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These bilingual posters educate workers on how to work safely with machinery on the farm.  Developed by two Occupational Health Interns (OHIP) during their internship with the National Farm Medicine Center, these posters accompany the Seguridad en las Lecherías curriculum.

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DATE RECORDED: Friday, July 11
PRESENTED BY: Ed Zuroweste, MD. Chief Medical Officer, Migrant Clinicians Network

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MCN’s Environmental and Occupational Health Programs

Learn more about MCN’s training and technical assistance programs to help clinicians and health centers improve the recognition and management of pesticide exposures and other environmental/occupational health conditions.

Migrant workers are often employed in some of the most dangerous jobs in the United States. Lack of training, poor safety precautions, regulatory exclusions, lack of health insurance, language barriers, piece-rate pay, undocumented worker status, and geographical and cultural isolation can put these workers at increased risk for occupationally related injuries and illnesses and chronic sequelae.  

This webinar will discuss health risks facing migrants as a result of their working conditions and highlight best practices and resources to incorporate environmental and work-related health into the primary care setting.  It will aslo showcase successful initiatives employed in Community and Migrant Health Centers.  Participants will become familiar with the importance of and feasible approaches to integrate environmental and occupational health into primary care from both a clinical and social justice perspective.

 

SPONSORED BY: Migrant Clinicians Network

OBJECTIVES: Participants will be able to:

  1. Understand the reasons for integratin environmental and occupational health into primary care
  2. Recognize the role of the clinician in work-related exposure
  3. Be familiar with tools and resources to address occupational injuries and exposures in primary care

 


CLINICAL TOOLS & RESOURCES



PATIENT EDUCATION MATERIALS



ARCHIVED WEBINARS & TRAINING RESOURCES


On Monday August 18, 2014 MCN submitted technical comments to the EPA regarding the proposed changes to the Worker Protection Standard.  View MCN's recommendations for advancing stronger safeguards to protect farmworkers from pesticide exposure. 

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This proposal will I) provide a profile of the agricultural industry and Farmworkers in Washington State II) propose a theoretical framework to understand farmworker housing accessibility III) describe prior legislative actions to address farmworker housing IV) and propose a set of recommendations to address farmworker housing.

Published July 15, 2014

MCN holds the position that immigrant children fleeing violence in their home countries must receive priority consideration for their safety and health. We have provided several links with additional resources on this issue.

Safety in Words

Este diccionario ilustrado bilingüe de MCN, "Seguridad en Palabras/ Safety in Words", muestra los peligros que hay en el lugar de trabajo y las mejores prácticas para la salud y la seguridad en la agricultura. Desarrollado con el apoyo del Programa de Subvenciones Susan Harwood de OSHA, este recurso refuerza el vocabulario en inglés de los trabajadores que hablan español lo que ayudará a prevenir lesiones en la agricultura. 

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DATE RECORDED: Wednesday, June 17, 2014
PRESENTED BY: Matthew Keifer, MD, MPH, Dean Emanuel Endowed Chair/Director National Farm Medicine Center

Webinar: Pesticide poisonings. Are you prepared?
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EOH iconMCN’s Environmental and Occupational Health Programs

Learn more about MCN’s training and technical assistance programs to help clinicians and health centers improve the recognition and management of pesticide exposures and other environmental/occupational health conditions.

 

Mistakes can be dangerous. Accurate identification of pesticides responsible for a patient's illness is important to avoid iatrogenic errors with respect to acute treatment.  Join us for an important webinar that will focus on key decision points in the diagnosis of pesticide exposures and emphasize the usefulness of the newly revised resource for clinicians - The Recognition and Management of Pesticide Poisonings, 6th ed.  Through interactive case studies, this webinar will illustrate effective recognition and treatment of patients over exposed to pesticides. 


The webinar, sponsored by Migrant Clinicians Network, the National Farm Medicine Center and AgriSafe Network features Dr. Keifer, a board certified occupational medicine specialist and internationally renowned researcher regarding pesticides and agricultural health and safety. For over 30 years, Dr. Keifer has focused his clinical practice and research largely on farmworkers. 

