Earlier this summer, when the news broke about an outbreak of cyclosporiasis — a parasitic infection that results in abdominal distress and is passed on via food or water that has been contaminated by human fecal matter — spreading across the country, one question came up again and again: How did human poop end up in our food system?
On the internet, speculation abounded. Could farmworkers be sick themselves? Were they relieving themselves in the field because their working conditions didn’t ensure proper access to bathrooms? Or did this have something to do with farmworkers, often migrant men and women, being deported? Perhaps, all along, they were the ones protecting consumers from foodborne illnesses. Posts about the outbreak, centering farm labor as either the potential source of disease or as stewards of the food supply, began to crop up.
But these theories are all either incomplete or misguided, say food safety experts. The scale of this summer’s outbreak — the biggest known in U.S. history — suggests widespread contamination of the food supply. For that, they say, we should look closely at irrigation water and other water that’s used in our highly industrialized, global food supply chain.
For example, in some agricultural regions, sewage water is treated and then reused to irrigate crops. This practice is common in areas experiencing drought or water stress, and it is legal in nearly half of U.S. states. When water in such a system is not treated to the highest standards, complications can occur. Whether contaminated water contributed to the ongoing cyclosporiasis outbreak this year is unknown. Public health authorities are still investigating to understand the source of the current outbreak; so far, one company, Taylor Farms, has been associated with the outbreak in multiple states. Last week, the FDA announced it had begun an on-site inspection at a Taylor Farms facility in central Mexico.
Meanwhile, the increase in scrutiny on farmworkers only compounds the other stresses that the population is facing, said Amy Liebman, chief program officer at the Migrant Clinicians Network, an organization connecting farm laborers to health care. In the following conversation, which has been edited for length and clarity, Liebman discusses the risks of further stigmatizing this vulnerable workforce at a time of mass deportation, public health breakdowns, and climate change.
Q. It feels like there are potential risks of further stigmatizing immigrant farmworkers based on how we talk about this infectious disease. What are the things the public should know about this issue, and what are the most accurate, responsible ways to talk about it?
A. Basically, I think we have a disconnect between what we expect and demand in terms of a safe food supply and how we actually do that. I am concerned that farmworkers are actually more vulnerable to getting the disease than they are likely to be the source of the outbreak.
Whenever there’s any infectious disease outbreak, we’re concerned about people living in close quarters. So recognizing that the living and working conditions are often one and the same for farmworkers, that’s really important. There’s other issues that might come up with farmworkers, such as the number of bathrooms or where their well water comes from.
There’s a lot of unknowns — it’s very hard to understand the source because of the amount of time that it takes to trace infections. But it does seem more likely that this involved some kind of contamination from water. So it’s important to understand the overall environment in which our food is grown and processed — from the harvesting to the processing and the selling and finally to being put on our tables. And understand that there’s all kinds of room for contamination in that process.
Q. What are things your organization has been hearing from clinicians in the field? When migrant farmworkers get sick with cyclosporiasis, are they seeking care?
A. So there’s multiple things going on. We have the dismantling of our public health system. We really depended on our frontline folks at health departments trying to figure this out without huge direction or support, at least initially, from the CDC. That piece impacts everybody. Everyone is impacted by a weaker public health system where the frontline personnel are working tirelessly with limited resources. Then you have a real change in our approach to immigration policy. We now have this draconian approach to immigration enforcement. All of that has really pushed our farmworker population further into the shadows. There is a lot of fear in our farmworker community.
So now, if we have someone that might be sick, what does that mean? That means they need to have access to health care. They need to have transportation or somehow the geographic isolation of their situation needs to be addressed. You might have language differences between farmworkers and health care providers. All of these traditional barriers that make it difficult for farmworkers to access help are now also layered on top of these scenarios that we know are going to further disenfranchise and further marginalize our farmworker community.
Q. There seems to also be an added layer of challenge, in terms of how we address extreme heat and worker safety in the U.S. For instance, Congress recently advanced a bill that would prevent OSHA, the federal workplace regulator, from passing a federal standard for protecting workers from heat injury and illness.
A. I think that sort of exemplifies some of the conversation that I’m having with you. That’s just like another layer on top of everything that we’ve talked about. We have an infectious disease outbreak and we know that our farmworkers are going to be more vulnerable because of the work that they do, their access to health care, and our immigration enforcement. And then what’s happening in terms of the changes of our weather patterns and our climate, I think is really important to talk about.
I started off this conversation saying there’s this disconnect between our expectations of food safety and what that means for the worker that’s putting the food on our table. The interesting thing about the proposed heat rule is that there’s documentation that when workers are provided with water, rest, and shade during high heat days, we actually are seeing an increase in productivity. So it really seems very short-sighted, to say the least, in terms of the productivity standpoint, to be passing a law that is so prohibitive in terms of protecting workers.
The bottom line with both of these issues is that worker health and safety is public health. Whether we’re looking at infectious diseases or exposures to weather related issues like the heat, when we think about the worker and think about making sure the worker is protected — that benefits our broader community.
