Ag Worker Health Day is August 17th!
Join us in commemorating Agricultural Worker Health Day and share your health center's Ag Worker Health Day plans with us! Be sure to include the Ag Worker Access 2020 Campaign in your celebration! Then post your photos on our Facebook wall and be automatically entered to win a FREE poster of your choosing! Downloadable/printable campaign resources are available here. Remember to use the tag #AgWorkerAccess! Winners will be announced live on Facebook, Friday August 18th 2pm Central Time. Join us at the Midwest Stream Forum in Grand Rapids, MI on Monday afternoon, September 18th, for some great intensive educational sessions! Is your health center ready to train staff on the topic of the opioid epidemic? Our session on the opioid crisis will give you key issues in prevention, treatment, and the science behind it. You will also be introduced to a toolkit that will provide best practices in planning and implementing your substance abuse services. If your health center needs some assistance in developing a strategy to increase access to care for the Ag Worker population, then don't miss the intensive on developing a migrant-health action plan. Rounding out the afternoon is an informative session on Diabetes for both managers and front line staff. First learn how your health center can learn about national diabetes programs that are providing quality services and steps for implementation; then take part in an interactive session that will help participants understand the self-care behaviors recommended for optimal management of diabetes. All of these sessions are included with your registration, so don't miss out!
To register, click here. #MidwestSF17 The University of Kansas, with support from the Patient Centered Outcome Research Institute (PCORI), and in partnership with several organizations including the National Center for Farmworker Health (NCFH), is leading the Midwest Stream Engaging Migrant and Seasonal Farmworkers in Healthcare Research project. The Project’s aim is to increase the knowledge base available regarding farmworkers’ (agricultural workers’) preferences and needs related to healthcare decisions, as well as effective methods of engagement, and using that information to guide practice and research. Short-term objectives include the following:
The project team’s long-term objective is:
NCFH invites you to participate by answering the Stakeholder or Service Provider survey by August 7, 2017. Both surveys are available in English and in Spanish and links are provided below. Thanks a million for your participation! - Hilda Ochoa Bogue, NCFH Your opinion matters!
Staff at The University of Kansas School of Social Welfare are interested in learning more about migrant and seasonal crop/orchard farmworkers’ health. As a first step, we are asking individuals who are key stakeholders or provide direct care to farmworkers to complete a short survey. What encourages farmworkers to seek health care? What helps them get the health care they need? What makes it harder? In what areas is research needed? We need your help! To participate in an anonymous survey or to learn more, choose the link that is best for you: Direct Service Providers
The survey should take about 20 minutes and can be taken between now and Aug. 7, 2017. Please take the survey and then forward this information to others who might be interested! Thank you! Cheryl Holmes, Principal Investigator/Project Lead – [email protected] or 785-864-6493 Michelle Levy, Co-PI – [email protected] or 785-864-2291 Susy Mariscal – Researcher/Speaks Spanish – [email protected] or 785-864-9285 ¡Su opinión es importante! Personal de la Universidad de Kansas, Escuela de Trabajo Social está interesado en aprender más sobre la salud y el cuidado de salud de los trabajadores agrícolas (de huertos y cosechas) migrantes y estacionales. Como primer paso, estamos pidiendo a personas interesadas o a quienes proveen servicios directos a trabajadores agrícolas que completen una encuesta corta. ¿Qué alienta/anima a los trabajadores agrícolas a buscar cuidados de salud? ¿Qué les ayuda a buscar el cuidado de salud que necesitan? ¿Qué les dificulta buscar este cuidado? ¿En qué áreas se necesita investigación? ¡Necesitamos su ayuda! Para participar en una encuesta anónima o para tener más información, presione el link que sea mejor para usted: Personas Que Proveen Servicios Directos
