For Ritta Wadawu, success comes in tiny bites of apple sauce and clicks of the television remote control.

The simple act of pushing a button to see Joel Osteen, her favorite televangelist, is a big step.

Louie Favorite/AJC (ENLARGE)

Occupational therapist Eusebia Niako (left) and rehabilitation manager Shara Brown move Ritta Wadawu into a wheelchair at Crestview Health & Rehabilitation Center. Wadawu, a quadriplegic, spent time at Grady Memorial Hospital, some of which was because she had nowhere else to go.

Louie Favorite/AJC (ENLARGE)

Occupational therapist Eusebia Niako moves Wadawu's foot. The cost for the stay at Crestview runs about $300 a day.

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Stalled for two years in a state of paralysis, Wadawu is making progress at last.

In late January, she was moved from Grady Memorial Hospital, where she had been for eight months, to Grady's Crestview Health & Rehabilitation Center, where she is receiving speech, physical, respiratory and occupational therapy.

But while her condition is slowly improving, her immigration status remains in limbo. The U.S. government has refused to recognize her as a refugee but allows her to stay for humanitarian reasons — and because the cost of sending her back to her native Zimbabwe would be too high.

She came to Atlanta in 2001 to find work to support her family after Robert Mugabe's controversial policies sent her homeland into a spiral of economic and political disintegration. Mugabe stood for re-election late last month, but results are uncertain. Wadawu was working three jobs as a nurse's aide when she was injured in a car crash on Dec. 31, 2005, left with only slight movement in her right hand and foot.

For her and her family, her story is a terrible personal tragedy. For Grady Health System, it's one of the thousands of stories of patients who depend on the hospital for care. Like Wadawu, about a third of Grady's patients are uninsured.

Wadawu was airlifted to Grady after the accident, spent several months there, then lived with her son and daughter-in-law in Marietta for several months. But they found the around-the-clock care overwhelming. She returned to Grady in May 2007, after a medical setback, and stayed there until late January. Though she wasn't in need of acute care for much of that time, she stayed at the hospital because she had nowhere else to go.

Wadawu's hospital bills at Grady have amounted to more than $1.3 million and remain unpaid. Her semi-private room at the hospital cost about $1,400 per day, according to Grady spokeswoman Denise Simpson. Charges for her care at Crestview, including therapy and medication, are roughly $250-$300 a day.

She doesn't qualify for Medicaid, and her family has paid nothing. "We can't afford it," said her son, Noel, 26.

Grady operates Crestview, the state's largest nursing home, to provide for patients such as Wadawu who can't live on their own but can't afford private nursing or assisted living care.

"She needs to be in that type environment," said Noel Wadawu.

Speech therapists are working with Wadawu to help her tolerate apple sauce and pudding, hoping that eventually she'll be able to live without the tube in her stomach. Occupational therapists are trying to improve the strength and movement in her right hand and foot, with the goal of eventually having her propel her wheelchair. And respiratory therapists are trying to get her off the machines that help her breathe.

But getting her out of bed and into a wheelchair on Mondays, Wednesdays and Fridays for her therapy sessions is a 20-minute process. The whole morning ritual of personal hygiene takes more than an hour.

"We're working to get her to the highest level she can attain," said Kim Morris, director of fiscal management for Crestview. "She has a good attitude, good drive. We feel like she will go as far as she possibly can."

"She has such a good attitude," said Joyce Clark, nurse manager at Crestview. "She wants to get better."

Wadawu is at Crestview indefinitely, said medical social worker Veronica Gambrah. "She's going to be with us long term. At least for the next year, and then we'll see."