2 to 6 weeks” (Exhibit 1.9e).
If my husband’s waiver was denied and I was forced to relocate to Honduras, the costs of diagnosis and treatment without medical insurance would be prohibitive. The eye drops used to treat ocular herpes infections are quite costly, even here in the United States. Average costs for a single bottle of Viroptic® or its generic equivalent range from approximately $132 to $143 (Exhibit 1.9f). This represents almost 10% of Honduras’ current GDP per capita as reported by the United States Department of State (see Exhibit 1.1c in Medical Concerns Section 1.1 – Background Information). Obviously the high cost of this drug and the very low earning potential in Honduras would make treatment virtually impossible, thus increasing my likelihood of further corneal scarring and even blindness. Although corneal transplant is a treatment option for extensive scarring and blindness caused by HSV keratitis, there are no medical facilities available in Honduras to perform this advanced surgery and to my knowledge no cornea donor pool exists in Honduras (see Exhibit 1.1c in Section 1.1 – Background Information).

1.10 – Infectious Diseases
In addition to the aforementioned serious medical concerns, the ever present threat of infectious disease is also cause for great concern if my daughter and I were forced to relocate to Honduras for the duration of my husband’s exclusion from the United States. Those living in, or even visiting Honduras are at high risk of contracting one or more major infectious diseases including HIV/AIDS. In fact, Honduras has the highest adult prevalence rate of HIV/AIDS infection in the region with approximately 63,000 infected individuals (see Exhibit 1.1a in Section 1.1 – Background Information). The Centers for Disease Control (CDC) provides travelers to Honduras with a rather lengthy list of disease risks in Honduras most notable of these being malaria and dengue fever for which a recent Travel Notice went into effect on November 10, 2009 (Exhibit 1.10a).
Less than 1 year ago, my mother-in-law was diagnosed with hemorrhagic dengue fever and was hospitalized for over a week. Hemorrhagic dengue fever is a more severe form of the disease that can prove fatal if not treated quickly (Exhibit 1.10b). Thankfully, my mother-in-law recovered, but had it not been for the financial support of my husband and I she would not have received the medical care necessary to save her life. Some primary risk factors for contracting dengue hemorrhagic fever that are particularly disconcerting include being younger than 12, female, or Caucasian. Although the occurrence of all of these risk factors does not guarantee contraction of the disease, it would still place my daughter and me at a significantly higher risk to contract this disease for which there is no known cure.
There is also the new emerging threat of the H1N1 virus (swine flu) pandemic. A recent regional update on the 2009 H1N1 Pandemic published by the Pan American Health Organization indicated ‘widespread activity’ in most all countries in Central America and also noted that some countries has reported cases of pandemic flu and dengue fever co-infections (Exhibit 1.10c). The CDC has consistently reported that children younger than 5 are at greater risk of severe illnesses from the H1N1 virus. If I were forced to relocate with my daughter to Honduras, I would be placing her at greater risk for not only severe illness from the H1N1 virus but also a greater risk for dengue-pandemic flu co-infection because she falls within the high risk groups of both diseases. The thought of my daughter becoming gravely ill with either of these diseases frightens me because I do not know how my husband and I would be able to afford the medical care necessary to treat her given our low earning potential.


Section 2: Employment Concerns

2.1 – Present Employment
I am presently employed with the City of XXXX, North Carolina as a Geographic Information Systems Analyst. Through my local government employer my daughter and I have access to excellent medical, dental, vision insurance. They monthly premium for my health and vision insurance is $XXX and my dental premiums are only $xxx monthly (Exhibit 2.1a). Given my medical history discussed at length above I felt it prudent to purchase short term disability insurance for $XX per month to help ensure my family’s financial wellbeing in the event I am ill or injured and cannot work (Exhibit 2.1b). My insurance plan covers 100% of my medical costs after any applicable co-pays and deductibles are met with a maximum out of pocket expenditure of $3500 per year per individual (Exhibit 2.1c).
As a City employee I also contribute 6% of my weekly pre-tax income to the North Carolina Local Government Employees’ Retirement System which my employer matches up to 6% (Exhibit 2.1d). In order to receive any retirement or disability benefits, an employee must work a minimum of 5 years prior to reaching retirement age. If my husband’s waiver was denied and I was forced to move to Honduras, I would need to withdraw my pension contributions and place them into a private 401k or IRA and in doing so would forfeit any funds previously matched by my employer. I would also forfeit the high quality health, dental and vision insurance provided me as a City employee.