¡Por favor responda esta encuesta y envíe esta información a otras personas que también puedan estar interesadas! ¡Muchas Gracias! Cheryl Holmes, Investigadora Principal/ Líder de Proyecto – [email protected] o 785-864-6493 Michelle Levy, Co-Investigadora Principal – [email protected] o 785-864-2291 Susy Mariscal – Investigadora/Habla Español – [email protected] o 785-864-9285 ![]() Sandra Leal, PharmD, MPH, CDE serves as Vice President for Innovation at SinfoníaRx in Tucson, Arizona. She is currently the Board Chair for the National Center for Farmworker health. I have always had a special place in my heart for agricultural workers. One of my father’s first jobs when he came to the United States from Mexico was working the fields in California picking lettuce. When I was young, and later in life, my father would recall the hard work he had to endure in order to provide for his family. He would tell me about the long days, the back pain, waking up very early in the mornings and having to work late into the day and at night irrigating the fields. In trying to recall how long my father did this work, I called my mother to ask her if she could give me more detailed information, since my dad passed away in 2008. She remembers him working for over five years as an Ag worker. He was in his mid 20’s at the time and they were new parents to my older brother. She reminisced about those times fondly because it was that work that allowed for them to reunite, as she had stayed in Mexico until he was able to find them a home in the United States. I was honored to work on a project that NCFH launched in 2008 to improve prescribing in health centers. It was incredible to assist the population my father once belonged to, especially because his efforts provided me the vehicle to be able to go to college to become a pharmacist. As a pharmacist working on this project, I immediately saw a tremendous need to decrease fragmentation of care, especially for populations that migrate. I was especially taken aback by the number of chronic conditions that Ag workers faced and the challenge of being able to take care of these conditions with issues like low health literacy, access to care, and lack of health insurance. I decided very early on in my career to work with underserved and underinsured populations because I felt that I could positively impact those populations the most. I grew up in a Spanish speaking household and realized how difficult it was to ask questions of health care providers that did not speak the same language. I specifically decided to become a pharmacist since pharmacists are some of the most accessible providers and I could help advocate for people that came to see me. Over the years I ended up becoming a certified diabetes educator to target the disproportionate amount of diabetes in my community. I developed team-based care clinic at El Rio Community Health Center to improve health outcomes, access and affordability for people with diabetes and other chronic conditions. During my time there, I ended up obtaining a degree in public health since it became apparent that we needed to work on population health and policy to address issues on a large scale. Today, I continue to work on many of the same issues that still exist. I have been blessed to serve on the board of NCFH to continue to support agricultural worker health. My experience on the board has exposed me to some of the most caring individuals that continuously work to improve access to quality care for the Ag worker population that works so hard for us. I truly believe that if enough of us care for this population and take action, we will eventually eliminate structural and cultural barriers to provide equitable access that eliminates unjust and unequal treatment. ![]() Wow, what can I say? Thirty-seven years working with Migrant Health Service, Inc. (MHSI) was an amazing opportunity. I began as an intern in the mid-seventies while I was in college, then was hired for a one-year position as a health educator, and over the years I transitioned to Executive Director. What did I learn over the years? I learned the inner workings from a dedicated administrative staff, including an amazing and creative Executive Director, Ann Zuvekas. The program provided access to health care services to 8,000-14,000 farmworkers and their families in a two-state area of Minnesota and North Dakota (with the majority of care provided in a 8-10 week period of time each summer) through the operation of fifteen seasonal nurse-managed health clinics. There were no cell phones, no electronic health records, no fax machines or scanning capabilities. We utilized family charts and telephones at the health centers (which were rented spaces in the small communities - churches, storefronts, social service buildings, etc.). Health center staff provided care through home visits, voucher referrals to local providers, coordination with migrant schools, and evening clinic services. I learned how challenging it was to have such a large service area which included two states, two regions, spanning over 45 counties. I learned how rewarding it was to have voucher referral agreements with over 300 service providers throughout rural Minnesota and North Dakota. I learned our program was quite different from many migrant programs as we had only two areas where farmworkers lived in migrant camps (southeastern Minnesota - corn harvest and asparagus picking). The remaining farm worker families worked in the Red River Valley for over 1300 individual growers. I learned that the health center staff were creative and very resourceful in working with the farm worker families. I learned that home visits