TURNER — Maurice Logan’s lower back had been hurting for weeks. It wasn’t enough to stop the 44-year-old Jamaican man from working at Ricker Hill Orchards harvesting apples, but he still ached for relief.

He knew going to the doctor would have been expensive. A migrant worker, Logan sent all of his money home to support his wife and four children, and he didn’t relish the thought of using a chunk of that limited income to make his pain go away. 

So last Thursday, as the sun set over the orchard, Logan signed up to get help from the Maine Migrant Health Program. The program’s new medical van had just parked next to the workers’ bunk houses in Turner and physician assistant Sara Roberts would see him for $5 — or for free if he didn’t have the money.

The 10-minute physical in a small, well-equipped exam room uncovered no nerve damage or severe injury. Roberts diagnosed muscle strain, offered Tylenol or ibuprofen and advised Logan to use the rest of the pain relieving cream he’d gotten during one of the van’s past visits. Although his back still hurt, Logan enthusiastically shook Roberts’ hand and smiled broadly as he left the tiny mobile exam room. He felt better just hearing his back pain didn’t mean a major health problem.

“Thank God they are here,” he said.

For 17 years, the Augusta-based Maine Migrant Health Program has traveled from farm to farm throughout Maine, offering basic health care and counseling to thousands of migrant workers, domestic seasonal workers and their families. The program’s three mobile units typically include an exam room or two and are stocked with basic medical supplies, medication and the kind of equipment found in a family doctor’s office. The vans are staffed by one or two medical professionals, a social worker and an outreach coordinator, paid and volunteer.

Recently, the program received $200,000 in grants from the Maine Health Access Foundation and tens of thousands more from the Massachusetts’s-based Jane’s Trust to buy a new van to replace the mobile unit the program started with 17 years ago. The original van was so old that wallboards were buckling, cabinets were coming off the wall and the spongy section in the floor had to be covered by plywood. Because there was no room to hold counseling sessions inside the van, social workers had to talk with farm workers about topics like depression, anxiety and alcoholism under a tent pitched nearby.  

The new van houses a private counseling space and two exam rooms. 

“It really does make a difference. The workers are moved by the fact that there’s this lovely space for care to be provided. They’re not used to someone thinking so much about them,” said Barbara Ginley, executive director of the Maine Migrant Health Program. “It has made a difference . . .  having that feeling ‘I matter to someone else.'”

The program estimates there are 8,000 to 10,000 migrant and seasonal workers in Maine, both Americans and foreigners. Those workers are often recruited to work in fields and orchards harvesting broccoli, blueberries, apples and other goods.

“If you think of the role farm workers have in our lives in terms of providing fresh fruits and vegetables to help keep us healthy, to me there should be a reciprocal piece of insuring our farm workers stay healthy,” Ginley said.

Some workers don’t have insurance. Others have some form of insurance but still must pay for their first doctor’s visit or more, a sum many would rather send home than part with for health care. Some don’t have an easy way to get to a doctor’s office. Others don’t quite trust doctors they’ve never met before.

“The first year when they came around I thought, ‘Well, this is a joke, because (my employees) are already getting health care if they need it,'” said farmer Harry Ricker of Ricker Hill Orchards. “But what happens is these guys come up three or four times a year and my employees have gotten comfortable with them and say, ‘Well, you know, I have this old ache and pain’ or ‘I’ve had this toothache for two months.” And they get them taken care of, which is definitely a good thing for (employees) as far as their quality of life.”

Thursday evening, more than 30 Jamaican workers returned to their bunkhouses at Ricker Hill Orchards. The new health care van was waiting for them, its second visit this season. Within minutes, one man asked to be seen for a pain in his knee. Within a half hour, two others signed up, one with wrist pain, one with back pain. Within an hour, a half dozen people were on the list to be seen, including one who needed a diabetes check and one who wanted to talk with the social worker as well as Roberts, the physician assistant.  

Horace Noad, 57, has asthma, was experiencing sinus pain and, in a thick Jamaican accent, admitted to Roberts that he had shortness of breath “every time it’s cold.” After a brief exam, Roberts concluded Noad’s asthma was under control but his sinus problems needed help. She gave him a small paper bag with eye drops and a small supply of sinus pills.

Noad said he’d been to the mobile medical unit before and liked it.

“They give me medication for my health and it helps,” he said. 

He wasn’t sure whether he would have gone to a doctor otherwise.

By the end of the night, a dozen workers had signed up, including Logan.

Logan, who has picked apples for seven years, also visited the mobile unit before. During the very best harvest season he could make up to $400 a week, he said. During poor seasons, he’d make a lot less. All of his money goes to his family in Jamaica. Like Noad, he wasn’t sure he’d see a doctor if not for the van. 

“It’s a nice program,” he said. “It’s helped me a lot.”

ltice@sunjournal.com