Michael Moore's Sicko Tells the Story of One Ugandan American Woman

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Every time there is talk about Africa today, words like corruption, human rights abuses, injustice and all nature of crime usually escape from the lips of not only preachers of democracy in the western world but those of many Africans too. To the majority of Africans, all is well in the western world. Injustice and corruption are only synonymous with the African continent.

Barbara Clark.

The case in which a Uganda born American nurse is pitted against her former employer has revealed otherwise. Barbara Clark has been searching for justice in the US for over a decade. Justice, however, continues to elude her. Her case against the Adventist Health System (run by the Adventist Church) was dismissed in the lower U.S. district court serving Sacramento, when attorneys representing John Rea, the Acting Director of Industrial Relations, claimed immunity from the suit under the 11th Amendment of the U.S. Constitution.

She now hopes that her decade-long nightmares are about to end in what is expected to be a landmark case before the Ninth Circuit Court of Appeals. Her case now hinges on the argument that a claims adjuster could be considered an actor of the state. "We are hopeful that the Ninth Circuit will balance state interests with those of injured workers fighting workers' compensation bureaucracy," Clark said while awaiting the final verdict on her case at the Ninth Circuit of Appeal. "When an injured worker complains to the state through more than one hundred letters, it is difficult for me to see how the state can deny culpability in the alleged misconduct of claims adjusters."

Meanwhile, she has a six-year-old lawsuit pending at the State Court serving Bakersfield, California. This action was filed by her attorney under the Racketeer Influenced and Corrupt Organizations law. Known as "RICO", the law was created to fight organized crime in the 1960s. Mail and wire fraud are amongst its main targets. Clark claims that hospitals operated by the Adventist Church are similar to an organized crime syndicate, judging by the manner in which they extort compliance from injured workers like her. Presently, this case is pending appeal in California's appellate court. According to Clark: "As has become very typical of the Adventists, they employ every possible legal technicality to postpone and delay the court's proceedings. Their latest appeal to California's Fifth Appellate Court represents the height of frivolity."

Barbara Clark says that this turn out of events and the whole history of the case, which resulted from an accident in 1994 in which she was injured when a patient in labour kicked her in the face in a sub-standard delivery room in Bakersfield hospital qualifies for a scene in Michael Moore's new film, SiCKO. SiCKO is a documentary about the dismal state of health care in the world's richest country, the United States. In the documentary, a physician who works for a large health insurance company makes a profit motivated decision to allow a patient to die to save her employer medical costs. The film, which has been endorsed by a very vocal group known as the California Nurses Association, actually mirrors what Barbara Clark has been going through and could continue to go through for many more years if justice is not done.

During a rally sponsored by the group and attended by Mr. Moore in California's State Capital, Sacramento, Clark said that the documentary is living proof of the wretched state of affairs of health care in the United States, a country many people around the world dream of living in. "The insurance industry's control of health care is responsible for the untimely deaths of thousands of people each year. Even more reprehensible is the fact that tens of thousands must live in constant agony and pain while medical treatments are routinely denied and delayed by these insurance companies."

These are the kind of injustices that Clark says she is fighting. The legal storm she is riding would rival Hurricane Katrina or the 2004 Indian Ocean tsunami in ferocity. This is because although she was expected to get compensation after her 1994 accident in which her head struck concrete in the delivery room, the compensation has not materialized yet because of loopholes in the insurance and legal systems in the United States. From the day she suffered the accident and was ordered to the emergency room for x-rays scans of her head and entered the American health care system as a patient, the whole incident is, and continues to be her biggest personal nightmare. "Working for a so called Christian health organization, I thought I would receive treatment and return to work easily. The opposite has proved true.

"I was ordered to continue working without medical treatment for the next two and a half years. Although I complained of headaches and was losing my teeth, I was finally forced to resign for continuously asking for time off to have my injuries treated," she told this writer in an e-mail.

According to Clark, even minimal treatment or medication requires months, or even years, of battling in the California 'workers compensation' legal forum to obtain. She claims that the state's legal system is just as corrupt as its insurance industry. Although she obtained worker's compensation 'awards and orders' for medical treatment which were certified by the California Supreme Court in 2001 and 2002, her ex-employer hired an attorney who started what she calls a nasty letter writing campaign to her physicians. This attorney has used every imaginable and despicable avenue available to further contaminate the facts of the case and cause years of delay. The attorney was cited for 'vile, conniving and despicable' acts by the same judicial tribunal that has removed at least one judge from her case for violating judicial ethics, while another judge is under investigation for similar misconduct. "The attorney told doctors that they would be in serious trouble if they dared to treat me for my spinal and jaw injuries," she says.

To make matters worse, Clark says that although she is still registered as a nurse, she has not been formerly employed since 1997 and is instead receiving a monthly stipend of about $1,000 on the Federal Government's disability program known as Medicare. She says that given the high cost of living in California, $1,000 is barely enough to guarantee her three meals a day, heating in winter or even public transportation for her and her three children. "I have, since that time, lost my house and legal counsel. I have been turned away from my former workplace and been denied basic medical attention," she says, adding that attempts to confront the San Joaquin Community Hospital and its parent organization have earned her nothing but grief and an unwarranted eight restraining orders.

