In the process, Marta (not her real name) has learned lessons about what the area's fast-growing population of Spanish-speaking immigrants should do if they get hurt, despite their fears of being deported.

Her case illustrates the kind of societal challenges brought to light in a new report by a group called Democracy Works, about the health-care and other barriers faced by immigrants in Connecticut. (Click here to read a story on the report; click here to read the report.)

The report focuses not just on the many uninsured immigrant workers in the state, but those like Marta who do have some insurance but still encounter barriers that unnecessarily harm their health -- and deprive the economy of a productive worker.

"I am very worried," Marta said through a translator during an interview in the tidy room of her Fair Haven apartment. Marta sat on a couch next to her roommate's daughter's Mongoose brand "Butterfly Summer" miniature bicycle. "I am just sitting here holed up. I start thinking." Will she need an operation? Will insurance pay for it? Will she have a job to go back to?

Marta, who's 40, came north from Puebla, Mexico, in February of 2004. She crossed the border without legal permission. She left behind three young children. She knew friends with whom she could crash at first. Through one friend, she found a factory job in nearby North Haven, where she has worked since.

"They treat me and people like me very badly," she said, "because we don't speak English and because of our status." She said workers with legal documents to be in the U.S. get paid $4.50 more an hour for similar jobs. Still, she was grateful for the work. It paid her $7.50 an hour. She worked seven days a week.

Then, one day in early November, she sat down in a wheeled chair. The chair slipped; she fell and felt a sharp pain in her hip.

Marta continued trying to work. The pain was too intense. She couldn't sit; her job requires sitting.

Afraid to Call for Help

She chose not to call an ambulance. That was mistake number one, she would later learn. It would have created a record of the accident.

"I was afraid [to call] because I don't know how things work here. They call us 'illegal' here. I was scared if I called an ambulance they would call the police or call immigration." She has since learned that the ambulance companies don't do that.

A friend picked her up and brought her to Yale-New Haven Hospital. An X-ray was taken; it showed no broken bones. But the doctor saw Marta couldn't move her leg. She couldn't put her weight on it; it hurt too much. The doctor spoke Spanish and treated her well, Marta said. He gave her crutches and referred her to the Fair Haven Community Health Center.

Yale-New Haven sent a written report to her employer. Mistake #2: Marta should have asked for a copy of that paperwork, too, but she didn't.

It took three days for Marta to get an appointment at the health center. She was in intense pain; all she could do was stay in her apartment. Too much aspirin and Tylenol upset her stomach; she used Johnson's Baby Oil to mitigate the pain instead. She alternated between sitting up and lying down. Her friend heated up rags to put on her hip so she could sleep.

She waited an hour to see someone at Fair Haven Health Center. Then, she said, she was informed that because nothing was broken, the center couldn't do much for her except refer her to a specialist.

Getting an appointment with a specialist took another eight days. Marta showed up there -- only to be told she couldn't be seen, because no one in the office spoke Spanish. Mistake #3: She should have brought a Spanish-speaking friend.

Marta found help at a local social-service agency where she takes an English as a Second Language course. Someone there arranged for another appointment with the specialist; Marta arranged for a Spanish-speaking friend to accompany her this time.

Meanwhile, Marta is living on the last of the $480 in wages she was last paid. She doesn't get workmen's compensation. She doesn't even know if insurance will pay her bill. A form letter she received last week from Anthem BlueCare was unintelligible not only to her, but to an English-speaking reporter. She said her boss at work told her, "If you don't bring a paper from a doctor to show you're hurt, I'm going to fire you, and you're not going to get" reimbursed by the insurance company. She said the boss also claimed not to have that paperwork sent by Yale-New Haven.

Further, the boss claimed that Marta's injury was a pre-existing condition, because Marta had hip surgery in Mexico three years ago. Marta noted that she had been working just fine in the factory with the hip for more than a year and a half until her accident.

Waiting for the Next Step

She wants to return to work as soon as possible, even if she's still hurting. But she doesn't know if she'll need surgery first; she's told that she can't have an operation until January at the earliest. Also, according to her insurance plan, the company can't take her back if she's injured.

For all the lessons Marta learned about how to deal with an injury, the larger lessons are those contained in the Democracy Works report: a need for systemic change, from greater availability of Spanish translators to protections for immigrants who get hurt on the job. It's not just a moral issue, the report argued: it's about dollars and sense for an economy that increasingly relies on immigrants to do jobs no one else here wishes to do.

Ana De Santiagio served as translator during this interview.