Laura Villa-Torres

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Radha Patel: Okay well, good afternoon. I am the Radha—I mean (laughter), the interviewer, Radha. I am interviewing Laura Villa Torres, who is a graduate student at the school of Public Health at UNC Chapel Hill. We are doing this interview in her office in Rosenau on March 29, 2014. Well, thank you so much for letting me interview you. Could you start with maybe a basic overview of your personal history and your relations and interests in health?
Laura Villa Torres: Well I come from a family from public health professions so that's how I got interested in health and public health. And yea, I think when I was about to go to college, I was deciding whether to go for medicine school or for sociology- two very different. But I really wanted to do public health so I asked my parents what could I study that I could go and do public health without studying medicine. And they said, “well you can do several things including sociology,” and that's how I decide to do sociology. So when I was in college, in Mexico it’s a bit different- you go straight to your “major,” let’s say. I did sociology for 4 years. So when I was there, I started working for a non-profit organization that’s called Ipas, which actually has the headquarters here in Chapel Hill. So I started working there and I started working on reproductive health, and the sexual and reproductive health and rights movement, and the youth movement in Mexico. And, I don't know, it just happened naturally. From then on, my college was particular in the sense that it requires you to do research instead of exams or papers. It’s divided in trimesters— quarters. And yea, you have to do research and it’s a module instead of a class. So lets say we have a module on economy. All my classes and seminars were related to economy. So after my I think 7th quarter, all my research started just gravitating towards health, so that just happened naturally. And then, I did my – you have to do in Mexico- one year of social service, meaning you work for free for the government. So I worked in the Ministry of Health. I was working on the adolescent health program and doing several things, but mainly I was trying to do all the literature review for the National Guidance for the Adolescent Health Program. And then I participated in actually developing the National program for Adolescent Sexual and Reproductive Health, but I will tell you about that later. Anyhow, so I came to work in health and then after a few years working locally and globally, I was a member of the Youth Coalition for Sexual and Reproductive Health. And that's an organization that is volunteer-based and its member-based, too. And the main objective of that organization is do advocacy at the global level. So I started working a lot at the UN and working on advocacy related to sexual and reproductive health again, including HIV, sexual violence, adolescent reproductive rights, and from there, I applied for a job in Ipas here in Chapel Hill. And that’s how I migrated. Yea, and then after working at Ipas, I decided I wanted to continue my training because I only had my Bachelor’s. I started at a different program, a master’s program on Gender and Public Policy but I couldn’t finish. It was just too much to work and study. So I decided to go back full time for schools and I was looking for schools, I was already here.
RP: In North Carolina?
LVT: In North Carolina, yea, because I was living in- I came to work for Ipas. And when I was here, everybody was telling, “Well, UNC was one of the best schools of public health, so you should apply there.” And it was kind of a dream because I thought, “it’s not gonna happen, they’re not gonna accept me.” But it happened, and I’m very happy about it.
RP: That’s great! Cool, thank you.
LVT: It’s a bit of a long story.
RP: Oh, that’s okay, that’s an awesome story. So I know that you mentioned you were doing reproductive work—of reproductive rights work in Mexico—what part of Mexico was that in?
LTV: Mainly Mexico City, but I worked in many states because we had a partnership with the Ministry of Health to work on the Adolescent Health Program and Ipas has a manual that was called “Gender and Sex, Who Cares?” and it was a training manual that taught people about gender issues. So we started using that to train health care providers in several states of Mexico. And so, we went by the people that were in charge of the of the adolescent program at the state level and we’d bring out the lesson so they both would come together and do work. It was a lot of fun and we did that for a year and a half. So I got to travel in many places. I went to Sinaloa, Sonora, Guerrero, Oaxaca, Veracruz, Puebla, Quintana Roo. I don’t know, I think I went to ten- fifteen states. There are states that I’ve only been once it was like San Luis Potosi, Zacatecas, Michoacán.
RP: Did you go to Guanajuato at all?
LVT: I’m trying to think if I went to Guanajuato. I went, but not for that. In Guanajuato, I remember they tried to ban, from the local penal code, the extension for abortion for women that have been raped. But that was like ten years ago or something like that. And we went there because we were advocating for it not to happen. So we went with the women’s movement in Guanajuato and we had a conference and so I went for that, I didn’t go for the other stuff.
