Skip to comments.For Oaxacans, a struggle with health services
Posted on 07/05/2004 7:23:00 PM PDT by JackelopeBreeder
[Note: This is a long read, but worth it. This is how small town California has to deal with the illegal alien problem -- but with a strange twist. It is not the usual sob story; it gives some depth to the whole miserable mess and raises some very ugly questions.]
Immigrants contend with economics, culture in pregnancy
As she shepherds scores of Monterey County's most vulnerable mothers-to-be through their pregnancies, Celia Serrato has learned to communicate without words.
Two-thirds of her patients at Clinica de Salud in Greenfield are indigenous Mexicans from the impoverished southern state of Oaxaca. Many speak native dialects and don't understand Spanish, so Serrato, the head of the prenatal program, has become an accomplished mime.
With gestures and expressions she tells the women to take their medicine, regulate their diets and submit urine samples.
In blue medical scrubs on a recent afternoon, Serrato employed some of her tried-and-true gestures even though her young patient spoke some Spanish.
Do you work with many chemicals in the lettuce fields? she asked. How much sleep do you get? Do you have diarrhea? Do you know how to read?
The 24-year-old woman in Serrato's narrow office answered quietly and tersely. Finally one question washed over her and left a smile in its wake.
"Tomas café?" Serrato asked. Do you drink coffee?
"Si, café con leche," she replied with a giggle. Coffee with milk.
Serrato shared the laugh while breaking the news that caffeine would have to go. The patient, just recently arrived from a small village in Oaxaca, left with some other doctoral admonitions and a follow-up appointment.
"For someone who's been here about three months, to already be connected into the system, it's good," Serrato said between appointments. "Because oftentimes there's fear and they don't know what to do."
For several weeks now the social service providers who struggle to keep Monterey County's migrant workers healthy have been agonizing over the case of one such young woman who remained beyond their reach.
A teenager living in Greenfield, like Serrato's patient a Oaxacan migrant in the country for only three months, is facing criminal charges for allegedly abandoning her baby. She is accused of leaving her newborn girl floating in the portable toilet where she had just given birth on June 17. She had been working in a butter lettuce field near Soledad.
Beyond its own tragic repercussions, the facts of the case contain troubling echoes of other recent incidents. At least four other young women from Oaxaca have been accused of abandoning their babies in Central California since 2000. In fact, each of the three babies known to have been abandoned in Monterey and Santa Cruz counties over the past four years had been born to Oaxacan mothers.
Experts in immigration and migrant health are quick to point out that women of all national and ethnic backgrounds have faced similar accusations, and that if any pattern exists, it is most likely a function of the difficult circumstances facing Oaxacan women in California.
Many Mexican Indians from states like Oaxaca speak indigenous dialects, not Spanish. The language barrier is especially high for this class of immigrants, who tend to fill the region's lowest-paying jobs. Most are in the country illegally to do the work that keeps Monterey County's agriculture and tourist industries afloat.
"The immigrant women who've more recently arrived from southern Mexico are among the most isolated and vulnerable -- almost I would say traumatized -- people in our whole region," said Paul Johnston, head of the Citizenship Project, a Salinas organization that guides immigrants to citizenship.
"Unfortunately, our social services system is not prepared really to respond to their needs."
A publication by the National Abandoned Infants Assistance Resource Center at the University of California at Berkeley says that while research on the subject is limited, available literature suggests that abandoning infants is not "limited to certain races, ethnicities, or incomes." Rather, a "fundamental similarity among these cases is the seemingly self-imposed silence and isolation during pregnancy."
Silence and isolation
The Mixtec Indian teenager from Greenfield who now faces criminal charges apparently went through her pregnancy in such a state of isolation. It is not clear if she even knew she was pregnant, said her lawyer, Miguel Hernandez.
"She's overwhelmed," he said. "It's like she's in a shell right now and very timid and it would take a lot to draw her out."
Detailed information about the teenager and her situation has not been available as her family and authorities keep tight-lipped while the case works its way through the juvenile court system.
In the other recent cases that have now been legally resolved, isolation and difficult circumstances are common threads.
