cu-knmanring0716-blog

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november 28, 2018

well, our presentation is complete and the semester has ended. It was truly a pleasure to work with this group. Our personalities and our passion created a strong team that wanted to help this population seek care and understand. I cannot wait to see what the next group of #teamfarmworker will be able to accomplish and how they will overcome challenges.

The presentations were so cool to see how everyone was able to work together and create powerful changes in our community.I think in the future we could create dual teams, there could be so much more opportunities to tag team, and reach a larger population. 

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final reflections

With the semester coming to an end I wanted to look back and have a true moment of reflection on what working with the NC Team Farmworker’s has been like.

Honestly, I did not know what to expect. And I don't think I really knew how much health fairs could impact a community. I have seen through our involvement and our care that a little can go a long ways. There are so many opportunities to be there for this community. Through Thursday night clinic at Benson Area Medical Clinic, to Tuesday night pop-up camps. The NC Farmworker’s Project is giving access to a community that is providing us in more ways than many realize. However, there is still much that can be done. 

This past fall North Carolina was hit by Hurricane Florence. This hurricane was a storm that impacted our education, but on a larger scale, flooded crop land, destroyed homes, and left many jobless for days. Farmworkers already live at low standard of living- this hurricane hindered their lifestyle even further. With the hurricane occurring we had to be flexible, roll with the punches and push our efforts even more. 

We were able to conduct a health fair following the hurricane where we were able to present on health topics ranging from nutrition to mental health. I gained a stronger sense of my Spanish and was able to interact with these individuals more than I thought I would be able to. Learning of their background, their family and hurricane experience, I saw that this opportunity was benefit to them. Farming in North Carolina allowed them to gain an income ( when there is not a strong storm present) and through the NC Farmworkers Project, this community has access to health care. With our added health education before seeing a Spanish speaking provider, allowed them to gain more material on how they can better themselves. 

During the second fair, we were preparing for the same type of fair- continued health education. We were based in a farming factory close to school and had about 35 males and females. Our first obstacle was attempting to find food to provide during this lunch oriented fair. Not only did we call Moe's, but we also seeked stores for donations. We learned it was too late in the game to ask. A great point to remember for the future. This fair further pushed our flexibility and instead of providing health education, we were assisting with health assessments. We were stationed at various locations, taking heights and weights, blood pressures, blood sugars and simply talking with this community. Many had questions and I noticed many had poor dental care. Also something to note for future groups. I saw that this health assessment was more beneficial than our first health fair. People were able to see what their health was. At the end of this fair we were able to donate our semester long t shirt collection to a farm. These t-shirts, in hope will help with the pesticide exposure these farmers face during a long day on the field. 

The hurricane caused many challenges: many farmers could not work during terrible weather conditions, crops were ruined, leading to more lack of work. Many farmers left to protect themselves, and following the hurricane there was a lot of repair that needed to be done. Our group discussions towards the end of the semester revolved around wanting to create an emergency fund/grant that would allow for some economic help during disasters. When the farmers are not working, they are not getting paid. Their economic stability is already a minimal, and not getting paid on a consistent basis is going to highly affect their decisions. We saw how their income and lack of education impacted their health at the fairs. This new idea that we were hoping to implement would allow for there to be a slight decrease of a financial burden. 

These people matter. They are helping provide food to the everyday person. Their health should matter just as it does to those who are working a 9-5 job. 

Personal challenges for me included a language barrier-I thought my Spanish was decent-- I was wrong. Talking to a community of Spanish speakers was very intimidating. I often doubted myself. I can see why providers are hesitant if they decently know Spanish. You do not want to tell someone the wrong thing about their health. 

I look forward to seeing how other groups in the future can continue to help this community 

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This week #teamfarmworker met to reflect and begin the next phase of the practicum- our video presentation! We began a google doc where we were able to express our thoughts and experience throughout the past semester. We will start filming and wrap up! Anna also wants to meet with us so we will have to plan that as well!

