February 1, 2017
Suffering in Silence: Migrant Farmworkers Need Massage
By Seraine Page
Each year, more than three million seasonal migrant farmworkers take to the soils of America’s farms, stooping, planting and picking our fruit, vegetable, flower and nut crops, according to the USDA Census of Agriculture (2012). Most of these people are of Mexican heritage or citizenship—and up to 50 percent of them lack the proper documentation to work in the U.S., according to Harvest Public Media.
In addition to the stress of working illegally, especially with recent news of building a wall between the U.S. and Mexico and deporting illegal immigrants, a recent investigation by The Philadelphia Tribune revealed the unsafe transportation to and from fields where migrant farmers work. Layer on to that many workers’ poverty and reluctance to obtain health care, and you can see how migrant farmworkers—some who are as far as 4,000 miles away from home and their traditional medicinal practices—live daily with aches, pain and strains.
One of the traditional medicinal practices that many Mexican people leave behind is massage. And, increasingly, farmworker advocacy organizations are considering the idea of networking with massage therapists, and encourage massage therapists to offer services to migrant workers, both on and off the fields.
With the strenuous work of bending, picking, lifting and walking, oftentimes for many hours under a hot sun, comes back pains, muscles strains and more that could be lessened through massage. Several studies have indicated, for example, that massage can help alleviate lower back pain.
Lack of Access
Shannon McClure, program coordinator at Connecticut Area Health Education Center Network said she isn’t surprised by the lack of access migrant farmworkers have to complementary medicine, especially massage.
“There is no doubt that the workers would benefit from massage therapy, but I see a number of barriers to access the care,” McClure said.
McClure works with community outreach programs through the UConn Migrant Farmworker Clinic, an all-volunteer organization dedicated to providing no-cost medical and dental screenings to farmworkers.
Most workers are foreign-born, coming from Mexico and Central America to find work on farms in the U.S. For many of them, finding access to affordable health care is difficult, according to the National Center for Farmworker Health..
That organization found that 45 percent of agricultural workers are uninsured, and that 75 percent live below the poverty level—making it difficult for regular, preventive health care, let alone complementary options.
Much of the money migrant farmers make is sent back home, McClure said, preventing workers from spending money on perceived luxuries like massage. Additionally, workers often don’t have reliable transportation and would unlikely be willing to take time off work for a massage appointment “as they don’t want to look bad to their supervisors,” McClure explained.
With short-term and temporary contracts, staying on a supervisor’s good side is crucial for many of the workers, according to several farmworker studies.
In turn, many of these people suffer with health woes in silence.
During work seasons, farmers report using over-the-counter medications and “non-pharmacologic methods” to deal with work-related illnesses, according to a health study of migrant farmworkers.
That’s why health centers like Connecticut AHEC and other programs network together to offer medically disadvantaged farmworkers well-being services. To ease the workers’ burden of getting to appointments, that’s also why physical therapy volunteers head to the fields, McClure said.
Volunteers show farmers rehabilitation exercises, as some workers may never be able to step foot in a doctor’s office, let alone a massage therapist’s room, to address shoulder, neck or back pain issues.
McClure added that the time with physical therapists is “very well received by the workers.”
Other nonprofits, like th North Carolina Farmworkers’ Project, have successfully utilized the massage volunteer model to benefit migrant farmworkers.
Based out of Benson, North Carolina, the project’s focus is on educating local farmworkers on how to receive health services. Volunteers also offer medical check-ups and massage services at special community events to assist the underserved population of migrant farmers.
The project has set up a partnership with nearby Campbell University’s physical therapy department to get students training hands-on. Students visit with farmworkers during health fairs to demonstrate stretches and offer complimentary massages.
Migrant Farmworkers’ Clinics
Proof of the need for migrant health care centers is in the numbers: 165 such centers exist nationwide. Yet, few centers offer massage as a healing option, even though back pain is a commonly reported problem among workers.
Some centers do provide back pain clinics, like the Southern Jersey Family Medical Centers, which offers health services to migrant workers on farms in five different counties throughout New Jersey.
The center celebrates affording 40 years of community health services to the migrant population this year. Evidence of the center’s popularity is recorded each season, and more than 10,000 migrant workers get free care through the nonprofit, many for issues like back pain, said Sharine Davis, director of marketing and community affairs.
