My Ag Worker Health Champion Story - Joan Altenbernd

Wow, what can I say? Thirty-seven years working with Migrant Health Service, Inc. (MHSI) was an amazing opportunity. I began as an intern in the mid-seventies while I was in college, then was hired for a one-year position as a health educator, and over the years I transitioned to Executive Director. 

What did I learn over the years?
I learned the inner workings from a dedicated administrative staff, including an amazing and creative Executive Director, Ann Zuvekas. The program provided access to health care services to 8,000-14,000 farmworkers and their families in a two-state area of Minnesota and North Dakota (with the majority of care provided in a 8-10 week period of time each summer) through the operation of fifteen seasonal nurse-managed health clinics. There were no cell phones, no electronic health records, no fax machines or scanning capabilities. We utilized family charts and telephones at the health centers (which were rented spaces in the small communities - churches, storefronts, social service buildings, etc.). Health center staff provided care through home visits, voucher referrals to local providers, coordination with migrant schools, and evening clinic services.

I learned how challenging it was to have such a large service area which included two states, two regions, spanning over 45 counties. I learned how rewarding it was to have voucher referral agreements with over 300 service providers throughout rural Minnesota and North Dakota. I learned our program was quite different from many migrant programs as we had only two areas where farmworkers lived in migrant camps (southeastern Minnesota - corn harvest and asparagus picking). The remaining farm worker families worked in the Red River Valley for over 1300 individual growers.

I learned that the health center staff were creative and very resourceful in working with the farm worker families. I learned that home visits were often times challenging for the health center staff due to the sheer numbers of farms, location of housing and hours families worked. In spite of these challenges, home visits were the most rewarding for health center staff and appreciated by the farmworker families.

I learned that the farmworkers and their families who traveled to Minnesota and North Dakota each summer from South Texas were some of the hardest working, family focused, proud, and talented people I have known. They came to work in sugar beets, potatoes, small grains, asparagus, corn and cucumbers. I learned that changes in agriculture (space planting and chemically resistant seeds) impacted the work lives of the migrant farmworkers. Jobs were eliminated for many people. I learned that the migrant workers were resilient, finding other jobs to fill in between spring planting and harvest employment, or going back to school and learning other trades.

I learned that I had great support and direction from our Board of Directors, project officers, fellow health center directors, HRSA grantee programs such as National Center for Farmworker Health, Health Outreach Partners, and the National Association of Community Health Centers. Minnesota was a foundation rich state and the state offered a number of grants and I learned how important it was to have their support and direction as well. While project reviews and annual audits were sometimes painful, I learned that MHSI and the patients served did indeed benefit.

While a majority of the folks served through MHSI had Spanish as their first language and, often times, their only language, I learned the farmworkers and their families shared what our family wished for as well: a solid education, fair pay, safe work and home environments, respect, health, and to practice their faith. 

While I continue to enjoy retirement, I am thankful others continue to work toward furthering the mission of migrant and community health centers. 

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