In late 2002, 24-year-old Juliana Martinez Dionicio, a migrant from a remote Oaxacan village who can neither hear nor speak, gave birth in a backyard dog kennel in the San Joaquin Valley town of Livingston. Prosecutors initially thought she might have tried to choke the infant, so she was charged with child endangerment.
In a series of hearings, a line of translators went from crude sign language to her family's dialect of Triqui to Spanish to English. Eventually charges were dropped. It remains unclear how Dionicio was impregnated, although press reports indicated she may have been raped.
Last month in San Jose, a 33-year-old woman from Oaxaca left her newborn son in a shopping cart behind a bar. Prosecutors declined to press charges because she called 911 to alert authorities shortly after leaving the baby.
On the Central Coast, Virginia Lascarez, 23, was sentenced to a year in jail for felony child endangerment and later deported after she left her baby in a Santa Cruz parking lot in 2000. Lascarez told police the baby was a reminder of a failed relationship with a man who left her after she became pregnant.
Lascarez abandoned her baby after being discharged from Santa Cruz's Dominican Hospital and put in a taxi. The circumstances were similar to Monterey County's last abandoned-infant case, in which Anna Maria Aguilar, 28, was arrested in early 2002 after leaving her newborn on the steps of a Seaside house. She went there after giving birth at Community Hospital of the Monterey Peninsula, where she was discharged and put in a cab.
The Lascarez and Aguilar cases both raised questions about whether hospital officials should have done more to intervene and inform the new mothers of the state law that allows parents to give up their babies at hospitals within 72 hours of birth without penalty or prosecution.
In the Lascarez case, an internal inquiry at the Santa Cruz hospital found that the staff there had ignored several warning signs, including the mother's lack of interest in the baby. At the Monterey hospital, however, officials said they had done everything possible to assess Aguilar's situation before discharge, and had no hint that she might abandon the infant.
Aguilar had three children in her native Oaxaca. Her husband left for the United States to work and when he stopped sending money home Aguilar decided to trek north herself, said Juliet Peck, the public defender who represented her.
When her husband rebuffed her, Aguilar assumed the role of breadwinner. She joined the roving fieldwork circuit, and at one point became so desperate for money to send home to her children that she had sex with another fieldworker for cash, Peck said.
Aguilar became pregnant from the encounter, but when she ran into a cousin and followed him to Monterey County, she hid her condition because she was afraid the family would shun her.
After giving birth she became lost walking around Seaside with the baby, which she left on the steps of a nearby house where she heard Spanish.
"It was just such a profoundly difficult time for her," Peck said. "She had just gone through nine months of this solitary pregnancy and was left to wander the streets carrying this large baby in a car seat and still bleeding from a tear that she had suffered."
A judge eventually sentenced Aguilar to probation, saying she showed "remorseful contrition and sacrifice" and that her actions seemed driven by poverty and despair.
The Greenfield experiment
This past Wednesday, such woeful stories provided a thick subtext for the monthly Oaxacan community outreach meeting in Greenfield.
Oaxacan migrants now make up about one-quarter to one-third of the South County farm town's population of 12,000 people, according to Police Chief Joe Grebmeir. The chief, along with officer Francisco Ceja and City Councilman Agapito Vazquez, have spearheaded the community meetings to educate immigrants on the ins and outs of U.S. law. They have convened special gatherings to talk about timely topics such as driver's licenses or scams targeting immigrants.
By coincidence, they had long planned last week's meeting to be a discussion about health care and teen pregnancy.
In the bright gymnasium of Greenfield High School, a small group of Oaxacans sat listening to officials explain how to access health services.
Although the community meetings have drawn upward of 200 people, turnout this evening was light. The event had to compete with a United Farm Workers march in Soledad in response to recent Border Patrol activity. Plus, it is the peak of lettuce season and many Oaxacans were still hard at work in Salinas Valley fields well into the evening. Linda McGlone of Monterey County's teen pregnancy prevention program addressed the crowd in English and Spanish. Eulogio Solano Donato, who volunteers as an interpreter for the police, translated into the Mixteco Alto dialect.
McGlone later said that Greenfield has the nation's highest teen pregnancy rate for girls under 17.
"All of the risk factors are here," she said. "You have poverty, you have low education and you have an overall cultural acceptance of starting a family when you're young."
