Monica Gomez Reflection

Monica Gomez, one of the class of CO2023’s Global Health Certificate Program participants, provides her thoughts on a recent case study below.

Global Health Certificate Program Field - Inside Wake PA Feb 2022
Reflecting on last week, I realized there were a couple different aspects in this case that could be identified as a Global Public Health issue. Hepatitis, unprotected sexual encounters, and the migrant farm worker population are all topics that have to do with the global population. For this assignment, I am choosing to focus on the migrant farm worker population. This case was set right here in North Carolina, in Surry County, which is not very far from Winston-Salem - yet the case was one that included a non-English speaking patient. I was glad that we had a case that addressed a population that not many people are familiar with. I think it is easy for some to say, “I am not really sure about what migrant farm workers do,” and leave it at that. However, it is a completely different approach to sit down and take the time to understand who they are and what they do. I was proud of my IBL group’s passion in addressing the importance of looking further and educating ourselves more.

For me, I think this case reinforced the value in changing and updating policies to better serve our patients. Instead of just identifying that there is a problem and obstacle that arises with non-native English language patients, policy has been put in place to help enhance their care. My thoughts on this subject are that all people regardless of occupation, financial stability or language are entitled to healthcare as a human right.

The most meaningful learning that took place during the IBL case was the in-depth research about what a typical day looks like for a migrant farm worker. It was heartbreaking to learn the conditions they spend their days in. I also was unaware of the large number of migrant workers that work right here in North Carolina – totaling approximately 150,000. When reading more on the NCFAN website it was frustrating to learn that only 10% of the farmworkers report having health insurance through an employer health plan. With all the injuries that can occur on the job such as chemical/nicotine exposures and having to work in extreme conditions, I would expect that out of necessity they should have some form of health insurance. The majority of workers are here while their families are still in their home country - even though that was not the case for last week - it still made me think about the lack of family that they would have for care or support and how that could be an obstacle.


Hands in Dirt - Global Health - Inside Wake PA Feb 2022
I was also surprised to learn in my research that using family members or children under the age of 18 to translate in the room for the patient, is illegal as stated in the Affordable Care Act of 2016. The translator is required to have gone through the certification process. There have been many times when I have been asked to translate, or when the family member in the room was asked to translate without giving the patient the option to use an interpreter or blue phone system. I think this is disappointing, it has reinforced the importance for me that all our patients deserve and should receive equal care.


As a future clinician I plan to do my best to understand my patient’s community and be open to constant growth. I am never going to know everything about every patient’s culture or community, but I will actively do my best to continue to educate myself on the barriers my patients could possibly face receiving care. I understand that everyone has some form of implicit bias, we are all human and shaped by our own life experiences. However, I plan to try to uncover these biases not just in myself, but in my future work environment by holding my fellow coworkers to a higher standard. The goal is and should always be our patient, addressing these situations are only meant to better improve the care provided to our patients.