2.2 – Employment Prospects in Honduras
GIS is a rapidly growing field with many different specialties. Prior to moving to North Carolina in August of 2007, I was employed with the XXXX and XXXX in St. Petersburg, Florida and XXX Marine Laboratory in Sarasota, Florida and specialized in marine mammal conservation GIS. Due to equipment and software expenses, robust GIS programs in second and third world countries, either private non-governmentally or governmentally managed, are very few. Of the few GIS programs that do exist in Honduras, many involve conservation or natural resource management. PROCIG, the Central American Geographic Information Project, published extensive information regarding the use of GIS in Honduras and “identified ten projects and programs which manage GIS and/or geographic information”(Exhibit 2.2a). This list, consisting of government agencies and non-governmental organizations (NGOs), has likely grown conservatively, if at all, since this publication’s release.
If my husband’s waiver was denied and I was forced to relocate to Honduras for the duration of his 10 year ban from the United States, my GIS employment prospects would be few and limited to low-paying or volunteer positions with conservation- or natural resource management-focused government agencies or NGOs, potentially placing myself and my family in serious danger (see Safety Concerns Section 3.1 – General Safety). Even in the United States, most positions in government or NGO programs devoted to conservation or natural resource management are highly underpaid. Speaking from personal experience, most professionals enter these fields not for monetary gains, but rather for a true passion for their work. A similar correlation between low wages and conservation- or natural resource management-related employment likely also exists in Honduras. My academic background in biological sciences would likely limit my GIS employment prospects to positions with very low wages within a government agency or an NGO like those previously described. This low wage-earning potential would only further complicate my difficulties affording medical care and treatments for my medical concerns discussed in the Medical Concerns portion of this letter.

Section 3: Safety Concerns

3.1 General Safety
The United States Department of State (DOS) has long published information for tourists regarding specific safety precautions that should be taken while traveling in Honduras (see Exhibit 1.1a in Medical Concerns Section 1.1 – Background Information). The DOS recently published that “Honduras has a precarious security situation” at present due to the recent political unrest (see Safety Concerns Section 3.2 – Recent Political Unrest). The DOS also published that “crime is endemic in Honduras and requires a high degree of caution by US visitors and residents alike” and that crimes against US citizens have included murder, kidnapping, rape, assault and property crimes. In the last 2 years 9 US Citizens have been murdered and 8 have been kidnapped (4 of whom as recently as January and February of this year). The United Nations Development Programs reports via the DOS information that Honduras has one of the highest per capita murder rates in the world. The US Embassy in Honduras has gone so far as to report that ‘direct eye contact’ is a sign of possible impending violence (Exhibit 3.1a). In addition, apparently not only criminals are guilty of committing crimes in Honduras but the government or its agents and private security forces are as well.
The 2008 Human Rights Report: Honduras published by the DOS states that “unlawful killings by members of the police and government agents, arbitrary and summary killings committed by vigilantes and former members of the security forces” were reported (Exhibit 3.1b). Of specific concern to myself and my family were the reports of the murders of environmentalists and their loved ones. Crimes against environmentalists are not a new occurrence in Honduras; several environmentalists have been murdered in Honduras in the last decade. One of the more notable murders was that of Blanca Jeannette Kawas Fernández in 1995 whose murder sparked uproar among human rights activist around the world (Exhibit 3.1c). In July 2008, 4 policemen were convicted of murdering 2 environmentalists in 2006 and were sentenced to 20 or more years only to escape soon after sentencing. These crimes are especially disturbing to me because my academic and professional backgrounds would likely limit my employment in Honduras to environmental or conservation oriented professions (See Employment Concerns Section 2.2 – Employment Prospects in Honduras). If my husband’s waiver were not approved and I was forced to relocate to Honduras I would have only 2 options – obtain employment in a position that might endanger my life or the lives of my family or remain unemployed which would further complicate my abilities to obtain treatment for any of my severe medical conditions.

