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Binational Health Week targets immigrant health needs


By LAURIE DAVIS, Register Correspondent
Monday, November 7, 2005 12:06 PM PST


Mexico, like all countries, has its problems providing health care to its residents. But insuring all residents isn't one of them.

In Mexico health care is available to everybody -- a kind of health care-for-all system that many medical providers wish we had here in the United States. When Mexican nationals come to work in the United States, they don't always know what kind of health care services are available to them, where health services may be accessed, or what coverage they are entitled to as workers. Language and cultural differences can be intimidating, and they may be fearful of jeopardizing their future citizenship status by asking for help.

This and other concerns were raised recently on behalf of Mexican immigrants working in this country by Dr. Carlos Esquivel Duarte, a pediatrician visiting Napa as part of local events held during Binational Health Week in mid-October.

Duarte spoke to about 25 local physicians and other health and social service providers at Community Health Clinic Ole about how health care is delivered in Mexico so that providers here can better reach and serve the Mexican immigrant population. Most participants were bilingual and familiar with the daily struggle to meet the needs of a rapidly growing immigrant population.


"Much has been done in the Napa Valley to address health care concerns for immigrant families, but it is still challenging to connect immigrants with the help they need," said Catalina Chavez-Tapia, the lead local organizer for Binational Health Week in the Napa Valley. "I've seen it many times on the faces of people when they come to a community health fair. Many are simply bewildered by the health delivery system here. They are often afraid to step forward to ask for help, and are so grateful when someone just listens to them with compassion and care."

"When you are in pain or afraid, you need someone who will truly listen to you," Duarte said. "A Mexican immigrant is no different from anyone else in that they need to be treated with dignity and respect."

Mexico's universal health care program, modeled after elements of health care delivery in the United States and Colombia, was instituted by President Vicente Fox. It includes a "Cdigo de BioEetica" (Code of Bioethics) that calls for "respecting a person's dignity, promoting an environment of equality and a balanced distribution of justice" as part of addressing the physical, emotional and social needs of patients and their families.

There is also a "Carta de los Derechos Generales de los Pacientes," or Patients' Rights code assures Mexican residents legal rights to receive adequate health care; to be treated with dignity and respect, to be informed about their health status, to have their health information kept confidential, to be able to obtain a second opinion and to have access to local clinics and emergency or urgent care.

Despite the best of intentions, however, such guarantees do little to solve the problem of those who live in the mountainous regions, far from any clinics or hospitals. In some areas, it can take anywhere from one hour to a week, depending to the mode of transportation, to get to a doctor. Duarte says many physicians and health care providers try to visit the campesinos (farmers) in the remote areas as often as possible, but he feels more needs to be done to ensure health care is equally available to all. Mexico still has a serious problem with infant deaths due to diarrhea, something that could be addressed effectively with more health education and better access to health care providers.

The changing cultural composition of our workforce

According to statistics from Binational Health Week materials, there are nearly 27 million working Mexican-Americans and Mexican immigrants in the United States who contribute to the U.S. and Mexican economies.

The Latino population increased by 13 percent, making it not only the fastest-growing population but also the second-largest racial/ethnic minority in the country. California is home to 39 percent of all Mexican immigrants.

Census statistics put the total number of Napa County residents who identified themselves as being at least partially of Hispanic origin up from 59,792 to 71,426 in the last four years. Hispanics now represent 27 percent of Napa County's population.

People of Mexican origin also constitute a large part of several economic sectors, including agriculture and construction. Recent studies have estimated that 76 percent of Mexican immigrant males age 18-64 are in the U.S. labor force.

The logic behind Binational Health Week is that, given the contributions of Mexican workers to both the U.S. and Mexican economies, their health status and access to health care is being recognized by numerous health organizations as a bilateral responsibility.

First year for Binational Health Week in the Napa Valley

Binational Health Week workers conduct health promotion activities for Latino, including Mexican immigrants and migrants, on both sides of the U.S. borders with Mexico and Canada. This year, it expanded to include 25 states, Washington, D.C. and three Canadian provinces. This was Napa County's first year participating in the program.

Chavez-Tapia, who works as a Bilingual Community Services Coordinator at Queen of the Valley Hospital Community Outreach, joined with representatives from several local community health organizations to form local committee. Participants included Rosaisela Alfaro (St. Helena Hospital Women's Center), Gloria Castaon (Healthy Moms & Babies), Sue Nahass (Napa Valley Community Housing), Manuel Cordero (Napa Valley Community Action) and Elia Rubio (Clinic Ole).

The committee worked with the California-Mexico Health Initiative and the Institute for Mexicans Abroad to organize the activities, which included a health and wellness fair, a community health resource fair at Queen of the Valley Hospital, a Latina Women's Conference, a visit from the Mexican Consulate -- normally only available in San Francisco and a mental health workshop for Latina women.

"An important function of Binational Health Week is to show respect and appreciation for the immigrant and seasonal Mexican population living in Napa, for their important economic and cultural contributions to Napa County," says Dr. Robert Moore, medical director of Clinic Ole.

Like most of California's agricultural industry, Napa's grape growers, vintners and vineyard management companies rely on seasonal skilled labor, which comes largely from Mexico. According to Moore, an agriculture labor shortage in California this year underscores the need to focus on keeping seasonal workers healthy and happy.

"Napa County's forward-looking agricultural employers want to retain skilled seasonal workers by promoting health care," Moore said. "Some offer health insurance; others invite Community Health Clinic Ole to conduct health screenings, paying their employees wages to be screened."

Moore further notes that consistent access to quality health care for seasonal workers here and in Mexico is more efficient for workers.

"The first step toward this goal is to understand each other's health care delivery systems," Moore said. "Dr. Duarte's presentation to the bilingual physicians of Napa County helped us understand the health care system in Mexico."

Local funding for the Binational Health week came from the Community Foundation of Napa Valley, the Gasser Foundation, Queen of the Valley Hospital and St. Helena Hospital.

Napa Valley organizers estimate more than 700 Latinos and Mexican immigrants participated in the events, with the help of 45 community health agencies and more than 100 local volunteers

"This has been a huge success for our first year," says Chavez-Tapia. "We'll definitely be doing Binational Health Week again next year, further expanding services based on assessed community needs."