were often times challenging for the health center staff due to the sheer numbers of farms, location of housing and hours families worked. In spite of these challenges, home visits were the most rewarding for health center staff and appreciated by the farmworker families. I learned that the farmworkers and their families who traveled to Minnesota and North Dakota each summer from South Texas were some of the hardest working, family focused, proud, and talented people I have known. They came to work in sugar beets, potatoes, small grains, asparagus, corn and cucumbers. I learned that changes in agriculture (space planting and chemically resistant seeds) impacted the work lives of the migrant farmworkers. Jobs were eliminated for many people. I learned that the migrant workers were resilient, finding other jobs to fill in between spring planting and harvest employment, or going back to school and learning other trades. I learned that I had great support and direction from our Board of Directors, project officers, fellow health center directors, HRSA grantee programs such as National Center for Farmworker Health, Health Outreach Partners, and the National Association of Community Health Centers. Minnesota was a foundation rich state and the state offered a number of grants and I learned how important it was to have their support and direction as well. While project reviews and annual audits were sometimes painful, I learned that MHSI and the patients served did indeed benefit. While a majority of the folks served through MHSI had Spanish as their first language and, often times, their only language, I learned the farmworkers and their families shared what our family wished for as well: a solid education, fair pay, safe work and home environments, respect, health, and to practice their faith. While I continue to enjoy retirement, I am thankful others continue to work toward furthering the mission of migrant and community health centers. ![]() NCFH, with support from Consumer Reports Best Buy Drugs (CRBBD), has produced a collection of health education resources for health centers, including digital stories, accompanying health briefs, and consumer factsheets. Covering a range of topics including Asthma, High Blood Pressure, and Diabetes (with more topics coming soon), these resources are free to use and easily accessible. Digital Stories & Accompanying Briefs Digital Stories All digital stories are about five minutes long and are a great way to promote health information and offer support to patients that have been recently diagnosed with particular health issues. Each story highlights one person's experience in managing their diagnosis, provides health awareness, and engages community members in taking charge of their health. The digital stories are bilingual, narrated in Spanish with English subtitles. Health Briefs The accompanying health briefs are easy to follow tips on how to manage diagnoses addressed in the digital stories. These are great to print for clinicians to use as handouts for newly diagnosed patients, for health educators to use in the community, and to have in your clinic as information reference tools. Click Here for Digital Stories and Health Briefs Factsheets Factsheets on affordable medications recommended by CRBBD are also available. Topics include Diabetes, Heart Disease, Menopause, Depression, and many others. These are easy to read and available in both English and Spanish. Click Here for Factsheets Contact: Patricia Horton([email protected]) ![]() Ivory Lopez serves as a Registered Dental Assistant at Community Health Development, Inc. (CHDI) in Uvalde Texas. This is Ivory’s story, shared with her fellow CHDI staff members when she returned from the 2016 Midwest Stream Forum for Agricultural Worker Health. I never really knew why it was so important to get the word out there about our health centers and what we can provide for agricultural workers. In all reality the Ag workers are the key to our food system, it’s because of their hard work and their hard labor we have food on our tables. While at the Midwest Stream Forum, these questions came up: “What is your story?” and “Why do you care?” Until I really thought about it, I didn’t think I had a story. But, my grandfather, who is an immigrant from Mexico, got his visa and is now working on a ranch with horses. He's on a fixed income and can't afford too much, he comes to us at CHDI to get his medications and lab work, and I think it’s awesome that we go by sliding fees. Health coverage is very expensive and if it wasn't for health centers like ours, I’m not sure what or where people like my grandpa would go. The fact that Ag workers don’t know about our services, and the help that’s out there, makes me want to get involved. With our generation, now I feel like no one is willing to work like they do, we don’t have that work ethic like they do. I feel like we need reminding of what they go through because our parents, our grandparents and ancestors did most of this work at some point. This is part of our