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With all of our health fairs completed #teamfarmworker is able to set their eyes on something bigger! With a crazy semester of rain, the farmworkers too have experienced an interesting harvest season. Many left early, or were not paid due to the inability not to work. Our hope is to help create/ start a write up of an emergency fund that can benefit the farmworkers NC Farmworker’s Project serves. Today I contacted NC Field from their website to hopefully gain some of their knowledge about their emergency fund. NC Field is based out of Kinston, NC. See their website regarding their emergency fund (https://www.ncfield.org/farmworker-emergency-fund/) . Our hope is to begin the steps of helping NC Farmworker’s Project have one of their own!

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Dupree Farms Health Fair 10/26/18

#teamfarmworker must thrive during pouring rain. This semester, I have learned a ton about flexibility and how to be more go with the flow than I thought possible. Dayten arrived at our original health fair address and was told that we did not have official confirmation from NC Farmworkers Project. All of our group members were a little anxious as to where/if we were going to actually have a fair. We over prepared- packing an extra tent, large jackets, rain boots. Fortunately, the new location of our fair occurred in a warehouse of Dupree Farms outside of Benson. This warehouse packs sweet potatoes in boxes. We arrived at 11 to set up our boards in addition to a nurse practitioner student from UNC, and members of the health department conducting HIV tests. We were told that the majority of these employees were women so we had material prepared to discuss women’s health such as contraceptives, gestational diabetes, and domestic violence. I was really excited to be able to present this material. We attempted to seek food donations for lunch- from Moe's, Trader Joes, ect, but ultimately were unsuccessful. The NC Farmworker’s Project however,  was able to have their own donations of fruit, vegetables, and chips and salsa. 

We had the use of the employees break room, and were going to be able to talk with employees during their lunch break. With all the boards set up we were ready to discuss our topics at hand. While setting up, Leo noticed Ivonne and my board regarding domestic violence- he said that many are victims already of abuse. This left me speechless.. how can you talk to a victim about abuse when they have lived it, they know it. 

My original thought of the fair changed... 

for the better. 

Instead of talking at the employees we were able to assist the NC Farmworker’s Project in conducting health assessments of the workers. Ivonne was weighing and measuring height of the employees, Dayten and the NP student were conducting glucose checks, Doug and I were doing blood pressure screenings, and Oliver was monitoring our education booths to share information about mental health. I was not prepared to do this but It was a hustle and bustle to get all employees the correct screenings. While conducting the blood pressure screenings, I was able to take a look at their health assessment forms. The ages ranged, some employees younger than I was, their wages ranged, and education ranged. When going over everyones blood pressure, I saw that some of the employees were relieved to know their blood pressure, some had no idea that their blood pressure was high. I saw how we were able to be a resource for this community and assist with the knowledge regarding their stress, their diet, and the conversations they can have with their doctor. 

It was a blur; I have no idea how many employees we were able to assist with the conduction of the assessments. Leonardo was telling me that these types of assessments happen often. He stated that at times the employees will keep the assessment forms, but these forms are very helpful to NC Farmworker Project.

Once we were done with all of our assessments, we were able to talk more with the employees. Many were drawn to Oliver’s booth regarding mental health, and Ivonne’s booth, discussing OTC’s (over the counter drugs). We had a lot of leftover OTC’s from our previous fair. We were able to have a “treasure box” of drugs that the employees could take. They had many questions for her regarding Tylenol, Benadryl, ect. Drug conducted his information about contraceptives. Even though there were men at the warehouse, they even partook in his game of Verdad o Falso. Many of the women were aware of the trues and false’s of the pill. It was funny to hear the employees making banter at each other.  Following the contraceptive information session, condoms were handed out and the banter continued.

I think it would been nice to share our education material. In a way, I was able to share small bits of information about nutrition when I was taking their blood pressure. However, I realize that these health assessments may be the only way of obtaining information about their own health. Many of these migrant farmworkers are not citizens, and do not have insurance. Many of these employees may not be able to go to Benson Area Medical Clinic with the Thursday night clinic. We are their access.

As a team, we came together. We played to our strengths, and assisted each other. Through the change in the clinic location, the change in original plan, we succeeded. I am so proud of the fair we were able to conduct and assist so many men and women in learning more about their own health.