RP: I know that when we went over spring break, we were tourists for a couple of days and in a lot of the churches that we went to visit, there were posters talking about abortion and showing babies. Do you find that things like that happen in other states, because I know that, well I guess Guanajuato is a very conservative state in that sense. Do you think that happens in a lot of Mexican families here in the United States as well or..?
LVT: That they have abortions, you mean? Or that they are conservative?
RP: I guess just that they have very strict views towards things like that? And so did that make your work very difficult or do you not get that sense?
LVT: No, I would say...interesting…I don’t know but I’m gonna guess. Yes, Guanajuato is one of the most conservative states and it has always been. That’s for sure. Now, I think what happened with migration is that the pressure of migration really put a very difficult situation. And you start realizing that those conservative views cannot be held because they are in detriment to yourself. For example, with the work that I’ve done here on reproductive health with Latinos. The patterns are even though they are really religious, they are sending their kids to the training, the reproductive health training. And when we ask them, “why, if you’re so religious, you’re still sending them?” And we’re very open with them. “We’re gonna talk about condoms, protection, and abortion.” And they’re like “no no, but it’s okay because I cannot talk to my kids about that because of my views. But I know they need it because I don’t want them get pregnant next year and then ruin their lives forever. Which of course a negative view of pregnancy in adolescence, and that’s also constructed, but it’s a reality that if I’m an adolescent or a young woman without the means and haven’t finished school and all that, it’s gonna be more difficult to make it. So, I think there’s a relaxation of the norm. Now, I also think that when people migrate here they start getting more and more religious because churches are a natural place to go and form communities. So I don’t know if that relaxation then again turns around after going to church and then they start becoming even more conservative again. So I think it’s a process, but it has to do with—I think migration impacts their view.
RP: Interesting. I think I’ve noticed that a lot with my parents as well. Well, this is sort of a different topic, but it seems like a lot of programs nowadays are focused on health education, like the ones you were saying. Do you think that it maybe holds a greater or lesser value than actually providing medical care? I don’t know—does that make sense?
LVT: yea well, I have my views about that. I think location is important. I think community participation is important and that people get involved in their own wellbeing, I will say instead of health care. It’s more their well-being. Like okay, let’s build safe neighborhoods, let’s have safe roads, let’s clean, let’s have our houses clean, let’s recycle, and things like that. But this approach of substituting “health care,” per say, with a physician and a nurse and people that are trained for that, with community health work. I think it’s a bit denying their right to care for people. Because there’s only so much you can get through a person that provides information. For example, I can tell you right now, “this is how you use a condom. This is how Plan B works. But if you have an infection, I cannot tell you what to do about that. But if the only thing you have related to health care at all is whatever I can provide you is information, that falls short in terms of what the people need. And you see it, like that’s what they call about the health-immigrant paradox. People come here very healthy and of course they come very healthy because they are the ones that are strong enough to migrate and they are the entrepreneurs of their families and they want to go and make a better life. Of course they are healthy. But as time passes and they start not having access to health care, ask them ten years later how many times they have been to see a doctor or a dentist, or even a nurse. They have gotten their vaccinations? They have pap smears done? A woman has to do the pap smear every two years or three years at the minimum. So, that’s gone after migration. So I think we need to keep building the issues related to education and health promotion and prevention, but not forget that access to health care is important.
RP: Thank you, that was really interesting.
LVT: Which, for example, now with the Affordable Care Act, many immigrants are out of it.
RP: Are out of it?
LVT: Yea, because that was the negotiation for signing the Affordable Care Act. Undocumented immigrants are not. But those who are documented immigrants, like people holding temporary visas, student visas, like me, and I would say even like the long term visas- the H-1Bs, which are for professionals or high-tech visas. All of those are out of the Affordable Care Act. So, we don’t have that- the ones that we have some sort of authorization to be here, we have to pay for our own health care. The ones that are undocumented, they’re gonna be the ones that have a very, very hard time- even finding an insurance that wants to SELL to them.
RP: Even if they have the means to pay?
LVT: Yea, mhm.
RP: Wow. Okay, so for students- what do they- so what did it do for North Carolina specifically? Sorry, I’m a little confused about that.
