From left: Dr.Christopher Keefer, Eustace Orleans-Lindsay,pharmacist; McMaster University health anthropology graduate student Stephanie Mayell; Isabel Chilean and Lorena Acuna, both translators; and back row,clinic's primary care assistant Tricia Gutierrez.
By Sofia Ramirez, Communications Lead, Policy and Communications
Each year Ontario hosts roughly 18,000 seasonal agricultural workers (SAW). Although they pay taxes and have OHIP cards most face multiple barriers accessing healthcare services. These barriers can create difficult and dangerous situations because their work is physical and often challenging to one’s health. Social and geographical isolation can also influence their mental health status.
Two of Ontario’s Community Health Centres (CHCs) are helping to address the needs of these workers: Grand River CHC in Brantford and Quest CHC in St. Catherines. They have been funded for 2 year pilot projects through the Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN). The region hosts about 8,000 seasonal agricultural workers every year.
"Recent research pointed to the Community Health Centre (CHC) care model as a good fit to meeting the primary care needs of Migrant Agricultural Workers," said Donna Crips, LHIN CEO. "I am pleased Quest and Grand River CHCs in our LHIN stepped forward for these people in their communities."
In May, Grand River CHC (GRCHC) opened the Grand River Migrant Worker Clinic in Simcoe along with another clinic site running adjunct to the CHC in Delhi. These clinics together served almost 350 clients with 500 visits. GRCHC also went beyond the clinic walls and participated in a Seasonal Agricultural Worker fair, partnered with a health literacy program, and hosted a healthy cooking demo.
The Grand River Migrant Worker Clinic is a unique scenario where a medical office, pharmacy and grocery store can be found under one roof. Synchronicity and determination played a large role in the opening of the clinic.
The Norfolk Health Equity Committee had been collecting information and documenting the problems for seasonal agricultural workers for many years. They then brought together organizations and stakeholders in the region to make the case for healthcare services for this specific population. “The committee undertook a great deal of planning and partnering and invited us to the table,” said Peter Szota, Executive Director of the Grand River CHC.
Then pharmacist Eustace Orleans-Lindsay, a member of the committee, persuaded the local Loblaws that houses the pharmacy he manages to allow the SAW clinic to use the empty medical office on the second floor. Loblaws agreed and also provided a bus to transport workers to the store from downtown Simcoe where workers visit weekly for shopping and chores.
“My involvement with the equity committee began because of my previous experience with these workers. They would come see me at the pharmacy with a wide range of requests. They would come with packages from their home countries, with trade names that I didn’t recognize, and it was challenging. I put the pharmacopeia to good use matching these meds. Sometimes it was beyond what I could do and I would tell them to go see a doctor,” recounted Orleans-Lindsay. “They would tell me that they couldn’t. They couldn’t see a doctor even though they had a health card because doctors were not available at the times that they were and their employers were not going to sit with them for 5 hours in the emergency room waiting for a simple script renewal.”
In response, Grand River CHC recruited a team to provide services out of the clinic on Thursday and Friday evenings. The team included a Spanish-speaking doctor, 3 translators and an administrative assistant.
“I was drawn to this project because migrant workers are a population that is underserved and I always try to find a place where I can be most effective. Having sensitivity to their needs, and being Spanish speaking has been very helpful,” says Dr. Chris Keefer the physician at the clinic. “The workers are grateful to be at ease to speak in their own language.”
The majority of people that came to the clinic were Spanish-speaking workers from Mexico (65%) and the rest were from various Caribbean countries. Some have been coming to the Simcoe area for over three decades.
"Having this clinic here means a lot. I have been coming here for the past 30 years and this is the first time I am able to see a doctor regularly,” said a worker from Jamaica on the last day of the clinic. “I am lucky though, my brother and sister-in-law live in Toronto and so they helped me before. Some of the other guys, sometimes they get pretty stressed. They come in good health but the pressure gets to them. They need a place like this."
The pilot projects underwent continuous evaluations this first year; learnings that will help to improve the model for next year.
“I had the opportunity to witness first-hand the impact these clinics had on the migrant workers. They addressed the unique health needs of the workers, and the presence of translators made the provision of health care possible,” said evaluation researcher Stephanie Mayell. “When asked where they would have gone for health care had the clinic not been available to them, many replied that they would have gone without. This speaks not only to the success of the project, but to the need for the expansion of similar clinics into other areas populated with migrant agricultural workers.”
More to come: The Quest Migrant Worker Clinic in Virgil will be featured in a future issue of Voices.