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The F7 competencies was met when we went in the fields to pick sweet potatoes with the farmworkers. We were better able to assess the needs of the farmworker by feeling the physical toll that this job places on their bodies. It was also easier to understand that various issues that arise from dust inhalation and prolonged exposure to the elements. It was a very rewarding an interesting experience because due to some circumstances our group ended up at the farm camp without a translator. We all worked together in order to communicate with the men and were able to come to an understanding that we would go to the field with them. The workers had to get ice and water before the day began, so one man named Antonio decided to come with us in the car and direct us to the field. While we were waiting for the others we were taught how to lift the tilled sweet potatoes up, so that it is easier to grab them. Antonio also explained that some potatoes are too large and some are too small to be sold in grocery stores and must be left. The van arrived, and the men soon began working. It was no surprise to us that when the men started working they and cleared out the section we started within minutes. I have honestly never seen someone move so quickly given the nature or the job. The buckets are very heavy and they hoist them onto their shoulders. They then walk to trailer with empty boxes and hand over the bucket to be dumped. The workers receive a ticket for each bucket and this is how they keep track in order to be paid. It was mesmerizing to see how quick the men were working, to the point where several would literally run to the tractor. It was bittersweet because they are working so hard in extreme conditions, but the whole purpose is to provide a better life for their families. It was a humbling experience to see the amount of effort put in to providing us and this nation with food. I really enjoyed seeing where our food comes from and working with the hands that pick it. I must admit that I was tired several minutes into picking and could already feel soreness in by back and knee from the hunched over position. I could not imagine working 8,9, or 10 hour days constantly in this position. I noticed that I had poor body mechanics while working and can understand how the men really enjoy having PT students teach them stretches and yoga poses. It was unique to experience first hand the conditions that play a role in developing negative health outcomes for the farmworkers. We noticed how many sweet potatoes where left behind due to sizing issues and decided to brainstorm some ideas to present to Anna. We were excited about possibly implementing a gleaning program that could benefit a local soup kitchen or even the Campus kitchen. Some groups members felt that gleaning could be completed by many different campus clubs and organizations and it would be a great volunteer opportunity. It was nice that other classmates wanted to experience working in the fields with us, and also gain an appreciation for farmworkers. Anthony discussed with us an idea of getting ipods donated to farmworkers to have the time pass while working. We spoke about the fact that English lessons could possibly be downloaded too if the workers were interested. There were several concerns such as safety and who would be the workers that would receive the electronic devices. It was really nice trying to brainstorm ideas stemming from physically being at the location and immersed in the environment of the population we were seeking to improve healthcare access to. Overall, picking potatoes with the farmworkers was very humbling and rewarding to gain a larger appreciation for where our food comes from, and the had work that makes it possibly for people in this country to have such a variety of food choices.

Our group met in preparation for our second focus group. Nick finished his internship, so Leonardo graciously volunteered on his birthday to be our translator. This group was several minutes from the office and we meet with some men who were leaving that Thursday. They were excited to go home but very bored. His group of men was very open and felt comfortable sharing about the fact that they believe alcohol use is an issue in farmworker communities. They also would feel comfortable speaking with a psychiatrist that was through the Episcopal Farmworker Ministry.

We met with Anna to tie up some loose ends. We spoke about what we have accomplished this far and discussed some different programs that could be implemented. We spoke about the first focus group findings and how the NCFWP can be a part of increasing access to mental health services for farmworkers. We also spoke about possibly partnering with the local farm owners to create a gleaning program for the CampusKitchen.

