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By student from Miami, Rachel Becker
A paucity of literature provides an in-depth exploration of the mental and physical health of migrant workers. Researchers and clinicians have a variety of unanswered questions that could help them better serve this community, ranging from methods of health promotion to help-seeking behaviors to resiliency factors. High quality research will not only provide them with a better understanding of this population, but also assist them in tailoring their efforts and interventions.
Given the historical trauma, marginalization, and disenfranchisement of migrant workers, research frameworks must empower communities to have a strong voice in the focus, process, and dissemination of research. Without this type of paradigm, the best-intentioned research projects can maintain the status quo, silencing and pathologizing the community. Furthermore, without extensive community input the results of research might not have strong validity and applicability. In this article, we outline community-based participatory research (CBPR) methodology that privileges the needs and input of the community throughout the entire research process. We, undergraduate and graduate students at the University of Miami, are currently working with the Everglades Community Association (ECA; a migrant worker camp) and EnFamilia (a community organization that provides a wide range of services to ECA) to examine aspects of educational attainment and mental health. We will use our experiences in our current work to illustrate the core elements of CBPR and to provide other practitioners with ideas on how to incorporate these principles into their clinical work and research.
Before initiating research, we focused on building relationships with different community partners. By focusing on building alliances and identifying key stakeholders, CBPR ensures that researchers stay grounded in the community instead of locked away in ivory towers. The second step formalizes this process and provides a foundation of community input that will shape and guide the research throughout the project. During this stage, we formed a community advisory board (CAB). For us, this group included the heads of EnFamilia, who are not only service providers, but are also on the board for ECA. The CAB is a core guiding force that helps to ensure that the community’s needs, not those of outside groups (e.g., a university) or those only perceived by service providers, are the focus of research. Additionally, the CAB co-creates the focus of the research, data collection methods, analysis, and how the data will be reported and used within the community. In a fully developed article, we will outline each of these steps in more detail and illustrate each phase with lessons learned from our own experiences.
There is a critical outbreak of pertussis (whooping cough) in California: it is classified now as an epidemic. Five infants, all Latino, have died. This is due to unrecognized pertussis in older children and adults which then infects babies before they’ve had a chance to get their shots.
PLEASE spread the word through every mechanism you have that it is critical to get Tdap in adolescents and adults and to get children immunized properly. Providers are not recognizing pertussis and MUST keep this in mind with cough illnesses. Families must not fear immigration to get in for shots, and the public must understand that pertussis is not brought here by immigrants---it is local people passing it around to vulnerable populations.
Please share any media resources you have with us so we can all work together! This is a NATIONAL problem as increases are also being seen in several other states. We have been talking with people at CDC and have the following links for your interest. We are working on low literacy methods to assist the public. We will send an update as soon as these materials are available. Please check MCN’s website for up-to-date information www.migrantclinician.org.
CDC Web Feature
English - http://www.cdc.gov/Features/Pertussis/
Spanish - http://www.cdc.gov/spanish/especialesCDC/TosFerina/
CA Pertussis Materials (English and Spanish)
There is great concern from clinicians we talk to that many of the migrants we serve, specifically those who work for large agricultural companies that raise and slaughter pigs and chickens (CAFOs-- concentrated animal feeding operations) are at high risk for not only contracting H1N1 but also because of frequent migration and crowded living conditions they are likely to spread the virus rapidly. Even a greater “theoretical concern” that we have is that these workers may be a source of new novel more virulent strains of the H1N1 virus because of their constant daily close exposure to pigs and chickens. We have tried to explain to the CDC, NIOSH, OSHA that this group of workers should be in the category of “high risk” and therefore eligible for both early vaccine and treatment if illness occurs.
Unfortunately, we have been unsuccessful for a variety of reasons. This population, as you probably know, are for the vast majority, recent immigrants and frequently undocumented. So, it is always “controversial” when we try to highlight this population.
A recent article: http://www.ehponline.org/members/2009/117-9/focus.html more completely describes many of my concerns.
Increasing numbers of worksite raids across the country exemplify the intensity of stepped up immigration enforcement activities. It is especially heart wrenching to hear the stories of citizen children who are left behind in precarious situations when their undocumented parents are detained or deported (see NCLR’s website). In light of these actions, advocates and service providers are attempting to prepare immigrants and their family members should they endure a raid. In these efforts, we might do well to think about how preparing for raids overlaps with our efforts in planning for emergency and/or disaster preparedness.
On the one hand, the potential impact of a worksite raid on an immigrant family warrants special planning—How will immigrant families ensure that children are cared for? What are essential items for survival? Where is money held and is it accessible?
On the other hand, preparing immigrants for natural disasters or other crises may need to include setting in motion mechanisms that will protect them from punitive authorities during an emergency. Stories from the recent California wildfires of immigrants who were fearful of evacuating or approaching aid workers, point out the unique kind of assistance that may be needed by immigrant workers.
Disasters can be natural or created by society. A social network of clinics and other organizations can help cushion these events for marginalized people in this county. MCN and Migrant Health Promotion recently held a free web cast called “ Integrating Promotores(as) Into Emergency Management Plans” that provides practical suggestions for helping the mobile poor deal with emergencies.
Please share your experiences with immigration raids or with helping immigrants prepare for the possibility of a raid.