She did nothing more sinister than write letter after letter to State and Federal officials asking for help. "Instead of receiving compensation from the Christian hospital chain whose mission is to share God's love by providing physical, mental and spiritual healing, I was hung out to dry," she says. Fed up with the status quo she took legal matters into her own hands.

She presently has a petition before the U.S. Court of Appeals for the Ninth Circuit (San Francisco) in which she claims that every American has a fundamental right to 'pain avoidance', and that the State of California cannot force individuals to live in pain when cost-effective treatments are available. While referring to the vexatious refusal by the Adventist health insurance group to settle this claim, Hon. Armand Arabian, a retired judge of the California Supreme Court said the Barbara Clark case is a 'teaching case'. Clark says that there have been reports that the entire State Government workers compensation machinery wants to bury her 'work comp' case as it illustrates the loopholes and abuses that can be exploited by insurers to avoid payment of legitimate claims.

The whole incident has left Clark to associate the American system with real hell. In an e-mail, she writes: "Gideon, I had to write it this way otherwise my brain shuts down, this is a very difficult issue and the frustration for me is high. This fight against corruption takes every breath from me. I get very emotional, because of not only how it has affected me, but also because of what it is doing to all the other people that have no strength left to fight. Lives are destroyed daily."

September of 92 before the accident.

Clark says she sees her struggle to hold state "work comp" players accountable as similar to holding employers accountable for not paying a minimum wage, or to bringing slum lords profiting from substandard housing and banks that charge predatory rates for consumer loans to book. "The public demands for a minimum wage, affordable, decent housing and reasonable credit terms. Likewise, the public demands for a legitimate workers' compensation system. The public just doesn't understand how deplorable present conditions are and how broken the system really is," she adds.

Genesis of the case:

In February 1994, while assisting in the delivery of a baby at the Seventh Day Adventist Church owned and operated San Joaquin Community Hospital in Bakersfield, California, Clark was unintentionally kicked in the head by a patient in the delivery room. The force of the blow sent her reeling backwards onto a concrete block wall where she lost some teeth, injured her jaw and skull.

Initially, Ms. Clark's injuries did not seem serious. She received treatment in the hospital's emergency room after an x-ray scan and was told to take some pain medication. The emergency room treatment was sub-standard and worthless. About a year or so later, in accordance with the California Labour Code, she was awarded compensation for her injuries. Although no temporary or permanent disability treatment was awarded, her compensation ruling authorized future medical treatment to cure or relieve her from the effects of the injury sustained.

Unfortunately, what were initially perceived as slight injuries, turned out worse than expected. In May 1997, Ms. Clark was diagnosed with chronic temporomandibular joint dysfunctions and possible cervical disk disease. More treatment was recommended to address the new complications. What was to follow should have been a clear-cut case: treatment recommended, additional compensation disbursed and medical attention received. Instead, it turned into a 10-year long court drama of unexpected proportions.

In 2000, after a protracted legal battle against the Seventh Day Adventist Church, a workers' compensation administrative law judge ruled that the industrial injury had resulted in new and further disability and that Ms. Clark was entitled to further medical care and reimbursement for the self procured medical expenses and benefits. However, a year later, a new lawyer for the Adventist Health System assured Ms. Clark that she would not get a cent for further treatment.

Who is Barbara Clark?

Letters from Sonja: Ulrike-Barbara is Born.
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Born in Uganda in 1960, Clark attended Nakasero Primary School and grew up in Kampala. "My mom was a stay home mom and my dad worked in Kampala. I recall many great times growing up and had many great friends, some of whom I am still in contact with to this day," she says.

Letters from Sonja: Barbara's parents' wedding in front of Mau Mau prisoners in Kenya.
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As a young girl, Clark left Uganda with her parents during the Idi Amin era for Europe where she completed schooling. "The times were very difficult. Arriving in Europe from Uganda and not really recognising much was a true culture shock," she says.

After completing an apprenticeship programme as a production potter, Clark decided to go to America for 'greener pastures' and better standards of living. "I was about 19 years old when I came to America, having the same dreams as so many before me. I was convinced at the time, that I was truly coming to a country where, if one worked hard and was diligent in all their efforts, one would truly be blessed."

In 1988, Clark graduated from nursing school in the United States. Around the same time, she became a single parent after her marriage fell apart for 'some reasons'. After an 18 month long stint in Europe, she returned to USA and shortly thereafter began working as a registered nurse in Lancaster, California. "Labour and delivery is where I seemed to have found my calling and giving care to the indigent population was a great reward for me in so many ways.

"I then began working in Bakersfield and thereafter, at the end of 1993, was recruited to work for San Joaquin Community Hospital in Bakersfield, CA. It seemed to me like my dreams were finally coming true. I was able to care for the indigent population as many of my patients were poor and non-English speaking," she says.

Clark says that working for an Adventist Hospital, at the time seemed like a very good choice because they operated hospitals worldwide. She believed at the time that the organization itself would stand true to its mission statement, which is posted at the entrance of each one of its facilities. However, once she began working for the Adventist health system, she began to see that the hospital was not what it seemed to be from the outside. "Its all about business and money. There is no Christianity involved!"

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