Simon Machuca, 59, of Mecca gets blood pressure checked by medical assistant Susana Sanchez at Centro Medico Thermal on Wednesday December 02, 2009 in Thermal, Calif. / Marilyn Chung, The Desert Sun
Did you know?
The unincorporated communities of Mecca, Oasis and Thermal have fewer than 10 physicians serving more than 22,800 people. The World Health Organization recommends one physician per 1,000 patients.
To compare, Palm Springs has 242 physicians serving a population of roughly 46,800.
Source: Riverside County Center for Demographic Research; World Health Organization and Riverside County Economic Development Agency
Farmworker health care
Here's a closer look at where Coachella Valley farmworkers received health care services in 2006.
48 percent received care from valley health clinics.
24 percent traveled to Mexico for their health care needs.
15 percent received care from a private hospital or clinic.
11 percent never receive health care services.
2 percent said other places such as the emergency room or drug store.
Source: 2006 Coachella Valley Farm Worker Needs Assessment Survey Report
How to help
To help, contact Judee Cox, CEO of the Regional Access Project Foundation in Palm Desert.
Created by the Board of Supervisors in 1989, the RAP Foundation provides grants to address unmet health needs and juvenile intervention in eastern Riverside County.
Last year, RAP distributed roughly $900,000 to local charities.
Cox can establish a fund or direct donations to a specific east valley organization.
Call (760) 674-9992 or write the foundation at 75-105 Merle Drive, Suite 800, Palm Desert, CA 92211.
The uninsured
In 2008, the farming industry generated more than $1.2 billion in Riverside County — $503 million in the Coachella Valley alone.
A 2006 Riverside County report on Coachella Valley farmworkers found that 78 percent in the Coachella Valley earn less $15,000 a year. Health care was identified as the “most helpful” service for their family.
Among the report's findings:
87 percent of respondents did not have health insurance.
Nearly half, or 44 percent, do not receive health care services or do so only for emergencies.
Farmworker health
More
In the shadow of the Coachella Valley's country clubs and multimillion-dollar homes is an area where more than 1,200 people recently lined up for hours to see visiting doctors for free.
One man's tooth was so rotten, the infection reached his ear. Another registered a blood sugar level of 500, more than 300 points above normal. Donated prescription glasses were doled out so patients could see, and much-needed medicine was distributed.
The eastern Coachella Valley's health care situation has reached crisis level, said Yvonne Bell, CEO of Clinicas de Salud, which operates health clinics in Coachella and Mecca.
The situation shows no signs of improving immediately for two primary reasons: About 20 percent of residents lack health insurance, and the area is woefully short on doctors.
Budget-strapped Riverside County also is limited in its ability to assist, which means private and nonprofit groups are desperately needed to provide financial assistance.
“Just the sheer amount of people waiting so long is a statement of the enormous need,” said Dr. Raul Ruiz, an emergency physician at Eisenhower Medical Center in Rancho Mirage and a Coachella native.
He volunteers with the Flying Doctors, who visited the eastern Coachella Valley on Nov. 14.
The doctors typically visit Third World countries to help the sick, but twice a year they make an exception and come to the eastern Coachella Valley for the day.
“I think it's astonishing that they land not more than 30 miles away from one of the richest cities per capita in the U.S.,” Ruiz said.
Many suffer from muscular and skeletal problems because of their physical work, allergies to dust and pesticides, painful kidney stones, and diabetes.
“They've been unable to have any care, so they just simply suffer,” said Dr. David Morgan, a founding member of the Flying Doctors.
“The need in the Coachella Valley is as great as any place we've been, whether it's Mexico or Central America,” said Morgan of Lincoln in Northern California. “You can't tell the difference at all. It's exactly the same.
“We were asked over and over again for several years to do this work because no one else was doing it,” he said.
The reasons behind the east valley health care crisis are as straightforward as the solutions are multifaceted.
Health officials and immigration advocates blame:
Poverty
Rising health care costs
Lack of insurance
U.S. dependence on cheap labor
A constant influx of immigrants
Lack of doctors
In Mecca, Oasis and Thermal, there's roughly one doctor for every 3,000 people, Bell said.
By comparison, Palm Springs has one doctor for every 193 people, according to the Riverside County Economic Development Agency.
The World Health Organization recommends a doctor per 1,000 people.
“Private practices aren't going to come to low-income communities,” said Fred Deharo, director of corporate development with Borrego Community Health Foundation, which operates two east valley health clinics that serve roughly 1,500 people a month.
