Local Global Health

The opportunity to help address health inequities in the local community by helping provide flu shots to Latin American migrant farmers was both exciting and humbling. I was working with the same attending physician that I had spent the previous summer with in the Dominican Republic for a global health rotation. However, this time, I would need to challenge my concept of global health as I was not traveling to another country to help provide care. Instead, we were working with limited resources and maximizing our impact on the local community, which was equally challenging and rewarding.

We were a team of four – two doctors and two students – and we drove to the first farm on the itinerary. We were not necessarily equipped with state-of-the-art materials to set up our clinic. Instead, we had a box of vaccines stored in a cooler with water bottles for ice packs and a sharps container that was a previously used laundry detergent bottle. Our makeshift clinic was in the greenhouse of a farm; we did not work out of a medical office or have a private tent. We had pop-up tables and chairs and a used tapestry hung with clothespins for patient privacy. We learned to make do with what we had. We worked in the freezing temperatures that many of the migrant farmers worked through for 10-plus hours each day.

Little by little, we caught a glimpse of what it meant to be a migrant farmer in Vermont. For many, communication was solely in Spanish. When walking around the farm, we saw the kitchen and bathroom that dozens of workers shared and what those conditions were like. We also saw the camaraderie between the workers and their families. We saw them laughing at each other’s jokes while peeling carrots or exchanging smiles when walking past each other. We came to appreciate the sense of community and support that exists in a group that constantly faces challenges stemming from immigration issues.

While learning how to deliver flu shots was a great educational opportunity, the real learning occurred when I gained insight into what local global health looks like in Vermont. Obtaining consent in Spanish for flu shots reminded me of taking blood pressures in the homes of patients in the Dominican Republic. Seeing families working day and night on the farms showed me that being a farmer in Vermont is far from easy, especially without documented legal status. However, my experience showed me how happiness can stem from a sense of community and the people around us, and is not necessarily confined to the circumstances we are enduring.

As the world grapples with the COVID-19 pandemic, there has never been a more important time to promote vaccination. Most workers were excited when we came to offer our support and resources. Obtaining the trust of individuals navigating a challenging healthcare system is important to promote health literacy in all communities. The flu vaccine offers protection, peace of mind, and a sense of empowerment over one’s own health. It is an important precursor to the COVID-19 vaccines. The migrant farmworker outreach program is a great example of how we can lend a hand to our partners from around the world, even if we are not hopping on a plane and waking up in a different time zone.