history. How I can implement what I learned into my work is spreading the word to everyone. We had a speaker tell us his story. He talked about his grandma praying to the Lord and how she was always doing the sign of the cross on his forehead and blessing him. It was routine that every night and every morning his grandma prayed for him. He talked about growing up when people would come to his home, his mom welcoming them with open arms and treating them like her home was their home. That’s how we need to be with our patients--welcome them with open arms and treat them like nothing in the world matters but them at that time. I feel like sometimes we forget these patients come to us when they’re in pain, hurting or just not feeling well. As an agricultural worker you’re always in danger of pesticide exposure in the fields and lead poisoning; some suffer from diabetes, hypertension, cancer, tuberculosis, asthma, and don’t even know it. All of these conditions require medication and regular routine check-ups with the doctor. We need to make sure we are making them feel at home. What I plan to bring back to staff is tell them more about these agricultural workers. Working in the back dealing with procedures every day I really never knew the importance of agricultural workers and I now know it’s who we are, it’s the appreciation for everything they do. The job can be unpleasant and undesirable but yet agricultural workers never really show it; most of them are pleased to just be working and having an income to take care of their families. They don’t know about all of our services here at the health center; we need to put the word out there so we can help them, let them know we are here for them. ![]() This is the first story in our monthly Ag Worker Access 2020 Campaign blog series. Hilda Ochoa Bogue has been with NCFH for 15 years, and serves as the Research and Development Director. This is Hilda’s story. In 1990, I was living in a small Illinois university town where only very few people spoke Spanish. One day when my husband and I were at the grocery store, I heard people in the next aisle speaking Spanish and I decided to go and introduce myself. It was a young couple with three little girls; the family was one of the 30 mostly Spanish-speaking migratory agricultural workers from the TX Rio Grande Valley. We had a lovely conversation, exchanged contact information and invited each other to visit and to call if something was needed. The following weekend, we invited the 30 families for a picnic in our back yard and all of us had a great time; my husband and some of the male ag workers cooking hamburgers, the ladies making tacos, the teenagers sharing experiences about schools and places they stopped along the migratory stream; and the kids playing “a los encantados.” Later the group invited us to their houses for a great “tamalada.” During our visits, I learned that every April those families left their TX hometown and traveled to Washington State for asparagus harvest. In that state, it was legal for teenagers to work along with their parents from 5:00am to 11:00am, as long as they attended school—so the kids would bring a clean set of clothes and their books to work with them. At 11:00am a school bus took them to school where they showered before presenting to the classroom for a full class day. The group stayed in Washington until the end of May when the asparagus harvest ended, and then drove to Illinois for 6-8 weeks’ work detasseling corn for the Pioneer Seed Company. At the end of July or middle of August, the group started their return to their Texas home base in the Rio Grande Valley and arrived just in time to enroll their children in school. Two weeks after we had the picnic, I received a call from Dona Tonita--one of the grandmothers that was taking care of the children while the parents were working in the fields. She said that one of her neighbors, a farmworker woman, was very scared because her baby had “calentura” and she didn’t have any medication. She also said that the baby’s father was working and that there was nobody there that knew how to drive or where the hospital was. I drove to Dona Tonita’s home and she took me to the very worried mother. I took the mother and her baby to the emergency room at the County hospital; the baby was treated and discharged later that night. On another day, I received another call from Dona Tonita; this time she reported that a wife of an agricultural worker was having “dolores de parto” and needed to go to the hospital. I took the pregnant woman to the hospital and stayed with her until she delivered a beautiful little boy. The delivery was without any complications but the mother was sad because the father didn’t arrive in time to witness the birth of their first child. As a nurse, I had the opportunity to be present at several deliveries, but none of them have touched me as much as that one did. I don’t know if it was because I felt sorry for the young, first-time mother that was there delivering her baby without the support