Calming Fears and Opening Communication Between Farmworkers and Law Enforcement

Reaching out to Farmworker Men via a Soccer Tournament Event

Improving Diabetes Management

Convening Head Start Community Partners at an Annual Meeting

Influencing State-Level Policy on Behalf of Farmworkers

Cross-Border Collaborative Outreach Efforts

Where Health and Community Education Meet

Involving Youth in Outreach: Partnering with a Local High School

Hats Off to Farmworkers in the Fields

Hosting a Health Fair with the Mexican Consulate

Post-Natal Program for Farmworker Families

Locating Offices in the Labor Camp

Farmworker Children and Diabetes

Collaborating with the Mexican Consulate to Issue ID Cards

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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.


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.


Improving Diabetes Management
2007, Bluegrass Farmworker Health Program top

Bluegrass Farmworker Health Center (BFHC) collaborated with the Lexington Fayette Health Department to teach a series of diabetes self-management classes in Spanish to diabetic farmworker patients. The four-week class was based on the Living Well with Diabetes curriculum developed by the Kentucky Diabetes Prevention and Control Program, which is focused on giving patients the tools and knowledge to manage and control their diabetes. Two local health department staff developed and taught the classes and provided Spanish language support. The BFHC outreach program coordinated the advertising, registration, and child care as well as provided space for the classes.

Immediately preceding the classes, BFHC outreach specialists offered individual instruction on how to use glucometers and self-monitor blood glucose levels. Each class included a healthy snack and interactive instruction. A walk-in-place exercise tape was the highlight of many classes. Incentives such as glucometer strips, medication boxes, gift cards, calendars, exercise tapes, and recipe books were included as part of the program. BFHC also provided bus tokens and child care to participants to overcome some of the typical barriers farmworkers face in taking advantage of this type of program.

Diabetes continues to rank 2nd in all diagnoses seen at the BFHC and self-management is recognized as critical to the successful management of this illness. This program was the first Spanish-language diabetes self-management series to be taught in the state. In addition to barriers such as child care and transportation, this program alleviated the language barrier which has kept farmworkers from accessing classes such as this one in the past. By collaborating with the local health department, the BFHC was able to offer a valuable learning opportunity that was responsive to the needs of the patient population. The class was very successful, graduating 11 participants who attended all six classes in the series. Since the class series ended, the BFHC and health department have continued to provide follow-up activities with graduates through a monthly support group. In addition to the original participants, some of whom drive 70 miles to attend the monthly meeting, many interested family members and friends also attend to learn about diabetes prevention.


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.


Influencing State-Level Policy on Behalf of Farmworkers
2007, North Carolina Farmworker Health Program top

NCFHP participates in several state-level task forces in order to influence policy and be a voice for farmworker issues. Because farmworkers are not always included on certain policy and programmatic agendas, NCFHP strives to ensure that policymakers are aware of their presence in the state and their unique needs. In 2006, NCFHP made significant contributions to the North Carolina Office of Minority Health and Health Disparities’ (OMHHD) Hispanic Health Task Force and the North Carolina Emergency Management Human Services and North Carolina Department of Health and Human Services Disaster Coordinator's committees.

Through involvement on the Hispanic Health Task Force, NCFHP staff were able to inform the development of a Community Health Workers curriculum used for a Lay Health Advisor Program. Originally, the curriculum only addressed issues affecting Latinos in the state as a whole, overlooking farmworker-specific demographic data and cultural information. NCFHP staff highlighted the unique vulnerabilities of this population and shared information on popular education techniques that are effective with farmworkers. As a secondary and unexpected result of this effort, the OMHHD now collects and disseminates farmworker demographic data and health information on their Latino Fact Sheets.

As a result of increased advocacy and education with the two emergency management and disaster committees, consideration for the state’s farmworker population has been incorporated into emergency response plans. Before NCFHP’s participation on these committees, disaster response agencies were relatively uninformed or unaware about farmworkers and their unique lifestyles and living conditions that impact these organizations’ abilities to respond effectively. NCFHP recently trained state disaster coordinators on issues such as the barriers farmworkers face in accessing emergency shelters, the challenge of communicating with non-Spanish speaking emergency responders and how to provide financial reimbursements to farmworkers during the recovery period when they have already left the area. Though these efforts are relatively new, it is anticipated that the critical discussions started by NCFHP will ensure that North Carolina farmworkers are no longer overlooked when emergencies occur.


