I recently went to a talk by M.D./PhD. Seth Holmes, who has worked with migrant farm workers to understand the social context which affects their health and health care.
As an M.D. with a PhD. in Anthropology, Seth Holmes has a unique multi-disciplinary perspective on the health issues surrounding migrant workers. For his study, he observed the treatment of indigenous Triqui Mexicans both on farms and in clinics in the Skagit Valley.
What he essentially observed was a social hierarchy with subtle racist reinforcements in Triqui farm life and clinic visits. This hierarchy determined health disparities, with Triqui Mexican workers having the worst health.
His ideas on how the interpretive lenses of local physicians normalize an ethnic stigma around migrant workers were particularly insightful. This is not a fault of theirs, as Holmes pointed out, but it brings the value of anthropological thinking to the forefront. Physicians were not aware of the social stratification on the farms because structural and symbolic violence diminished that awareness and perpetuated charged ethnic stereotypes. Holmes observed that one physician commented, "They like to work bent over." So, Triqui Mexicans are being blamed for their own health issues, which is not in the least productive in their recovery and general well-being.
A medical degree which included cultural anthropology and community health curricula would let M.D.'s treat the unique person with the social context of that person in mind. This is probably the most effective when treating cultural or ethnic minorities, but I think it is important for any patient-physician relationship. In the case of the Triqui workers, what good does it do if a doctor prescribes rest to someone who will be made to work just as hard to make a quota? How is the clinical gaze limiting the care of Triqui patients? Ideally, adequate care for Triqui workers would address the interaction of social, environmental, and biological factors which influence their health and well-being on the Skagit farms and in the community at large.
The rift between hard medical science and social science is not the only factor in the treatment of migrant workers in the Skagit and across the United States. Semantics has a large part to do with it, too. One can't turn on CNN without seeing news perpetuating terms like "illegal alien." "Undocumented worker" is a bit better of a label, but a label nonetheless. Associating these words with migrant workers brings attention only to the illegality and the "criminality" of their state of being. Those labels become attributed to a seemingly intrinsic nature that they may or may not possess.