LVT: Yea, the Affordable Care Act mandates health insurance for everybody in the country. And that's why there are a lot of announcements. People have to enroll, and for people with low income, the federal government and some states will supplement the cost. And then it got rid of several things also, like the pre-existing conditions. That applies to a lot of folks too, for example.
RP: So it’s like everybody who is a citizen is guaranteed this access to health care, but people who are on different types of visas—
LVT: Yes, exactly. I think residents—permanent residents or green cards and citizens enter in the pack. And everybody else (shakes head, indicating no coverage). We see it that, I don’t know.
RP: What was it like before the Affordable Care Act for people with visas and student visas and thing like that?
LVT: It was like everybody, you just have to pay your insurance. For me, it’s gonna continue like the same. This is an example of the- it’s an example of how big changes in policy might not affect individuals directly, but affect- in general, the health of the population. Because for me, it’s the same. I mean, my life before the Affordable Care Act and after the care act remain the same. But for people that were never ever able to get insurance because of pre-existing conditions or because they didn’t have the money to pay, they aren’t gonna have health care. And that's huge. That’s huge and that has a big impact in very marginalized communities and minority communities. So, I’m not saying it’s bad but the negotiation was around immigrants.
RP: Okay, I didn’t know that. So, how are people accessing health care resources? Like for people who either are undocumented or who have these types of visas? I know that you said that you have to pay for it, and somebody else that I’m interviewing said earlier on- she said that she works at a health clinic and people pay based on their income. So how is that- do people just go to a clinic?
LVT: Yea, well, there are several things. There are—. For example for me, I just pay my health insurance but I am a student so it is the same for all over. If you go here to student health, you don’t even have to pay a co-payment or anything. Now, I recently have a more serious issue and the insurance pays most of it, but I still, I now have a debt of one thousand dollars. Just because of the co-payments and the insurance doesn’t cover all of it. I meant that’s gonna still happen to everybody. Now, for people that are on the- and I think everybody that has a, I want to say, maybe the professional visas and student visas, I’m pretty sure people have insurance. Now for temporary visas like the farmworker..?
RP: H-2A?
LVT: H-2A, yea. The H-2A or the H-1B2 or something like that. I don’t know if everybody has health insurance or care of some sort of—. There are federally qualified health centers- you’ve heard about those. So those centers are community centers that are federally funded and those are the ones that provide income-based costs or scale of payment. So a lot of people go there because they receive everybody, without needing documentation. But the problem with those is that they are really saturated. And there are priorities— children and women have priority and men don’t have really, so they feel they don’t have access. So those are one option, and they are great. And actually, they say that with the Affordable Care Act, everybody is going to have insurance, there is not point to keep the federally qualified health centers open, so that’s a problem because those are the centers that cover the health care of the undocumented. And also, the, some of these federally qualified health center also receive funding for farmworkers’ health. So I know that one in Fuquay, they have the farmworker clinic Thursday afternoons. And they go and pick up- like the farmworker has to tell whoever in the camp, “I need to see the doctor.” They make an appointment, somebody picks them up and takes them to the clinic and drives them back. I think the volunteers that do that, just to transfer people from camp to camp to the clinic and return them, they are very good. They are doing—because they are volunteers and they drive people around. But again, there is only one place during the week and it’s only once.
RP: Do you think that—does that happen at most farm work organization or is it just a few?
LVT: I don't know if it’s everybody.
RP: ‘Cause we had guest speakers come into one of my classes last year and she was talking about how, for people who are undocumented, especially farmworkers. And they’re working very long hours, and they say they feel like if they step up and ask their employers for better working conditions or for health care, for those issues and they will report them and they get deported and things like that?
