More than just healthcare for Upstate New York undocumented farm workers

Isobel van Hagen
Aug 31, 2018 · 9 min read

Veronica, 32, moved from Mexico to Goshen, a town in upstate New York, 14 years ago with her husband Juan. While Goshen is only about two hours north of the city, being in the town feels like you somehow took a wrong turn and ended up in rural Idaho. Veronica and Juan went to Goshen to make some money as onion farm workers at Gordon Gardens for a while, then planned to return home to Mexico shortly thereafter. This was a time, Veronica said, where it was not so impossible to go back and forth between the two countries the US and Mexico. Their plan had to change once their son was born.

Once they realized they were stuck as undocumented farm workers in the middle of pretty much nowhere, Veronica began to wonder where she and her family would get healthcare — especially with her second child on the way.

Juan’s colleagues at the farm told him about The Alamo (so named by Texan farmworkers who thought the building looked like a smaller version of the real Alamo) where he and his family could get healthcare without insurance.

Tucked away in the middle of the sprawling farmland in Goshen, NY is “The Alamo”, a health center clinic that provides for the farm worker community. There are two buildings at the top of the dirt driveway — one is a small white converted-house with a sign that reads “Clinical Care — Doctor and Dentist.” The other is a large square stucco building

The job of migrant workers in Upstate New York is not a particularly easy one — hours are long and the work is physically demanding. The migrant worker population in Goshen currently is made up of mostly undocumented men and women from Mexico. Many of them live on the farms on which they work without much possibility of mobility, in any sense of the word. A major concern in places from undocumented people are living, particularly in rural places, is the fear surrounding healthcare. Especially with the recent administration, workers without papers are very unlikely to go to get clinical healthcare because they don’t have insurance, because they are afraid of being picked up by the police or ICE, or just because of a lack of trust in bureaucratic institutions. This is not to mention language barriers, fear of American clinical treatment, fear of being fired for taking a day off work at the farm, fear your doctor will give your name or address to ICE, fear of driving your car without a license, etc.

“Our top concern are people being afraid to get healthcare,” said a VP administrator at HRHcare. “So, we have big effort in Goshen to make clear that we’re not connected with ICE, and that we won’t share information with ICE.”

The Alamo is unlike any other clinic of its kind. It aims to close this gap in trust not only through a sliding scale clinical fee — a means of healthcare payment that doesn’t require insurance — but also through a kind of community center that most other healthcare clinics would perhaps consider a kind of overreach.

Kathy Breiger, the de facto boss of The Alamo, is a short brunette who wears baggy jeans and a fleece top every day to work. She worked in clinical healthcare in Goshen for more than 30 years as a nutritionist. Breiger helped to realize that the best way to abate the fear of receiving healthcare in undocumented communities, was to create a kind of solidarity at the clinic itself. She helped to design this new model by introducing a free hot meal every Sunday of winter. The Alamo offers a food pantry, clothing donations, ‘community’ rooms where farmworkers can come to socialize and relax, ESL classes, homework assistance, a new teen mother’s support group.

In the basement of the stucco building, there is a big open space with two long tables, seating about 40 farmworkers and their families. It was lunchtime on a Sunday, which meant people were gathering for the weekly hot meal. Today, the options were mac and cheese or pasta with meat sauce — most people took a healthy portion of both. Volunteers were passing out apple juice and Shakira played over a speaker. Kathy Brieger , registered nutritionist and Chief Staff Development and Patient Experience at Hudson River Healthcare, grabbed a man who was eating his lunch and made him dance a salsa-like dance with her. He laughed embarrassedly and sat down quickly.

Kathy turned down the music and made some announcements about the events going on next week, and everyone listened intently. As she was sitting down again to finish her lunch, she shot back up and said loudly, “Oh! Uno mas announcement! Uno mas! Lilliana made honor roll!” Lilliana, who is 13 and both of her parents are farmworkers, sank down in her chair and rolled her eyes but laughed. “God knows we are in need of some more doctors,” said Kathy. “Or maybe you’ll be a lawyer, and we are DEFINTELY in need of a new president — so she could be the next one!”

The job of migrant workers in Upstate New York is not a particularly easy one — hours are long and the work is physically demanding. The migrant worker population in Goshen currently is made up of mostly undocumented men and women from Mexico. Many of them live on the farms on which they work without much possibility of mobility, in any sense of the word. A major concern in places from undocumented people are living, particularly in rural places, is the fear surrounding healthcare. Especially with the recent administration, workers without papers are very unlikely to go to get clinical healthcare because they don’t have insurance, because they are afraid of being picked up by the police or ICE, or just because of a lack of trust in bureaucratic institutions. This is not to mention language barriers, fear of American clinical treatment, fear of being fired for taking a day off work at the farm, fear your doctor will give your name or address to ICE, fear of driving your car without a license, etc.

“Our top concern are people being afraid to get healthcare,” said a VP administrator at HRHcare. “So, we have big effort in Goshen to make clear that we’re not connected with ICE, and that we won’t share information with ICE.”

