Anelyse Weiler is a PhD student in Sociology with research focusing on migrant farm workers in Canada. With two medical co-authors, Anelyse recently published an article on the BC Medical Journal’s blog. The BC Medical Journal is a general publication for the continuing education of physicians in British Columbia. The blog consists of “short timely pieces for online publication…on any health-related topic.” The piece appeared on Wednesday, September 21, 2016 and the complete article is available online . The following is an excerpt of the longer article.
Coming to Grips with Health Barriers and Structural Violence for Migrant Farmworkers: A role for BC physicians
“In Kelowna I walked around all the time with a headache, and I covered my mouth with something so I wouldn’t absorb all of the [pesticide] dust coming out of the cherries. And I mentioned it to the boss . . . from what I have seen. . . . If you get worse, the boss sends you back to Mexico, and the following year he won’t request you [as an employee]. And just like that he has gotten rid of his problems. That’s the issue; I’ve seen bosses discard their best workers simply because they became ill, fell, broke a hand, or fractured part of their body.”
—Felipe, from an interview on 29 September 2013
Felipe (a pseudonym), a 28-year-old man from southern Mexico, is one of approximately 8600 migrant farmworkers living throughout BC. He and other migrant farmworkers are engaged in one of the province’s most dangerous, least regulated, and lowest paid occupations. The majority are men and most are from Mexico or Jamaica, but an increasing number come from other countries. Even though they make tremendous cultural, social, and economic contributions to Canadian society, migrant farmworkers often experience disproportionately adverse health outcomes because they are excluded from many of the rights and protections that citizens and permanent residents enjoy.
Migrant farmworkers are legally entitled to health care—they must be covered either by MSP or private insurance. But Felipe’s story shows how a fear of job termination and deportation generates unique barriers to health for migrant farmworkers. Furthermore, workers are often dependent on employers for transportation from remote rural areas and help to navigate the Canadian medical system.
BC physicians can play a critical role in reducing the gaps in health care for migrant members of our communities, both through everyday clinical practice and advocacy.
Resources and considerations for physicians
If language barriers are a concern, physicians can draw on the Provincial Language Service (PLS), which provides interpreting and translation services over the phone or in person.
To address cultural barriers and migrants’ long working hours, the Umbrella Mobile Clinic provides periodic pop-up farmworker mobile clinics throughout the Fraser Valley. These are staffed by a physician or nurse practitioner as well as multilingual cross-cultural health brokers.
If a physician is clarifying medical or billing issues with private insurance providers, sending-country representatives, English-speaking coworkers, or employers, they should be sensitive to the potential implications of putting patients’ confidentiality at risk. Medical repatriation, where a migrant worker is sent to their country of origin after sustaining an illness or injury (often against their will), is a documented risk for farmworkers. Once repatriated, access to health care and compensation granted to other ill or injured workers in Canada becomes much more complicated.