LVT: Yea, we were saying yesterday, because we went to a talk, that they—kind of a benefit system that reproduces itself very easily because people is afraid, they need the income, they don’t pick. The others have all the power over the other people. They will never improve the conditions—there’s no incentive to improve conditions. And even though there are labor laws and I would say even human rights treaties, although that is more vague in the United Stated, but they are still there, there’s no way to enforce those. Like whatever happens inside of those camps, it is a land of nobody. And, yea, I don’t see that as a priority of the immediate state level government or the federal government because if you really want to deport undocumented people, like the federal government does, then you go to the camps. Go and see how they’re living and take them out. There are people who have been almost like slaves because they are there without willing to be there but there is no escape. They have taken away their papers, they live in so remote areas, they don’t know where to go. And there is this story of – it’s in video. They took them on a bus to a Wal-Mart, but they would close all the doors of the Wal-Mart, let them shop, and then put them back in the bus and take them to the camp. But somehow, two of them escaped and that’s how people started talking about this almost new way of slavery. So, it’s terrible. And they don’t have any power. And at the same time, it’s like if there is some type of internal organization, what else can they do? Researchers, we can advocate for them. We can put out research that shows the conditions, but so what, then—who has the power? That’s the big question.
RP: Do you think that—how big of a role do you think the public perception of Latino people and of immigrants, how big of a role do you think that plays in I guess affecting what politicians want and what their priorities are? Do you think that’s a big role, or?
LVT: Well I think that, well I think that what we were saying yesterday was that there’s symbolic violence and the materialization of the suffering of bodies. Like the certain groups of people are like, “oh well, shame, but that’s how it is. These people are born to be that and suffer.” I mean I keep reading more and more lately about the black slavery and how similar the stories are and the replacement of one group for another. Because for me, there is a lot of similarity with the African American slavery produced. And then they sort of made segregation. So this again is not recognition of full citizenship, which translates into not having rights. And the ones that are “the others,” and the separation and segregation. And that's happening now with Latinos. And there is a construction about Latino migrants were equal to migrant workers, equals undocumented, equals illegal. So you don’t want anything to do with any of those people, no? And at the same time, there is deep, I don’t know the word, but like, “Oh, Mexican food is great!” and which is like, what are you talking about? Don’t you… I mean, there’s no coherence. But this is what you are as a citizen of this country that is putting so much suffering on these people. I’m sometimes very radical. (laughter).
RP: No, that’s completely fine! Okay, well I guess, do you think that how the people think is actually going to affect how the politicians want to enforce rules? Like do you think that if more people were like “hey!” If more people were standing up, if more people were advocating, do you think that the people would, amend the Affordable Care Act to make it more inviting or…I don't know?
LVT: Well, I think that for the Affordable Care Act, it’s not gonna happen soon. But, again, I was thinking for these kinds of problems, they really kind of need a revolution. Nothing that’s kind of guns or anything like that, but there’s only so much that we can do, for example, from the academia or the research to show, show the evidence, right, of things that are happening. Because the politicians can say, “well yea, but it’s not our priority, our priorities are this or that,” from both the federal and the local or state government. So for me, it’s the people getting organized and start saying the things, or telling the things as they are. Like, “look, we’re second class people. We’re the ones that move big machinery. Without us, it’s not gonna hold too long.” And also, the historical relationship with Latin America—It’s like denying all that tradition because sometimes North Americans, here and Canada, they kind of deny that they live in a continent that is, that has a lot of history together, no? And a lot of the economic benefits and the solid economy of the United States and Canada rely on many things that happen in Latin America. So it’s like, why cannot we just share a little bit of the cake? It’s not that we’re asking—and, this para—this brings a little bit of paranoia. Like “if we open the borders, everybody is gonna move here.” I don’t think so. It’s actually the opposite.
RP: You mean..?
LVT: People have been forced to move here with their families because of the hard boarding. Like the hard borders and how if you cannot cross the border… but if they were able to just come work and return, safely return, no? Because now the problems of the violence and other problems. If they can come work, safely return, families wouldn’t come here all together. Some might, I mean I’m not saying that it’s not going to happen, but it’s not gonna happen in these huge numbers that people think happen. I mean, it’s more circular, people coming and going. But for example, one movement the… going back to your question, the Dreamers, I think, is one example of getting organized and getting the word out. It’s like, we were raised here, we were grown up here, what are—I mean, what is our future and who’s in charge of us? Because, kind of, “we don't have states,” no? Nobody—their countries of origin have forgotten about them and the country where they grew up is not recognizing them. But the arguments that they bring out are very strong. And you even see some parallels with other movements, like the LGBT movement, no? Like coming out of the closet, it’s kind of this idea, “well, I’m unashamed and I’m gonna disclose that I am undocumented.” That’s very powerful. That’s very powerful. So I think that at least that, even though the Dreamer- the Dream Act hasn’t passed fully, it has created change because I believe that promoted the DACA, the stopped deportation of the students. And I think, their arguments are less challenged, even by conservative people. Because they are really substantiated or based on what people are so proud of the so-called “American Values,” no? which is entrepreneurship. And we’ve been studying where, how workers, you know? How can you go against that? It's almost going against yourself. So, I think the, the Dream Act, or the Dreamers are an example of a movement. Now, will the parents benefit from that? The parents of those dreamers? I don’t think so. They’re still seen as the “bad” migrants, no? the ones that crosses illegally, etc.