3.2 Recent Political Unrest
In June 2009, President Manuel Zelaya was removed from office and banished to Costa Rica (Exhibit 3.2a). In the following weeks the United States halted foreign aid and suspended non-immigrant visa services and condemned the actions of the new government lead by Roberto Micheletti. The United States has issued multiple travel advisories to advise US citizens about existing situations in Honduras and advising the suspension of all non-essential travel to Honduras until the conflict has been resolved. The situation became intensified upon ex-President Zelaya’s return to Honduras and his installation within the Brazilian Embassy in September. Protests and general civil unrest ensued, prompting extended curfews country wide. As the United State’s position became clearer and the other organizations including the OAS (Organization of American States) and the European Union condemned the actions of the new Micheletti-led government in their unwillingness to compromise, the threat of possible violence towards American citizens increased. This perceived possibility of danger was so extreme that American citizens were warned to avoid large crowds and were cautioned against attending large public sporting events for fear of violence and to avoid some retail locations because of the recent discoveries of bombs/grenades discovered inside. Although a tenuous agreement has been reached and the Ex-President Zelaya and the new Micheletti-led government with the signing of the Tegucigalpa-San Jose Accord, the situation continues to be quite tense in anticipation of the upcoming elections in late November (Exhibit 3.2b). Although this waiver packet will have been prepared for delivery prior to the conclusion of these elections, I fear that tensions will remain high for quite some time after the elections take place. If my waiver was not approved and I was forced to relocate to Honduras, I fear that I would be placing myself and our daughter in even more danger than that described in the previous section because of the ongoing political unrest in Honduras.


Section 4: Financial Concerns
Although not sufficient in and of themselves to prove extreme hardship, financial concerns must also be considered when evaluating the degree of hardship I would face if my husband’s waiver is not approved and I were forced to relocate to Honduras for the duration of the 10 year bar currently in effect.

4.1 Debt Reduction and Retirement Planning
Over the past several years my husband and I have struggled financially and are just now beginning to get our heads above water so to speak. During these years, we were forced to use credit cards to cover many of our monthly expenses and accrued a large amount of credit card debt which we are still working to pay off. We have worked hard to reduce our original credit card debt from over $10,000 to our present balance of $XXX (Exhibit 4.1a, 4.1b). My husband and I felt it prudent to work hard towards eliminating all of our debts so that we could work towards a more financially secure future. In order to accomplish this, we have contributed approximately 60% of our monthly income towards debt reduction thus limiting the amount we have been able to invest in our savings and retirement plan. As of November 2009, we have $XX in our savings account and $XXX in our money market account (Exhibit 4.1c). If we were forced to wait the entire 10 year bar outside of Honduras, I would be almost 40 and my husband over 40 when we were able to return to the United States and begin to invest in our retirement and savings again. As mentioned previously in Employment Concerns – Section 2.1 Present Employment, if I were forced to relocate to Honduras I would have to rollover the funds invested in the North Carolina State Pension Plan into a private 401k or IRA and would have to forfeit any funds that were matched by my employer. For the duration of the 10 years I would be living out of the country I would be unable to add any additional funds to this account thereby reducing the amount of money that we have saved for retirement.

4.2 Student Loans
My undergraduate college education was funded primarily through the federal student load program. As of November 2009 I still owe $11,353 in student loans. My interest rate is relatively low and so are my monthly payments. However, if my husband’s waiver was denied and I was forced to relocate to Honduras I would be unable to meet these financial obligations given the extremely low earning potential even for the more skilled white collar employees.

