Yolanda S.

Jarrett
HEA 609: Community Health Interventions
Book Review

I. Brief Summary

The book Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United
States focuses on the oppression of migrant workers in a system that uses
migrant labor to generate affordable food but restricts access to necessary
basic needs for people laboring to produce that food. In the book, Holmes
depicts an exhausting and severe struggle between Triqui laborers trying to
support families in indigenous Mexican communities while attempting to
access economic opportunities in America to provide for families. The lack of
procedural and distributive justice for migrant workers in these farming
environments, systemic barriers to economic development domestically, and
oppression leading to physical and emotional harm result in a disturbing
oppression among Triqui migrant workers.

As evidenced by Holmes experience living among the Triqui people, the

violence migrant workers experience domestically, crossing the border, and
working in American farms are all forms of systemic violence against the
Triqui people. As laborers, Triqui migrant workers endure structural violence
that emphasizes low pay, high levels of discrimination, lack of access to
basic needs, and high rates of exposure to multiple sources of bodily
degradation from grueling work that occurs during fruit farming. They also
experience high exposure to environmental toxins in the form of carcinogenic
farming tools and intensely debilitating work that changes the strength and
structure of their bodies. Additionally, Triqui migrant workers experience
symbolic violence, the naturalization of inequality (Holmes, 2013, p. 71).
These various forms of systemic violence against the Triqui people make it
hard for them to work to provide for their families and live healthy lives.

Paraphrased by Phillipe Bourgois the foreword of the book, Holmes (2013)

emphasizes how access to affordable fruit in the United States, and in many
of the wealthier parts of the world, is made possible by a symbolic violence
that treats racism as a natural state of affairs (xi). The way Americans
obtain access to diversity and quality in fruit comes directly off the struggle
that workers encounter through systemic violence towards them as they
migrate to find paid labor. The book analyzes how hypocritical American
culture is to benefit from the healthy options provided by fresh produce at
the cost of the health and welfare of migrant laborers, who lack access and
often receive barriers for the same healthcare.

In his study, Holmes identifies the purpose of Triqui people entering America
as a source of the only source of money and resources for their families. As
mentioned in the book, Oaxacas economic depression is linked to
discriminatory international policies such as NAFTA originating in the
United States as well as unequal economic practices with colonialist roots in
Mexico (Holmes, 2013, p. 92). There is also an active military repression of
indigenous people who seek collective socioeconomic improvement in
southern Mexico (Holmes, 2013, p. 25). Due to barriers from the
international market and militarization of the border, the Triqui people lack
domestic access to resources, and thereby pursue them in American farms
where they know they may obtain options for paid labor.

Disenfranchisement of migrant workers ultimately stems from the system of

violence inherent in U.S. practices. Holmes (2013) emphasizes the systemic
influences of violence by mentioning the different forms in the continuum of
violence: direct political violence, structural violence, symbolic violence, and
everyday violence (Holmes, 2013, p. 89). Direct and everyday are
recognizable as physical and consistently normalized forms of violence,
respectively. However, structural violence as a hierarchical system of
inequality and symbolic violence as an internalization and legitimation of
the structural hierarchy of violence are often ignored as sources of
disenfranchisement for migrant workers (Holmes, 2013, p. 89). Ethnographic
research like this allows for more evidence of the systemic barriers that exist
for disenfranchised people in need of care and assistance.

II. Significant issues of Migrant Health in the United States (Notes)

1. Structural violence through governmental policies and

restrictions
As Holmes mentions, blaming the individual behaviors of migrant workers
lacks a focus on the central importance of structural context and the ways
in which structural forces constrain and inflect individual choice and direct
the options available to people (Holmes, 2013, p. 17). Throughout the book,
Holmes highlights violence as having a significant effect on the health of
migrant workers. Triqui people are excluded by both international market
inequalities and local discriminatory practices from all but one narrow and
particularly traumatic labor position (Holmes, 2013, p. 95). This limited labor
market option, coupled with migrant worker determination for employment,
results in migrant workers whose bodies ache, decay, and are injured
(Holmes, 2013, p. 30). Like many of the disenfranchised groups we
encounter in public health, lack of access to the health care needed due to
barriers in the system enacts structural violence on disenfranchised people.

