[Fwd: The Idea of Border at Eagle Pass]

[Guest guest]

Enclosed in the body of this message is an article by a free lance

journalist, Lindsey Eck, on farmworkers, border issues, and includes interviews

with NCFH staff as well as Adolfo Valdez, President of the National Advisory

Councilon Migrant Health. It is an excellent article, well written

and humorous..it is long, be sure to read all the way to the bottom, I

hope you get as big a laugh as I did over his quotation of me comparing

hand washing and hygiene facilities to rocket science.

Lindsey's next article is going to focus on the Mexican side of the

border and he wants to work with a Gomez and Domingo to look

at the solid waste, housing and maquila conditions in that area.

Hope you like it, and I look forward to your feedback. Bobbi

The Idea of Border at Eagle Pass

Lindsey Eck

Bad Subjects, Issue # 53 , January 2001

I cross the first border inside the San city limits, on the

south side. It's one I've crossed often; I used to teach on the south side.

This frontier is an economic one: the boundary between the First and Third

Worlds. It coincides roughly with a series of military bases that form

the main federal line of defense for South Texas. South and west of this

line people live by marginal agriculture and off archaic industries, such

as fixing old cars and later junking them. But, though I have now crossed

into the Third World, what surrounds me is still unmistakably semi-rural

Texas, USA and I am unmistakably on a federal Interstate highway.

I am heading toward the dusty border town of Eagle Pass, Texas

to meet with Adolfo Valdez, who serves as Chairman of the National Advisory

Council on Migrant Health. He is also a migrant farmworker who travels

the US much of the year picking crops. He was born in Eagle Pass and has

lived his whole life along the Mexican border.

I exit the Interstate onto US57 and before long I am in some of

America's loneliest country: not even gas stations, just mesquite and prickly

pear cluttering up acreage too poor for agriculture. It is not the Rio

Grande, but this no-man's-land that forms the real barrier to the immigrant

worker illegally trekking north.

To some far-off pundit inside the Beltway, the border is definite

and defensible, a threshold. The closer I get, the more evanescent it seems.

There is not a single border but a series of frontiers, not a line so much

as an ill-defined tissue where Mexico and the United States mesh together.

If, from a distance, the border seems as impermeable as an organ wall,

upon inspection it is more of a membrane through which people and goods--and

pathogens--flow freely in both directions.

Somewhere in this vacuity I realize I've crossed another border--a

linguistic one. I press SEEK on the truck radio and it finds only one FM

station, in Spanish. From the time I arrive in Eagle Pass until I return,

I will be in a monolingual Spanish-speaking area, though still culturally

within the United States. Says Bobbi Ryder, CEO of the nonprofit National

Center for Farmworker Health (NCFH), "A lot of people think of that

whole area along the Rio Grande as home, whether it's one side or the other,

and in fact they're quite content to live on one side and cross back to

the other, from either direction."

In this region most people with a job are doing migrant farm work.

US farmworkers migrate along three principal streams, like the flyways

of bird migration, and the central route is by far the biggest. Various

maps show the migration fanning out from a home base in Texas across much

of the US. Thus the Rio Grande Valley is the nexus from which migrants

fan out across the country. The social problems of the border zone are

intimately connected with the problems of migrant farmworkers and, when

it comes to health problems, migration quickly makes the Valley's problems

a problem for all of North America.

By the time I enter Eagle Pass I've crossed another boundary,

too: a climatic line between a warm temperate zone where it is a crisp

fall day, being Thanksgiving weekend, and a subtropical zone where it is

still summer, with an uncompromising sun blazing across a cloudless sky.

I wait to meet Adolfo in a truck stop inside Eagle Pass, a couple miles

north of the Rio Grande (or Río Bravo, as it's known on the Mexican

side). Suddenly I recall an experience two decades ago in central Wales,

walking into a pub that looked like a hundred others I'd seen in the UK,

except that everyone was speaking Welsh. They all understood English, as

they had studied it in school, but used it only with outsiders. So it is

in Eagle Pass. This truck stop-diner-pool hall looks classically Texan,

but I am the only blue-eyed patron and non-native Spanish speaker. Like

the Welsh, these Latino Texans understand English because they have studied

it in schools, but use it only with outsiders. Most of Eagle Pass is visually

the same as anywhere else in Texas -- big parking lots, fast food, one-story

buildings, recent plastic everything -- but Spanish is the language of

business.