4.3 Medical Expenses
Compounding these financial concerns is the considerable medical expenses that I have incurred during the last 7 months during my recovery from a complicated knee surgery. As of the end of November I owe XXXX Hospital over $3000 in medical expenses (Exhibit 4.3a). Because of the continued complications resulting from my soft tissue realignment surgery in April 2009, I will be forced to delay my bone realignment surgery until after the New Year. My insurance company calculates my maximum out of pocket expenses on a calendar year basis. Because the bone realignment surgery will likely take place after December 31, 2009, I will be faced with an additional $3500 in medical expenses for this surgery. This extra amount does not include the weekly orthopedist co-pays of $50 each visit, nor the $50 co-pays for each physical therapy visit. My co-pays alone for my physical therapy visits calculated at $50 per visit 3 times a week for 6 weeks would be an additional $900 in medical expenses. Calculating my existing hospital expenses and the additional $3500 out-of-pocket expenses I would incur as a result of the bone realignment surgery in early 2010 mean that I would owe approximately $7000 in medical bills. If my husband’s waiver were denied I do now know how I will be able to continue making my monthly payments to XXXX Hospital. Following my next surgery I will likely be forced to take unpaid leave from work because I have exhausted all of my vacation and sick time during my recovery from the April 2009 surgery. Although I have short term disability insurance through my employer, the maximum monthly payment amount would not be sufficient to meet my normal monthly expenses, much less the added medical expenses I would be incurring. Nor would I be able to meet these financial obligations if my husband’s waiver was denied and I was forced to relocate to Honduras.

Section 5: Education Concerns
I was raised in a family where academic success and the pursuit of higher education were extremely important. My parents realized the benefits of higher education and instilled these values in myself and my sisters. According the US Census Bureau report published in 2002, “over a work-life, individuals who have a bachelor’s degree would earn on average $2.1 million – about one-third more than workers who did not finish college, and nearly twice as much as workers with only a high school diploma” (Exhibit 5.0a). Individuals with a master’s, professional, or doctoral degree have a potential lifetime earning even higher. Although earning potential is not the only benefit of higher education it is important, especially given today’s economic pressures.
In 2003 I received a Bachelor of Science degree in Marine Biology from the University of North Carolina at Wilmington and in 2007 I received a Graduate Certificate in Geographic Information Systems (GIS) from the University of South Florida in Tampa, Florida. It is very important to my husband and me that our children have the same educational opportunities as I did. If my husband’s waiver was denied and I were forced to move to Honduras for the duration of the 10 year ban, our now three year old daughter would be 13 or older before she could attend school in the United States. She would be thrust into an academic environment that public schools in Honduras could not even begin to prepare her for. A more appropriate course of action would be for our daughter, and any other children we may have, to attend a private college preparatory school in Honduras where they could receive a US High School Diploma. Very few schools in Honduras provide US-equivalent content and instruction styles and tuition for these schools is very high. The US Department of State Office of Overseas Schools endorses only two such schools in Honduras, both located in Tegucigalpa (Exhibit 5.0b, 5.0c). Both schools have annual tuitions in excess of $4,000 for grades kindergarten through 5th and in excess of $5,000 for grades six and above. As stated previously, the less than $1700 GDP per capita in Honduras would make paying for private school tuition impossible, even with 100% of both my and my husband’s earned income being devoted to tuition payment. Given the importance we place on a strong academic upbringing, my inability to afford quality education for my children to prepare them for their return to the US represents an extreme hardship.