RP: I don’t know— have you had a lot of experience with people trying to access health care? I’m not sure? I know that you mentioned earlier that you worked with some of the…
LVT: Community workers. Yea. Not that, I mean, what they did was sort of refer people to health care or health services. But I was not the one referring people, no. But I was working with the promotoras do to that
RP: The promotoras?
LVT: Mhm, the community health workers.
RP: Ohh, okay.
LVT: Aha, yea sorry.
RP: Oh no no, that's okay. I wasn’t sure. Okay so I had a question. During class, one of my classmates this year said that he recently travelled to Texas and was talking to some of people that he met there about health care and things like that. And some of them didn’t really notice that they didn’t have access. And the people we was talking to were undocumented, so do you think that, I don’t know ‘cause, I’m involve with SLI. I don’t know if you know what that is but it’s a mentorship program for high school students and I was talking to my mentee’s mom and she, yea so she—oh she’s the one that works at the health clinic. And she was like, “Yea I mean, I don’t really see a problem. It’s based on income and people get what they need.” So I mean, I’ve heard two very different sides of the story and so I don’t know, what do you think about that?
LVT: Do you mean that it doesn’t seem to be a problem really?
RP: Oh, well that's what I’ve heard very recently, like from a couple of people and I was really curious because I would think that it was a big problem.
LVT: It’s actually a huge problem. It, it’s like, somebody was here two days ago and she leads a big…she’s a super person. She has created the Ventanillas de Salud, the Mexican consulate, the binational health week that now is like multinational because it’s in the U.S. and in the countries of origin. But anyway, she said that day that health is more a commodity than a right.so if you have money, you have health, right? Because even though these community health clinics are income-based, one, you still have to pay. And in general twenty dollars is not a lot, but to some I mean, just to us as students is like twenty dollars is like “uh okay” (laughter). So that’s one. Whereas in other countries, in or course Europe and Canada, but I’m mostly talking about Latin American countries or African countries, where health has been recognized as a right, people don’t have to put any money out of their pockets to pay for health care. And that’s based on the different allocation of taxation. The taxes from marginal locations to health care. In this country, most of the money goes for military purposes. I mean, with a little bit of that money to health care, people wouldn’t even need to have health insurance. I mean, everything would be covered. That’s one. And also who has access to these community health centers. Even though they exist, they don’t cover everybody. And for example, these guys that I work with, they were saying that the waiting time to get an appointment there is at least six months.
RP: Wow.
LVT: So imagine you go with diarrhea, fever, things that need immediate care. Or you broke your something or you have a cut. There’s no option, so that's why people go a lot to the emergency room. And you know how expensive it is, the emergency room, right? So, and people get into that getting to debt that is health related debt. I cannot ima—I mean it’s counted up so quickly. So quickly, you start to have, like I told you, that one thousand dollar debt because of the co-payment here and—. So, I think that’s an issue. Now, the other thing is it’s true, there might be some cultural things that—I am less and less attached to that reason—but the main reason is because they didn’t go to health, they didn’t have access to care in their countries of origin. Or they didn’t used to go to the doctor in their countries of origin, so when they come here, it’s not something that they lack because they never did. But I have—we will need to explore that more. Like what were their health practices before coming. But at least, I’m sure they had vaccinations. That—I mean every country in Latin America has very good vaccination records. I’m sure they went to see the doctor at least once. So, I think it’s a big issue. Now the other is maybe how people feel about themselves and if they are entitled to health care. You know?
RP: What do you mean by that?