SPONSORED BY: AgriSafe Network, Migrant Clinicians Network, and the National Farm Medicine Center

OBJECTIVES: Participants will be able to:

  1. Better recognize the signs and symptoms of pesticide overexposure
  2. Identify key decision points in diagnosing pesticide exposures
  3. Demonstrate an understanding of how to use The Recognition and Management of Pesticide Poisonings, 6th ed. in a clinical setting

We encourage all participants to order The Recognition and Management of Pesticide Poisonings, 6th ed. prior to attending this webinar. Order here. PDF versions are also available at http://www2.epa.gov/pesticide-worker-safety/recognition-and-management-pesticide-poisonings
If you have experienced any trouble ordering your copy please contact: kbrennan@migrantclinician.org 

 

 


CLINICAL TOOLS & RESOURCES



PATIENT EDUCATION MATERIALS



ARCHIVED WEBINARS & TRAINING RESOURCES



LOCAL PESTICIDE RESOURCES


The following will provide information regarding the pesticides used in your areas:

Part 5 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: June 5, 2014
PRESENTED BY: Katherine Brieger, RD and Elizabeth Magenheimer

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Participant Evaluation  

Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

Diabetes continues to be one of the most common and challenging health condition confronting migrants and other underserved populations. It is clear that a healthy lifestyle is critical to mitigating the impact of diabetes on individuals and the population, however effective and appropriate interventions can be difficult to design. Fairhaven Community Health Center in Connecticut and Hudson River Healthcare in New York, are two health centers that have long led the way in creating culturally appropriate lifestyle programs for migrants and other underserved patients. In this session the presenters will discuss lessons learned from the development of a variety of programs for diabetics and other patients including a community garden, nutrition classes, cooking classes, weight management and strategies to encourage exercise. The session will address the clinical core measures related to nutrition and BMI and will also discuss current research test second line drug effectiveness in Type 2 DM. Available in English

Learning Objectives:

  1. Describe culturally appropriate diabetes intervention strategies
  2. Identify strategies to address clinical core competencies related to nutrition and BMI to improve quality care.
  3. Receive “take home” examples of how to incorporate effective nutrition, weight loss, exercise and other health lifestyle strategies.

 

FURTHER READING

Download the Spanish Toolkit Materials

National Diabetes Information Clearinghouse, http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram

Bright Bodies, http://brightbodies.org

Part 4 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: May 14, 2014
PRESENTED BY:  Candace Kugel, FNP, CNM and Megan Danielson, CNM

View Recorded Webinar 

 Participant Evaluation  

 Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

Migrant women face significant disparities with an additional layer of complexity and require different intervention strategies. Among them are reproductive health, pregnancy and childbirth, sexual and intimate partner violence, and cancers that disproportionately affect women, including cervical and breast cancer. Women often face environmental and occupational health exposures both in the home and in the workplace that heighten health risks. This session will provide a follow-up to the July 2013 presentation “Women’s Health at the Intersection of Poverty and Migration” that was part of our Clinician Orientation to Migration Health webinar series.  During this presentation Candace Kugel, FNP, CNM, and Meagan Danielson, CNM will discuss quality improvement and health care services for migrant women. The HRSA clinical performance measures related to women’s health will be reviewed as well as resources and best practices for improving the health of migrant women.

Learning Objectives:

  1. Describe strategies to address clinical core measures that relate to women’s health .
  2. Discuss case studies that assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
  3. Participants will be able to access clinical resources for working with female migrant patients.

 

FURTHER READING

Low Birth Weight Resources

Cervical Cancer Resources

Other Resources

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Part 6 of the 7 webinar series: Clinician Orientation to Migration Health

DATE: presented live on July 17th, 2013

PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.

 Women's Health at the Intersection of Poverty & Migration
View Recorded WebinarParticipant EvaluationPresentation Slides

  

Additional Resources:

MCN Women's Health page

MCN Health Network

Any prenatal patient who may move out of your area before giving birth is eligible to be enrolled in the Health Network. MCN will provide care coordination throughout the course of her pregnancy, until her postpartum visit is completed, to help ensure that there are no gaps in her health care.  512-327-2017 or 800-825-8205.