Section 6: Plea for SpecialConsideration
Like most of us, my husband is not perfect and he has made some mistakes in the past which he regrets. In May of 2005 and August of 2009 he pleaded no contest to driving while under the influence (Exhibit 6.0a, 6.0b). Although my husband was not a frequent drinker, following his first offense he completed all court-mandated counseling and quit drinking all together. As our immigration case progressed and the time for his departure became closer he also lost his job. My husband had always before bore the greater financial burden in our household and he struggled with the knowledge that he could no longer provide for his family. After more than 6 months of unemployment and with his departure from his family seemingly just around the corner, he broke. While visiting a friend he had a few beers and then instead of staying at his friend’s house like he told me when he called, he decided to come home to his family. Shortly after leaving his friends house he was pulled over for failing to use his turn signal and was charged with driving under the influence. XXXX of Alternatives Counseling in XXXX, NC felt that this occurrence was not the result of a substance dependence handicap during a substance abuse assessment required under North Carolina law (Exhibit 6.0c). During the assessment she went as far as to remark that this incident seemed the result of increased stress and depression given my husbands long-term unemployment, upcoming departure from the country, and the guilt he was suffering over leaving his wife alone here to face 2 complicated surgeries and lengthy recoveries all while taking care of a young child. He began treatment for depression as soon as possible following this incident and as a result was more equipped to cope with our problems (Exhibit x.d). We both realize that this is no excuse for what happened, but hope that this information would be taken into consideration during the adjudication of this case, especially considering the extenuating circumstances surrounding my medical hardships. The ongoing recovery from my April 2009 surgery has been extremely difficult both physically and emotionally and even more so in the last 2 months since my husbands return to Honduras.


