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Associated Press
Ohio health centers serve migrant workers
<p>Sophie Broach</p>
August 27, 2012

WOODVILLE, Ohio (AP) - On a recent evening, migrant farm laborers trickled in from the cucumber fields at Liskai Farms to visit the mobile health clinic that had sprung up in front of the rows of low, white houses where they live during their stay in Ohio.

Liskai Farms, on Woodville's southern edge, is one of six camps for farm workers in northwest Ohio that the migrant family mobile health clinic was visiting on six Tuesdays this summer. It's organized by the Farm Labor Organizing Committee in Toledo and the Campaign for Migrant Worker Justice to provide health services to an often overlooked population.

Mercy St. Charles Hospital, the Ryan White Project at the University of Toledo Medical Center (the former Medical College of Ohio Hospital), the Perrysburg Heights Free Medical Clinic, Prevent Blindness, Food for Thought, Church of the Cross, and Promedica make the clinic possible.

"The mobile health clinic has really filled a big void that there was out here for health care for migrant workers," said Baldemar Velasquez, president and founder of FLOC.

In 2006, the U.S. Department of Agriculture estimated that only 9 percent of migrant farm workers in the country had health insurance.

Outdoor stations clustered around the Mercy van offered physical therapy, HIV and vision testing, and basic physicals. One tent functioned as a dentist's office, where children sometimes gathered to watch molars being extracted. The van itself is divided into two exam rooms where patients can receive private consultations and see an obstetrician-gynecologist.

"A lot of these people have never seen a doctor before. We take out the blood pressure meter, and they have no idea what we're doing. We take out a thermometer, and they don't know to put it under their tongues," said Luis Espinoza, a nurse at UT Medical Center who has worked at the mobile clinic since it began 17 years ago.

Richard Paat, an internist with a practice in Maumee, frequently serves in medical missions in Nicaragua, Guatemala, and Tanzania. Four years ago, he decided to participate when the mobile health clinic invited him to join its summer visits.

"It's like doing a mission in your own backyard," he said. "The limited resources that people have in a country that has unlimited resources is really striking."

About 14,000 migrant farm workers travel to Ohio every summer to pick crops, according to the Ohio Latino Affairs Commission.

Dr. Paat calls them a hidden population.

"They're bent over the whole time they're picking pickles and tomatoes, and since they get paid by the pound, they're trying to pick as many as they can. So there are many complaints about musculoskeletal issues," said Wendy Avinas, a FLOC employee who has organized the clinic for the last three years.

Last year physical therapists joined the team of mobile clinic caregivers, and patients, some of whom were provided with anti-inflammatory medications and muscle relaxants, were shown simple exercises and better posture for their work.

For the first time, the clinic this year offered counseling services.

"We started doing mental-health assessments last year, and we had several people who were severely depressed. We see a lot of people who self-medicate with alcohol," Avinas said.

Typically, three or four physicians attend each clinic. They commonly treat people who have uncontrolled diabetes and skin infections brought on by exposure to allergens and pesticides in the fields.

But sometimes they uncover more serious conditions that require surgery.

Last year, a man came into the clinic complaining about a bump on his back, and an examination revealed high blood pressure and an irregular heartbeat.

"That's dangerous in any situation, but this guy was working in the fields every day, and it was so hot last year," Dr. Paat said.

The worker eventually saw a cardiologist at St. Luke's Hospital.

"He's still able to work and provide a living for his family," Dr. Paat said. "If we hadn't found him by last year, he probably would've died."

The clinic also saw a woman who had learned two years earlier in a clinic in Florida that she had gallstones.

"She suffered until she got here. We were finally able to get her gall bladder removed for free at St. Luke's," Dr. Paat said.

The transitory nature of farm work, following harvests around the country and staying in several camps each year, often precludes consistent care, Espinoza said.

"They may have been treated in Florida, then the Carolinas, and then this area, and that's if they've gotten medical care at all," Dr. Paat said.

On a Tuesday last month, Mariana Garcia waited in line to see the dentist about tooth sensitivity she believed was brought on by her pregnancy.

She had been harvesting strawberries in Florida before coming to Ohio to pick cucumbers.

"It's annoying keeping track of all the papers," she said of moving away from her prenatal care provider in Florida.

"The lack of insurance, lack of English proficiency, and transportation issues all compile to make it difficult to treat the migrant worker population," said Dr. Paat.

Illegal immigrants face additional hurdles to receiving adequate care.

"Sometimes they don't seek services because they think the facility will call immigration upon finding they are undocumented, and then they'll be deported," Avinas said.

The workers will, though, venture into a clinic when it appears in front of their own homes.

"We realized that we had to get out to the camps," said Espinoza. "There's a language barrier, they're very isolated, and they work a lot, from sunup to sundown. So we have to find them," he said.



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