Bringing Community Agencies Together through an Annual Summit

Opening a Dialogue with Growers through a Growers’ Survey

Providing Health Education on a Weekly Radio Program

Increasing Access to Health Care through a Patient Benefits Department

Conducting Outreach in the Fields with a Lunchtime Celebration

Targeting Settled-Out Farmworkers in an ESL Class

Convening Head Start Community Partners at an Annual Meeting

Reaching out to Farmworker Men via a Soccer Tournament Event

Picking Blueberries to Raise Money for Farmworkers and Increase Cultural Competency

Calming Fears and Opening Communication between Farmworkers and Law Enforcement

Tracking Farmworkers Using ID Cards

Regional Coalition Assesses Farmworker Needs in Eastern North Carolina

Reinventing Delivery Options for HIV/AIDS Health Education

Bringing Key Stakeholders to the Table

Putting Farmworker Needs First

Involving Youth in Outreach: Partnering with a Local High School

Conducting Outreach from a Variety of Angles

Collaborating with a Local Mexican Grocery Store

Maximizing Mass Media Outlets to Market Available Services

Reaping the Benefits of a Farmworker Coalition

Hats Off to Farmworkers in the Fields

Mid-Season Farmworker Appreciation Festival

“The Importance of the Father” Parenting Classes

Bringing Cultural Competency into the Community

Bringing Care Directly to Migrant Children

Monthly Newsletter of Community Events and Resources for Farmworkers

Providing Comprehensive Diabetes Care in One Location

Delivering Health Education in a Culturally Appropriate Context

Community Coalitions Reducing Barriers to Care

Using Novelas to Address Culturally Sensitive Health Topics

Advisory Committees Increase Cultural Competency
Using MiVia and Telemedicine Technology to Increase Access to Specialty Care

Increasing Access to Medications while Maximizing Internal Resources

YMCA Collaboration Focused on Promoting Exercise

Family Support Group Meetings Encourage Networking and Promote Preventive Care

Creating a Safety Net for Homeless Farmworkers

Migrant Health and Safety Fair for Children

Annual Farmworker Eye Clinic

Empowering Oaxacan Farmworkers through Monthly Community Meetings

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Bringing Community Agencies Together through an Annual Summit
2007, North Carolina Farmworker Health Program top

In 2005, North Carolina Farmworker Health Program (NCFHP) held the first Farmworker Summit and Networking Event to bring farmworker-serving advocacy agencies together. This has become an annual program coordinated in collaboration with other members of the North Carolina Farmworker Institute, an interagency project of the Farmworker Ministry Committee and funded through participant registration fees ($15 per person) and local sponsorships. In 2006, about 100 people representing approximately 35 organizations attended the day-long event. Session topics included the following: legal rights of farmworkers, trends in H2A recruitment, participatory educational techniques, college access for undocumented students, and ways for religious congregations to support farmworkers during the harvest season. During the closing plenary, there was a dinner and multi-media presentation titled, Nuestras Historias/Nuestros Sueños: Our History/Our Dreams – Educational Aspirations of Immigrant Farmworkers and their Families.

For several years, there was not a coordinated effort in North Carolina to bring together farmworker advocates from various disciplines, including health, education, legal rights, advocacy, and regulatory agencies. Individuals from these organizations expressed various needs, including:1) the need to collaborate more and make the most of limited resources; 2) the importance of agencies targeting farmworkers to be informed about what other organizations are doing; and, 3) the need for farmworker groups to be informed about national issues that affect the well-being of farmworkers in the state. The Farmworker Summit and Networking Event successfully responded to these requests bringing together a large interdisciplinary group of individuals from across the state. Overall, the response has been very positive and participants have encouraged the continuation of this event.


Opening a Dialogue with Growers through a Growers’ Survey
2007, Northwest Michigan Health Services, Inc. top

NMHSI designed and conducted a survey with over 30 growers in the tri-county service area of one of its clinic sites. The objective of the survey was to discover perceptions of farmworker health issues and barriers to care from the growers’ perspectives. In addition, growers were asked about: 1) the location of farmworker housing areas; 2) how they recruit farmworkers; 3) the percentage of farmworkers who return each year; 4) how the growers prefer to be approached and contacted by NMHSI; and, 5) whether they would be open to hosting an outreach clinic on their property, ensuring minimal workers’ time lost due to travel to and from the clinic. Most of the surveys were conducted over the phone and in person and took place during the off-peak season when the growers were not as busy. Some growers expressed their unfamiliarity with local resources and requested materials in Spanish for their workers. All interviews were followed up with a thank you letter and relevant informational materials about the organization and other community resources.

Maintaining positive relationships and open dialogue with growers supports the health and well-being of farmworkers. The survey opened a forum for discussion and exchange of information with growers. It also reinforced anecdotal evidence that the vast majority of growers in NMHSI’s service area care about the welfare of their farmworkers. As a result of this survey, NMHSI was invited to set up four outreach clinics on growers’ premises. In addition, because the survey allowed NMHSI to quantify for the first time the number of farmworkers in the area who are monolingual Spanish speakers, NMHSI has set up a language assistance program in the community for the benefit of all community-based providers who serve Spanish-speaking patients. Based on last year’s successes with this survey, NMHSI plans to repeat the project this year in the service areas of its other two clinic sites.


Providing Health Education on a Weekly Radio Program
2007, Columbia Basin Health Association top

In working with the farmworker population, most will agree that there is no single best way to reach out to this population. The idea of using the radio as a medium for conducting health education was suggested by one of CBHA’s outreach workers. She noticed that during lunch breaks, all of the farmworkers gathered as a group and listened to the radio.

CBHA collaborates with a local Spanish-language radio station who donates air time as a public service in order to provide listeners a weekly, one-hour radio talk show on health education and prevention. The talk show, La Caliente takes place once a week during the lunch hour. A staff member was trained to use the equipment and facilitate the show. Previous topics from the show have included diet and nutrition, depression, family planning, sexually transmitted diseases, dental care, diabetes, alcoholism, and health insurance programs. Typically there is an expert guest speaker, such as a doctor, nurse, social worker, or farmworker advocate that is very knowledgeable about the topic. The facilitator asks questions to engage in a discussion of the topic and listeners are able to call in and ask questions on the air.

The radio talk show has been an effective mechanism for reaching farmworkers with health information. Oftentimes, it is difficult to engage this population in an office environment or even in a community setting. The radio program provides a non-threatening and accessible way to share information. Over the past year, clients have come into the health center stating that they heard about CBHA on the radio, proving to staff that this program is also an excellent marketing tool. On one occasion when CBHA was not able to do the radio talk show, people called in to find out if it would be rescheduled to another day. This kind of feedback has let CBHA staff know that people rely upon the radio program for critical health and social services information.


