Many Dartmouth students know about the number of farms in and around the Upper Valley, which provide fresh dairy and other foods to the region. But few know about the migrant workers who keep these dairy farms running, or the struggles that they face on a daily basis.
One group at Geisel, the Migrant Health project, is dedicated to improving care for migrant workers at farms across New Hampshire and Vermont. Founded in 2010 as an Albert Schweitzer Fellowship, one of several projects that year designed to address health needs of underserved populations, the project has since grown into a student-run project at Geisel that takes new members each year.
The group has a mobile health clinic that travels to farms, providing healthcare for the workers there. Some of the services the group provides include vaccines, blood pressure measurements, disease screenings and other basic medical care, all of which are performed on site. For more serious issues that require traveling to local clinics, the group also provides translation services for Spanish-speaking workers.
This year, co-leaders Caledonia Moore Med’18, Claire Hogue Med’18 and Michael Connerney Med’18 also focused on conducting research to learn about barriers to healthcare for migrant workers. Their work has highlighted the need for improved dental care. In response, they launched the Migrant Oral Lifestyle Advocacy and Advancement Resource Service, or MOLAARS, in conjunction with the Dartmouth Primary Care Cooperative Research Network. MOLAARS partners with a local dental clinic to provide regular checkups and cleanings for migrant workers, offering them transportation and translation services.
MOLAARS has also focused on providing dental education, Connerney said. Currently, the group has a two-pronged strategy. The first part is to get workers into dental clinics and keep them coming back, so they can be exposed to dental professionals and pass on what they have learned to their friends and family. The second is to provide education about how to properly care for one’s teeth with regular brushing and flossing. MOLAARS also distributed toothbrushes, toothpaste and floss to migrant workers, Connerney said.
In addition, the Migrant Health project is working on providing better mental health care to workers, an initiative that started this spring. Right now, first-year students are working in focus groups with farmers to figure out how to model their programs.
Hogue spoke about the health issues that the migrant workers she treats face, including high blood pressure, diabetes, gastrointestinal complaints and upper respiratory issues. Language barriers, long hours and high costs can make it difficult for them to get care, she added.
The rural nature of Vermont and New Hampshire also provides unique challenges for workers in the area. Connerney said that the spread-out nature of farms in the region make it difficult for migrant workers to form a sense of community outside of their own farms. This is compounded by lack of access to transportation, he said.
Moore spoke about the lack of resources for Spanish speakers in the area. For example, she said she does not know of any Spanish-speaking churches near the farms for workers to go to. She mentioned one worker who found it difficult not be able to walk to Spanish-speaking stores.
Hogue highlighted the struggles of those who speak languages other than Spanish, such as Chinese and Arabic. There are few language resources avaliable for these groups. She said that the Migrant Health project is looking to add more translators who speak these languages.
Cathleen Morrow, chair and associate professor of community and family medicine at Geisel, who has acted as a mentor for the Migrant Health project, echoed the students’ comments. Isolation is a significant issue for workers in the Upper Valley, Morrow said. The small sizes of communities in the area, combined with low levels of diversity and lack of resources for Spanish speakers, exacerbate the problem. Grocery stores, for instance, lack traditional Hispanic ingredients.
Morrow also said that migrant workers’ long hours could make it difficult for them to access proper health care. Many of them find it difficult to take time off of work, she said, leaving them little time to go and visit physicians.
Morrow said that migrant workers’ more active lifestyles lessen some of the issues that many sedentary Americans face. However, they do suffer from more acute issues such as musculoskeletal pains, skin problems and injuries sustained on the job. There are also issues with getting appropriate levels of screening and preventative care, she said.
Connerney said that he thinks it is important to have more qualified health centers at both the state and federal level to address the needs of migrants and other underserved populations. The qualified health centers the group works with have been indispensable in fulfilling the group’s mission, he said.
Medical issues are not the only obstacles that migrant workers in the area face. Another group, Migrant Justice, is focused on providing access to better housing, transportation and work conditions in addition to health care. The group was founded in 2009 after the death of a migrant worker, José Santiz, in a workplace accident, member Will Lambek said. Santiz was caught in a machine and strangled by his clothing. This served as the catalyst for the group’s foundation, which has organized approximately 1,500 workers across Vermont, Lambek said.
One early project for the group was increasing access to transportation, Lambek said. They campaigned to change Vermont’s laws to allow undocumented migrants without Social Security numbers to obtain driver’s licenses. Ultimately, their efforts were successful, and in 2013 Vermont became one of the first in the country to give undocumented immigrants driver’s licenses, Lambek said, allowing migrant workers to leave their farms, form communities and shop for groceries much more easily.
Hogue said that she thinks a similar law in New Hampshire would be helpful for immigrants.
Lambek also highlighted the daily struggles many migrant workers face, such as long hours and low pay. Many migrants work 60 to 80 hours a week, he said, while nearly half are paid at levels below the Vermont minimum wage or do not receive any days off.
Another issue unique to Vermont is housing, Lambek said. Many workers live in housing on the farm, housing which Lambek said is often “unfit for humans to live.”
“It’s old trailers next to manure pits, or it’s leaky apartments right above the cows on the second floor of a barn,” he said.
Many workers say they have gone without sufficient heat in the winter, he said, or lack access to potable water.
To improve farm conditions, Migrant Justice has begun work on a campaign they call “Milk with Dignity.” It uses what they call “worker-designed social responsibility,” a phrase they adapted from the Coalition of Immokalee Workers, which fights for, among other things, workers’ rights on tomato farms in Florida.
The campaign is centered on targeting dairy buyers, Lambek said. It seeks to persuade them to buy milk only from farms that have met standards for working conditions set by workers on the farm. Companies that agree to the plan will pay higher prices to those farms to support their business model, the farm owner and the workers, Lambek said. An independent third party will monitor participants to ensure the standards are met.
In 2015, Ben and Jerry’s became the first company to join the program, Lambek said. They are currently in talks with Migrant Justice about how to organize their supply chain to meet the organization’s standards. The program has not yet been implemented for any supply chain, Lambek said.
