Monday, January 19, 2015

Visa Hell

This post was written by my husband, Drew.   To this day no one from CKGS has ever acknowledged the reality that our son died alone because they refused to give us our visas.

Through all of our research into Indian surrogacy, we’d heard plenty of horror stories about the visa application process under both BLS (who ‘handled’ my visa for my first trip in November ’13) and CKGS, who took over from BLS in May ’14, supposedly after BLS just got buried in complaints.  We budgeted three months to get our applications in and maneuver through whatever obstacles would arise and still allow us to make our flights as intended.  So on August 13, 2014, we took all of our forms and piles of supporting documentation and sent them off.  As you probably know, things didn’t quite go as planned.

A week went by, and we didn’t even get a confirmation of receipt from CKGS.  I emailed their support staff, and the case was escalated by the following day.  While we already had our first obstacle fresh out of the gate, it was at least getting a level of response that was reassuring.  Another week passes, and since that initial escalation, we again had received no updates from CKGS.  So I emailed them again.  The following day, we got notified that:

- I had applied for the ‘wrong’ visa.  On the advice of our facilitator, I had applied for a medical visa, but should have applied for a medical attendant visa.
    In all fairness, this did make sense.  Rhy applied for a medical visa, since she was technically the ‘patient,’ and I would be accompanying her.  I re-did the application form and sent it to CKGS within a week.
- The photographs we sent (I will call these Photo Set #1) were deemed inadequate.
    This would be the same picture of us that were used on our visas the first time around.  But were now not acceptable.  For reasons.
- Our payment was short by $5 each.
    This sent me through the roof.  I used CKGS’s website:

and their order form to arrive at the amount that EACH application would need.
Per the instructions that came from the auto-generated email, I attached a new set of photographs (Photo Set #2) and sent them to the two addresses I had for CKGS’s San Francisco operations.  I then proceeded to call CKGS directly about the fee dispute.  Over the course of the next week or so, I spoke to several different people about what their website listed as the fees required and the amount that I sent.  ALL of them agreed that what I sent was appropriate.

Just after Labor Day, I am again told that the photos we sent did not meet the consulate’s requirements.  Furthermore, I was informed that photographs for visa applications weren’t accepted via email, and that physical copies were required.  While I fumed at this person that their generated email SAID that I could, I hastily compiled Photo Set #3 and mailed it in.
By this point, it had been three weeks and there had been ZERO forward momentum on getting our visas.  That’s three weeks that we are not in possession of our passports.

For the next three subsequent weeks, I make more phone calls.  I send more emails.  Rhy even joins in on the fun.  (And even makes one phone monkey cry!)  We get alternating stories: on one day, our applications were at the consulate being evaluated.  Another day, our applications are still at CKGS awaiting that final $5 before being sent out.  Each time they try to say that, I point out what their own website lists for the fees, and am told that the amount that I sent is correct.  Eventually, we get fed up and start to reach out to the US Consulate in Delhi and the Indian Consulate in San Francisco, pleading for help.  We simply couldn’t keep doing the same things over and over again and expect the results to be any different.

Finally, with six full weeks gone by since the applications were originally sent, we get an email from CKGS that essentially says “Please resend us digital copies of everything that you sent us hard copies of.”

I started to freak.  This, combined with the inconsistent stories, made me afraid that they’d lost our applications and/or our passports and were stringing us along to buy time to find them.  If we not only had to start from scratch with the application process, but also obtain emergency replacements of our passports, not only would we have to give up any hope making our flight, but pay through our noses in additional fees.  While they assured us that they still had our passports, they never did give us an explanation as to why we had to send them everything all over again.

Thankfully, I’d scanned each and every page that we had to send to CKGS.  This allowed me to simply attach everything to a couple of emails, so I (re) sent them to CKGS that same day.  The following day, we were told that our passports would be sent on to the consulate “on Monday.”

Monday comes and goes and we don’t hear anything about where our visas are, so we resume the phone call/email barrage.  What we were met with was ANOTHER request for visa photographs.  So we compile and send Photo Set #4, with our level of anxiety rising with each passing day.

On the evening of October 10, Pacific Time, as I was driving across the state to spend the weekend with Rhy and the kids, she calls me in hysterics.  Our twins were being born.  Despite the fact that we had sent our visa applications two months earlier, Maizy and John were in New Delhi and we were trapped in the United States.  On top of that, we seemed to be no closer to getting our visas than we were in August.  At the time, it was our worst nightmare.

Despite the fact that it was the weekend, we emailed everyone and their brother’s dog, pleading for updates and begging for action to be taken.  On Tuesday, we were contacted by Henry Lindpere, a manager at CKGS.  He informed us that the reason our applications hadn’t been sent to the consulate yet was because our payments were short by $5 each.  I gave him the same figures from the same forms that I had given the half-dozen phone techs I’d spoken to, but he insisted that nothing would happen until our account was settled.  With John’s health already precarious, we did the only thing we could and sent CKGS the money.  We still do not know what the money was for.

The day after they received the money, we got another email saying that our photos were again not acceptable.  Desperate to get to our son and daughter, we went out and paid for someone to physically take the pictures for us, making this the FIFTH set of photos we had to send to them.  Up to this point, we’d been using an app on our phones suggested to us by our surrogacy coordinator, Kim Hendrix.  Throughout the issues we encountered with CKGS and our photos, she kept telling us to use the app, as it would be faster and cheaper than getting them physically taken.

