SLOCOMB, AL - Many of the Mexican men and women picking green beans, peaches and strawberries in this lush, southeast corner of the state are fearful about seeking health care since a tough new immigration law was enacted last year.
Marisela Clemente, outreach coordinator from Slocomb Family Health Center, is trying to ease those fears one farm at a time. She joins eight workers taking a break at 150-acre Aplin Farms. After joking with the men and women in Spanish, she asks about their health and urges them to visit the nearby migrant clinic, where the staff speaks Spanish and doesn't require proof of citizenship.
"We have to go to them because they are afraid to come here to the clinic," says Clemente.
Such clinics, part of a 50-year-old federal program that treats migrant and seasonal farmworkers, have become flash points in the national immigration debate.
Local, state and federal law enforcement authorities have staked out some migrant clinics, detained staff taking patients to medical appointments and set up roadblocks near their facilities and health fairs as part of immigration crackdowns, according to federal reports and interviews with clinic officials in Alabama, Arizona, Florida, Georgia, New York and North Carolina.
"We are looking at a growing climate of fear where folks really think long and hard about accessing basic services," says Milton Butterworth, who oversees outreach migrant health services for Blue Ridge Community Health Services in Hendersonville, N.C.
Even many legal workers do not seek care at the health centers because they are fearful of exposing family members who are not legal residents, says Tara Plese, a spokeswoman for the Arizona Association of Community Health Centers. "It's a big concern from a public health perspective."
Those concerns include making sure farmworkers' children are vaccinated, stopping the spread of infectious diseases such as AIDS and treating those with chronic problems such as diabetes, officials say.
Backers of the nation's 156 migrant clinics say caring for all farmworkers is a humane way to treat 3 million people toiling at the heart of the nation's food supply. About half are illegal immigrants , according to the latest federal survey in 2009.
Federal aid opposed
Conservative groups say the federal government shouldn't pay for those here illegally, except in emergency cases. "These people have a responsibility to take care of their own health needs," says Ira Mehlman, spokesman for the Federation for American Immigration Reform, a group seeking stricter immigration laws.
In 2010, the federal government spent $166 million to help care for nearly 900,000 migrant farmworkers, who pay on a sliding scale. A visit in southeast Alabama averages $30.
A report in November found that immigration enforcement fears kept workers from getting care at centers in Alabama, Florida and Georgia.
"There have been credible reports of roadblocks and raids near health clinics, giving farmworkers good reason to be afraid," said the report by the Florida Association of Community Health Centers. It said 82% of surveyed migrant providers indicated that in the past year "there have been incidents of farmworkers or immigrants in their area being arrested or intercepted in the process of accessing health care services."
In December, a caseworker for Finger Lakes Migrant & Community Health in Upstate New York was pulled over by federal border patrol agents while driving two farmworkers to a dentist. She was handcuffed, detained for several hours and accused of transporting illegal immigrants. The farmworkers were taken to a detention center. The caseworker wasn't arrested, but the incident shook up the staff, CEO Mary Zelazny says.
Daniel Hiebert, U.S. Border Patrol deputy chief patrol agent in Buffalo, says the case was a "single incident," and not part of a crackdown on care providers. But he notes that it is illegal to transport illegal immigrants, whether knowingly or not.
Gillian Christensen, a spokeswoman for U.S. Immigration and Customs Enforcement, denies that her agency targets clinics to find illegal immigrants.
Outreach is pivotal
Since Alabama's law took effect in September (several provisions are blocked pending court review), the Slocomb Family Center has seen a change: The clinic's annual health fair at a local church in September drew 74 people, down from 300 in previous years.
"People feared immigration services would be there," says Melissa Bradford of Southeast Alabama Rural Health Associates, which runs the center.
Maria Lopez, who has worked at Aplin Farms for several years, says the center helped treat her back pain and arthritis. "They are very good for me," she says.
John Aplin, whose family owns Aplin Farms, says he welcomes outreach staff because they help keep his workers healthy. Noting that state troopers have set up nearby roadblocks, he adds: "They say they are looking for drugs, but we know who they are really looking for."