Our group attended a Dia de Los Muertos celebration for the farmworkers. The event was held at the Episcopal Farmworker Ministry on a Sunday afternoon. There were farmworkers, nursery workers, and their families. The Episcopal ministry staff and the NCFWP staff were also in attendance. Tamales and horchata were being served along with a traditional Spanish dessert. Â When were arrived at the ministry a group of volunteers was setting up and designing the alter. It included pictures of farmworkers, sugar skulls, day of the dead bread, candles, flags, and other symbols representing loved ones. The ceremony was to honor farm workers who had lost their lives this year in the industry. Leonardo played his guitar and sang a traditional song. Anna gave opening remarks and a woman provided a history of Dia de Los Muertos. It was interesting to hear and understand the reasoning behind this traditional and to learn that this is a celebration of the loved ones who have passed away. Maria was able to go through each part of the alter and explain the meaning s of each piece. One unique piece was a wreath of flowers. I enjoyed hearing about how each petal represented a person in the farmworker industry, and how the wreath represented their strong bond and love for each other. Several obituaries were read out and it was concerning to hear the amount of very young people who had lost their lives. A representative of Wake Forest School of Medicine then spoke about the organizations work in researching child labor and advocating for better labor regulations for farmworkers. A very interesting part of the ceremony was hearing testimonies from poultry workers. They are similar to farm workers in the fact that work conditions are not always safe. It is a very dangerous job prepping poultry, and physically demanding. There were also testimonies shared by farmworkers. I really enjoyed hearing the men speak about why they endure farmworker conditions. It was humbling to hear them speak about how the tolerate the long hot work days because they want a better life for their family. It was sad and encouraging to hear one man explain that he has worked 20 years in this industry all so his children can go to school and make a better life for themselves. The next part of the program was followed by several more obituaries and a prayer. One of the most shocking obituaries that stuck with me was about a young man who had been in a tractor accident. The machine had tipped and somehow ended up in a manure pile, ultimately causing his death by asphyxiation. This was such a very disturbing and sad thing to hear. I honestly could not imagine this situation being the last memories in a person’s life. What made be sick to my stomach was the fact the someone decided that the investigation was not longer necessary to understand how this happened. This occurred many times throughout the obituary readings. A cause of death would be identified but no further investigation would be conducted to determine how it actually occurred. It made me upset to hear that these people with a life, purpose, and should were being treated as if they were just another fact related to fam life. As if they were the same as loosing a portion of a crop or losing a couple of farm animals. This made me understand why this celebration was so important for the families to rightfully and respectfully honor their lost loved ones. F14 was incorporated into the last portion of the ceremony. There was a call to action from the poultry workers. The work conditions were described as standing on your feet eight workers straight, shoulder to shoulder, with often no opportunities for restroom breaks. The chickens are fling down the conveyer belt at least 60 chickens a minute and at certain times even more. This has cause many injuries specifically many cut hands. It also created soreness and the syndrome carpal tunnel is developed in many poultry workers. We were able to sign a petition advocating for line speed regulations. There is a policy in the poultry industry right now trying to increase line speed. It felt great that we were able to be apart of this advocacy and hopefully help stop this policy from increasing line speed for poultry workers. I enjoyed being a part of this celebration and being welcomed so warmly by the farmworker community. It was a very informative time and rewarding to be a part of an advocacy campaign. I hope that this policy is rejected, and that industry leader can gain some perspective as to the limitations of those working. I really hope to see change and for industry leaders to gain some empathy for those working very hard for their companies.

This past Sunday we held a focus group at a local farm camp. Through this focus group we were able to complete the R2 competency by speaking with this population and seeking to identifying their mental health needs, available resources, and aspects that impede their healthy emotional and mental state. We developed the questions in a two-week period. Anna and Leonardo spoke with us about the data that would be beneficial to the NCFWP in order to provide adequate services for the farmworkers. The only information that the organization currently has on mental health is based off one or two questions on the health records from the mobile clinic. Their desire is to gauge which types of mental illness are most prevalent in the camps. Our group met with Dr. MacNell to map out and organize our focus group. We discussed three major themes that we wanted to focus on, personal barriers, logistics barriers, and cultural barriers. We then wrote questions that would coordinate with these major themes We wanted to know what farmworkers considered healthy mental and emotional states. Several questions asked the men about factors that affect their mood, how they feel in a bad mood, and their strategies to combatting negative emotions or mood. Our group was interested in understanding the way the farmworker community views mental health. It was also a concern to understand how mental health is viewed in Mexico, or within their own families. NCFWP would like to be able to design and implement a mental health program for the workers, so it was important for us to ask if the men felt there are people that they trust and feel comfortable speaking to about conditions such as anxiety or depression. We finally were extremely interested in the farmworker’s opinions on what service or programs would be beneficial. Due to the nature of their work, creating a program that can run later in the evening or on weekends is essential. Language barriers, stigma, and transportation issues are also factors that need to be considered by the NCFWP, when creating a program that will be effective for the farmworkers.

