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UMaine hosts Ethics Day discussion on immigrant healthcare access

On Thursday, April 25, the University of Maine co-hosted its 7th annual Ethics Day, an event held each April through coordination between UMaine and the Northern Lights Eastern Maine Medical Center in Bangor.

This year, the UMaine schools of nursing and social work collaborated with the Department of Philosophy to hold a multidisciplinary discussion on the various healthcare related issues confronted in predominantly immigrant communities. The conference, which began at 7 p.m. in the Buchanan Alumni House, featured a group of four distinguished panelists, each with personal experience on the topic, and special guest Mark Kuczewski, chair of the Department of Medical Education at Loyola University in Chicago.

A variety of students, educators and medical professionals attended the discussion, which concluded with an open question and answer period.

Jessica Miller, the chair of the philosophy department and an associate dean of faculty affairs and interdisciplinary studies in the liberal arts college, acted as the event’s moderator. In addition to her teaching and administrative duties, Miller works as a clinical ethicist at Eastern Maine Medical Center in Bangor, a role through which she has become familiar with the limits to healthcare access faced by many of the state’s immigrants.

“[Clinical ethics is] a service that helps providers, patients and families overcome disagreements, and find the best path forward for the patient,” Miller said.

She added that “a difference in culture or language, for example, if the doctor or the patient is an immigrant, can contribute to the sense that not everyone is on the same page.”

Edith Flores, the first panelist to speak, shared with the audience stories of her youth in a migrant worker family and her eventual settlement in Milbridge, Maine. After graduating from high school, Flores became a certified nurse and spent time practicing in elder care before co-founding Mano en Mano, an organization dedicated to serving Maine’s migrant workers.

In addition to her work with Mano en Mano, Flores further assists the Maine Mobile Health Program, a group which advertises itself as “a network of doctors, nurses, counselors and community health workers that brings essential primary and preventative care to farmworkers across the state.”

The Mobile Health Program estimates the number of its patients to be more than 1,500 each year. According to statistics compiled by the U.S. Department of Agriculture in a 2012 census, 125 of Maine’s farms employ a total number of 2,706 migrants, constituting 18 percent of the state’s hired farmworkers.

“Despite their significant contribution to Maine’s economy, not only through their hard work on farms (they comprise 18 percent of hired farm labor) but also as consumers who spend their earnings in local stores and services, MSFWs arriving in Maine go mostly unnoticed by the general public,” the Maine Department of Labor stated.

Silvestre Guzman, a member of the admissions staff at UMaine and another of the four panelists, recounted personal experiences of migrant farm work in both his native Mexico and the United States.

At age 11, Guzman explained that he was forced to leave his home and become a full-time migrant worker. After ten years of working in Mexico, Guzman migrated to California, where he suffered knee injuries that led to the termination of his employment. The book “Fresh Fruit, Broken Bodies” by Seth Holmes, Guzman said, details the everyday lives and difficulties of migrant workers, who, like him, came to the U.S. from Mexico searching for employment.

In 1999, Guzman moved to Maine, where he has lived ever since. He is now an admissions counselor and multicultural student recruiter at UMaine’s Office of Admissions. His job, he said, is to contact senior-year high school students, mostly of underrepresented or first-generation backgrounds, and offer to help and guide them through the college admissions process.

Representing Eastern Maine Medical Center, Resmi Rajan explained that the struggles of being an immigrant in the health field go both ways. Having lived in Maine for 10 years now, Rajan told the audience of experiences in which patients had refused treatment by her, and by some of the hospital’s other physicians, simply because they were immigrants.

Professor Judith Josiah-Martin, a lecturer at UMaine’s School of Social Work and director of its Office of Multicultural Program, is originally from Antigua in the Caribbean. She first came to the U.S. to study medicine at Andrews University in Michigan, and, despite having nearly no money to spare, was able to earn a degree in four years and continue her post-graduate education.

Josiah-Martin now has over 25 years of experience as a clinical social worker and specializes in assisting women with opioid and other addictions.

The event’s honored guest, Mark Kuczewski, who was visiting Maine for the first time, started his talk by relaying a story that both inspired him and prompted his involvement toward helping undocumented immigrants enter the field of medicine.

In 2011, Kuczewski said, he received a forwarded email from a professor in California requesting help for one of his best students, an undocumented woman who had been brought to the U.S. as a child and faced deportation. An executive order by President Obama in 2012, known as Deferred Action for Childhood Arrivals or DACA, allowed her to say in the U.S. and attend Medical School.

Kuczewski, above all, stressed the importance of self-education on issues like immigration and asked that the attendees lobby their representatives for the changes they wish to see implemented.

“The vitality of our nation,” Kuczewski said, “is dependent on immigration.”

“Immigrants contribute immeasurably to Maine’s economy, as both workers and consumers, and to our culture and social life,” Miller stated. “Events like this, with immigrants speaking to their own experiences, can help us become more aware of their challenges and successes, to hopefully be better advocates and allies.”

The Ethics Day panel and discussion were sponsored by Northern Light Eastern Maine Medical Center, Northern Light Acadia Hospital, Maine Mobile Health Program and UMaine’s Department of Philosophy and schools of Social Work and Nursing. More information about Mano en Mano or the Maine Mobile Health Program can be found on their respective websites:; and

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