Plan Aims to Boost Health of Farmhands

Farm worker Arturo Magana, who picks lemons, oranges and avocados in the orchards of Ventura County, is the picture of health, his face burnished a deep brown, his body fit after 32 years of physical labor.

But last year, the 46-year-old Magana’s employer sent him to Hawaii to pick coffee beans. There, he tested positive for tuberculosis, and he now takes medication to manage the condition.

Magana is one of the lucky ones with an employer who provides medical coverage. Most of the 1 million agricultural workers in California have no health insurance and cannot afford a doctor, leaving them oblivious to pressing health issues or to suffer in silence.

Uninsured and underserved by the medical industry, migrant workers can be unwitting carriers of communicable diseases, such as gonorrhea, chlamydia and all three types of hepatitis. Often unaccompanied by early symptoms, infectious diseases can be spread unknowingly through sexual contact, drug use and other high-risk behaviors, health officials said.

To reduce that possibility in Ventura County, a private agency and four rural health clinics run by Santa Paula Memorial Hospital and Ventura County Medical Center won a two-year, $500,000 grant from a health-care foundation and $30,000 more in tobacco settlement money to steer agricultural workers and their families to inexpensive health care.

The Ventura County Medical Resource Foundation and the rural health centers will hold free screenings this week at a migrant camp in Fillmore and another in Piru, specifically to detect and treat infectious diseases.

Known as La Familia Sana, or the Healthy Family, the program aims to reach male agricultural workers in rural Ventura County and help them find services that can provide long-term health care, said Kathy Kramer, grant project manager for the Ventura County Medical Resource Foundation, which helps find money for medical programs for the poor.

La Familia Sana will use the tobacco money to conduct the screenings and the grant from California Endowments to pay for follow-up visits by outreach workers.

Specially trained social workers, or los promotores, will talk with the estimated 110 residents of each camp about their health concerns and tell them about services such as Healthy Family or rural health clinics in Fillmore, Santa Paula and Piru, Kramer said.

The outreach specialists will visit churches, schools, Laundromats and other locations to speak with families of agricultural workers, Kramer said. They will carry the message that preventive health care and regular checkups are important--and are, in fact, available at little or no cost. The goal is to talk to 15,000 people in each of the program’s two years and convince at least 7,000 of them to take the next step and seek health care.

Experts say programs such as La Familia Sana are crucial to dealing with the spread of infectious diseases. In Ventura County, the most troubling communicable diseases are chlamydia and hepatitis C and B. The number of cases of chlamydia, a sexually transmitted disease, rose to 1,206 in 2000, up from 983 in 1999, according to the Ventura County Public Health Services.

La Familia Sana will focus on men because they are the least likely to seek medical attention for a variety of reasons, including long hours toiling in the fields and a fear of deportation if they illegally entered the United States.

The lack of health care among California’s agricultural workers was found to be so acute in a 1999 survey commissioned by California Endowment that the agency set aside $50 million over five years to address the issue. La Familia Sana is a beneficiary of that endowment.

“We saw severe deterioration of these men in the prime of their lives, from 22 to 40 years old,” said Mario Gutierrez, who manages the agricultural worker grant program for Cal Endowment. “The conditions under which they work are extremely hard. Being away from their families and being isolated from home and their communities, it leads to all kinds of problems--alcohol abuse, drug abuse, infectious disease, tuberculosis, hypertension and obesity.”

Luis Noriega, 23, said that some of the men at the Fillmore housing camp believe that drinking a beer on an empty stomach helps keeps them healthy.

“It’s been a long time that I haven’t seen a doctor,” Noriega said. “I don’t even know how long. We live in the fields. If we’re getting a cold, we just pick up an orange and bite into it. And lemons, too. You can take care of yourself with orange juice. And you drink a lot of water.

“And beer helps, too,” he said, only half-jokingly.

Noriega used to get a checkup every six months through his former employer in Mexico. He made sure to get one before leaving 3 1/2 months ago. He does not get sick, he said, but likes knowing he is healthy.

“I need to get a checkup often,” he said. “That way you know what you have. It would be good to have medical services. Yes, that would be good.”

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Times staff writer Elena Gaona contributed to this report.