Section 1: Medical Concerns
1.1 – Background Information
1.1a City of XXXX, North Carolina Pay Stub evidencing bi-monthly insurance and short term disability payments (pp 1)
1.1b City of XXXX, North Carolina Summary of Medical Insurance Benefits through Aetna
1.1c US Department of State Bureau of Consular Affairs International Travel Information: Honduras Country Specific Information (pp 9)
1.1d International Health Insurance Quotes from Global Insurance Net for coverage for my daughter and I (pp 2)
1.1e US Department of State Bureau of Western Hemisphere Affairs Background Note:Honduras (pp 6)
1.2 – Recurrent Knee Dislocations
1.2a MedlinePlus Article: Kneecap Dislocation
1.2b Henrichs, Andres. “A Review of Knee Dislocations”. Journal of Athletic Training, 2004; 39(4): 365 – 369. ( pp 1 *please note only the abstract portion of this journal article is included here*)
1.2c Hip and Knee Advice article describing the 2 causes of patellar instability (pp 4)
1.2d Iredell Memorial Hospital Pre-Operative History and Physical performed by Dr. Serene on May 20, 1995 (pp 2)
1.2e XXXX Hospital Emergency Department Report dated October 9, 1999 (pp 1)
1.2f XXXX Hospital Orthopedic Consultation Report by Dr. XXXX and dated November 6, 1999 and X-Ray Results Report dated November 6, 1999 (pp 3)
1.2g XXXX Hospital Right Knee MRI and X-Ray results dated November 11, 1999 (pp 1)
1.2h XXXX Orthopedics & Sports Medicine office visit notes with Dr. XXXX between November 8, 1999 and August 31, 2001 (pp 5)
1.2i XXXX Orthopedics & Sports Medicine office visit notes with Dr. XXXX between September 22, 2008 and November 13, 2008 documenting my most recent dislocation of a previously surgically repaired right knee (pp 2)
1.3 – Previous Knee Surgeries
1.3a XXXX Hospital Operative Report of the arthroscopic surgery on my left knee performed by Dr. XXXX on May 5, 1995 (pp 2)
1.3b MedlinePlus Article: Chondromalacia patella (pp 2)
1.3c XXXX Hosptial History and Physical and Operative Report of the soft tissue realignment of my right knee performed by Dr. XXXX on August 26, 2000 (pp 4)
1.3d Hip and Knee Advice article describing Soft Tissue Realignment and Bone Realignment procedures to treat recurrent patellar dislocations (pp 2)
1.4 – Post-Surgical Complications
1.4a XXXX Hospital Operative Report of the soft tissue realignment procedure performed on my right knee by Dr. Ronald XXXX on April 20, 2009 (pp 2)
1.4b XXXX Orthopedics & Sports Medicine office visit notes with Dr. XXXX dating from March 26, 2009 to July 24, 2009 documenting recommended surgeries and in-office procedures and therapies I underwent to attempt following surgery (pp 4)
1.4c Photo documentation of my recovery process from April 23, 2009 to July 31, 2009 (pp 14)
1.4d Wound VAC therapy information (pp 2)
1.4e Medical Maggot Debridement Therapy information provided by Monarch Labs in California, the only licensed medical maggot provider in the United States (pp 1)
1.4f XXXX Hospital History and Physical Report outlining symptoms and diagnosis upon admittance by Dr. XXXX, my Primary Care Physician (pp 2)
1.4g XXXX Hospital Operative Report of the arthroscopic debridement of my left knee by Dr. XXXX on July 29, 2009 (pp 2)
1.4h XXXX Hospital Discharge Summary Report prepared on August 1, 2009 by Dr. XXXX
1.4i XXXX Plastic Surgery Operative Report of the split-thickness skin graft procedure performed on my left knee on August 20, 2009 by Dr. XXXX (pp 1)
1.4j XXXX Orthopedics & Sports Medicine office visits notes with Dr. XXXX describing the various in-office procedures that occurred between September 15, 2009 and October 28, 2009 (pp 4)
1.5 – Continued Post-Surgical Recovery
1.5a Dr. XXXX evaluation notes and letter (pp 2)
1.5b XXXX Hospital MRI Report revealing impressions of osteomyelitis and soft tissue infection (pp1)
1.5c MedlinePlus Article: Osteomyelitis (pp 2)
1.5d MedlinePlus Article: Perhipherally Insterted Central Catheter (pp 3)
1.5e CancerHelp UK Diagram of PICC Line Placement (pp 1)
1.5f XXXX Hospital PICC Line Insertion Discharge Instructions (pp 1)
1.5g MedlinePlus Article: Ceftriaxone Injection (pp 3)
1.5h MedlinePlus Article: Rifampin (pp 2)
1.5i XXXX Home Health Visitation and Treatment Information (pp xxx)
1.6 – Patellectomy
1.6a Letter from Dr. XXXX (pp xxxx)
1.6b Encyclopedia of Surgery: Kneecap Removal (pp 2)
1.6c KneeGuru Information Hub: Consequences of a Patellectomy (pp 2)
1.6d UnboundMedline “Function after Patellectomy” Journal Article Abstract (pp 1)
1.7 – Need for Daily Assistance
1.7a Letter from MOTHER JEIALEIGH regarding inability to provide necessary daily care (pp 1)
1.8 – Pyelonephritis
1.8a MedlinePlus Article: Pyelonephritis
1.8b XXXX Hospital Emergency Room Report and Discharge Instructions dated October 26, 1999 for treatment of acute pyelonephritis (pp 2)