Cross-Border Collaborative Outreach Efforts
2006, Hudson River HealthCare, Inc. top

Hudson River HealthCare has partnered with a health department in Oaxaca, Mexico in response to the discovery of a large underground migrant population in its service area originating from Oaxaca. HRHCare signed an agreement with the Oaxacan Secretary of Health to collaborate in any way possible and arranged for some of its staff to visit the village in Oaxaca that is the home-base for farmworkers in HRHCare’s service area. HRHCare tries to serve as a link by maintaining contact and sharing information with the appropriate local Mexican health departments. In several cases, HRHCare informed their Mexican health department counterparts when patients under treatment would return home so that they could continue to provide care to them upon their return.

HRHCare has truly redefined the geographic limits of farmworker outreach by communicating directly with the health system in the sending state in Mexico. As a result of this initiative, HRHCare staff members are better able to understand their farmworker populations as well as increase the chance that their farmworker patients will receive follow-up care once they return home. In addition, HRHCare staff members have appreciated the opportunity to get to know their colleagues in Mexico, and to mitigate the effects of the US-Mexico border as a barrier to providing quality care.


Where Health and Community Education Meet
2006, Quincy Community Health Center, Moses Lake Community Health Center top

Last year, Quincy Community Health Center (QCHC) was instrumental in organizing and carrying out a migrant parent leadership conference sponsored by the Educational Service District entitled “United, Educated and Success.” The program was guided by the desires and concerns of migrant farmworker parents. Nine of the sixteen speakers at the conference were related to QCHC’s health promoter program. Several of the speakers were clinicians and all discussed many traditionally touchy subjects: sexual health, mental health and drug and alcohol use.

This collaborative effort with the school district allowed QCHC to serve the whole family and for the clinic to become more fully integrated in the community. QCHC’s health promoters were chosen because of their status as leaders within the Latino/farmworker community. Their involvement in the conference helped to draw out the issues of most importance to the farmworker community. Since the event, QCHC has become a place where professional and non-traditional partners have been able to capitalize on the expertise of the health promoters and bicultural staff.


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.


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.


Hosting a Health Fair with the Mexican Consulate
2005, Southern Jersey Family Medical Centers top

Southern Jersey Family Medical Centers (SJFMC) jointly hosts a health fair each year at the beginning of the migrant season with the Mexican Consulate, drawing participation from area farmworker serving organizations and over 300 farmworkers. Farmworkers in attendance receive health information and health screenings along with passports and identification documents needed for getting bank accounts, employment, and other necessities. SJFMC outreach staff and promotores de salud perform health education skits and provide screenings, health information, and materials from the health center while farmworkers wait in line to meet with consular officials.

Southern Jersey Family Medical Centers has successfully combined two important services for farmworkers, medical and consular services. Through their health fair, SJFMC introduces itself to farmworkers new to the area or previously unaware of all the services offered by SJFMC, as well as reestablishes a relationship with farmworkers who reside or have been in the area before. By providing health services while farmworkers are waiting in line for consular services, SJFMC takes a step further in brining outreach services to farmworkers and makes accessing health services and information even easier for attendees.


Post-Natal Program for Farmworker Families
2005, Golden Valley Health Centers top

The Puentes Program at Golden Valley Health Centers (GVHC) provides post-natal care to new mothers, and enrolls many farmworker mothers. The Puentes Program starts working with new mothers in the hospital immediately after birth, where they are registered for the program and offered health education and breastfeeding advice. A few days after the mother and baby come home, a GVHC nurse will visit the home and conduct a well-assessment of the child. If the child does not have any health issues that need attention from a doctor or nurse, an outreach health educator will visit the home and work with the mother throughout the course of the program. The program curriculum includes breastfeeding and parenting skills as well as screenings for post-partum depression and domestic violence. The Puentes program sometimes serves as a bridge to geographically and culturally isolated farmworker moms, and is an important way for GVHC outreach and Puentes Program staff to access farmworker women and children.

