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This story was published in partnership with Southerly.
On a Thursday afternoon in August, Andrea Hinojosa crossed 140 miles of southeast Georgia in her van, handing out masks, informational fliers, and posters about Covid-19 to farmworkers and immigrant communities. All of the towns she stopped in — Alma, Baxley, Glennville, Reidsville, Lyons — have populations of 5,000 or fewer. They’re surrounded by fields of blueberry, Vidalia onion, pecan, tomato, and other crops.
Hinojosa, who runs the Southeast Georgia Communities Project, a small nonprofit she founded 25 years ago, wanted to ensure Latino-owned stores, laundromats, and other places farmworkers may visit had information about the pandemic.
She said that no one else is doing this sort of public health grassroots work in rural towns in the area, and public health resources for Latinos are also scarce. “I’m the only thing going in a 100-mile radius,” she said.
One state over, a similar story was unfolding. Melissa Castillo, a former outreach worker at North Carolina’s Kinston Community Health Center — which is part of a federally-funded, nationwide network of clinics for low-income people — spent the last six months trying to find as many of the 10,000 to 17,000 farmworkers who live in camps, trailers and houses spread across six counties as possible. (In late September, she began working for the nonprofit NC Field.) Like Hinojosa, she handed out Covid-19 information, and she also helped people get tested or find transportation to local hospitals. Sometimes, to find workers, she’d call a number a worker gave her last year. Other times, she followed a rumor: “There’s a few who have gotten sick, at the end of that road, off to the right a couple hundred feet.”
The quixotic tasks Castillo and Hinojosa have taken on during the pandemic illustrate the gaps in the patchwork healthcare system available to the farmworkers who plant and harvest in the rural South’s fields. Though classified as essential workers, farmworkers have been largely overlooked in public health responses to the pandemic. “They’re designated as essential workers and yet their lives are treated as expendable,” said Judge Laura Safer Espinoza, executive director of the Fair Foods Standards Council, a Florida-based organization that works with growers on human rights and labor standards.
Some are in the region on temporary H-2A visas; others are undocumented and live in the communities where they work. Many travel from state to state during the growing season, and have been on the job since mid-spring, shortly after the Covid-19 pandemic began spreading through the U.S.
According to interviews with nearly two dozen nonprofit leaders, community organizations, and public agency representatives in Florida, Georgia, South Carolina, and North Carolina, this insufficient healthcare infrastructure has made it difficult to slow the spread of Covid-19 in rural areas of the South. Tests are hard to access. Contact tracing is nearly absent. Living and working conditions for farmworkers can make it impossible to quarantine or isolate. Federal and state regulations on safe working conditions are lax.
Some farm owners offer workers information, protective equipment, and assistance isolating. But many don’t — and information isn’t always available in Spanish or indigenous languages. For immigrants who are undocumented or on work visas, these difficulties are compounded by fears of interacting with the government. They may avoid healthcare altogether, fearing that speaking up about unsafe working conditions could result in retaliation.
Limited Access to Testing
Kinston Community Health Center is one of nearly 12,000 sites in a nationwide system. About a quarter of the patients who use them lack insurance. In 2018, the most recent year for which data is available, nearly one million farmworkers, or about one-third of the estimated total number across the U.S., visited a center. Many workers either don’t have access to healthcare or keep working through health issues, according to nonprofit and community organizations.
Community health center staffers in the Carolinas told Southerly they have struggled during the pandemic, facing shortages in staffing and personal protective equipment. In late April, a federal Health Resources and Services Administration (HRSA) survey showed that nearly a quarter of centers were likely to run out of N95 masks in two weeks; one in seven employees missed work due to Covid-19. By September, more than 35% of the centers reported not having enough N95 masks for the next month. Only 4% of all employees reported missing work due to the virus.
At the beginning of the pandemic, it took two weeks to get Covid-19 test results back to Kinston, Castillo said. Now, it takes less than a week. As of mid-September, nearly one in nine health centers in North Carolina took four to five days to process tests, according to the same survey; in South Carolina, one in four; in Tennessee, one in eight.