The lack of medical attention means health problems, even the most minor ailments, worsen without a physician's care or supervision.
About 15 percent of residents in the Coachella Valley lack health insurance, according to a 2007 report by the Health Assessment Resource Center in Palm Desert.
But in the eastern Coachella Valley communities of Mecca, Oasis and Thermal, one in five people and nearly nine in 10 farmworkers lack health insurance.
“We have the resources to eliminate poverty, but we choose not to,” said Bobbi Ryder, CEO of the National Center for Farmworker Health, a Texas group dedicated to improving health by providing information to universities, researchers and nonprofit groups.
“We have a very high dependence on cheap labor. We enjoy the lowest cost per capita for food than any other industrialized nation.
“A lot of times, we have a tendency to blame the immigrant, but if the jobs weren't available, they wouldn't be here.”
The problem endures because of a constant need to replenish this workforce as the second generation becomes educated and moves out of the fields, advocates say.
Ensuring farmworkers have access to quality health care means protecting everyone's health, Ryder said.
“If we don't care because of human nature, then we should care in order to protect the food source,” she said.
“You don't want sick people picking your fruits and vegetables.”
While the 700-plus nonprofit groups in the valley frequently fund raise for local charities — helping those afflicted with HIV/AIDS, homelessness, illiteracy and family abuse — few specifically address the chronic east valley health care needs.
“It's an embarrassment,” Deharo said.
“In these 10 years, we should have generated support from the feds, the state and local economies to build up services,” he said.
“It's frustrating that you have groups going into Duroville (a poor mobile home park near Thermal) to rescue dogs and there's a lack of response to the people that live there.
“I would hope at some point that we wouldn't need the Flying Doctors.”
Agencies step up
Officials at Desert Regional Medical Center in Palm Springs said the hospital was investing in a La Quinta expansion, but that JFK Memorial Hospital in Indio is better suited to meet the health needs in Mecca, Oasis and Thermal.
“We serve those areas on an emergency basis,” said Cliff Daniels, a hospital spokesman. “It's way out of our service area.
“We prefer the providers that already exist to (make) those investments.”
Michael Landes, president of the Eisenhower Medical Center Foundation, disagreed.
“All of us go into the business of health care because we want to help people,” Landes said. “Everybody, not just our service area.
“I think we all have a responsibility for the underserved, especially in the east valley. Period. I disagree that it's JFK's responsibility. They can't handle it. The east valley is huge and it can't be just their responsibility.”
All three hospitals have agreed to each give $50,000 annually for five years for a free clinic to open in summer 2010.
The late Riverside County Supervisor Roy Wilson worked to set aside $2 million to refurbish a building.
Eisenhower stipulated that the clinic should be in the east valley, Landes said.
Volunteers in Medicine, a national group that creates all-volunteer, free clinics, plans to create the center for the roughly 35,000 working poor in the Coachella Valley who do not qualify for government programs, said Dr. Ron Hare, president for the board of directors for the local VIM.
Meanwhile, the valley's only health care district is limited because it collects taxes up to a boundary, and that ends at Cook Street in Palm Desert.
“We're not immune to the problems that are down there,” Donna Craig, chief program officer of the Desert Healthcare District, said of the eastern Coachella Valley.
“We try and look and see how we can help in the district.”
In the past, the agency has provided grants to valleywide groups such as FIND Food Bank that can demonstrate they provide services to those within the district, Craig said.
New Riverside County Supervisor John Benoit said he will try to continue many of the same initiatives of Wilson, his predecessor.
“Roy was very, very active and I'll make a very aggressive effort to continue those programs,” Benoit said. “They're all going to be under tremendous pressure because of the shortfall in the county's budget.”
Lack of medical access
According to a 2000 report by the California Institute for Rural Studies:
A majority of the state's agriculture workers have unhealthy weights, a result of poverty and poor nutrition.
Nearly one in five male workers had at least two high-risk factors for chronic diseases such as diabetes, high blood pressure and obesity.
About 20 percent of emergency room patients do not have insurance, an expense that gets passed along to consumers. That drives up health care costs for everybody.
“Eventually, the system has to pay for the lack of health care,” said Dr. Frank Curry, medical director of the Emergency Department at JFK Memorial Hospital in Indio.
Nicole C. Brambila covers health and social issues.
She's been with The Desert Sun for four years and has covered stories ranging from immigration and hunger to same-sex marriage and the Esperanza wildfire.
You can reach her by e-mail at nicole.brambila@thedesertsun.com or by calling (760) 778-6445.
