University Provides Free Medical Care to Migrant Field Workers

During a 10-month growing season, about 100,000 farmworkers, many of them unable to feed their own families, toil the fields of Georgia to pick produce the rest of the country gets to enjoy.

They work in the blazing sun, during the coldest of winters and in the dirt – and if they are injured or have medical problems they keep working because they don’t have money to go to the doctor, much less the hospital.

In an effort to make medical care more available to this impoverished community, South Georgia Farmworkers Project and the Physician Assistant Program at Emory University have been providing free health care and medication to migrants at their two triage locations, Bainbridge and Valdosta, for the past 16 summers. Most of the physician assistant students – about 90-95 percent – at Emory choose to participate in the project to fulfill an elective.

The medical team departs to the fields at 7 am and their day is segmented into morning and evening clinics, which helps accommodate the field workers schedule as they get paid by the bushel and will not take work time off to seek medical care. The students are each teamed with a certified Physician Assistant to provide clinical services until 11 pm with a short mid-day break, usually heading to bed around 1 a.m., repeating the process for two weeks.

The payoff is not only work experience but, according to many of the students, the big return is helping underprivileged people and gaining insight to the daily life of the migrant field worker.
Raquel Vasquez Ludwig, a graduate of the Emory Physician Assistant program, remembers her time providing medical care in the fields and how appreciative the workers were.

“One patient told me through tears that he felt God had sent angels to help him.” Vasquez is fluent in Spanish and had the opportunity to get to know several of her patients beyond taking care of their medical issues.

She learned numerous personal stories, but one that stays with her is that of a 16-year-old boy who’d been working in the fields to keep his family fed since he was 12. She asked him what his dreams were and his reply was:

“I don’t have time to dream. When I work in the fields all I can think about is my family back home. I wonder how they are doing. I miss them.”

The Emory students caravan out to the site in their own cars and bring personal folding chairs for both themselves and the patients. A trailer with donated supplies and pharmaceuticals is stationed near the fields and the exams take place out in the open. Plastic drawers filled with medical supplies act as a mobile office space. Makeshift areas that provide more privacy are reserved for those who need discrete treatment or examination.

Many of the worker’s injuries involve repetitive motion, such as rotator cuff damage – which is no surprise after day in, day out hoisting 25 – 35 pound buckets of tomatoes onto a truck for .40 - .50 cents per bucket over 10 hours a day.

Heat-related complaints occur frequently, many preventable by proper hydration. But there’s limited access to drinking water in the fields and stopping for water breaks slows productivity. The workers often choose more portable drink options that are full of caffeine and sugar or even alcohol – all of which encourage dehydration.

Other common ailments include diabetes, hypertension and allergies. Those patients with more serious illnesses or injuries are sent to a hospital.

The care extends to local schools and the Emory team performed over 200 Well Checks for 2nd – 4th grades at schools where children from migrant and other underserved families attend.

After his first week in the fields, third-year Physician Assistant student Chris Fritzen feels his ideas on migrant workers have changed.

“I developed much-needed compassion for this group of individuals who I saw first-hand just how hard they work for this country. It was an honor to provide what I could – to say thank you. Everyone deserves to be healthy,” he said.

The migrants are often fearful of being identified and are cautious about going to hospitals when necessary – the fear is derived from a general lack of knowledge about hospitals, or that treatment will cost them money. There have been incidents where a serious medical condition was suspected and the individual literally hid from care providers because they were terrified of going to a hospital.

Educating the migrant workers is a large part of what the project is about:  Everything from hygiene to over-the-counter remedies and preventative care are explained and demonstrated through translators.

The seasonal workforce the Emory students serve is comprised of a distinctive mix of nationalities and in recent years there’s been a rising need for volunteer Creole interpreters to serve the Haitian workers. The large majority of workers are Mexican, but the Haitian migrants are a demographic that is steadily increasing and there are definitive, but smaller groups comprised of U.S. citizens, Guatemalans and Jamaicans.

Many of the workers come to the U.S. under an H-2A visa that permits employers to recruit temporary workers, but they must show proof U.S. workers are not available to perform the work specified before being permitted to hire migrants. Under the H-2A the employers are also required to meet wages and working condition standards for their region. There are no work status requirements for the laborers to receive medical care from the South Georgia Farmworkers Project.

The non-medical community volunteers are an important aspect of the project and help to fill in the gaps where needed by providing everything from interpreting to handing out donated clothing and assisting with the logistics of seeing from 1,400 – 1,700 workers per two-week program.  The South Georgia Farmworkers Project at Emory University School of Medicine has no state or federal funding and relies on volunteers, community partnerships and donations.
“I want more Americans to be aware of the reality of the US agricultural industry… to know and appreciate where their food is coming from, and whose hands they go through before they reach our grocery stores and dinner tables,” says Jeri Sumitani, Director of Community Projects with the Emory Physician Assistant program and Coordinator for South Georgia Farmworker Health Project, “I truly believe the program has the potential to reach many more individuals. It is a powerful experience for anybody who participates, and many volunteers have agreed that this project ‘changed their lives’.”

On average, approximately 60-70 percent of the migrant workers report they have never had medical care in their lives. The good news, program officials say, is that the South Georgia Farmworkers Project is seeing repeat patients over the years.

Proof, they say, that the education and treatment they are providing is making a difference in the lives of those who receive the care.