Filipina nanny asks to stay in Canada after kidney diagnosis

Most young mothers don't have to make a choice between hugging their children and accessing the medical treatment that keeps them alive, but that's the situation Kherin Dimalanta says she faces here in Ottawa.

Dimalanta, 33, is a Filipina nanny working for a family of two doctors, one of whom has become the face of the fight against COVID-19 in this city.

While Dr. Kwadwo Kyeremanteng, a regular contributor to CBC, goes to work in the ICU and his wife Dr. Cathy Kyeremanteng sees patients at her private psychology practice, Dimalanta is at home caring for their three young boys.

"We would not have been able to do what we did through the pandemic, to continue our work, if we did not have help at home," said Cathy Kyeremanteng.

Dimalanta arrived three and a half years ago under a live-in caregiver visa. After a few years of working in Ottawa, she had hoped to apply for permanent residency and bring her own two children to live with her in Canada.

But six months after she arrived, Dimalanta went for a routine blood test as part of an insurance application and discovered she had chronic kidney disease.

The diagnosis meant she was no longer medically admissible to Canada, even though she had already worked and paid taxes in Canada for months before she fell ill.

"It just turned my life upside down," Dimalanta said. "I feel like I don't have the right to dream anymore."

Immigration system 'doesn't feel Canadian'

Dimalanta's nightly dialysis costs around $40,000 a year. That's almost twice the annual health-care cost threshold set by the Liberal government in 2018. Prospective immigrants who would cost the health-care system more than $21,204 a year are ineligible for permanent residency because they're deemed an excessive burden.

But Cathy Kyeremanteng believes that rule shouldn't apply to people who were already working legally and paying taxes in Canada.

"She fell sick while she was here, by no fault of her own," Kyeremanteng said. "How could Canada send somebody home to die in front of their children, just because we have to pay for the medical treatment?… It doesn't feel Canadian to me."

Immigration, Refugees and Citizenship Canada was unable to provide a comment by deadline on the situation facing people who, like Dimalanta, are already living and working in Canada, but are not medically admissible.

"It illustrates the structural problem in our immigration system," said Jamie Liew, an associate professor of law at the University of Ottawa.

Liew says that while highly skilled immigrants often come to Canada with their permanent resident status pre-approved — which means they're not at risk of being sent home if they get sick — low-skilled migrant workers can only apply for permanent residency after a few years.

"We, for whatever reason, don't value [them] the same way … despite the fact that a lot of skilled migrant workers provide essential services, as we've seen through the pandemic," Liew said.

Nanny's difficult choice

Dimalanta has applied for permanent residency on humanitarian and compassionate grounds because she cannot afford dialysis treatment in the Philippines. Without it, her doctors have told her she will die.

While she waits for the humanitarian appeal, a process that often takes years, she has applied for both a temporary resident permit and an open work permit so that she's eligible for OHIP and has the freedom to return to the Philippines to see her children.

Almost two years later, no decision has been made on Dimalanta's application.

She has "implied status," so she's allowed to continue to work and pay taxes, but every few months she must appeal to the OHIP review committee for continuing coverage. She can't risk leaving the country in case she's not allowed back in.

It's now been almost four years since she last saw her children.

"My kids will always say, 'Don't worry, Mama. Just stay there and get well.' Even if I ask, you know, what gift do you want for Christmas? It's, 'Don't think about us, just get well,'" Dimalanta said.

Without a reprieve, she has a stark choice: stay in Ottawa and access life-saving treatment, or go home to her children and watch her condition worsen.

"Is it better for me to stay here and get the medication and work still? Or is it better for me to go home, see them, hug them?" she asked. "What would you choose?"