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Field of Dreams by Raquel Vasquez Ludwig PA-S

Dedicated to my amazing classmates at Emory University who looked beyond language barriers, different cultures, and a heat index of 116 F  to provide healthcare to those in need...

The following are excerpts from an essay documenting my experience doing medical mission work with Emory University's Migrant Farmworker project. These anecdotes do not represent my entire experience, but they were the ones that moved me the most. The patient's names have been changed. 

Each one of them is Jesus in disguise.  – Mother Teresa 

About half of my patients had H2A visas, while the others did not. We learned that farmers are required to recruit American citizens to work the fields before they can recruit people from other countries. I like this requirement. I love to work hard  – it has gotten me further in life than I could have possibly imagined, but I’m the first to admit that it would take a starving family to feed for me to do this brutal work.


Jacob is a 9 year-old boy who is in the 3rd grade. He was born in the U.S. and his parents are from Haiti. His mother recently left his father. He wants to be a policeman when he grows up and is eager to start working in the fields like his mother. He wants to help his family. During the dietary assessment, this is the conversation that took place:

R: How many times a week do you skip breakfast?

J: 5-6

R (thinking he misunderstood me I rephrase the question): How many times a week do you eat breakfast?

J: One or two

R: It’s important for kids to eat breakfast every day… Why aren’t you eating breakfast, buddy?

J (he stares at his feet and after a long silence, whispers): My mom told me that if I eat, we run out of food faster. That means she has to go to the grocery store again. We are poor and don’t have money for food. So I help my mom and don’t eat – except for lunch at school.

I feel sick to my stomach and am speechless. I am looking into the eyes of a little boy who is hungry.


I meet Abraham and am surprised to learn that he is 16 years old. He is short, thin, extremely shy, and looks several years younger. He dropped out of school and began working the fields full-time when he was twelve years old. He lied about his age so that the farmers would let him work. His family consists of four siblings and his mother. His older brother is paralyzed after a head injury two years ago. When I learn that his father abandoned their family, it hits me that this youngster is the man of the house.

R: Wow, that seems like a lot of responsibility for such a young person. Do you feel like you have a lot on your shoulders?

A: Yes (as he straightens his back and puffs out his chest). 

R: Young man, I’m very proud of you. I really admire what you are doing – it takes a lot of courage and love to do this.

A: I have no choice…they’ll starve without me. 

I wonder what he thinks about his future:

R: Abraham, what do you want to do when you grow up? When you get older? What do you dream about?

A: I don’t have any dreams…I really don’t know.

R: Everybody needs a dream! That’s how you get through life – it keeps you from giving up and helps you to constantly better yourself. Why don’t you have a dream?

A: I don’t have time to dream. When I work in the fields, all I can think about is my family back home. I wonder how they are doing. I miss them. 

We spend the rest of our conversation talking about the importance of learning English. It will prepare him for better paying jobs both in the U.S. and Mexico. He’s very excited about this possibility and will try to learn however and whenever he can. The foreman calls the men to work, and the youngster quickly thanks me, gives me a hug, and runs off with the other men into the fields. He looks like he is twelve years old.

There must be a reason why some people can afford to live well. They must have worked for it. I only feel angry when I see waste. When I see people throwing away things that we could use.  – Mother Teresa


Rafael is a 30 year old man from Mexico. He does not have an H2A visa. According to him, the farmer knows, but “he never has enough people to help him pick the tomatoes”. Rafael has not seen his family in six years and lives with nine other men in a one-room concrete house. He earns $0.55 per bucket of tomatoes; he can pick about 80 buckets per day (others can pick up to 200 per day). The farmer and contractor are nice to him. He can take as many breaks as he wants to get water or go to the bathroom. The nature of the work makes this difficult due to the distance. 

His medical problems are extensive and there is little I can do to help him. Once again, I feel defeated. In the middle of my next patient visit, I see Rafael walk by with a bag of used clothes from a local church and a small box of canned food. He has a beaming smile and is walking with a new source of strength. He looks like a kid at Christmas.

 Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat. –Mother Teresa


Alejandro is a gentle 22 year-old. He is from Mexico and speaks the most articulate Spanish I have ever heard. He studied 3 years of engineering in college before coming here to work. He is immaculately groomed with clean, pressed clothes and his shirt tucked in. He seems slightly effeminate and carries himself elegantly. I ask what in the world he is doing here – most of our patients seem to have no choice. 

I was being pressured by my family to get married. As you know, it’s not acceptable for children to move out on their own in Mexico. I felt like I was drowning so I came here to escape. I need testosterone injections. Ever since I was a baby, I felt different from the other boys. I know I’m different, but I want so badly to be like everyone else. I want a wife and children…but, I can’t be with a woman – this is a very big problem for me. I don’t understand why I am the way that I am, and I hate myself for it. I just hate myself. I tried to commit suicide once, but stopped because I wondered who would take care of my mother when she is old. I just couldn’t do that to her. And I have never told her about my problem – she will never know. 

The men in the camp treat me like a leper. They sense that I am different, too. They don’t look at me or talk to me. I feel like I have a disease. A few have said horrible things to me and I just feel so dirty and so disgusting. I don’t blame them for treating me like this. It’s not their fault.  I’m not manly. I need to be more manly – please, please, please help me. 

All he hears is that we don’t have the injections he thinks he needs. He starts crying into his shirt trying not to let the other men see him. I wonder how such a beautiful person can be made to feel so worthless. It is 1:30 AM and no one else is in line. We talk for a while and he is shocked to learn that there are other people who feel the same way and that he is not alone. There are many others who have found happiness in their lives. We cry a little, laugh a few times, and carry on as if we have known each other for years. We conclude that human beings aren’t very good at determining each other’s potential or worth.

It is not the magnitude of our actions but the amount of love that is put into them that matters. – Mother Teresa

My classmates and I pack up our shade canopies, medical supplies, and camping chairs. Our clothes are damp with sweat, our hair is wild, and our noses are filled with dust. The hunger and fatigue are kicking in. As we walk through the field, I reflect on how amazing my classmates are as people and as providers – most couldn’t speak Creole or Spanish; yet, they conveyed love with their eyes and hands. One patient told me through tears that he felt God had sent angels to help him. My thoughts are interrupted when the flood lights shut off. The field is completely black and I look up at the bright, starry night. It is quiet and peaceful. I am completely fulfilled as I realize that it is in serving the poor, the hungry, the vulnerable, and the unwanted that I felt the presence of God.

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