In Georgia, nearly 5% of centers were taking as long — though less than two-thirds of all centers in the state responded to the survey. D.A. Kavka, the executive director of the Georgia Primary Care Association — which oversees the state’s community health centers — said in an email that he did not “want to get involved in anything that is any way controversial or offer opinions that might be in conflict with the norm and what the state is doing.” Kavka referred Southerly to Tiffany Hardin, director of the state’s farmworker health program at the Georgia Department of Community Health, who did not respond to multiple requests for comment.
R.B. Tucker, CEO of the South Central Primary Care Center, which has health centers in seven rural locations, told Southerly “this conversation is over” when asked about outreach to farmworkers.
During work hours, testing is not easily accessible, leaders of multiple community organizations said, and farmworkers often don’t have access to transportation. In some rural Georgia counties, farm owners bussed workers to health departments or clinics for testing, but these services are few and far between.
Some community health centers offer tests on-site at farms, but they can only do so when owners allow them. “Some bosses, they say, ‘It’s not as bad as they say it is — it’s all political,’” Castillo said. Other farm owners don’t want workers to promote testing because they’re afraid of losing their workforce, said Dr. Viviana Martínez Bianchi, who advises North Carolina’s Health and Human Services Department on marginal populations. The state’s Farmworker Health Program provides testing at some sites, and the Health and Human Services Department recently began funding transportation for farmworkers to get tested and offering stipends to offset lost wages.
But those who test positive for Covid-19 are often unable to isolate themselves from their families or fellow workers. If in the U.S. on temporary visas, workers often live in barracks-style housing on or near farms or in trailers. “What I’ve seen so far is they just kind of shelter in place,” Castillo said. “If two are positive and there’s 10 people living there, all are going to become positive.”
Nonprofit organizations and community health advocates like Hinojosa are left to try to fill the gaps. Some groups have had relative success: In March, the Coalition of Immokalee Workers, a 27-year-old organization representing farmworkers in the southern Florida tomato fields, successfully petitioned for increased testing. But public health officials didn’t begin testing until May; even then, results were delayed and only available in English. The coalition then sought the help of international organizations that generally work in developing countries, including Doctors Without Borders, Partners in Health, and Global Response Management. At least 5,000 people were tested.
Since then, thousands of farmworkers in Immokalee have left for work in Georgia. Some left before receiving results, and others may have been exposed to Covid-19 in these places, said Nely Rodríguez, an organizer with the coalition.
“Without a coordinated federal response that transverses [state] borders, it’s really difficult to respond to the virus — from state to state, there’s no continuity,” said Andrea Leiner, a doctor with Global Response Management who worked in Immokalee. “It’s a disservice to those who are protecting our food supply.”
The Unregulated South
No Southern states have instituted statewide public health mandates for farm owners to follow in response to the pandemic, according to a mid-July analysis by the Environmental Working Group. North Carolina has recommended protocol, but nothing is enforceable by law. The state put federal CARES Act funding toward hiring 250 community health workers to reach vulnerable populations in 50 counties, including agricultural areas, as well as creating a Department of Health and Human Services position for a director of Hispanic/Latinx policy and strategy. As of this writing, the position has not yet been filled.
South Carolina, Alabama, Mississippi, Louisiana, and Tennessee have no guidelines at all. Georgia has developed some guidelines to prevent the spread, but they don’t include measures on testing or educational materials and training.
“There’s a complete lack of interest on the federal and state level in putting resources into this community,” said Pedro Viloria, operations coordinator for Latino Community Fund Georgia (LCFG), a nonprofit organization. “There’s no leadership.”
Viloria and a colleague visited Colquitt and Tift counties several hundred miles south of Atlanta for a week in mid-July and spoke to hundreds of farmworkers on buses, at a blueberry farm, at tiendas, or small stores, and laundromats. They met with immigrant families who didn’t know public health authorities were providing free testing and had either paid for tests out of their own pockets or avoided them. Some people said they were charged exorbitant amounts for hospital bills. None wore masks, he said. The group produced a report from their visit and hired four people to provide additional public health education and emergency funds for farmworkers and other immigrants in rural Georgia.