Increasing Access to Health Care through a Patient Benefits Department
2007, Columbia Basin Health Association top

CBHA has established a Patient Benefits Department that assists farmworkers in determining and applying for the health care coverage and insurance options available to them. In addition to providing assistance inside of the clinic, two of the department’s seven staff routinely conduct patient benefits education outside of the health center setting. The aim of these outreach efforts is to increase the health care access of farmworkers who are not current CBHA patients who unnecessarily avoid seeking medical care out of fear of the costs involved.

Patient benefit outreach activities consist of presentations to growers, farmworkers and community stakeholders and take place at work sites, migrant day care programs, and school parent meetings. Topics include different health care financing options in Washington State such as Medicaid, Basic Health Plan (a subsidized insurance program), managed care programs, and reduced fee programs. In addition to CBHA’s local efforts, the supervisor of the Patient Benefits Department advocates on behalf of farmworkers at the state level by participating in a state advisory group for health insurance.

By proactively addressing farmworkers’ health care payment concerns at both the local and state level, CBHA strives to increase farmworkers’ access to care and cultivate a wider understanding for the challenges they face. Some of these challenges include: 1) a lack of employer-provided insurance; 2) low incomes that inhibit their ability to buy private insurance; 3) lack of understanding of available health care coverage options; and, 4) a lack of documentation making them ineligible for many public assistance programs. As a former farmworker himself, the Patient Benefits supervisor knows firsthand the financial barriers farmworkers face. He places a great emphasis on his staff being sensitive and responsive to the unique needs of CBHA’s farmworker population which involves putting forth the extra effort to take their assistance directly to the community.


Conducting Outreach in the Fields with a Lunchtime Celebration
2007, Clinica Sierra Vista, Bakersfield, California top

Clinica Sierra Vista (CSV) staff and promotores/as have implemented a special outreach and education project called the Cuadrillas de Mes or Farmworker Crew of the Month, which identifies a different crew of farmworkers to provide medical services to in the fields each month. At each event, CSV’s mobile medical unit staff—two physicians and four medical assistants or nurses—conduct glucose and blood pressure checks, provide minor treatment and consultations, cancer screening, and nutrition education. Rotating CSV staff representing some of the 30 health and social services programs housed within the health center such as Medi-Cal, WIC, and the local family resource center, provide critical information on the various services available to the farmworkers and their families. These staff members also routinely follow up with farmworkers after the event to ensure that they get connected with needed services even if the services are not provided by CSV’s respective programs.

In order to attract farmworkers and make the staff more approachable, this event is set up to be a lunchtime celebration with all of the fanfare of a mini-festival. CSV staff provide participants with information packets that include incentives such as water bottles and toothbrushes. A raffle is also held to give away larger prizes such as toasters and coffee makers. A local restaurant donates a delicious lunch that feeds upwards of 125-150 farmworkers at each event, while a live DJ also volunteers his time to provide the necessary entertainment to draw a crowd.

The Cuadrillas de Mes event is a fun and highly effective venue for providing the much needed health care for hardworking farmworkers in CSV’s area communities. This project was initially proposed because CSV had a difficult time getting area farmworkers to come in for services even though CSV and its satellite sites offer bus passes, extended hours, and weekend hours to mitigate some of the common barriers farmworkers face. Farmworkers are often not culturally accustomed to and financially able to seek medical care until it is too late. By targeting a different crew each month and making it fun to receive health care and information, CSV staff have been able to create trust with the crew leaders and the farmworkers who might otherwise never access services. As a result, not only have crew leaders become more open to hosting events, but farmworkers in need of further care have been more inclined to follow up after participating in one of these events.


Targeting Settled-Out Farmworkers in an ESL Class
2007, Oklahoma Community Health Services Farmworker Health Program top

In the service area of Oklahoma Community Health Services Farmworker Health Program (OCHSFHP), the farmworkers either return to their homesteads or move on to another location as the winter months approach. To take advantage of the down time and to target the seasonal farmworkers who now live in the area permanently, the Director of the OCHSFHP’s outreach program approached the instructor of a community-based ESL class about attending one of the classes to promote the health center’s services. The Director also hoped that by meeting with this group, she could solve a mystery as to why many of their former farmworker clients had stopped coming to the clinic for services. The Director knew that some former clients who had not visited the clinic recently, participated in this ESL class. The Director conducted a presentation along with Quality of Life Associates, Inc. (QOLA), another community agency which provides services to farmworkers who have been disabled on the job. Each representative described the benefits of their respective programs. OCHSFHP offers medical, dental, and prescription assistance. QOLA assists farmworkers with locating surgeons who will render services for free or at a reduced rate, and also provides rent, utility payment assistance, and medical interpretation services for disabled farmworkers.

As a result of this presentation, local farmworkers received critical and updated information about services available to them. The collaborative effort also strengthened the relationship between OCHSFHP’s Outreach Director and the representative from QOLA. They now routinely communicate about other farmworkers in need of each others’ services. In addition, the Outreach Director discovered that many farmworkers had not returned to OCHSFHP because they thought that the farmworker health program ended in 2004, when the program stopped issuing vouchers due to a lack of funds. The Director explained to the former clients how the fiscal year runs and that funds were renewed and made available from year to year. The conversation proved to be enlightening for both parties.


Convening Head Start Community Partners at an Annual Meeting
2007, East Coast Migrant Head Start Project, North Carolina Direct Services top

The East Coast Migrant Head Start Project North Carolina Direct Services (ECMHSP/NCDS) organizes and hosts an annual Community Partners Meeting for each of its Head Start Centers in North Carolina. The meeting brings together service providers and other potential community partners to lay the ground work for better collaboration to improve services for children and families. Representatives from numerous local, state, and regional organizations attend this one-day meeting, including: local health departments, private providers, community health centers, social service agencies, community colleges, universities, mental health providers, the North Carolina Farmworker Health Program, and the Agricultural Resource Center’s Pesticide Education unit among others.

The meeting is split into three general segments: 1) a Health and Family/Community Partnership session, 2) a catered networking lunch and 3) an Early Childhood Education and Family Literacy/Disability session. Participants are welcome to attend the entire meeting or the segments of their choice. The meeting is scheduled before the center is open for the peak season and is a component of ECMHSP/NCDS’s planning process.

ECMHSP/NCDS has taken collaboration to a new level by expanding beyond farmworker-serving organizations to address the health and social service needs of farmworkers in North Carolina. This unique cross section of partners would not ordinarily be at the same table together. By giving them an opportunity to meet and share information, unique and effective service delivery plans are often developed.

For the past four years, this meeting has yielded numerous fruitful outcomes, such as nutrition and physical education training for teachers, ESL classes for parents, health fairs for migrant children, expedited Medicaid services for families, and pesticide education classes for parents and staff. These collaborative initiatives are essential to address Migrant and Seasonal Head Start’s Performance Standards, and ultimately yield more effective and efficient programs for serving farmworkers and their families in the state.


