On the surface, the classroom at Sunset Elementary School is like
any other. Young children scurry to-and-fro, dodging colorfully
decorated desks and bulletin boards, while adults twist and turn
to avoid their random wanderings.
A closer look though, makes this group stand out. First of all,
the children in this southwest Georgia school are all Hispanic.
Their parents, for the most part, are migrant workers. Sunset Elementary
is located outside Moultrie, in Colquitt County, about 225 miles
south of Atlanta. Colquitt County is one of the states agricultural
centers with 75 cash crops and a migrant population that reaches
10,000 at its peak.
An even closer look reveals that these children have gathered in
this too-small classroom for a specific purpose. At one table, a
little boy inspects a breadbox-size set of teeth made of construction
paper. His tablemate holds a construction-paper toothbrush. Many
of the children grip plastic bags filled with toothpaste, dental
floss andfor somethe first toothbrush they have ever
Among this claustrophobic chaos, Heather Watkins finds a small
space in between two desks and collapses in a heap on the floor.
Over the past two weeks, the Atlanta dentist (and now periodontics
student at the Medical College of Georgia) has peered inside the
mouths of hundreds of peopleboth children and adultsand
pulled so many teeth she says she has lost track. With no Medicaid
or insurance available to migrant families, dental care among them
borders on the abysmal.
You know, Id really be enjoying this if I wasnt
so tired, she says.
For Watkins to admit being tired is saying something. The upbeat,
approachable dentist has more energy than the Tasmanian Devil after
a double latte. Watkins remains seated for about 45 seconds.
But this is what I like, Watkins says as she bounces
up off the floor upon hearing that an 11-year-old boy in dire need
of checkup has been found. He had wandered off a few minutes before.
Welcome to the Migrant Family Health Program, which is led by the
Nell Hodgson Woodruff School of Nursing. The program encompasses
undergraduate and graduate nursing, dental hygiene and physical
therapy students from several Atlanta-area universities who team
up to provide basic health care services and education to migrant
workers and their childrenone of Georgias most underserved
From June 921, more than 1,000 migrant workers and their
children received basic health care through the program.
Taking his seat, the eyes of Watkins aforementioned patient
never meet hers as she explains to him that he has an abscessed
tooth that needs to be removed. She tries psychology (Girls
dont like boys with nasty teeth, is a particularly good
line), but he never shakes his veneer of misplaced cool. After the
lecture, he leaps off the seat and bolts out the door.
I call this intensive immersion service learning,
says Lorine Spencer, who created the program at Georgia State University
in 1994 and brought it to Emory this year. She and Judith Wold,
visiting professor of nursing, direct the program for the nursing
Most of the students havent been to rural America.
They had no idea how food goes from the field to the market. Ive
had more than one student say that they would pay more for food
so that the lives of the people who picked it would be better,
The program is a masterstroke of coordination and cooperation.
While Emory provides the nursing students and faculty, the hygienists
are from Clayton State College and University and the physical therapists
and psychologists from GSU. And South Georgia College in Waycross
provides a van for the programs mobile clinic in the evening.
The students mornings are spent at Sunset Elementary a few
miles south of Moultrie, where they treat the school children, ages
316. When they enter the gym where the clinic is set up, each
childs name is written on masking tape and stuck to his or
her chest and back. The youngsters then weave a varied path among
stations that measure blood pressure, height and weight, and vision.
In one corner is the pharmacy where neat stacks of childrens
Tylenol, chewable vitamins, cough medicine and Klout (which combats
lice) wait to be placed in brown paper bags for children who might
Written in blue, ball-point pen on the half dozen or so bags awaiting
delivery are the names and addresses of the children in question.
Rather than send medicines home with the children, outreach workers
with the Colquitt County Farm Worker Health Programaccompanied
by an Emory nursing studentwill deliver the meds personally
to families and explain how they should be administered.
Next to the makeshift pharmacy is where nurse practitioner students
are conducting exams. Their private work is hidden behind walls
of white sheets.
In the opposite corner of the gym are the physical therapists.
Some of the children are undergoing physical tests; others are coloring
on large sheets of paper taped to the floor or constructing small
towers with blocks. These activities test cognitive skills.
Behind the physical therapists, nursing students are pricking fingers
for hemoglobin tests. This is usually the last test the children
will undergo, since no one wants blood to be everywhere. On the
opposite end of the school, are the hearing tests and dental room.
Each night, a caravan of vehiclespunctuated by the Nightingale
Van, which resembles a rock bands tour busleaves
the Hampton Inn on the Moultrie bypass, where everyone stays, to
set up the programs mobile clinic. On June 20the last
night the students are in townthey set up at the L&M packing
shed part of town.
In 10 minutes, the crew of student nurses, hygienists, physical
therapists, et al turns a concrete slab used for loading and unloading
vegetable trucks into a free clinic with tables for administrative
duties, a dentistry area, padded massage tables and a couple dozen
chairs. Everyone pitches in. Susan Aydlotte, a nursing school faculty
member at Grady, even brought daughters Nell and Zan (a senior and
sophomore, respectively, at Lakeside High School) to act as runners.
Patients are waiting in line even before all the equipment is unloaded.
The question is, says Elizabeth Downes, assistant professor
of nursing and one of the Emory faculty members leading the program,
Who takes longer to set up a tent? The therapists or the hygienists.
Its the hygienists, who must deal with netting that will
surround patients who come to get their teeth pulled. But its
a close race.
Unlike the elementary school, the patients who visit the evening
clinic are almost exclusively adults. Most of the men have the dark,
leathery skin signifying someone who spends a great deal of his
time in the sun. Both the men and woman look much older than their
years. Working in the fields can make a 26-year-old woman resemble
someone whos 40. Few speak English.
This is definitely harder than working at the school,
says nursing student Corinne Leonard. People have a lot more
serious problems, and that makes this more challenging.
This night, Leonard worked the front tabletriagewith
fellow nursing student Carly Brooks. Their job was to listen to
the people seeking treatment; do an initial, informal diagnosis,
then direct them to the appropriate station. Hundreds of people
came through the mobile clinic over the two weeks, but Brooks said
this evening was lighter than previous ones. Dental and back problems
were most common, Brooks said. One person appeared to have an ulcer
and another a sexually transmitted disease. There also were two
people with heart problems.
One group that is particularly busy is the physical therapists,
who treat men with a host of ailments. Something that isnt
We had one person who we wanted to squat instead of bend,
says Serena Lund, a physical therapy student at Georgia State. Lund
earned her undergraduate degree at Emory and works as a research
specialist in neurology while attending GSU. He said hed
get in trouble for sitting down.
Everyone remains well past 10 p.m. The previous night, Watkins
and her team pulled teeth outside a local Baptist church until midnight.
(Until I ran out of patients or instruments, whichever came
first, she said afterward.)
In between the day and night clinical work (which numbers 100 hours),
Emorys undergraduate students meet for an hour-long seminar,
which is where part of their grade comes from (there also is a final
paper, a take-home exam and a daily journal).
Two weeks of nearly nonstop work more than 200 miles from home
clearly takes its toll. In their final meetingin between a
group discussion of child health and a rollicking trivia game regarding
the same subjectthe students crankiness shows as the
class almost en mass expresses its displeasure about a variety of
Just as quickly as the orneriness rears its head, though,
Were not really like that, says Tammy Renn, in
an unnecessary apology afterward. The students unquestioning professionalism
in the clinic would win over even the most cynical doubter. I
think everyones just really tired, she says, turning
down the hall to complete her final journal entry.