Farm Work and Flowcharts

By Michael Ladd, GHS master's student

Michael Ladd, UCSF Global Health Sciences master's student
Michael Ladd

Access to water. Dehydration. Water consumption habits and behavior. Barriers. Facilitators. These are the topics my capstone project is meant to address and elucidate. As I studied the literature and did my best to become an expert of sorts prior to starting field work, I began to see farm worker hydration and the factors that impact it as a flow chart:

a. Pay structure influences the likelihood that a worker will take breaks

         b. Workers who do not take breaks will drink less water

                    c. People who drink less water are more likely to reach a dehydrated state

                                 d. Dehydration leads to acute and chronic illnesses

                                             → Solution: Fix the pay structure, avoid illness, receive gold star

Of course, I was cautious of unknown complexities, but I began to construct explanations, unconsciously or consciously, under the assumption that I would need to make only minor adjustments.

It really is not that hard. I can fix this.

Then I started talking to people. I had lined up a few Sunday morning interviews at an office in the Central Valley. Coffee in one hand, digital recorder in the other, I began by thanking the participant for taking time out of her weekly day off of work to speak with me. The interview progressed and I was feeling great. She was hitting all the buzzwords and throwing out all of the important phrases. Then something happened. Her eyes became moist; her voice cracked. Tears still streaming down her cheeks, she continued. I paraphrase here:

I realize now that the American dream, for which I crossed borders and left my family, friends and culture, is not real.

I am not prepared. I have no tissues.

It turns out that many components of the flow charts I had mapped out, either on paper or in my mind, were pretty accurate. Pay structure does appear to be a real influencing factor in many people’s ability to stay well hydrated. The complexity of that issue, though, was not captured when I was attempting to look through my “science project” lens. I realized that I did not truly know farm workers. I could not predict or always understand the history, goals or values of this population, and addressing the most pressing issues rarely, if ever, involved a simple cause-and-effect relationship.

This was the first, but certainly not the last, conversation that resulted in a tearful expression of sadness, anxiety, pride or resolve. As I reflected and asked myself why I was caught off guard by these responses, I concluded that the answer lay, at least in part, in my ability to treat another’s pain and hardship as a science project. Indeed, I have the luxury of looking at farm worker health through the lens of a scientist, as a series of flowcharts, without getting distracted by the reality of the influencing complexities like figuring out how to support a family, raise a child and get ahead in life—in Spanish, “salir adelante.” I accepted this project because I felt passionately that no one’s job—the way they make a living—should kill them. This conviction remains, but my view has shifted: from interest to responsibility, from flowcharts to families, from science to lived experience.