DAYTON, Ore. — It’s 2 p.m., two hours short of quitting time, when the pickup trucks roll in from the vineyards. Workers, all Latino, hop down from the truck beds; 10, now two dozen, 44 in all. They take seats in the shade of the Stoller Vineyards maintenance shop, chatting, laughing, still wearing their field garb: hats, hoods and head scarves to protect from the sun, long sleeves despite the heat, many with pruning shears in holders on their belts.
The green and white ¡Salud! Services van before them is a familiar sight by now. It is from Tuality Healthcare, which operates hospitals and clinics west of Portland and for more than 25 years has brought basic medical care to Willamette Valley vineyard workers. The van, staffed by bi-lingual nurses and medical assistants, provides blood pressure and cholesterol checks, vaccinations, treatment and referrals — about 5,000 patient visits annually. “¡Salud!” is like a toast in Spanish, meaning “cheers” or “good health.”
Oregon vineyards recognize a broader translation, and it is the reason they pay for the mobile medical service. The industry raises an average of $700,000 annually — including a record $928,000 in 2016 — with a two-day auction of their best Pinot noir wines.
The vintners’ broader interpretation of ¡Salud! is part of the van’s logo, which shows a kneeling worker tending a grapevine. It includes the slogan, “To Our Health,” because everyone in the industry benefits.
Hand in hand
Leda Garside, a registered nurse who manages ¡Salud! Services, is from Costa Rica and counts herself lucky. She came to the U.S. with an American husband, the proper papers and an education. Many of the patients she sees at the mobile clinic lack those advantages, yet they are the “backbone” of Oregon agriculture, she said.
It’s fair to say Garside’s work is widely admired within the wine and medical professions. One vineyard owner described her as “the rock of the whole place.”
Garside said the work is rewarding. Routine blood pressure and cholesterol checks provide early warning of hypertension, cardiovascular problems and diabetes. Flu shots and tetanus vaccinations aid people who routinely work outdoors and handle sharp tools, wire and the soil.
Some workers migrate to jobs depending on what is in season, others juggle two or three jobs, both of which complicate the time and expense of traditional doctor appointments. Some put off seeking help with medical problems, which can become worse with lack of intervention. For others, hospital emergency rooms, open all hours, become the treatment option for even minor injuries or illnesses.
When she was asked to advise and then take over ¡Salud! in 1998, Garside insisted the service had to be holistic to be effective.
“For some workers, this is it,” Garside said of ¡Salud! “Bringing the services to them fills the gap on that.”
Treatment and examinations at the mobile clinic are free. If the patient is referred to a partnering clinic or agency for further care, a stipend is paid to the provider by ¡Salud! on behalf of the patient and the patient is responsible for the balance. Those treated at a facility designated as a federally qualified health center can pay on a sliding fee scale based on income.
¡Salud! partners with Pacific University in Forest Grove, Ore., which sends a motorhome to accompany the Tuality Healthcare van. University students and faculty provide vision, dental and physical therapy exams and treatment. Tuality pays Pacific a stipend for its help; the students gain practical experience as they prepare for medical careers. Other partners receiving stipends include community clinics and Medical Teams International.
“We collaborate with other agencies to bring services,” Garside said. “We stretch that dollar until it’s ready to snap.”
Jose Reyna, a physical therapy professor at Pacific University, regularly accompanies the ¡Salud! van each summer. Vineyard workers often have lower back pain from stooping and lifting, and sore wrists and shoulders from repetitive picking or pruning motions are a common ailment. Reyna and his students provide massage and demonstrate stretching techniques.
The wine industry’s financial support for the service shows it is invested in the people who do “very taxing labor,” he said.
“Who else is going to harvest the grapes and tighten the lines?” Reyna asked.
A 2014 survey by the National Center for Farmworker Health, based in Texas, showed poverty is “pervasive” among the nation’s 3 million migrant and seasonal agricultural workers. About 30 percent of families reported total family income below national poverty guidelines.
“One of the biggest dichotomies with the agricultural worker population is that despite providing the hard work behind the foods that sustain us, they are a group that receives very few benefits and protections, and are frequently excluded from regulatory labor protections,” the center concluded in a 2017 report.
Access to healthcare is a major problem, with workers hampered in some cases by language or cultural barriers, a lack of money or transportation, low literacy and frequent mobility, according to the farmworker health center.
In the Pacific Northwest and California, agricultural workers had higher rates of asthma, hypertension and obesity than elsewhere. The Midwest had the highest prevalence of diabetes among farmworkers. Tuberculosis, hepatitis B and C, and sexually transmitted diseases are problems to varying degrees nationally.
¡Salud! grew from discussions in the early 1990s between a handful of vineyard owners and Tuality Healthcare doctors who had become acquainted due to a shared interest in fine wine.
Nancy Ponzi, of the pioneering Ponzi Vineyards in Sherwood, Ore., said the idea of a fundraising event percolated and emerged as a commitment to “do something to help our workers, especially the field workers who are at the bottom of the heap in terms of having access to social programs.”
“To my great surprise and pleasure,” Ponzi said, “the wineries were all for that.”
Ponzi said she originally presumed family planning would be one of the most important things the industry could offer Latino workers, but soon learned otherwise.
“This culture does not want to discuss family planning,” she said. “What they need help with is health.”
Then, as now, the vintners heard angry grumbles about health care costs, immigration policies and illegal “aliens” taking “American” jobs. Providing them health care was controversial.
“We were aware it was a political statement at the time,” Ponzi said. “We knew it was political, which was the reason I was happy to see the wine industry step up in spite of possible repercussions.”
Convincing the cautious medical bureaucracy to go along also took some doing. Ponzi said she and the other advocates countered with, “Look, if we can give service to this population and keep them out of the emergency room, that’s a big help to the hospital.”
The industry’s two-day ¡Salud! auction and black tie gala, held in November, provides about 90 percent of the funding needed to staff and pay for Tuality Healthcare’s mobile clinic, the staff’s case management work and partner agency stipends. A “Summertime ¡Salud!” fundraising dinner and tasting has been added as well. It’s on July 27 this year at Stoller Family Estate, tickets are $175 per person.
Ponzi said the program could be adopted by other ag sectors, such as the nursery industry, but so far it hasn’t been replicated. She said the workforce deserves support.
“We respect what they do,” she said. “This is not charity. It’s an obligation to protect these workers and their families.”