Here’s a closer look at health care providers who, regardless of the temperature, check on the well-being of farmworkers as part of a federal program.
It’s right before sunrise and farmworkers are receiving mini-checkups from health care providers. Staff from Community Health Partnership of Illinois set up stations in a Harvard, Ill. farm’s main garage.
Workers have their blood pressure taken and get a finger pricked to test their glucose level for diabetes.
“If the readings are too high,” Elena Galarza, the clinic’s outreach coordinator, said, “we’ll refer them for a follow-up at the clinic.”
In addition to taking their vitals, Galarza said the visit lets the workers know the clinic is available to them.
Galarza was once a farmworker, newly arrived in the US, and recalled not knowing how to get healthcare.
“I know what it’s like to work in the fields, to arrive to another county and not know English,” Galarza said, “To work while feeling ill because you don’t know how to visit a doctor, because you don’t even know who to call.”
Galarza said for five years she lived and worked on a farm cultivating corn and broccoli.
She said one of the factors that makes farmworkers susceptible to illness is working outside.
“If it’s raining, you’re still working, if it’s very hot, you’re working, and if it’s cold you’re working, too,” Galarza said.
Another factor is the farmworkers schedule, said Daniel Garcia, the clinic’s nutritionist and diabetes specialist.
“The work schedule can determine what I eat,” he said, “at what time and the moment that I eat -- all important factors.”
It's the height of the farm season and the men and women have been working long hours, seven days straight for several weeks.
To meet farmworkers where they’re at, Galarza and the team set up shop at the job site — But do so, they receive permission from the employer.
Galarza reaches out to employers throughout northern Illinois and southern Wisconsin to arrange the visits.
She said some employers understand the benefit of having their employees receive health checkups. Others tell her it’s a waste of time.
"What they don’t understand is if you have a healthy worker he’ll be a better worker,” she said.
“The employer and the employee win. In addition, the service is free.”
The clinic is partly funded through a federal program under the Migrant Health Act. The law was signed by President John F. Kennedy in 1962 and authorizes healthcare services to farmworkers.
“This was the first federally funded approach to trying to get primary health care services to people that didn't have insurance,” said Bethany Boggess Alcauter, the research director for the National Center for Farmworker Health. “And farmworkers were the impetus for that whole program.”
She said the law launched federally-qualified clinics across the country. These are places that can’t turn anyone away from receiving primary care and charge for services based on household income.
Among the uninsured are many undocumented farmworkers who are not eligible for Medicaid nor the ACA Marketplace.
“It's estimated that around 50, or 60%, of everybody, that is a farm worker is undocumented, they have no authorization to be or work in the US,” Boggess Alcauter said.
“And then around 10 or 15%, have these temporary H2A visas.”
Farmworkers are at higher risk than other professions of developing respiratory diseases, skin disorders, and other health conditions. That’s because of the hazards some are exposed to on the job, like pesticides.
The National Center for Farmworker Health provides clinics and organizations with consultation, logistics support, and trainings, including one on heat stress. She said it’s a major issue, since there’s no federal protection for farmworkers against the heat.
“How would we feel if we sent firefighters into fires with no protections?” she asked.
“Like really no regard for their safety or well-being. We recognize that that's a hazardous thing to send someone to do, and we're asking farmworkers to do that same thing.”
Challenges to the migrant health program
Boggess Alcauter said even with the migrant health program, in some parts of the country, farmworkers face barriers to accessing care.
One of the logistic issues is transportation.
“It's a really big issue for those visa workers because they rely on their employer to provide transportation, they don't have -- none of them have their own transportation,” she said.
Galarza said it’s an issue they try to overcome at the clinic. If a provider refers a patient for a follow up at the clinic and the patient doesn't have a way to get there, she’ll reach out to friends and acquaintances to arrange for a ride.
“We find a way,” Galarza said.
Galarza started her new role in November and said she already sees areas she’d like to see improved to increase access to care.
“I’d like to find more partnerships with other providers that we can make referrals to workers that have serious health issues,” she said.
She said those partnerships have dwindled over the years.
An Illinois program offers health insurance to adults regardless of immigration status that helps close this gap. But the JB Pritzker Administration suspended enrollment to the program in June.
In the site visits Galarza serves many roles —translator, traffic controller and hugger.
She said the hugs are a small way to build relationships with patients. It’s when she has their trust, she said, that patients will be willing to share their concerns, thus giving her an opportunity to help address them.
She said one patient told her she feared that by seeking healthcare, she may not be hired for another harvest season.
“I told the manager that out of fear of losing their job, they were working while feeling ill,” Galarza said, “and the manager reassured me that seeking care is not a problem.”
