Chapter 4 La Vista Gorda Reorienting the Science of Learning

Binaries in the Field

They said “you went to Mexico?” and everyone said, “he’s coming from Mexico, he’s from Mexico.” And no, I had not left for Mexico. I was working. I was over in Arizona and Sacramento and that is where I contacted valley fever. And since one is working in the fields, it is all of that that is there, the pesticides and everything. The fungus developed over there with the help of something.

Arturo recalls catching valley fever after stacking fruit boxes into his semitruck and transporting the produce across two states. When the medical staff in Kern County asked him how he had become sick with valley fever, he spent much of his time challenging the doctors’ belief that it had something to do with being Mexican. They focused on his national origin rather than on Arturo’s interaction with the chemicals frequently applied to crops, the fungus, his job, and his overall health under the pressure of these conditions. Arturo’s explanation to medical physicians was lost in translation. The doctors did not deny Arturo medicine, but they did ignore his observations and their implications. Arturo attributed his illness to the conditions of his job, insisting that valley fever derived from a combination of events tied to working for industrial farms and their environmental and social practices, both of which exposed him to harmful conditions.

Maria is a Mexican woman in her midforties who similarly explains a connection between pesticides and valley fever. Accompanied by two young children, Maria arrived on foot for our interview in the conference room of the CBA. Inside the office, the children examined the pictures on the wall adorned with images and newspaper clippings about CBA’s protests while we shared a moment to talk. Maria explains:

maria: I was taken to the doctor right away because I was working in the fields when I began feeling sick. What happened was that we were piscando [harvesting]. We were working, and in the fields just in front [of us] they started fumigating. I cannot remember what was growing in the fields. I breathed in the fumigants. All that day and since then, I began feeling bad. I could not work any longer. I just kept laying down and stayed laying down. The supervisor told me, “You know what, you are sweating too much. You had better rest and if you begin to feel a little better then you can continue working. And if not, you will have to wait here until we are done so that we can take you home.” . . . I was diagnosed with valley fever in Lamont [clinic]. The day that I got it, I felt several things. I had a lot of coughing, a high fever. . . . When I went to the doctor, they told me that I had valley fever because the red spots [on my legs] had turned black.

author: You were working outside when someone sprayed the fields nearby. How close were you from that field?

maria: It was an airplane spraying. It was across the street. The smell [of the chemicals] was strong. I figured that since that moment, I began to feel bad. I got the flu [symptoms]. I had a high fever. I had all of that. When they took me to the doctor, they gave me plenty of medicine because I had that flu. [They said] that I had part of it in my lungs. . . . I do not remember what they said but that I had a lot of it. And I asked them, what am I going to die from? Because they had given me a lot of medications.

Maria clarified that other workers also complained of smelling pesticides, but she was the only person who collapsed that day at the site. At urgent care, the doctors seemed confused by her explanation of pesticide exposure and the visible symptoms she harbored. Maria recalled that the doctor sent another physician to conduct a second exam. She also recalls that no one addressed the pesticide poisoning she described experiencing. Even though physicians did diagnose Maria with valley fever, they also ignored any pesticide drift exposure and symptoms of poisoning. Maria did not return to work for five consecutive months after the diagnosis.

Throughout the United States, approximately twenty thousand farmworkers or 1 percent of all agriculture workers, are diagnosed with pesticide poisoning each year (NIOSH 2013; Farmworker Justice 2013). In theory, the Worker Protection Standard, a federal regulation that requires employers to apply minimum safety precautions when using pesticides on farms, should have protected Maria or Arturo (EPA, n.d.a.). Workers are not allowed to enter fields where pesticides have been applied recently, and the fields must undergo a Restricted-Entry Interval of twelve to forty-eight hours, depending on the crop and the method of application (EPA, n.d.c.). In California, the Pesticide Regulation Department further requires that applications be prohibited if there is a reasonable possibility of harm to people or the environment (California Department of Pesticide Regulation, n.d.). In Maria’s case, however, it is unclear whether these minimum safety standards were considered because certain chemicals fall under exceptions to these rules. Nonetheless, for Maria and her coworkers the conditions attendant to pesticide poisoning posed a considerable danger to their health, and no one did anything about it. Maria reported all the symptoms of acute pesticide poisoning and pointed to the exact moment when she was exposed. Her symptoms ranged from dizziness, confusion, and nausea to skin irritation, shortness of breath, and heavy sweating, which are much like those of valley fever. While physicians rightfully and in a timely manner diagnosed her with a cocci infection, they also ignored her exposure to pesticides, leaving any symptoms untreated and unreported. Maria simply could not forget feeling poisoned by the aerial spray near her. It was crucial to her diagnosis of valley fever. When I asked Maria to explain where she thinks valley fever comes from, she replied:

