By Claire Hutkins Seda, Senior Writer, Migrant Clinicians Network and Managing Editor, Streamline
El Coronavirus y el Trabajador Agrícola: Coronavirus and Agricultural Workers
The curriculum covers numerous topics relevant to the life and work of agricultural workers, including:
• How COVID-19 is transmitted.
• How to disinfect surfaces, with a focus on high-touch surfaces in common spaces.
• How and when to wash hands.
• How to stay safe in agricultural worker housing and during farm-provided transportation.
• How to stay safe while at work.
• When and how to visit others, including clarifications around whether agricultural workers can leave housing if they are not under isolation or quarantine.
• The difference between a mask and a respirator (like an N-95).
• How to put on and take off a mask.
• Symptoms of COVID-19.
• Agricultural worker rights.
• Programs and benefits for agricultural workers.
In March, as the first COVID-19 cases began to shut down parts of the United States, Mary Jo Ybarra-Vega, MS, LMHC, quickly recognized that COVID-19 was going to impact the agricultural workers in rural central Washington State where she works as the Outreach and Behavioral Health Coordinator for Quincy Community Health Center. She teamed up with another Community Health Worker (CHW) in a nearby county who drew up a simple Spanish-language curriculum to share with the CHWs and promotores de salud about what was known about the disease and how to prevent it. It was soon thereafter adapted for agricultural workers.
"When we started, we only listed three symptoms,” she recently recalled with astonishment, but the list of symptoms quickly expanded as data and research around COVID-19 were compiled across the world. The resulting refined understanding of the disease and its spread, plus Washington statewide emergency regulations to protect workers, prompted new editions of the curriculum: “We’ve probably updated it at least 10 times,” and counting, she admitted.
Ybarra-Vega also took those early days to begin collecting data from agricultural workers on their knowledge about COVID-19 before the prevention trainings conducted at the labor camps. “We found out that they didn’t have the language,” to talk about COVID-19, she said. “They used ‘virus,’ ‘bacteria,’ ‘sickness,’ and ‘illness’ all interchangeably." This in turn affected the curriculum development, which considered participants’ various backgrounds and education levels.
Over time, she began to witness firsthand the gaps in agricultural workers’ understanding of how to prevent disease, as she trained workers. “Wearing the masks, people know that. And social distancing. But, the one piece that’s missing is the handwashing,” she said. “There’s a certain technique that’s important,” in addition to frequency, she said. So, her curriculum emphasizes handwashing, in addition to providing masks when needed and talking about physical distancing. “We teach [the workers] how to handwash and watch them handwash to make sure they know how,” she said. “We joke around a lot – they'll say, ‘I’ve never washed my hands like this before!’ -- that’s a common thing we hear.”
Before the pandemic, approaching farms for permission to train workers on health and safety brought mixed results. After state regulations required certain measures to be enacted to keep essential workers safe, Ybarra-Vega found "the doors are opened up, a little bit.” She provides in-person training to small groups – some groups as small as four – outdoors, with everyone in a mask. The in-person training is key, as is checking in on housing conditions, Ybarra-Vega said. While a short duration inside housing facilities may increase risk for the health team, she finds it invaluable, and emphasized that the health team is always protected with an N-95 respirator while inside, and limits group size to two or three. During one training in the agricultural worker housing, Ybarra-Vega pointed out to the workers the smudges along a light switch. "We talk about, do you see how it’s dirty? So, you need to focus on this. A lot of people are touching it, so you need to clean it more often. Or, you have a fridge in your room – that's good. But if you’re eating in your room, then you’re touching your mouth and you’ll need to wash your hands. Being inside the homes, we can see things, point things out.”
She also works closely with the farm owners, to ensure they are clear on how to uphold the state regulation. She recalled that one farm owner, when working on a checklist before a training, told her that the farm was providing sufficient towels and soap, but when she stepped inside to demonstrate handwashing with the agricultural workers, there were no supplies available. “They found out that someone was stealing their products,” and fixed the issue, she said. Not all farms are so quick to step in, she added. “At other places, we say, ‘they don’t have soap,’ but we keep finding that they’re not giving them the products they need to stay safe. It’s one thing to train the agricultural workers, but if they don’t have the materials – hand sanitizer, water, bleach – how are they going to stay safe?”
Ybarra-Vega and her team work hard to keep the communication open between the CHWs and the farm owners, in hopes of gaining trust and building relationships for the long term. For example, she translated their curriculum from Spanish into English so there is full transparency for English-speaking farm owners about the content being provided to the farm’s workers. “It’s horrible that it had to come to this for the doors to be open for trainings,” she clarified. “We hope the doors will remain open after this so we can keep helping workers.”
Mary Jo Ybarra-Vega and Priscilla Tovar presented their curriculum to CHWs during a training presented by the Northwest Regional Primary Care Association. Watch the webinar (in Spanish) and access numerous related resources at the NWRPCA’s Learning Vault: https://bit.ly/2EI63Yo
The curriculum is available to CHWs and others who would like to use it. Please contact Ybarra-Vega directly to gain access to the curriculum: 509-787-6423 x 5226 or firstname.lastname@example.org.
Read this article in the Fall 2020 issue of Streamline here!
Sign up for our eNewsletter to receive bimonthly news from MCN, including announcements of the next Streamline.