July 22, 2014
By Simar Nagyal
After driving an hour or so towards the Blue Ridge Mountains, we finally arrived at the labor camps. Situated on the outer edge of the vast blueberry farms, the labor camps were a combination of trailers and wooden houses colored in a faint blue. To the left, red wooden barns housed tractors and other farming machinery. Outside, wet clothes, hung on the clotheslines, lined the perimeter of the housing units. As I stepped out of the car, an aroma of sautéing frijoles rushed into my nostrils. Two bags of trash (recycling?) filled with Coke and Pepsi cans were dumped next to the kitchen door. One of the outreach workers, Jim*, knocked on the kitchen door of the female labor camp, and a dark-skinned woman named Isadora* came out. After a few minutes of conversation, Isadora slipped back in and a few more women trickled outside, either excited by the prospect of visitors or in need of healthcare attention.
Jim began filling the healthcare assessment form with Isadora. The other women needed a little more convincing to divulge their personal health information to complete strangers. The other outreach worker, Mark*, who was also a nurse, began explaining the various reasons for seeking out the services of the clinic in Spanish. Si necesita ayuda con caulquier tipo de enfermedad como problemas dentales o problemas con los ojos o si quiere una chequeo regular… (If you need help with any sort of health problem like dental or vision problems or if you need a physical checkup…) Some women’s facial expression still displayed their clear discomfort. Others felt bien and resumed to their cooking activities in the kitchen.
Nonetheless, at least seven to ten circled around the outreach workers to fill out the healthcare assessment forms and get their weight and blood pressure checked. I was quite surprised by how willing some women were to reveal their personal information to us. Although trust is generally built over the course of a relationship between a healthcare professional and a patient, it seems that it had been quickly established in this case. Isolated from the rest of the world, migrant farmworkers who reside in labor camps rarely have easy access to grocery stores, let alone clinics or hospitals. Not only do they need to gain consent of the employer to leave the farms’ premises, they also must rely on their employers for transportation. In fact, the clinic had needed prior permission from the growers to even be able to do this sort of outreach work. Considering that this was probably their only chance to seek out healthcare during the eight-month stay on the farm, they had no choice but to be honest about their health concerns with us.
I grabbed the healthcare assessment forms and a pen and trotted towards the women waiting for the outreach worker. Necesitan llenar a la papeleria? As I filled out the paperwork, I learned that none of the women had any sort of medical insurance. If they needed to visit a clinic or hospital, all expenses would have to be paid out of pocket. For a group of women whose average salary is less than eight thousand a year, medical costs would cast a significant burden on their financial situation. When a person works in one of the most dangerous industries, having health insurance becomes imperative. As farmworkers, these women face risks such as heat stroke, pesticide exposure, injuries and fatalities due to heavy/improperly maintained machinery and equipment. Thankfully, this charitable clinic provides transportation to and from the fields, waives fees for medical visits, and greatly subsidizes the costs of medications through its participation with the Farmworker Health program.
Most of them had recently migrated from Mexico to the United States. A couple had seasonally worked at farms in Georgia and Florida. Nonetheless, this appeared to be the first time they had access to healthcare in the United States. If they had caught a cold or suffered from bodily aches, they had generally treated the problem by using pills (Tylenol, Advil, etc.) borrowed from someone at the camp. Although most stated they wanted a routine physical, others presented immediate health issues (i.e. concerns about sexually transmitted diseases, irregular menstrual cycle, urinal tract infection, bloody nipple discharge). For these cases, I noted that they needed to be put down on top of the priority list of appointment.
I was most surprised by the high incidence of mental health concerns among the women. Nationally, forty percent of farmworkers indicate that they suffered from depression. Although a startling truth, this almost becomes inevitable for a group of people who are thousands of miles away from their loved ones. Though they may build bonds with their co-workers/housemates, their migrant status forces them to bid farewell to those friendships and re-establish relationships with a set of new faces.
Furthermore, the desolate location of the labor camps only contributes to feelings of isolation and loneliness. Scattered throughout the vast fields, labor camps are miles away from the hubbub of the town, and these women are confined to the camp’s boundaries as per the rules of the employer. They are only able to interact with the town’s residents during their short, designated trips to the grocery store.
For this group of women, language particularly limited this interaction. None of the women spoke any English. A large number were Spanish speakers. A few had limited Spanish skills and primarily spoke Purepeche, an indigenous language spoke in the Mexican state of Michoacán. They had to largely rely on the aid of their fellow co-worker, Isadora*, to communicate their health needs to me.
Despite the immense difficulties these women may face as farmworkers, they were some of the most jovial and high-spirited people I had met during my outreach work. Beaming with smiles and infectious with laughter, these ladies cracked jokes as they finished their “exhaustive interviews” with me. Perhaps, their love for their families or their belief in the Almighty gave them the strength to push through the hard times. I will explore this in further detail in my next blog post.