BURLINGTON (Vermont) FREE PRESSFebruary 11, 2007 Report: Mexican farm workers lack adequate health care By Sam Hemingway
Free Press Staff Writer
Dr. Scott Nelson's patient was eight months pregnant and scared.
Nineteen years old and poor, she had no health insurance. She had just been turned away by a local health center, which had concluded it could not treat her because she had not received prenatal care during her pregnancy and was a high-risk patient.
The woman was a Mexican who had entered the country illegally and was working at a Franklin County dairy farm. Only now, after being caught and detained by Border Patrol agents, had she decided to go off the farm and see a doctor.
"She said she didn't have anything to lose now," said Nelson, a second-year resident family practice physician at Fletcher Allen Health Care in Burlington. "Her situation was what really piqued my awareness of what the situation is for Mexican farm workers in Vermont."
The woman, who later gave birth to a healthy baby, is still in the state pending a deportation hearing, Nelson said. The baby, because it was born here, is by law an American citizen. So is her husband, who was born in Mexico but became a legal U.S. citizen.
The woman's case, plus those of 48 other Mexican workers employed at dairy farms in Franklin, Grand Isle and Addison counties, is the focus of a new state Health Department report on the unmet health-care needs of some 2,000 migrant farm laborers in Vermont.
Most of the Mexican farm workers are believed to have entered the country illegally but, according to state agriculture officials, are critical to the viability of the dairy industry because they do the physically demanding work most Vermonters don't want to do.
The report, conducted last summer and fall, found that the workers largely shrug off injuries, infections and illnesses until the problems become too severe to ignore.
The report, titled "Assessing the Health Status, Health Care Needs and Barriers to Care for Migrant Farm Labor," gave several reasons for the delay in seeking health care: lack of Spanish translators, unavailability of transportation, reluctance to take time off from work and fear of being caught and deported while away from the farm for medical treatment.
"Because of the horrible climate of fear, when these people become ill they don't get treated," said Cheryl Mitchell, a former deputy secretary for the Vermont Agency of Human Services who assembled the 45-page report for the Health Department. "They put it off, put it off. We need to let people know that."
Among the cases profiled in the report:
A Mexican worker at a farm near St. Albans told of a painful eye infection that had made the eye completely bloodshot and his vision blurry. Nelson referred the man to a specialist, and the worker was later diagnosed with tuberculosis uveitis.
"I know treatment was started," Nelson said, but he has been unable to find out whether the man received follow-up care or if the man's co-workers on the farm were tested for tuberculosis.
A Mexican working at an Addison County farm was described as struggling with digestive problems he believed were associated with worms or parasites.
"Asked if he sought out medical care, he says, 'I don't know anyone to drive me. ... I don't know how to explain this to my patron (boss). ... The most important thing is to get medicine. I don't eat, and I fear that it will return," the report recounted.
Another Mexican worker in Franklin County, unable to endure the pain of a decaying molar any longer, said he used a pair of pliers to pull out the problem tooth. The report said fewer than half of the workers interviewed had ever received dental care.
"Many lamented that they visited a dentist even less frequently than a doctor," the report said.
The report also found that while a majority of the workers are young -- most are men in their 20s -- the frequency of cases of high blood pressure, something usually associated with aging, was higher than normal for that age group.
"I was under the lovely delusion that these people were getting good health care in Mexico and were coming here healthy," Mitchell said. "I found out it wasn't true. A lot of them have never been tested for TB, have never been vaccinated."
Seeking a solution
Christine Finley, the state's deputy health commissioner, said last week she was studying Mitchell's report but was not sure what the Health Department could do about health-care services for Mexican farm workers, given their undocumented status.
"We are still dealing with illegal immigrants here," she said. "We also have to respect the rule of law. We have to place this issue in the larger picture beyond health care."
Finley said the value of the report was that it provides her department with a "snapshot" look at an emerging health-care issue in the state.
"We have a population that we knew nothing about to begin with," she said. "This is a start. Until this point, we didn't have the information down on paper to look at."
She said it might make sense to establish a mobile health clinic to serve Mexican farm workers, but wondered how that could be accomplished when such a service is not being provided to rural, low-income Vermonters who are U.S. citizens.
Mitchell, a leader of the Addison County Migrant Workers Coalition, said the Health Department needs to take a step back and understand the implications of not addressing the health care issues raised in her report.
According to a 2005 Agency of Agriculture, Food and Markets study, 75 percent of the milk produced in Vermont comes from farms that employ Mexican workers, Mitchell's report noted.
"We are talking about the health of workers who are directly involved in producing food that goes to Vermonters and to the rest of the nation," she said. "This is really a public health concern."
Mitchell said the Addison County Migrant Workers Coalition has begun working on legislation it hopes Sens. Harold Giard, D-Addison, and Claire Ayer, D-Addison, will sponsor during this legislative session.
Giard said he was determined to "do something" for the farmers and their work force. Ayer said Vermont needs to do what it can to make the Mexicans feel welcome in the state, considering their importance to the dairy industry.
"They're here for a reason, and the reason is they're doing jobs Vermonters won't take," Ayer said of the Mexican workers. "There's no reason why the state can't step up to the plate and offer these people some kind of access to health care." She said the workers could help pay for the care, but shouldn't be afraid to seek it when they need it.
Mitchell's group is also pushing for legislation that would have Vermont establish a pilot farm worker program designed to legalize the presence of noncitizen farm workers in the state by permitting them to obtain valid work visas.
Federal rules allow only for admission of some "seasonal workers" to perform harvesting and planting work. The rules do not allow for the extended stay required for dairy farm work, which is year-round.
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