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By Beth Lawrence
A service organization is using the example of the biblical Good Samaritan to help an overlooked portion of the county whom people don’t often think of as neighbors. Farmworkers.
Vecinos, meaning neighbor in Spanish, is a farmworker health program that arranges affordable healthcare for farmworkers and their families.
“I remember the first day we went, they had a bunch of free stuff out,” Mari Ramirez said. “They had toothbrushes and personal hygiene stuff to give. They had vitamins as well that people need and can’t afford. They had food as well as fruit and vegetables.”
The college student and her family have lived in Jackson County for almost two decades.
Vecinos was founded in 2004 and serves Western North Carolina.
With contributions from the rotary clubs in Cashiers and Highlands, Vecinos purchased a mobile health clinic that serves farmworkers in their neighborhoods after work. The group also holds a weekly clinic at Western Carolina University.
Those clinics have been a blessing to Ramirez and her family.
Her parents came to the United States as agricultural laborers. They have now moved on to other jobs. Ramirez’s mother heard about Vecinos from a friend. After she received help, Ramirez’s mother saw that her children got medical care.
“None of us really have insurance or anything,” Ramirez said. “We were always looking for somewhere with free medical care because it’s really expensive for us. So she went, and when they told her that it was useful for the whole family, that’s when she enrolled me.”
Through the program, Ramirez has been treated for a number of issues that left untreated could have caused worse problems in the future.
“When I would feel bad my mom would be like, ‘Call Vecinos,’ and they immediately would get on it,” she said. “They would say, ‘Come in here and we can check it out.’ And if you need to get referred they’ve got you on that.”
She says that knowing she had somewhere to go for help gave her peace of mind, even as a child.
At age 15, Ramirez received care for sports injuries to her knee and ankle. Medical providers were able to correct both problems with a little guidance that she would not have had access to otherwise. The doctor taught her therapeutic exercises to rehabilitate her knee and ankle and provided braces for both joints until they healed. Without treatment the problems could have led to damaged tendons or arthritis.
At one point Ramirez was experiencing hair loss which can be a symptom of a number of medical issues like lupus, diabetes or thyroid disease.
Vecinos arranged tests and discovered the problem was improper nutrition. They provided vitamins to remedy the issue.
“They did the blood tests for me, and I came out good,” she said. “I just needed more vitamins.”
Not being able to access regular healthcare, especially preventive services, puts a strain on public health and emergency services.
It also puts patients at greater risk from unmanaged illnesses and increased risk of death.
“Patients not receiving primary prevention messaging and/or screenings puts them at risk for contracting diseases such as cancer, diabetes, hypertension, HIV, mental illness, etc.,” said Melissa McKnight, deputy health director Jackson County Department of Public Health. “Additionally, patients may experience difficulty managing these chronic diseases upon diagnosis if they are not receiving adequate healthcare.”
Like others who cannot afford access to healthcare, farmworkers and their families often do without medications or medical attention. They do so for a number of reasons, a lack of insurance being the most cited reason, said Marianne Martinez, Vecinos executive director.
Farm laborers are often underpaid, especially if they are not operating under a Visa program.
“A farmworker on the H2A visa is paid a flat hourly rate, which changes a little each year,” Martinez said. “Agricultural workers do not receive overtime pay. People not on a work visa typically get a piece-rate, meaning they are paid for each piece of produce that they pick. The compensation varies a lot.”
It is estimated that laborers in the farming industry earn $11,000 a year and contribute $12,000 a year to North Carolina’s economy.
“Their labor is what drives the food, fiber, and forestry sectors – activities which combine to form North Carolina’s leading industry,” Martinez said.
Beyond financial constraints, other issues keep farmworkers from seeking regular medical care.
“The health care system in the U.S. and in Western North Carolina is confusing to anyone, especially someone who is used to a different system in another country,” Martinez said.
Like others in rural areas, Vecinos clients also deal with a lack of transportation. Another barrier is time. Often primary care providers are not open past 5 p.m. or on weekends. For this reason, Vecinos clinics are open after hours.
Language is another obstacle to adequate healthcare for many farmworkers. Western North Carolina has what Martinez calls a “drastic shortage” of medical professionals who are fluent in Spanish.
“Spanish speakers contribute immeasurably to the region’s economy, society, culture, and well-being, but they do not have the same access to services as English speakers,” she said. “For example, there are only three bilingual licensed mental health providers in the eight western counties; two of them are employed by Vecinos.”
That is where Ramirez hopes to be able to give back to the program that gave her so much. She is pursuing a social services degree and will work her internship at Vecinos.
“I’m going to start my internship there in January,” she said. “I’m really looking forward to it. If they need help translating, I’m there to help. I’m fluent in both English and Spanish.”
As of this year, the organization has 950 registered patients across Western North Carolina.
The program is open to all farmworkers and their immediate families who are uninsured or under-insured regardless of race or ethnicity.
It is just a matter of course that Vecinos concentrates on Spanish speakers because the “vast majority of farm work” is done by them, Martinez said.
“Having access to health care is a basic human right,” she said. “Not only is it important that each and every person in our society has reasonable access to health care that is affordable, timely, and culturally responsible, but it is a basic human right.”
To volunteer or donate, visit www.vecinos.org/get-involved/volunteer.