The Alamo is unlike any other clinic of its kind. It aims to close this gap in trust not only through a sliding scale clinical fee — a means of healthcare payment that doesn’t require insurance — but also through a kind of community center that most other healthcare clinics would perhaps consider a kind of overreach. The Alamo offers a food pantry, clothing donations, ‘community’ rooms where farmworkers can come to socialize and relax, ESL classes, homework assistance, a new teen mother’s support group, and during the winter months, a weekly hot meal.

Another key component in closing that trust gap, it seems, is Kathy herself.

Kathy has been working at Hudson River Healthcare for over 30 years, and worked at The Alamo even before HRHCare acquired it as part of their network in 1990. “See how this lunch is about more than just food?” She said as her husband Joe passed around bingo cards to everyone. “It’s really about a sense of community.” She also mentioned that times can be particularly tough during the winter in Goshen. Because everyone works on farms, there is very little, or even no work in the winter, so people may be living on as little as $25 a week. This hot food provided at The Alamo may be the main meal in a family’s week. “See how it feels like a big family dinner?” She asked. On the wall behind Kathy were two maps, one of Mexico, and one of the whole of Central America.

Kathy interrupted herself,

“Lilliana did I embarrass you? Yaneli — you need to get honor roll too!”

“I’m never really at school.” Yaneli, a freshman in high school, said while looking at her phone.

“Just passing isn’t good enough, you’re too smart. You’re one of the smartest people I know! Probably smarter than me for sure.” Said Kathy as she took a bite of mac and cheese.

Yaneli had mentioned earlier that she had been coming to The Alamo for as long as she could remember, and that, “Kathy runs the show around here.”

Kathy has been at The Alamo for so long that sometimes she will know 3 generations of families. “This weird thing will happen to me where I’ll say, ‘Hey that kid looks so familiar,’ and it’s because I knew their mother as a child as well.”

Veronica, who had finished up playing a round of bingo, went over to Kathy to ask about the Easter Celebration. Around the room hung pictures of the regular ‘members’, artwork by the children and local newspaper clippings. Easter would be the last day for hot lunch and English lessons, because they only run from January to April. Once spring comes around, most of the farmers are working all day, seven days a week so wouldn’t have time to hang out at the Alamo.

She told Brieger that her kids were really looking forward to it, but she may not be able to attend because of her new job. Breiger had introduced Veronica to Cecelia Moran, a social worker, who had helped Veronica to move on from her job of packing onion to become a personal care assistant in the town over.

“I like it so much better than working on the farm, it makes me feel much more useful.” Veronica said. Juan still works on the farm as a “handyman.”

Kathy turned to a couple, Veronica and Juan, and saidJuan came over, and Breiger said to both of them, “Michelle was so helpful today.” Their daughter, Michelle, was nine (“but almost ten!”) and had been helping Kathy make tortillas in the kitchen earlier. Michelle had also mentioned that she was looking forward to homework club that coming Tuesday.

Veronica and Juan came from Mexico to Goshen about 14 years ago. Veronica, 32, says they come primarily for healthcare, but also for the English lessons and the Sunday meal in the winter. She mentioned that she particularly liked the English lessons here because, while she could speak fairly well, the teacher also taught them how to write. Veronica is particularly good at English compared to her peers; “They always say to me, you should teach the class.” She said smiling.

Veronica worked for about 12 years packing onions at Gordon Gardens, a farm practically next door to The Alamo. She explained that she was lucky to have worked in the packing house, because there is often work all year round.

She now works in Warwick, a town nearby, as a personal care aid (PCA). “I like it so much better than working on the farm, it makes me feel much more useful.” Juan still works on the farm as a “handyman.”

Veronica met Kathy almost immediately when she came from Mexico — she had to come to the clinic for healthcare because she didn’t have any papers. She and her husband never expected to be here this long, they just wanted to make money and leave again While she does not fear going to the clinic to get healthcare for her or children, she still fears the government because she pays taxes.. “It’s But then we had kids, and we started paying taxes,” she said. “And that’s pretty scary because that means the government knows we’re here and there’s no place to hide, nowhere to go.”

Juan was helping to sweep up in the background, and Michelle, their daughter, showed pictures of her older brother. People were getting ready to go, and staff were asking who needed a ride home in a van.

“Without these other opportunities at the Alamo, my friends and I would just spend our whole lives on the farm or in our houses,” Veronica said. “We come to the Alamo because it’s not that expensive [for healthcare], it’s close and we all know Kathy.”

That said, while she and her family do feel close Breiger and the affordable healthcare is a draw, “Wwe don’t expect too much.” Because the price is so low and they have so many patients, the healthcare itself could perhaps be better. “But there’s nowhere else we can go to get treatment,” Veronica pointed out.

“To be honest,” Kathy said, “I got involved with all of this when I was 17. I was involved in the United Farm Workers campaign where I grew up in New Jersey. You’ve heard of Caser Chavez? I worked with his brother. I once met Dolores Huerta. But you know what? That was all about the political and it’s really all about the people.”