'Promotoras' a lifeline for the undocumented, sick and scared through COVID

MORTON — The aftershock of the largest worksite immigration raid in U.S. history had yet to fade when COVID-19 hit Mississippi this year. 

People started getting sick and Cliseida Rodriguez worried help would be limited. 

She was at the frontline of yet another humanitarian disaster and she knew the most vulnerable members of her community would need food, medicine and other basic supplies to survive the turbulence of the pandemic. 

She wasn’t alone. Rodriguez is part of a small collective of immigrant women known locally as the “Promotoras de Salud.” Since the pandemic began, the 12 women have helped distribute food, homemade masks, gloves and cleaning supplies to immigrant families in Morton, Forest, Carthage and Laurel on a near-weekly basis. They are also arming people with vital information to help them fight COVID-19. 

Wearing a blue T-shirt emblazoned with the phrase, “Aqui estamos y no nos vamos”— we are here and we’re not leaving — Rodriguez beams when she describes her self-appointed role:  

“Our people needed to know how to defend themselves. So we had to be able to talk directly to people. To know their fears, their worries and to get to know our community,” she said. “That’s why I got involved. So we could support each other and find strength with each other through this.”

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CLISEIDA RODRIGUEZ. PHOTO: BARBARA GAUNTT/CLARION LEDGER

Our people needed to know how to defend themselves. ... That’s why I got involved. So we could support each other and find strength with each other through this.

On a balmy mid-October afternoon, she stood underneath a carport surrounded by 99 boxes of frozen chicken, plums, apples and packaged foods. 

Thirty-three boxes were headed to families in Carthage, 33 to Forest and 33 would be distributed right there in Morton, according to the meticulous list her friend and colleague Ernestina Perez, 52, kept track of in a spiral-bound notebook. 

Under every town's name is a list of families awaiting food and supplies. “Carthage is here!” Rodriguez announced as a white pickup truck pulled into the carport. 

She has seen first-hand the impact of the raids and the pandemic in her own home. Her son suffers from asthma and is distance learning this year. She is also caring for the 10-year-old son of her best friend who was deported to Uruguay last year after the raids. 

Many of the workers and their families are undocumented, which means most can’t qualify or are too afraid to apply for unemployment benefits, rent relief or other social services during the pandemic. They’re uninsured and primarily speak Spanish or indigenous Mayan languages. A deep-seated distrust of authority figures — exacerbated by the raids — has prevented many from getting tested and seeking medical care, advocates say. 

“The raids devastated this town,” Rodriguez said. “It left us impotent, scared. No one could go to the store because they were afraid of encountering immigration officers. Then we were struck by the coronavirus.” 

These marginalized communities are not only vulnerable, but often overlooked, said Lorena

Quiroz-Lewis, organizer with Working Together Mississippi and founder of the Immigrant Alliance for Justice and Equity. 

“We do not acknowledge that we have a growing immigrant community,” Quiroz-Lewis said. “A lot of the time Mississippi concentrates on the Black and white communities and immigrant communities have grown exponentially since the last Census …. They have endured so much. They are so resilient and … they are being treated as less than here.” 

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Volunteer community health workers feel a commitment to serving. BARBARA GAUNTT, CLARION-LEDGER

That’s where the promotoras came in. 

They’re well-connected among some immigrant communities in Central Mississippi. They share a language, whether it’s Spanish or Mam, one of several Mayan languages spoken by indigenous Guatemalan poultry plant workers in the region. They share a cultural heritage, which uniquely positioned them to identify the pressing needs of these communities during the pandemic. 

Dr. Leandro Mena, an infectious disease specialist with the University of Mississippi Medical

Center, said that community-based approaches should be integrated into the COVID-19 pandemic response across the state. 

“It’s important to include grassroots strategies and the community's knowledge,” he said. “(We are) all the time thinking, what’s good for people. Very rarely do we stop to ask people, “What do you think would be good for you? That’s what I think we should be doing more.” 

Delayed response from Mississippi health officials impacts plant workers, families  

Mississippi’s response to outbreaks in communities of color was slow from the start. This is a fact State Health Officer Dr. Thomas Dobbs acknowledged during a virtual town hall held in August at Tougaloo College, a historically black institution. 

In the early stages of the pandemic, the primary focus of the health department was on new cases stemming from travelers with little focus on growing outbreaks among Black, Latino and Native American communities, he said. 

“We need to make sure when we consider new and evolving threats that we have to use a health equity lens early and not wait until it’s so abundantly apparent,” Dobbs said. “We weren’t at the front edge of it, we were always trailing and we’re still there. We’re still behind trying to make sure we get those resources, the communication strategies and everything… to where the need is.” 

Race breakdown of  positive COVID-19 cases 

April is when state health officials began to develop “culturally and linguistically appropriate material and programs” for Black and Latino communities, said Victor Sutton, the state health department’s director of preventive services and health equity, in an email. 

The state health department has also found success in partnering with community leaders and groups, including immigrant rights and faith-based organizations, Sutton said. 

COVID-19 had been affecting Latino residents at a disproportionately high rate across the state for most of the pandemic, and that disparity has decreased over time. By mid November, 4% of all COVID-19 cases were among Latinos. The disproportionate impact is starker when looking at coronavirus cases tied to chicken processing plants, where the majority of employees are Black or Latino. Of all chicken plant workers who have contracted coronavirus, about 21% are Latino, according to the health department. 

Community residents and advocates say the prevalence of COVID-19 among Central American immigrants in Mississippi is likely more widespread than the numbers suggest because of a lack of testing. 

Limited testing, lack of access to care, higher rates of underlying health conditions and other social factors have led to the disproportionate impact of COVID-19 on certain communities of color, Sutton said. 