Reaching out to Farmworker Men via a Soccer Tournament Event
2007, Benton County Health Department top

Last year, the Benton County Health Department (BCHD) organized the 1st Annual Benton County Soccer Tournament and Family Weekend over two days in August. The goal of the event was to attract a large number of farmworker families, particularly the men of the family. In support of the event, the BCHD administration proposed this idea to a Benton County Commissioner, who in turn provided funding to rent the soccer fields for two days. Eight local and regional recreational soccer teams played in approximately 18 hours of soccer matches over the weekend. The County Commissioner presented the trophies following the championship match. With little funding to host the event, BCHD’s promotores/as secured support and donations from local businesses for time, money, food, water, prizes and even a DJ. In addition to the tournament, a community resource fair was organized with over 30 community agencies. One of the key community partners to participate was the Lion’s Club who provided health screenings on their mobile health unit and worked closely with the Benton Community Health Center to organize follow-up medical care. Approximately 400 people attended this event.

Recognizing the difficulty of reaching Latino men with health services, the idea for this event came from one of the health promotores/as who felt that it would offer a non-threatening environment to men. The added benefit though was that in organizing a soccer tournament, the men’s families also came out to participate, cheer on the teams, and take advantage of all that the weekend event had to offer. BCHD staff were present throughout the weekend to share information on medical, dental, and mental health services. In addition, the smooth collaboration between the Lion’s Club and the community health center to schedule appointments immediately after the screenings increased the likelihood that participants would receive follow-up health care services even after the weekend event was over.


Picking Blueberries to Raise Money for Farmworkers and Increase Cultural Competency
2007, Southern Jersey Family Medical Centers, Inc. top

Each year, Southern Jersey Family Medical Centers, Inc. (SJFMC) asks staff to take a few hours one morning in July to pick blueberries in order to raise money for a Farmworker Emergency Fund. SJFMC staff work with different crew leaders each year to organize the activity. Flyers are distributed around the health center asking family, friends, and other staff members to make pledges based on the amount of blueberry flats picked. Although it has been the outreach staff primarily who have volunteered their time for this event, clinical staff have also participated.

Approximately 8-12 staff participate in this effort every year picking between 20-30 flats of blueberries. Last year, the effort added $400 to the Farmworker Emergency Fund, the proceeds of which are used to fill a gap when assistance is not available. There are many organizations that help with food, clothing, and medicines for farmworkers, but many times, for one reason or another, some farmworkers do not qualify for these programs. There are also instances of farmworkers in abusive or dangerous situations who need emergency monies for transportation or temporary housing. In addition to raising money, this event helps SJFMC staff increase their cultural competency by gaining a better understanding about the nature of farm work and building rapport with farmworkers by working side-by-side with them in the fields.


Calming Fears and Opening Communication between Farmworkers and Law Enforcement
2007, Ellenton Health Clinic Farmworker Health Program top

Following an outbreak of violent and deadly home invasions against Latino farmworkers in two South Georgia counties, the Ellenton Health Clinic Farmworker Health Program (“Ellenton Clinic”) served as a safe haven of understanding, awareness, and advocacy for the farmworker community. Committed to cultural responsiveness, the Clinic Director invited the local sheriff’s department, the US Department of Justice, Colquitt County Cooperative Extension Service, MALDEF (the Mexican American Legal Defense and Educational Fund), the Superintendent of Schools for Colquitt County, and the Southern Pines Migrant Education Agency to discuss concerns at two community forums and help allay the fears of the farmworker community during this difficult period.

Concerned farmworkers were able to raise the following issues: 1) their mistrust of and inability to access the banking system; 2) the lack of Spanish-speaking law enforcement officers and 911 dispatchers; 3) the lack of proper housing available to undocumented workers; and 4) the fear that if they report crimes, they themselves might get deported as a result. The clinic provided space and translation services for two of these community forums.

Because many farmworkers are unable to open bank accounts and subsequently forced to keep a lot of cash at home, they become easy targets for violence. Organizing these community meetings brought the community together during a time when fears could have grown into explosive divisiveness. The Ellenton Clinic successfully demonstrated the role that community organizations can play in facilitating dialogue among city, county, and federal officials on behalf of the farmworker community. At the community forum, the 75-person classroom overflowed with participants. Farmworkers attended these meetings because clinic outreach staff were effective in making them feel safe enough to attend.

The Ellenton Clinic continues to support the farmworker community by: 1) providing home safety education to farmworkers; 2) collaborating with the Justice Department to create an ongoing community committee to address these issues; 3) educating the farmworker community about the US banking system; and, 4) partnering with the University of Georgia Archway Partnership to advocate that the banking community offer alternative banking services to farmworkers.


Tracking Farmworkers Using ID Cards
2007, St. Bernadette Catholic Church top

St. Bernadette Catholic Church partners with area non-profit organizations and congregations to meet farmworker needs. St. Bernadette’s offers a screening clinic on Sundays after mass. Farmworkers who need follow-up care are referred to the Wake County Human Services Migrant Farmworker Health Program. During outreach visits to camps, outreach workers provide farmworkers with laminated ID cards, which often serve as the only identification many farmworkers possess. One side of the card includes information for providers: the individual’s name, date of birth, and instructions for accessing the patients’ medical records. The reverse side has instructions for the farmworkers: a welcome note in Spanish that explains the use of the card and that they should call 911 in case of emergency. The ID card also includes the name of the individual’s camp and the date of issue. The cards are linked to a master log sheet referred to regularly by outreach and clinical staff.

The identification card system enables the farmworkers to have a handy telephone number that they can call for assistance, offering a degree of ownership and self-direction regarding their health care. The farmworkers no longer have to wait for an outreach worker to discuss concerns or request an appointment. The master log sheet allows St. Bernadette’s outreach team to easily locate clients for follow-up and appointments. The ID cards have reduced language barriers faced by non-Spanish speaking outreach volunteers in the past. The ID cards provide consistent birthdates and spellings of farmworkers’ names and therefore, do not require that volunteers be able to converse in Spanish with the farmworkers to solicit this information.

The cards have also improved data management by enabling the church to track the types of visits to the clinic and determine if there are clusters of diseases or injuries among or within camps. These epidemiological data have been used in community advocacy efforts and to train volunteers on what they can expect to see at screening clinics and when they do outreach. An unexpected benefit of the ID system has been the calls from growers, emergency rooms, and hospital wards on behalf of the card holders in their care seeking the church’s assistance for their farmworker employees or patients.


