ABSTRACT

North Carolina employs 78,000+ migrant/seasonal farmworkers (MSFWs) annually. Arrival/departure dates are crop and weather dependent. MSFWs may be employed by a grower or a farm labor contractor (FLC). Like farmworker housing, FLCs may be registered or unregistered. Primary care or enabling services are provided by the NC Farmworker Health Program or community health centers that receive dedicated federal funding for MSFWs. The arrival of NC’s growing season, MSFWs, and COVID-19 brought unforeseen challenges even to those experienced in caring for MSFWs. Challenges include congregate activities, consistency/accuracy of COVID-19 related communications, availability of alternate housing, barriers to testing and contact tracing, lack of internet connectivity in farmworker housing and insufficient personal protective equipment. Challenges are discussed in no order of occurrence or level of importance as many are inter-related. To meet these challenges, a migrant health and housing workgroup was convened. Members include the NC Department of Labor-Agricultural Safety and Health Bureau, NC Department of Health and Human Services – Communicable Disease Branch and NC Farmworker Health Program, NC Community Health Center Association and NC Agromedicine Institute. Members work collaboratively along the continuum from local to state levels and across agencies and communities to facilitate strategies to address COVID-19 challenges. Implications exist for practice, research and policy including testing of MSFWs on arrival with a 14-day quarantine before moving to assigned farm, a “strike team” to do on-farm tests for workers in the event of a positive case or exposure; and, research on COVID-19 outbreaks and impact of telehealth on MSFWs wellbeing.

摘要

北卡罗来纳州每年雇用78,000多名移民/季节性农民工（MSFW）。到达/离开的日期取决于作物和天气。MSFW可能由种植者或农场劳动承包商（FLC）雇用。像农民工住房一样，FLC可以注册也可以不注册。NC农场工人健康计划或社区卫生中心提供初级保健或扶持性服务，这些中心获得了针对MSFW的联邦专项资金。NC的生长季节，MSFW和COVID-19的到来，甚至给那些照顾MSFW的人带来了无法预料的挑战。挑战包括集体活动，与COVID-19相关的通信的一致性/准确性，可替代住房的可用性，测试和联系追踪的障碍，农场工人住房缺乏互联网连接以及个人防护设备不足。挑战没有按照发生的顺序或重要性的级别进行讨论，因为许多挑战是相互关联的。为了应对这些挑战，召集了移民健康和住房工作组。成员包括北卡罗来纳州劳工，农业安全与卫生局，北卡罗来纳州卫生与公共服务部-传染病科和北卡罗来纳州农场工人健康计划，北卡罗来纳州社区卫生中心协会和北卡罗来纳州农业医学研究所。成员在从地方到州以及整个机构和社区的连续过程中进行协作，以促进应对COVID-19挑战的策略。这对实践，研究和政策都有影响，包括在到达指定农场之前对MSFW进行14天检疫测试，或者在出现阳性病例或暴露时，成立“罢工小组”对工人进行农场测试；和，