We know from lecture and farmworker interaction that mental health is a sensitive issue to speak about. This is compounded by the mental health stigma faced in rural settings. Leonardo suggested providing a copy of our questions ahead of the session as a way to familiarize the workers with the topic of the session, and to make them more comfortable with speaking about mental health. Leonardo and Nick acted as the facilitators for this focus group. We met at a local house in Anger and were pleased that the men seemed excited about being involved. We started with consent forms to ensure that the men agreed with being recorded and photographed. Before we began with the questions each person in the room introduced themselves and spoke about where they were from. We conducted to discussion in the living room around a kitchen table. We handed out the questions and set up the voice recorders. Nick was the main facilitator for this focus group, while Leonardo was able to pick up any important comments that may have been missed during the discussion.

With the first couple of questions the men were more reserved and gave short answers. However, with more questions more dialogue between the men and between our group developed. We were happy to find that there were several outlets the farmworkers used to relieve stress and feelings of depression. One of the main ways this is accomplished is by a priest coming and speaking with the men. Throughout the session it was evident that church played a significant role in destressing for the men in this focus group. It was interesting to hear that the men would rather have a program from a church compared to going to a clinic. I felt honored that the men felt comfortable enough to share with us about the stress put on them by family in Mexico. There is a misconception that when you come to America that you will have a nice car and big house, and this certainly is not the case in these farm camps. One area that the farmworkers would like help with would be healthy ways to resolve worker conflict. We were told that some men have issues with one another, end up fighting and then are sent home. The workers would like to be educated in how to deescalate situations such as these. My favorite part of the focus group was having a man named Fernando speak about how he was worried before we started because he received a call about his son being bitten by a spider. He said that having people here who cared and being able to speak freely made him feel better. This focus group left me with a new-found respect for the strain put on the workers, all so that they can provide for their loved ones.

We have been working to try and identify which type of mental health questions would be appropriate for the focus groups. We also are trying to figure out the set up of the focus group and are in search of translators to ensure that our questions are understandable. We plan on meeting with Dr. MacNell to answer questions about formatting and creating an effective document. In our meeting with Anna we also plan on setting up a time to work with the farmworkers in the fields.

Leonardo will be working with us with the focus groups planned for October 22 and 29. He has many connections with the farm camps in this area and has helped us identify which groups of men that can benefit from mental health screenings.

This week we debriefed on our health fair. Anna was very supportive of our efforts and felt that it ran successfully. We took some time to reflect on our expectations going into the fair and our feelings now that it is completed. We moved on to the next task of deciding dates for focus group sessions. Mental health in farmworkers is a health disparity that NCFWP has identified as a growing concern. The organization is willing to help address mental health, but is in need of data. Our goal with the focus group is to identify the prevalence of mental health issues in this population and narrow down specific types of conditions, such as depression or anxiety affecting farmworkers. Leonardo is a promotore who will be helping our group with this project. He is well known and liked throughout the farmworker camps, and is happy to help is with the planning of the focus groups.

Team farmworker organized and planned a health fair for Nursery and Farmworkers on September 20th. There were between thirty to forty participants at the event that included a mixture of women, men, and children. Our group decided to provide dinner for the fair because we wanted to foster trust and connectedness with the families. It was also a token of appreciation for their willingness to listen and interact with our activities after a long day of difficult labor in the heat. With the help of our fellow classmates hygiene donations were collected to distribute that night. We were very grateful for our adopted team members Morgan and Shaniqua, who volunteered to help with set up and documenting.

Nursing students from the local community college partnered with our group and the NCFWP to provide blood pressure, weight, blood sugar, and several other health screenings. It was a great IPE opportunity to be able to work with clinicians outside of our own Campbell group.

