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In Puerto Rico’s Migrant Farming Communities, a Health Center Cares for All

Economic uncertainty for farmers remains more than a year after Hurricane Maria, but health center acts as a safety net.


Puerto Rico

The view from of the Migrant Health Center in Las Marias, Puerto Rico. The health center is working to serve the rural community, which is still seeing economic hardship after Maria devastated the island's agricultural industry. (Erika P. Rodriguez for Direct Relief)

Disasters don’t end when the earth stops shaking or the wind dies down. The effects are often felt for years. Puerto Rico is no exception.

Hurricane Maria wiped out a vast majority of Puerto Rico’s crops, propelling those who made a living off the land into economic crisis.

Las Marias, a region on Puerto Rico’s west coast known for its citrus farming, was accessible only by helicopter for weeks after the hurricane.


The region is home to a population that immigrated from the Dominican Republic to find work. Among them is Rosario Jiménez, who immigrated to Puerto Rico in 1981 in search for a better life.

The 55-year-old began working in agriculture at plantain, coffee, yam, bananas and orange farms in the northwestern part of the island 37 years ago.

Jiménez acknowledged that life isn’t always easy for Dominicans in Puerto Rico, but it’s made better by places like the Migrant Health Center, an organization that cares for roughly 24,000 patients a year regardless of their immigration status or ability to pay.

“They treat me very well, without discrimination,” Jiménez said.

Eight percent of Puerto Rico’s population is foreign born, according to 2010 U.S. Census statistics. Of this population, immigrants from the Dominican Republic comprise the largest group.

From left, Nilda Valentín, 53, and Rosario Jiménez, 55, pose for a portrait at their home in Las Marias, P.R., on September 11, 2018. The couple, who receives health care at the Migrant Health Center in town, suffered damage in the second floor of their home and have find it hard to make ends meet when the renters left. (Erika P. Rodriguez for Direct Relief)
Nilda Valentín, 53, and Rosario Jiménez, 55, pose for a portrait at their home in Las Marias, Puerto Rico on September 11, 2018. The couple, who receive health care at the Migrant Health Center, suffered damage to the second floor of their home and have found it difficult to make ends meet after their renters left. (Erika P. Rodriguez for Direct Relief)

The Migrant Health Center was founded in 1971 to provide basic health care services to vulnerable groups on the island. In 1986, the group became a nonprofit and expanded its medical services to the larger community.

“Many of them come to work in agriculture, but lack health care services,” explained Ivette Pérez, Administrator of Las Marías Migrant Healthcare Center, one of the 10 clinics operated among the island by the corporation Migrant Health Center. “That’s why we take action. We visit farms, organize health fairs in the community. We build trust with them. Part of our mission, vision and goals is to provide services to all populations regardless of their social status, race or ethnicity.”

Entrance of the Migrant Health Center in Las Marias, P.R., on September 11, 2018. (Erika P. Rodriguez for Direct Relief)
The entrance of the Migrant Health Center in Las Marias, Puerto Rico. The health  system has nine health centers across the western part of the island. (Erika P. Rodriguez for Direct Relief)

After Hurricane Maria, Perez estimated the number of patients served at the Las Marías clinic increased by 15 percent, a rise that reflects the additional hardship faced by the community in the storm’s wake.

If Maria’s impacts on Jimenez’s life could be measured from 1 to 10, with 10 being the most severe, Jimenez said his situation is an eight. Hurricane winds damaged the roof of the multi-unit building where he lives with his wife, Nilda Valentín. The couple relied on rents from tenants in the other units, many of them farm-workers, to buy groceries and other essentials.

Not anymore. Since the hurricane they have been struggling.

According to Migrant Health Center’s Pérez, an estimated 40 percent of the farms on Las Marías have closed under economic pressure following Hurricane María.

Jiménez has been doing his best to find job opportunities as a farmer while Valentín has spent her days looking for work as a domestic employee. Their search is ongoing.

Disasters often have an impact on local economies that extends far beyond the initial event. Such is the case in Puerto Rico, where many like Jimenez and his family are still working to rebuild their lives.

In the meantime, the couple said they take comfort in knowing they can depend on the Migrant Health Center for care.

“When we’re sick, we come, and they take care of us,” said Jiménez.

Solar panels on the roof of Migrant Health Center in Las Marias, P.R., on September 11, 2018. The solar power system was funded by Direct Relief. (Erika P. Rodriguez for Direct Relief)
Solar panels were recently installed on the roof of Migrant Health Center in Las Marias, Puerto Rico, with funding from Direct Relief.  The power system will allow the health center to be more resilient during the next emergency, and dozens of other health centers across the island are being outfitted with similar power systems. (Erika P. Rodriguez for Direct Relief)

Editor’s note: After Hurricane María, Migrant Health Center received an emergency operating donation of $25,000 from Direct Relief, and also received medicines of a total value of $178,800. With support from AbbVie, Direct Relief has funded solar energy systems at the Migrant Health Centers at Maricao and Las Marías. In August 2018, Direct Relief granted Migrant Health Center an award of $1,067,683 for a Mobile Medical Unit, two off-road Jeeps, diesel truck, backup batteries, and Information Technology upgrades.  The Mayagüez location of the Migrant Health Center was one of the 13 sites in Puerto Rico that received a Hurricane Preparedness Pack for this year’s hurricane season.

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