Running Head: Migrant and Seasonal Farm Workers

Migrant and Seasonal Farm Workers in Skagit and Whatcom Counties:

Barriers to Healthcare
Camille Clarke, Kathleen Minor, Estelle Maassen, and Hannah Nilsen
Western Washington University
2016

Migrant and Seasonal Farm Workers in Skagit and Whatcom Counties:

Barriers to Healthcare

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1
Introduction

In the past month local migrant and seasonal farm workers have been picketing for their
rights to decent wages and unionization. Currently the issue is with the company Driscoll, who
works with Sakuma Brothers Farms in Burlington. They do not pay their employees for breaks,
or allow them basic rights that American citizens are granted. There have been reports of threats
and intimidation used when workers ask for breaks (Democracy Now, 2016). The majority of the
agricultural work that is done in the United States is completed by migrant farm workers. In the
agricultural arena there are seasonal and migrant farm workers. As defined by the United States
Department of Labor (2013), a seasonal farm worker is an individual who works at least 25 days
or earns half their income from farm work over the last twelve months. These individuals are not
necessarily employed by the same business. A migrant farm worker is an individual who has to
travel to work, without the option to return to their residence on that same day.
In Washington State we have both migrant and seasonal farm workers. The Washington
State farmworkers Survey (2008) reports that 70% of the agricultural employees are residing
where or near their work. In Skagit and Whatcom counties combined there are 15,721
agricultural workers. This population is closer to 30,000 when their dependents are accounted
for and 99% of these coming from Mexico (Population Estimate, 2012).
Migrant farm workers face a variety of issues including poor living conditions, lack of
education, rampant discrimination and cultural isolation. These workers are paid below
minimum wage and given poor housing to live in. According to Farmworkers Justice (2014),
the average familys total income from farm workers is $15,000-$17,499 [some of this income
is from sources outside agriculture]. There are a range of statistics on the number of
undocumented workers in the United States. According to the, the National Agricultural Workers

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Survey, the Department of Labor (2013) reports that 48% of farm workers lack authorization to
be working legally in the United States. However according to Serrano (2012), Roughly 70% of
the 1.2 million people employed by the agriculture industry are undocumented (p. 1). The
Washington State Farmworkers Survey (2008) revealed that 80% of the farm workers did not
have health insurance and 69% of these normally receive health care from a community health
clinic, this leaves a large gap for those not receiving care to fall through. In Skagit and Whatcom
communities, the SeaMar Clinic works to fill that gap, by providing affordable or free healthcare
for those at risk.
This paper outlines the needs of the MSFW communities in Skagit and Whatcom
Counties and assesses and evaluates the interventions available to agricultural workers through
SeaMar Clinic. Outcomes of this assessment include a more thorough understanding of this
vulnerable population and what can be done to continue to address and improve on the resources
available to seasonal farm workers in Skagit and Whatcom county.

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(Washington State Farmworker Survey, 2007)

Assessment data summary

Migrant farm workers are exposed to pesticides, toxic substances, sustain injuries or
infections, and may have visual or dental issues as a result of poor working conditions. As
reported by the Washington State Farmworker Survey (2008), nearly 8% of those surveyed
reported that they or a family member had been told by a healthcare professional that they had
been exposed to pesticides. Respondents were then asked if they or a family member thought
they had been exposed to pesticides. Almost 14% indicated they believed they had been exposed
to pesticides and about 57% of those respondents sought medical attention (p. 49).

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The Promotores Program was developed through SeaMar community health clinic to
establish resources and access to health care. It is a program that has specific people who are
trained and speak different languages that are able to work directly with the migrant
farmworkers. Currently there are seven Promotores, with hopes of recruiting more. Ideally there
would be a male and female for each identified language to work in both counties. Promotores
receive health benefits through Sea Mar Clinic and are financially compensated. It can be
difficult to find individuals to fill this role who have the capability of translating. Among this
group of migrant and seasonal farm workers in Skagit county they speak Mixteco and Triqui.
According to Geyman, M., Schmitt A. L., Leyrer, S., Ford, D. G., Smith, R., Adams, M. (2011),
there are eight main languages also spoken by indigenous populations in Washington State,
Amuzgo, Kanjobal, Mam, Mixteco, Nahuatl, Purpecha, Triqui, and Zapoteco.

Language/Education/Trust
One barrier to migrant workers receiving quality health care is that of language and
communication deficits. Two-thirds of workers speak a language other than English.
Unfortunately, it has only been recently that the SeaMar clinic in Skagit has identified the
different languages spoken by the migrant working population in Skagit County. By identifying
this variable, they are able to recruit volunteers that are able to speak these different dialects.
Other languages that are spoken include Punjabi, Nepali, Samoan and Vietnamese.
Another major barrier has been lack of trust between the migrant seasonal farm workers
(MSFW) and outsiders. Therefore opening a therapeutic communication between the workers
and the providers is extremely important. (C. Pacheo, personal communication April 5, 2016).
Only one in five are able to read or write English and four in five are able to read or write in

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Spanish. It can be difficult for a patient to understand their plan of care without the proper
educational materials. According to C. Pacheo, the Promotores Program provides health
education materials and continues to develop more that can be translated into a number of
languages. Many of the migrant farm communities separate themselves and do not interact with
other communities, creating mistrust with outsiders. The volunteer program helps overcome the
barrier of mistrust by involving individual community members to educate and work within their
own community.

