Logistical barriers prevent migrant farm workers from accessing health care

Image: Wikimedia Commons

This is the second instalment in a two-part series about migrant farm worker experiences in the Niagara region. Read the first instalment here. 

For the past nine years, hundreds of migrant farmworkers have been coming together in southern Ontario for a Migrant Worker Summer Festival. The festival provides food, music and entertainment, but it is also an information fair that provides migrant workers access to health services, legal counsel, and health and safety training, as well as important information on labour rights and English as a Second Language (ESL) courses. 

These festivals are organized by the Niagara Migrant Worker Interest Group (NMWIG), whose objective is to coordinate the efforts of individuals and organizations in Niagara who provide services and support to seasonal migrant workers. This year, about 300 migrant farm workers and community members attended the event on June 5. I spoke with Sonia Aviles and Stephanie Mayell, two of the festival volunteers. 

Aviles is a former NMWIG volunteer and works with the Agricultural Workers Alliance (AWA) of the United Food and Commercial Workers Canada (UFCW). According to her, two logistical barriers that continue to limit accessing health services are lack of transportation to the clinic or hospital and, for non-English speakers, not having interpreters available to translate. The workers she has spoken to say that, at the very least, these two issues must be addressed.

Aviles says that "workers feel frustrated because they cannot communicate what they really feel with the doctor." Often times they don't go to the doctors because they know that their isn't a solution for them. Even though they may have health coverage in Canada, their needs are dismissed because of the language barrier for non-English speakers.

Many workers are not impressed with the Canadian health-care system. Women often feel ashamed after contracting STDs and avoid going to the doctor because they fear being judged. Workers are often confused or don't understand the healthcare system and what is covered under OHIP and miss out on accessing health services that they are eligible for. They are simply unclear on what is covered.

Aviles also talked about the lack of cultural sensitivity from the nurses and doctors and overall public health-care workers who don't know how to address the unique health concerns of migrant workers. Health-care workers and practitioners tend to be unfamiliar with the differences between a migrant worker and a permanent resident.

Migrant farm workers are at a disadvantage, Aviles says, as "they most often cannot continue a treatment regimen prescribed by doctor because migrant worker timelines are unpredictable." Adhering to a strict medical treatment regimen is almost impossible. For example, there have been times when workers start a treatment and when they are close to their departure date are not able to continue after they leave.

Stephanie Mayell is a PhD student in medical anthropology at the University of Toronto and another one of the festival organizers. Mayell says that one of the main concerns for the Caribbean workers is safety on the farm and being asked to do unsafe work with minimal to no protection. This concern becomes a financial one, too, because they are often asked to purchase their own safety equipment when it should be provided for them. Mayell points out that "the minimal protections around health and safety risk physical health but also have serious mental health problems and outcomes associated with it." 

Work schedules also make it impossible to access health care. "Even though there is a migrant worker clinic in Niagara, it runs biweekly and at a time when lots of these workers are not able to take off," Mayell says. There are also bicycle safety concerns. According to Mayell, "It's a risk to bike long distances to access health care if it means that workers will be traveling back home under unsafe conditions. So there are practical and logistical barriers of transportation and not having the proper bike safety equipment. Migrant farm workers are constantly vulnerable to injury and illness."

Aviles suggests that public health-care workers should receive training on the migrant worker population because they are a special category, a vulnerable community that requires special care. They also need a way of transmitting important information that is culturally sensitive to the diversity that exists within the migrant worker population.

Mayell envisions a mobile system to bring health services to workers. A mobile clinic that would go to different areas in the same region within the same day during times that area accessible to workers. To really make it an intentionally accessible experience, it is important to have translation services available across the board.

Mayell is concerned about the delay in the distribution of health cards to workers. Even though a migrant clinic will see a worker that may not have a health card, having no health card becomes a challenge if they need follow-up care. It would make it impossible to access follow-up care without paying out of pocket that is not financially for these workers.

Like Aviles, Mayell emphasizes the need for health-care workers to understand the fact that workers from Mexico and the Caribbean all experience their health differently than we intuitively understand through our own health-care systems. The mobile clinic would value and welcome diverse cultural approaches to health and wellness with how these workers in their own socio-cultural settings take up healthcare. Cultural sensitivity practices would be fundamental in the clinic in tackling the real concerns of migrant workers.

Editor's note: This article has been updated to clarify that the two migrant justice activists interviewed were NMWIG volunteers rather than festival coordinators.

Heryka Miranda is a dance artist, community cultural worker and activist scholar in her last semester of her MA in the Faculty of Applied Health Sciences at Brock University. Her research explores the experiences of Mexican and Guatemalan, Niagara-Region migrant farm workers’ participation in experiential "dance for relaxation" community arts sessions. The purpose for her study was to provide temporary relief to feelings of isolation, and homesickness often experienced by the precariousness of migrant farm workers’ employment.

Image: Wikimedia Commons

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