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Thanks to this grant, this large pocket of resistance, which we had to contend with before, is now gone.
As you can see, this principal way of showing the public health of a community, infant mortality rate, has been cut in half. Our infant mortality rate now is actually slightly under the national average.
Senator WILLIAMS. Do you have with you your budget figures showing the division of money to various parts of the program?
Mr. GONZALEZ. No, sir; I do not.
Our migrant grant this year is approximately $60,000. This does not include hospital, which we are getting next year, hopefully.
However, we have for the most part now an integrated program. For instance, to the $60,000 we could well add at least one-third of the $20,000 that we have for our dental health clinic for children. Onethird of the children that receive that clinical help are migrants.
This is from other than migrant funds.
Senator Williams. What is the proportion of State and Federal funding?
Mr. GONZALEZ. Well, the State health department gives our local health department approximately $78,000, and this is really difficult to break down, Senator, but when we figure that in our clinics, our general medical clinic, in particular, one-third of the people we see are migrants.
Then we can say that one-third of that could very well go to the migrants.
Senator WILLIAMS. Are there many programs similar to yours elsewhere in Texas?
Mr. GONZALEZ. Yes, sir. There is a big one in Hidalgo County, which is the biggest county, as far as migrants are concerned. Out of the approximately 105,000 migrants from south Texas that leave each year, 25,000 come from Hidalgo County alone. They have an excellent program.
Senator WILLIAMS. That is also on the border?
Mr. GONZALEZ. That is across from Hidalgo County, yes, Reynosa. Nuevo Laredo is across from Laredo.
Of course, I can only speak for Laredo, and there are differences between the places where our migrants go to work to and the home base area.
But our end of the line is also very important. In many ways, the most important. If the Laredo migrant calls any place his home, it is Laredo, where he goes to spend the winter months and Christmas.
We firmly believe that the close association that our migrant health staff has had with them has given a little bit more meaning to the word "home.” Everyone wants to be accepted somewhere, by somebody. You do not have to be cultured and educated to want to be-wanted.
The identification of this program as a migrant health program has done that for them. They have opened up, as they had never done before.
The primary goal of public health is to influence and motivate man's behavior. Before anyone can be motivated in doing what you want him to do, that person has to be influenced by the public health worker attempting it. And in this I believe our staff has been immensely successful. The migrants consider them their friends. They consider our clinic, their own clinic, to which they look forward to coming back the following winter.
This change that we are now seeing in many of our migrants has taken time, and it has not come easily. It has taken a continuous and persistent effort by our staff patiently working with the same families every year, after they get back home, and the migrant is responding
He has not only found out that there is a health program that takes care of him and his family, but he knows that wherever he goes, this health department will insure that there is a proper followup for conditions requiring repeated medical attention.
One of the most encouraging things of all is that the migrant is now beginning to take responsibility for learning and applying better homemaking an personal health practices.
To be sure, the Laredo migrant is the unpardonable frustration of many a sociologist who contends that all Mexican-Americans would rather see a “curandero," or healer, than a medical doctor, and that they all believe in witchcraft, which is a lot of nonsense.
Witchcraft does exist, but to a very small extent. The curandero bit stems from their background. Most are descendants of people who came from the rural areas of Mexico, where there were few doctors, so some had to learn what do to in emergencies and rely on folk medicine.
Many still rely on folk medicines, when they cannot afford a doctor, but this does not cure their children or themselves when they really get sick. Folk medicines are not antibiotics--and many of them have now seen the effects of antibiotics. And they are seeing now that their children do not have to die when they get sick-even from serious illness-and even when they are following the crops.
Just how much they believe in antibiotics, and in coming to see a medical doctor when one is available to them, physically and economically, is shown by the number of them that have attended our clinics since the program started.
Handout No. 2 shows a 3-year period, from 1964 to November 1967.
We did not add a family health clinic until the second year of our grant, so data on migrants was not kept before. They have always been seen in our health department clinic, though not in such numbers.
Since 1964, 4,921 migrant persons have attended our general medical clinic. This clinic is financed mostly by local and State funds. Only 15 percent of the cost of the clinic is financed by the migrant health grant. Yet almost 30 percent of the people seen there are migrants.
Our migrant immunization clinic, staffed by our migrant health program murses, has had 21,771 clinical visits in this period. Our tuberculosis control program, financed by other than migrant grant funds, has taken 1,469 X-rays of migrants during this time, though the health educator, financed by the migrant program, has played a big hand in this.
Just to cite one more figure from handout No. 2, our dental health clinic for children, which I mentioned, financed entirely from other than migrant health grant funds, has seen 810 children of migrant families in the short period—15 months—that it has been operating.
Two of the most significant figures I have cited above are the close to 5,000 migrants, or members of migrant families, that have taken advantage of our general medical clinic, an enormous increase in migrant participation from years past.