Adolfo graciously invites me to the relative quiet of his home

to conduct the interview. On the drive over I notice his Purple Heart license

plate. When we arrive, I ask him about it. "It was in 1967-68 I served

in Vietnam. Probably the worst part of the war. I had just graduated from

high school and went into the service. A lot of us did. I served my three

years ... I was wounded three different times." Having already traveled

as far as Michigan to pick cherries before he went into the Army, when

he got out he returned to migrant labor because there was "nothing else

to do." Decades later, Adolfo is not just the chair of a federal advisory

board. He still migrates every year with his family:

Let's take, for instance, last year. My family--we went to

Montana, picked sugar beets in Montana, early June. Late May we left; I

took the kids out of school. ... Came back from Montana in late June, early

July. Came back to the [Texas] Hill Country, in fact. Marble Falls. And

we did grape picking for winemakers. ... We finished there in late July

and we headed on to the state of Maine to pick blueberries, way on the

East Coast. ... There's close to 100 farmworkers that go from Eagle Pass

to Maine to pick blueberries every summer. ... We came back to Texas and

dropped the kids off in September so they would not miss any school. Then

my wife and my older kids, we headed off to Washington. Right on the Washington-Oregon

state line, and we did potatoes. The potato harvest starts around the 20th

of September. We started peeling potatoes--my wife and my daughters would

work on the machinery in the storage sheds. ... It's not just picking.

In Montana we used hoes ... weeding the sugar beets. ... Harvests were

not ended in Washington and Oregon till about the first week of November;

then we come back to Texas.

Adolfo's prim little house in Eagle Pass has modern amenities, like lots

of houses in the interior of Texas, in towns like Lockhart or Seguin. But

most farmworkers are not so fortunate.

They live in colonias, unincorporated agglomerations of

mobile homes and shacks without basic services. Adolfo says "99.9% of the

inhabitants of the colonias" are farmworkers. "There are still colonias

that don't have water or sewerage. They buy bottled water." As for bathing?

"Who knows? It's reality." Lot owners "lay a foundation and go up north

and work the summer. In November, in the fall, they come back and build

a wall. Then they'll go up the following year, and come back, and put a

roof on it." Since they own the plot on which these structures stand, colonia

residents pay property taxes to the county in which they are located, however

low the valuation. Yet seldom do they receive basic services such as running

water or sewerage. According to the Texas Department of Health:

While the majority of residents in the El Paso colonias

study had water piped into their homes from shallow wells, over ten percent

had only outside taps, and another 20% did not have any source of water

on their lot. A surprisingly high number of samples contained bacteria

potentially of fecal origin; almost 80% of the food preparation areas and

32% of the respondents' hands were contaminated with these bacteria.

The colonias become colonies of disease inside a porous border that

is an all too permeable barrier. Adolfo agrees that the colonias

are "spreading ... faster than the services that need to be provided."

The United States can ill-afford growing sites of endemic disease, lead

poisoning, and mental illness. Yet, as the title of a study by the National

Advisory Council on Migrant Health warns, in this struggle migrants are

Losing Ground.

If these are the health conditions in the colonias, conditions

are worse when this same population encamps to do fieldwork, according

to this report:

Several families frequently live in one structure, sometimes numbering

fifteen or more people in one or two rooms.

Frequently there is no electricity or plumbing.

When housing is not available, they live in boxes, cars, garages, caves,

or in the fields and orchards where they work.

Available housing is often near or in the fields, making farmworkers live

with pesticides in their food and clothing and on their persons twenty-four

hours a day.

There are rarely any laundry facilities.

If their housing is linked to their job, when the job is finished they

are instantly homeless and unemployed.

If the migrants' home base is in the pores of an international border,

it is state boundaries that are hardest to ignore when it comes to receiving

federal services.

Although a federal entitlement, states administer Medicaid individually

under different rules that play havoc with migrants' ability to prove their

eligibility. Adolfo finds Medicaid "very bad" on this score. "If I'm certified

for Medicaid in the state of Texas and I go to Montana, I have to reapply.

A lot of times you have to be in the state 30 days before you can reapply

for Medicaid. Again, the rules change. The regulations change... On the

National Advisory Council we have taken that as an issue."

By contrast with the health care system, says Adolfo, pre-school

education provided by Migrant Head Start has been successful in its attempts

to maintain eligibility across state lines. "Migrant Head Start is a very

excellent program. In fact, I'd say that's the best. I have eight children.

All eight children have been in Migrant Head Start.....Parents are allowed

to be part of the decision-making process in the program. That's the key."

Adolfo praises the program's ability to "follow the child" across state

jurisdictions. "Let's say I'm coming from Michigan and we arrive in Texas

and enroll our children here in the Head Start program ... everything would

be transferred over." The boundary between, say, Texas and New Mexico may

seem an imaginary line as one drives across it, but try to show your Medicaid

card on the opposite side and the boundary is all too real.