The Mexican Consulate in Atlanta, which serves at least 900,000 Mexicans, Mexican-Americans, and their families in Georgia, Alabama, and parts of Tennessee, has for months been part of a regional task force formed to track the pandemic through farms and immigrant communities. William Lozano Arciniega, head of the Department of Protection for Mexican Nationals at the consulate, said the agency is struggling to reach people. “The owners don’t want us there,” he said, so he waits for complaints to come to him. But many people don’t come forward, fearing retaliation since they want to return to the fields in the future.
“As long as the health departments aren’t doing testing at the farms, it’s difficult to know [about the number of cases],” he said. “We’re surprised at the lack of emphasis on protecting essential workers.”
The federal Occupational Safety and Health Administration, or OSHA, is charged with protecting workplace and worker safety. As of early October, OSHA has received 28 complaints regarding working conditions related to Covid-19 in agriculture nationwide, and seven in Southern states. One of them is against Southern Valley Produce, owned by Hamilton Growers, a family-owned company in Norman Park, Georgia. Jon Schwalls, executive officer at Southern Valley, did not reply to multiple requests for comment.
“They didn’t give access to local organizations,” said Victoria Mesa, a senior staff attorney at the Southern Poverty Law Center. The problem goes beyond Southern Valley, she added. “There’s so much silence and intimidation; the workers don’t want to talk to anybody… My biggest fear is that many H-2A workers are getting sick and they do nothing about it,” she said. “They just put up with it, keep working with symptoms, and expose others.”
During the pandemic, federal agencies including the CDC and OSHA have released recommendations to farm owners for keeping workers safe, ranging from encouraging hand-washing and checking temperatures to offering farmworkers information on testing and overhauling barracks to increase airflow. These are recommendations, not requirements. OSHA began visiting some farms in the South in June to check for such measures as masks and social distancing, said Lozano Arciniega, from the Mexican Consulate, but “they don’t have a way to visit every farm.”
“When an inspector finds violations of OSHA standards or serious hazards, OSHA may issue citations and fines as part of the inspection,” an OSHA official wrote in an email. The Southern Valley complaint was filed on June 6, and the case was still open as of late September. The agency has up to six months to finish the investigation, according to OSHA.
Most growing seasons will have ended by then.
No End in Sight
On a Friday in late summer, several dozen farmworkers visited Alarcon’s Store and Restaurant in Norman Springs, Georgia. Most had spent the week in Southern Valley’s fields, planting cabbage, peppers, and eggplants. They ordered food, bought lottery tickets and beer, and sent money home to Mexico and El Salvador. Several who spoke to Southerly declined to give their names, for fear of retaliation but described their working conditions: bunk beds in barracks, crowded, company-owned buses. They said the only public health measures taken at work were hand-washing and temperature checks. None of them had heard of the OSHA complaint. None of them had been tested for Covid-19, and said they didn’t have symptoms. None wore masks.
As of October the Carolinas and Tennessee are among nearly half the states across the country where there is “uncontrolled spread” of the virus, according to the Covid Exit Strategy, an independent analysis compiled by public health experts. Georgia is “trending poorly,” according to the site.
Mandy Cohen, Secretary of the Health and Human Services Department, told Univision News that her state’s efforts to extend public health measures to the Hispanic community were like “build[ing] the plane while we fly it.”
“So many months in, so unprepared,” Castillo said. “We’re reaching workers so slowly … You go into one camp, everyone has their masks on, it’s obvious they are socially distancing. Then you go to the next camp and there’s none of that. They tell you, ‘No pasa nada. Es politica.’ (It’s nothing, just politics.”)
“I don’t think it’s about prevention anymore. It’s more about how to treat [the farmworkers],” she said. “You have to transition now. The spread is everywhere.”
Timothy Pratt has reported for 25 years on several continents, in English and Spanish, with work in The New York Times, The Economist, AP, Reuters, and The Atlantic, among others.
Jesse Pratt López is a trans Latinx organizer, activist, and photographer with work published in The Guardian, The Atlantic, PBS NewsHour and other outlets. She is the founder of the Trans Housing Coalition, aimed at alleviating chronic homelessness in the trans & gender non-conforming community in Atlanta.