The problem lies not in Mexican culture or American culture, but in a volatile mix of the two. Although Oaxacan women often have children when they're young, McGlone said, there is an emphasis on marriage and family stability. That is then eroded by the influence of American culture.
All of which left those in the Greenfield High gym on Wednesday with a daunting task. With attendance so poor, much of the burden shifts to people like Donato and Feliciano Santiago Velasquez, the Mixtec translators who are respected figures in the local Oaxacan community. They function like elders in rural villages: Information filters down from them.
"These meetings have created a vital support system for the Oaxacan community," said Velasquez, who wore a black baseball cap reading "Dios es Amor," or "God is Love." Donato, who came to the United States in 1991 from the village of San Jose de Las Flores, said that over the years it has been a struggle to interact with authority figures who were confused to encounter Mexicans who did not speak Spanish.
When the discussion turns to the teenage mother accused of abandoning her baby, Donato was adamant that the Oaxacan culture is not to blame.
"Es un problema mundial," he said.
It is a problem of the world.
Bonnie Bade, a medical anthropologist at California State University at San Marcos, specializes in the study of Oaxacan migrant health issues. She rejects any ethnic pattern to abandoned infant cases. However, she says the economic hardship suffered by Mexican Indians who work the fields in California cannot be ignored when looking at the issue.
Bade cites studies showing that California farmworkers have widespread medical problems and poor access to health care. Most lack health insurance, and their extreme poverty -- the average California fieldworker earns between $5,000 and $10,000 a year -- breeds unhealthy and dangerous living conditions.
"It all has to do with the economic circumstances," she said. "Because we have this dependence in California on this cheap labor."
Oaxacans have been coming to California for decades, and there are now more than 100,000 living throughout the state. In Monterey County, migration from Mexico's indigenous south has taken off in the last several years, experts say, and the local Oaxacan population is estimated at several thousand. The county's Oaxacan population encompasses three main ethnic groups: Mixtec, Zapotec and Triquis, each with its own dialect.
Back in Oaxaca, which stands at the bottom of Mexico's economic pecking order, migration to El Norte has become so common that men between 18 and 35 years old are rare in rural parts of the state.
Veronica Aragon, 21, of Seaside, emigrated from the village of Santa Inez with relatives when she was a young girl. Residents of her village struggled to grow corn, beans and alfalfa.
"It was just waiting for the rain to come, and if the rain didn't come, our crops were basically ruined," she said.
Researchers like Bade blame the North American Free Trade Agreement for hastening migration by bottoming out the price of Mexican crops while flooding the market with U.S. imports.
"You have all kinds of global situations that are increasing migration out of Mexico," Bade said. "That's why you're starting to see the Oaxaqueños and Mixtecos in the Salinas Valley."
Hurdles of distrust
Grebmeir became Greenfield's police chief after a Border Patrol raid in 2001 greatly divided the community. As he tried to heal the wounds and improve his department's relationship with the local Oaxacans, he encountered some surprising hurdles.
"I realized we had a couple of issues. One, that the Oaxacans were being victimized inordinately," Grebmeir said. "And two, they were more afraid of the police than the people robbing them. They have an inherent distrust of government."
Karina Lehrner, who works with Oaxacan women as a board member for the Citizenship Project, says it is a misperception that Oaxacan immigrants are a drain on U.S. social services.
"In fact," Lehrner said, "they're terrified by anything having to do with government. Actually getting them into any government building is often difficult, if not impossible."
Maria Giurato, a county Department of Social Services employee, has traveled to Oaxaca to do health training. She is in regular contact with the Mexican consulate.
"We're dealing with some deep-rooted customs," Giurato said. "Right now our schools and our health facilities are having to be creative in how we get information out to them." At Clinica de Salud, where Serrato and her colleagues reach across barriers of language, culture, poverty and shame, Serrato tells of women who stoically stick with their back-breaking fieldwork all the way through pregnancy. A few years ago a woman showed up at the clinic for her first visit and gave birth the same day.
"A lot of these women, it's amazing their pain tolerance," said Serrato.