Though Adolfo considers WIC a successful program in reaching farmworkers

-- who, ironically, suffer high rates of malnutrition -- here too he reports

problems with transferring eligibility across state lines. "If my wife

gets a WIC card in Michigan, we have to consume all the food she gets from

WIC, and buy it before we leave Michigan. Because we come with that card

and arrive here in Texas, they would not honor it. It would have to start

all over again." As for milk, cheese, and eggs, "you don't want to be hauling

it."

As for why states have made eligibility more easily transferable for Head

Start and even WIC than to Medicaid, Bobbi Ryder of the NCFH reminds me:

"It has to do with the value of the package. Because a WIC package per

month may be worth $50. But a Medicaid package or a CHIP package could

be worth thousands and thousands of dollars, depending on what the health

problem is. The risk to the grantor is much greater in Medicaid and CHIP

than it is in WIC." With farmworkers, as with the rest of the working poor,

their health care is no one's responsibility.

Transcribed calls from the NCFH's Call for Health line highlight

the conditions of life that begins in childhood, one lived in toxic conditions,

constantly on the move, and amid an alien culture:

A school-based outreach worker calls from Texas to let us know

about a former farmworker who lives along the border with Mexico named

Guillermo. He is currently working in a produce packing plant and has developed

a lump on his forehead, not due to any accident or fall. The lump is the

size of an orange and is located between his eyebrows. The lump is so large

that his skin and veins are stretched out causing him headaches, serious

sinus pressure, dizziness, and constant watering of the eyes. ... Guillermo,

assuming that he could not afford health care in Texas, went across to

Mexico and sought medical help. He was returned to his home with the simple

diagnosis of "inflammation" and told to rest. A week later he went back

to Mexico and had the lump surgically removed .... Eight days later in

Texas, the growth returned to his original size. It was now that this outreach

worker decided to call and see what kind of help we could find for him.

[Meanwhile he has shuttled between two hospitals without treatment due

to no insurance.] He was taken back to the first hospital having been diagnosed

with a periosteal reaction to something that he came in contact with. If

he had called before his conditions had become so serious, we would have

had a clinic, a nursing director, and a referral ready to send him for

help, at very little charge.

Absent health insurance and primary care, minor health problems develop

into major ones. Then there is the pathos of men who become worthless the

instant they cannot work:

A woman calls on behalf of her husband, , who is bedridden

because of serious pain and swelling in his legs. They have an appointment

in a local migrant health center in New Mexico but were just notified that

the date has been pushed back by five weeks due to staff changes.

makes himself go out to work in the fields at least 2-3 times a week, just

so the family can make ends meet, but the pain is getting intolerable.

Calling other clinics in the area results in the same answer: no appointments

for at least two months. We then call a larger health center in Texas where

we are told that if he is a migrant farmworker he can be seen the next

day if he shows up at 8:00 a.m. We then call the family back to tell them

about the new option. Even though they doubt that their own vehicle can

make the hour's drive they are sure that some friends will be able to come

through and help them out.

Even the children who pick crops have a hard time "deserving" basic health

care:

A social worker in Arkansas calls on behalf of a farmworker

family and their nine-year-old child, . The local county health department

has been providing medication at no charge for 's asthma for the last

two years. This service will now come to an end in about a month and they

are trying to find some way to continue providing medication at no charge

since the family cannot afford the costs. There is a local migrant health

center that is willing to provide medical services for the family at no

charge, but it does not have the ability to help with medication. ... We

find three [drug] companies that do have programs [to provide medications

to the indigent]. These programs require that an application be completed,

detailing the financial need, along with a letter from the physician that

prescribed the medication ... After the needs are established, which usually

takes 3-4 weeks, a three-month supply of the drug is sent directly to the

doctor to dispense. Every three months the patient can reapply...

In line with the general neglect of mental health in the US farmworkers

have a hard time finding counseling, yet their bucolic occupation is full

of stress that can crack even a strong person:

is a farmworker who calls us from North Carolina suffering,

in her own words, from depression and sadness. She breaks down often with

long periods of crying, and is very embarrassed when this happens. She

heard about our number on the radio.... She is desperate to find treatment

because these recent mood changes have her scared that she will lose her

job because others will think that she is unstable. Also, she is worried

about being around people in case she happens to just fall sad and begin

crying uncontrollably.

All of these anecdotes end with a successful referral by the hot line to

one or another free or low-cost treatment or rehab service.

They come from the NCFH's Call for Health Program, a national

hotline that matches farmworkers with health-care services in their current

locale and tries to arrange financing when needed. Sylvia Partida of NCFH

explains: "We get calls from health centers or farmworkers themselves many

times if they're in need of assistance either finding a place or financial

assistance to pay for medical care." The funding sources are eclectic.

According to Sylvia Partida, "We've had several different donations. The

first one came from the Sisters of Charity in San . ... There are

certain stipulations some of our donors want. For example, the Sisters

of Charity want [benefits] only to go to farmworkers from South Texas.

