Outreach to Hutterites in South Dakota
January 13th, 2016
Jenna Gibbs, PhD, Great Plains Center for Agricultural Health, Iowa City, IA
Melissa Gale, LPC-MH, Avera St. Benedict Health Center, Parkston, SD
Farming is at the heart of many rural communities, often involving family members, friends, and neighbors at busy times. Life on the farm can also pose hazards– livestock, machinery, chemicals, and vehicles can result in numerous injures and deaths each year. A grant from the Great Plains Center for Agricultural Health at the University of Iowa recently helped fund a farm safety outreach project tailored specifically to the Hutterite community in Eastern South Dakota. In this region, the residents of more than 50 Hutterite colonies manage farm land, operate large gardens, and raise livestock – including cattle, hogs, chickens, and turkeys. Typically, colonies are made up of approximately 20 families or about 100 individuals. Although the Hutterites are Anabaptists, they are uniquely different from the Amish and Mennonites in the way that they use modern agricultural technology, cell phones, and vehicles for transportation. Agriculture and communal living are ways of life for the Hutterites.
Despite the secluded location of some colonies, the Avera St. Benedict Health Center in Parkston, SD has been providing primary care, pediatric, emergency/trauma, and women’s health services to the Hutterites for many years. The health center has established a colony outreach program that uses mobile clinics, a full time registered nurse, a part time physician assistant, and a behavioral health provider.
About two years ago, the St. Benedict medical staff noticed that the members of eight nearby colonies were receiving emergency/trauma care with increasing frequency. In fact, there were 131 total emergency care incidents (among only 541 individuals over the age of 14) during a sixth month period in 2014-15. This was a surprise, given that the colonies are located in very rural areas, visits to town are infrequent, and emergency care is often sought only for more serious injuries. Most of the incidents for which care was given were related to agriculture and included eye injuries, bone fractures, skin wounds, crushed fingers, burns, and concussions. Although there was limited information regarding injuries among children, local newspaper articles detailed incidents such as a five-year-old and a two-year-old child run over by heavy equipment and the fatalities of two young boys who fell into a grain truck while playing on a farm.
Staff at Avera St. Benedict designed a unique outreach program, “Safe Farming, Safe Living,” to increase the awareness of farm hazards and to promote safe work practices among the members of eight Hutterite colonies. Financial support was provided by the Great Plains Center and organizational support was from local agribusiness representatives and the South Dakota Department of Game, Fish, and Parks. This program coordinated events throughout the colonies– in schools, dining halls, a machine shed, and even in the local colony butcher shop.
Special emphasis was placed on developing and delivering culturally appropriate safety and health education that would be accessible to all colony members, regardless of age or spoken language. Because younger children in the colony speak only German, the local pre-school teachers participated as interpreters. Agricultural health topics included cancer prevention and screening, zoonotic diseases, eye protection, heat/cold stress, and sun safety. Safety topics included livestock handling, All Terrain Vehicle operations, grain handling, firearm safety, and prevention of tractor-related injuries.
The training sessions involved a variety of hand-on demonstrations as well as visual and written materials. For example, a display of general farm hazards were presented by a local custom farmer who used a scaled down ‘model farm’ to demonstrate 20 unique hazards. Attendees participated by pointing out the hazards and discussing potential models of prevention. Another activity involved a “Wheel of Misfortune,” which showed the dangers of walking near or underneath farm equipment. The “Wheel” demonstration displayed human reaction times compared to the time it takes for a tractor loader to fall or the speed of a spinning mower blade. Local tractor dealers used model tractors and a visual display board to demonstrate how to prevent tractor rollovers.
Overall, the initial “Safe Farming, Safe Living” outreach program was a success—with more than 450 Hutterite participants. After the program, 88% of participants stated they were confident in identifying farm safety hazards. Most participants (92%) thought the tractor safety activities were especially helpful. The colony women were particularly eager to learn more about farm safety and how they can reinforce its importance in their homes and with younger generations. At the end of the program, safety equipment, including ATV helmets, was given to participating colonies to assist the adoption of safe pracitices. Since the event, many colony members have voiced the importance of the knowledge gained and additional Safe Living, Safe Farming events are being scheduled with other colonies. The colony outreach nurse has observed an increase in the use of car seats for children in vehicles and helmets by ATV drivers within the colonies. No major life-threatening agricultural injuries have treated at the health center since the program began in 2015. Future agricultural health and safety topics that Avera is considering may include the use of hearing protection equipment, hearing testing (audiology), and training for family emergency preparedness (such as basic first aid and cardiopulmonary resuscitation [CPR]).
To learn more about the Safe Farming, Safe Living outreach project, contact Melissa Gale at Melissa-Gale@avera.org.