Clinics, volunteers bring medical care to migrant farmworkers

In the 24 years since President Ronald Reagan signed immigration reform granting amnesty to undocumented immigrants, a generation of farmworkers has helped make Washington tree fruit a $2.5 billion industry.

Those seasonal farmworkers who achieved legal status as a result of the Immigration Reform and Control Act of 1986 now are retiring from the physically demanding profession. Replacing them are younger workers, half of whom are believed to have crossed the nation’s southern border illegally. They do the work no one else wants while looking over their shoulders for U.S. Immigration and Customs Enforcement agents, reform advocates say. Agricultural work takes a toll – spine injuries from ladder falls, eyes burned by sun and dust, neurological damage from pesticide exposure.

Some farmworkers who are legal residents of Washington state might have Basic Health coverage. But 80 percent of farmworkers have no health insurance at all, according to a 2006 survey conducted in 14 Washington counties by the Farmworker Housing Trust.

Although medical services are available to seasonal agricultural workers, the outreach necessary to make workers aware of them rests with a handful of clinic workers struggling to get the word out to a hodgepodge of public and private migrant camps scattered throughout central Washington.

“They are the people putting food on our table,” said Carol McCormick, supervisor for outreach for Columbia Valley Community Health. “Many are undocumented. They are afraid.”

Each year, McCormick helps organize health fairs at migrant camps, schools, churches and community events in Chelan and Douglas counties, where seasonal workers learn about health care options available to them.

During one such fair late last month, health care professionals set up information booths and brought food for more than 300 people living at the tent camp in Monitor, near Wenatchee, during the cherry harvest. Monitor Camp, established by the state after a crackdown on substandard migrant housing in the late 1990s, is run by Chelan County. The tents accommodate about six men who each pay $8 a night. Families stay in cabinlike structures nearby. The communal bathroom and kitchen facilities are stark but clean.

The workers return from their work in the late afternoon. Children play among the tents. Men shower before cautiously strolling out among the information booths.

There to greet them are health workers and volunteers from institutions such as Columbia Valley Community Health, Wenatchee Valley Medical Center, the Women’s Healthcare Center and Quincy Community Health Clinic.

At one booth, a couple dozen men in their 20s waited to have their blood pressure checked. A doctor told a man named Isais that his blood pressure is high. He should not smoke, should cut down on his drinking and follow up with a medical exam when he returns to his home base in California.

Like most of the farmworkers interviewed, Isais said he had no health insurance and could not recall ever seeing a doctor. Those who said they had seen a health care provider in their lifetimes probably saw one at a health fair like the one at Monitor.

The seasonal farmworkers travel from state to state following the harvests.

“When they arrive in the United States, they are very healthy,” said Lilia Gomez, an outreach coordinator for the Washington Association of Community and Migrant Health Clinics who has been coming to health fairs for the past six years.

The workers are young and their nutrition has been well balanced, despite a general lack of health care.

“Probably for the first 10 years that they are working here, they are being very productive without using any services at all,” Gomez said.

“It’s when they are starting to work here and getting exposed to pesticides and to the awful diet we have here they start getting sick,” she said, basing her statement on interviews with single male farmworkers in the Vancouver, Wash., area.

The health fairs put the workers in contact with primary health, immunization, mental health, dental and maternity services.

Health care for seasonal migrant farmworkers is funded under Section 330 of the Public Health Service Act. Qualifying clinics use a sliding scale with discounts based on a family’s size and income. Depending on annual income, a seasonal farmworker might pay $25 for a visit to the Columbia Valley Community Health Clinic, according to its CEO Patrick Bucknum.

Qualifying clinics must make services available to all, regardless of ability to pay.

The Farmworker Housing Trust survey found that the workers’ average annual household income was $17,500, well below the federal poverty level of $22,050 for a family of four. Six percent of farmworkers and 15 percent of migrant farmworkers described themselves as homeless.

McCormick and others who have worked closely with seasonal agricultural workers say the stress of working illegally in the United States takes a heavy toll on their health. She says many are afraid to access what services are available.

“In order for us to have a good, healthy work force, we need people who are not stressed by the fear of immigration,” McCormick said. “We need to recognize that those who received amnesty in the ’80s are ready to retire, and we need people who are free to work, who are stress-free and who are willing to do this difficult job.”