From tight living quarters to high rates of chronic illnesses to no sick leave protections, immigrant farmworkers have found themselves in particularly vulnerable positions as the COVID-19 pandemic spread throughout North Carolina.
During the summer of 2020, hundreds of farmworkers fell ill at more than 30 farms as COVID-19 ripped through the greater community. Farmworker advocates issued numerous calls to Gov. Roy Cooper, demanding he and other state officials implement policies to better protect workers. Cooper seemed likely to meet the demands, though eventually, he changed course.
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The state’s Department of Health and Human Services does not track COVID-19 infections by profession. At the start, the department tracked farmworker housing with outbreaks, as it does with other congregate living settings such as nursing homes and adult care facilities. But by summer 2020, the department changed its record keeping.
It moved migrant farmworker housing to the more general “other” category, which also includes homeless shelters. Instead of the name of the farm, only the cross streets are listed.
NCDHHS said the change was made to be more precise.
“In the former display, a business/farm was named even though the outbreak might have occurred at a housing site several miles away,” said NCDHHS spokesperson Catie Armstrong, adding that the precise address of the outbreak was removed “as an acknowledgement that marginalized populations reside in both settings and those settings/residents are at-risk for acts of discrimination and harassment.”
General infection data do show that since March 2020, 17% of COVID-18 cases in North Carolina have been among Hispanic residents, despite the group accounting for 10% of the population (about 94% of farmworkers speak Spanish as their native language).
To put it mildly, the pandemic has been rough for immigrant farm laborers. As vaccines have rolled out, though, many have finally found some relief and protection.
As of mid-December 2021, health care workers had administered 28,702 vaccine doses to farmworkers at centralized vaccination sites targeting the population, according to NCDHHS.
The total population of migrant and seasonal farm laborers in North Carolina is estimated to be around 150,000, including undocumented workers, those in the U.S. on H-2A temporary agricultural worker visas, along with U.S. citizens and permanent residents.
The number of vaccine doses given to the group is almost definitely an undercount since these workers — like everyone else — can get their vaccine at any location that administers them. If a farmworker went to a nearby pharmacy for a vaccine, rather than waiting for the vaccine pop-up at the labor camp, they wouldn’t be counted in the number of vaccines administered to farmworkers specifically.
AMEXCAN, a Latino advocacy group based in Greenville, recently conducted a survey of nearly 100 immigrant farmworkers to gauge their knowledge about COVID-19 and the vaccine.
Among the findings: more than 80% of the immigrant farmworkers surveyed said they knew where they could go to get a COVID-19 vaccine, a significant feat considering the language and transportation barriers the community often faces. Survey respondents primarily lived in Nash, Wilson and Harnett counties, rural areas in the eastern and central parts of the state.
Gaps to more general support remain for immigrant farmworkers. In the survey, workers said they needed help accessing other types of medical care, including mental health care. They also expressed needing clothes, masks, other personal protective equipment and food.
Perhaps most significantly, workers said they needed access to the internet.
“At this day in time, this is the way that we can communicate with our own communities,” said AMEXCAN’s executive director Juvencio Rocha-Peralta. “These communities or these individuals, they really live in a very remote area, so there's some room in there for us to advocate more for connectivity, for access to services.”
State agencies have also taken note of this critical need. Natalie Rivera coordinates the Farmworker Health Internet Connectivity Project within the N.C. Farmworker Health Program, an organization that acts as a liaison between clinics and farmworkers.
“We look for areas in North Carolina where there's a large density of farmworkers, but maybe not a lot of health services,” Rivera said. “Outreach workers go out into the community, go into farms, visit farmworkers where they're living and do health outreach to better connect them with the clinic services that are available to them.”
When COVID-19 arrived, the organization considered switching to a virtual model to better protect farmworkers, community health workers, and to limit physical appointments with doctors. But, they immediately ran into a problem: internet and cell service at most migrant housing ranges from poor to nonexistent.
“I knew that this issue existed,” Rivera said. She used to be an outreach worker, and she remembers having to go out to farms to deliver health information — a blood test came back, an appointment had to be rescheduled, etc. — which could have been relayed over a phone call or an email, had those services reliably existed.
Part of the challenge in getting internet to migrant farm labor camps stems from how isolated their housing often is.
