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Building Trust: Profile of Erika Peterson

Erika Peterson
The best is when the employee can sit down at a table with a family and just talk, hear from the migrant perspective what their issues and challenges are.
Building Trust: Profile of Erika Peterson

When a migrant farmworker mother discovered that her daughter was being sexually abused by her husband, she was upset, confused, and scared. If she reported her husband, would he be deported? How could she stop the abuse? “I was the first person that she thought to call,” said Erika Peterson, who took that call the day before the interview for this profile. “I’m sort of a clearing house for the Spanish-speaking community when they don’t know where to turn.” Peterson, the Migrant Program Manager and Outreach Worker at Eastern Shore Rural Health Systems, Inc., is one of three full-time Hispanic outreach workers for the health center system, which is headquartered in Onancock, Virginia. She interfaces with thousands of migrant workers on the small peninsula jutting out between Chesapeake Bay and the Atlantic Ocean.

“When the migrants first get here, I blanket the labor camps, I go on the school buses when they pull up to the gas station to get their soda in the morning, I’ll go to the laundromats, I’ll go out to the field at lunchtime and have the crew leader call them over to give a presentation and hand out my card…” she listed. “I get the word out, but it’s from repeated contact that they build that trust relationship, that they feel comfortable enough to come to you when they have a problem.”


Peterson grew up on the Eastern Shore, but was not aware of the migrant workers living in her own community. After receiving a bachelor’s degree in forestry, she returned to the Eastern Shore to begin work in a conservation area. To keep up her Spanish—she had studied in Mexico as a forestry exchange student—she began to volunteer as an interpreter during summer evenings at the local community health center.

“Even though I grew up in this community, I became aware of a whole world that existed under my nose that I hadn’t seen before,” she explained. “I was like most local people; we see the buses with the workers driving up and down the highway during the summer, we see them at the grocery store, but that’s about the extent of our contact and our knowledge. ... It really opened up a new world when I started working here.”

Soon after, her forestry position was at risk of being cut with the downturn in the economy—and the health center where she was volunteering had an outreach worker position open. The move to migrant health seemed like a natural fit: “I’m from here, I knew the growers, the backroads where the camps and farms are located, I speak Spanish, and I was familiar with the health center already,” Peterson said. Twelve years later, she’s never looked back. 

Her love of her work comes in part from good mentorship. The outreach workers at her organization are her mentors and role models, she said. “Barbara Ruffin, Ernest Augustin, and former coworker Wilmer Dagen have devoted most of their professional lives to helping the underserved,” noted Peterson. “They taught me how to do effective outreach, and most importantly they taught me how to treat our patients with humility, compassion, and respect.”


With fields of tomatoes as the backdrop, Peterson’s outreach work hit roadblocks—many of which were language-based. “In the camps where I was doing outreach, there was a majority of indigenous Mexican workers, mostly Zapotec and Mixtec workers. Their first language was not Spanish,” she continued. “It was difficult. We had to rely sometimes on another member of their group that spoke enough Spanish. I still haven’t found interpreter services for a lot of the indigenous languages.”

The barriers were cultural as well, particularly with the indigenous populations. “I think that the indigenous people take longer to trust an outside person, especially me being from the United States,” Peterson surmised. She has learned that “even within their own country, indigenous workers are often abused or exploited by other Mexicans who are not indigenous, so they are more wary of outsiders because of this history of being exploited.” 

Peterson overcomes the barrier, and others, through persistence, working closely and regularly with the migrant workers she serves. The relationships she has built are a big motivator for her to continue, Peterson said. “I feel honored that they trust me enough to share very personal things, both their highs and lows.”


Often, Peterson’s persistence must continue for months, but the payoff is felt for years.  When a bus transporting migrants to the fields got rear-ended by a tractor trailer, one worker suffered brain injuries and needed surgery. “He didn’t have any family here,” remembered Peterson, who managed the patient’s communication with the hospital, negotiated with worker’s compensation insurance, arranged for transportation and interpreted for medical appointments. She also kept in contact with the patient’s family in Mexico. “Once he was healthy enough, he went back to Mexico. It made him realize life is finite and he wanted to spend it with his family rather than be far away, even though he wouldn’t make as much money,” she said.  The family still calls Peterson every year on her birthday and at Christmas from Mexico. “It makes me feel sure that I’m doing something that has a positive impact,” she said.

That worker’s epiphany—that spending much of one’s adult life away from home and family might not be worth it—is the biggest struggle for many of Peterson’s immigrant patients, not just the migrant workers, but the immigrants who have settled on the Eastern Shore. “The biggest challenge for them … is the fact that they had to migrate to be able to make ends meet,” said Peterson. Their inability to be able to make a living in their home country is devastating to communities back home, explained Peterson, adding, “It’s really changed the culture, their communities, and their family structure because we have a generation of children in the home country who are being raised by grandparents and only know their parents through a weekly phone call and the money they send home, or the children born in the US who grow up not knowing their grandparents and extended family.”


To assure that Eastern Shore Rural Health employees understand the realities of the migrant population, the Board of Directors and all new employees—“from custodians, business staff, nurses, medical students and providers,” she said—meet with an outreach worker and visit a migrant camp with them as part of their orientation. “They see firsthand the living conditions,” and better understand what outreach services provide for the farmworkers. "The best is when the employee can sit down at a table with a family and just talk, hear from the migrant perspective what their issues and challenges are,” said Peterson. Most of the participants find the experience eye-opening. “It helps a lot with the level of care and compassion that [the migrants] are treated with when they come into the center to be seen,” Peterson thinks.

Eastern Shore Rural Health collaborates with a nonprofit called Student Action for Farmworkers by hosting college student interns interested in migrant health. “I train them when they get here, then get to watch them grow over the season,” Peterson said. She believes the interns go through “really transformative experiences that shape what they do with the rest of their professional lives.” Eastern Shore Rural Health also has a Letter of Agreement with the College of William & Mary to place students into the health centers for medical interpretation, another impactful program that provides direct interaction with farmworkers, Peterson said. 


Peterson intends to continue to dedicate her own life to her work: “As long as the need is there to serve the migrant farmworkers, I’d love to stay in migrant health,” she said.

30 CLINICIANS MAKING A DIFFERENCE is a project celebrating Migrant Clinicians Network's 30th anniversary through the life stories of 30 clinicians making a difference in migrant health. Learn more about Migrant Clinicians Network.


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