Michelle Gamage, Local Journalism Initiative Reporter, The Tyee

Francisco Barahona is recovering at home with a shattered arm after Surrey Memorial Hospital, he says, refused to treat him on the weekend because of unpaid past bills. 

The 53-year-old’s health has been deteriorating over the past three years as a cancer hollowed out his bones and he couldn’t afford health care.

Now the government is deporting him.

Barahona has lived in Canada for 15 years but has not yet found a way to get immigration status that would grant him lasting health-care coverage. 

When he was healthy he could get temporary Medical Services Plan or MSP coverage under a work permit.

But once he got sick he could no longer work.

Now Barahona is trapped. He is too sick to survive a deportation flight to El Salvador and has no way of quickly getting approved for health-care coverage, said Yanni Nicolidakis-Mustafa, an immigration lawyer with Edelmann & Co. Law Offices.

Nicolidakis-Mustafa is working with Barahona to help delay his deportation and apply for immigration status in the hopes of getting him covered by B.C.’s MSP and starting cancer treatment. 

Nicolidakis-Mustafa said Barahona went to Surrey Memorial Hospital on Saturday because the cancer had eaten a hole through the skin and bone of his arm.

But the hospital refused to treat Barahona unless he paid his previous bills, Nicolidakis-Mustafa said.

The Canada Border Services Agency, or CBSA, has said Barahona will be deported next Wednesday, he said, and the agency is looking into whether a team of doctors with him would reduce the health risks of the flight.

“We have been fighting his removal from Canada and just trying to convey to CBSA that this is somebody who is quite literally falling apart and needs palliative treatment. He is not safe to fly. Putting him on a plane will very likely result in his death,” Nicolidakis-Mustafa said.

“Even now he can’t really walk because his legs will break,” he added. “Coughing could break bones.” 

Barahona’s situation is not unique.

Dr. Kelly Lau is medical director of the urgent and primary care centre at the Reach Community Health Centre in East Vancouver, which is known for providing culturally sensitive care for Indigenous people, immigrants and refugees.

She said patients regularly come in suffering from cancer or other diseases and are not able to access the care they need because they don’t have MSP coverage. 

Lau said Barahona has accessed Reach several times, but an urgent and primary care clinic is limited in the care it can provide. For example, it cannot do surgeries or offer cancer care.

Lau said Barahona’s case is “not a one-off.” 

“There’s a lot of ways in which people fall through the cracks of our medical system,” she said.

Immigrants with work visas or student visas can easily lose their coverage if, for example, they get injured and are no longer able to work or study, Lau said. 

“We see a lot of people with work-related injuries who come in, we put in a WorkSafeBC claim and then they get fired from their job,” she said. 

Lau said undocumented people want to work and contribute, but there are barriers to being able to apply for more secure status.

Nicolidakis-Mustafa echoed this. People who are applying for immigration from within Canada can apply for humanitarian and compassionate consideration, but that process is currently estimated to take more than 10 years, he said. 

When people aren’t covered by MSP they have to choose between paying out of pocket, returning to their home country for treatment or not getting treatment. 

Nicolidakis-Mustafa said that when undocumented people go to the hospital they are being identified by CBSA, which has the right to deport undocumented people even if they are accessing health care. 

The Canada Health Act says health care is supposed to “protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” 

Lau said she’s seen patients suffering from breast cancer, prostate cancer, lung cancer and appendicitis who haven’t been able to access or afford the care they need.

‘I am very afraid’

Barahona spoke with The Tyee on Saturday, shortly before he broke his arm. 

The interview was translated with the help of Byron Cruz, a longtime advocate for migrant workers and a member of the Sanctuary Health collective, a grassroots organization that helps people access health care, regardless of immigration status or documentation.

Cruz has been advocating on behalf of Barahona and helping him get admitted to hospitals and access surgeries. 

Sanctuary Health is also helping Barahona by organizing a crowdfunding campaign to help cover medical and legal bills, as well as his rent.

In 2023 Barahona was diagnosed with multiple myeloma, a cancer that can weaken bones.

He said he is afraid of being deported and flown back to El Salvador because he is at high risk of developing blood clots after several surgeries to repair broken bones. He said his femur (thigh bone), his tibia (shin bone), his coccyx (tailbone), a vertebra in his mid-back, and his arm have broken since his cancer diagnosis.

He is also in “constant pain.” He has a prescription but it only reduces the pain level. 

Barahona said he was first diagnosed with cancer in 2023 while he was covered by MSP through a work permit. 

At that time, he said, he started treatment with BC Cancer, which withdrew his stem cells. But his MSP coverage ran out days before he was going to have stem cells injected back into him as part of the treatment, Nicolidakis-Mustafa said.

