The tenth anniversary of the attacks of September 11, 2001, has inspired a reflective mood in New York and much of the nation. While everyone looks back and recalls where they were when the towers fell, those who are sick as a result of the devastation are looking forward – and they do not like what they see.
Fifty-three-year-old Iris Sanchez has chronic asthma and high blood pressure, among other ailments.
"So many health issues, and everything related to 9/11," says Iris, speaking in Spanish which, even after 40 years living in New York, is still her primary language. "There are days I think I won't be here tomorrow."
Just two days after the Twin Towers fell, she took a job cleaning office buildings directly adjacent to the World Trade Centre site. Iris had done her share of janitorial work since emigrating from the Dominican Republic as a young girl and she wanted to help straighten out this mess. Working at Ground Zero seemed like the right thing to do.
"I wanted to be there to do any chore," Iris says. "To pass water to those doing recovery, and very much serve the country that has treated me very well."
Host of medical issues
More than 18,000 people have received treatment for 9/11 related illnesses, according to statistics compiled by the World Trade Centre Health Programme. The victims represent a working class cross-section of New York.
They include the very police and firefighters who spearheaded the recovery efforts on "the pile". Their dedication earned them national hero status – and a whole host of medical issues both physical and psychological.
A list of respiratory and digestive ailments have been scientifically linked to exposure to the site, as well as post-traumatic stress disorder and depression. Cancer is noticeably absent from the list, despite what appears to be plentiful anecdotal evidence.
People who lived or worked in the neighbourhood – which includes New York's financial district - have also gotten sick.
And then there are the people like Iris: an estimated 2,000 low-wage workers who mopped up the toxic dust of the pulverised World Trade Centre that coated the buildings around the site. Unlike Iris, many are undocumented immigrants.
Iris's son Alex, who was born in New York, and Manuel Checo, another Dominican, worked as a team clearing out air shafts. They worked in World Financial Centres 1, 2 and 3 on West Street where much of the debris from the twin towers landed. Alex describes crawling into the narrow shafts with an air hose to blow the dust though.
"Either I'd blow it toward Manny, or he would blow it toward me," says Alex, who now takes 13 different medications a day to help him with the basic tasks of breathing and eating. "I remember shining the flashlight into the dark and seeing all of the glass particles reflect in the air."
He says he was not properly trained or licensed for the job - and so had no idea that the face mask he was given was inadequate. The federal Department of Environmental Protection had told everyone the air was safe to breathe.
All responders – even those who are undocumented – are entitled to medical care under the James Zadroga Health and Compensation Act, which became law in 2011. Many will also get some form of compensation – sorely needed by those who can no longer work due to sickness.
The rules, which will establish the formula used to calculate the amount of the pay-out, were due out on September 1st, after which responders have 90 days to decide whether or not to take the money. If they take it, they give up the right to sue the companies who hired them and allegedly failed to protect them.
"These are uncertain times for us," explains Alex, who with his 10-year-old son shares an apartment with his mother to make ends meet. September is also when his son goes back to school - and he is already after a new backpack and sneakers.
Alex receives a modest disability pension from the government. Iris receives social security. But many of the sick clean-up workers who are undocumented do not have a regular source of income.
What really does not sit well with Alex, or his mother, is the fact that responders were not invited by the city to this year's memorial service, unlike year's past.
"Ironically, those who served the city so well, and those who served the country in our time of dire need won't be able to participate," says Iris.
Cut off from the ceremony, they feel forgotten by the government on whom their future security now largely depends.