Regional Coalition Assesses Farmworker Needs in Eastern North Carolina
2007, Kinston Community Health Center top

Kinston Community Health Center (KCHC) is a founding member of the Migrant Education Outreach Cooperative (MEOC), which began as a joint effort between the Migrant Education Program and KCHC to create a platform for communicating among agencies that serve farmworkers in Eastern North Carolina. The cooperative involves representatives from two public school systems, a head start agency, a community college, one health center, and two family-focused non-profit organizations. In addition to meeting monthly, conducting joint outreach activities, and communicating via a blog site, the seven coalition members are conducting a comprehensive farmworker needs assessment across the region. All representatives have assisted in the survey design, received training for administering the surveys, and mobilized their respective community volunteers to carry out the assessment. The assessment covers a five county service area, reaching 240 farmworkers and their families.

Some of the coalition members have carried out individual needs assessments of their farmworker clients in the past, but none have ever jointly conducted a comprehensive regional assessment that addresses farmworker needs beyond the scope of their individual organizations. The activities of this coalition, particularly the needs assessment, reflect a commitment to effective partnering so that each of the organizations can more comprehensively address the needs of farmworkers in this part of the state. Though data collection has just begun, all coalition members were eager to be a part of the assessment effort and the results will be used to identify and evaluate service gaps in the region and to guide and inform program design and grant applications.


Reinventing Delivery Options for HIV/AIDS Health Education
2006, Bluegrass Farmworker Health Center top

Bluegrass Farmworker Health Center began a pilot program based on the concept of “Tupperware Parties” as part of an effort to improve the effectiveness of HIV/AIDS prevention education. An Outreach Specialist makes arrangements with someone from the community to invite 6-10 friends to their home for a “party.” At the gathering, the Outreach Specialist begins by providing a general information session to the entire group. Following this session, the Outreach Specialist sets up office in a separate private room where each attendee can come and speak about personal concerns. If they so desire, they may also receive an HIV test.

The “Tupperware Party” model is effective because it engages people in a community setting with people that they know and trust while still respecting their need for privacy regarding a sensitive issue. These home-based health education sessions have been well received by members of the population who have tended to shy away from other types of HIV/AIDS education events that BFHC has offered in the past. The sessions are intimate and relaxed because of the small numbers of attendees who generally already know each other. Also, by offering one-on-one consultations, confidentiality is still maintained.


Bringing Key Stakeholders to the Table
2006, Hudson River HealthCare, Inc. top

Hudson River HealthCare has instituted a deliberate process for setting goals for the outreach program. Formal planning sessions are held annually, pre- and post- season, and involve all Migrant Health staff, including outreach staff working within the health centers as well as staff of the Voucher Program. Goal setting is also informed by feedback from the Community Advisory Board which consists of farmworkers, a grower, and community agency staff, and via direct visits to farms by HRHCare administrative and clinical staff. In addition, Voucher Program staff members meet monthly to do continuous planning to improve services.

Hudson River HealthCare involves and engages all key stakeholders in the betterment of health for farmworkers in the area through its comprehensive and deliberate outreach goal-setting process. The implementation of this process shows a commitment to collecting ongoing and timely information from sources that have the most insight and pertinent feedback to offer to improve services to farmworkers.


Putting Farmworker Needs First
2006, Hudson River HealthCare, Inc. top

Hudson River HealthCare outreach staff participated in a state-funded project with the New York Center for Agricultural Medicine entitled “Community Collaboration for Farmworker Health and Safety.” This project involved farmworkers identifying health conditions affecting them on the job. When the top three preventable diseases were identified, farmworker patients received information on possible prevention and treatment strategies for each of these diseases. A prevention program was designed to address eye problems, their biggest concern, as part of the project.

The process that HRHCare undertook to determine the needs of farmworkers in an occupational setting effectively demonstrates HRHCare’s commitment to being accountable to farmworkers. HRHCare prioritized and incorporated farmworker input and participation in all stages of the project design and delivery. HRHCare has also illustrated how well its outreach staff is able to collaborate with other farmworker-serving organizations in order to more comprehensively address farmworker health needs.


Involving Youth in Outreach: Partnering with a Local High School
2006, Quincy Community Health Center, Moses Lake Community Health Center top

Quincy Community Health Center collaborates closely with a project-based high school in the area, High Tech High, doing prevention education, holding community meetings and celebrations, conducting community needs assessments and spreading the word about a variety of topics. The majority of the students at the school are Latino and come from farmworker families. As one result of this partnership, a local senior developed an HIV/AIDS awareness art project that was accepted as a poster presentation at the most recent Western Migrant Stream Forum. The art project will be on display at the clinic to encourage youth research on the topic of HIV/AIDS, especially prevention.

This project uses the educational system, an existing system trusted by the farmworker community to stretch limited resources. The collaboration with a local high school, whose students are children of local farmworkers, crew chiefs and growers, has given students an opportunity to get involved with local, national and bi-national health issues and participate in projects that will impact local and state health outreach models. By tapping into the leadership of farmworkers and their children, QCHC hopes to make lasting and generational changes in regards to health issues.


Conducting Outreach from a Variety of Angles
2006, Johnson City Downtown Clinic top

Johnson City Downtown Clinic (JCDC) schedules its outreach services to fit farmworkers’ schedules. JCDC offers Sunday evening migrant clinics, either at the health center or within the farmworker camps. JCDC takes good advantage of its relationship with a farmworker-friendly church in the area by making announcements at chapel services that are held specifically for farmworkers. Transportation to the health center is provided in the 15-passenger church van. When JCDC brings health services to the camps, they set up clinics in the chapel space adjacent to the migrant housing area using volunteers recruited from the nearby medical school and clinic staff members working on flex time.

JCDC is reaching farmworkers in a variety of ways that respond to the special barriers farmworkers face in accessing health care. To ensure that geographic distance is no longer a barrier, JCDC brings both the clinic to the farmworkers and the farmworkers to the clinic. They also ensure that farmworkers are aware of their available clinic services by asking farm management to attach informational flyers to farmworkers’ paychecks. In addition, JCDC recognized that weekday clinic hours were not appropriate for most farmworkers’ schedules. By setting up Sunday evening clinics, JCDC is able to positively impact farmworkers’ ability to access needed services.


Collaborating with a Local Mexican Grocery Store
2006, Greater Baden Medical Services, Inc. top

Greater Baden Medical Services (GBMS) has entered into partnership with a prominent community-based Mexican grocery store, El Mercadito. The owner of the grocery store allows outreach workers to perform routine blood pressure screenings and blood sugar testing and to do case management on site. Culturally sensitive health education literature and information on access to care is readily available in the health section of the store. The store is also used as a pickup location for patients who need rides to and from their medical appointments. GBMS provides free transportation services for primary care appointments and no IDs are requested or required to board the van.

