were referred for orthopedic care and ten adults to the Tuberculosis Control Program. (See Table A under Part I-Medical, Hospital and Dental Services. The dental program was delayed in starting; however, limited emergency treatment, extractions, and fillings were carried out. A survey made by public health nurses in migrant schools and day care centers showed that the oral hygiene of migrants is poor. A marked increase in total effort will be necessary to improve dental health among migrants. Progress has been made in developing and expanding the existing program through personal contact and health education. Information regarding medical and dental care has been made available through health departments, physicians, nurses, churches, migrant councils, the Office of Economic Opportunity, and volunteers working with migrants. Health classes have been held in migrant camps at night, and the film "A Healthier Place to Live" has been of interest to the young adults and children. Health education materials have focused on the essence of healthful living and the value of a healthy environment. Many families now keep their own Personal Health Records and have presented them at clinics. Nursing services The number of nursing visits has increased in some counties; and in counties unable to hire additional nurses, visits have declined. This year, Cache and Weber Counties hired part-time public health nurses to work in the migrant program during this summer. In all other counties nursing services were provided by the regular nursing staffs of the county health departments. Services furnished by nurses were: (1) Regular visits to migrant camps and families. (2) Classes on health in the camps at night. Films were shown and health materials distributed. (3) Visits to day care centers and schools were these facilities were part of the community services to migrants. (4) Information regarding medical care and referral of persons found to be in need of medical care to physicians. (5) Immunization and screening clinics held in the evenings. (See Tables B and C under Part II-Nursing Services). There was less need for immunization this season since many families had completed immunization before starting to travel in the spring. This was verified by the personal health records presented at the clinics. Weber County rented and equipped a panel truck to furnish health services in the camps at night. It was planned that child health conferences, family planning, immunizations, and other health activities in the thirteen camps would be held from this truck. However, the health officer who was scheduled to participate in the clinics resigned and the extent of the services was limited. Public health nurses made good use of the truck for nursing conferences, immunization clinics, individual counseling, and various health activities. The following services were provided: A shortage of nurses working in the public health programs exists in most counties. Because of the large number of migrants employed in Box Elder County, a critical need for more nursing services exists than can be provided by the local health department and the Office of Economic Opportunity. Next year additional nursing services will be added by the migrant project in Box Elder County. Nurses for these services will be recruited, oriented, and supervised locally by the Regional Nursing Consultant of the Utah State Division of Health. Sanitation Utah's agricultural industry is currently providing over five hundred housing units for seasonal workers. The state migrant consultant sanitarian conducts monthly inspections of these facilities in conjunction with the local health department staff. The Utah State Division of Health's "Proposed Migratory Labor Camp Regulations" are used as a guide in establishing minimal sanitary standards. Subsequent to the inspections, recommendations are made to improve the migratory worker's living standards. State and local health departments and the Bureau of Employment Security and employers are cooperating to bring about improvement in the housing of agricultural workers. The local office of the Bureau of Employment Security has worked closely with the state and local health departments on camp inspections to improve the living conditions of the migrants. General description and condition of housing accommodations for migrants Permits for migratory labor camps are not issued by state or local health departments Division of Health Rules and Regulations governing migratory camps have been drafted and are in the process of being adopted. Camps are inspected for 14 major items. The greatest number of violations are in grounds, bedding, screening, garbage, and toilet facilities. Of 283 violations found among 101 camps, 20 percent of these were corrected. (See Table G under Part III-Sanitation Services.) Approximately one-third of Utah's migrant population is employed by private farmers and growers who utilize migrant labor for two weeks or less. They are housed in small single family units which are usually older abandoned farm houses or units the farmer or grower has purchased and brought onto his property for use by the migrants. The buildings are usually of frame construction with floors of tongue and groove lumber. Many of these units remain substandard because the small farmer feels financially unable to upgrade units having such limited occupancy. Several large, diversified, processing companies have constructed permanent labor camps ranging in size from five to forty units. These are most often frame or metal barracks with