 

MCN Environmental Health/Pesticides Resources
MCN Family Violence Resources
MCN Streamline articles
Other Women’s Health Resources for Migrant/Immigrant Care
  • Text4Baby:  A free service that provides health education by text to pregnant women and new mothers in English and Spanish
  • The Perinatal/HIV Hotline: The National Perinatal HIV Consultation and Referral Service (Perinatal Hotline) provides 24-hour advice from HIV experts on indications and interpretations of HIV testing in pregnancy as well as consultation on treating HIV-infected pregnant women and their infants. The Perinatal Hotline (888-448-8765) is available 24 hours, seven days per week.
  • Centering Pregnancy: A model of group prenatal care widely used in a variety of settings, including FQHCs and with immigrant populations.  Materials are available in Spanish.
  • Rural Women’s Health Project  Pregnancy fotonovelas in English and Spanish.
  • Auger Communications “Teach with Stories” Prenatal Care fotonovela series and “Pregnancy and Diabetes: Lucia’s Story”
  • Wake Forest University One-page pesticides and pregnancy handout in English and Spanish. 
  • Migrant Health Promotion Farmworker Doula Manual
  • National Women’s Health Information Center. This website and toll-free call center were created to provide free, reliable health information for women everywhere, including lots of materials in Spanish.
  • March of Dimes  An array of materials at various literacy levels and almost everything in Spanish. Pamphlets, videos, "Comenzando Bien" curriculum.
  • Centers for Disease Control The CDC's Spanish website for women's health includes handouts in Spanish that can be printed from the website
  • National Perinatal Association Published transcultural perinatal education curriculum.
  • California Diabetes and Pregnancy Program.  Catalog of patient education materials in English and Spanish for perinatal issues related to diabetes and gestational diabetes.
  • “Diabetes gestacional: Guía para la mujer embarazada”.  Spanish language guide on gestational diabetes from AHRQ.
  • Association of Farmworker Opportunity Programs: “The Fields: The Hidden Faces of Farmworker Women” Interviews and stories about the issues that matter most to farmworker women’s health and well-being
  • Human Rights Watch:  “Cultivating Fear: The Vulnerability of Immigrant Farmworkers in the US to Sexual Violence and Sexual Harassment”
  • Legal Momentum Immigrant Women Program legal rights for immigrant women
  • Trafficking information

 

 

Historically, the field of women's health consisted of issues surrounding reproduction and childbirth. However, increasingly, the health care community has come to see women as a distinct patient group that has unique health concerns over a lifetime. Migrant farmworker women experience unique risks during pregnancy and otherwise, due to the physical demands, environmental exposures and other circumstances of their lives.  The provision of healthcare services to migrant women presents distinctive challenges for both clinicians and organizations.  MCN’s Candace Kugel, CRNP, CNM, and Melissa Bailey, Executive Director of NC FIELD, Inc., both with many years of experience with this population will discuss the problems, solutions and rewards of working with migrant women, through case illustrations and review of resources.

After taking this webinar:

  • Participants will be able to identify at least 2 health risks unique to women farmworkers and the impact of those challenges on work, nutrition and health.
  • Participants will be able to describe environmental and occupational health exposures relevant to farmworker women of reproductive age.
  • Case studies will assist participants in understanding how creative collaborations and models of care can improve health outcomes for migrant women.
  • Participants will be able to access clinical resources for working with female migrant patients.

PRESENTER BIOS:

Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health, Migrant Clinicians Network

ckugel@migrantclinician.org

Candace Kugel is a Family Nurse Practitioner and Certified Nurse-Midwife with over twenty years of experience in health care for the underserved. She has worked in various clinical settings, including family planning, migrant health, community health center, and private practice. She has worked almost exclusively in rural settings.

Candace has also been active in aspects of health care other than direct patient services. She has served as a clinical instructor for nurse practitioner, nurse-midwife, nursing, and medical students, and currently has faculty appointments with the University of Cincinnati and Penn State University’s Schools of Nursing. She has worked in program development in various arenas, including co-founding a “Stork’s Store” prenatal incentive program, initiating a natural family planning education program, and teaching childbirth education classes.

Melissa Bailey, Executive Director of North Carolina Field, Inc.

 mbailey@lenoir.k12.nc.us

Melissa Bailey is a native of southern West Virginia. She has worked in North Carolina migrant education programs since 2001. In 2010 AFOP’s Children in the Fields Campaign assisted community workers with forming the nonprofit NC FIELD. This effort aimed to establish an organizational empowerment and advocacy model to build capacity in farmworker communities, particularly among child laborers in agriculture. In 2012 Melissa became the Executive Director of NC FIELD. 

She has presented to local, state, and national stakeholders; assisted media; has worked as a research assistant on farmworker studies; assisted with organizational development and the leadership training of child farmworkers, and is a successful field organizer, consultant, and project manager. Melissa holds a certificate in Nonprofit Management from Duke University, among other certifications related to the delivery of supplemental education services and data.

