Fresh Fruit, Broken Bodies – A Doctor’s Journey among Migrant Farmworkers

Editor’s Note: After spending two years among indigenous farm workers in Mexico and in labor camps in the United States, medical anthropologist Dr. Seth M. Holmes documents how market forces, anti-immigrant sentiment and racism undermine their health and access to health care in his book, Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States. He spoke to NAM Health Editor Viji Sundaram.

NAM: Did you set out on this project as a purely anthropological endeavor, but which later changed into something more?

Holmes: Yes, as I said in my book, I set out as an anthropologist to do the classic field research method of participant observation with migrant farmworkers. I wanted to learn about indigenous Mexicans who come to the United States to work on our farms, about their health issues, and about how this group of people is perceived.

NAM: So how closely did you observe the indigenous farm workers?

Holmes: I started this research in rural Washington State, living in a labor camp and picking strawberries and blueberries along with them. We next moved to the Central Valley of California, to Madera, where we first lived homeless for a week in our cars, until we found a slum apartment willing to rent to people without a credit history. In Central California, we were not able to find much work; we pruned vineyards very intermittently. After California, I moved with them to their home village in the mountains of Oaxaca, Mexico, and lived in a partially constructed concrete home built piece-meal with money sent by relatives in Madera and Washington State.

NAM: Did you participate in any border crossings from Mexico to the United States?

Holmes: In the spring of 2004, several of us left the Oaxacan village and crossed the border through the desert into Arizona, where we were caught by the border patrol and put in jail. My Mexican companions were deported to Nogales, Mexico, and I was kept in jail for a day and then released with the charge of “entry without inspection.” The first chapter of the book tells the story of the border crossing through detailed field notes.

NAM: Did you notice any differences between the working conditions in Washington State and California?

Holmes: The contractor system in California meant that we were always paid below minimum wage when working there, whereas we were always paid at least the minimum wage in Washington State. In the contractor system, the farm officially hires only the contractors and puts them on payroll. The contractor, then, goes and hires farm workers. However, few farm workers are put on the payroll so that there is no legal paper trail and it is easier for them to be taken advantage of. On the farms in Washington State, on the other hand, each farm worker was hired officially by the farm and was paid at least the minimum wage.

NAM: In your book, you talk about the doctors at the clinic in the Oaxacan village, who lacked cultural and social fluency, which is why the Oaxacans were discouraged from going to it. Could their experience back home contribute to their reluctance to go to community clinics in the United States?

Holmes: It is not so much that the clinicians in the San Miguel clinic lacked cultural and social fluency, but rather that the ways all doctors are taught medicine and the ways all clinics work in the U.S. and Mexico made the clinical interactions so problematic.

In medical school in the U.S. and Mexico, doctors are taught to see and consider only biological or behavioral causes of sickness and illness. We (I am also a physician, so I will say “we”) are not taught to consider the economic causes of disease or social causes such as hierarchies related to structural racism nor their relationship to working conditions and living conditions.

NAM: Having seen first hand the suffering of border crossers both here and in their homeland, what kind of immigration benefits would you wish for your former Triqui colleagues? If the undocumented farm workers are put on the path to U.S. citizenship, and the borders are secured, would this country need to fear a shortage of indigenous farm workers in the coming years?

Holmes: My Triqui colleagues have told me repeatedly that they want legal permission to come to the U.S. to work during the harvest season and then they want legal permission to return home to their village in Oaxaca. They often return there if they become injured or sick, or when they become too old to work.

However, there are other farmworkers who very much want the right to follow a path to citizenship in the U.S. for themselves and their hard-working children.

Would immigration reform cause a shortage of farmworkers in the U.S.? First, it is important to state that when I was researching my book, there were no U.S. citizens who were willing to do the strawberry and blueberry picking that my Triqui companions did. At the beginning of one of the summers, there were four U.S. citizens who started picking, but, by the end of the summer, I was the only one left picking. The others had left the job primarily because it was too hard, too backbreaking, and paid too little without benefits.

The Agricultural Workforce Coalition, made up of farms, nurseries and the farm bureau, supports immigration reform and wants those who work on farms in the U.S. to be able to come and go legally without risking their lives on the U.S. border. The voices of farm owners as well as farm workers need to be considered in the immigration debates.

NAM: Current discussions in Washington, D.C. seem to indicate that newly legalized immigrants are unlikely to have health care for about 15 years despite paying taxes. How do you feel about this delayed access to health care?

Holmes: I spent 18 months living in labor camps, picking fruit on farms, migrating and crossing the U.S.-Mexico desert border with undocumented Mexican migrant farm workers, whom I found to be good hard working people. These folks are anything but a drain on the American economy.

I watched my farm worker companions give premature birth, develop injured knees and backs, suffer from extreme stress, experience symptoms of pesticide poisoning, and even have farm trucks run over and crush their legs. I watched these same farm workers avoid medical care whenever possible, continuing to work against difficult odds in order to care for their families and provide us with fresh fruit. In essence, they work so hard under such difficult circumstances that they are giving up their own health in order to give us healthy fruit and vegetables. These immigrants deserve health care.

NAM: How has your research changed you?

Holmes: I can no longer look at or eat a strawberry or a blueberry without remembering the sicknesses and injuries of my former companions brought on by the work they do. I can no longer listen to the immigration debates going on right now in Washington, D.C., without thinking about my Triqui friends, Macario, Samuel, Crescencio.

It is unfortunate, in my view, that the immigration debates are often so abstract and do not include the voices and stories of real humans who are immigrants.

Seth Holmes and Oaxaquenos

Seth Holmes and Oaxaquenos

Seth M. Holmes, Ph.D., M.D. is an assistant professor in the School of Public Health and Graduate Program in Medical Anthropology at the University of California Berkeley. He is the author of Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United State


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