When the lunch hour and a half ended, the employees headed back into the warehouse. Leo informed me that the owner is one of the best to work for. All over the employee break room were Spanish documents regarding health concerns and rules. You can see the care that the owner wants for his workers.

Next week we will meet to discuss our pros and cons of this fair. We also will start the research phase of the Emergency Fund plan we have created with Anna. We will have to connect with a Kinston organization about their fund. Lots to look forward to in the next month of work!

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10/16/18

On Tuesday we met with Anna. We have our second health fair in a week in Angier. We mentioned to her our concerns with the expense of food.. Moe’s never got back to me, however Dayten was waiting on headquarters to get back on him for the potential food donations! So we are crossing our fingers! Anna was understanding of the costs, however we are still going to attempt to seek food donations from grocery stores close by. Since I live in Raleigh, I am hoping to ask some grocery stores for potential food donations and/or canned foods. Anna mentioned we could have a “treasure chest” of goods. The NC Farmworker’s Project has had other donations such as children’s books, and we still have our shirts from our t-shirt drive as well as extra OTCs. It will be a large collection of items. We agreed that this was ok, because everyone does not need the same things all the time. 

Doug created a flyer that Anna and Balbina will be able to hang up to advertise to the women at their job site: 

Simplistic is key!

Once the fair is complete we are hoping to assist the team with compiling research for NC Farmworker’s project own Emergency Fund. Kinston, NC has their own fund, NC field, and our goal is to seek out information in how the fundraise, obtain monetary donations, and make decisions on who is able to obtain funds. Anna stated that their staff is very small so it might take a while for them to get back to us, but it is cool that we will be able to help with a long term project. This emergency fund is important to the farmworkers. This year NC face Hurricane Florence and remnants of Hurricane Michael. This prevented work, ruined crops and many farmworkers left early. With this emergency fund in place, there is hope that the fund could help offset some of the lost salary during national disasters, as well as during illness during the flu. I think that it would be cool to see how we could create a fundraiser for future #teamfarmworkers or how we could collaborate with other practicums to raise funds. I a lot of in progress work to go. 

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#teamfarmworker is still preparing for our last Health Fair, which in October 26th. The fair will be during woman tobacco farmer’s lunch break. We have been told that previous groups have provided food in past events. Based off of our last health fair and the expenses we spent, all of us were a little apprehensive of providing lunch for such a large group. 

As mentioned before, we will be doing a women's health fair at a tobacco warehouse. The number of participants is expected to be almost X2+ than our last fair. The thought of paying or seeking donations is a daunting process to me. Our first thought was to contact Moe’s close to campus. I am still waiting to hear from their correspondent with information regarding donations. To feed 50 people it would cost us around $425... This is a large sum of money, that quiet frankly, none of us can afford, even if we split it up evenly.  We met with Dr. Tillman this past Tuesday to discuss our options. He stated collaborations with other organizations and seek donations- he said that pulling money out of our pockets is not going to truly solve the problem. 

The community of farmworkers has a large impact on our community- they are allowing food products to come to market. As discussed in one of our classes, the areas that often are helping with food production are often times food insecure. Providing these ladies a meal is the least we can do for the service they provide that often goes unnoticed. I believe that this education will be helpful, but will it be enough?

We are still playing with the idea of creating a grant. During class on Wednesday we were able to come together and discuss more what our future goals will be. Dayton had the idea of a “salary insurance” concept. The idea is that we, as a team, or a future farmworker team will create a fundraiser that will help start this insurance plan. With the fundraiser and the hope/thought that very very small part of the salary of a farmworker will be put into a “pot”. Therefore, if there is another natural disaster or if there is a poor farming season, then the farmworkers have an emergency pool of a salary. Oliver was told during our last fair that with the H2-A visas they have to stay and finish their contract regardless of the work available. Hurricane Florence hindered many weeks of farming and thus affecting the income of many. The hope is that this insurance would provide an income in the face of an obstacle. We still have to discuss this with Anna. I feel that this is a long term goal that would be beneficial in the long term. I believe the first thing that should be done is to research if this type of plan has been executed elsewhere, besides in Kinston, NC. 