We organized the educational materials into stations with two of us working together to disseminate the information. This effort was slightly community-based in the sense that we were able to identify the health topics that the families were most interested in learning about. Balbina was very helpful in reaching out to the nursery workers and guiding us in the right direction to design the fair. After our planning session it was determined that the three main topics to be addressed would be, Cancer, Nutrition, and Sex Education/Continuing Education. Our group created an activity table for the children with coloring sheets that had questions about healthy choices. The NCFWP brought books, and some coloring pages for the young ones as well.

James and Wrenn were tasked in nutrition education. They distributed flyers that included worksheets containing personal health goals related to healthy food substitutions. They chose to explain that a well-balanced diet is ideal, but even making small changes are steps in the right direction. They included visual aids that were outlines of two men. The participants were encouraged to interact in the activity by placing healthy foods and habits on the healthy hombre, and unhealthy foods and habits on the unhealthy hombre.

Jennah and Stephen decided to find resources pertaining to various types of cancer. Jennah took the lead with cancers typical in females while Stephen researched common cancers in males. They played a game called toss the cabbage. There were questions about cancer on sheets of paper that were balled up into a “cabbage”. This activity was a great way to gauge the level of knowledge within each session. This team also created a pin the tail on the donkey style game. Questions about cancer were asked and the participants were asked to pin the description to the specific type of cancer. It was extremely rewarding to see that this station had many questions, and one person was even evaluated by a nurse pertaining to an abnormally discolored mole.

Ashely and I prepared the sex education and continuing education station. This topic is awkward, to begin with, and we personally found it challenging attempting to translate this very important information into Spanish. We created a jeopardy style game the addressed STIs, Contraception, HIV/AIDs, and Reproduction. In addition, to this activity, we handed out brochures that contained more detailed information regarding STIs and the pros and cons of various contraception options. Many of the men and women were able to answer the questions correctly, but it was gratifying to see we educated many in the fact that HIV could be transmitted through breast milk. We were able to provide several resources to various young adults about the importance of finishing high school or obtaining a GED. There was also a flyer that highlighted the major similarities and differences between trade/technical school, community college, and traditional four-year colleges. Overall the participants were gracious with us stumbling through our limited Spanish, and we had nice conversations with some young girls about continuing education.

This health fair was a way for us to address the competency R3. The strategy we choose to utilize in responding to occupational effects was education. We endeavored to prevent some safety risks by addressing lifestyle changes. For example, heat exhaustion is a concern for both nursery and farm workers. By explaining that staying well hydrated based on activity level is a key in better nutrition we were hopefully able to help the workers understand the importance of having water breaks throughout the workday, which can aid in combating heat exhaustion. Due to the nature of farming systems pesticides are widely used and have been found to contain carcinogens. Our group was able to explain this and help workers be more aware of the potential dangers. I believe our health fair went well and that we were able to provide some helpful information to the families in order for them to take steps in creating more healthy lifestyles, protect against certain workplace hazards, and emphasize preventative measures to improve health outcomes in the farmworker community.

Two weeks ago Team Farmworker did not formally meet, because we were individually preparing our information for the health fair. Instead one week and several days before the event we paired up shared information and found translators to proof read our work. As a group we prepared presentations as well as a meal for the Nursery and Farmworkers that were going to attend the fair. It was challenging trying to find healthcare resources in Spanish as well as interpreting the information to ensure it contained the desired educational materials to present at the fair.

We met with Balbina this past week to find out which topics would be most beneficial for the health fair. While we have been learning about the disparities that affect rural health, it was eye opening to see important health concepts that the farmworkers do not have access to.

We received more information this week about our health fair geared towards women who work in the nurseries. Our team has been discussing several ways we can collaborate with other health sciences programs, and are hopeful that this event on September 30th will be a helpful resource to the farmworker families.

We had the opportunity to visit some farm worker camps. It was a privilege to meet with the workers and ask some questions.

Team Farmworker first meeting! Excited to be involved with this organization and to start interacting with community members.

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