Health care, housing access for farmworkers hindered by language, cultural differences

Irene Flores was pushing a strawberry cart through the rain-drenched Oxnard fields, the wheels clogged with mud, when she felt her back seize. She held onto the cart and wondered if she was dying.

She had spent the previous several days stooped over in the fields that carpet the Oxnard Plain, picking berries and arranging them in plastic clamshell boxes headed for grocery shelves nationwide. The more she picked, the more she got paid. She needed the money, so she worked quickly, ignoring the growing pain in her midsection.

She knew her body hadn’t healed correctly from the cesarean section doctors had performed when she gave birth to a son six months earlier, but she needed to work to feed her two boys.

So when her back spasmed, she kept on working. When she got home, she went to the bathroom but couldn’t get up. Her husband called 911. That was in 2005.

Flores is among thousands of indigenous people from Mexico living in extreme poverty in California — the second largest concentration of those workers are nestled in Ventura County.

Because many of them are living in the country illegally, they typically don’t have access to health care or farmworker housing. The result is they face slum living conditions, backbreaking labor, exposure to pesticides and higher-than-normal rates of illness.

They total about 20,000 locally — mostly from the states of Oaxaca and Guerrero — during the strawberry season, according to Sandra Young, founder of the Oxnard-based Mixteco/Indigena Community Organizing Project. The majority are Mixtecs. And about 60 percent of them don’t speak Spanish or English well enough to communicate, relying instead on their native Mixteco language.

It’s a complicated language full of clicks and tones not used in English or Spanish. Much like the native Chumash people in Ventura County, Mixtecs trace their ancestry to people who lived in what is now Mexico — before the arrival of Europeans in the 1500s.

“Certainly, there are language barrier issues,” said Young, an OB-GYN nurse practitioner at Oxnard’s Las Islas Family Medical Group, a clinic where about 40 percent of her patients are Mixtec. “The county has not fully embraced this population yet, and that’s not just in the health care system — in education, legal and social services, and the business sector, there are still big gaps in equity.”

Most Mixtecs moved to Ventura County in the past 15 years, driven by extreme poverty and drought in their native villages, she said. They pick the majority of the state’s strawberries — Ventura County’s No. 1 crop, valued at $691 million in 2012 — and largely live in low-income communities clustered around the berry fields in Oxnard, Santa Maria and Salinas.

POOR LIVING CONDITIONS

There’s a good chance that the strawberry someone bites into in New York City, St. Louis or Oxnard was picked by hand by a worker worried about their next meal, someone like Flores.

“I’m worried about my kids,” she said in June, sitting on a plastic stool in the kitchen of a one-bedroom apartment she rents in Port Hueneme. Outside, electrical wires and plumbing pipes snake across the yellow building, which is no more than 400 square feet — home to her, her husband and their three children.

Her stool wobbled on the broken linoleum tiles as she held her 2-month-old daughter. A fish tank was murmuring in one corner of the little kitchen, a table sat in another. The mostly empty shelves had a carton of cereal, a canister of salt and some cooking utensils.

“I just moved to this studio because before I was living in a room and it was not comfortable because of my kids,” Flores said, speaking through an interpreter in a mixture of Spanish and Mixteco. “They didn’t have their own space — there wasn’t a space to play. It was hard because the weather was hot and we couldn’t go outside in the living room because there were other people living there. Also, the bathroom — sometimes my kids or I wanted to use it but there was somebody else in there.

“It was not a good condition.”

There were 15 people living in the three-bedroom apartment — a family in each of the rooms and three men recently arrived from Mexico sleeping in the living room, Flores said. That living arrangement is typical for many farmworkers, particularly Mixtecs, according to Young.

“These are often poorly maintained houses that may even lack some of the basic things we take for granted, like water and heat and cooking spaces,” she said. “All of those things present big challenges to maintaining one’s health.”

Many Mixtec farmworkers make less than $15,000 a year — not enough to afford to rent their own apartment in a county where rents average more than $1,500 a month, according to recent surveys of rental properties.

Another Mixtec family of five interviewed for this story said they lived in a garage in El Rio, while others said they rented rooms in houses shared by other families in the La Colonia neighborhood and south Oxnard.

Because of the crowded housing conditions and, sometimes, lack of access to hot water or bathrooms, Oxnard-area health clinics see outbreaks of respiratory illnesses, such as respiratory syncytial virus, known as RSV, Young said.

“It particularly affects kids under 1 and is very contagious and makes the rounds every winter,” she said. “It ends up with not an insignificant number of kids getting hospitalized and even intubated in intensive care.”

Young believes the area also sees more cases of flu, gastrointestinal illnesses, diarrhea and tuberculosis because of poor housing conditions and lack of access to primary-care doctors.

TOUGHEST JOB

Mixtecs are largely without health insurance because it’s typically not provided to seasonal farmworkers and adults often are living in the country illegally. The Affordable Care Act, designed to provide all Americans with health coverage, will leave them out.

“When you drive along the agricultural fields, you’re not going to notice if someone’s indigenous,” said José Alamillo, a CSU Channel Islands professor who teaches a course on indigenous immigrants. “This population is not very visible. They’re in the shadows.”

Picking strawberries is widely regarded as the toughest job in agriculture, by labor experts. Strawberry pickers refer to the berry as “la fruta del diablo,” or “the fruit of the devil.” Most of their days are spent bent at the waist, carefully pinching off ripe berries and arranging them in the plastic boxes — as fast as they can.

During the peak season, pickers can work more than 80 hours a week, sometimes from 6 a.m. to 6 p.m., seven days a week. Oxnard’s peak season runs from January to June, with a smaller harvest occurring between October and November, according to the Ventura County Farm Bureau.

Because the job is so grueling, injuries are common, says Gaspar Rivera-Salgado, project director for the UCLA Center for Labor Research and Education, whose father participated in the Bracero Program in Santa Paula, a federal program that brought Mexican laborers to work in the U.S.

“If you’re young, in your prime years, you might be working great, but after five years, kids start experiencing symptoms of back injuries,” said Rivera-Salgado, who is Mixtec.

“I’ve seen this firsthand, and I know firsthand these people.”

LANGUAGE BARRIER

When they come to emergency rooms, as Flores did that day in 2005, Mixtecs face obstacles to care, because of language and cultural barriers.

About 10 Mixtec interpreters countywide are employed by a few health clinics and one hospital, Ventura County Medical Center, said Young, whose organization trains the interpreters. There are only a handful of interpreters in the county who can translate from Mixtec to English — so if doctors don’t speak Spanish, they must use a second interpreter and pray that the conversation doesn’t become too much like a medical version of the game “Telephone.”

Flores was given an injection — she’s not sure of what — and pain medication, and told to take time off work. After 15 days of rest, she went back to the fields, where she worked until giving birth to her daughter this year.

Her hips and back still hurt her every day.

“Now when I get up, I think that I’m not walking OK, because I think that my hips are not in the place that they’re supposed to be,” she said.

“But, even with all my pain, I will have to hurry up, because I need to get the job done so I can get more money. It’s the only job I have.”

She plans to start work in the fields this October, when her daughter is 6 months old. She knows the pain will likely worsen, and that eventually it may cripple her or force her out of the fields. But, for now, it’s her only option.

“For me, I would prefer to live in Mexico, but here we have better opportunities for my kids,” she said. “I tell them to read so they can be something. I would like for them to become a doctor or something, so they don’t have to work in the fields like I am. I want a better future for them.”

This story originally ran in the Ventura County Star on September 7, 2013

Image by noborder network via Flickr