I must recommend Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States (written by medical anthropologist and physician, Seth M. Holmes, and published this past June by UC Press), a text so marvelous that it deserves this post title’s quadruped alliteration. In this powerfully moving and hopefully significantly influential book, Holmes reveals through poignant thick description the life experiences, structural inputs, and health outcomes of Triqui migrant farmworkers.
Best described by his fellow fruit picker, Samuel, as a project in which “he wants to experience for himself how the poor suffer” (33), Holmes chronicles Triqui experiences as they live in Oaxaca, risk their lives crossing the U.S.-Mexico border, and labor in the fields of California, Oregon, and Washington. Holmes vividly depicts personal experiences of suffering, defined as “not only physical sickness, but also mental, existential, and inter-personal anguish” (89). Furthermore, while various scholars and researchers describe, list out, and point to structural inequalities and the fundamental causes of disease, Holmes’ combination of ethnography, theory, and medicine elucidates these causes and structural forces with refreshing complexity, dexterity, clarity, and empathy.
With an assertively activist aim, Holmes seeks to encourage acknowledgement, engagement, reform, and transformation of the social, economic, and political structures that have created the plight of the migrant farmworker. He points most specifically to NAFTA trade policies that benefited the United States, while decimating the Mexican corn industry and the jobs it provided (25). Without these employment opportunities available, Holmes argues that the migration of farmworkers is anything but voluntary. Rather, migration for agricultural work in the United States is a forced necessity for workers to support their families. As his Triqui companion, Macario, says, “There is no other option left for us” (18).
Beyond the economic politics of global neoliberal capitalism, Holmes depicts the causal pathways by which structural forces affect the wellbeing of migrant farmworkers. He sketches hierarchies, relationships, feedback and feed-forward loops with compassion and balance.
For example, Holmes reveals the different structural inputs that affect workers at every level of the social structure at Tanaka farm where he worked and observed. Within the “ethnic-labor hierarchy” of the United States, which places white and Asian American U.S. citizens at the top and undocumented indigenous Mexicans at the bottom (84), Holmes exposes “the primary fault lines of power” within the Tanaka farm hierarchy, which is segregated by race, class, and citizenship (50). At the same time, he reveals the way market pressures and concerns for the fate of family farming shape the actions of farm executives and how the work demands and perceptions of those in the middle of the hierarchy (administrative assistants, crop managers, supervisors, and checkers) influence how they treat the field workers paid hourly and by weight.
Similarly, Holmes acknowledges the structural factors (health system bureaucracy, positivist biomedical training, and lack of funding, supplies, medicines, and equipment) and challenges (language barriers, time constraints, incomplete health records, and lack of continuity of care) that affect clinicians and shape how they perceive, diagnose, and treat migrant patients (128-130).
By delineating the challenges and structural inputs at each level of these imposed hierarchies, Holmes is able to propose structural solutions that both remove the clinical gaze upon individual migrant workers as responsible for their fate and moderate the pointed blaming of healthcare workers and farm executives and managers.
While the theoretical concepts employed in the text seem disjointed and cherry-picked at times, Holmes’ use of structural violence (43) and Bourdieu’s symbolic violence (44) are a common thread throughout the text. In this way, Holmes reveals how social inequalities and hierarchies not only fall along “social categories of class, race, gender, and sexuality,” but also how they come to be internalized and legitimated (89). He forcefully argues that due to this violence the suffering of migrant workers has been “taken for granted, normalized, [and] naturalized” (156).
Depicting physical experiences that are powerfully shaped by perceptions of race and class, Holmes’ work also provides a contemporary view of the biological racism that others have depicted in historical perspective, such as Natalia Molina’s compelling 2006 study, “Medicalizing the Mexican: Immigration, Race, and Disability in the Early-Twentieth-Century United States” and very shortly forthcoming book, How Race is Made in America: Immigration, Citizenship, and the Historical Power of Racial Scripts also from UC Press.
The audience for Holmes’ message is wide, taking in the lay public, policy makers, and health care workers, all of whom he seeks to make aware of the structural violence exerted by global neoliberal capitalism and the labor hierarchies within American agriculture (109). He calls for reforming economic, immigration, and labor policy, including social structural analysis in the training of medical and public health professionals so that they can see more than the “biological and behavioral determinants of sickness” (153), and working toward a universal health care system (195).
Arguing that the inequalities faced by migrant farmworkers are not naturally but socially constructed, Holmes voices an impassioned call to acknowledge that these structures can, should, and must be changed (156); a call that most any reader would be hard pressed not to answer after reading of the broken bodies that provide our fresh fruit.