We then emailed them to our friend A.,  who printed them out and took time off of work to hand deliver them at the CKGS office in San Francisco.  The photos were delivered to CKGS at about noon that day, and delivered to the consulate in short order.  In what had to be an Indian bureaucratic speed record, our visas were approved and were FedExed back to us (after paying CKGS even MORE money, but I digress) by the end of that same business day.  It was wonderful news to hear on my birthday - we’d get our passports the following Monday, Rhy would be on a plane for Delhi Tuesday morning, and 24 hours later, she’d be with our babies.  There was a light at the end of the darkest tunnel we’ve ever been through together.

We watched  for the FedEx truck with more anticipation than two children on Christmas Eve.  When he finally comes, we tear open the envelope to see these visas with our own eyes.  What we saw was initially confusing: the photos that were on the visas weren’t from Photo Set #5, the ones that our friend Avi had delivered to CKGS personally.  Instead, the consulate used Photo Set #3, which had been sent to CKGS nearly SIX WEEKS earlier.  We contemplated sending emails to both CKGS and the consulate to express our bewilderment and anger, but decided it wouldn’t accomplish or fix anything.  So we jumped in the car and headed for Seattle - Rhy had a flight to catch, after all!

As we were driving, we got a call from the doctor in India - After 10 days of life, and having had to fight for each and every one, our beloved son, John P. H. Morrigan was dead, having never met the parents who loved him.

It took us two and a half months to get our visas through CKGS, which is just about what we had allotted.  But as I said in the beginning, things didn’t quite go as planned.  After weeks of unnecessary delays, we got our passports back on the day that our son died.  Even if we had gotten our passports back in September (when we sent in Photo Set #3), it may or may not have had an impact on whether or not John would have survived.  It would have, at the absolute least, given him a fighting chance, as we could have gotten Rhy on a plane immediately and she could have pushed for a medical evacuation to either another hospital in Delhi or all the way back to Seattle Children’s.  But even a single day’s worth of saved time would have allowed Rhy to have held John before the end.

Over the course of those two and a half months, our anxiety, frustration, and anger rose.  As time wore on and we encountered problem after problem, we reached out to Kim Hendrix, the US Consulate in Delhi, and the Indian Consulate in San Francisco.  Ultimately, none of them were able to help.  We finally reached out to our local senator’s office in the desperate hope that her office could help apply some pressure, so perhaps that speed record I mentioned was made possible in part to that pressure.  But for 99.9% of this ordeal, we were forced to deal with this monstrous situation completely on our own.

Over time, I will learn to integrate the tragic loss of my son into my everyday being, despite the fact that he died without ever having met his mother or me.  But what I am still bitter about is that while his death may or may not have been preventable, him dying alone WAS, and it is because CKGS screwed up in more ways that I can count that he did.

And I will ALWAYS be bitter about that.

Wednesday, January 14, 2015

When your facilitator means that your hospital in a third world country

might not be a five star resort...  Perhaps it would be more accurate to simply show people what that means:

One of the pictures from the hospital room my daughter and I were in.  This room was fifty feet from the NICU where my son died.  Klebsiella, the bacteria that contributed to his death is transmitted via the fecal oral route.  He had it in his lungs.  Based on this picture how confident would YOU be in the infection control protocols in this facility?

Monday, January 12, 2015

Professional Standards for International Surrogacy Professionals: Part 2 Qualifications and Conflict of Interest

My husband and I chose to use a surrogacy facilitator not once, but twice.  One of the primary reasons we made that choice was the recognition of our limitations in terms of evaluating a medical facility on the other side of the planet.  In retrospect, we should have recognized that those same limitations applied to the facilitator.

Most international surrogacy agents do not have degrees in the health care field; it’s probably not reasonable to expect them to.  However,  absent accreditation by a credible third party like the International Joint Commission, it seems unlikely that the average layperson  has the ability to evaluate doctors or facilities in a foreign country.   Given our experience,  a hospital that does not adhere to the standards set by the joint commission is not a hospital I would feel comfortable using for high risk pregnancies or infants.  To find out if a hospital meets these standards,  click here.

The fact that a medical facility has a nice website or that it “looks” clean doesn’t mean that it adheres to international standards for patient safety.  

At the same time, if a facility cannot maintain the most basic standards for cleanliness, it seems extremely unlikely they would have the capacity to prevent the spread of infection.  In a country like India, where antibiotic resistant bacteria kill fifty-eight thousand babies  every year it should be obvious why this is critically important. 

The second and equally concerning issue is the conflict of interest in the relationship between facilitators and clinics.  Facilitators frequently receive referral fees from the doctor/clinic.  This is problematic for reasons that I think are pretty clear. At the very least, transparency would seem to require that this relationship be disclosed.

There are hospitals in New Delhi that meet the standards set by the Joint Commission. Again, you can find them here.  I would not feel safe using a doctor who delivered at a hospital that did not meet these standards.    If my agency or facilitator was recommending that I go forward with surrogacy in a country where there were no facilities accredited by the International Joint Commission, knowing what I know now,  I would not be comfortable taking that risk with my baby.

Losing a child is one of the single most devastating things that has ever happened to my family.   Sharing our experience has opened me up to vitriol from strangers and from people I used to call friends. I’ve been threatened with legal retaliation and told that this blog “does not paint me in a positive light.”  What those people don’t seem to understand is this:  My beloved son died.  The last thing I’m worried about is other people’s opinions.  Frankly, I don't deserve to be painted in a positive light because I failed  my son by being arrogant enough to think that I had the ability to protect him from half a world away.  Telling my story isn’t easy.  It shouldn't be, but it’s the only way I can think of to say this:

“Johnny, Mommy is so very, very sorry.”