While the agricultural world relies on hardworking migrant farmworker communities, these communities remain some of the county’s most vulnerable as they exist in a labor system that is not designed to meet their needs or the needs of their families. Farmworkers suffer a higher rate of diabetes due to a lack of medical follow-up and dietary issues. Some workers only get paid if they show up to work, and others may not have access to refrigeration or ways to heat up food during the day. In these situations, meals need to be portable and therefore, often rely on heavily processed convenience foods.
Skin conditions are another issue. Farmworkers know they are exposed to chemicals, even on organic farms (as many organic properties are adjacent to conventional farms). Skin is foreign to workers and they rarely think of engaging in protective behaviors. Many workers simply accept that they will be exposed to harmful chemicals on a daily basis.
In the last year, COVID-19 exacerbated the inequities for more than 5,000 migrant farmworkers and their families who call North County home (despite the common misconception that farmworkers are largely undocumented workers, over 60% are permanent residents). The mission of the FarmWorker Care Coalition (FWCC) is to recognize these farmworkers as a vibrant part of the San Diego County community and to improve their living, working, and health conditions, and access to health, social, and educational services.
“Our work became increasingly more important due to the lives at risk. The pandemic also brought more awareness of the need to support farmworker communities. Our hope is that with increased awareness there is also recognition that we cannot only dedicate resources during times of an emergency, but that our country should come together to find a proactive and sustainable approach to bring and keep resources to serve our farmworker communities,” said Herminia Ledesma, Program Manager for Vista Community Clinic (VCC). Ledesma oversees VCC’s Migrant Health and Community Engagement Programs and focuses on improving access to healthcare for migrant workers and their families, as well as leading Community Health Worker (CHW) training programs and the facilitation of community organizing, advocacy, and peer education efforts.
FWCC represents the combined efforts of several local community-based organizations and institutions. Efforts include taking healthcare to the field through mobile immunization and screening clinics. “Our primary role is bringing agencies serving farmworkers in North County San Diego together so we can connect farmworker communities to resources, especially food access through programs like CalFresh and local food distributions,” she explained. “Even transportation is a barrier to accessing resources, so we focus on going out to agricultural sites.”
The farmworker community takes an active role in these efforts thanks to the Poder Popular program, which employs a group of resident leaders who live and work in the communities and serve as eyes and ears for FWCC. The team has grown to a group of over forty Lideres (Leaders) in the City of Vista, Oceanside, Fallbrook and Escondido. Their efforts range from health education and promotion to policy and advocacy for environmental changes for healthier communities. This partnership allows FWCC’s work to remain centered on meeting needs that come directly from the community. Perhaps just as important, the Poder Popular program has enabled the coalition to gain the trust of the communities they seek to serve.
“The communities we serve are often systematically disenfranchised. We are often doing the work of breaking down these systems to make resources accessible to communities, while at the same time providing direct services,” said Ledesma. “Community trust and sustainability in our efforts have been two key factors that have really contributed to the success of the coalition. The partnership with Poder Popular and each of the connections with our coalition members, have grown our trust with the community.”
The comprehensive outreach goes beyond the fields, extending to migrant families at their schools, apartment complexes, and even at La Posada, a homeless center that has dedicated beds for farmworkers. One best practice they have found is using text messaging campaigns to deliver health education through platforms like Whatsapp. The farmworkers themselves are committed to working hard and making the most of every opportunity. Though owning a farm may be unattainable in such an expensive place, education provides a stepping stone for their children that can open doors intergenerationally. For most, at this point, survival is the primary focus.
The clinic is a particularly successful example of the long-term trust that has been cultivated. “It is a peer to peer education model. Community health workers helped with the skin cancer screenings out in the field, led the focus groups, and conducted interviews. Our health workers give patients their personal cell phone numbers. They have built close relationships.”
FWCC’s vision for the future is increased support and sustained access to resources for farmworkers in San Diego County. “The services provided to farmworkers are at no cost to farms, yet we are not always able to gain access to reach workers.,” Ledesma explained. “Vista Community Clinic has provided backbone support, but to grow our coalition, and diversify our efforts, we also need sustainable funding that recognizes the importance of this work, not just for ourselves, but for our partners.”
Herminia Ledesma is the Program Manager for Vista Community Clinic (VCC) and Vice-chair of the Farmworker CARE Colaition. Herminia oversees VCC’s Migrant Health and Community Engagement Programs, supporting access to health care for migrant workers and their families. One of her career focuses has been leading Community Health Worker (CHW) programs, such as VCC's Poder Popular Lideres.