It could be anywhere in the United States but they had to have been from

South Texas. ... Avon donated some money ... it's going to primarily women

.... especially breast and cervical cancer." Through creative matching of

grant and farmworker, the hotline ensures that none are turned away--a

testimony to the flexibility afforded by nonprofit agencies, as opposed

to the interstate barriers erected by governments.

Yet it is clear that the kindness of the Church, a few 'good'

corporations, and the United Farm Workers is not sufficient to address

the health problems of a population whose rates of illness and other social

indicators should be a national disgrace. Says Partida, "Last year we served

over 200 farmworkers with over $15,000 worth of aid." Compared to these

miniscule resources, the hotline logged somewhere over 2000 calls during

1999. With the national farmworker population estimated at 3-5 million

it's clear that the patchwork of programs available through nonprofits

cannot come close to meeting the needs of this large and difficult-to-serve

group.

Health-care delivery among farmworkers, whether on the move or

languishing in a colonia, is via a patchwork of charity and ill

funded government and nonprofit agencies. This population remains one of

the most under-served in the US. In an era of compassion fatigue, CHILD

HIT BY TRACTOR stories are not enough to move public or agribusiness policy.

What argument might convince the bottom-line conservative who

is unmoved by noblesse oblige, but might understand Tocqueville's

concept of enlightened self-interest? Bobbi Ryder responded:

Just exactly what amount of fecal matter present on a strawberry

is a tolerable level? If we, as consumers, want to have fresh food that's

picked by healthy hands, then we ought to make sure that the labor force

is as qualified to do that job as our aerospace engineers are qualified

to send rockets to the moon. And, in fact, as a consumer, I have a much

greater interest in making sure that my strawberries are clean, and picked

by hands of people who have handwashing facilities and lavatories in the

fields, than I care about what goes to the moon. Because I consume every

day. That rocket-to-the-moon stuff is an incidental event.

Thirty-one percent of colonia children surveyed in 1995 were reactive

for hepatitis A antibodies. While not all these children work in the fields

and reaction does not mean capacity to spread infection, this infectious

disease might be endemic among the workers handling the nation's produce.

Ultimately, the borders separating farmworkers from decent health

care are an extreme example of the barriers almost everyone faces. There

is no automatic entitlement to health care for farmworkers because there

is no automatic entitlement to health care in the US, in contrast to most

of the industrialized world. Farmworkers' ineligibility due to waiting

periods, service and entitlement non-portability, and paperwork obstacles

is an extreme case of the barriers faced by all workers whose jobs are

temporary or contingent. We are all separated from a better life by internal

borders we have collectively erected between ourselves.

Bidding Adolfo farewell, I leave to finish my trip to the border.

The transition to Piedras Negras is a gentle one. It's been miles since

I entered the Spanish-speaking world and a subtropical climate. I drive

the last couple of miles and park in the free lot. I nonchalantly step

onto the pedestrian lane of a bridge about a half-mile, no, a kilometer,

long. Below me is the Rio Grande--that is, the Río Bravo--impressive

for its intense emerald hue but not for its breadth. To look down on this

river of such fabled political import is to realize how unremarkable is

the actual stream, how easy to ford unobserved even here among the shops

and soccer field, still more so in the empty country upstream and down..

How absurd is the Buchanan-style rant that the border must be sealed, both

because of its length and because it is not a line but a zone. One would

need not only a 1500-mile Berlin Wall but also a series of such walls,

each with its own checkpoints. A small bronze plaque on the bridge's concrete

wall announces the actual linear border, a profound anticlimax. At the

opposite end of the bridge I drop a US quarter into an automatic turnstile

and walk unimpeded into the lively downtown of a small Mexican city, Piedras

Negras.

The main difference between the Mexican and Texan sides is that

this small Mexican city is clearly urban, whereas Eagle Pass resembles

a suburb, with its sprawling parking lots and wasted space, people driving

everywhere and no street life. Real estate can hardly be any more valuable

on the Coahuila side than in Texas, yet Piedras Negras has three- and four-story

urban flats and storefronts, no space between. It must be the result of

instinct rather than city planning as such; no one would "plan" a city

where the main arteries are perpetually clogged by traffic backed up from

the border crossing. One motorist headed toward Texas gestures to the car

behind him to go around, if necessary, as he hops out and into a storefront.

He knows that no one will likely move anyway while he makes his purchase.

I am glad I walked, rather than drove across. For the first time in years,

since the last time I left Texas, I encounter actual pedestrian life. Despite

my imperfect Spanish and confusion over prices in pesos, I am reinvigorated

by the familiarity of a cityscape in which people on foot gab, flirt, and

do business in a lively communion. In this alien town I have strangely

returned home.