In her spare time Melissa enjoys reading, writing, gardening, and spending time with loved ones.

New bilingual resource available April 2014!

Student Action with Farmworkers (SAF) has been using theater as an educational tool with farmworkers for over twenty years. By drawing on techniques of popular theater, SAF performs culturally appropriate, lively skits and facilitates theater workshops at farm labor camps. These performances spur conversations about mental and physical health, living and working conditions, and farmworker movements for social justice.

Many of SAF’s performances have focused on health issues, and they aim for this guide to offer dynamic tools for health care providers, educators, outreach workers, and public health innovators. Practitioners can also use these techniques with other populations across the social justice spectrum. For both organizers and educators, SAF hopes that popular theater can bolster the messages and information that you so readily share and provide a dynamic approach to outreach. Resources include songs, scripts, theater games and icebreakers. Printed copies are free, but SAF accepts small contributions to cover shipping and handling ($5-10/copy).

 

Available in print and online

Contact: Laxmi Haynes , 919-660-3660

These files are part of the Engaging Migrant Men project.

MCN developed 3 vignettes that portray the three messages developed in video and printed form.

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These files are part of the Engaging Migrant Men project.

Accompanying discussion guides were created to be used by male peers, community leaders, or outreach workers for one-on-one and small group discussions with men.

Part 1 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: March 19, 2014
PRESENTED BY:  Deliana Garcia, MA, International Research and Development, Migrant Clinicians Network

View Recorded Webinar  

 Participant Evaluation  

 Presentation Slides (PDF)

To receive CME* or CNE credit after viewing any of these webinars you must do the following:
  • Complete the Participant Evaluation associated with each webinar
  • Send an email with your first and last name stating which webinar you completed to contedu@migrantclinician.org

**Note: Due to technical difficulities the first 7 minutes of the presentation are not recorded. Please refer to the pdf of the slides for the content that was covered in those 7 minutes.

Over the last 30 years, considerable attention has been paid in the clinical setting to cultural competency- the ability to mitigate against the effects of the sociocultural differences between clinicians and patients and to take into account how culture affects the symptoms presented or the patients’ attitude about health care.  More recently, scholars and clinicians have encouraged those in practice or health professions training to focus not only on the behaviors and beliefs of cultural groups but more importantly to consider the structural determinants, prejudices, injustices and blind spots, the “pathologies of social systems” that affect health outcomes and the stigma experienced by patients. The session will introduce participants to the broad framework of structural competency and the five core structural competencies.

Learning Objectives:

  1. Identify the structures that shape clinical interactions;
  2. Discuss the means of developing an extra-clinical language of structure;
  3. Rearticulate “cultural” formulations in structural terms;
  4. Explain the process of observing and imagining structural interventions; and
  5. Describe the concept of structural humility.

 

FURTHER READING

Farmer, Paul, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee. 2006. Structural Violence and Clinical Medicine. PLoS Medicine 2006 (3): 1686-1691.

Holmes, Seth, Fresh Fruit Broken Bodies, 2013

Messac, Luke, Dan Ciccarone, Jeffrey Draine, Philippe Bourgois. 2013. The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine 99 (2013): 176-186

Quesada, James, Laurie Kain Hart, & Philippe Bourgois. 2011. Structural Vulnerability and Health: Latino Migrant Laborers in the United States. Medical Anthropology, Vol. 30, No. 4: 339- 362

Srivastava, Ranjana. Complicated Lives—Taking the Social History. New England Journal of Medicine 2011 (365): 587-589.

Willen, Sarah. 2012. How is Health-Related “Deservingness” Reckoned? Perspectives from Unauthorized Im/migrants in Tel Aviv. Social Science & Medicine 74 (2012): 812-821.

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Hombres Unidos is a peer-led workshop focused on the primary prevention of sexual and intimate partner violence (s/ipv) with Latino migrant men.  Developed in 2005 with the support from the Centers for Disease and Control, this five session workshop is implemented using a popular education technique (Paulo Freire) which is a concept that incorporates notions of class, political struggle and social transformation.  

This webinar (sponsored by the Washington Coalition of Sexual Assault Programs) focuses on the collaborative development of a primary prevention workshop for Latino migrant men, the evaluation of the workshop, and the continuing effort on engaging Latino migrant men as allies with women in s/ipv prevention after the five session workshop.