Transportation
As reported by C. Pacheo, the majority of migrant farm workers do not drive or do not
have access to a car. Farms are located far from town which can make transportation difficult.
This lack of transportation is one of the reasons doctors appointments are missed or unscheduled
by MSFWs. Not only is it limited but most women do not drive. The bus system can be difficult
to use if language is a barrier and time off work has to be taken to go to an appointment which
can be a huge financial hardship for them. It also may be difficult to get time off work (C.
Pacheo, personal communication April 4, 2016).

Financial
The migrant farm worker has limited financial resources. A migrant farm workers
income is at or usually below the poverty line, with an average annual income of less than
$12,000. Most of the time, this income is for not only immediate but extended family members,
as well. It is reported that 80% of workers are uninsured (Washington State farmworker survey,

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2008). They do not have sick time or other benefits. Unfortunately this has meant that the
Emergency Room has been used for primary care or preventable health issues.

Cultural Perspective
There are many different cultural backgrounds within the migrant farm workers. They
have received inconsistent health care in part due to a nomadic lifestyle. They also have many
different beliefs when it comes to healing and well-being. It is important for SeaMar and the
Promotores program to gain a better understanding of the cultural differences to address some
the myths within the community.

Identification of interventions
Individual
Expand transportation services to include family members of the individual who is
traveling to an appointment. A major barrier facing health care for the migrant farm worker is
transportation to and from medical appointments. Due to the lack of transportation resources,
important medical appointments are missed that may detect, treat, or otherwise prevent health
issues. Expanding transportation services is especially important for women in this community;
women typically do not drive and are the primary caregivers of the children in the family.
Currently, bus and taxi vouchers available only cover the individual who needs to attend the
appointment. Because of this, women are unable to make important prenatal appointments due to
restricted transportation services and insufficient child care (C. Pacheo, personal communication
April 4, 2016) . The goal of prenatal appointments is to continually monitor both mother and
baby throughout the duration of pregnancy in hopes of detecting any potential problems.

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Therefor, expanding transportation services would be classified as a secondary prevention

measure.

Community
Incorporate migrant seasonal farm worker information into local schools. Culture shock
and isolation is an emotional barrier faced by many migrant farm workers and their families.
Highlighting migrant farm worker culture at all grade levels in Whatcom and Skagit schools
would not only educate the non migrant worker population of a local culture, but would help
address isolation felt by the migrant farmworker students and their families. This could be
accomplished by having the Promotores and program director speak at schools in an assembly or
classroom setting. Additionally, students could take field trips to local farms in Skagit and
Whatcom counties to learn about the migrant seasonal farm workers ties to our communitys
agricultural practices. Highlighting the migrant seasonal farm worker community and culture in
the academic setting may help eliminate feelings of shock and isolation in future generations of
migrant farm worker families, therefore acting as a primary prevention measure.

System
Advocate for increased federal funding to expand Promotores program. Colleen, her
administrative assistant and the Promotores volunteers coordinate health fairs, develop
educational materials, and organize mobile medical and dental clinics to over 30,000 migrant
farm workers and their families spanning two counties. SeaMar and the Promotores wish to
develop additional materials and services but lack time, money, and personnel to complete these
goals. By receiving more federal funding, the program can hire more staff to develop specific

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areas of importance for this population. Ideally, SeaMar could expand and have a team devoted
solely to the following: designing of educational materials, transportation services, coordination
of health fairs and managing the mobile dental/medical clinics. Increased funding results in
increased personnel and resources, therefore improving the overall education and health of the
population, making it a primary prevention measure.

Deliverable Interventions
It was determined that the best intervention for our practice experience site would be to
create and improve teaching materials used for the Promotores Program. They have several
power points that are used by the volunteers to educate migrant seasonal farm workers. The
program director, Colleen, determined that the diabetes mellitus powerpoint required revising.
This powerpoint is used to train Promotores and in turn they teach farmworkers about this
prevalent and chronic disease. Along with the improved powerpoints, a 3 minute video script
was created that can be easily understood in laymans terms and can be translated into different
indigenous languages. In addition, a new powerpoint was created that highlights the importance
and benefits of prenatal care. A script was also developed for this powerpoint.
For the migrant camp health fairs this summer, information boards/posters were created
that cover health information regarding the Zika Virus and the importance of hydration.
Hydration is a simple concept that is often neglected. It is important to teach farmworkers how
valuable it is to stay hydrated in warm weather working conditions. Zika Virus is on the rise and
there have been reported cases in parts of the United States. It is important to teach the
farmworkers the ways in which they can avoid infection by the virus and ways in which they can
detect an infection if that should happen.

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9
Conclusion

In conclusion, three main points were brought to attention during our research of MSFW
and completion of the community assessment in Whatcom and Skagit counties. Interventions for
better serving MSFW populations were as follows: providing increased transportation services to
the community in order to receive continuity of care, include information in schools related to
the MSFW community, and advocate for Seamar to increase their funding. The most important of
these interventions is funding. Sea Mar relies on the majority of its funding being provided by
government subsidizing. The Promotores program operates under their funding but also receives
grants and additional funding through community programs and charity auctions. They will not
be able to make the changes necessary for their organization to grow without increasing
subsidization.

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10
References

A Sustainable Bounty: Investing In Our Agricultural Future. Washington State Farmworker

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Department of Labor (2013). Who are Migrant and Seasonal Farmworkers? Retrieved from
https://www.doleta.gov/programs/who_msfw.cfm
Farmworkers Justice Selected Statistics on Farmworkers. (2014). Retrieved from
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