Lindsey Eck is a writer, scholar,

and composer who lives in central Texas. Thanks to Adolfo Valdez of the

National Advisory Council on Migrant Health, and Bobbi Ryder and Sylvia

Partida of the National Center for Farmworker Health for invaluable assistance.

Copyright ©

2001 by Lindsey Eck . Original drawing by Mike Mosher. All rights reserved.

Permission to link to this site is granted.

--

Bobbi Ryder

CEO

National Center for Farmworker Health

1770 FM 967

Buda, TX 78610

512.312.2700, ext. 201

512.312.2600 (fax)

http://www.ncfh.org

Attached is an article for an internet publication entitled " Bad

Subjects " that you might want to take a look at. (Bobbi and Sylvia are

both quoted in the article.) There is also copy of the article in your

box.

Mimi

--

Mimi ez McKay

Director of Library and Information Resources

National Center for Farmworker Health

P.O.Box 150009

Austin, TX 78715

512.312.2700, ext. 234

512.312.2600 (fax)

http://www.ncfh.org

The Idea of Border at Eagle Pass

Lindsey Eck

Bad Subjects, Issue #

53

,

January

2001

I cross the first border inside the San city limits, on the south side. It's one I've crossed often; I used to teach on the south side. This frontier is an economic one: the boundary between the First and Third Worlds. It coincides roughly with a series of military bases that form the main federal line of defense for South Texas. South and west of this line people live by marginal agriculture and off archaic industries, such as fixing old cars and later junking them. But, though I have now crossed into the Third World, what surrounds me is still unmistakably semi-rural Texas, USA and I am unmistakably on a federal Interstate highway.

I am heading toward the dusty border town of Eagle Pass, Texas to meet with Adolfo Valdez, who serves as Chairman of the National Advisory Council on Migrant Health. He is also a migrant farmworker who travels the US much of the year picking crops. He was born in Eagle Pass and has lived his whole life along the Mexican border.

I exit the Interstate onto US57 and before long I am in some of America's loneliest country: not even gas stations, just mesquite and prickly pear cluttering up acreage too poor for agriculture. It is not the Rio Grande, but this no-man's-land that forms the real barrier to the immigrant worker illegally trekking north.

To some far-off pundit inside the Beltway, the border is definite and defensible, a threshold. The closer I get, the more evanescent it seems. There is not a single border but a series of frontiers, not a line so much as an ill-defined tissue where Mexico and the United States mesh together. If, from a distance, the border seems as impermeable as an organ wall, upon inspection it is more of a membrane through which people and goods--and pathogens--flow freely in both directions.

Somewhere in this vacuity I realize I've crossed another border--a linguistic one. I press SEEK on the truck radio and it finds only one FM station, in Spanish. From the time I arrive in Eagle Pass until I return, I will be in a monolingual Spanish-speaking area, though still culturally within the United States. Says Bobbi Ryder, CEO of the nonprofit National Center for Farmworker Health (NCFH), "A lot of people think of that whole area along the Rio Grande as home, whether it's one side or the other, and in fact they're quite content to live on one side and cross back to the other, from either direction."

In this region most people with a job are doing migrant farm work. US farmworkers migrate along three principal streams, like the flyways of bird migration, and the central route is by far the biggest. Various maps show the migration fanning out from a home base in Texas across much of the US. Thus the Rio Grande Valley is the nexus from which migrants fan out across the country. The social problems of the border zone are intimately connected with the problems of migrant farmworkers and, when it comes to health problems, migration quickly makes the Valley's problems a problem for all of North America.

By the time I enter Eagle Pass I've crossed another boundary, too: a climatic line between a warm temperate zone where it is a crisp fall day, being Thanksgiving weekend, and a subtropical zone where it is still summer, with an uncompromising sun blazing across a cloudless sky. I wait to meet Adolfo in a truck stop inside Eagle Pass, a couple miles north of the Rio Grande (or Río Bravo, as it's known on the Mexican side). Suddenly I recall an experience two decades ago in central Wales, walking into a pub that looked like a hundred others I'd seen in the UK, except that everyone was speaking Welsh. They all understood English, as they had studied it in school, but used it only with outsiders. So it is in Eagle Pass. This truck stop-diner-pool hall looks classically Texan, but I am the only blue-eyed patron and non-native Spanish speaker. Like the Welsh, these Latino Texans understand English because they have studied it in schools, but use it only with outsiders. Most of Eagle Pass is visually the same as anywhere else in Texas -- big parking lots, fast food, one-story buildings, recent plastic everything -- but Spanish is the language of business.

