From KALWNews.org, CrossCurrents, Bridget Huber, 9 May 2011.
Health, Science and Environment
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In California, many of the farm workers who harvest the state’s crops are undocumented. Their lack of legal status often means they don’t have health care, even though they work in hazardous conditions that put them at increased risk for pesticide exposure, skin diseases, and even diabetes. So across the state, a network of grass-roots healthcare groups are finding innovative ways to reach those farm workers. Reporter Bridget Huber recently visited a mobile clinic serving agricultural workers on the Central Coast and brings us this story.
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BRIDGET HUBER: Every Tuesday afternoon, residents of Evans Park – a public housing neighborhood in Santa Maria – gather under some tall trees in a parking lot and wait for their doctor’s office to arrive. The clinic looks like something your grandma might take on a road trip. It’s a 38-foot long RV with seashells painted on the side. But it’s been retrofitted into a well-equipped primary care clinic, complete with two examining rooms.
The clinic sees hundreds of patients a week. Most are farm workers, like Estela Enriquez, a strawberry picker.
ESTELA ENRIQUEZ (translated from Spanish): Sickness doesn’t give any warning sometimes. You feel sick and you don’t want to go to the doctor. But then you look and see the clinic and there’s really no excuse for not coming to the doctor and getting a quick check-up.
The clinic is convenient. It’s also free, which is great for Enriquez who says it’s been a tough year for farm workers like her.
ENRIQUEZ (translated from Spanish): You know, work’s really slow. And one doesn’t really have the money to pay the doctor. In reality, this is a big help.
One of the people helping is Leonor Rubalcava, a medical assistant.
LEONOR RUBALCAVA: My name is Leonor, Leonor Rubalcava.
She weighs patients and makes sure they know how to take their medicine. She also drives the truck.
RUBALCAVA: I don’t know exactly my title because I’m doing different things. But I am the driver, I am MA, I am the health educator, and I am the receptionist.
Leonor is one of a team of four.
VARTAN TACHDJIAN: The people call me here Dr. T. Tachdjian. Like Mr. T.
Dr. T is Vartan Tachdjian. He’s the M.D. for the team, and he’s not exactly new to the job.
DR. TACHDJIAN: So, you want me to introduce myself? It’s a long a history – I am old. I am not a teenager.
He’s been working in Southern California for decades. Dr. T and his team do checkups and screenings and they treat all kinds of conditions from their mobile medical office.
DR. TACHDJIAN: Illnesses like diabetes, obesity, high blood pressure, arthritis, skin problems, and viral infections, bacterial infections, fungal infection…
They’re also at risk for heat exposure, dehydration, and pesticide poisoning. Even though farm workers spend their days doing hard work, surrounded by fruits and vegetables, in some farm worker communities 80% of the population is overweight or obese. And diet related diseases like diabetes are rampant.
FRANK PEREZ: It’s just the lifestyle, you know? The food we eat.
Frank Perez is a medical assistant with the mobile team. He says on the salaries farm workers make – about $16,000 a year, on average – it’s just cheaper to eat fast food.
PEREZ: You can get a Little Caesars pizza for five bucks. You can get a burger for a dollar. And it’s convenient and it’s cheap.
Cheaper than that proverbial apple a day.
PEREZ: An apple’s going to cost you a buck, a nice juicy red apple. Or you can get a pizza for five bucks that’s gonna feed your whole family.
The workers Perez and the rest of the clinic staff treat have another problem in common – crowded living conditions. Migrant camps are illegal in Santa Maria, so people pile into low-rent housing in town. It’s not uncommon for 15 to 20 people to live in a one-bedroom house. That means infectious diseases like the flu and scabies can spread fast. It also makes it harder to treat diabetes – some of the farm workers don’t even have refrigerators where they can store their insulin.
RUBALCAVA: I was working in the field and we were living in one house all kinds of people. Maybe 15 people when I was only 15 years old.
Rubalcava, the multitasking medical assistant, is the daughter of farm workers so she understands these problems firsthand.
RUBALCAVA: I came from Mexico and when I came from Mexico I was living almost in the same conditions that they are right now. And to me it was hard when I was in that situation and that’s why I really understand because I came from that, from the bottom and I know how that feels. I get like, choked up, because I know how that feels and I know the people are passing through a lot of difficult times right now. And because I was there I know, I know how that feels.
Now Rubalcava does outreach into neighborhoods to let people know the mobile clinic can help.
RUBALCAVA: I really love what we do here because we’re going out to the apartments, knocking doors, door to door, and going to all the places they usually go like to the laundries, to the markets.
Perez has started a walking club for farm workers. And the clinic staff works to get every patient they see connected with a primary care physician and specialists if needed. They’re sort of evangelists, going to where the need is and bringing patients into the health care system. Farm workers can be hard to reach, but once the clinic staff establishes trust, Dr. T says they are model patients.
DR. TACHDJIAN: They respect us as we respect them and religiously they follow our counselings, advices, treatment, whatever.
By the end of the day at Evans Park, Dr. T has seen more than 40 patients – many more than a doctor in a typical brick-and-mortar clinic. But, with about half a million farm workers in California, the need only continues to grow – this year, the clinic will see twice as many patients as it did last year.
For Crosscurrents, I’m Bridget Huber.
Bridget Huber is a reporter with the UC Berkeley Graduate School of Journalism. Learn more about the mobile clinic at Community Health Centers of the Central Coast.