The Mexican grocery store partnership has been an effective strategy because many members of the target population traditionally avoid seeking medical care due to distrust and citizenship concerns. Greater Baden chose the owner of El Mercadito because he is well respected in the community; as a result, farmworkers have felt much more comfortable accessing information and securing appointments. Outreach workers have conducted over 250 face-to-face encounters with the target population and farmworker primary care visits have increased by 30% since implementing the partnership in August of 2005.


Maximizing Mass Media Outlets to Market Available Services
2006, Community Health of South Dade, Inc. top

Community Health of South Dade, Inc. (CHI) uses all available channels to publicize their services. CHI appears on TV, radio, and in the local newspaper regularly. CHI representatives speak on Radio RCH, a Haitian weekly radio program and appear on Cable Tap TV, a Community Television Access Project sponsored by Miami Dade Community College promoting health awareness and education to over 500,000 viewers. Available CHI services are featured in the Farm Bureau newsletter and the South Dade bi-weekly newsletter for local growers in the area.

Community Health of South Dade, Inc.’s comprehensive marketing strategy is notable because it uses a variety of media outlets to reach farmworkers, a traditionally hard-to-reach population. CHI targets both farmworkers and the growers who employ farmworkers to share information on CHI’s services thus increasing the probability that farmworkers will learn about available resources in their area.


Reaping the Benefits of a Farmworker Coalition
2006, Mendocino Community Health Clinic, Inc. top

Mendocino Community Health Clinic (MCHC), which began its farmworker outreach program in late 2004, noted quickly a significant gap in communication and integration of the various farmworker service providers in the community. As a result, MCHC established the Agricultural Workers Integrated Services for Health (AWISH) committee structure. This committee brings together representatives of all organizations that have service to the agricultural working population as part of their mission. This coalition has provided a comprehensive structure for county-wide health fair planning and has resulted in greater collaboration in creating a successful health fair event during Bi-National Health Week.

The formation of AWISH is the first time that a coordinated effort has been organized to focus specifically and comprehensively on the health needs of the farmworker population in the area. Surprising new facts and trends have been brought to light through this collaborative effort. For instance, one organization in the coalition discovered a much younger farmworker population than had been previously noted. This new group of younger farmworkers demands a different health education strategy and a focus on health problems unique to adolescents. Without the formation of AWISH, this information might not otherwise have been revealed to the larger farmworker-serving community.


Hats Off to Farmworkers in the Fields
2006, Choptank Community Health System, Inc. top

Choptank Community Health System, Inc. Migrant Health Program (CCHS-MHP) outreach staff work together to identify strategies to contribute to improved health conditions for farmworkers. In 2005, CCHS-MHP prioritized the availability of clean cool drinking water, sunscreen and head coverings at the worksite as the top three priorities. Drinking water is generally provided to farmworkers by employers and CCHS-MHP was able to secure sunscreen from Queen Anne’s County Health Department. To acquire a sufficient number of head coverings, an email was sent to friends and colleagues to donate new or used hats to the “Hat Project” for distribution to farmworkers throughout the season. Within a short time, hats had arrived from nine states in the United States and Canada including many donations from within Maryland.

This project was initiated by the outreach staff that interacts directly with the migrant farmworkers in the area and understands the needs of farmworkers. The project effectively used a wide network of people whose contributions, large and small, made a real difference in the health of farmworkers. Other staff members of CCHS and partnering agencies in the area were very receptive to the Hat Project, providing good exposure for the Migrant Health Program. The project was easily incorporated into CCHS-MHP’s everyday operations and will be repeated again this year.


Mid-Season Farmworker Appreciation Festival
2006, Southern Jersey Family Medical Centers, Inc. top

Southern Jersey Family Medical Centers, Inc. organizes an annual farmworker festival that brings together over 1000 farmworkers and provides them with a social outlet in the middle of the busy picking season. The event is advertised as an appreciation day for the hard-working efforts farmworkers contribute to the community. Community organizations such as churches donate money and time and many items such as clothes, bikes, household and spiritual materials to support the festival. They also provide fun games for the children. Medical students conduct health screenings and provide health education while social service organizations distribute information about their services. Local DJs and Mexican folkloric groups provide the entertainment at the event. The biggest draw of all is the soccer tournament, in which prizes are awarded to the winning team.

Since many farmworkers suffer from depression and isolation, this event provides a much-needed opportunity for social interaction outside of the work setting. The festival sensitizes the community to the significant contributions of farmworkers while also mobilizing community members to donate their time, money and talents to express their appreciation for these contributions.


“The Importance of the Father” Parenting Classes
2006, La Clínica de Baldwin top

La Clínica de Baldwin collaborates with La Casa de Amigos, a local Migrant Head Start agency, to offer La Importancia del Padre parenting classes, the purpose of which is to strengthen the image of fathers and foster a positive impact on their families’ health. Quarterly, male clients with children are targeted to attend a one-hour class in the evening at La Clínica de Baldwin. Refreshments are provided and various topics related to health and the family are presented in a positive manner, displaying sensitivity to the “machismo” of Latin culture.

This interagency collaboration combines the strength of many professionals and disciplines resulting in a high quality learning outreach activity for migrant workers. By combining the collective knowledge of the two organizations about Latino culture, La Clínica de Baldwin is able to provide health education in a culturally sensitive manner. La Clínica hopes that families will be emboldened to practice healthy lifestyles as a result of targeting migrant fathers with positive health messages.


Bringing Cultural Competency into the Community
2005, Greene County Health Care, Inc. top

The outreach department at Greene County Health Care, Inc. provides free trainings on cultural competency and traditional Mexican medicine and curanderos to community and migrant health centers, hospitals, medical centers, and universities throughout North Carolina. The trainings are advertised through referrals, primary care associations, and migrant stream forums. An average of twenty trainings are provided each year.

Greene County Health Care, Inc. is not only doing outreach with farmworkers, but conducting outreach in the larger community to increase awareness of farmworkers and farmworker issues, and to ensure more culturally competent care across North Carolina. By conducting free trainings for other health care providers, Greene County Health Care, Inc. engages other organizations in sharing their mission to provide appropriate and adequate care to farmworkers, and increases the potential network of culturally competent health care services accessible to farmworkers in North Carolina.


Bringing Care Directly to Migrant Children
2005, Beaufort Jasper Hampton Comprehensive Health Services, Inc. top

Beaufort Jasper Hampton Comprehensive Health Services, Inc. (BJHCHS) works closely with the Migrant Education and Migrant Head Start programs in its community to bring quality health care directly to farmworker children. During peak harvest season, BJHCHS clinical staff go to the Migrant Education and Migrant Head Start school sites twice each week and do physicals for all children and “sick visits” for any child needing additional care. As a regular part of their outreach activities, BJHCHS staff provide information to farmworker families about the Migrant Education and Migrant Head Start programs. Similarly, the Migrant Education/Migrant Head Start programs share information regarding BJHCHS with farmworker families. When families sign up for these programs, they are given the opportunity to automatically register as a patient with BJHCHS.

