When Claudia Salazar and her family moved to San Elizario, Texas, a small city in El Paso County, they landed in a colonia — informal, low-income housing commonly found in rural areas along the United States-Mexico border. Their house was small but sufficient for her four children, and it soon seemed like home.
But the remoteness of their new residence quickly caused difficulties; Salazar found herself in a medical wasteland. The closest hospital is 35 minutes away by car. Even that is difficult to reach, as the majority of the community’s residents are farm workers who work 10- to 12-hour days and frequently lack the time to go for medical care between shifts.
As per The Guardian report, the lack of continuous medical access is one of the numerous public health problems colonias face, and a group of women familiar with the dynamics of this region devised a seemingly easy solution: providing medical treatment to the people in these borderland towns who need it most. Salazar remarked, “Familias Triunfadoras has been of great assistance because they provide a mobile clinic.” This is when we can visit a doctor or make an appointment with one.
Familias Triunfadoras is a non-profit organization in San Elizario comprised of women who serve as community organizers to connect residents like Salazar to resources they may not be aware of. In border areas, they are known as promotores de salud, or more popularly as promotoras, and they assist with a variety of public health issues, from housing to food aid. Residents have found their efforts to make healthcare more accessible in medical deserts like San Elizario to be useful.
Salazar has worked as a promotora since 2019, in addition to being a full-time agricultural laborer, taking English classes, and working for her GED. As a promotora canvassing her neighborhood, she asks locals specific questions about their healthcare needs and then links them with the appropriate medical resources and professionals.
Sometimes this involves directing them to mobile clinic doctors, and sometimes it involves delivering immunizations herself. In addition to focusing on long-term solutions, Salazar and her colleagues are collecting community testimonials to argue for further financing. Although it is not unheard of for a colonia to have its own health clinic, language problems and fear of deportation frequently prohibit colonia residents from utilizing the offered resources to their full potential.
The importance of promotoras in the populations they serve, which have been disproportionately affected by the pandemic, has been clearly obvious over the past three years. However, these networks are increasingly endangered by the continuous politics of healthcare in the United States, the previous administration’s funding cuts, and the rising expense of healthcare. In Texas, the maximum hourly wage for promotoras is $15, however in locations such as El Paso County, many get less. Promotoras get funding from public and private sources, and it can be difficult for them to secure continued financial support for their efforts.
Maria Covernali moved to Texas from Juárez, Mexico, in the 1970s. Covernali, a survivor of domestic violence, became a promotora in 2009; in the same year, she founded Familias Triunfadoras to certify other survivors of gender violence as promotoras. In rural areas with a dearth of hospitals and physicians, community health workers are providing essential services and information.
When Claudia Salazar and her family moved to San Elizario, Texas, a small city in El Paso County, they landed in a colonia — informal, low-income housing commonly found in rural areas along the United States-Mexico border. Their house was small, but sufficient for her four children, and it soon seemed like home.
But the remoteness of their new residence quickly caused difficulties; Salazar found herself in a medical wasteland. The closest hospital is 35 minutes away by car. Even that is difficult to reach, as the majority of the community’s residents are farm workers who work 10- to 12-hour days and frequently lack the time to go for medical care between shifts. San Elizario, Texas is a medical wasteland in which residents must travel great distances to receive treatment.
San Elizario, Texas, is a medical wasteland, requiring residents to travel great distances to receive care. Image credit: ADB Travel/Alamy
The lack of continuous medical access is one of the numerous public health problems colonias face, and a group of women familiar with the dynamics of this region devised a seemingly easy solution: providing medical treatment to the people in these borderland towns who need it most. Salazar remarked, “Familias Triunfadoras has been of great assistance because they provide a mobile clinic.” This is when we can visit a doctor or make an appointment with one.
Familias Triunfadoras is a non-profit organization in San Elizario comprised of women who serve as community organizers to connect residents like Salazar to resources they may not be aware of. In border areas, they are known as promotores de salud, or more popularly as promotoras, and they assist with a variety of public health issues, from housing to food aid. Residents have found their efforts to make healthcare more accessible in medical deserts like San Elizario to be useful.
When they can afford it, nearly every colonia household has its own technique for storing the water they pay to have supplied by truck. Salazar has worked as a promotora since 2019, in addition to being a full-time agricultural laborer, taking English classes, and working for her GED. As a promotora canvassing her neighborhood, she asks locals specific questions about their healthcare needs and then links them with the appropriate medical resources and professionals.
