Farm labor ranks as one of the top three most dangerous occupations in the country and farmworkers suffer from incredible occupational risks, disproportionate general health issues, and extreme barriers to care. Agriculture is NC’s leading industry, yet farmworkers are some of the most underserved in the state. Vecinos believes that access to health care is a basic human right, but due to our geographic isolation, lack of public transportation, and institutional and social discrimination, many farmworkers and their families do not enjoy that right.
We are a free clinic, serving 100% uninsured and underinsured patients with free primary and behavioral health care. Our patients identify as Hispanic or Latino and 97% fall at-or-below 150% of the Federal Poverty Level. We hold a weekly static clinic for non-migrant farmworkers and also use a mobile clinic to bring services directly to migrant farmworkers, while also providing focused health education and case management services, including medical interpretation and transportation, as well as other ancillary programs.
Mobile Clinic for Migrant Farmworkers
Our primary service is a mobile medical clinic, which we use to provide primary care and mental health services to migrant farmworkers in their homes or camps after the work day.
Outreach workers conduct annual health assessments, including substance abuse and food insecurity screenings; coordinate referrals to specialist services; manage individual cases; provide medical interpretation, transportation, and health education; and coordinate the arrival of medical providers and counselors on the mobile clinic after the farmworkers arrive home from work.
The mobile clinic provides nursing services including health education, point-of-care blood work, and flu vaccines; behavioral health and counseling services, including substance abuse counseling; and primary care services with mid-level and MD providers.
Migrant farmworkers face extreme barriers to care, including a lack of transportation, cost, and timing of appointments, language, health literacy, and cultural barriers. Vecinos reduces those barriers by providing free mobile services through bilingual staff with specific training on agricultural medicine while on the farmworkers’ schedules. However, our current 15-year-old clinic does not meet health clinic standards, is too small to accommodate behavioral health, and has significant mechanical issues.
Our current mobile clinic was purchased and outfitted 15 years ago through a generous grant from the Rotary Clubs of Cashiers Valley and of Highlands. Since 2005, we have used the mobile clinic to serve migrant farmworkers and their families even in the hardest-to-reach areas of Western North Carolina, like Little Canada, Scaly Mountain, and Rosman. Over the past 15 years, we have grown to serve the 8 western-most counties and surrounding counties and in 2018, we served 780 patients, 383 of which sought services exclusively on the mobile clinic. Our current mobile clinic is aging and has had significant upkeep over the past 5 years, with a recent total re-wiring of battery systems due to a fire hazard and replacement of the gas tank due to leakages. The mobile clinic is imperative to the success of our mission and to migrant farmworkers receiving health care since migrant workers experience the highest barriers to health care.
Vecinos is currently raising funds for a new mobile clinic and we need your help. A new mobile clinic affords us the opportunity to create a private space that is inclusive of the integrated model of care Vecinos offers. A new mobile clinic would have an exam room, a nursing lab, a behavioral health screening room, and space to store health education materials and over-the-counter medications.
View the photo galleries below for photos of our current mobile clinic versus the vast impact a new mobile clinic could have on the farmworker population in far-western North Carolina.
Traditional Clinic for Seasonal Farmworkers and Other Patients
Outreach workers conduct annual health assessments, including substance abuse and food insecurity screenings; coordinate referrals to specialist services; manage individual cases; provide medical interpretation, transportation, and health education. Our weekly static clinic provides everything the outreach workers and the mobile clinic does to non-migrant (seasonal) farmworkers, but in a traditional clinic setting.
Mental Health Program
Before offering our own bilingual behavioral health services, the last bilingual counselor who served the general Spanish-speaking population had left the region in 2017. Vecinos bridged the gap by interpreting for mental health appointments. In January 2019, we began behavioral health services at our static weekly clinic and have since been actively working to also include services on the mobile clinic for migrant farmworkers.
Half of the farmworkers identify as food insecure in North Carolina (https://academic.oup.com/jn/article/136/10/2638/4746709). Compacted by fear, discrimination, transportation, and language, many farmworkers do not access existing food banks. Vecinos offers one-time and on-going assistance to patients who screen for food insecurity, as well as those who self-identify.
Cullowhee Methodist Church is our sponsoring agency for our food bank, providing funding for purchases and space for food storage, as well as the congregation’s support in building non-perishable food bags.
Vecinos accepts some donations of clothing and basic household items so that when we have a patient in need, we can help them right away. Cullowhee Baptist Church hosts our clothes closet and provides volunteer hours to keep it organized and well-stocked.
Children’s Christmas Gifts Program
For years, generous community volunteers have purchased, wrapped, organized, and coordinated over 150 Christmas gifts for our farmworker families. Every child that is registered with Vecinos receives a Christmas gift.
We host several wellness groups in response to identified needs. Some examples of current and past wellness groups include a women’s-focused wellness group, personal coping skills group, and parent support group.