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A Lifetime of Migrant Farmworker Experience: Profile of Wilson Augustave

I have been able to encounter farmworkers that are so grateful, so appreciative of the services we provide… They thank me, but it takes the whole organization that works to cater towards them.
A Lifetime of Migrant Farmworker Experience: Profile of Wilson Augustave

In the middle of the interview for this profile, Wilson Augustave, the Senior HIV Case Manager at Finger Lakes Community Health in New York, received a call from Haiti. After a minute of silence, Augustave apologetically returned to the line, saying that the call had been from a nephew, asking for financial support. “In Haiti, there are no jobs, and they call whenever there’s a need,” he explained. “It’s really tough for them. They really count on people who are in the states to wire money.” He noted that hospital patients typically have to pay up-front for medical procedures and hospital care, before being admitted into the hospital: “Apparently, if you don’t have any money and you need to go to the hospital, they won’t see you.” Augustave, due to his childhood experiences and his continued relationship with family in Haiti, has a deep and heartfelt understanding of what drives families to emigrate to the US, and he has an equally nuanced grasp of the unique struggles that farmworkers and their families encounter when they arrive here.


Augustave’s parents left Haiti before he was born, searching for a better life in the Bahamas, where he was born.  When he was six, his family moved to Abaco, an island in the Bahamas where his parents found work in cucumber, pumpkin, and sugar cane fields. Augustave attended an English-language school, while living in the Haitian migrant farmworker community, where the primary language was Haitian Creole. He spoke Haitian Creole at home. “That kind of kept [me] fluent in both languages,” he said. 

His parents were undocumented in the Bahamas. “During those times, because of the issue of documentation, immigration would make these raids,” he explained. “I remember as a kid, [my parents] picking me up out of the house and running into the woods in the middle of the night, and everyone being quiet and just waiting.”  When the immigration agents left, the adults would go right back to work: “The need was there for the workers, but the politics was a different story.”

The reality was confusing to young Augustave. “Those kind of things, you don’t forget them.  You look at your parents, and see [what] hard workers they are, and [that all] they’re just trying to do is take care of your family in the Bahamas and back home in Haiti, and …you wonder why they have to go through all of that.”

When Augustave was 11, the family moved to Miami, in search of better opportunity.  They eventually found work in central Florida, picking oranges.  They began to find work in other parts of the country as the seasons progressed: they went to Georgia for peaches, to Missouri for watermelons, then back to Florida, then to upstate New York to pick apples, until the winter returned and they would travel back to Florida for oranges. “It was a very migratory life.  It was tough with schooling… but it was the norm,” explained Augustave.


In the early 90s, Augustave decided to stay in New York year-round, where he found work in the apple fields. Eventually, he caught the attention of Pat Rios and Mary Zelazny, the senior management of Finger Lakes Community Health, who were interested in having a case manager who is bilingual in English and Haitian Creole: “Basically, they came out into the field where I was picking apples and they interviewed me -- while I was picking apples!”  In his free time, Augustave had already been assisting Haitian migrant farmworkers who needed interpretation services, like in the court system, in the emergency room, or at doctor’s appointments. He began work as a case manager to more formally assist Haitian Creole-speaking farmworkers in Finger Lakes Community Health’s sprawling service area across almost half of New York.  Now, Augustave has been working as a case manager for over two decades. Augustave has participated in a wide range of councils and boards for both government agencies and nonprofits, working “to advocate for farmworker rights,” he said. “I guess you have to realize that, over the years, [your work]  accumulates, and that [recognition] could happen to you.”


In the mid-90s, Augustave was assigned Finger Lake Community Health’s first migrant farmworker with HIV, an African American apple picker.  “It was intimidating, and I didn’t know what to think or expect,” admitted Augustave, but he connected quickly with the patient.  “From brother to brother, I just loved this guy. I knew how hard it was on him, and he was still working, putting his heart and soul into working, travelling 1,300 miles each year. He was soft-spoken, [but] he was grateful to the organization and to me.  It helped to solidify why I was doing what I was doing, and that lasts for a long time.”  Eventually, the patient was too sick to continue his migratory work, and Augustave lost track of him.   “His spirit… I see in all the other farmworkers,” Augustave said, adding, “ I feel privileged to work with that population. It has been a personal and professional journey in doing this line of work.”

MCN AugustaveAs HIV cases among farmworkers increased, Augustave found that patients were being referred his way, on account of his early experiences with HIV patients.  Now he is the Senior HIV Case Manager, where he works to better connect migrant workers with HIV to the extensive and expensive care they need, both in New York state and as they migrate. “Some of these medications cost two or three thousand dollars, and some of these folks are making $200 a week,” he noted. “Plus, they have to… send money back home, and they have children and families.”  His goal is to help patients “get into care, and be able to manage it.”  If they travel on, or return home, Augustave works to make sure “they’re linked up with people who can assist them so they can maintain some form of continuity of care.”  He refers them to other case managers in their next location “for linkage to care,” he says. Augustave has even travelled on his own time to other states: “Sometimes I actually go down to those states and try to find ways to improve health outcomes...Whatever it takes.”


Even as Augustave watches sick migrant farmworkers continuously encountering barriers to continued care, he remains optimistic. “I’m an idealistic dreamer,” he said, noting that improvements have occurred in the overall system of care, and he anticipates that with continued improvements in technology and infrastructure, that farmworkers will become better integrated into the overall health system, which will permit them to more easily seek out care.  He also stresses the import of factors beyond health: “Health is important—but you also need good housing, protection from environmental factors like pesticides, a fair wage, and fair labor practices.” Collaboration has to happen, he says, “not just between health providers, but with all these service agencies that can help...The overall health [of farmworkers] is definitely affected.”

He also recognizes that his work is only possible with the support of the overall organization, including Finger Lakes Community Health’s senior management. “It takes planning, it takes compassion, it takes caring, and it takes people who enjoy working with this population,” he said. Farmworkers are thankful for the program “because they say that, in all the places they go, they get the best care – with people who really care about them – from our organization,” he said.  “They thank me, but it takes the whole organization that works to cater towards them.”  

Photos by Debbie Patrick

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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