Our Patients

Our mission has always been to serve and provide care to the underserved

Mexican migrant and seasonal farm workers (MSFWs) and their families represent the majority of patients the KLC serves. The seasonal farm worker population lives in Knights Landing and the smaller community of La Tijera year round. The migrant farm worker population lives in Knights Landing and the nearby migrant labor camps from February/March-August each year. 

Mexican MSFWs and their families are a highly vulnerable and underserved population that is difficult to care for. In the U.S., there are an approximate 3 million MSFWs whose work enables a multi-billion dollar agricultural industry to thrive.1 According to Rosenbaum & Shin, “California is the largest domicile state, representing 30% of all farmworkers.”2 In Yolo County where the KLC operates, it was estimated that 20,521 MSFWs and the family members who accompany them lived there in 2000.3 These farm worker families contribute enormously to this state’s economy yet they “confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care.”2 The farm workers themselves “are often in poor health and they are at elevated risk for an enormous range of injuries and illnesses.”2
The Mexican MSFWs in and near Knights Landing are part of this largely uninsured California farm worker population that also has low medical care-seeking behavior in the U.S. In California, approximately 91% of crop workers were Mexican-born in 1999 and a survey of a cohort of this group that year suggested that 73% of them were uninsured, 25% had never had a medical or clinic visit, and 38% of the undocumented compared to 23% of the documented had not had a doctor or clinic visit in the U.S.4 In fact, the Mexican migrant subpopulation uses several strategies to resolve health problems and seeking medical care in the U.S. is not the primary one: a) self-medication, b) telephone consultation with relatives, c) utilization of private services (in U.S.) d) travel to border towns, e) return to place of birth, f) getting medical care during their visits to places of origin.5
Migrant farm workers face other obstacles to seeking medical care that contribute to preventable poor health outcomes. Other than insurance, other barriers migrants face when wanting to seek medical care include finances, fear of deportation, working long hours during clinic hours, and transportation.6 Ralston & Escandell add that discrimination and lack of knowledge of the U.S. healthcare system and English language skills are also contributing factors.7 The preventable poor health outcomes associated with this limited medical care include: chronic non-infectious diseases, allergic conditions, work-related physical injuries, and infectious diseases.6

Apart from the MSFW population aspect, the KLC serves a rural community that faces the low resource environment that plagues most rural areas across the country. In late 2010, Knights Landing community members shared that their community had been steadily losing resources vital to its wellbeing. The first loss was the migrant clinic. Then, the public park and the teen center were closed. Afterward, the community clinic, CommuniCare, which operated from the Yolo Family Resource Center (YFRC), stopped offering services in 2008 because the small volume of patients was not enough to financially sustain the clinic. This meant that in order to see a doctor and purchase medications, many community members, mostly housewives with young children and the elderly, would need to travel 20 minutes by public bus to the city of Woodland. Woodland, also being the closest source of affordable & fresh fruits and vegetables, caused the limited bus hours to compound the obstacles to healthy living. For the farm workers that did seek medical care, the situation was an almost complete deterrent to accessing medical care, as they worked during the time that clinics in Woodland operated. 

In reaction to this looming poverty and deteriorating social capital, a group of predominantly monolingual, Spanish-speaking, farm worker housewives and mothers surfaced as leaders. They formed the “Grupo de Mujeres” (Women’s Group) as a way to discuss and advocate for the needs of their community. Not long after, the Knights Landing Community Engagement Project (KLCEP) was established to support the “Grupo de Mujeres” in opening a local source of healthcare in Knights Landing. UC Davis professor Natalia Deeb-Sossa and UC Davis medical and undergraduate students formed the KLCEP and saw it as a means to use a community-centered approach to advocate for the underserved farm-working community within Knights Landing, CA. The objectives of the KLCEP were to: (1) establish a local source of free primary care services for the citizens of Knights Landing that are uninsured and or lack access to health care, (2) to provide culturally and linguistically sensitive health care, and (3) to engage UC Davis undergraduate, graduate, and professional students as advocates of a vulnerable population and as medical/public health volunteers in a rural area that suffers the health and social repercussions of unmitigated under-service.
The “Grupo de Mujeres” and the KLCEP, in partnership with Rural-Program In Medical Education (Rural-PRIME) at the UC Davis School of Medicine, the Yolo Family Resource Center, and the California Rural Legal Assistance Foundation, persuaded Clínica Tepatí to open its first satellite clinic in Knights Landing. In January 2012 the Knights Landing Clinic opened its doors and became UC Davis School of Medicine’s 8th student-run clinic. The clinic is run by volunteer physicians and nurses as well as volunteer medical, masters in public health, and undergraduate students. It is a clinic that since its inception remains a community engaged organization.

References:

  1. Facts about Farmworkers. 2012; http://www.ncfh.org. Accessed February 18, 2013, 2013.
  2. Rosenbaum S, Shin P. Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care. Kaiser;2005.
  3. Larson AC. Migrant and Seasonal Farmworker Enumeration Profiles Study: California. 2000.
  4. Villarejo D, McCurdy SA, Bade B, Samuels S, Lighthall D, Williams D, 3rd. The health of California’s immigrant hired farmworkers. Am J Ind Med. Apr 2010;53(4):387-397.
  5. Nigenda G, Ruiz-Larios JA, Bejarano-Arias RM, Alcalde-Rabanal JE, Bonilla-Fernandez P. [Strategies by Mexican migrants in the USA to seek health care]. Salud publica de Mexico. Sep-Oct 2009;51(5):407-416.
  6. Clark PA, Surry L, Contino K. Health care access for migrant farmworkers: A paradigm for better health. The Internet Journal of Health. 2009;8(2).
  7. Ralston ML, Escandell X. Networks Matter: Male Mexican Migrants’ Use of Hospitals. Population Research and Policy Review. 2012:1-17.