By maintaining close working relationships with other farmworker-serving agencies in the community, BJHCHS is able to maximize its own outreach efforts while responding to the needs of farmworker families that are not directly health-related. BJHCHS runs a full-service evening clinic every Monday through Thursday during peak harvest season. By simultaneously conducting physicals and sick visits at the Migrant Education and Migrant Head Start sites, BJHCHS ensures that farmworker children who do not present for care at these evening clinics still receive screening and care. Since most of the families who send their children to the education program have already signed the BJHCHS consent forms, BJHCHS clinical personnel can give immediate treatment to any child who needs it when visiting the school sites.


Monthly Newsletter of Community Events and Resources for Farmworkers
2005, Southeast Missouri Health Network: Farmworker/Community Health & Resources top

Southeast Missouri Health Network’s (SEMO) Farmworker/Community Health & Resources program distributes a monthly newsletter, Cosechando la Noticia, to farmworkers across their five county service area. The newsletter highlights community events, educational and training opportunities, and programs and resources available to farmworkers through private and government agencies. Highlights also include information on programs available across SEMO’s six clinic sites and through their outreach program. Newsletter submissions are collected each month from SEMO’s Farmworker Advisory Council, made up of area farmworker serving agencies, state and local government agencies, universities, area hospitals, and churches. The newsletter is distributed to farmworkers at all SEMO clinic sites, as well as through SEMO outreach workers and promotoras, SEMO’s food distribution program, outreach and case management home visits, and through other SEMO sponsored events such as tai chi classes, legal aid, and fair housing and renters’ seminars.

Through the creation of Cosechando la Noticia, Southeast Missouri Health Network has effectively utilized resources in their organization and community to reach a large number of farmworkers with a needed service. Cosechando la Noticia is the only Spanish-language publication in the surrounding five county area, and SEMO has led local efforts to gather submissions and distribute the newsletter at a variety of locations. The result of their effort has been increased knowledge in the farmworker community of area services, programs, and community activities, increased knowledge of SEMO among farmworkers and other agencies, and increased networking between the six SEMO sites and the SEMO Farmworker Advisory Council member organizations.


Providing Comprehensive Diabetes Care in One Location
2005, Migrant Health Service, Inc. top

Migrant Health Service, Inc., (MHSI) in conjunction with providers from the surrounding community, holds “Diabetes Cluster Clinics” seven times during peak season in which farmworkers are able to access a multidisciplinary diabetes team consisting of lay health educators, outreach workers, a diabetes educator, a nutritionist, an ophthalmologist, a hygienist, a physician or mid-level nurse specializing in podiatry, MHSI clinical staff, and a phlebotomist. At locations throughout the service area in Minnesota and North Dakota, patients are able to cycle through what would normally take up to eleven outreach and clinical office visits in 3-4 hours time, addressing issues such as nutrition, diet, exercise, eye and foot care. At the final station, patients meet with a nurse who reviews the patient’s overall findings and makes any necessary referrals for further care.

By holding the Diabetes Cluster Clinics, Migrant Health Service, Inc. has successfully made services more accessible to farmworkers in an area of particular health concern, diabetes. This practice meets the needs of farmworkers who may not have time for more than one office visit, and also allows farmworkers and MHSI to save on medical costs by cutting down on the need for multiple appointments. The practice has also successfully integrated services offered through MHSI with those of area practitioners to the benefit of farmworker patients.


Delivering Health Education in a Culturally Appropriate Context
2005, Columbia Valley Community Health top

Columbia Valley Community Health delivers health education to farmworkers that is relevant and culturally appropriate. Health education topics are determined and prepared with input from farmworker focus groups, and planned in advance to maximize participation. On the day of the presentation outreach staff go out to the session location early and spread out across the camp to knock on doors and personally invite people to the session. The sessions are held in the camps’ central eating areas and usually attract 65-85 participants. In spite of their large size, sessions are interactive and participants have the opportunity to ask questions in the group or privately following the session. Participants receive an incentive for attending.

Columbia Valley Community Health uses essential principles of adult education and cultural appropriateness in its health education efforts. The program seeks to determine what farmworkers already know and what they want and need to know about key health topics through focus groups, and then use the experiences of participants to develop educational sessions. Additionally, since the majority of the area’s migrant population is Latino, CVCH responds to the important cultural concept of personalismo – personal interaction – by personally inviting each participant to the session, rather than just posting the information or making a general announcement. Finally, CVCH effectively uses community resources to help attract participants to health education sessions. For example, they always bring copies of the local Spanish language newspapers to the sessions, and, through a partnership with a local tienda, each participant receives a dozen tortillas.


Community Coalitions Reducing Barriers to Care
2004, Farmworker Health Center, Union/Jackson Labor Camp top

SHSDC creates relationships with other agencies in the community that increase and improve the services they are able to provide to farmworkers and their families. Two examples of this collaborative initiative are their interpreter services and dental services. Responding to the need for interpretation services for farmworkers, an SHSDC outreach worker began interpreting on a volunteer basis in hospitals and anywhere the service was needed. This has turned into an official interpreting service that has five members who carry beepers and are available twenty-four hours a day, seven days a week. Some hospitals reimburse for the service and formal negotiations are underway to encourage reimbursement by all users of the service.

Dental care continues to be a desperately needed service for farmworkers in Southern Illinois. The center works to provide care, but has difficulty finding dental providers. To alleviate this barrier, the health center partners with the Southern Illinois University Dental Hygiene Program. Students rotate through the clinic providing assistance and, in turn, receive a hands-on public health experience. The center also utilizes the expertise of the Dental Hygiene Program’s faculty for promotor de salud training and community health education programs.

Creating partnerships with outside organizations enables SHSDC to effectively leverage their funding. Through these partnerships, SHSDC avoids duplication of services and employs a creative way to approach service gaps for their clients while providing continuity of care.

Additionally, the interpreter and dental services added to SHSDC’s menu of services provide supplementary training expertise for SHSDC staff members, including cross training for the majority of staff members, and engages students in the field of public health.


Using Novelas to Address Culturally Sensitive Health Topics
2004, Terry Reilly Health Services top

As part of their outreach activities, outreach workers produced innovative educational materials such as an eight-part radio novela (soap opera) on sexual and physical abuse, Los Secretos del Abuso Sexual/Secrets of Sexual Abuse, and a short video presentation on common mental health situations of farmworkers, Cuentos Del Campo/Stories from the Field. TRHS collaborated with a local radio station in the production of the radio novela and negotiated free airtime in return for ads placed with the radio station. In addition to using outreach workers, TRHS used specialists on the topics to review the radio novelas before presenting them to the public to ensure that the information provided was correct and clear.

