The caravan pulls out of a Moultrie hotel at 7 p.m., heading for a nearby farm.
Inside the chain of vehicles are dozens of university students who are learning to be nurse practitioners, nurses, physical therapists, dental hygienists and pharmacists. They are joined by volunteers and faculty members who are veteran health care professionals.
Sharon Quinn, RN, of Atlanta leads the procession onto rural roads outside the South Georgia town, and eventually down a dirt road, past a dirt basketball court, stopping in a lot between a barracks and a cantina. It’s a camp for workers at a huge, privately owned vegetable farm.
Quinn, 51, has been taking these trips to farms in the area for several years. She is a veteran of Emory University Hospital’s intensive care unit who recently switched to the health IT field. She takes two weeks of vacation each year to help oversee an Emory program for students in health care professions, who come to Moultrie to treat farmworkers and their children in a four-county area.
Over 19 years, the program has delivered care to more than 15,000 migrant and seasonal farmworkers and their children in South Georgia during the peak growing season.
“It’s the completely opposite experience from academic health care in Atlanta,’’ Quinn says.
This farm has an H2A camp, meaning the farmer has applied to the federal government to employ workers with temporary visas. Several Hispanic workers are already seated in chairs, ready to be seen.
The students, after dousing themselves with bug spray and lugging portable chairs, set up the stations. There’s one for check-in. One for blood pressure, BMI, and glucose screening. Then there are tents posted for nurse practitioners, for physical therapy, for dental examinations.
Pharmacy students and faculty members set up a table in front of an Ellenton Health Clinic van. A nurse passes out hand fans to ward off the swarming gnats.
Lives of poverty and pain
One of those waiting is “R,’’ a man in his 60s, who points to several areas of pain: shoulder, back, foot. He also mentions headaches. Like others interviewed, he does not want to use his name, and speaks to a reporter through an interpreter.
“R” comes from Mexico. He said it has been perhaps 20 years since he has seen a physician. He doesn’t make enough money to go to a doctor, he says.
“A,” a man in his 20s, also has back problems, he tells a nurse practitioner. He almost passed out from the heat the day before, he says.
“J,’’ 39, from Mexico, wears a Georgia Bulldogs baseball cap. He says he always looks forward to getting a general checkup, especially of his blood pressure. He stays in the Moultrie area from May till December, picking fruits and vegetables.
A long line forms at the glucose checkpoint. Diabetes is a problem among these workers. Yet many, too, get treated at the physical therapy tent. It’s run by grad students and a faculty member from Georgia State University.
The patients here do the backbreaking work of picking vegetables and fruits, such as peppers, eggplant, watermelons and cantaloupes.
The medical stations are run efficiently, with the only real hindrance being a scarcity of interpreters. Max Estrada, an Emory nursing student, is in constant demand because he’s one of the Spanish speakers, though many of the graduate nurse practitioners speak Spanish, too.
During the day, the students bring health care to workers’ children, who attend a local school. “We see every child, every year,’’ Quinn says. Common health problems among the kids are tooth decay, bug bites, obesity, anemia, earwax buildup and vision problems.
The student program was launched by Judith Wold, a professor in the Emory School of Nursing. The nurse practitioners come from Emory, as do the undergrad nursing students. Dental hygienist students come from Darton College in Albany, and Clayton State in Morrow, the pharmacy students from the University of Georgia. The Department of Psychology from Georgia State also participates.
Patients found to have serious problems are referred to the Ellenton clinic.
“C” says he saw the Ellenton Clinic van and realized it meant medical help. This is his first season as a farmworker, and he reports pain in his back and stomach. He says through an interpreter that the work is very hard. He never expected it to be this hard, he says.
“A lot of them are educated people,’’ says Cynthia Hernandez, director of the Ellenton Health Clinic, who helps set up the two-week visit, choosing the camps, getting the necessary permission, setting up the lunches.
“They cannot make enough money in their country,’’ she says. “They came to do a job that our folks are not willing to do.’’ They work 12 to 14 hours a day in 100-degree weather, many of them away from their families for six to 10 months a year.
Health risks of all kinds
The Ellenton clinic is one of six farmworker health clinics operating in Georgia, getting federal funds passed along by the state.
The student program allows farmworkers access to health care where they work and live. “Many of them, they are seen for the first time,’’ Hernandez says. The students get clinical hours and an eye-opening experience in rural health care, she adds.
“The students absolutely love it,’’ says Trina von Waldner, a professor at the UGA College of Pharmacy, while helping run the pharmacy station.
Besides muscle strains and back problems, there are foot fungus problems and dental aches that need attention.
If a dentist shows up, Wold says, workers ‘‘will stand in line to get their tooth pulled.’’
The night before, the students treated many farmworkers with severe foot rashes, a result of working in the rain and having pesticide and fertilizer runoff get into their shoes and over their feet, then standing in those wet shoes for as many as 12 hours.
One station at the Moultrie area camp offers an unusual sight: Health workers treating the feet of workers. They are washing feet, trimming toenails, applying powder, giving out free socks. It’s an almost biblical scene.
A table of drugs is set up in front of the van, with containers of Tylenol, ibuprofen, multivitamins and antifungal cream piled up, ready for pickup by the men who have passed through their final checks.
Sometimes the students visit camps populated with workers who are in the country illegally. But the health people don’t ask about immigration status.
The issue of illegal immigration flared up in Georgia the year before, after the General Assembly passed a tough new law.
The student caravan hit a roadblock last summer. A lack of laborers last year, in fact, led to farmers plowing under some vegetables.
Yet, Wold says, ‘‘the farmers trust us to come here.’’
A friendly reception
Whatever the legal issues, immigration doesn’t appear to be a dirty word here in the heart of farm country. Local residents are friendly to the students. The Moultrie mayor spoke this year at an orientation dinner for them this year, and churches in the area supply lunches.
“The community is used to us,’’ Quinn says. The students in their standard blue medical smocks are a familiar sight around town.
Wold and Quinn are known as the “jefa,’’ Spanish for boss lady. Quinn sees the workers as they check out and depart into the night. They are given water bottles and other personal items, along with medicines.
Last year, she says, she brought along her 21-year-old daughter, who was curious about the work her mother was doing.
“She was here two weeks’’ and enjoyed it, Quinn recalls.
The program is not just a big act of kindness, Quinn explains. If not for its work, she says, the children would spread more communicable disease, and ER costs at area hospitals would rise.
The care the teams administer can include something as simple as a long-sleeved shirt, to ward off pesticide exposure, or a new pair of socks.
For a farm laborer, Quinn said, “a pair of socks can be invaluable.’’
The students keep working late into the evening, before returning to the hotel. The next day they will examine children, and the next night will travel to another camp.
It’s not the typical two-week vacation that many workers enjoy. But Quinn sees that she is making a difference, both with the farmworkers and with the students.
“This is my happiest time of the year,’’ she says.