1.8c XXXX Emergency Room notes and discharge instructions dated February 20, 2000 (pp 3)
1.8d XXXX Outpatient Surgery Consultation by Dr. XXXX on February 23, 2000 noting the extreme fever and impressions of pyelonephritis (pp 2)
1.8e XXXX Radiology Report of CT of Abdomen and Pelvis diagnosing pyelonephritis (pp 1)
1.8f XXXX Discharge Summary Report identifying definitive diagnosis, treatment summary, and discharge instructions following hospital stay (pp 1)
1.8g XXXX Regional Medical Center Emergency Room notes on August 1, 2003 indicating diagnosis of “UTI, early pyelonephritis” (pp 2)
1.8h XXXX Family Practice office note indicating oral antibiotic treatment for early UTI/pyelonephritis (pp 1)
1.8i MedlinePlus Article: Levofloxacin (Levaquin®) (pp 1)
1.8j Drugstore.com price estimates for 500mg dosage of Levaquin® (pp 1)
1.9 – Herpetic Eye Infections
1.9a MedlinePlus Article: Corneal Ulcers and Infections aka Herpes Simplex Virus (HSV) Keratitis (pp 2)
1.9b Letter from ophthalmologist Dr. XXX to pediatrician Dr. XXX on July 6, 1983 confirming the presence of HSV Keratitis in right eye (pp 1)
1.9c Relevant office notes from Dr. XXXX dating from July 5, 1983 to August 22, 2000 (pp 19)
1.9d XXXX Ophthalmology Progress Records dated March 24, 2000 to March 31, 2000 (pp 4)
1.9e Letter from Dr. XXXX detailing the treatment of HSV Keratitis and consequences if left untreated (pp 1)
1.9f Drugstore.com price estimates for 1% Solution 7.5mL bottle of Viroptic® and it’s generic counterpart Trifluridine® (pp 1)
1.10 – Infectious Diseases
1.1c See Exhibit 1.1c - US Department of State Bureau of Consular Affairs International Travel Information: Honduras Country Specific Information (pp 9)
1.10a Centers for Disease Control and Prevention Health Information for Travelers to Honduras (pp 5)
1.10b MedlinePlus Article: Dengue Hemorrhagic Fever (pp 2)
1.10c Pan American Health Organization Regional Update Pandemic (H1N1) 2009 (pp 9)
Section 2: Employment Concerns
2.1 – Present Employment
2.1a City of XXX Direct Deposit Receipt showing pre-tax deductions for medical, dental, and short term disability policies (pp 1)
2.1b AFLAC Short Term Disability Coverage and Benefits Information (pp 1)
2.1c City of XXX Aetna Health Insurance Summary of Benefits and Supplemental Dental Insurance Schedule of Benefits (pp 5)
2.1d North Carolina Retirement Systems Local Government Employees’ Retirement System Benefits Summary (pp 5 *please note that some portions of the original document are not included here*)
2.2 – Employment Prospects in Honduras
2.2a PROCIG – Central American Geographic Information Project – Project Summary Honduras (pp 5)
Section 3: Safety Concerns
3.1 – General Safety
1.1a See Exhibit 1.1a - US Department of State Bureau of Consular Affairs International Travel Information: Honduras Country Specific Information (pp 9)
3.1b US Department of State US Embassy Tegucigalpa, Honduras: Information for Travelers – Personal Security Measures (pp 1)
3.1c US Department of State Bureau of Democracy, Human Rights, and Labor: 2008 Human Rights Report: Honduras (pp 11)
3.1d Organization of American States Inter-American Commission on Human Rights: Application to the Inter-American Court of Human Rights – Blanca Jeanette Kawas Fernández Against the Republic of Honduras (pp 8 *please note that only Section VI. Considerations of the Fact pp 6 – 13 of the original document are included here*)
3.2 – Recent Political Unrest
3.2a US Department of State US Embassy Tegucigalpa, Honduras: Public Announcements Dated June 28, 2009 (pp 1), August 10, 2009 (pp 1), September 21, 2009 (pp 1), October 8, 2009 (pp 1), October 20, 2009 (pp 1), October 22, 2009 (pp 1), and November 6, 2009 (pp 1)
3.2b Copy of Tegucigalpa-San Jose Accord signed by representatives of Mel Zelaya and Roberto Micheletti (pp 5)
Section 4: Financial Concerns
4.1 – Debt Reduction and Retirement Planning
4.1a XXXX Credit Union – Credit Card Statement dated xxxxxxxxx (pp x)
4.1b XXXX – Credit Card Statement dated xxxxxxx (pp xxx)
4.1c XXXX Credit Untion – Account Summaries dated xxxxxxx (pp xxxx)
4.2 – Student Loans
4.2a XXXX – Student Loan Summary dated xxxxx (pp xx)
4.3 – Medical Expenses
4.3a XXXX Hospital Bill dated xxxxxx (pp xx)
Section #: Education Concerns
5.a US Census Bureau “The Big Payoff: Educational and Synthetic Estimates of Work-Life Earnings”, published July 2002 (pp 9 *please note that the tabular portions of this document have been excluded*)
5.b US Department of State Office of Overseas Schools: American School of Tegucigalpa (1 pp)
5.c US Department of State Office of Overseas Schools: Discovery School (1 pp)
Section 6: Request for Special Consideration