TRHS identified an effective way to reach the farmworker community by using the radio media. Radio novelas are very popular among Hispanic families. Having a radio novela on topics such as sexual abuse or health situations provides health education in a widely accessible, informal and non-threatening way and in a language that can be easily understood by a broad audience.


Advisory Committees Increase Cultural Competency
2004, Terry Reilly Health Services top

TRHS has a Farmworker Health Advisory Committee that includes farmworkers as members. The Advisory Committee reviews all their bilingual materials and assists in the assessment of the needs of the farmworker community. The committee was established 11 years ago to include community input. TRHS identified the importance of including service users in addition of staff providing services to assess the quality of their services. The Advisory Committee meetings are held sometimes at the labor camps or in Spanish.

The practice of including farmworkers at different levels is a key component in outreach. Including farmworker feedback on educational materials ensures that the material is appropriate for the community in terms of culture and language. Involving members of the community to assist in the assessment of the community needs provides wider perspectives about the health needs of the community. The inclusion of service users also helps to assess the quality of the services provided. Finally, holding the advisory committee meetings at labor camps or conducting the meetings in Spanish ensures farmworker participation since their ability to participate is increased by the location and language used. Using MiVia and Telemedicine Technology to Increase Access to Specialty Care
2008, Finger Lakes Migrant Health Care Project, Inc. top

Finger Lakes Migrant Health Care Project, Inc. (FLMHCP) has teamed up with a major regional hospital to provide access to a variety of healthcare specialists for migrant and seasonal farmworkers using both telemedicine equipment and MiVia software.

Prior to an appointment, a FLMHCP clinical provider enters all of a patient’s vital information as well as notes on past interactions. On the day of the visit, the patient is accompanied by a bilingual case manager into the clinic the farmworker normally visits. By then, the off-site specialist has already accessed the patient’s record using MiVia, and is aware of the patient’s health concerns and important medical information. Using telemedicine cameras and digital diagnostic instruments such as otoscopes, stethoscopes, and cameras, the visit is conducted just as if the specialist were in the room with the patient except that a trained nurse provides the hands-on piece of the exam, under the specialist’s direction.

Thanks to this system, patients do not lose an entire day of work because of a trip to a specialty care center in a distant city, yet they gain access to top specialists. Also, FLMHCP’s case managers are more efficient because they do not have to drive long distances nor spend most of a day with one patient. A new component of the program is the use of a portable camera to transmit video images back to providers in the clinic. The camera will be used in farmworkers’ residences so that they will be able to access specialty care without having to leave their homes. The telemedicine program is effective, but more importantly, it addresses transportation barriers while assuring that patients have access to high-quality health care in a setting with limited providers.


Increasing Access to Medications while Maximizing Internal Resources
2008, Migrant Health Service, Inc. top

To combat a shrinking pharmacy budget, Migrant Health Service, Inc. (MHSI) staff have developed and implemented an innovative program whereby patients bring a pre-stamped postcard to the pharmacy and pay $10 for each 30-day supply of prescription medications received. There are approximately 50 generic medications that qualify for the $10 card program including antibiotics, anti-hypertensives, and diabetes medications. Agreements were established with more than 50 local pharmacies throughout rural Minnesota and North Dakota. The $10 card program, combined with aggressively utilizing the $4 retail programs where available, has allowed MHSI to continue to provide or increase patients’ access to pharmaceuticals while drastically lowering the operating costs to the agency.

Two unique Excel tracking systems were developed to determine initially which medications should be included in the $10 card program and to track the cards mailed back from the participating pharmacies. In addition, an extensive retail list that is updated quarterly was created to assist clinicians in determining where their patients could find the most appropriate medications at the lowest prices. Patients are more apt to adhere to their treatment regimen because they are now more likely to afford their medications. Also, by being switched to generic medications, the hope is that they will be able to continue with less expensive medications upon returning to their home base when MHSI is no longer able to assist them with cost.

Approximately 500 patients have benefited from MHSI’s $10 self-pay card program since its inception. The $10 card plan is easy for pharmacies to use because they get immediate payment with little paperwork; they simply drop the pre-stamped card in the mail and receive reimbursement shortly after. MHSI has also seen a decrease in the workload for staff. Fewer pharmacy vouchers are written and the number of phone calls to/from pharmacies for voucher requests and authorizations has decreased substantially. Most importantly, however, staff are assured that patients are getting the medication they need both in and out of the service area which increases the likelihood of uninterrupted care for the mobile farmworker population.


YMCA Collaboration Focused on Promoting Exercise
2008, Migrant Health Service, Inc. top

In 2006, Migrant Health Service, Inc (MHSI) received a small grant from the Blue Cross Blue Shield Foundation of Minnesota to purchase YMCA memberships for migrant and seasonal farmworker families. The YMCA waved enrollment fees and adjusted the price to fit the unique needs of the agency and its patients. The relationship has been very successful; as of September 2007, a total of 19 families (77 individuals) have benefited from MHSI’s partnership with the YMCA.

With this project, MHSI clients have utilized facilities in multiple locations that would have been unattainable to them normally. The nurses and program staff have been determined to make the project a success so that families have a safe and fun atmosphere to exercise and become motivated to engage in healthy lifestyles. Staff recruited members for enrollment, accompanied them on tours of the YMCA facility, provided interpreting services for them in Spanish, and enrolled them in fitness classes.

Participants in the program are required to have at least one family member attend the YMCA a minimum of eight times per month to maintain the membership. One family, a 79-year old gentleman and his wife, has averaged 23 visits per month! The combination of medication, nutrition, and exercise helps the gentleman manage his Type 2 diabetes, hypertension, and hyperlipidemia. Their participation in the program has served as a true inspiration and proof that healthy living can occur at any age. Another success story comes from a woman who goes to the YMCA about 10 times a month and has lost more than 20 pounds and 2½ inches off her waist since starting with the program. The success of this initial collaboration with the YMCA has prompted the MHSI Chronic Disease Program to seek additional funding to continue the program.


Family Support Group Meetings Encourage Networking and Promote Preventive Care
2008, Community Health Centers of the Central Coast top

In an effort to better communicate with their Spanish/Mixteco-speaking patients, Community Health Centers of the Central Coast (CHC) began to work closely with local organizers to develop El Pueblo Entero: Foro para los Campesinos (The Whole Community: Forum for Farmworkers), a monthly family support group addressing the concerns of farmworkers in the Santa Maria Valley. This grassroots outreach effort with non-traditional organizers provides an opportunity for farmworkers to network among themselves and to learn about local social service agencies.

Working closely with the United Farm Workers and local agricultural agencies, the monthly meetings were developed to address the importance of preventive health care as well as to facilitate discussion regarding health and social services to farmworkers. CHC recognizes the need to listen to farmworkers in order to effectively address their needs and break down barriers to health care.

