Cada año Maine celebra una conferencia sobre raza, color, etnicidad y minorías. El 2 diciembre participé en la sexta edición, en un panel donde otros colegas y yo contamos qué es un «Community Health Worker», el noble oficio en el que me desempeño desde fines de diciembre de 2015. Mi participación fue en inglés. Acá va el texto. Sepan disculpar mi nivel de principiante.
My name is Marco Avilés, and I’m a Community Health Worker in the Maine Migrant Health Program. I’m also a Peruvian writer who immigrated to the US two years ago. At that time, the only two things I new from Maine were:
- Stephen King lives here
- Mainers love lobster
As a writer who writes in Spanish, my life plan didn’t include moving to this country (no hard feelings). But the woman I love and, whom I was living with in Lima, is from Maine. She is also a writer, and after 10 years living as a correspondent in South America, she was homesick and wanted to come back. Among other things, she missed family and friends. Maine families like lobster. So that –lobster and love– briefly explains why I am here this afternoon.
I am an immigrant and am very thankful to Maine because I quickly integrated into the community and have this amazing job. I love being a CHW because it’s about helping people that are also immigrants. The people I serve come from Mexico, Honduras, El Salvador, Guatemala, among other countries. And they are immigrants in many ways like me (same language, same color of skin, of course we love soccer and hot chilies). But these immigrants are in many other ways not very much like me. They are not integrated into de community. On the contrary, they are segregated.
- A lot of them don’t speak English
- Most of them don’t have a car
- All of them work in physical activities, mostly in the food industry, and suffer from conditions related to their work: back pain, allergies, physical injuries.
- The irony is that, even though they work hard to provide most of the food we enjoy, a lot of them can’t have health insurance because they don’t qualify for it.
I work mostly in rural areas such as Turner, Minot, Clinton, Knox, West Paris. And here is other irony. We are in America, the most developed country in the world, but talking about public transportation in rural areas is like talking about space travels: science fiction. So if you live in the middle of nowhere, and you have a lot of health needs, no insurance, no car, don’t speak English, believe me, life will look very hard and you will need a lot of help. That is the reality where the Maine Migrant Health Program works, and where I have the privilege to participate.
* * *
One day I got an unexpected phone call. The manager from a local farm told me her company needed to hire a lot of workers. But they had a specific requirement: they only wanted latino workers.
No. They are lazy –she said–. They wanted latinos.
The question is why?
Is it true we are better workers? Is there something special in our genes? Is there something special in our food? In our chilies, maybe?
I asked these questions to a patient. I was driving him to a medical appointment. Driving patients to clinics and helping them with interpretation are activities I do a lot as a rural CHOW. This patient is almost 60 years old, shares a small apartment with two coworkers, all his family lives in his country, and he sends money to them regularly, after paying taxes, of course.
He told me that the farm doesn’t like Americans workers because this guys just work for one day, two days, a week, maybe, until they realize the amount of work and risk is not worth the salary. So they leave as soon as they find a different job. Latinos (who, you know, don’t speak English, don’t have a car, and so on) they just prefer to keep the job. No matter the hard conditions.
* * *
I was at an eye care clinic with a 24-year-old dairy farm worker who needed an eye surgery. And while we were waiting for the doctor, all of a sudden, he started telling me a story. This happens a lot. Some patients like to share their experiences when they feel confortable: in a car, in a waiting room. Listening to them makes me feel like a therapist.
During his first 3 years in Maine he worked more than 12 hours a day, 7 days a week. No vacations. No days off. Like a machine. But then, he started feeling sick, tired and developing allergies. So one day he went to the boss office and told him he needed to have a day off. The boss looked at him and said he didn’t understand. Why did he need a day off? What for?
The worker knew the boss was going to say something like that and invented a plan. So he told the boss that a farm in Vermont had offered him a similar job but the payment included a weekly day off. So if he didn’t get the similar conditions here, he would quit. The boss went out the office, talked to somebody, and at the end gave the worker a weekly day off.
The patient told me this story with a smile in his face. After working non stop for 3 years, getting some time off to rest, was a triumph for him.
* * *
I also work with Jamaican migrants who come to Maine in the apple harvest season. Even though they come with visas, some of them don’t qualify for marketplace insurance. One day, a Jamaican patient was referred to a surgeon. After examining him, the specialist said the patient had some hernias and needed a surgery. The doctor left the patient with an assistant to schedule the procedure. The patient preferred not to have the surgery because of his lack of insurance.
I will never forget the expression of the woman saying:
–You don’t have insurance? Then who is going to pay for this visit?
A lot of our clients are uninsured, so the MMHP pays for their appointments. But as our funds are limited for preventive care, we do not cover surgeries.
The assistant could not understand why the patient had come to see a surgeon if he couldn’t afford a surgery. The patient –I explained– didn’t know that he needed a surgery until the specialist confirmed so. He now just wanted the medical records so he could give them to his doctor back in Jamaica. The assistant smiled.
–So you have insurance in Jamaica.
The patient said yes, he had. While the assistant completed the paperwork, I asked her if she had ever seen a person who had no health insurance.
Never was her answer. Was it true? I will never now. How can you work in a hospital in Maine and never see an uninsured person?
Back in the car, I asked the patient if he really had insurance in Jamaica.
He didn’t. He lied because he felt embarrassed.
When I think of the barriers that the population I serve faces, I believe biggest one is that they are invisible for the system and for the community.
The food industry in Maine is openly demanding immigrant workers, but policy makers (and clinics, and hospitals, and insurance companies) are not addressing this population’s needs.
The whole picture is very ironic. We go to the supermarket to buy milk, eggs, apples, but we don’t think much about the people who work very hard so we can bring those products to our tables.
Let’s make these workers visible so they have the same rights we all do.
Maine, December 2, 2016