Well, it comes from everything that is collected in the air, in the smog. Everything that accumulates, the pesticides, and all of that. They are in the wind, the air, all of that. That is what gets trapped together and what I believe we breathe. And from all that comes from the garbage dump site, where people throw away their trash. You know, sometimes all sorts of their aromas come all the way here. I believe it is all those things that makes people sick. . . . People start to feel sick. Your body starts hurting, your chest and lungs, and your head hurts. That is when you begin to ask, what is wrong with me?

Like Arturo, Maria points to environmental pollution as cumulative and with a threshold. It adds up inside the body unknowingly until it can no longer endure and control its ill effects. Being from a city with recent EJ struggles, Maria pointed to the detectable repulsive smells emanating from multiple sources. For example, CBA organizers often noted that tractors applying pesticides in the open fields created dust clouds while moving through the rows. They could also point to the pesticide drift stains on car windows, tiny white specks that clung to the surface. As Maria noted, the nighttime was when one could smell the stench of spoiled food and rotting mud coming from the old community recycling center that has since closed. For Maria, the environmental hazards that she faces at home and at work and the underlying relationship that toxic industries have with residents were inseparable from her experiences with the disease.

Elisa and I spoke over the phone about how her partner Jorge caught valley fever. At the time of the interview, they both had moved to Utah in hopes of a better recovery. They made the decision to leave the Central Valley after spending ten years treating and suffering from valley fever. Elisa and Jorge’s story began in 2003, six months after moving to the city of Arvin. They followed the company that employed them, which had transferred operations from Oxnard to save money. Elisa explains that Jorge was packing fruits and vegetables in Arvin for them when he became ill.

elisa: He first had flu symptoms. He would sneeze and sneeze, then he had a bad cough, and it was getting worse. He went to the doctor, and they said it was just the flu. Within a few days he had a higher fever and many chills. So, he kept taking the medicine that the doctor had prescribed for him. But it was not going away, and he returned to the doctor. They told him that he had a strong flu and possibly bronchitis. They gave him more medicine for that. He began to feel stronger pains behind his head and on his back. That is when we decided to go see a doctor in Tijuana. The doctors could not figure out why he had such a strong fever, but they said that they were going to run very advanced tests. We went for the weekend. By Monday [in Arvin] he still had a strong fever. The chills and the pain in his back, he could not handle it any longer. That is when the doctor [in Arvin] ran some x-rays on his back. The doctor asked him “are you working in the fields?” and he said “yes, I’m working at a packing house where they pack peaches.” So, the doctor said, “Well, you have valley fever. The bad news is that you have an advanced stage of it in your lungs.” . . . The doctor explained that it was like a virus and that it can attack the lungs and head, and he said that Jorge had it in both. Within two weeks, Jorge lost 30 or 40 pounds, I think. He was sick. Until recently, he was still taking medication. He feels better now. But for many years, he was taking medication. Jorge asked the doctor, “How long am I going to have to take medication?” And he said, “Look, I am going to tell you the truth. While you do not leave, you are going to have this disease because this disease is found in this place. . . . Until you do not leave to a place that is fresher, a place that is not like here, you are always going to have to take medication.”

author: When the doctor said it was in the [Central] Valley and that while here, he had to take the medicine, did the doctor explain anything else?