The monthly gathering allows CHC to simultaneously focus on the health care needs of each individual family while also educating the entire group. Shortly after the forum, monthly bilingual (Mixteco and Spanish) health classes are held that address the needs expressed by participants in the forum. Personal health care needs are discussed with a specialized educator, addressing topics such as women’s health, sexuality, HIV, pesticide exposure, housing, labor laws, and cancer support. The health education sessions are conducted in a comfortable, non-threatening environment with many service organizations represented. CHC believes that the familia approach lets farmworkers know that CHC cares about their health and empowers them to make their own health care decisions while also facilitating leadership development within the community.


Creating a Safety Net for Homeless Farmworkers
2008, Community Health Centers of the Central Coast top

Community Health Centers of the Central Coast (CHC) has begun an inter- and intra-agency collaborative program specifically targeting homeless farmworkers which maximizes resources within the health center as well as within the community. Housing in CHC’s service area is particularly expensive and not only are there no labor camps, farmworkers are not allowed to park their cars in the fields, forcing many to sleep in parking lots and outside of local community hubs. In many cases, it is very difficult to tell who is homeless until night falls.

CHC’s Los Adobes de Maria farmworker clinic has joined forces with the organization’s mobile unit and the Healthcare for the Homeless Program in order to find homeless farmworkers and offer case management as well as screenings, medical care, and urgent care. Aside from intra-agency collaboration, the program also works with other local organizers, farm companies, agencies, charities, as well as several Mixteco organizations such as Unidad Popular Benito Juarez to do referrals and organize community events. This unique collaboration, both internal and external to the organization, has opened many doors for the program to gain greater access to and better serve the population.

The program’s case managers follow the promotora model. Many of the case managers have been homeless themselves. As a result, they are better able to understand a diagnosis of anemia from lack of food or a communicable disease from lack of health access. The program also utilizes innovative community building methods to find farmworkers, such as organizing cultural events offering free food, or projecting documentary films in farmworker housing areas, and then conducting health outreach afterwards. As case managers speak with attendees at these events, they become aware of major issues such as mental health or basic necessities of life. The case managers make referrals to the clinic, the mobile unit, or any number of other collaborating agencies, which brings the community together to achieve better health follow-up and outcomes within the homeless farmworker population.


Migrant Health and Safety Fair for Children
2008, Eastern Shore Rural Health System, Inc. top

Eastern Shore Rural Health System, Inc. (ESRHS) partners with local schools to provide a Migrant Health and Safety Fair each summer for children ages 3-16. Approximately 190 children participate annually. Throughout the day, multiple organizations, such as the fire department, rescue squad, police, and the Coast Guard give presentations and lead hands-on activities on specific safety issues. The children explore ambulances and fire trucks while learning information such as the “stop, drop, and roll” technique, and where to go in a fire emergency. Representatives from 911 perform call simulations with the children where they practice relaying their name and emergency information to a dispatcher.

Separated by grade levels, the children also learn about vehicle and pedestrian safety such as how to properly fit a bike helmet or life jacket and the importance of buckling up. Younger children learn to look both ways before crossing the street and not to run into the street while playing. The children also get information on hygiene, lead poisoning, water, and smoking at various stations. Other activities involve making good food choices, taking care of their teeth, and the importance of exercise. Finally, children are given a toothbrush and educational materials printed in Spanish to take home to share with their parents.

The Migrant Health and Safety Fair is different from other area health fairs because it focuses primarily on children and their needs. ESRHS hopes to reduce the risk of accidents and injuries to children by teaching them how to avoid potentially dangerous situations and how to respond in an emergency. The children also come away with increased confidence in rescue personnel which is especially important for migrant children, whose parents may fear law enforcement officials due to their legal status. As an unexpected benefit, many children come away wanting to be rescue personnel or police officers when they grow up.


Annual Farmworker Eye Clinic
2008, Valley-Wide Health Systems, Inc. top

In the course of facilitating outreach screening activities, it became apparent to the staff at Valley-Wide Health Systems, Inc. (VWHS) that farmworkers had no access to eye care. With large numbers of individuals needing diabetic eye exams or experiencing occupational hazards such as chemical exposure, VWHS pioneered a Farmworker Eye Clinic in 1998 to provide annual vision screenings to area farmworkers. Since that time, well over 2,400 patients have received eye care through this program including examinations and eyeglasses. A dedicated optometrist from an urban area has donated his expertise and time throughout the years, while glasses are donated by other local professionals. VWHS staff volunteer their time to carry out the event.

Personal testimonials emphasize the impact of this program. One patient, initially seen for an eye irritation, was referred to the eye clinic and given an exam and glasses. He remarked how surprised he was at what he was able to see, noting that his restored vision would make his work much easier, more productive, and he would be able to earn more money. As the event concluded last year and the clinic doors closed after 195 patients were screened, the optometrist looked to the event coordinator and said, “See you next year.” This play on words highlights the value of this event as many migrant farmworkers must be able to see in order to drive to their next place of work.


Empowering Oaxacan Farmworkers through Monthly Community Meetings
2008, Mixteco/Indigena Community Organizing Project top

Since 2001, the Mixteco/Indigena Community Organizing Project (MICOP) has been empowering the 20,000 indigenous Oaxacan farmworkers in Ventura County who face linguistic and cultural barriers to health care. In monthly community meetings, an average of 200 Mixtec families come together to share a communal meal, exchange information and concerns in their own language, receive assistance with the necessities of life (i.e., food, clothing, and disposable diapers), and develop a strong collective voice. The meetings offer an excellent forum for presenting health-related information, collaborating with public and private service agencies, and assisting community members to access medical services.

The community meeting approach is culturally appropriate and effective because it draws on the inherent strengths and communication style of the indigenous community it serves, with an emphasis on cultural pride and language preservation. The Mixtec traditional community service model, where everyone is expected to share in the work of maintaining the community, aids the functioning of the meetings. Also, because Mixtec is a non-written language, verbal exchanges and interactive presentations are the most effective approaches to communication. Cultural events are celebrated as well such as “Children’s Day” and Guelaguetza, a traditional holiday where Oaxacans renew their commitment to contributing to the betterment of their community. Also, instead of banning children at meetings, a degree of disruption is accepted as a small price to pay for enabling entire families to attend.

Mixtec health promoters are a key example of the leadership development that MICOP embraces; they play a critical role in organizing these monthly meetings. They serve as community health advocates and have assisted the community in demanding culturally and linguistically appropriate services. Their efforts have resulted in the hiring of over a dozen Mixtec interpreters and outreach workers at health care agencies. The visibility and leverage of the Mixtec community in Ventura County and beyond has increased immeasurably due to this program.