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An Apple a Day: Eva Galvez on Working with Seasonal Farmworkers in Oregon

They’re going through so much adversity but despite that, they remain hopeful, and positive, and so grateful. How can you not enjoy a job where you have people who are constantly giving you that kind of feedback?
An Apple a Day: Eva Galvez on Working with Seasonal Farmworkers in Oregon

For Eva Galvez, MD, her work as a family physician with obstetrics at Virginia Garcia Memorial Health Center in Hillsboro, Oregon, is not just a day job. “When I see my patients, I see my family. I see my community,” she said. From her childhood in Oregon with seasonal farmworker parents, Dr. Galvez intimately understands the struggles and barriers her patients encounter. “Most of the patients that I see in my day-to-day practice are working in seasonal farmwork, but are living in town,” she explained, as her parents had when she was a child. She finds her background makes her ideally suited for her position. “First of all, you have to understand the language. That’s key,” she said, explaining that most of her patient panel has their primary language as Spanish, in which Dr. Galvez is fluent. “Then also having an understanding of that cultural component, and having an understanding of those barriers,” solidifies the relationship between physician and patient, Dr. Galvez believes.


Dr. Galvez’s story starts with her parents. Her father immigrated to the US from Mexico with his family before she was born. “Like most of the people coming to this country, there was a lot of economic hardship in his small town and he felt the economic need to look for work with the intent of hopefully improving the lives of his family back home,” Dr. Galvez explained. He eventually found work in the apple and pear orchards in Oregon, where he met Dr. Galvez’s mother, his future wife. Dr. Galvez’s mother was born in the US to migrant farmworker parents. Dr. Galvez and her siblings were born and raised in the seasonal farmworker community where their parents continued to work.

At a young age, Dr. Galvez and her twin sister began volunteering at a local community health clinic where their aunt worked. At first, their volunteer work was focused on small tasks, like handing out snacks. But at the age of 11, Dr. Galvez and her sister were asked to interpret for doctors who were coming from medical school and interacting with patients, but had no Spanish language skills. They interpreted for two years, during which their passion for medical service grew. (Her sister, Olivia Galvez, also eventually became a physician.) “I realized at a really young age that I could be useful,” she said.


Dr. Galvez studied medicine in Washington state, and completed her residency at a community health center there, but she wished to return to Oregon. “My intent was to be closer to family,” she said.

“Before I even moved to Oregon, I already had my eye on Virginia Garcia. There was no other place I wanted to work,” she noted. Its mission to provide high-quality, comprehensive medical care to the underserved, with an emphasis on migrant and seasonal farmworkers, paralleled Dr. Galvez’s personal reasons for going into medicine.

She has now been working in Hillsboro, Oregon, one of Virginia Garcia’s five sites, for almost four years. Her patient panel is quite diverse in age and gender, she says, but most are Spanish-speaking farmworkers.

“My patients are oftentimes not easy or straightforward. There are lot of complexities in their lives because of all the barriers that they have: social barriers, economic barriers, language barriers,” she explained. “So it can be very challenging to try to address something like diabetes in 20 minutes.”  She gave the example of a woman who came in the previous week with a work injury—but turned out to have uncontrolled diabetes as well.  Such overlapping health issues are commonplace, she said.  “But I have the advantage of seeing these patients time and time again,” because many are seasonal, but not migrant, farmworkers. “It’s a long-term relationship that I build with them.  With time, they have trust in me and I really get to know them.”


Dr. Galvez has been pleased by the many changes she’s noticed in health care as a result of the Affordable Care Act. “Suddenly, I’m seeing more patients who are covered by insurance,” she said. “But, there [are] still huge numbers of people who are not insured, and that’s the undocumented population,” whom she regularly sees in her clinic.

Undocumented workers are often “working in really dangerous jobs where there’s a lot of exposures to pesticides, to farm equipment, a lot of them have chronic health conditions, and because they’re undocumented, they can’t get insured, so we’re still providing that care, but if they had some type of insurance it would make their care even better,” she said.

Even those with insurance can have a hard time getting adequate care, due in part to a lack of primary care providers, she said, but “it’s definitely getting better,” overall.

Dr. Galvez is not shy in expressing her love for her job, despite the difficulties her patients have in receiving care. “A lot of people are really suffering.  They have suffered, and oftentimes they continue to suffer. But there’s just so much hope that they have,” Dr. Galvez noted. “They’re going through so much adversity but despite that, they remain hopeful, and positive, and so grateful.  How can you not enjoy a job where you have people who are constantly giving you that kind of feedback?”  


Dr. Galvez has been involved in several innovative programs at the forefront of migrant health services. This year, her health center was one of several Oregon health centers piloting an alternative payment plan, wherein the clinic is not paid based on the number of patients that are seen. “Now, we get a chunk of money every month, and we get paid to manage a certain patient panel,” Dr. Galvez explained. “We’re being paid [to meet] certain measures,” like getting a patient’s diabetes under control, or addressing obesity. The push to see more patients in a day has lessened, and the funds have allowed her clinic to hire more support staff, like a diabetes educator and a behavioral health provider, which “actually helps us follow through with treatment plans,” Dr. Galvez said. “For me, this has been a wonderful change in the way we practice medicine, at least in my clinic. It has made me enjoy my job even more in the last year.”

Dr. Galvez is a member of the scientific advisory board for the Project to Prevent and Reduce Adverse Health Effects of Pesticide Exposure on Indigenous Farmworkers, spearheaded by the Oregon Law Center and funded by a grant from the National Institute of Minority Health and Health Disparities. (Amy Liebman, MCN’s Director of Environmental and Occupational Health, is also on the board.) The project’s recently-created educational materials include a video that features Dr. Galvez, and is available in three different languages: Spanish, Mixteco Alto, and Mixteco Bajo. She noted that translation services are extremely limited for indigenous languages, and the materials help address a communication barrier. Dr. Galvez is continuing to explore ways that Virginia Garcia can implement the educational materials and keep the materials integrated into their programs for years to come.  

Last summer, Dr. Galvez also organized a training for providers at Virginia Garcia and another local site on pesticides, entitled “Workers and Health: How Frontline Providers Make a Difference in Protection of Migrant Workers and their Families.”  Dr. Galvez coordinated the training with MCN's Amy Liebman. “This was very successful as most providers attended and feedback was excellent,” she noted.

Dr. Galvez is happy to continue to serve seasonal and migrant farmworkers, through the many changes, barriers, and advances in medical care that they will see in the coming years. “Every day, I see patients that are going through adversity, patients that are trying to manage their diabetes but just lost their job, or patients who are pregnant but their partner was just deported. I see that every day,” she said. “Each day I come home and I am inspired to continue to work hard because I see that there’s truly a need for doctors like me to continue these services.”

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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