For Juana Acevédo, a waiting room at the doctor's office is far from an air-conditioned space filled with magazines and buzzing electronics. Instead, it's plastic patio chairs scattered between the clinics—two white RVs with "La clinica migrante" imprinted on the sides and tarp tents that serve as exam rooms and check-in stations. The temporary migrant health and dental clinics are stationed in a field adjacent to Finley Point Cherry Orchard, near Polson. Many of the patients work late into the night sorting the cherries they spent the first half of the day picking. Acevédo, who has picked for 15 years, waits with her six children, who all have the same rashes. The rashes turn out to be nothing more than swimmers' itch—not the bed bugs or pesticide-induced irritation the family thought them to be.
"We see the whole gambit," says Helena nurse Marilyn Greely. "They come in with a lot of skin problems from the insecticides and pesticides on the trees or open wounds from falling."
Primary and preventative care are the clinics' main focus, Greely explains. Greely has worked in the clinics for two years and says that work-related injuries are comparatively low. Most patients are more interested in the free health care and basic dental work they can't afford elsewhere.
The clinics are provided and staffed by the Billings-based Montana Migrant and Seasonal Farmworker Council, better known as the Montana Migrant Council. MCC Executive Director Claudia Stephens estimates the healthcare network treats about 500 migrant workers in the Flathead every summer. "They're very isolated and hard to reach," Stephens says. "It makes it very hard to give them the services they desperately need."
The Migrant Health Program, founded in 1971, gets its funding from the U.S. Department of Health and Human Services. The MCC has three permanent clinics in Billings, Fairview and Dillon that serve different populations of seasonal agricultural workers employed everywhere from Hutterite farms to commercial cattle ranches. But on the Flathead, everything's mobile.
The majority of the workers that flock to the Flathead live in the Yakima Valley in Washington, which is famous for its variety of crops. Many of the seasonal workers who call it home travel a circuit that includes picking onions in Oregon, potatoes in Idaho and cherries in Montana. Others stay in the valley to prune grapes in the winter and pick asparagus in the spring. Juana Acevédo's family starts the summer picking cherries in Washington before migrating in mid-July to the Flathead to pick the late season of cherries. When they return to Washington in mid-August, they pick pears until the apple season begins in the fall.
Families like the Acevédos only travel in the summertime, when their children are out of school. Rita Acevédo, 18, and her sister Mayra, 16, moved to Ranger, Wash., from Michoacán, Mexico, with their parents, Juana and José, when they were toddlers. This is the second year the family has come to Polson to live and work in the Glacier Fresh Orchards. The family lives in one of the multiple cabins provided to workers by Glacier Fresh in a camp between the orchards, where workers relax during their mid-day break. The girls laugh as they remember how their mother used to work in the fields until she was eight months pregnant. They turn serious when they remember how she fell from a ladder and landed on a box when she was pregnant with their little brother Ángel. Neither was seriously injured.
These children have been in the fields all their lives. "Our mother used to bring us to the field or the orchard when we were babies and set us in empty boxes," Rita says. "Then, when we were about four or five, we got our own little buckets and started helping our parents." Now, Montana state law mandates that children must be 14 or older to legally work in agriculture. Programs such as the Flathead Lake Migrant Education Program at Polson Middle School provide summer education and childcare for migrant children while their parents work.
For three days in July, the Flathead clinic visited Polson Middle School to offer primary check-ups for children. "We go over basic nutrition and dental care with the children as well," Greely says. "You see a lot of kids who are overweight and have decayed teeth as babies or toddlers."
The clinics plan their dates of operation around the time the workers say they will return the next summer. This year, the clinics opened on July 16, as workers started to arrive. The season was expected to last until Aug. 11, but on July 20 word started to spread through the valley that the factories were prematurely full and no more cherries were needed. It could mean the workers will go home to Washington weeks early. If so, the clinics would return to Billings.
But many of the workers may decide to wait another week in case more work shows up. "It's a world based on temporary schedules," Rita says, moving her chair under the awning of their cabin to escape the rain. "And sometimes that world is just day-to-day."