LVT: Like, for example, if they feel, “Well, I am undocumented. It’s okay that I don’t have health care.” So, it’s not a problem, so maybe like, okay. And because they are undocumented, they expect the worst. “Yea, it’s okay I gain less money. It’s okay I don’t have holidays. It’s okay I don’t have health care because I am undocumented.” So there is all this stereotyping of the labeling, the separation, and then the self-stigma, or the self-discrimination or the, yea, that you are not entitled to anything because of your condition. So, I don’t know if that’s also going on in their heads, like “it’s okay because I am undocumented.” Instead of thinking that “I am a human being. I have rights. And I am not doing anything wrong, I just want to have a better life, as anybody else.” Yea, so I think it’s a problem, it’s just from what people say.
RP: Okay, interesting. Have you noticed any—or in your—what is your current research that you’ve been doing?
LVT: I am working on well, three things. One is how I’m going to get more involved in community-based. The other is we’re planning to do an education program on use of personal protection equipment for day laborers because they reduce the risk for accidents. And the other, which is my dissertation, is looking at mental health of undocumented men. I’m gonna focus on men. So, that’s what I’m working on.
RP: Have you, so have you noticed—I know you’ve been working with a lot of laborers—do you work with both agricultural and construction?
LVT: No, just day laborers. No farmworkers.
RP: Oh, okay. Well never mind then. Could you tell me a little bit more about the mental health perspective? I don’t really know much about that.
LVT: Yea, well, I wanted to do migration. So, because we’re in public health, they’re sort of like what are the health implications of what you want to study. I kept thinking like people who cut the, what we call distal outcomes, like things that happen later in life. Let’s say diabetes or heart disease or hypertension. So when you think about that, you almost just think like okay, almost like everybody’s gonna have that. You’re natural and you’re aging and you’re gonna get some age, but that’s gonna happen to you.
RP: Like things like glasses?
LVT: Yes, exactly, vision. Anyhow, but there are many studies showing that there’s people that age faster and it’s related to of course the genetics, but also the exposition to risks and harms and things like that. So that’s called allostatic load, like the wear and tear of the body.
RP: Allostatic?
LVT: Allostatic Load. So there has been some research done about how things like discrimination, stigma, go through your mind, of course, and activate certain hormones in your body that, if they stay activated, they cause aging faster. And that process of aging introduces into chronic disease, illness, etc. So what I’m thinking is, I’m thinking well, mental health is the path, one of—I’m not saying it is unique—but it is the pathway, one of the pathways through which all the issues associated with documentation status, which is racism, discrimination, stigma, all that, goes through the mental health of a person, causing anxiety, depression, problems with the sleep, and others. It could even cause eating problems and them some behaviors, no? Like alcohol, tobacco, poor diet, etc. And at the end, I mean, you have a person with a chronic disease. But the difference is that as the process of—I saw a forty year old with the arthritis of a seventy year old.
RP: A forty year old?!
LVT: A forty year old with the arthritis of a seventy year old. So these types of quicker aging just because of exposure to that. So I am trying to see just the first—whatever the explanation, whole thing is. Of course I cannot do that in one dissertation, but I want to see the association between documentation status and mental health and how much really, that affects your mental health. I have, from the lit review I’ve done, I have a good evidence that there’s something going on there. Discussing a lot of anxiety, about depression, about the fear, a lot of fear related to being undocumented. How people really—and it’s even the serial deportation because of all these massive deportations and family separations that have happened in the last few years, because there is a report that shows that people are more concerned or will feel better immediately if deportation would stop, even if they don’t get citizenship. Because it’s the, it’s the vulnerability they are put at just by being undocumented. So I want to find the people that is undocumented and see how much is this causing mental health problems and then how much is it affecting their life. Because we are always exposed to stressors and we get stressed because of different things, no? But their situation is particularly hard because of all the implications of their lives as migrants. Like the pre-migration, the process of migration, and the post migration all that happens around that.
RP: Do you think that it also has to do with, like I guess, mental health, do you think it also has to do with peoples’ expectations when coming to the United States? ‘Cause I know that I have family members who came to the U.S. and they’re like, you know, “oh yea this is gonna be SO great, there’s so much money everywhere and all these things!” And then they get here and they’re like and they’re like “oh by, you know, the culture’s so different and my family’s not here with me.” And then, I know I have a couple family members who have wanted to just move back. So do you think that also plays a role in it, or…?
