A generous grant from The Leon Levine Foundation is helping the Campbell University Community Care Clinic (CUCCC) deliver crucial healthcare services to migrant farmworkers in Harnett, Duplin, Johnston and Sampson counties in eastern North Carolina.
The volunteer-based clinic, established in 2014 within the Campbell University School of Osteopathic Medicine (CUSOM), is composed of physicians and physician assistants who oversee teams of medical, PA and pharmacy students. The clinic partners with NC Field, the NC Farmworker Program and local health departments to identify and establish relationships with farms employing migrant workers.
The focus of the mobile units underscores the medical school’s primary mission of training physicians to serve underserved populations in North Carolina. In addition to seeing local patients in Buies Creek, home to Campbell University, the student-run free health clinic uses two mobile health units to provide on-site care. The clinic sees only uninsured patients at or below the U.S. poverty line.
Some 150,000 migrant workers and their families reside in North Carolina each year, according to the N.C. Department of Health and Human Services (DHHS). Their work is oftentimes dangerous and physically demanding, and yet they face myriad obstacles in accessing adequate healthcare.
Working days that often run long into the evening and accessing reliable transportation are paramount among those barriers, says Dr. Joseph D. Cacioppo (DO), chair of CUCCC’s Department of Community and Global Health. “These workers have virtually no access to healthcare,” he says.
Dr. Cacioppo cited estimates of 6,000 to 7,000 undocumented workers in Harnett County. In neighboring Duplin County, he estimates that between 11,000 and 12,000 migrant and seasonal workers, as well as their families, have limited or no access to quality healthcare. “There are no facilities that stay open late at night, and that’s the only time they can go,” Dr. Cacioppo says.
He pointed to a camp of 24 workers in Wayne County, about an hour east of Buies Creek. The landowner bought health insurance for his workers through a Duke Health HMO, but the healthcare providers who are part of that network are more than an hour away in north Raleigh.
“We are their only source of medical care,” Dr. Cacioppo says. “Probably about 15,000 people in our catchment area are without healthcare, except for our ability to reach them with the mobile unit.”
Trust, too, can be an issue for undocumented workers, who are often wary of accessing services outside their respective communities. “We don’t ask for documentation, and we care for them regardless,” Dr. Cacioppo says.
Cultural and language barriers are other reasons some workers are reticent to reach out, though Campbell bridges that gap by utilizing non-governmental agencies, such as the NC Farmworker Health Program, which is based in Benson, North Carolina, and NC Field/Sembrando Salud of Kinston, North Carolina.
The clinic provides medically certified interpreters for Spanish-speaking patients and has a team that works to ensure follow-up and continuous care, as well as establishing a medical record that stays with the patients, wherever they may go. DHHS and other rural health agencies cover about just 40 percent of workers in south Wake, Harnett, Johnston and Sampson counties.
The 2022 Harnett County Community Health Assessment showed 20 percent of the survey cohort had trouble accessing health care. Of that 20 percent, 42 percent had challenges with accessing primary care.
Harnett County has 3.77 primary care physicians per 10,000 residents, according to the Sheps Health Workforce. Sampson County has 4.23 physicians per 10,000 residents, Johnston County has 3.69 physicians per 10,000 residents and Duplin County has 2.83 physicians per 10,000 residents. Hypertension and diabetes are the two most frequent diagnoses in migrant camps served by the clinic.
The mobile units, purchased in 2020 with state COVID-relief funding, serve the workers in their camps, and a centralized site in Duplin County allows the clinic’s partners to offer transportation, giving the workers an opportunity to benefit from a variety of health services. Free services include medical exams and treatments, laboratory evaluations, imaging referral to an in-kind provider, medications, behavioral health counseling and treatment, nutritional counseling, smoking cessation counseling and specialty provider referrals in addition to childbirth and breastfeeding classes.
William Bukowski is a second-year medical student at CUSOM, where he serves as president of the Surgery Club and a mobile clinic manager. The clinic, he says, has provided him with an invaluable opportunity to work directly with patients and to strengthen his connection with his peers and colleagues.
“As the mobile clinic manager, I was responsible for directing our care teams and coordinating the care for the hundreds of patients we saw over this past year,” Bukowski says. “It is easy to be absorbed into the demanding world of classes and learning, but working with patients offers a profound source of motivation and perspective.
“I was able to continually develop my humanistic and diagnostic skills with each patient in need, and I know I will be a better physician because of every second spent with them,” he says. “It has been truly inspiring to see the hard work my peers have committed to this student-run clinic and it makes me confident in our future doctors, PAs and pharmacists.”
About The Leon Levine Foundation
Established in 1980 by Leon Levine (Founder and Former Chairman of Family Dollar Stores, Inc.), The Leon Levine Foundation supports programs and organizations that align with its four core mission areas: education, healthcare, human services, and Jewish values. Based in Charlotte, N.C., the Foundation invests in nonprofits across North Carolina and South Carolina with strong leadership, a track record of success, and a plan for financial sustainability. Through its investments, the Foundation intends to create pathways to self-sufficiency, champion strategies for permanent change, and facilitate opportunities for growth. Learn more online at www.leonlevinefoundation.org or follow TLLF on Twitter and Facebook @LeonLevineFdn
About Campbell University
Founded in 1887, Campbell University is a private, coeducational institution where faith, learning and service excel. Campbell offers programs in the liberal arts, sciences and professions with undergraduate, graduate and doctoral degrees. The University is comprised of nine colleges and schools and was ranked among the Best National Universities by U.S. News & World Report in its America’s Best Colleges 2023 edition.
John Trump
Health Sciences writer