The Sylva Herald, By Beth Lawrence

Vecinos, a nonprofit dedicated to meeting healthcare and other needs of Western North Carolina’s farmworkers, has had to change the way it delivers its services amid the COVID-19 pandemic.

The biggest impact to Vecinos has been the change in how it provides medical services, said Marianne Martinez, the group’s executive director. The organization previously hosted a free health clinic on the campus of Western Carolina University. When the campus closed the clinic was forced to close.

“I guess our last clinic was at the end of March, so we started right away offering telehealth,” Martinez said. “Since then about 99 percent of what we’ve done as far as medical stuff has been telehealth. We transitioned really quickly and have tried to keep that up to keep the contacts low in our population since it’s such a vulnerable population.”

Telemedicine itself presented a unique set of challenges. Clients sometimes do not have internet or smart phones to video chat, and cellular and internet service can be spotty, rendering video calls nearly impossible. After recent changes in formerly strict telehealth policies, visits are now allowed to take place by phone call.

However, some clients must be seen in person. When that happened early on, visits took place at Vecinos medical director’s office. A tent was set up outside, and providers wore full personal protective equipment.

The organization recently began offering clinic visits again albeit in an adapted fashion. Staff set up an outdoor health center under tents in Jackson County Department of Public Health’s parking lot after hours to see patients.

“We just had our first in-person clinic a week and a half ago,” Martinez said. “It’s just like an outreach clinic. It’s not very different than what we do for our migrant workers.”

Early on, Vecinos outreach team picked up, to some extent, where the clinic left off when it closed. They began visiting each migrant camp in the area.

“(They) gave health education and handed out hand sanitizer, facemasks and did check-ins,” Martinez said.

Martinez and her outreach coordinator spoke to farmers in the region to assess plans to protect their employees and themselves, gauge their needs and offer assistance.

An outbreak among migrant workers in Macon County in July allowed the organization to fine tune its response to the disease in a congregate living area.

“We worked really close with the grower to get everybody tested,” she said. “When you’re quarantined you can’t go to the grocery store or go out and do your own thing, so our team mobilized to get them groceries and get them all kinds of stuff. We did daily check-in calls either with outreach workers or the medical providers to make sure (exposed workers) were healthy and not having symptoms.”

Migrant workers are often deeply affected by reduced hours, unemployment or wages lost due to sickness. Vecinos raised funds to help with rent, utilities and food.

“A lot of these folks are in the frontline jobs where if you don’t work you don’t get paid, or it’s high exposure, hard to wear masks or they don’t have the resources available to them,” she said.

The group raised nearly $40,000 to meet the immediate needs of approximately 75 families.

The nonprofit also created a COVID Community Health Worker team to coordinate with community partners.

“They have three charges,” Martinez said. “The first charge is resource distribution. They’re doing these mask and hand sanitizer distribution events at different places. The second charge is to work with businesses and individuals to give out health education, going around to different businesses helping them make sure they have masks helping them make sure they have the right signage, going to different communities or worksites talking to different people.”

The team reaches out to businesses with a large Hispanic workforce.

The third goal is increasing the availability of tests for the Hispanic community. 

Like most everywhere else, that is a work in progress, Martinez said.