In another case of organophosphate poisoning, a group of thirty infants and chil-
dren was poisoned by organophosphates and carbamates. Of twenty cases transferred
to Children’s Medical Center in Dallas, sixteen (80 percent) had an incorrect transfer
diagnosis ranging from encephalopathy to seizure disorders to pneumonia to whoop-
ing cough.^34
There must be some specialized training for doctors who work in rural medicine.
South Carolina may have the best system in the nation, the South Carolina Rural
Health Research Center. A network of experts helps physicians by teaching them to
spot peculiar agricultural illnesses or by providing information for treatment. Under
this network, physicians are linked with various extension agents, poison specialists,
and other experts who have experience treating specific problems. To make a real differ-
ence, farmers and farmworkers must also learn what they need to tell doctors. When a
farmworker goes to a doctor for treatment, it is up to that individual to say, ‘‘I work
on a farm.’’ Then it’s up to the doctor to ask the questions. A farmworker who thinks
he or she has problems because of exposure to some sort of toxic substance also needs
to learn to urge the physician to contact poison control centers because those institu-
tions often have suggestions for treatments that are immediately available.^35Financial ProblemsThe EPA has concluded that using existing surveys, particularly the Consumer
Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System
(NEISS) and the National Center for Health Statistics’ National Hospital Discharge
Survey (NHDS), and supplementing them with additional data collection specific to
pesticides, as well as increasing coverage of hospitals in rural areas, would be more
cost effective than initiating a new data collection system. However, the EPA never
allocated funding to expand data collection and coverage of hospitals in rural areas,
and the agency has not collected hospital emergency room data since 1987.^36
With respect to the migrant health care centers, a lack of sufficient funding has
hampered their ability to effectively serve farmworkers. Financial burdens due to cut-
backs in migrant clinic funding have prevented many clinics from improving their
health care services or expanding their knowledge about these types of patients. With-
out sufficient funding, many migrant health clinics cannot invest in the laboratory
equipment necessary to make correct evaluations of work-related illnesses and injuries
such as pesticide exposure. In addition, many large companies maintain contracts
with private physicians and refer their employees who become injured or ill while
working to them. This removal of a significant number of farmworkers from the
patient pool treated by migrant health clinics creates further economic difficulties for
clinicians. For the few farmworkers who remain, the significant amount of paperwork
involved with workers’ compensation claims, coupled with low reimbursement and
the fear of litigation, may deter them from accepting such cases.
Also, funding for health surveillance projects has on occasion been inadequate.
Without the necessary dollars, it is impossible for health projects to enlarge their42 | Pesticides