Nearly 40% of migrant camps are “hidden,” according to a 2015 study by researchers at Wake Forest School of Medicine, meaning they’re far off the road, or tucked behind other structures. The distance between the road and migrant housing makes it more likely trees or other physical barriers will need to be removed, which can lead to rising costs when laying the fibers and cables.
“The other part about migrant housing is, in many cases, it's congregate housing,” Rivera said. “So that also creates a challenge."
Researchers from Wake Forest School of Medicine analyzed the "structural vulnerability" that hidden migrant labor camps places farmworkers in. Among the housing units analyzed, researchers found that more than one-third were hidden.
Much migrant housing is also built from metal or concrete, which can impede getting internet access inside. Rivera said she’s heard from many growers who’ve gotten quotes from internet service providers saying that it will cost tens of thousands of dollars to wire up such buildings.
Housing being “hidden” can also contribute to health problems beyond a lack of internet access.
“Crowding, lack of access to sufficient bathing facilities, pest infestation, and structural damage are common to dwellings in farmworker labor camps,” the authors of the 2015 study wrote. “Employer-provided farmworker housing seldom meets the requirements of state and federal regulations.”
While improved internet access wouldn’t address those problems, those in the field have seen how expanded access has helped immigrant laborers in other capacities.
“We've learned that the internet is not only beneficial for health access, but also just for emotional well-being,” Rivera said.
Despite the benefits of internet access, and the increasing dependence on web-based services during the pandemic, neither North Carolina nor federal migrant housing regulations require internet access be available to workers living in migrant housing.
Wi-Fi vs. broadband
As the virus spread, members of the farmworker health program began speaking with people at the North Carolina Broadband Infrastructure Office to strategize the easiest and quickest way to get internet access to farmworkers. They decided on Wi-Fi hotspots.
Hotspots use cellular networks, such as Verizon and AT&T, to deliver internet access. They’re small, essentially the size of a cell phone, and portable. But their size poses some problems.
“They can easily get lost,” Rivera said. They also don’t work especially well if multiple people are trying to do simultaneous things that require a lot of bandwidth, like watching YouTube or video chatting with family, not to mention a child trying to participate in video classes.
Since the start of the program, the Farmworker Internet Connectivity Project has distributed more than 200 hotspots to labor camps throughout the state.
The organization distributes hotspots to farms through the health partners with whom they already worked. Some nonprofits and other community-based organizations that have existing relationships with farmworkers also participate.
Blue Ridge Health, a federally qualified health center that works with migrant farmers in western North Carolina, participated in distribution.
Kenett Melgar, the vulnerable populations manager at BRH, said the hotspots were critical. They enabled many migrant workers, who didn’t previously have internet access, to participate in telehealth appointments, and to speak with their families using WhatsApp.
“The need for the migrant population parallels the needs of the community as a whole,” Melgar said. “Internet access — especially in remote mountainous areas, such as the ones that we have around here — can sometimes be spotty, and a lot of people just don't have good internet. Which, in today's world, is kind of a need.”
As of August 2021, the most recent data available, the group had distributed 258 hotspots, enabling over 2,000 farmworkers to gain access to the internet. They did not have documents available showing the geographic distribution of the hotspots.
An emergency stopgap
The Wi-Fi hotspots were always designed to be a short-term response, generated by the pandemic. There’s only funding for the service through the end of 2022, according to Rivera.
Alongside the hotspot program, the agency also partnered with the N.C. Institute of Agromedicine to come up with a more permanent solution.
Broadband infrastructure takes time to build out and it can be very expensive. It’s an issue rural communities across the state and the country have reckoned with, especially during the pandemic when so much of life has moved online.
“Wired internet… like fiber or cable, really needs to be sort of buried underground. It costs a lot more money,” Rivera said, “but it ends up being more permanent and more cost-efficient once it's available to you.”
In addition to the Wi-Fi hotspot program, the internet connectivity project is also working with the N.C. Agromedicine Institute to reimburse expenses for installing more permanent internet access.
The agencies designed a program whereby farm owners and growers who want to install more permanent internet at their locations can do so and get reimbursed by the Agromedicine institute for up to $1,000 per migrant housing unit.
The reimbursement, though, is also temporary.
To achieve digital equity, Rivera said, it’s critical that migrant farmworkers have access to the internet. The question is, who is financially responsible for making that happen?
“The challenging part has been what would happen afterward,” she said. “Do we pay for it? Or do they pay for it? And I think we were trying to go through this to learn and see.”
North Carolina Health News is an independent, nonpartisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org.