When 5 year-old Kay Bell moved to Houston, Texas, with her family in 1994, she was too young to remember details of her childhood in Nigeria, much less realize that she and her family were violating U.S. immigration law.
"I don't remember anything from before I came here," said Bell, a 21-year-old undocumented immigrant whose name has been changed to protect her identity. "Where my mom goes, my sister goes, and where the both of them go, just for peace of mind, I have to go."
Yet unlike many illegal immigrant families who migrate to the U.S. in search of better jobs, education or physical and financial security, Bell says her family came to Texas primarily seeking medical treatment for their youngest child, Bayo, who suffers from cerebral palsy.
"My parents came once to get her surgery and went back, then came once more to get a shunt in her brain, maybe when she was three or four years old," Bell said. "The last time they decided we should stay."
Bayo, who was three years old on her first trip to the U.S., underwent surgery at the Texas Medical Center to relieve dangerous pressure in her brain. After the procedure, her mother, a Nigerian medical doctor, and father, who works in the country's oil business, realized they would put Bayo at risk if they returned home.
"There's a lot of superstition in our culture, there's a big stigma and taboo around people with special needs," said Bell. "There was some tension and harassment and things going around in Lagos because of my sister's condition, which played a part in why we came here to stay."
Experts say people with mental and physical disabilities across Africa commonly confront a level of prejudice more severe than what one might face in the U.S., including physical abuse, ostracism, and fear of contagion.
"In large parts of Africa, the stigmas tie what we would call disabilities to ideas around occult power and witchcraft," said Clifton Crais, director of Emory University's Institute of African Studies. "It would be a much, much harder life and one would be living in a world in which a substantial portion of the population feared them and ostracized them and suspected them."
Fifteen years later, the Bells continue to live in the shadows in the U.S. without legal immigration status. Their case highlights the diversity of backgrounds among the country's 10.8 million illegal immigrants, including more than 200,000 from Africa.
Bell said her mother, who declined to speak with ABC News for privacy reasons, made several attempts to legitimize the family's immigration status, but at least one application was denied. The mother did obtain a temporary work visa, which has allowed her to legally hold a job and get health insurance to help cover medical costs.
"Mom tried to have two jobs so that we'd have more than one insurance company to bounce off of when one said, 'No,'" said Bell. "But after my sister has grown older she has stabilized a lot, so now it's mostly maintenance bills and supply bills… It's paycheck to paycheck but we're still breaking even."
Bell, an undergraduate double major at the University of Texas who works for minimum wage at a hospital gift shop, says she filed a tax return for $11,000 in earnings last year. She estimates her mother, who was a practicing doctor in Nigeria but now works as an aide at nursing homes, makes under $40,000 a year.