elisa: He said that the chemicals that they use there [in the fields], all the dust that is there, since there is so much dust around the fields, kept the virus alive. The chemicals that airplanes spray the fields with and the dust from the fields, since there is so much wind, that dust and the heat, all contribute so that the virus in him stays active. So, the treatment that he receives keeps the virus asleep. He said, “if you do not want to take any more medication and you have the possibility of leaving this place, then I suggest that you better leave.” It has been since 2003 until recently that he has taken medication for valley fever. So, that is almost 13 years. The thing is that the medicine is just to control or maintain the valley fever fungus count low, but at the same time it is damaging his liver.

author: How did you end up in Utah?

elisa: The truth is that I came to visit some relatives who moved here and when I came, I saw that the environment was nice, and I liked it. I asked him [Jorge], why don’t we move over there? We did not have any plans to leave anywhere because we had our home and everything in Arvin. Leaving for another place meant that we had to start all over. And we are older in age now and one thinks about starting over as a little heavier to bear, more difficult. But I came first, and I liked the environment. Nothing looked contaminated. Arvin is a ditch. I suffered enough. I also suffered from high blood pressure and depression. And over here [Utah] I felt calm and well. I told him [Jorge] you should come over here so that you can see how the environment is and how it could help you recover. He said he would look, and he came for a month. He said that he felt well. He came here in November and in January he stopped taking his medication. 

Jorge’s suffering began when health officials could not make a correct and timely diagnosis on his first visit to the emergency department. Their second visit was no better; it pushed Elisa and Jorge to seek a third opinion from a physician in Mexico. Having neither the economic resources to conduct expensive tests nor the time since Jorge’s symptoms were worsening, they returned to their county hospital desperate for help. Elisa points out that in Jorge’s diagnosis with valley fever, his job as a farmworker became important in the doctor’s examination. This made Elisa more aware of the environmental conditions of industrial farmwork. Jorge’s primary physician also elucidated the cumulative impacts of dust, heat, and pesticides that might have made him less likely to recover. But these environmental conditions were and are not exclusively in the fields. Over the course of ten years, Elisa learned to be vigilant about how pollution around them affected Jorge’s symptoms. They noticed that the frequent dust storms, heat, and air quality affected his recovery at home. Now in Utah, they look forward to leaving the worst behind. But Elisa is keenly aware of how the cumulative environmental pollutants hampered their quality of life and chances of recovering from valley fever. At the same time, it would be entirely up to Elisa to cobble everything together to seek and obtain better prospects.

For Arturo, Maria, and Elisa and Jorge, there are new and compelling connections across valley fever and evidence of environmental injustice felt in the flesh. They bridge their physical experience with the disease to the larger more socioecological politics of the Central Valley. Their observations are attuned to what might otherwise be a spectrum of neglect at one end and an eagerness to champion biomedicine at the other.

“Chavistas” at the Hospital

A woman I name Felicita joined as an organizer for the Committee for a Better Earlimart after a pesticide drift incident poisoned everyone in her town. When I met Felicita, we were carpooling to a court hearing in San Francisco. Two other community organizers were in the car, Tina who was driving us and Dulce. They formed part of our recorded conversation. I asked Felicita to describe her experience during the pesticide drift accident.

felicita: We were inside the house with my daughter and grandson. My husband was there too. We were all inside watching TV or something, but we were inside the house. Then my son arrived. . . . He is the father of my grandson. He says, “why does it smell so bad?” He was just arriving, and he says, “everything smells horrible outside.” And so, I went outside. Oh, it smelled ugly outside. But it was something like, I do not know how to explain the odor. It smelled ugly. Our heads started hurting. We started coughing and feeling dizzy. Then, we started to notice that the firefighters, the police, and the ambulance were around the streets. And we did not know why. We were outside and then an ambulance stopped and asked us, “Are you breathing? Come inside [the ambulance]. . . . There was an accident outside. They spilled pesticides in the field.” It was that that was in the air. We went inside [the ambulance], but we could not be inside [the ambulance] either. We were riding in the ambulance and seeing who else they could pick up, right? They asked me, “Are you feeling bad?” and then asked, “do you want to go to see the doctor?” And I said “yes, yes, I want to go.” They took me to Delano [hospital]. There, they did not pay any attention to us. I was not the only one there. There were other people there. And the doctor said, because we started coughing and coughing . . .

