Building a Bridge to Better Health

Years of toil have broken many a farm worker like Genaro Saucedo, whose body looks older than its 78 years.

A field hand since 1954, Saucedo walks in a crouch. His eyes barely flicker. And still he tries to work.

“I am dying,” he sighs.

Under an ambitious program unfolding along Orange County’s rural edges, the sick and the weary among the farm workers, people like Genaro Saucedo, are receiving some sorely needed care.

A group of nurses and nuns, backed by private money, is taking medicine directly to the county’s 40,000 agricultural workers and their families.

The program’s directors, based at St. Joseph’s Hospital in Orange, have $1 million to spend over three years. They hope to document the condition of Orange County’s farm workers and keep the program alive as long it’s needed. Bridge to Health, as it is known, is the only program of its kind in the United States.

“Farm workers tend to be very healthy, but when they get sick, they don’t have the time or the money to take care of themselves,” said Rocio Magdaleno, the program director. “For many of them, this is their only chance.”

Each weekend, Magdaleno and her crew of six drive their van to places around the county where farm workers gather and live.

One of their stops is the California Labor Camp, bare-bones living quarters for about 200 farm workers. It is Orange County’s sole remaining labor camp, located at the eastern end of Jeffrey Road near Irvine, and it thrives by sending workers to the growers who need them.

On a recent Sunday at the camp, nurses from Bridge to Health gave immunizations for tetanus and influenza. They screened patients for tuberculosis. They measured blood pressure and pulse. In the camp’s combination chapel-cafeteria-meeting hall, a nurse, standing under a picture of Christ, lectured a group of men on the benefits of dental health--and the hazards of doing without.

Many of the men had never known such care.

“Look at my teeth. Bad. Very bad,” said Guadalupe Ruano, a 58-year-old who has picked beans and tended plants on California farms for 24 years.

When a nurse handed Ruano a huge plastic jaw in order to practice his brushing technique, he gaped at the thing and then got down to work.

“You have to brush each individual tooth,” he said, parroting his instructor. “Tooth by tooth.”

Bad teeth are among the more prevalent problems among migrant workers. Anemia and dermatitis are common. Influenza periodically sweeps the camp, where the men live 16 to a room.

The nurses also treat problems particular to farm workers. Many workers suffer from skin and eye problems brought on from years of handling pesticides, and many have parasites from eating unwashed fruits and vegetables picked in the field.

In addition to treating acute illnesses, the health workers teach preventive care as well: how to handle pesticides, how to avoid sexually transmitted diseases, how to bend and stand to prevent muscle strain.

Earlier this year, a Bridge to Health team passed out hats and sunglasses, donated by a local department store, to help prevent pterygium, a chronic eye condition brought on by prolonged exposure to the sun.

“When people have diseases, we want to treat them, but we also want to give people the skills to manage their own health,” said Sister Mary Therese Sweeney, vice president of St. Joseph’s Hospital.

The health of California’s farm laborers is not well documented, largely because the population is so mobile.

Dr. Marc Schenker of UC Davis says the available data suggest that the fate of the migrant worker is not an enviable one.

“You don’t grow old as a farm worker,” Schenker said.

According to statistics compiled by the National Center for Farm Worker Health in Austin, Texas, farm workers are far more likely to die on the job, contract parasitic infections and suffer toxic chemical injuries than workers in other professions. Their per capita income is about half the U.S. average.

The health problems of farm workers often go untreated, because, for many of them, decent care is unavailable or unaffordable. At the California Labor Camp, the men say they typically earn about $4.60 an hour. They pay $10 a day to stay at the camp.

Most of the men work six days a week, and if they don’t work--when, for instance, they visit their families at Christmastime--they don’t get paid. While some growers provide health insurance to the farm workers, Magdaleno said, most do not.

Ruano, the farm worker learning dental hygiene, said that when his wife had a heart condition in the mid-1980s, he did not have the $10,000 needed for her surgery. Ruano sent her to Mexico, where the procedure was cheaper. She died shortly after her operation.

“Too expensive here,” Ruano said.

Public assistance for migrant farm workers is scarcer than ever. The recent tightening of eligibility rules for Medi-Cal has left many of the workers, even legal immigrants, without access to medical care. There are 17 publicly funded migrant health clinics still operating in California, but none in Orange County.

That’s where Bridge to Health comes in. Magdaleno and Sweeney conceived the program in 1994, and secured grants from several foundations: the St. Joseph’s Foundation, Kaiser Permanente, the Irvine Health Foundation, the California Wellness Foundation and the PacificCare Foundation.

The program began treating patients last year.

In addition to the California Labor Camp, the Bridge to Health team visits three sites where farm workers and their families congregate: El Modina Community Center in Orange, Corbin Community Center in Santa Ana and SOS Clinic in Costa Mesa.

Ray Espinoza, the owner of the California Labor Camp, welcomes Bridge to Health. He says agricultural work often causes problems for even the toughest farm worker.

“If you are picking asparagus for 10 hours a day, you are going to be a hunchback,” Espinoza said. “It’s hard work.”

Still, the workers say that even though the work is backbreaking, they will keep coming as long as it is here.

Rodolfo Ortega, 56, arrived at the California Labor Camp from Mexico only six months ago. He finds the work exhausting, the pay lousy. “I make $20 a day. That’s not so much,” said Ortega, who used to drive a taxi. “But way more than in Mexico.”