OPINION: Why protecting farmworkers against COVID-19 is essential

Erick Martinez Juarez with his parents Loreto and Maricela Juarez at his medical-school white coat ceremony.
Erick Martinez Juarez with his parents Loreto and Maricela Juarez at his medical-school white coat ceremony.

My parents are farmworkers. I will be a medical doctor. We're both fighting close to the frontlines against COVID-19. But while I'm living the American Dream and may seem more vulnerable in a pandemic, mis padres, like the 2.5 million farmworkers nationwide, may soon suffer through an American nightmare.

Albany has become an unlikely epicenter of a rural outbreak of the virus. By invading towns that were once thought geographically insulated against infection, COVID-19 threatens the lives of our nation’s most defenseless and “essential” workers: farmworkers, and immigrant laborers, in particular.

“Don’t worry about me, my son. There’s nothing we can do about it. Only God knows what’ll happen” is a general sentiment among farmworkers expressed by my father, who has spent 30 years toiling in South Georgia fields.

Like so many before them, my mom and dad – with no education, no money, no sociocultural capital – crossed the Rio Grande from Mexico in the late 1980s in search of a better life, eventually gaining legal status here. Initially cultivating vegetables inside nurseries in North Carolina and plucking oranges in South Florida, they eventually settled in an isolated farmworker camp surrounded by tomato fields in Decatur County, tucked away in the southwest corner of Georgia.

Deplorable housing conditions defined their early years – decrepit trailers and cottages packing upwards of 10 people in cramped rooms without air conditioning. I remember being confined to a large closet-sized room with my four siblings, sleeping shoulder-to-shoulder at night. Transportation for farmworkers is similarly claustrophobia-inducing, as many of them cram into repurposed school buses that shuttle them to and from the fields. You can see many of these laborers empty those buses at local big-box retailers. I saw them stepping off, deblousing and donning bandanas as masks, every day after school.

Consequently, implementing our biggest weapons to control the pandemic – social distancing and self-isolation – is a Sisyphean task. One of the few times farmworkers come close to self-isolating is when they’re laboring in the fields. Their tradeoff for exposure to the deadly virus is exposure to pesticides and the unrelenting Georgia sun.

Now, with the ongoing crisis in Albany spreading to the Georgia countryside and the reopening of the economy, farmworkers will battle the virus without adequate defense. Already burdened by the social determinants of health, including poverty and both limited education and transportation, like other marginalized communities, they will bear the brunt of COVID-19 by virtue of their location. In particular, southwest Georgia continues to lead the state in barriers to healthcare access. What’s more, many lack documentation needed for insurance in spite of a long list of comorbidities (like diabetes). With that and the risk of deportation, most hesitate to seek care until too late.

Many Georgia farmworkers depend on state-funded programs like the Georgia Farmworker Health Program for healthcare needs. My own family is no exception; as a child, I received medical care from Emory University’s South Georgia Farmworker Health Project, an initiative from which my parents still benefit and where I now often volunteer. Now, however, a primary source of farmworker healthcare is in peril — these clinics could be shut down, placing the burden of sick farmworkers on their employers.

These inequities are amplified not only by a shortage of providers in rural areas and representation in healthcare (hence, a call for more diversity in medicine) but also by a lack of major advocacy infrastructure voicing farmworker rights in Georgia, such as that established in Florida by the Coalition of Immokalee Workers and in the midwestern U.S. and North Carolina by the Farm Labor Organizing Committee.

All of these conditions will inevitably engender a traveling incubus of coronavirus, perhaps resulting in an uncontrollable outbreak. With or without healthcare, some infected workers may soldier on, regardless — after all, food needs to be placed on the table, not just for family stateside, but also back in the mother country. Those who do seek care will likely go to overwhelmed, underfunded hospitals, already ill-prepared to confront language and cultural barriers. And let’s not forget the children – many of whom are American citizens – of sick parents, who will live with this trauma for the rest of their lives.

As a future healthcare provider and advocate of farmworkers and the underserved, I am honored to give back to my community through the principles of the Hippocratic Oath. Like many children of immigrants, I am proud to be an American and to serve this country through the power of medicine and healing. But helping farmworkers weather our nation’s current crisis is an undertaking that stretches far beyond just healthcare.

During the last week of March, National Farmworker Awareness Week and César Chávez Day quietly crept by, as they often do, unobserved by many Americans. These holidays – and to a great extent, Cinco de Mayo as well – ask us to acknowledge what many would rather not: that it takes a staggering amount of cognitive dissonance to deem immigrant laborers both expendable and essential, that it takes a pandemic to remind us who keeps our shelves stocked, our refrigerators full, our children fed.

Remember: when the vulnerable are made more vulnerable, so are you. Because a virus does not discriminate or care if we live, much less starve.

Erick Martínez Juárez, the second of five children born and raised near Bainbridge, is a Harvard University graduate and rising 4th-year medical student at the Medical College of Georgia in Augusta. Dr. Jodie L. Guest, professor and vice chair of epidemiology at the Emory University Rollins School of Public Health, contributed to this piece.