tina: But when you arrived at the hospital, Felicita, were there other people from Earlimart? The nurses or the doctors, were they in the waiting room? Did someone ask, “is anyone affected from the pesticides, come this way?” Or did they give you directions or ask you questions?

felicita: No, not by the time I made it inside. I entered fast because the ambulance took us. If I had arrived in my own car, I would still be there, I think, waiting for the doctors. Because going to the emergency room, the truth is they leave you there. The emergency rooms are only for people whose guts are spilling out, who are bleeding to death, or have a traumatic wound. The doctors will say, “you yes. you no, no.” Well, I arrived with my daughters in the ambulance. Then they brought us into a room. A few minutes later, like 10 minutes later, a doctor entered. And he then asked, “Why are you here? What do you have? What is it that you feel?” I said, “a lot of pain in my head, I am vomiting and have diarrhea.” And the doctor told me, “All of these people are waiting.” There were a lot of people waiting outside. “There are a lot of people!” He said, “what you are doing, what you are is a Chavista!”

dulce: What is that? As in Cesar Chavez?

felicita: Yes, Cesar Chavez. I did not know who Cesar Chavez was. In that moment, I did not know who he was. Do you know what he prescribed? Imodium, I think that is what you call it. He told me to buy that. That it was not serious. That we did not have anything and to go home. That it was nothing, that we were faking it. Those who lived near the fields had many more problems. Even the pets were coughing and coughing. I think Tere had a dog that died. And she saw how he was coughing and coughing. And it died, it was poisoned. Thank God no person died. But we suffered the consequences. No one is the same.

author: What were the consequences?

felicita: That thing about valley fever. I have asthma too, and my two daughters now have asthma. My grandson is now asthmatic. My grandson grew up and is big now. He just turned 18 years old. But since he was a little boy, he would get asthma attacks, especially when he started playing football in high school. Well, that is what happened to almost all of the people. Almost all of us in Earlimart have asthma. I think that it is not going to go away until we die because we keep breathing dirty air.

Medical officials accused Felicita and others like her at the hospital of being a “Chavista” during one of the most horrific pesticide drifts in history (more information is available at https://rememberingteresa.org/). They accused her to be a labor activist from the UFW union, not someone escaping poisoned air and seeking medical attention. Felicita along with her daughters received no recognition or help at the hospital, treating her pesticide poisoning with an over-the-counter medicine that she herself would pick up at the local pharmacy despite arriving by ambulance. Like dozens of others suffering from pesticide poisoning that day, she was berated by authorities, never treated, and ordered to return home to what was allegedly safe.

Farmworkers and activists’ stories highlight more than moments of stress and inconvenience. They also underscore how little authorities care about them. Liz’s body became damaged from years of exposure to raw gas waste because of poor industry regulations, slow bureaucratic procedures, and knowledge regimes deciding the scales of risk. Similarly, Felicita’s, Maria’s, and Arturo’s stories detail how the health authorities silenced their observations about being poisoned. All their cases expose the moral crimes committed against them. The medical experts who situate the risk of valley fever in individuals who have health problems dismiss how some workers and activists experience the effects of cumulative environmental health hazards in the neighborhoods where they live and in their occupations.

Naturalizing poverty, disparate health outcomes, and the alleged ignorance of the afflicted, make it seem that farmworkers and activists have little to contribute to the understanding of the disease. Yet, participants in this study, while not credentialed experts on environmental health hazards, are positioned in Kern County as attentive observers and thinkers. They have, and continue to generate, new questions and knowledge about the routines of diagnosing valley fever and identifying other environmental hazards because they experience their everyday lives as “raced subjects in concert with deadly health consequences” (Lipsitz 2006, 27). The authoritative experts in science and medicine regularly neglect to integrate laypeople’s knowledge, a practice well documented by epidemiologists. They dismiss evidence that comes from people with limited educational backgrounds and an absence of scientific training. Consequently, scientists and public health experts resort to understanding the role of laypeople as objects to be studied in research rather than as subjects capable of being active participants (Epstein 1995). It is not that laypeople have no knowledge but rather that, for experts, laypeople’s knowledge is considered qualitatively inferior compared to the rigor of science. Steven Epstein (1995) warns that this consensus on the production of scientific knowledge dangerously portrays lone scientists as the sole developers of new knowledge. This top-down approach dichotomizes “experts” from “citizens” along class and racial hierarchies (Sze 2007).

