April 3, 2026. By Gabriella Morin.

The culture of Eastern North Carolina is deeply rooted in agriculture. From tobacco and
sweet potatoes, our farms fuel local economies and put food on tables across the state.
But behind every harvest is a workforce whose health needs too often go unmet.
As a medical student and public health researcher in Eastern North Carolina, I’ve
experienced firsthand, the living and working conditions of migrant farmworkers, from
pesticide exposure to the physically demanding labor they endure. I’ve also seen the
consequences repeatedly until it became clear that poor health does not guarantee
access to care.

Each year, thousands of farmworkers come to work in North Carolina through the H-2A
visa program to fill critical labor shortages. They work long hours, often six days a week,
performing some of the most physically demanding jobs in our economy. While safety
regulations exist, barriers such as language differences, limited health education,
transportation challenges, and lack of insurance continue to put workers at risk.

I saw this reality clearly while working in outreach in Western North Carolina. I still
remember the relief on Fernando’s face when I handed him the diabetes medication he
had gone days without, worried about what missing doses might mean for his health and
his ability to keep working. I remember sitting in a crowded emergency department late
into the night with a young farmworker and her husband after she began bleeding
unexpectedly midway through her pregnancy. I translated for them until nearly 2:00
a.m., explaining symptoms, answering questions, watching their fear grow with the fast
pace of medical providers assessing her. What stayed with me wasn’t just the medical
urgency—it was the fear layered on top of it: fear of the cost, fear of a healthcare system
they didn’t understand, and fear of what might happen next. Without community
support, her chance of receiving timely, compassionate care would have been uncertain.
These experiences are not isolated. According to farmworker health research in North
Carolina, fewer than 20 percent of farmworkers in the state receive regular
health care, and 20% of farmworkers in Eastern North Carolina lack basic
information about where to go for medical services. For workers living in rural
labor camps, clinics may be miles away, transportation is limited, and missing work can
mean lost wages or job insecurity. Preventive care becomes a luxury rather than a
standard.

These realities shaped my work as an Albert Schweitzer Fellow in Eastern North
Carolina. Alongside my colleague Maribel Reyes, I helped bring chronic disease
prevention education directly to farmworker communities. We traveled long distances
to labor camps, often on their only day off for the week, to share meals and
conversations centered on realistic, practical health strategies.

What we found was powerful. When education respected culture and daily realities,
engagement followed. Participants spoke openly about wanting to stay healthy for their
children, to keep providing for their families, and to avoid long-term illness. Small
changes, switching from regular soda to diet, reducing excess oil in meals, waiting to
add salt, felt achievable. Many of the best ideas came not from us, but from the
farmworkers themselves, shared and strengthened through group conversation.
Education like this works because it meets people where they are. But education alone is
not enough.

Farmworkers also need easier access to affordable, local healthcare. Preventive services,
chronic disease management, and timely treatment for workplace injuries should not
depend on zip code. When rural healthcare systems fail to reach agricultural workers,
preventable conditions worsen, emergency visits increase, and entire communities bear
the cost.

Eastern North Carolina has a long tradition of pride in hard work and resiliency to life
challenges. Honoring that tradition means caring for the people who labor in our fields.
When we invest in farmworker health through education and accessible care, we invest
in the future of our communities and our state. When farmworkers harvest our crops
but cannot access our healthcare system, we fail both our values and our economic
interests.

I encourage you to support local organizations like Access East and Kinston Community
Center, whether financially or through volunteerism, both of which continue to reach
farmworkers and those in need with preventive training and medical care.

Gabriella Morin

2025-26 Jim Jones Schweitzer Fellow

ECU Brody School of Medicine, Class of 2028

The opinions expressed are the author’s own and do not reflect the official stance of the Fellowship or
University.