Colin Austin, North Carolina
When I started working as an outreach coordinator, I had trouble conceptualizing my role. I was unsure about expectations, and how to accomplish even simple things like meeting farmworkers. For a few weeks I suffered from "outreach anxiety". Slowly, by going to trainings and learning about my area I became more comfortable with my job description.
What exactly is outreach anyway? A lot of confusion exists because outreach workers are often temporary and they operate outside the clinical setting. Because outreach workers go to where farmworkers live and work they are often the first point of contact into the health care system. Part educator, part social worker, part advocate, part friend, the outreach worker sounds like some sort of mythical creature. In an age of increased specialization, it may be difficult to conceptualize the many roles that outreach workers play. An encounter with a farmworker outside of the clinic is a valuable moment. In a more natural and relaxed setting, outreach workers have time to talk with individuals and groups about their backgrounds, health problems, and perceived needs. When you sit down with a farmworker there is a window of opportunity to gather information and create a health impact.
Outreach work is not a 9-to-5 job. Outreach efforts may just be beginning when most clinical staff are going home -- during the late afternoons, evenings, and week-ends. Sometimes outreach workers can reach farmworkers on lunch breaks, but most often after they have returned from work in the field. This means that outreach workers are often out late. You can find outreach staff at churches, flea markets, soccer matches, laundromats, and other places where farmworkers gather.
One thing that outreach workers do is tell farmworkers about the clinic and local health services. Farmworkers can identify the outreach worker as a friendly representative from the clinic -- someone that cares and a name that they can use if they do need help. While visiting farmworkers where they live and work, outreach staff can also perform health screenings. A lot of health education occurs on outreach. With almost every outreach encounter, educational material and information can be distributed. Outreach workers may also conduct educational presentations in labor camps or other places that farmworkers gather. Through outreach, farmworkers themselves may be trained to be trainers and create lay health advisor programs.
By being on the front line, outreach workers have an opportunity to provide many direct services and to respond to the various barriers that farmworkers face. A farmworker may need help obtaining social services, housing, education, transportation, interpreter services, or hospital care. This can be overwhelming. The outreach staff should carefully establish a system and policies for conducting case management. But this type of individual assistance is an essential component of comprehensive care; the help of an outreach worker often makes the absolute difference between a client accessing or going without a needed service. Outreach workers also look for ways to work with other organizations to better serve farmworkers.
In all their roles, it is critical that outreach workers document their efforts. Outreach workers usually only get credit for a small percentage of the work that they do. Consistent gathering of demographics and health status information can also help the clinic focus their health care efforts.
Outreach is more like a process than a one-time treatment. The need to revise and improve is constant. Operating a good outreach program is a long-term process. It is unlikely that you can develop a full range of outreach services in a single summer. Being effective requires building relationships with farmworkers, growers, and local service providers. The outreach worker needs training and practice as a health educator and case manager.