of her family, because I remembered her black eyes looking at me with an expression of confusion every time a member of the great team that took care of her tried to communicate with her in English, or perhaps because I saw how that mother’s worries dissipated as soon as she heard her baby crying, or when the father arrived in surgical clothes—provided by the hospital because he arrived completely soaked since it was a rainy day—and was able to hold his first baby and kissed his wife. Perhaps because of all those moments. For the rest of those weeks, when I was not at the university, I became the group’s advocate, interpreter, driver, and…the best customer for Dona Tonita fresh breakfast tacos. Knowing so little about the migratory agricultural worker movement in the USA—even though my own father, a Bracero, had been a migratory worker even before I was born, and three of my brothers worked in California as agricultural workers—and closely witnessing the difficulties encountered by this group, I decided to learn as much as I could about migratory workers. I learned as much as I could about agricultural workers from my father and brothers, and for my master’s thesis I traveled to the Valley and lived with Dona Tonita and her family for a month while I conducted field interviews assessing the health care needs of the group of migratory agricultural workers at their home base and along the migratory stream. Through that experience I not only learned about the difficult life and working conditions of migratory agricultural workers, but also their strong family ties and sense of community--the way they helped and supported each other during migration, their work ethics, how much they urged their kids to continue their education—so they would not end up working in the fields all their lives. I also learned how to prevent “mal de ojo” and how to treat “susto” and how to prepare some home remedies. Oh… I almost failed to mention, I also learned how to make fresh tortillas! After graduation, I was accepted to the Man Power Access to Community Health (MATCH) program, a one-year clinical administration fellowship. After classroom orientation and training at Johns Hopkins University, I selected the Colorado Migrant Health Program (CMHP) to do my fieldwork. The CMHP was a state-wide Migrant Health Voucher Program operating 16 seasonal sites to serve the seasonal migratory workers and their families arriving to work in agriculture. In that Program I felt right at home and, needless to say…I was hooked in Migrant Health. The rest is a story that is still being written since I don’t plan to move away from Migrant Health anytime soon. The 4th annual NCFH Ugly Sweater and Christmas Decorating Contests were held earlier this month.
The Christmas Decorating Contest winners were: 1St Place: Santa’s Farm Village 2nd Place: Santa’s Toyland 3rd Place: Wish Upon a Star 4th Place: Whoville 5th Place: The Grinch Who Stole Christmas Participating staff members, and children from a neighborhood day care, enjoyed the decorations, sweet treats, and even had an opportunity to take a photo with Santa Claus. In May of 2015 the Ag Worker Access 2020 Campaign was launched jointly by NCFH & NACHC. The goal of the Campaign is to increase provision of quality primary health care services to 2 million Migratory and Seasonal Agricultural Workers (MSAWs) in Community/Migrant Health Centers by 2020. This represents a more than 100% increase in Ag Workers to be served. NCFH and NACHC have joined forces to embrace and advance this effort and Farmworker Health Network members, as well as the Bureau of Primary Health Care, are actively engaged. There are three Ag Worker Access 2020 Campaign strategies, which are: 1) Credit Where Credit is Due; 2) Open Hearts, Open Doors, Open Access and; 3) Building Capacity to Sustain Growth.
The motivation for this effort was the input provided during the Closing Plenary at the 2014 Midwest Stream Forum, in which a picture of health centers’ reality in serving MSAWs was painted through an exercise called the Wall of Wonder (WOW). This information made it clear that there is a continued need for access to quality care, as testimony illustrated an outstanding and unmet need. Two additional WOW exercises were conducted at the 2015 East Coast and Western Stream Forums to verify that the need is not isolated to the Midwest, rather a national trend. Data from these three events is available on the NCFH website at www.bit.ly/NCFH_WOW. We found it to be a compelling call to action. Several things have become clear since the Campaign was launched. These include:
We could not have started without your support in 2015 and we will not succeed without your continued support within your home communities. Please help us reach the goal of increasing access to quality care to 2 million MSAWs and their families annually. Join the Ag Worker Access 2020 Campaign at: http://www.ncfh.org/ag-worker-access-2020.html and let’s make 2017 the best year yet! |
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