6.a XXXX Florida – Relevant Court document for May 2005 DUI Conviction (pp 5)
6.b XXXX Carolina – Relevant Court documents for August 2009 DWI Conviction (pp 4)
6.c XXXX MA, LPC, CCS of XXX Counseling, Inc XXX, North Carolina – Letter in reference to August 2009 DWI Conviction
6.d Dr. XXX – office records pertaining to MR JEIALEIGH treatment for depression


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This is the letter I faxed/emailed to the Field Office Director @ DHS in Tegucigalpa. He personally reviewed our case and handed over the approval within 3 days. He got it on Monday 1/3 and we were notified by him of the approval on 1/7 via email. Included with this letter was the an awesome letter from my orthopedist regarding my conditions. I've posted a copy of this letter here

Field Office Director Emigdio Martinez
American Embassy
Tegucigalpa, Honduras

December 17, 2009

Dear Director Martinez,
I am writing to request your assistance with the expedited processing of my husband, MR JEIALEIGH, pending Immigrant Visa Petition & I-601 Waiver of Excludability (Case# xxxxxx) filed in Tegucigalpa, Honduras on December 15th, 2009.
My husband returned to Honduras in August of 2009 despite my recent admission to a local hospital for treatment for a suspected septic leg. Sepsis is an extremely dangerous infection of the blood that can be deadly if left untreated for long. I acquired this infection as a result of a realignment surgery on my left knee performed in April of 2009. My husband has been out of the country now for almost 4 months and since his departure, my heath and declined dramatically. Due to the ongoing complications following my surgery, I acquired osteomyelitis in my patella which is presently being treated with daily IV medications administered via a PICC line. I have no one here that can help me administer these medications, so I am forced to rely on our 4 year old child to help with the daily administering of these medications. Obviously, this is not the ideal situation but my insurance will only allow 8 total visits in 6 weeks. I’ve had to resort to drawing my own blood for lab work and leaving a dressing in place that should really be changed thereby increasing my risk of developing a more severe infection.
Because of this infection in my bone I will need to undergo an additional operation to remove the infected portion of the bone, if not the entire bone because it will be left severely weakened by the infection. My orthopedist has informed me that recovery for this operation will be upwards of 6 months, 3 months of which I’ll be unable to put any weight on my leg, and another 3 months of intensive rehabilitation several times a week. There is absolutely no way that I can care for myself following this procedure – much less care for my young daughter. I have had several surgeries on my knees over the past few years and I speak from experience when I say I won’t even be able to use the bathroom without help for at least a month following such an invasive surgery.
In addition to this ongoing issue of infection and the need for the surgical removal of my patella, I also require another surgery on my other knee. This surgery would involve relocating the portion of shin bone where my patellar tendon attaches to a more anatomically correct location. Again, this will require roughly 12 weeks of non-weight-bearing status and another 12 weeks of intensive recovery. In essence, I face at least 6 months to a year of painful recoveries from multiple surgeries. It is imperative that I have both surgeries as soon as possible to prevent further damage to my joint and to prevent the spread of infection throughout my body.
I have included with this request a copy of a letter written by my orthopedist, Dr. XXXXX explaining in detail my existing medical condition and the need for the surgeries mentioned above and how the absence of my husband is detrimental to my health and recovery. I am not sure what I will do – there is no way I can undergo these surgeries without my husband, but it is also medically imperative that I do so. I do not know who will care for me and our daughter if I have these surgeries. At this point, I am desperate for any assistance your office could provide so that my husband may return home and resume his role as father and caregiver for me as I undergo these 2 very lengthy and very painful recoveries.
Sincerely,

JEIALEIGH