They Leave Their Kidneys in the Fields: Illness, Injury, and Illegality among U.S. Farmworkers

by Sarah Horton

They Leave Their Kidneys in the Fields  takes the reader on an ethnographic tour of the melon and corn harvesting fields of California’s Central Valley to understand why farmworkers suffer heatstroke and chronic illness at rates higher than workers in any other industry. Through captivating accounts of the daily lives of a core group of farmworkers over nearly a decade, Sarah Bronwen Horton documents in startling detail how a tightly interwoven web of public policies and private interests creates exceptional and needless suffering. 

 

Genres: Nonfiction, Anthropology, School, Social Science

264 pages, Paperback

First published January 1, 2016

Reviews

[Molly · Rating 5 out of 5]

I picked this up out of a free book box in DC pretty much entirely because it’s part of the California Series in Public Anthropology (shoutout also to The Land of Open Graves), and it did not disappoint. Horton uses detailed, long-term ethnographical research to lay out a series of (to me) non-obvious arguments about how immigration law, labor conditions, food safety regulations, the physical and social environments, and healthcare policy work together to inflict disease and death on migrant farmworkers in California’s Central Valley. Her arguments come together around the idea of the “syndemic” (“the unique biological interactions between diseases like hypertension and heat illness, which exacerbate the negative health effects of one or both conditions” and interact with the social and political world to create health consequences greater than the sum of their parts) of hypertension, heatstroke, kidney disease, diabetes, migration stress, and economic marginalization.

Horton untangles the syndemic by detailing the many ways her interlocutors interact with their social and policy context. She describes how migrant farmworkers engage in “identity loan,” which, on the one hand, allows documented and undocumented migrants alike to reap the benefits of legal work papers, and, on the other hand, makes it harder for injured workers to get workers’ compensation. She highlights the unintended consequences of food safety regulations: in their zeal for certification by third party groups (one called, incredibly, the Leafy Green Marketing Agreement, or LGMA), produce companies have essentially banned workers from drinking water while working, including on 100+ degree days. She details the consequences of California’s patchy health insurance system, which, for example, provides care to undocumented birthgivers but only when they are pregnant or have a newborn, and allows foreign-born farmworking men with legal status (a group with disproportionately high rates of kidney failure, even at young ages) to access dialysis but 1) not kidney transplants and 2) only under the condition that they give up pretty much all their material possessions and income. It was interesting to read about how actual people interact with the weird patchwork of local, state, and federal policies on immigration, labor rights, healthcare, and so on.

The book was very accessible, not jargony at all and pretty quick to read despite the heavy subject matter. I also appreciated Horton’s short essays on public vs. activist anthropology and how she designed her methods to achieve her goal of meaningful policy impact. Overall, highly recommend!

[Tea and Spite · Rating 4 out of 5]

Brilliant look at the myriad factors impacting farmworker health. Reasonably accessible, at least once you get past the introduction, the use of individual profiles helps bring the overarching concepts to life. Everyone who's not already familiar with the realities of farm labour should read this to understand how the food they eat got from the farms to their tables.

My only criticism is that it could use an update. The conclusion brings up new reforms enacted under Brown and Obama, but with little indication of the impact they might have. Understandable as at the time it was largely unknown. A new edition with a look at those reforms (and possibly whether or not they survived the Trump administration) would be helpful. Particularly given the ways in which immigration status and anxiety play into the health of farmworkers.

[Matt Shaw · Rating 3 out of 5]

While I have a great deal to say about this book, I'll write something brief. As advocacy -- as a nuanced and detailed analysis of the social, economic, and physiological factors at work in causing deaths among migrant farmworkers in California -- this work succeeds. But that is just what it is: sociological journalism with a heavy dose of polemic, meant to draw attention to the legal framework that maintains a status quo of exploitable inequality. Between the Introduction and Conclusions, Chapter Five stands out most for developing the concept of syndemic to describe the interactions of separate medical issues and the social milieu that incubates them to hatch a complete mortality template. Much of the rest of the book is repetition of anecdotes, statistics, and discussion of various government programs involved; these are central to the thesis but blitheringly poorly written.

While labeled again and again as anthropology and self-described by the author as participant observation, this is neither. It is social journalism compiled via interviews. Look, I KNOW senior Editor Rob Borofsky and I have been involved with the Public Anthropology Project; if anything, I am biased in favor of the dynamic. But as to the matter at hand, Horton does not live with the migrant workers, work in the fields beside them, employ with a contractor, nor fully immerse any of this in the culture of the Latinx workers (whether Mexican or Salvadoran). Further, her theoretical framework is a pastiche of postmodernist and sociological, allowing Bourdieu to carry the bulk of the load. These factors, coupled with the choppy writing and "oral report at a staff meeting" presentation make this fit for a legislative committee far more than an undergraduate classroom or a casual reader.

[Mélo · Rating 4 out of 5]

This is an extremely thoroughly researched book that follows the lives of farm workers in Mendota, California. The books underlying premise is: what happens to those who NEED medical care, but don’t have access or only receive it when it is too late? (Prevention being an impossibility, maintenance being the best and only option). Care should be a human right, not only reserved to those who have the papers and the money - especially when one works and contributes within a society.

Along with medical research , policies (present and past) and more, we follow the subjects from the author’s ethnographic research and weave the complicated web that created the terrible circumstances farmworkers live in.

PERSONAL WARNING: It is NOT an easy book to read, I had to to it in many sittings. This was NOT because of the dense nature of the information given - it is actually incredibly accessibly written for this type of book. This was because some of the stories were simply heart wrenching, to bad, to terrible, to unthinkingly inhumane and hopeless.

If you want to know what happens to those who pick our food, those who make it possible for us to eat produce everyday- this is an excellent place to start.

[RYAN PHAM · Rating 4 out of 5]

Man this book is dark.

I did not think that people had kidney failure at age 52. You accumulate injuries and lifelong disabilities by working as hard as these farmworkers. Also, the chemicals that you take in after decades wrecks your bodies. Since you are in the US illegally, you get less rights, like how OSHA bans certain knives for safety concerns and you don't get that benefit. You are not able to get dialysis due to the limited resources going to American citizens. It's honestly kind of heartbreaking to think about how they have to put up with all this and still live in fear of deportation

[Sarah · Rating 5 out of 5]

Brilliant and accessible. The author explains the situation with nuance and care, and centers the expertise of the workers and their families. Possibly the best book I've read in a decade.

[Andrea Steiner · Rating 5 out of 5]

excellent analysis

[Maggie · Rating 5 out of 5]

Incredibly well written and well researched. I appreciated the accessibility of the language and the story telling that wove the information together.

[Mills College Library]

363.11963 H8236 2016