What Health Needs Should I Plan to Address with Farmworker Victims?
Sexual violence creates both short-term and long-term health care needs. A sexual assault victim’s injuries can range in severity and therefore require varying responses such as:
- Immediate treatment of physical injuries such as cuts, bruises, dislocations, sprains, weapon wounds, strangulation or broken bones;
- Completion of a Sexual Assault Forensic Examination (SAFE) to collect and preserve evidence of the sexual assault for criminal prosecution or civil litigation;18
- Prenatal care or abortion for a resulting pregnancy;
- Testing and treatment for sexually transmitted infections (STI) and HIV/AIDS;
- Diagnosis and treatment for mental health issues including anxiety, depression and posttraumatic stress disorder;
- Mental health counseling and therapy or spiritual counseling; and
- Drug and alcohol abuse treatment.
Additionally, a farmworker’s health needs may extend beyond the more immediate and resulting injuries from the sexual assault. They may have any number of health needs related to their agricultural work, including:
- Respiratory and dermatological illnesses from exposure to pesticides, dust and fungi;
- Dehydration, heat stroke and heat illness from unsafe or inadequate amounts of water in combination with heat; and
- Chronic muscular/skeletal pain from heavy lifting, repetitive motions and bending over.
Farmworkers may also suffer from health issues related to substandard living conditions. They may live in makeshift housing, remote and unsafe labor camps or crowded housing–any of which may expose them to mold, unsafe drinking water, raw sewage and poor heating and ventilation. Living in labor camps located near the fields may increase their exposure to pesticides through drift and water contamination.
Even with great health risks and injuries, few farmworkers seek medical care for a variety of reasons. One is that medical care is cost prohibitive for farmworkers who earn low wages. Another is that clinics keeping regular business hours are closed before and after farmworkers’ long days. Additionally, few farmworkers have sick leave benefits, and many fear they will lose their jobs if they ask for time off to go see a doctor during working hours. There may also be language or cultural differences with staff at clinics. Transportation to a clinic is yet another issue because farmworkers may be in remote and rural locations where they are dependent upon their employer or others for transportation. The result of these many barriers is that:
- Farmworkers typically forgo treatment, allowing the condition to worsen, and go to a hospital emergency room when the situation is urgent;
- Routine dental, vision and reproductive care does not occur; and
- Illnesses such as diabetes, tuberculosis and hepatitis may go undiagnosed and untreated.
Given the serious potential health needs of farmworker victims of sexual violence, and the barriers to accessing medical care, you may need to be prepared to help victims by:
- Providing transportation assistance to appointments;
- Finding a low-cost health care provider with flexible hours and preferably bilingual, bicultural staff;
- Locating low-cost mental health care providers with flexible hours and preferably bilingual, bicultural staff;
- Locating a sexual assault advocate who can explain the SAFE process and purpose; and
- Locating a culturally competent sexual assault nurse examiner to conduct the SAFE.
- What are the living and working conditions of the farmworkers in my area?
- Who are the farmworker attorneys in my community to whom I can refer a victim living in unsafe working conditions and substandard housing?
- Which are the state and federal agencies to whom I can report unsafe working conditions and substandard housing?
- Where is the nearest migrant health service in my area? What are its hours of operation? How accessible is it to farmworkers?
- Do the health care providers on my referral list offer appointments at times that farmworkers are available?
- Is my agency able to provide transportation assistance to victims? If not, who can?
- What alternatives to counseling are available for farmworker victims of sexual violence?
- Who are the Sexual Assault Response Teams (SARTs) and Sexual Assault Nurse Examiners (SANEs) in my area? Are they bilingual and bicultural?