cement or tongue and groove lumber floors. The majority of these camps have separate service buildings with flush toilets, wash basins, shower, and laundry facilities. All have electricity, accessible potable water supplies, adequate sewage, rubbish disposal, and sleeping and cooking facilities. Northern Utah Growers in the northern counties generally provide required facilities such as water, sewage disposal, garbage and refuse disposal, and service units. However, an insufficient number of these facilities are available. Water is either potable city or well system. The pit privy is still the most common toilet facility. Garbage and refuse disposal is improving. No camps in the state use any type of kitchen or mess hall facilities. (See Table F under Part III-Sanitation Services) Southern Utah Growers in Carbon, Sanpete, Sevier, Piute, Washington, and Wayne Counties provide fewer and poorer facilities for their migrant laborers. Most farmers and growers feel that because their migrants are Navajo Indians, and because they are used for so short a time, the cost of facilities cannot be justified. There is a problem of providing the necessary health education for the Navajo so that he would utilize the sanitary facilities properly. During the next year there will be an effort to bring interested parties together to discuss methods for improving migrant camp facilities and the necessary improvement in other migrant health activities. Health education To coordinate and bring together all people working with migratory farm workers, Seminar No. 2 was held in Logan, Utah, in April of 1967. There were 115 people in attendance with representatives from the U.S. Public Health Service, state and local health departments, the Utah State Medical Association, industry, growers, church organizations, volunteers, local Office of Economic Opportunity, and migrants. Three migrant farm workers participated on the program. Health education programs have been conducted by public health nurses, sanitarians, church groups, and volunteers. Films in Spanish and English have been shown and pamphlets in Spanish distributed. Utah's Migrant Health Program is now in its third year. The objective of the program is to improve the health of the migrant and his family by providing health education, outpatient medical and dental care, payment for prescriptions, public health nursing services, and improvement in environmental health. Migrant worker health services are provided in all fourteen counties where migrants are employed. The extent of these services vary with the number of migrants and the length of time they stay in the area. Migrants first arrive in Utah about April 1 and remain until November 1. There were approximately 5,695 migrant farm workers in Utah during the 1967 season, an increase from the 3,211 of last year. The medical program provides payment for medical care in physicians' offices. Preventive services include chest x-rays, tuberculin testing, serological tests, venereal disease control activities, health education activities, and environmental health consultation to migrants and migrant camp operators. Services are provided at the convenience of the migrant. Clinics are held frequently at night. Health education films were shown at the clinics and public health personnel were available to discuss health problems with the migrants and their families. To coordinate activities and bring together agencies and individuals involved in the migrant program, a statewide seminar was held in Logan, Utah, on May 3, 1967. A total of 115 persons attended this seminar. During 1967, public health nursing services visits numbered 784 and there were 682 visits to physicians' offices. Public health nurses made periodic visits to the migrants living in camps and to individual housing areas. During these visits the following services were provided: (a) Nursing care and counseling of parents on positive health practices. (b) Referring those in need of medical care to a physician. (c) Arranging for immunization and screening clinics. (d) Showing educational films and conducting group discussions on health and sanitation. (e) Teaching medical self-help as appropriate. The value of maintaining and carrying their Personal Health Records has been emphasized to the migrants. More frequently these records are being brought into the clinics. Physicians will be further encouraged to record pertinent information on these records. Utah's migrant labor camps range in size from a single-family unit located on a small farm to 40-unit camps owned by large corporations. Over half of Utah's migratory laborers work for individual growers. Most housing is old, consisting of abandoned buildings which have been repeatedly repaired. Environmental health services consist mainly of frequent housing inspections and consultation provided by local and state sanitarians. The Migrant Health Program sanitarian made 282 inspection visits to 103 migrant camps during the 1967 season. During these inspections, 283 significant violations were found. Checklists prepared by the State Division of Health were used to define the camp violations. The greatest number of violations were in garbage disposal, water supplies, window screens, cleanliness of mattresses, and privy construction and maintenance. Many problems still remain; however, significant progress has been made. The goal for next year is to improve existing migrant programs, add other needed services, and continue working with communities promoting interest and participation in the Migrant Health Program. |