Next week we will meet with Anna to discuss the fair as well as our other plan. 

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Post Clinic Fair! Yesterday we were able to have a group meeting and call Anna. She told us many were impressed with our topics at the fair and she looks forward to the upcoming fair at the end of October. Next week we are going to make a flyer to email to Anna so she can distribute it to the tobacco farm location where we are having the fair. 

The only thing I am worried about is the expectation of feeding all those who participate in the next fair. For the Thursday clinic fair, we spent money on the boards, the medications, and food. NC Farmworkers Project has said the fair will be about 40-60.. this is a lot of food and a lot of money. 

Next week we are meeting with Dr. Tillman to discuss potential donation strategies or using the public health credit, and will meet with Anna the following week. 

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Benson Area Medical Clinic

Well, #teamfarmworker pulled it off! The first clinic fair is complete! This week has been a long yet rewarding week and I am glad to end the week off on a good note with a successful fair.

Originally, our fair was supposed to be last Thursday, but due to the hurricane and our team’s feeling of unpreparedness, we were able to change the date. We met with Anna earlier this week to discuss any last minute details. During this meeting not only were we given details regarding the Thursday clinic we also learned of the farmworker’s situation post hurricane.  The details for the Thursday clinic included arriving at 5/5:30 to begin set up, 7-9pm would be the busiest, a pharmacy student would be giving information about blood pressure, and that there would be up to 30 farmworkers seeking care. I have been in front of large groups before. I was a tour guide for my undergraduate university. However, standing up in front of a group where I am not 100% confident in my ability to speak their language gave me a little anxiety.

In terms of the farmworkers post hurricane, Anna informed us that many had to leave due to the lack of no work. The H2A plan does not have disaster unemployment attached to it, so the farmworkers are truly left with nothing to do or earn when a hurricane strikes. She stated in other cities there were emergency funds that were in place to assist farmworkers with such disasters. Originally we were going to assist with the prometores program, but due to many farmworkers leaving we have the potential for a new project! There is possibility that as a team we can potentially write a grant to apply a NC Farmworkers Emergency Fund grant for the farmworkers.

On the 26th, we met to finish up bagging the OTC goodie bags and reviewed last minute details. I am impressed how we were able to bring all of our ideas to life. The Benson Medical Clinic is about 20 minutes from Smith Building. We arrived at 5pm to begin set up and get a feel for the clinic. The staff was helpful and welcoming! They provided us tables and we set up in the lobby.  Dayton and I were in one area together were we discussed nutrition, diabetes and pesticide information.  It was cool how we were able to combine our talks together. Dayton does not speak Spanish so we were able to tag team our presentations. Oliver, Doug and Ivonne were on the other end of the waiting room were they discussed mental health, and OTC. It was nice that we were able to have 2/3 presentations going on at the same time.

Patients started arriving around 6. We obtained consent to take pictures that they may be in and explained our reason for doing so.They came in at various times due to their transportation. We would divide up and begin our discussions. In the beginning, Leonardo stood in to help potential translate since I was a little rough in my Spanish skills, but by the second and third presentation he roamed around and realized I could handle the speaking. I began by discussing food nutrition labels and the food pyramid. Then discussed the Plate Method and how it tied into diabetes. It was a good way to combine the presentations, and Dayton and I will probably be doing this combo again for the women’s fair at the end of October. We provided oranges, bananas and sugar free snacks- all relating to our discussions. Many had questions, and I felt like a resource due to the fact that I could understand their question as well as answering it and they knew what I was talking about. Doug was able to bring glucometers as well. We were able to explain what glucometers do, as well as checking patient’s blood sugar. This was a great aspect, and many of the transporters of NC Farmworker’s were excited about this assessment. A lot of their questions related to Red Bull or sodas and the extra sugars added.

At the other end of the waiting room, Oliver, Doug and Ivonne were going up individually to people to explain their topic. I think this approach was nice. Being able to speak one on one was probably less intimidating to ask private questions in front of a group. I think this way worked well in this setting.  