The center sends a medical van filled with providers to farms daily during the season, offering health screenings to workers on site. While many of the workers prefer complementary therapies like massage, those options are not available just yet.
Davis said referrals are often made instead, but having massage therapists on-site would be ideal.
“That would be fabulous to bring in the massage therapists. We have not done that,” Davis said.
Davis said therapists who are open to volunteering would be more than welcome on the medical van trips to the farms.
“I think it’s a great idea,” she said.
More Range of Motion, Less Pain
Lydia Sivel-Irons, L.M.T., owner of The Flexible Farmer in Hadley, Massachusetts, knows first-hand the challenges of getting farmers to book a massage: She grew up in a family of farmers.
She also worked on farms herself, discovering personally how beneficial massage for keeping a hard-working body healthy. Deep tissue work is particularly helpful for farmers, but consistent treatment to prevent common farming-related injuries like low back spasms and torn rotator cuffs is key, she said.
Once farmers finally give in and get treatment, Sivel-Irons said, they are usually grateful.
“I once had a client who had a severe case of torticollis (rye neck) from looking over [his] shoulder on the tractor. His wife had to practically drag him in to see me, but after a session he had more range of motion and less pain,” she said.
Sivel-Irons added that convincing one worker about massage benefits sometimes brings in more clientele.
“The next day he was good as new, and he has sent his whole family and crew to me for regular treatments,” she said. “He is a true massage convert.”
In her work with migrant farmworkers, Sivel-Irons admits there is difficulty when it comes to translations, which is why she doesn’t often get to work with that particular clientele.
Sometimes, though, just getting a client in the door and being open to a massage is the first step—but, again, this can often be a challenge with migrant laborers who have limited time and funds.
From Sun-Up until Sun-Down
From sun-up until sun-down, migrant workers toil in produce fields in the heat of the day.
The work is not easy.
The center’s doctors provide on-site checkups and screenings for health issues like blood pressure and diabetes. Back pain is also often addressed through education on proper posture and stretching.
While massage is not a provided service, Davis, of the Southern Jersey Family Medical Centers, said partnering with a local massage school would certainly benefit the workers.
“They’re hunched over the whole time picking,” said Davis. “I could imagine [massage] would be a tremendous help to them. I imagine it would alleviate the stress that their body experiences being out in the sun all day, and I’m sure it would provide some comfort to them.”
Network, Volunteer, Teach
Bobbi Ryder, president and CEO of the National Center for Farmworker Health, advises massage therapists to network with local community and migrant health centers to volunteer on site or offer a sliding fee scale for farmworkers.
“I think that a massage therapy regimen would benefit migratory or seasonal agricultural workers as much as it would benefit you or me,” said Ryder. “If there are massage therapists who can afford to work for a nominal fee, and do not have the burden and expense of a salon, it is possible that a mutually beneficial arrangement could be worked out.”
Teaching opportunities are also available for massage therapists, she added.
“The other option would be to teach agriculture workers or health center staff how to train the workers and their families on how to strengthen their core so that they can protect themselves from damage,” she said.
Additionally, massage therapists interested in volunteering at community events—festivals for farmworkers in particular—can learn more about professional development options online through articles and other resources.
According to studies done by the National Center for Farmworker Health and similar organizations, migrant farmers are open to complementary therapies such as massage based on historic and cultural patterns of ancient civilizations. The Mayas of Central America and Southern and Central Mexico are quite interested in holistic measures, according to an August 2011 National Center for Farmworker Health study.
That preference among indigenous farmworkers continues today.
Another study by the National Center for Farmworker Health found that traditional healers like herbalists, spiritual healers and massage therapists are preferred by the indigenous working in the United States.
Ryder has seen that trend in her 30-plus years of working with migrant workers.
“I believe that farmworkers appreciate alternative therapies in addition to the miracles of medical science, as they often have lived in areas where there is no physician available,” said Ryder. “Necessity and the wisdom of their cultural upbringing provide them with alternative options that most gringos think of as second-class medicine.”
Unfortunately, many migrant workers report pain as just part of the job. A small study of Hispanic workers found that acute and chronic musculoskeletal pain and injuries were commonplace, and even expected.
Motivated therapists, like Sivel-Irons, however, know that perception can be changed through the healing powers of massage.
“Because most [farm employees] will have never have had a massage, you want to impart how much massage can help to heal and prevent injuries,” she said. “It’s not just a luxury.”