Adolfo graciously invites me to the relative quiet of his home to conduct the interview. On the drive over I notice his Purple Heart license plate. When we arrive, I ask him about it. "It was in 1967-68 I served in Vietnam. Probably the worst part of the war. I had just graduated from high school and went into the service. A lot of us did. I served my three years ... I was wounded three different times." Having already traveled as far as Michigan to pick cherries before he went into the Army, when he got out he returned to migrant labor because there was "nothing else to do." Decades later, Adolfo is not just the chair of a federal advisory board. He still migrates every year with his family:

Let's take, for instance, last year. My family--we went to Montana, picked sugar beets in Montana, early June. Late May we left; I took the kids out of school. ... Came back from Montana in late June, early July. Came back to the [Texas] Hill Country, in fact. Marble Falls. And we did grape picking for winemakers. ... We finished there in late July and we headed on to the state of Maine to pick blueberries, way on the East Coast. ... There's close to 100 farmworkers that go from Eagle Pass to Maine to pick blueberries every summer. ... We came back to Texas and dropped the kids off in September so they would not miss any school. Then my wife and my older kids, we headed off to Washington. Right on the Washington-Oregon state line, and we did potatoes. The potato harvest starts around the 20th of September. We started peeling potatoes--my wife and my daughters would work on the machinery in the storage sheds. ... It's not just picking. In Montana we used hoes ... weeding the sugar beets. ... Harvests were not ended in Washington and Oregon till about the first week of November; then we come back to Texas.

Adolfo's prim little house in Eagle Pass has modern amenities, like lots of houses in the interior of Texas, in towns like Lockhart or Seguin. But most farmworkers are not so fortunate.

They live in colonias, unincorporated agglomerations of mobile homes and shacks without basic services. Adolfo says "99.9% of the inhabitants of the colonias" are farmworkers. "There are still colonias that don't have water or sewerage. They buy bottled water." As for bathing? "Who knows? It's reality." Lot owners "lay a foundation and go up north and work the summer. In November, in the fall, they come back and build a wall. Then they'll go up the following year, and come back, and put a roof on it." Since they own the plot on which these structures stand, colonia residents pay property taxes to the county in which they are located, however low the valuation. Yet seldom do they receive basic services such as running water or sewerage. According to the Texas Department of Health:

While the majority of residents in the El Paso colonias study had water piped into their homes from shallow wells, over ten percent had only outside taps, and another 20% did not have any source of water on their lot. A surprisingly high number of samples contained bacteria potentially of fecal origin; almost 80% of the food preparation areas and 32% of the respondents' hands were contaminated with these bacteria.

The colonias become colonies of disease inside a porous border that is an all too permeable barrier. Adolfo agrees that the colonias are "spreading ... faster than the services that need to be provided." The United States can ill-afford growing sites of endemic disease, lead poisoning, and mental illness. Yet, as the title of a study by the National Advisory Council on Migrant Health warns, in this struggle migrants are Losing Ground.

If these are the health conditions in the colonias, conditions are worse when this same population encamps to do fieldwork, according to this report:

Several families frequently live in one structure, sometimes numbering fifteen or more people in one or two rooms.

Frequently there is no electricity or plumbing.

When housing is not available, they live in boxes, cars, garages, caves, or in the fields and orchards where they work.

Available housing is often near or in the fields, making farmworkers live with pesticides in their food and clothing and on their persons twenty-four hours a day.

There are rarely any laundry facilities.

If their housing is linked to their job, when the job is finished they are instantly homeless and unemployed.

If the migrants' home base is in the pores of an international border, it is state boundaries that are hardest to ignore when it comes to receiving federal services.

Although a federal entitlement, states administer Medicaid individually under different rules that play havoc with migrants' ability to prove their eligibility. Adolfo finds Medicaid "very bad" on this score. "If I'm certified for Medicaid in the state of Texas and I go to Montana, I have to reapply. A lot of times you have to be in the state 30 days before you can reapply for Medicaid. Again, the rules change. The regulations change... On the National Advisory Council we have taken that as an issue."

By contrast with the health care system, says Adolfo, pre-school education provided by Migrant Head Start has been successful in its attempts to maintain eligibility across state lines. "Migrant Head Start is a very excellent program. In fact, I'd say that's the best. I have eight children. All eight children have been in Migrant Head Start.....Parents are allowed to be part of the decision-making process in the program. That's the key." Adolfo praises the program's ability to "follow the child" across state jurisdictions. "Let's say I'm coming from Michigan and we arrive in Texas and enroll our children here in the Head Start program ... everything would be transferred over." The boundary between, say, Texas and New Mexico may seem an imaginary line as one drives across it, but try to show your Medicaid card on the opposite side and the boundary is all too real.