After this webinar, participants will be able to identify:

  • methods on how to begin a conversation on sexual and intimate partner violence with Latino migrant men
  • process and outcome evaluation techniques on a primary prevention workshop developed for a specific population
  • efforts to continue to engage Latino migrant men in sexual and intimate partner violence prevention
  • how to incorporate existing efforts with your population

Recording & Materials

During the webinar, Adrian referenced a few handouts that are used in the program.  Below you will find a few of these in Spanish.

Print, cut, and distribute this handy bookmark to providers who treat migrant and seasonal farmworker patients. The bookmark includes links and a qr code to connect you to pesticide - related clinical tools and resources. In addition, we've included some useful phone numbers in case of a pesticide emergency.

You can also use the bookmark to keep handy the Health Network phone number to be sure your patients on the move remain in care.

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Reducing exposure to toxic environmental agents is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals.  The evidence that links exposure to toxic environmental agents and adverse reproductive and developmental health outcomes is sufficiently robust, and the American College of Ostetricicans and Gynecologists and the American Society for Reproductive Medicine join leading scientists and other clinical practitioners in calling for timely action to identify and reduce exposure to toxic envrionmental agents while addressing the consequences of such exposure.

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This colorful bilingual comic addresses workers' compensation and immigrant dairy farm workers’ rights and responsibilities. It tells the story of a Mexican dairy farm worker who is injured on the job and the steps he and his employer take to make sure he receives his benefits, and the farm improves its safety. 

The resources listed below are available from the National Immigration Law Center’s website, www.nilc.org. Each of them is subject to being updated or otherwise revised as new developments warrant. The documents available from the links provided here may be downloaded by individual readers and either printed out or viewed electronically, but electronic copies of the documents MAY NOT BE UPLOADED TO ANY WEBSITE other than NILC’s.

These resources from the Health Insurance Marketplace can be used to help direct clients to information about the Affordable Care Act.

This resource summarizes key points to bring up with your patients who have questions about ACA.

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This resource from the Health Insurance Marketplace and the Health Services and Resources Administration provides a concise summary of key points that clinicians need to know about ACA.

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Families Talking Together (FTT) is an evidence based program designed to help Latino parents better communicate with their children and teens about healthy relationships, sex, contraceptive use, and preventing pregnancy.  Dr. Vincent Guilamo-Ramos, the creator of the program and co-director of the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social work, along with Planned Parenthood Los Angeles and Visión y Compromiso, recently enlisted 25 promotores (community health workers) from three communities in California with high rates of teen pregnancy and high percentages of Latinos in an effort to help Latino parents address teen pregnancy. Over a four-day period, the 25 promotores were trained to deliver the FTT intervention.  In the next two months, the promotores will deliver the intervention to 250 families in California.  The National Campaign wishes to recognize and thank Dr. Guilamo-Ramos, PPLA, and Visión y Compromiso for their work on this innovative and important project. 

The FTT intervention—both the community health worker curriculum and parent materials---are available online, free of charge.  

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MCN's Director of Environmental and Occupational Health, Amy K. Liebman, appeared on the radio broadcast Epicenter: West Marin Issues on KWMR 90.5 FM to talk pesticides and the Worker Protection Standard. Liebman was joined by Hector Sanchez of the Labor Council for Latin American Advancement. Host Frederick Smith discusses with Liebman and Sanchez a variety of pesticide-related issues, including protections for farmworkers and their families, farmworkers' risks of pesticide exposures, how pesticides are regulated, their health effects on farmworkers and their families, and what healthcare providers can do to mitigate, diagnose, manage, and report pesticide exposures.

During the interview Liebman referenced the Agricultural Health Study, which is available here.

A report prepared by researchers at The George Washington University School of Public Health and Health Services features a wealth of information on occupational health and safety and the migrant population, from farmworkers to fast-food chain employees to restaurant cooks and servers.

News release:
http://defendingscience.org/news/labor-day-looking-back-year-us-occupational-health-and-safety

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Dramatic, visual and culturally relevant, fotonovelas are a successful means of communicating health information. The following fotonovela materials are downloadable.

Provided by Farmworker Justice 

Dramatic, visual and culturally relevant, fotonovelas are a successful means of communicating health information. The following fotonovela materials are downloadable.

 

Provided by Farmworker Justice