¡Salute! to ¡Salud!
The seasonal workers who plant, prune, pick, and press Oregon’s wine grapes often struggle to get the healthcare they need. Supported by Oregon vintners, ¡Salud! brings care—from chiropractic adjustments to chronic disease management—right to the vineyard, improving health outcomes and supporting the backbone of the wine industry.
STORY BY MJ SKEGG
PHOTOS BY AUBRIE LEGAULT
The cork pops on an Oregon Pinot Noir. A moment of anticipation as the wine tumbles into my glass. A few things run through my mind: where’s it from, the varietal, who’s the winemaker. One thing I’m not likely to be thinking about is the vineyard workers. The guy or gal making 30 cuts a minute pruning, lifting tubs of grapes, constantly bending forward, the long days under a hot sun. My bottle of Pinot wouldn’t exist without their labor. In fact, the industry wouldn’t exist, period.
Wineries depend on seasonal and migrant laborers. There are 90,000 such agricultural workers in Oregon, a large proportion of whom work in vineyards. They are mostly Hispanic with little formal education, and their English proficiency is limited. The majority can’t afford health insurance and aren’t eligible for Medicaid Which is why, for over 20 years, vintners in Oregon have run a program called ¡Salud!, set up specifically to offer medical assistance to vineyard workers and their families.
I took a visit to White Rose Estate in the Dundee Hills one summer’s morning to see the ¡Salud! team in action. The thermometer was set to break 90, and brilliant azure skies cradled the Willamette Valley. A half-dozen vineyard workers had gathered, each one dressed for the heat of the day in loose-fitting cotton shirts and large-brimmed hats. Their ages spanned three generations. They spoke Spanish, laughing softly, as though sharing some inside joke. The ¡Salud! mobile clinic was parked nearby, and the workers waited their turn to enter its examination room.
During a break from checking blood pressure and sugar and cholesterol levels, Leda Garside, the services manager and one of the outreach nurses, explains the importance of the program. “For many of them, this is the only health encounter they will have,” she says. “It makes a difference to a person’s life.”
A sprightly 58-year-old from Costa Rica, Leda has been with the program nearly 20 years. In that time, she has seen numerous patients who required immediate treatment – exposure to poison oak in the vineyards is common, and in some cases, it’s been a life-threatening condition they were unaware of.
The program was set up in 1991 by a group of vineyard owners. Maria Ponzi, president and director of sales and marketing of Ponzi Vineyards and a member of the ¡Salud! steering committee, recently described how the project came about: “A desire to produce wine sustainably, fueled the need for more skilled workers and the desire to better care for the community.”
Part of the Tuality Healthcare Foundation, the program is self-funded, primarily through an annual auction of custom-made Pinot Noir donated by over 40 of Oregon’s leading vintners (each winery provides six cases for auction and tasting). These exclusive bottles are a big deal for Pinot fans. The ¡Salud! Oregon Pinot Noir Auction, which takes place every November, attracts buyers from across the country willing to pay up to $3,500 a case. “It’s the best place to see and taste an entire vintage from Oregon’s Willamette,” says David Millman, managing director at Domaine Drouhin. Last year, close to $900,000 was raised, a record sum.
A feverish auction night seems very distant at White Rose. Here, after a general medical check-up, the vineyard workers are seen by physical therapists from Pacific University, one of the project’s partners. Vineyard work is often repetitive (think of those constant pruning actions), and it’s very physical. Hand, wrist, and back problems are common. Physical therapists provide massages and advice on posture and vineyard ergonomics.
This holistic approach, which tackles all aspects of a patient’s health, is a cornerstone of the program – as well as physical therapy, they have access to vision and dental services. Mental health is also emphasized, which is a big, if often overlooked, problem of migrant work. “Many workers are split from their families,” says Leda, “which creates stress, especially if loved ones are dependent on money being sent home.”
Inside the mobile clinic, an AC unit keeps the temperature comfortable. There is a full examination room, as nice as I’ve seen in any doctor’s office. I also notice literature and information concerning immigration and workers’ rights. “Our main goal is breaking down barriers to help our patients access the services they need,” says Leda. “We give guidance to immigrants on everything from navigating the healthcare system to how the educational system works.”
Once they’ve been to the clinic, workers aren’t simply cut loose. Maria McCandless, Tuality Healthcare Foundation manager and auction manager, has come out on the morning’s visit. She emphasizes how important follow-up visits are. “If we identify a problem, we ensure they get to go where they need to. There’s lots of time spent dealing with case management.” Community-based clinics provide much of the primary health care, with ¡Salud! acting as a kind of triage, making intervention recommendations and making certain that workers are seen by the right people.
For Leda, this means her work doesn’t end with the clinic. She makes all kinds of visits, such as to the dental office to translate for a patient who wasn’t getting the right treatment. The patient’s family had been trying to interpret for her, a situation that often creates problems. Apart from what may get lost in translation, family members are often reluctant to discuss sensitive information, or they don’t want to hurt the patient’s feelings. As many migrant workers don’t speak English very well or at all, clinic staff must be bilingual and bicultural.
Given Leda’s years of service, it’s no surprise that her favorite part of the job is the interactions she has with people. “I love getting to know them. The relationships are so important.” She receives phone calls from former patients — some from 17 years ago, who have since moved out of state — wanting to catch up.
“Seeing the children growing up is incredible,” she says. She reels off a list of those she knows are getting married or going to college, and it is with obvious pride that she tells me that one worker’s daughter is finishing her nursing degree.
The morning at White Rose is comparatively quiet – at the bigger vineyards, the clinic can see up to 100 workers a day. In 2016, ¡Salud! tracked more than 5,000 visits. I ask Leda what she thought the clinic has achieved. “A key outcome has been the drastic decline of use of ER for healthcare services – it is no longer the norm, and instead is used for emergency needs only.”
Before I leave, I talk to Maria McCandless again. I want to know more about the people who spend thousands of dollars on a case of wine. She tells me about some of the regulars who fly in for the event – there’s a groups of Texans who fly in every year – looking for the Pinots that can’t be bought anywhere else. She has respect for Oregon’s wine community. “The industry is a huge supporter. They work year-round and donate in all sorts of ways. It’s amazing how the momentum has continued.”
I leave the clinic to its work and stop by the White Rose tasting room. Stepping in from the bright morning, the dimness and cellar-like temperature is a shock. The wines here are small-batch Pinots that run up to $125 a bottle. The winemaker, Jesus Guillén, is one of the few Latinos in the state making wine.
As I swill the wine in my glass this time, I think of the workers outside who contributed to its making. I also think of wines, like the one I am drinking, that the average laborer couldn’t afford. And I think of the thousands and thousands of dollars spent at the auction that helps the people who help make it. I couldn’t smooth out the incongruities of it all.
Another quote comes to mind, this one from Nancy Ponzi, Maria Ponzi’s mother and one of the original founders of ¡Salud!. She had co-established one of the first wineries in Oregon, who had helped set up the now fêted International Pinot Noir Celebration, and has countless other accolades to her name. Yet she believes that ¡Salud! is her “greatest accomplishment.”
There’s no doubt that the life-changing, life-saving work is crucial, especially in a political climate that has migrants fearing any kind of official interaction. It’s also crucial to the development of the Oregon wine industry, and to the Pinot in my glass, which is very good indeed.
The ¡Salud! auction takes place November 10 & 11, 2017.
MJ Skegg is freelance writer based in Portland, Oregon. His work has appeared in the Guardian, Wallpaper, Time Out, and the Financial Times, and he is the Portland Mercury’s wine columnist.