Though Adolfo considers WIC a successful program in reaching farmworkers -- who, ironically, suffer high rates of malnutrition -- here too he reports problems with transferring eligibility across state lines. "If my wife gets a WIC card in Michigan, we have to consume all the food she gets from WIC, and buy it before we leave Michigan. Because we come with that card and arrive here in Texas, they would not honor it. It would have to start all over again." As for milk, cheese, and eggs, "you don't want to be hauling it."

As for why states have made eligibility more easily transferable for Head Start and even WIC than to Medicaid, Bobbi Ryder of the NCFH reminds me: "It has to do with the value of the package. Because a WIC package per month may be worth $50. But a Medicaid package or a CHIP package could be worth thousands and thousands of dollars, depending on what the health problem is. The risk to the grantor is much greater in Medicaid and CHIP than it is in WIC." With farmworkers, as with the rest of the working poor, their health care is no one's responsibility.

Transcribed calls from the NCFH's Call for Health line highlight the conditions of life that begins in childhood, one lived in toxic conditions, constantly on the move, and amid an alien culture:

A school-based outreach worker calls from Texas to let us know about a former farmworker who lives along the border with Mexico named Guillermo. He is currently working in a produce packing plant and has developed a lump on his forehead, not due to any accident or fall. The lump is the size of an orange and is located between his eyebrows. The lump is so large that his skin and veins are stretched out causing him headaches, serious sinus pressure, dizziness, and constant watering of the eyes. ... Guillermo, assuming that he could not afford health care in Texas, went across to Mexico and sought medical help. He was returned to his home with the simple diagnosis of "inflammation" and told to rest. A week later he went back to Mexico and had the lump surgically removed .... Eight days later in Texas, the growth returned to his original size. It was now that this outreach worker decided to call and see what kind of help we could find for him. [Meanwhile he has shuttled between two hospitals without treatment due to no insurance.] He was taken back to the first hospital having been diagnosed with a periosteal reaction to something that he came in contact with. If he had called before his conditions had become so serious, we would have had a clinic, a nursing director, and a referral ready to send him for help, at very little charge.

Absent health insurance and primary care, minor health problems develop into major ones. Then there is the pathos of men who become worthless the instant they cannot work:

A woman calls on behalf of her husband, , who is bedridden because of serious pain and swelling in his legs. They have an appointment in a local migrant health center in New Mexico but were just notified that the date has been pushed back by five weeks due to staff changes. makes himself go out to work in the fields at least 2-3 times a week, just so the family can make ends meet, but the pain is getting intolerable. Calling other clinics in the area results in the same answer: no appointments for at least two months. We then call a larger health center in Texas where we are told that if he is a migrant farmworker he can be seen the next day if he shows up at 8:00 a.m. We then call the family back to tell them about the new option. Even though they doubt that their own vehicle can make the hour's drive they are sure that some friends will be able to come through and help them out.

Even the children who pick crops have a hard time "deserving" basic health care:

A social worker in Arkansas calls on behalf of a farmworker family and their nine-year-old child, . The local county health department has been providing medication at no charge for 's asthma for the last two years. This service will now come to an end in about a month and they are trying to find some way to continue providing medication at no charge since the family cannot afford the costs. There is a local migrant health center that is willing to provide medical services for the family at no charge, but it does not have the ability to help with medication. ... We find three [drug] companies that do have programs [to provide medications to the indigent]. These programs require that an application be completed, detailing the financial need, along with a letter from the physician that prescribed the medication ... After the needs are established, which usually takes 3-4 weeks, a three-month supply of the drug is sent directly to the doctor to dispense. Every three months the patient can reapply...

In line with the general neglect of mental health in the US farmworkers have a hard time finding counseling, yet their bucolic occupation is full of stress that can crack even a strong person:

is a farmworker who calls us from North Carolina suffering, in her own words, from depression and sadness. She breaks down often with long periods of crying, and is very embarrassed when this happens. She heard about our number on the radio.... She is desperate to find treatment because these recent mood changes have her scared that she will lose her job because others will think that she is unstable. Also, she is worried about being around people in case she happens to just fall sad and begin crying uncontrollably.

All of these anecdotes end with a successful referral by the hot line to one or another free or low-cost treatment or rehab service.

They come from the NCFH's Call for Health Program, a national hotline that matches farmworkers with health-care services in their current locale and tries to arrange financing when needed. Sylvia Partida of NCFH explains: "We get calls from health centers or farmworkers themselves many times if they're in need of assistance either finding a place or financial assistance to pay for medical care." The funding sources are eclectic. According to Sylvia Partida, "We've had several different donations. The first one came from the Sisters of Charity in San . ... There are certain stipulations some of our donors want. For example, the Sisters of Charity want [benefits] only to go to farmworkers from South Texas. It could be anywhere in the United States but they had to have been from South Texas. ... Avon donated some money ... it's going to primarily women ... especially breast and cervical cancer." Through creative matching of grant and farmworker, the hotline ensures that none are turned away--a testimony to the flexibility afforded by nonprofit agencies, as opposed to the interstate barriers erected by governments.

