Wine Notes: Health care comes to vineyard workers through Salud mobile clinics
Published: Tuesday, August 30, 2011, 8:00 AM
On a sunny Wednesday morning in August at Knudsen Vineyard, Allen Holstein climbs up the steps of a white bus and offers his arm. The bus is parked on a patch of grass dotted with wildflowers in front of a stand of Douglas fir; behind it are neat rows of grapevines, each supporting a few tight bunches of tiny and still-green grapes.
Holstein is the vineyard manager for Argyle Winery, and he's leading by example, showing his team of workers that it's OK to get on this bus and have his blood pressure checked. Not that he had much trouble convincing them to come here. "My guys are happy to come in, particularly if it's on paid time," he says with a chuckle.
The bus, from Adventist Health, is actually a mobile clinic, set up to efficiently provide annual checkups to many patients in a short window of time. It's here and at other sites throughout the Willamette Valley all summer long, thanks to Salud, a local winery-powered nonprofit that has been providing health care to migrant workers for the past two decades.
Outside on the grass, nurses measure the height, weight and body mass index of each laborer. Once on the bus, the patients receive blood pressure, diabetes and cholesterol screenings as well as tetanus shots -- essential for workers who often are exposed to rusty wires.
Jose Sanchéz, tall and affable, steps up to be measured and weighed. Originally from Jalisco, Mexico, Sanchéz now lives in McMinnville; he has been a vineyard worker for Argyle Winery for four years. He drives a tractor and sprays pesticides; today, he's been tilling the earth between the rows of newly planted vines, turning over the soil to keep it soft.
Sanchéz has been attending these mobile health clinics three times annually since he started with Argyle: once for a health exam and twice for dental checkups. The great thing about Salud, he says in Spanish, is that, "Anyone can go -- they don't ask to see your papers. They just want to be sure that you are healthy."
There's an irony about a fine, expensive bottle of wine: In the United States, the fruit that made it was almost certainly nurtured and harvested by migrant laborers, many of them undocumented. These workers often sleep in tents, and their occupation can be backbreaking: Hours spent bent over, pruning or weeding, in the hot sun or pouring rain; carrying heavy buckets of grapes up and down steep hillsides at harvest time.
That said, the Oregon vineyard worker's lot is better than that of laborers in many comparable industries.
For example, food writer Barry Estabrook's new book, "Tomatoland: How Modern Industrial Agriculture Destroyed Our Most Alluring Fruit," exposes the shocking underbelly of the positively medieval Florida tomato industry: babies born deformed and workers sickened by chemical exposure, beatings and mistreatment, filthy living conditions, even modern-day slavery.
By comparison, the Willamette Valley wine industry is much more humane, and, through Salud, offers the only health care program of its kind in the U.S. In no other farming industry in this country, according to Salud organizers, do workers receive regular and comprehensive on-site, free medical assistance, no questions asked.
Of course, not every medical problem can be easily resolved. One 53-year-old laborer, short but solid, in jeans and a white shirt, his skin dark from the sun, sits on a portable treatment table that's set up on the grass as Melanie Sharp, a student in the physical therapy department at Pacific University, shows him some leg exercises. The laborer prefers not to share his name; Sharp later tells me that he fractured his knee eight years ago and never received medical attention for it. All this time, he has been performing demanding field work despite the painful injury.
"He's been in the program a long time," remarks Myriam Vazquez, a health educator with Tuality and Salud. "He always says, 'I'm fine.' We have to tell him to go and get treatment."
Barriers to care
As with so many agricultural industries, the Oregon wine-grape community can't provide health care to its laborers through normal channels because so many of the workers are seasonal; it's not clear how many are here legally and thus eligible for traditional health care coverage; and very few of them speak English.
And so, two decades ago, a group of winery owners and doctors got together to come up with a plan to provide health care to vineyard workers. Their program came together in 1991 when 18 Oregon wineries joined forces to plan an auction modeled on the Hospices de Beaune, the annual barrel sale in Burgundy that's said to be the oldest charity auction in the world.
The event kicks off every November on a Friday afternoon at Domaine Drouhin Oregon, where wineries offer barrel samples of their newest vintage of pinot noir, and participants bid on cases of special Salud cuvées. The next evening, a dinner and gala at Portland's Governor Hotel includes silent and live auctions for lots such as library wines and wine-travel experiences.
Because so many of the health services offered by Salud are donated, every dollar raised represents more than three dollars in health care services provided to vineyard workers, according to Leda Garside, Salud clinical services manager at the Tuality Healthcare Foundation, which partners with Adventist to provide the medical services.
The benefit auctions have raised an average of close to $700,000 annually for the past four years. In addition, the International Pinot Noir Celebration, the Dundee Hills Winegrowers Association, Willamette Valley Wineries, McMenamins and individual wineries such as Winderlea and Raptor Ridge all run programs that benefit Salud.
Still, all this fundraising isn't enough to cover every vineyard worker in the state. The mobile clinic visits approximately 50 sites each summer season; at present, it only serves 40 percent of the vineyard workers in the Willamette Valley. But those who are able to use the services benefit hugely.
"Hypertension and diabetes are very common in the Latino community," Garside says. "People come to the U.S. and start making changes in their diet and lifestyles. We want to catch these issues early. We encourage them to keep walking, moving and continue eating those traditional foods, like beans and rice, fresh salsas, fresh fruits and vegetables -- all the things that they had in their home country. And to substitute oil for lard."
The goal is to get the workers eating healthfully, so as to avoid related health problems, such as diabetes or kidney failure, in the future.
In addition, Salud provides education and information for workers to take home to their families, connecting workers' wives with obstetric and gynecological services and their children with pediatric care. At today's clinic, participants are taught how to examine a breast for lumps and receive handouts on how to prevent their children from being exposed to pesticides.
When program participants are hospitalized, says Garside, "We help them through the entire process." For less serious medical issues, Salud connects patients with community health centers, such as the Virginia Garcia Memorial Health Center in McMinnville, for continuing care and low-cost prescription medications. "You have to close the circle," Garside explains. "You can't just say, 'Here are your test results, have a great day.'"
As the morning session draws to a close, 11 vine tenders in dirty boots and baseball caps gather in folding chairs to go over the results of their examinations. They listen attentively as health educators present quick, lively lessons in fluent Spanish on topics such as dental health, STD awareness and cancer detection. A special segment this year focuses on alcohol, tobacco and energy drinks. Yes, energy drinks: In a line of work where dehydration and heat stroke are real threats, an energy drink full of sugar and caffeine can wreak havoc on the body.
"It's a pretty comprehensive program," vineyard manager Allen Holstein reflects. "It started out as just tetanus vaccines, and now they're doing vision testing and dental care. I call it the 'Compassion Department.' "
Follow Oregon's wine scene with Katherine Cole on Twitter at twitter.com/kcoleuncorked and on YouTube at youtube.com/kcoleuncorked.
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