Laypeople’s contributions to developing biomedicine have deep roots in community activism (see Lipsitz 2024). Sze (2007) notes that popular epidemiology, the process through which laypeople gather statistical data, creates new knowledge and assembles resources that experts can use to advance and improve science meaningfully. Popular epidemiology in the form of health surveys and alternative environmental research projects can expand the categories that are considered important for inquiry and the methods for interpreting the latest information (Sze 2007). Community-based environmental health research can meaningfully improve traditional risk assessments. When communities collaborate with scientific experts, they create better knowledge through an improved understanding of the intersections of disease and race, class, and place. Collaborative research can improve rather than discount science by expanding what is assessed, raising questions such as “Who is producing the risk, who benefits from this production of risk, and why [are] certain groups and not others [. . .] exposed” (Sze 2007, 181). New coalitions are possible when expert authorities, whether environmental scientists or biomedicine professionals, work collaboratively with residents.

The genuine participation of “lay” people in research can also meaningfully reshape biomedical research and reinvigorate therapeutic regimens (Epstein 1995). Using the AIDS movement as an example, Epstein documents how people with AIDS inserted themselves into the biomedical research agenda and the public health decision-making process. The AIDS movement provoked self-help groups, health educators, journalists, advocacy organizations, people with AIDS or HIV, and other members of the affected community to engage with how patients received care and how treatment regimens reached the affected communities. This system of counterknowledge was not in opposition to expert knowledge but rather complemented the evolution of science. At the same time, the participation of ordinary people in projects of popular epidemiology can help identify “many cases of bad science,” such as studies fueled by secret investigations or studies that never reach local officials. They can reveal a general unwillingness to investigate disease clusters and raise questions about the demands for “standards of proof that may be unobtainable or inappropriate,” as well as experts’ unwillingness to accept innovative ideas about toxic causality (182). Revealing the limitations of biomedical science can both encourage residents to seek alternative sources of information and analysis and yield valuable data from unexpected and previously unanalyzed sources.

The stories told by community organizers and farmworkers in this chapter reveal that valley fever is not a health problem that incidentally produces racial disparities but rather that Kern County has an environmental racism problem, which deliberately and systematically undermines the health of poor and nonwhite residents. These narratives also reveal the creative pathways and the physical and embodied knowledge processes attuned to a spectrum of observations that expand the boundaries of what counts as environmental health knowledge.

There Are Many Stories

The stories of Felicita, Maria, Elisa and Jorge, Arturo, and Liz underscore that valley fever is intertwined with other environmental health threats facing them. They connect the inadequacies of health care practices to the racial legacies of an agricultural industry and its environmental practices that threaten the residents in Kern County. They underscore that mitigating valley fever, as health authorities ever so constantly recommend, has not made life at work or home safer for them. In this way, the participants’ knowledge about valley fever traverses time and place. They see the disease as intersecting with and shaped by race, class, gender, citizenship, and other axes of power, as well as where they live and once lived. They hold both a local and a global perspective revealing the illogic of dominant scientific regimes. Seeking the recommended medical help in a moment of illness is not easy and has no absolute impact on the social and environmental conditions shaping the poor and vulnerable residents’ health.