LVT: Yea, and I think with the men I’ve have interviewed and those in the literature, that people all over—or most of the time they, for economic reasons. And there is an expectation there like of both having a better life here but also being able to provide resources for the families that are left behind. And yea, when those expectations are not able to be met for whatever reason, there is just stress, particularly among men, although women send most of their remittances back, than men. But I think a lot of the identity of men, migrant men, is built around their role of providers. So when they are not able to get a job and get a good payment, and pass through the—then, when they disappear almost, they don’t want to talk to anybody, they don't want to talk to their family, the families think that they are having now another family or spending all the money, and when what is really happening is that they are here by themselves, depressed, without money, without jobs, especially because they’re working really seasonal. Places like this are really seasonal. In the winter, for some, they don’t have any jobs and they need to be prepared for the season, the very low season. And it’s interesting because I think it’s a little bit of denial which all humans do, even though they’ve been here for years, every winter is the same. Every winter, they are not prepared, they didn’t save enough money. But also, I think I never sat with them to ask them how much they could really save for the winter. Maybe there’s really nothing they could save. Between what they have to pay here to live and what they send back, how much can they really save? So anyhow, yea, I think all mental health issues are also related to also the expectations. And how, how much pressure is from the community of origin for them to be here making money and how, or if, the community is willing to receive them back without judging if they decided to back if they “fail.”
RP: Do you think that—has that, in your experience, has that been a problem? Of people “failing” and then going, going back. Do you think that the receiving communities are like “oh, you should have done better” or...?
LVT: I haven't seen it, but I have read it in a lot of the literature. They are afraid of not going back because they fail. But what I’ve seen is the idea of time passing by quickly because they all want to return. They all want to go back. So when and how they decide to go back, that’s the question.
RP: Interesting. So I guess to conclude, what do you think are some things that we can do, that the general population can do to help issues of mental health and also just help access in general?
LVT: Well I guess, there are several things. I mean from the microcosm, I think people can donate a little bit of their money to these clinics or programs that do work with migrants. I think medical students or providers can also donate part of their time to provide some care for these populations. Those are things that kind of add a little bit of band aids, but everything helps, I think. I think in a more general way, I would say keep advocating. Try to bring about the—or visibilize, visibilize the… that’s not a word in English… make people aware of the racism and the discrimination and how that affects certain groups of people. And speak up in making all of the spaces possible. I think, I think that’s important. So the norms are changing, right? Now, nobody would even dare to say anything about African American groups no? I mean they do, but they are careful of when they do it or how they do it. Like changing, also, the norms around other groups. And also, I’ll say make some efforts of communities to integrate the people because I think also the part of the mental health, besides what I talked about the fear and the family expectations, it's also the isolation they experience. Because there is no real community integration and I think that’s really easy to promote. People really are welcoming, say “Okay, you are part of our community now. Let’s share this space.” Instead of segregation, segregation, segregation, it’s more like wow integration. And I think that will help a lot because people will feel more welcome and that those who have felt… So I think there are several layers. The ultimate will be at the state level, they decide to provide care, right? Like in other states, California or what is it, where is Boston? Maine? Or Michigan? Some of these states that have full coverage.
RP: Oh, for everybody?
LVT: For undocumented.
RP: That’s interesting, I didn't know that.
LVT: Yea. Or even following some other models, like some European models like Germany. Germany doesn’t discriminate. Now they’re starting, but up to now. For Spain, Spain used to not discriminate based on documentation status, but now they do. So, like just don't do it, I mean for the benefit of everybody, the people would benefit. Because then the costs, the social and economic costs later are gonna be huge. People don’t see it like that. Everyone is just talking about “cost,” because it’s not the same to have some prevention care and some health education, and later deal with a chronic disease that requires medication and money spending for longer. That’s more, more. And all the mental health issues that are very hard to unthread. And you don't, North Carolina doesn’t have the psychology needed for that, so we do more community based things to address mental health issues. Because not everybody can go to therapy, that is ridiculous. It happens only in the very rich society. Yea
RP: Yea. Okay, well thank you so much, this was really helpful. Oh, it was very helpful. Thank you!