While many health centers have pre-natal programs, Golden Valley Health Center has an additional program that focuses intensively on post-partum care. The program provides much needed services to families in the area, and provides a very important link between the health center and farmworker women and children. The program builds trust and relationships between farmworker families and the health center through home visits and access to outreach health educators. In addition to the care given in the clinics and in home visits, mothers can also use a “warm line” to reach their health educator by phone for any questions or concerns. Golden Valley works in a tight collaboration with WIC, the Public Health Department, and the Office of Education to provide comprehensive services to program participants.


Locating Offices in the Labor Camp
2004, Terry Reilly Health Services top

The farmworker outreach program has its main office in the largest of the three local labor camps. Initially, TRHS provided periodic outreach services at this labor camp, but that was not convenient enough for farmworkers. TRHS in partnership with the Housing Authority was able to get a building at a local labor camp for outreach services. The Housing Authority remodeled the building and in recognition of the benefit of the service provided to farmworkers, is planning to expand the facility.

It is important to facilitate access to outreach services but TRHS has taken outreach one step further by actually placing their main outreach program office in one of the largest camps in the area. This facilitates access to the outreach services and makes the outreach program part of the farmworkers community. Being part of the community is one way to gain farmworkers’ trust. It is important to build coalitions with local agencies and organization to maximize resources and to be able to overcome challenges and barriers.


Farmworker Children and Diabetes
2004, Terry Reilly Health Services top

TRHS conducted a pilot study with 182 farmworker children whose body mass indexes placed them in the overweight or obese range to check for possible early signs of diabetes and pre-diabetes. Preliminary results showed levels of overweight and obesity was at least as high as national averages. TRHS staff went door-to-door to recruit participants for the study and sent letters out to the community. The initiative was well received by the community. As a result of the study, TRHS was able to secure a community collaboration funding from the Governor’s Office, State of Idaho to establish a Childhood Obesity Task Force.

Conducting studies with the farmworker community is essential in identifying and verifying health needs. Studies conducted with farmworkers can serve as a stepping stone for building a program effort and securing funding for it. The personal contact with farmworkers, such as going door-to-door to recruit participants for studies or focus groups, is sometimes more effective in securing farmworker participation. As a result of TRHS’ well-planned study with adequate farmworker participation, they not only earned state-wide recognition, but also additional funding, which will further enable them to provide quality services to farmworker children, often not the focus of farmworker health care services.


Collaborating with the Mexican Consulate to Issue ID Cards
2008, Central Florida Health Care, Inc. top

Central Florida Health Care, Inc. (CFHC) collaborates with the Mexican Consulate to provide farmworkers in its service area with a Matricula Consular, a document that identifies an individual as a citizen of Mexico and provides other important information such as a person’s name and birth date. Considering the multiple barriers farmworkers face in obtaining a U.S. driver’s license or even a Mexican passport, having a government-issued Mexican ID provides them with several benefits. This ID can help farmworkers open bank accounts and eliminate the need to routinely carry large amounts of cash, a practice which often makes farmworkers a target for crime. The Matricula Consular can also greatly assist authorities in the unfortunate event of a medical emergency.

Many farmworkers are unable to go to a consulate office to get a Matricula Consular due to inflexible work hours and lack of transportation. To overcome these barriers, a community health worker at CFHC scheduled the Mexican Consulate to give a talk at an annual health fair about how farmworkers can access consular services. Many farmworkers attended the presentation, making it a huge success. Upon seeing the vast interest in Matriculas Consulares, the Mexican Consulate returned to the community with a network of computers and issued 225 IDs to individuals who had no prior form of identification.

Like many collaborations, this one started as an individual’s humble idea and turned into a responsive project benefiting a large number of people. CFHC will continue assisting area farmworkers through this collaboration with the Mexican Consulate in the future.