Martina Alvarez, a Triqui Indian from the village of Rio Venado, explains that many of her peers do not seek medical care because of the language barrier, the cost and difficulty understanding the system. And, she says, because Oaxacans "are not used to going to a doctor."
"There's no explanation for how we can get care and some women are afraid because there is little or no support," she said. "Especially if you don't speak Spanish."
Some linguistic data for that scenario we were discussing...
All hospitals these days have a telephone translation service available - from any language to english and back. The ER just calls the service on the phone and hands one phone to the patient with the doctor on the other. Simple.
Doesn't sound like the type of people who would trek thousands of miles risking their lives just to take advantage of American welfare programs.
Their real motivation must be to cause Buchanan the Traitor to choke on a meatball.
Lived in Oaxaca a few moons ago, and may I mention that the women not only knew how to give birth, but nursed in the public square. Of course, that was offensive to the tourists, but they gave it a pass because it was so picturesque.
For most major languages, yes. It's very hard to find interpretors for minor dialects like these. I've bumped into a few from Oaxaca and Chiapas here at the border and they only knew a few words of Spanish.
It is probably pretty hard to find an interpreter for Mexican Indian languages. Pretty arcane languages, and probably pretty hard to learn too. It just shows you how isolated these folks are.
A good analogy would be to the Highland Scots of the 19th century. Even though they lived in Great Britain and mostly emigrated to English-speaking countries, when they arrived in the US or Canada (mostly Nova Scotia or the North Carolina mountains), they usually didn't speak English because there were few if any schools in the Highlands, and the Highland Scots couldn't afford to send their kids to school anyway.
Most Mexican-Americans (and Mexican immigrants) are of mestizo background, or even if they are of Indian ethnicity, they don't speak any Indian languages.
Most of the people speaking Indian languages are in remote, mountainous areas, and there are a lot of different languages spoken in Oaxaca and Chiapas (e.g. Mixtec, Zapotec, Mixe, Chinantec, Zoque, Tzotzile). Some are Mayan, and some belong to totally different language groups.
I did a study back in 1991 for a certain government agency on what languages were still in use in this old world. There were literally thousands. I originally tried to draw the line at languages with at least 10,000 speakers (about 1,700 meet that criteria), but some very minor ones were deemed of strategic importance and I just got sucked in further and further as the data accumulated.
I imagine. With the WoT a number of arcane languages have become more important. Chechen, for instance (it's related to Basque, IIRC, so it's got to be pretty hard to learn) but there are Chechens attacking our soldiers in Iraq and Afghanistan, and training European Muslims in chemical warfare and "martyrdom operations", so it might be worth learning.
As for the government of this country and the do anything for a buck crowd who hire these illegals, go to hell.
You're far more polite than I am.
That's only because I fear arrest and possible incarceration. A real test of my character would be my behavior after being diagnosed with a terminal illness.
But, but, but the Cato Institute and the Heritage Foundation said just the opposite would happen and everyone's lives would be improved.
How many of those 3,000-4,000 Oaxacan migrants in Greenfield are here legally? If "most are in the country illegally," at least 1500 Oaxacans in Greenfield (or 12.5% of the town's population) are illegal aliens. If the border patrol visited similar towns, they could round up many illegal aliens.
The chief, along with officer Francisco Ceja and City Councilman Agapito Vazquez, have spearheaded the community meetings to educate immigrants on the ins and outs of U.S. law. They have convened special gatherings to talk about timely topics such as driver's licenses or scams targeting immigrants.
... explain how to access health services.
Are these community meetings voluteer work, or do the officials get paid for holding them?
turnout this evening was light. The event had to compete with a United Farm Workers march in Soledad in response to recent Border Patrol activity.
Choosing between a chance to learn (for free!) how to improve their lives and an opportunity to attend a meaningless political rally, apparently many of the migrant workers chose the latter. Perhaps it is because of their choices that they typically are poorly educated and have not learned English or Spanish.
... McGlone said, there is an emphasis on marriage and family stability. That is then eroded by the influence of American culture.
Why do people always think American culture is such a bad influence? Plenty of good Americans strongly value marriage and family, although perhaps the vast silent majority isn't as noticeable as the more promiscuous people who work in the arts and media.
That was before we all got NAFTA-shafted.
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