The other one is the almost unbelievable figure of almost 22,000 clinical visits in our immunization program.
These figures do not include December of this year. December is always our biggest month.
The second part of handout No. 2 also shows some of the accomplishments of the migrant environmental health program. The interest shown by the migrants in our clinical requests has been matched by their enthusiam in cleaning up their yards and premises, and in complying with environmental health regulations.
Chief among the accomplishments of our project sanitarian has been the elimination of 132 privies from homes of migrants, with accompanying sewer connections.
The 1966 Texas m grant labor report of the Good Neighbor Commission of Texas states that there has been a big increase in the number of families migrating out of Texas in 1965 and 1966 as a result of the termination of the Bracero Act in 1964. This is resulting in a cessation of competition from alien workers.
In 1964, the last year of the Bracero Act, only some 129,000 migrated. In 1965, a total of about 167,000, including migrants and their families, migrated, followed by 162,000 in 1966, and this year has been described as one of stabilization in the use and availability of farm labor in Texas.
Out of the 162,000 that migrated in 1966, about 129,600 migrated out of the State, and about 32,500 remained entirely in Texas. This then indicates an increase, if anything, in our work with the migrant.
The one matter that I firmly believe we have not perfected is actually one of the very first points considered when the original Texas-Michigan study was made-health service continuity:
This has been a difficult problem, providing this continuity of health services on an interstate basis, particularly when many of the migrants do not even know where they are going to end up after they leave Laredo.
In all fairness, I believe that progress is finally being made in this regard, thanks to the State program in Austin, which is now demanding that all referrals from other States come through them, for a centralization of this most important item.
I feel that, in summary, the Migrant Health Act has accomplished more than it ever set out to do, in identifying this program as the migrant's very own. The more than 100,000 south Texas migrants of Mexican descent needed this slmost as much as they needed the longawaited and invaluable public health benefits the migrants are now finally receiving
In providing the funds for additional personnel to our health department to conduct this program, the Migrant Health Act is not only providing health benefits to one of the populations in our country that needed it the most, but it is also assisting and maintaining the health of the resident citizens.
This is evident in Laredo, where the Migrant Health Act brought a large recalcitrant segment of the population under the influence of public health.
The migrant health program has been the single most effective long-range program ever conducted by the Laredo-Webb County Health Department, particularly in results obtained from dollars spent.
In the light of recent statements made by the Surgeon General of the United States, Dr. William J. Stewart, that health is not being made available to the people who need it, the migrant health program stands out as one program that is most assuredly doing exactly what it was intended, providing health to a people who need it.
(Attachments to Mr. Gonzalez's statement follow :)
HANDOUT No. 2. Migrant health project operations, 1963-671
(a) General medical clinic...
Migrant immunization clinic (visits) (k) Chest clinic (X-rays).
(l) Dental clinic... 1 Information tabulated through Nov. 30, 1967.
97 21,771 1. 469
Activity 2. Nursing services:
Total (a) Home visits.
5, 689 (b) Referrals from home visits to migrant immunization clinic.. (c) Referrals to other sources of medical service or health-welfare
10, 557 services..
4, 119 (d) Immunizations given.. (e) Heaf (tuberculin) tests given.
4, 742 (D) Serological test for syphilis ...
1, 800 3. Environmental sanitation: (a) Number of inspections.
1, 568 (6) Discrepancies
3, 533 (c) Corrections.. ? These include substandard homes, inadequate sewage disposal, unapproved solid waste disposal, rodent and insect nuisances. poor environmental sanitation, etc.
* These include corrections or improvements obtained on above discrepancies. This figure also includes 132 pit privies eliminated.
HANDOUT No. 3.-Number of families and States (Laredo migrants) Minnesota. 239 Indiana..
26 California. 133 Washington..
18 Wisconsin, 127 Oregon.
7 Michigan 116 Oklahoma.
101 Florida Idaho..
94 Kansas. North Dakota.
93 Alabama. Wyoming
73 Montana. Texas..
71 New Mexico.Nebraska.
69 Iowa.... Colorado.
59 Mississippi. Ohio.
7, 701 Children registered:
1 to 5 years of age. 6 to 12 years of age.
1, 666 13 to 18 years of age.
725 18 years and up.. Number of children in school while in Laredo.
2, 731 Number of actual workers migrating-.
3, 386 Number of employed while in Laredo..
688 Number of unemployed.
630 American citizens.
410 Property owners.
122 Other (living in same household with relative) Inside plumbing
776 Septic tanks.
31 No facilities (use neighbor's or relative's)
18 Galvanized garbage cans.
551 Open, unapproved cans.No garbage containers
36 Standard housing
540 Substandard housing
4 Poor environmental
Remarks: Information for 1,318 inspections mentioned is complete. Total of 503 inspections not mentioned, as these have to be reevaluated.