When experts and authorities apply binary categories to nonwhite rural residents, they do more than label someone as an activist or passive worker. They enact the racist logic that reinforces their authority and the superiority of the scientific process. But, rather than only diminishing workers’ and activists’ experiential knowledge and observations to justify their own, they also failed to document the embodied ailments of patients in official medical records and environmental reports. The farmworkers and activists contest the power of the agro-industrial complex and the environmental and biomedical politics that sustain it through a collective sense of willingness to confront the causes of illness and inequality. Tenaciously seeking an adequate diagnosis and treatment for their health problems reflects a collective advocacy for their right to receive lifesaving, timely, and adequate treatment. Community-based participatory action research does not cast experts and authorities as enemies but rather as potential collaborators in generating visionary and responsible solutions to the surrounding toxic ecologies. The strategies for survival of farmworkers and activists, their unexpected collaborations, and the relationships of solidarity they seek elevate a collective wisdom and desire for environmental health approaches that work.

Many universal abstractions and their attendant narratives can repress the lessons to be learned from the overlapping stories of farmworkers and activists. Liz’s community building and scientific tools go against the standard norms of scientific research, but they do monitor pollution and help make people safer. Whether the Kern County officials who record medical and environmental history will acknowledge Liz’s efforts is yet to be seen, but her story will persist and survive across time and place. Latinx/Chicanx’s ecological knowledge has, indeed, survived repetitions of settler colonialism and ongoing forms of exile (Peña 2005). These creative ways of knowing reemerge in the conflicts for sovereignty, unearthing land-use values such as agroecological systems, multispecies relationships, and water agreements that transcend privatization values. The stories rooted in the opposition to displacement due to extractive farm industries and uneven rural development have also imparted collective social and cultural mechanisms for refuting perpetual forms of subordination (Pulido 1996). I argue that stories in the pursuit of health justice will also survive. These stories survive when we tell them and retell them.

Pérez (1999) questions why some narratives become integrated into the official record, while others are purposefully excluded. Pérez wisely points out that there is “no pure, authentic, original history. There are only stories—many stories” (xv). Pérez argues for illuminating the decolonial imaginaries that break apart binaries like colonizer/colonized or active/passive to articulate the stories in between in what she references as the “interstices.” Binaries such as expert and nonexpert limit our scope of understanding of the complexities of human life. They are often mechanisms for ongoing forms of dispossession, displacement, and deportation. Binaries reemerge as harmful reinterpretations of an imagined past in the present moment. Categorizing “Chavistas” at the hospitals or workers as “passive” does little to improve or refine science. Rather, they are unapologetically political and charged in ways that reinforce power and knowledge regimes.

In public health institutions and throughout the practice of medicine, it remains common practice to blame nonwhite immigrant farmworkers for “risky behavior” that results in sudden and chronic disease, for living in conditions described as “crude and primitive,” and for “draining” public health resources (Devra Weber 1996; Shah 2001; Molina 2006; Horton 2016). Immigrants get subjected to “quotidian forms of intimidation and harassment” and practices that reinforce their status as a highly exploitable workforce, subsequently resulting in a declined quality of life (De Genova 2002, 438). Understanding farmworkers’ and rural residents’ knowledge has important implications both for providing public health services across urban and rural communities and for establishing appropriate structures of care. This approach can also serve to improve the very practices of science and technology.

Inspiring projects like “Sexualidades Campesinas,” which sought to develop an understanding of the diverse sexualities of farmworkers (Irwin et al., n.d.; Lizarazo et al. 2017), further illustrate why informal systems of knowledge are valuable. “Sexualidades Campesinas” makes visible what is invisible in the agricultural fields and the broader politics of where people with different sexual orientations work, learn, and live in their everyday lives. The many stories authored in this project illuminate both the sexual diversity among California’s heterodox farmworkers and how homophobia and dominant perceptions about farmworkers make them reluctant to “come out” in their communities. They give voice to the profound wisdom and experiential knowledge that farmworkers have developed, which have implications for providing adequate public health services in both rural and urban communities. Similarly, this chapter hopes that by bringing into conversation farmworker and activist experiences, it can also deconstruct binaries and unearth the many stories needed for the pursuit of health justice.

Chapters 2, 3, and 4 describe the current conditions shaping valley fever and responses to it. But racial health projects and the resistance to them have long histories. These form the basis of Chapters 5 and 6, which follow.