The Maine Mobile Health Program (MMHP) is Maine’s only farm worker health organization whose mission is to preserve and improve the health of the state’s seasonal and year-round agriculture and aquaculture workers and their families. Community health workers struggle to navigate the country’s complex health system amidst various cultural barriers. A government-funded non-profit organization, the MMHP fights to reduce health disparities for farmworkers to ensure their health.
Laura Ochoa, a current community health worker, feels strongly about supporting migrant farmers in Maine.
“[If] you don’t take care of those guys, you are not going to have your veggies. You’re not going to have your fruit [or] your seafood because [they] work really hard to give us those beautiful tasty foods that we eat,” Ochoa said.
Medical Director of the MMHP Demetri Blanos described the variety of services the program provides.
“We’re working on colon cancer screening and hypertension control, as well as a whole host of things: cervical cancer screening, breast cancer screening, diabetes control, improving outcomes for cardiovascular disease, cholesterol management, childhood immunizations, depression screening and referral for care and nutrition and weight counseling,” Blanos said.
The MMHP sends out “mobile health unit” vans to various farms state-wide where farmers live and work during harvest seasons.
Community health workers, like Ochoa, provide services including educating workers on local community organizations, registering patients, driving vans to the farms and connecting patients to other qualifying providers.
“We not only do the referrals, but [also help] if they need the interpretation and the transportation. I go to their house. I [pick] them up. I stay with [them] the entire time for any services, and I bring [them] back home,” Ochoa said.
The organization thrives on providing “culturally-appropriate” care to farmworkers—many of whom are undocumented immigrants from Latin America, Haiti and Jamaica—in attempts to mitigate health disparities due to barriers like language inacessibility and citizenship status. Many employers do not offer these undocumented workers insurance due to their legal status.
This is only one of the many barriers in accessing adequate health care services, leaving migrant communities even more vulnerable to poor health outcomes, according to Laura Valencia-Orozco, the MMHP’s behavioral health director.
“If you’re continuously traveling, moving from one place to another, you can’t get yourself established as a patient anywhere,” Valencia-Orozco said.
The task of providing culturally-appropriate care can be challenging in the state of Maine, the second-whitest state in the country. However, cultural insiders like Ochoa, who herself is a Mexican migrant, and Valencia-Orozco, who is a Mexican migrant and former Maine aquaculture worker, bring with them a background similar to that of their patients. This shared background between patient and provider allows for an improves delivery of care.
“I think it helps a lot, because we are speaking not only the same language, but also the same culture,” Ochoa said. “I give them that trust. I treat them with respect and with care…I’m Latina, [I] know the culture, I know the limits.”
However, health transcends the realm of clinical care. Valencia-Orozco notes that other tenets of well-being, such as mental health, physical safety and family reproductive planning play a large role in the well-being of these workers.
According to Ochoa, it takes a cultural insider to better understand how workers communicate their symptoms. This skill has helped Valencia-Orozco in diagnosing mental health issues, ranging from PTSD to depression, in workers who may otherwise not have been able to communicate their concerns.
“We had a patient recently that has had a lot of panic attacks,” Ochoa said. “We mostly talked [about] different breathing techniques…And then slowly [she] started talking about like, ‘oh, you know, when I’m less stressed…when I sit, when I’m relaxed, [I’m] not having these panic attacks.’ So that allowed her to kind of [make] that connection herself versus me. Talk about her stress, [about] causing the panic attacks.”
The MMHP plans to expand its services and is currently working towards developing interventions for issues they have found to predominantly affect women, such as domestic violence and reproductive health.