Sometimes this involves directing them to mobile clinic doctors, and sometimes it involves delivering immunizations herself. In addition to focusing on long-term solutions, Salazar and her colleagues are collecting community testimonials to argue for further financing. Although it is not unheard of for a colonia to have its own health clinic, language problems and fear of deportation frequently prohibit colonia residents from utilizing the offered resources to their full potential.
Today, Familias Triunfadoras collaborates with 26 distinct community programs and approximately 700 certified promotoras in El Paso County to link colonia residents with healthcare options. In contrast to other communities or enclaves in the region, colonias frequently lack access to running water, appropriate sanitation, sidewalks, and traffic lights. According to Guillermina Gina Nez-Mchiri, dean of the Imperial Valley campus of San Diego State University, numerous colonias were constructed during the 1960s Bracero program, which allowed millions of Mexican immigrants to enter the nation on temporary work permits.
“Colonias, I would argue, were the answer to farm worker housing in order to have workers close to their workplace,” Nez remarked. And because agricultural incomes are poor, what can individuals buy or rent? Barriers to colonia residents’ access to healthcare can be numerous, reflecting the larger borderland; according to a survey, one in three persons in the Rio Grande Valley of Texas are uninsured or underinsured. As a result, inhabitants experience a variety of health problems, including chronic diabetes, obesity, depression, and social isolation. The obesity, diabetes, and depression rates in colonias near the Texas-Mexico border were higher than the national norm in a 2021 community case study.
The fact that it might be difficult to recruit medical experts to rural America exacerbates the situation. Even in colonias with a medical clinic, residents may find it difficult to schedule or keep appointments. “In rural areas, if you become ill after 5 p.m., the clinic is already closed. “There is no medical care on the weekend whether you have a fever, your child has a fever, or an elderly person has a heart attack,” Nez remarked.
Here is where promotoras come into play. Covernali stated, “We will go out two to three times per week to collect information from the farm laborers because they work all day.” “We must travel to the ranchers and farmland to discuss the situation with them.” Promotoras can direct residents to mobile clinics, help them register for health insurance and food stamps, provide immunizations, and more after identifying community needs.
During the epidemic, the significance of promotoras’ work grew significantly. Over the course of two and a half years, the University of Texas at El Paso (Utep) has collaborated closely with the Morehouse School of Medicine to mitigate the impact of Covid-19 on disproportionately impacted communities, focusing on farm, dairy, and meatpacking workers in El Paso, Texas, Moore, Texas, and Doa Ana, New Mexico.
According to Nora Hernandez, who works on the project at Utep, the primary emphasis of the project was the distribution of Covid-19 information. However, depending on what promotoras were reporting back, the project swiftly extended. Soon thereafter, protection equipment, food baskets, and personal hygiene goods were also distributed.
“They were out in the neighborhood, delivering the necessary education and supplies while risking their lives,” Hernandez said. Promotoras enhance the emotional health of people in addition to their physical health. According to promotora Maria Retana, who works in Doa Ana and El Paso counties, her colleagues have recently been spreading the news about the new national suicide hotline, 988. Promotoras are also educated to de-escalate situations involving emotional anguish.
Promotoras campaign for the establishment of new life-saving amenities, such as helping citizens lobby for drinkable water in their town, in addition to linking them with current healthcare resources. Despite the odds being stacked against them, promotoras continue their hard work: the Trump government decreased healthcare funding dramatically, restricting prospects to hire these individuals. And now that Roe v. Wade has been overturned; it will be difficult for promotoras to connect citizens with reproductive health treatments.
“The [US-Mexico] border region is the most organized: We do not wait for the federal government to tell us what to do. We must survive, said Eva Moya, an associate professor in the social work department at Utep. “Community health workers don’t necessarily have the resources to [organize at the national level], but they’re in the trenches performing the necessary work.”
In Moya’s ideal world, promotoras would serve their communities more effectively by working in emergency centers, addiction rehabilitation programs, and alongside researchers. She has witnessed firsthand the impact a familiar face can have.
“The community expects us. “When people see that table, they get out of their cars and strike up a discussion with us,” Retana explained. “And as they leave, I remind them, ‘Hey, you neglected to enter the store,'” to which they respond, ‘No, I wasn’t planning on entering the store. I just arrived to see you.