Yet it is clear that the kindness of the Church, a few 'good' corporations, and the United Farm Workers is not sufficient to address the health problems of a population whose rates of illness and other social indicators should be a national disgrace. Says Partida, "Last year we served over 200 farmworkers with over $15,000 worth of aid." Compared to these miniscule resources, the hotline logged somewhere over 2000 calls during 1999. With the national farmworker population estimated at 3-5 million it's clear that the patchwork of programs available through nonprofits cannot come close to meeting the needs of this large and difficult-to-serve group.

Health-care delivery among farmworkers, whether on the move or languishing in a colonia, is via a patchwork of charity and ill funded government and nonprofit agencies. This population remains one of the most under-served in the US. In an era of compassion fatigue, CHILD HIT BY TRACTOR stories are not enough to move public or agribusiness policy.

What argument might convince the bottom-line conservative who is unmoved by noblesse oblige, but might understand Tocqueville's concept of enlightened self-interest? Bobbi Ryder responded:

Just exactly what amount of fecal matter present on a strawberry is a tolerable level? If we, as consumers, want to have fresh food that's picked by healthy hands, then we ought to make sure that the labor force is as qualified to do that job as our aerospace engineers are qualified to send rockets to the moon. And, in fact, as a consumer, I have a much greater interest in making sure that my strawberries are clean, and picked by hands of people who have handwashing facilities and lavatories in the fields, than I care about what goes to the moon. Because I consume every day. That rocket-to-the-moon stuff is an incidental event.

Thirty-one percent of colonia children surveyed in 1995 were reactive for hepatitis A antibodies. While not all these children work in the fields and reaction does not mean capacity to spread infection, this infectious disease might be endemic among the workers handling the nation's produce.

Ultimately, the borders separating farmworkers from decent health care are an extreme example of the barriers almost everyone faces. There is no automatic entitlement to health care for farmworkers because there is no automatic entitlement to health care in the US, in contrast to most of the industrialized world. Farmworkers' ineligibility due to waiting periods, service and entitlement non-portability, and paperwork obstacles is an extreme case of the barriers faced by all workers whose jobs are temporary or contingent. We are all separated from a better life by internal borders we have collectively erected between ourselves.

Bidding Adolfo farewell, I leave to finish my trip to the border. The transition to Piedras Negras is a gentle one. It's been miles since I entered the Spanish-speaking world and a subtropical climate. I drive the last couple of miles and park in the free lot. I nonchalantly step onto the pedestrian lane of a bridge about a half-mile, no, a kilometer, long. Below me is the Rio Grande--that is, the Río Bravo--impressive for its intense emerald hue but not for its breadth. To look down on this river of such fabled political import is to realize how unremarkable is the actual stream, how easy to ford unobserved even here among the shops and soccer field, still more so in the empty country upstream and down.. How absurd is the Buchanan-style rant that the border must be sealed, both because of its length and because it is not a line but a zone. One would need not only a 1500-mile Berlin Wall but also a series of such walls, each with its own checkpoints. A small bronze plaque on the bridge's concrete wall announces the actual linear border, a profound anticlimax. At the opposite end of the bridge I drop a US quarter into an automatic turnstile and walk unimpeded into the lively downtown of a small Mexican city, Piedras Negras.

The main difference between the Mexican and Texan sides is that this small Mexican city is clearly urban, whereas Eagle Pass resembles a suburb, with its sprawling parking lots and wasted space, people driving everywhere and no street life. Real estate can hardly be any more valuable on the Coahuila side than in Texas, yet Piedras Negras has three- and four-story urban flats and storefronts, no space between. It must be the result of instinct rather than city planning as such; no one would "plan" a city where the main arteries are perpetually clogged by traffic backed up from the border crossing. One motorist headed toward Texas gestures to the car behind him to go around, if necessary, as he hops out and into a storefront. He knows that no one will likely move anyway while he makes his purchase. I am glad I walked, rather than drove across. For the first time in years, since the last time I left Texas, I encounter actual pedestrian life. Despite my imperfect Spanish and confusion over prices in pesos, I am reinvigorated by the familiarity of a cityscape in which people on foot gab, flirt, and do business in a lively communion. In this alien town I have strangely returned home.

Lindsey Eck is a writer, scholar, and composer who lives in central Texas. Thanks to Adolfo Valdez of the National Advisory Council on Migrant Health, and Bobbi Ryder and Sylvia Partida of the National Center for Farmworker Health for invaluable assistance.

Copyright © 2001

by Lindsey Eck

.. Original drawing by Mike Mosher. All rights reserved. Permission to link to this site is granted.