As the appointments were wrapping up and the waiting room began to decrease in numbers, we were able to ask Amy and Balbina suggestions for the October fair. They said they were impressed with what we had, but said more snacks, add more pictures to our presentations, and add information about medicines for depression and other mental health illnesses. Adding more snacks will be interesting. We have put a lot financially wise in these fairs. We will need to discuss further how we will afford the snacks, as well as if we continue the OTC goodie bags- not all the medicines were donations. Amy and Balbina informed us of the flow and other roles we will be taking on next month. We will be assisting with health assessments and there will be other volunteers assisting us.

Leonardo, Amy and Balbina will report how we did to Anna and we will FaceTime her next week to hear! I don’t think there were too many slip-ups, so I hope she is proud of us!

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Pre Benson Clinic

Post Hurricane Florence! Since the hurricane, #teamfarmworker had to change our original dates of the clinic. Our first clinic is at the Benson Medical Clinic next week, September 27th! It will be here very soon, and puts the pressure on to deliver a great executed fair. 

 Our thoughts go out to Dayten as he was in the path of the hurricane and are communicating with him as much as we can. On top of him and his family welcoming a new family addition! 

This week we had one day of class and were able to meet following class. Ivonne was able to help me translate my educational materials. She told me what I had tried was ok, but not to worry about word for word translation. I still need to decide on a recipe before meeting with Anna. I want the recipe to be healthy and considerate of one’s culture. I have a few ideas from my research. My hope is to be able to hand out recipe cards for everyone to take home. In addition to having healthy snacks, like oranges and bananas. I am hoping my Spanish isn't too rusty when trying to converse with the farmworkers. I think by the end of the clinic night, I will be only able to talk in Spanish. 

Doug was able to bring in medication donations that a friend sent him! This will be exciting to see how the farmworkers will react. This portion of the presentation will be so beneficial. Doug has gone above and beyond and arranging “goodie bags” filled with medicine and other first aid necessities. 

We have been able to collaborate and have seen what each other has been working on. All components relate to what a farmworker deals with in their daily life. From pesticide exposure during work, to needing medicine during an illness or pain, to sun/heat exposure and knowing what to be on the lookout for and  the knowledge about what one should put into their body. I know the farmworkers will have come from the fields and probably be tired, but I’m hoping a little of what we have to say resonates and are able to learn one thing from our mini presentations. At work, I am used to speaking to children, I am wondering what teaching adults will feel like. 

We are going to meet with Anna next Tuesday and we all agreed to have our presentation material completed next Wednesday for us to go over together before the fair on Thursday! We have not seen here since we met at the main headquarters due to her vacation and the hurricane. It will be nice to see her and look for her for guidance as we are in the final days of preparation. We still have a few questions we need to clarify before our second fair at the end of October.

The Benson Medical Clinic knows we will be in attendance this coming Thursday and are allowing us to use their tables. I am interested to see how this clinic functions. From what we have heard from other Project Farmworker employees, the clinic lasts late into the night, until all farmworkers are seen. The clinic employees said it is about 20-22 patients. It takes pure dedication to be able to open up a clinic and commit to long hours. I hope one day when I am out in the medical field, I will remember such graciousness to give my time to others. 

I am so thankful that the Farmworker’s Project was able to work with us on moving dates. As a group, we want to show our best work, and we did not think that with the hurricane and missing ample meeting times would have created a successful fair. 

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Post Clinic fair next week, I hope to be in communication with Amy. I want to see how I can be of use with the Project Farmworker team in other ways than helping put on education health fairs. I think that even if it is assisting check in or simply discussing with a farmworker on their day to day would be meaningful to me. My goal post September 27th is to email Amy and have a date where I can contribute potentially solo. This might be intimidating at first, but I think I would be missing a large opportunity to truly connect with this community. 

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This week, due to the hurricane, #teamfarmworker was unable to meet. However, we will meet  three times next week. During this weeks meeting, we were supposed to over our information collaboration and begin translating into Spanish. Our thought with translating together would allow all of use to be mentors to those in the clinic. We will have to do translate early next week. My task was to generate information pertaining to nutrition and domestic violence. 

