Assessing the Unseen Community

As a requirement for our Public Health Nursing course, BSN students who participate on the Farmworker Family Health Program conduct a “community assessment” on one of the four counties where Moultrie area farmworkers live and work. In groups of five, we set out in groups to discover what resources are available in the county, how health services are accessed, whether or not transportation is available, etc. to determine what the barriers to healthcare might be.

Yesterday my team was able to meet with two women who work for the Southern Pine Migrant Education Program. We spoke at length with the woman who runs a migrant summer camp for school-aged children of farmworkers and a Regional Recruiter — a woman who finds and meets with migrant families when they first arrive to assess the educational needs of their children. By default, she also ends up assessing many of the family’s other needs, including any health problems they may have.

We went with these women into the trailer neighborhoods where migrant workers live and were able to speak to a man who once worked as a migrant farmer, but now works in construction. He had overcome a major hardship when he first arrived in the US (“Gracia de dios,” he repeated many times) — his daughter had a severe vision problem and he was referred to a big hospital in Atlanta where services were provided to her for free. Since then, he said, his family had experienced few health problems in the 13 years they’d lived in the US. We spoke with him for the better part of an hour, explaining that we hoped to learn more about the community and possibly offer ideas for improving healthcare services to farmworkers. Then he and his son let us feed maiz to the two pet sheep he kept penned up in the yard beside his mobile home.

We also visited with a woman who had the day off of work from the packing sheds. Her trailer home was small but impeccably clean, especially considering that she was caring for eight children under the age of seven — a rotation worked out by the women at the packing sheds to reduce childcare costs. I made a mental note to remind myself of this woman’s workload the next time I complain about having too much homework on the weekend. She told us many interesting things about the health of the children in the community: there are a lot of allergies and asthma, and they tend to get worse at times when the parents’ hours in the fields are longer, or just after major pesticide sprays take place. She also noted that colds and viruses are hard to keep under control in the children, because everyone lives in close quarters. At the same time, she was forthcoming about her opinions on high diabetes rates within the population. “We have plenty of grocery stores and access to fruits and vegetables,” she said in Spanish. “It’s just la cultura — the culture — to eat few vegetables and more starch.”

Perhaps the best thing about my experience speaking to these two members of the immigrant community was the opportunity it gave me to confront my own stereotypes and biases. The gentleman we spoke with was exactly that — a gentle, kind man who loved his family and was grateful for all that he has been able to achieve in the US. I suppose I expected more machismo and weariness of outsiders on his part. The woman was so well-spoken and aware of her situation in life — clearly, as she cares for the children of the neighborhood, she considers how things like dietary choices and pesticide exposure pose a threat to their development. I had to kick myself for thinking that just because she doesn’t speak English well (though she is taking classes) and has a lot of diapers to change, she wouldn’t think of things in a complex way. It’s hard to put into words the feeling I had visiting these two families’ homes, but it changed the way I think about migrant farmers.

I think when we provide service to vulnerable populations, we run the risk of creating a hierarchy or caste system — we are the knowledgeable healthcare providers, and they are the sad, downtrodden people who need our help. The migrant farmworkers I have encountered on this trip are not lesser beings. They don’t need my pity and they certainly don’t need a bunch of kids from an affluent school in the city to teach them how to take care of themselves. Really, all they need is access to quality healthcare. Which they don’t have, because they are undocumented workers. In the future, I hope to do more as a nurse to advocate for access to insurance and services for underserved populations. But it was enough for the day to simply understand that the best way to find out what services people need is to ask them — in person.

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One comment

  1. Michael J. Johnson says:

    Wonderfully written reflection. I am seeking permission to run excerpts in the Southern Cross. The Southern Cross is the newspaper of the Catholic Diocese of Savannah. I received a photo from a dinner at Immaculate Conception Church – but no real information on what the nursing students did during the visit. The blog post answered many of my questions.

    I would also appreciate the name of the student who wrote the blog so we might provide proper credit.

    Kind regards and keep up the good work,

    Michael J. Johnson
    office 912-201-4054
    mobile 912-660-0415 (good after business hours)

    I hope to hear from you soon – we go to press 6/25/13 at 11:00 A.M.

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