Labor migration is more complex than just the dichotomous push and
pull factors of workers wanting to work in America rather than Mexico
(Holmes, 2013, p.17). With a lack of consistent jobs for their families, the
Triqui and other populations need access to this work to survive. As Holmes
mentions, there are heartrending stories of the difficult state of family
farming in the United States that have led farm owners to meet the basic
needs of migrant workers (Holmes, 2013, p. 46). The structural violence
enacted on these farming families through corporatization of farm work
overseas has led to fierce competition for compensation of goods, which
could be a reason why farmers find it hard to compensate migrant workers
more.

2. Symbolic violence through racist practices and policies

Holmes (2013) emphasizes Pierre Bourdieu definition of symbolic violence, in
that it the naturalization, including internalization, of social asymmetries
(p. 156-157). Not only do victims succumb to the game of structural and
symbolic violence, but perpetrators often participate in the game, not
realizing they have warped perception of the other through structural and
symbolic violence. Often in the farm communities, the powerful tend to
believe they deserve the successes they have had and that the powerless
have brought their problems on themselves (Holmes, 2013, p. 44). This is
evidenced in the treatment of Triqui workers on the farms.

As Triqui workers labored hard, those higher on the hierarchy instituted

symbolic racism. The young white American workers who served as checkers
are allowed to treat the pickers as people who do not deserve equal
respect and learn also that they deserve to have power over Mexicans, even
those old enough to be their parents or grandparents (Holmes, 2013, p. 70-
71). Holmes even benefited from the symbolic violence of racism and
privilege when the farm executives gave him special permission to
maintain a job even when he couldnt keep up with the work; Holmes
indicated these farm executives treated me as a superior due to my social
and cultural capital (Holmes, 2013, p. 79). These forms of symbolic violence
normalize the harmful treatment of disenfranchised people.

3. Necessity for increased visibility and advocacy for migrant health

needs

An essential form of advocacy for improving the lives of disenfranchised

populations comes in the form of bringing visibility to inequalities suffered by
these populations. Holmes states in order to bring about the amelioration of
social suffering, people must first be aware of inequalities that cause
suffering (Holmes, 2013, p. 156). There is a heightened need for more
understanding about what causes people to migrate, the suffering effected
by the living and working conditions of Mexican migrants in the United
States, and the responses of migrant health clinicians and policy makers, as
well as the perceptions and stereotypes that might normalize these
problems (Holmes, 2013, p. 43). Understanding why people pursue
dangerous or undesirable options is an essential process for public health
educators to understand and effectively help communities.
III. Using ethnographic data to help inform future public health
interventions

Like completing a community health assessment, Holmes entered in the

environment and experience of migrant workers to educate himself on the
circumstances Triqui people and other farmworkers encounter when crossing
the border to pursue work. As Holmes (2013) mentioned, helping address the
complexity of the labor migration experience requires participant
observation in order to understand the complicated issues of immigration,
social hierarchy, and health (Holmes, 2013, p. 3). In the same way, public
health educators must conduct participant observation to gain access to the
complex nature of the communities we intend to serve. We must actively
engage in understanding not just the perceived societal perspective of
community outsiders, but the real and significant structural and societal
barriers that biased systems implement to restrict the abilities for
disenfranchised communities to access the treatment and resources needed
for consistently improved and maintained health.

As we mention often in public health, looking at the individual level as a

source of blame for the lack of improvement in health negates the other
levels of influence in the socioecological model. We must be sure to conduct
immersion fieldwork that legitimizes our role as public health educators
while simultaneously allowing us to prove to the communities we serve that
we intend to use our position to help them bring voice to the health concerns
and needs they identify as important (Holmes, 2013, p. 33). This form of
work seems to give a more informed perspective on the health of
communities, and focuses on a partnership between public health educator
and community members in emphasizing a holistic and humanizing approach
to the complexities, assets, and challenges of communities.

Public health educators should persistently combat bad faith practices

American citizens particularly those in the privileged White American
population use to deceive themselves in order to avoid acknowledging
realities disturbing to them (Holmes, 2013, p. 87). We should avoid
prescribing or implementing inappropriate and culturally irrelevant
interventions to end coping mechanisms in a system that severely lacks
access to more effective and fair treatments and interventions. Public health
educators should see hierarchies as socially and historically constructed and
malleable and make attempts at dismantling the structures that produce
social suffering (Holmes, 2013, p. 181). In addition, we should make
attempts to adapt to practical applications to advocate for communities. If
we make attempts to generate research and interventions that change the
structural and systemic barriers and policies, we could help improve the
health of communities and reduce or remove the barriers to access for
disenfranchised people.
 References

Holmes, S. M. 2013. Fresh Fruit, Broken Bodies: Migrant Farmworkers in the

United States. Berkley, CA: University of California Press