For my nutrition piece, I focused on how to read a food label, as well as including the food pyramid. I am hoping I will be able to sum up the facts in a few sentences. I know if I have worked long hours, I will not want to really listen/read a lengthy presentation. I want to be able to print off a few healthy and cost saving recipes to share with both farm workers and families. 

For my domestic violence piece, I have gather information as to what is violence, and resources in NC that women and families can go to. During our meeting at the Farmworkers Headquarters, they mentioned they would pull the women aside during our family fair to discuss this and contraceptive use. 

I am interested to see how this upcoming week plays out. I feel that we have a lot to do in one week. 

We have started the T-Shirt drive and boxes are spread throughout CPHS buildings. It was mentioned in the weekly email this week as well. Hopefully we will be able to gather enough supplies to share with everyone. Benson Medical Clinic stated that they have tables for us to use and see about 20-22 farm workers each Thursday Clinic. If we do not get enough shirts, I think we should still continue the fundraiser and donate what we are able to obtain at the end of the semester for the NC Farmworkers Project to have for next year’s season. 

As well as individual research, I also heard back from Amy regarding potential inclusion in Tuesday mobile clinics and other outreach events. She informed me that they would be going out on Wednesday to share shelter and other hurricane preparedness material. Unfortunately, I was unable to do this. However, she stated I could email her each week of my availability to help with outreach and to send her dates I’d be interested in to help with the mobile clinic. I am hoping I can go on 2 mobile clinics in October. 

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Yesterday #teamfarmworker had a brief meeting to discuss the roles we each will play in planning for the health fairs we have in the upcoming weeks. Our major themes are pesticide exposure, diabetes (kids and adults), nutrition, domestic violence, mental health, over the counter drugs, contraception, and heat stroke information. These seem daunting. However, we split up the topics fairly. We also were able to steal Dr. Tillman and discuss potential fundraising/ budget for the fairs. We plan to bring fruit to the family fair and wanted to ask about reimbursement and/or a budget for events. Dr. Tillman also stated that there is possible water bottle promotion goodies. He was weary on advertising goods and being able to provide for all. Hopefully through potential donations and promo we will have more than enough. We are waiting to hear back from the Benson Medical Clinic to give us a little more updates on the space itself. We will meet next week to go over the material we will present and to translate the material in Spanish. 

Individually, I still need to email the Farmworker Project to discuss helping in outreach or joining in the mobile clinic. 

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This week #teamfarmworker met twice this week. We met as a group to discuss potential themes to present in our meeting with Anna on Wednesday. We came up with possible donation ideas: water bottles and long sleeve t-shirts, we discussed focusing on nutrition, medication information, and to include a game/fun interactive activity. We seemed pretty comfortable with these ideas. As well as discussing themes, we also discussed potential dates  of when we should reveal the fair. 

 We met this Friday at Farmworker Project in Benson, NC. We met with Anna, Balbina, Amy, and Leo. They presented potential themes they also thought we should include, such as, diabetes in children, domestic violence and contraceptive information. They really enjoyed our idea about medicine information. This meeting was a big test for me regarding my Spanish skills. The meeting was predominantly spoken in Spanish. We planned the health fairs, both at the clinic and the family clinic, for the end of September (20th and 21st). We have a lot of work to prepare for! At first we thought of having a survey to see what the farmworkers were knowledgeable at, however, since the farmworker team knew the themes we wanted to address, we no longer will need a survey. 

Prior to the meeting, I arrived early and Anna was able to show me the inside of the mobile clinic mobile. This was such a cool vehicle. Anna said we would be able to meet up with the van or be able to ride out with the mobile clinic group in the future. There was also mention of other outreach clinics to assist with health assessments. I continue to look forward to what I can contribute. I know these next few weeks will fly by with preparing for the fairs, but I am excited!

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Yesterday we met with Anna Jensen, our preceptor for Team Farmworker. During our meeting, she informed us of our main objectives and the other opportunities we can take advantage of. We will focus on health fair creation and evaluations of STIs and vegetable subsidies. Next week as a group we will meet to brainstorm possible topics for the health fairs, and report to Anna on Friday. We are meeting Anna and the rest of her team at the main office in Benson. In the future, I’d like to go on a mobile clinic or a Thursday night clinic.