The treatment was stopped and he was discharged home with a prescription to manage the pain, he said, adding Barahona has not received cancer treatment since.

Barahona also wouldn’t be able to access the stem cell treatment in El Salvador, he said. 

“So yes, I am afraid. I am very afraid,” he said. 

Barahona told The Tyee BC Cancer has contacted him several times over the last two years. But he has been told his treatment will be approved only once he has MSP. 

The Tyee contacted BC Cancer to ask what its policies are when people don’t have MSP. We were referred to the Health Ministry, which said in an email that “BC Cancer does not refuse treatment if someone is unable to pay” and that BC Cancer will “work directly with the patient to find a solution if they are unable to make their payments.” 

If a patient is not covered by MSP, BC Cancer may ask them to pay $5,000 before starting treatment and bill the rest of the treatment cost incrementally, the ministry added.

However, Lau said that’s not her experience. 

She said it’s really hard to get specialists to work with patients without status, even if the patent has lived in B.C. for decades and, for example, recently lost their status because they are sick and can’t work. 

“We’ve called and asked BC Cancer for support and to see these patients, and they will not provide care if they don’t have insurance and cannot pay,” she said. 

‘Hospitals are not supposed to call immigration’

On Sept. 23, 2025, Barahona went to Langley Memorial Hospital’s emergency department. His leg was extremely painful and he later learned it was because a bone leg had shattered, likely due to the cancer. 

While he was waiting in the emergency department he was approached by a CBSA officer. Barahona had been flagged as a person without immigration status, which meant the officer had the right to start the deportation process — even while Barahona waited to be admitted to hospital. 

“There’s no other way for CBSA to find out he was there unless the hospital called them,” Nicolidakis-Mustafa said.

It used to be common for Fraser Health to call immigration services when undocumented people sought care; it referred patients to the CBSA about 500 times from 2014 to 2015.

After Fraser Health faced public criticism for its actions, it revised its policyin 2016 to not contact CBSA without patient permission. 

In an emailed statement to The Tyee, Fraser Health said it was still not proactively sharing information with the CBSA. When The Tyee asked how a CBSA officer knew where to find Barahona, or if Fraser Health would be reviewing what happened, the spokesperson said Fraser Health would not comment further.

Lau said she knows of three other recent cases where Fraser Health called immigration when people sought health care. 

CBSA officers are allowed to arrest anyone who is in violation of the Immigration and Refugee Protection Act, the agency told The Tyee in an emailed statement. 

Essentially, anyone who is in Canada without status can be arrested and deported as quickly as possible. However, CBSA officers are not supposed to get in the way of people receiving health care. 

“The CBSA will not remove an individual from the hospital until they have been medically discharged,” the emailed statement continued. 

Cruz said he’s frustrated that Fraser Health is once again reporting patients to immigration services. 

“Hospitals are not supposed to call immigration,” he said. “They’re supposed to keep a patient’s privacy and confidentiality.” 

Barahona said he wanted to move to Canada to be with family and, literally, build a better future. He works in construction and has helped build hospitals and donated his time to help people repair their roofs, even if they couldn’t pay him. 

“I came here to work and show we are good people — not to damage anyone,” he told The Tyee.

He said a CBSA officer said he was a “nightmare for this country.” 

“It hurt a lot when he said that,” Barahona said. 

He also feels abandoned by the health-care system. 

By withholding cancer treatment, “they are damaging a person, a family,” he said. “Canada is characterized as a humanitarian place. But I feel alone, like there’s cold water on my back.” 

Cruz said Canada needs to revise its health-care policies to improve access for residents and payment options for people not covered by provincial health plans.

If someone is working in B.C. they deserve to be given MSP coverage on arrival, he said. 

For everyone else there should be a “humane way of paying,” with a sliding scale of fees based on a person’s income.

“We’re not speaking about tourists,” he said. “We’re talking about people who are working here, whose refugee claim was denied and now they’re trying to get status another way. Or a woman whose immigration was sponsored by her partner, but the partner gets abusive and when she leaves him he cancels her insurance. What then?” 

Barahona said his health-care bills currently add up to about $10,000. 

That bill could increase sharply if hospitals decide to charge him a per-night fee, which can be up to $6,000 per night, Cruz said. Barahona has recently spent months in hospitals.

Cruz said he has worked with undocumented people who were charged $75,000 and $300,000 in health-care fees. 

Barahona said he is paying what he can and getting small donations from his community. 

“The medical system failed me,” Barahona said. “When I went into hospital, when things started, I had MSP. They started the process but didn’t finish it. What has happened since is a consequence of them not finishing the procedure.”

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