“Things like increased rates of poverty, larger portion being uninsured, living in food insecure areas, inadequate housing, and other social determinants of health have been major contributors to the community’s ability to address the impact of COVID-19 in Mississippi,” Sutton said. 

Also driving up the numbers is a lack of “trusted education” on how to prevent the spread of the virus, Sutton said. This is particularly a challenge because sometimes materials are not available in languages other than English. 

"Misinformation has been a major issue during this time. We have especially seen this in our communities of color with so many conflicting messages about the virus. "

Victor Sutton, state health department’s director of preventive services and health equity

“Misinformation has been a major issue during this time,” Sutton said. “We have especially seen this in our communities of color with so many conflicting messages about the virus.” 

Luz Lopez, a 43-year-old promotora who works out of Laurel said she’s heard people ask if going to the hospital will result in the doctor injecting them with something that will kill them. 

Lopez said it hasn’t helped that state health officials have been slow to reach her community and others. 

“It’s causing panic.” 

More information from trusted official sources could go a long way in quelling the fears and anxiety she has seen, Luz said. 

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LUZ LOPEZ. PHOTO: BARBARA GAUNTT/CLARION LEDGER

“Information. That’s what we need,” she said bluntly. “A health professional coming here to talk to people about COVID, how to take care of themselves, that would do a lot to calm people down.” 

The spread of misinformation around COVID-19 is not unique to Central Mississippi immigrant communities, said Dr. Sergio Aguilar-Gaxiola, a professor of Clinical Internal Medicine at the University of California, Davis, School of Medicine. 

A common misconception he’s heard from farm workers in rural California is that infrared thermometers — which take a person’s temperature by focusing a laser on his or her forehead — affect the brain by erasing memories. This leads to people being unwilling to have their temperatures checked. 

Overall, it speaks to a larger problem with communication to the general American public during the pandemic. 

“People don’t know what to believe,” Aguilar-Gaxiola said. “The messaging is very muddled. This is one of the big challenges we’re facing and have faced all along.” 

Aguilar-Gaxiola said sometimes misinformation is also rooted in distrust stemming from desperation. 

“They live day-to-day, therefore sometimes they prefer to deny and hide that these things are happening to them,” Aguilar-Gaxiola said referring to employees on farms and chicken plants.  

Pandemic intensifies problems for families still reeling from ICE raids 

Irma, a 42-year-old chicken plant employee, said the only way an outbreak at her job could have been stopped would have been for the plant to close. But that would have meant risking her financial stability. Irma asked to be identified by her first name only due to her immigration status. 

Irma tested positive for the virus in May and was out of work for nearly three weeks without pay. At least four others on her processing line also showed symptoms including fever and headaches. They continued coming to work, she said. 

“The company didn’t seem to know it or notice symptoms,” she said. “They would take Tylenol before coming to work to sweat out the heat before getting scanned for their temperatures.” 

According to health department records, more than 100 people have contracted COVID-19 at Irma’s plant. Despite the risk, Irma said she’s glad she was able to continue working. 

“On one hand, it was good that they didn’t close. If everyone had had savings and was able to survive something like this, then closing would have been the most logical thing,” she said. “In my case, I didn’t have savings to cover rent, bills.” 

By the time COVID-19 hit Mississippi, resources to help families affected by the raids were already dwindling, with many people still out of work or trying to cover legal fees in the aftermath of the raids. The pandemic intensified the problems, according to Jessica Manrriquez, an organizer with Immigrant Alliance for Justice and Equity. 

“There are not a lot of financial resources available, or grants for people who are undocumented. When the pandemic hit we were still reeling from the humanitarian crisis the raids caused,” Manrriquez explained. “A lot of folks were already out of work.” 

When workers and their families started getting sick, many avoided going to the doctor, either because they couldn’t afford medical care or out of distrust. Many turned to the natural medicine they grew up taking in their home countries. 

In the early months of the pandemic, Miriam, a promotora from Carthage, would brew large batches of homemade teas using cinnamon, ginger, lemon, garlic and eucalyptus leaves. The teas are sipped hot to manage symptoms like fever, cough, sore throat and chest pain, she said. 

“There were so many families who came here asking for help. A lot of them were chicken plant workers,” she said. “When the disease got here so many people got sick. I even got calls from New York asking me how to prepare the medicine.”

Nearly two hours away in Laurel, Lopez has also seen the growing use of what she calls “medicina ancestral,” or ancestral medicine, during the pandemic. 

“This is something that people had forgotten about. But when there is no medicine, little help and people are afraid, they have to find ways to help themselves.” 

While she’s never received professional medical training,16 years ago she worked with doctors and nurses in her hometown of Veracruz, Mexico on health campaigns to educate her neighbors about different health issues affecting that community. 

“How to make sure your baby is well fed, diabetes, breastfeeding…” she listed off. “We would even talk to people about how to manage stress after an earthquake.” 

Amid a global pandemic, her work continues. She imagines how much healthier her community would be if doctors or nurses could come out to talk to people about COVID-19. 

“Information is important to share face-to-face. They believe more in you than in a sheet of paper,” she said referring to informational flyers. “The paper is thrown away.” 

In her front yard, Lopez keeps a small shrine to St. Jude, the patron saint of desperate causes. 

This is where she prays for the health of her community. Sometimes all she can do is leave it to a higher power. 

“All I can do is try to tell them everything is going to be fine,” she said. 

Maria Clark reports from New Orleans for The American South. Alissa Zhu formerly reported for The Clarion-Ledger in Mississippi. 

This article was produced as a project for the Dennis A. Hunt Fund for Health Journalism, a program of the USC Annenberg Center for Health Journalism’s 2020 National Fellowship. 

[This story was originally published by the Clarion Ledger.]

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