Bringing healthcare to Maine’s fields and waters

By Amy Harris

For 40 years, the Maine Mobile Health Program (MMHP) has brought healthcare directly to Maine’s agriculture and aquaculture workers and their families. Describing themselves as a “community healthcare center on wheels,” MMHP provides care at a time and place that is convenient for its patients. According to Medical Director Dr. Demetri Blanas, MMHP is “truly the way healthcare should be,” because it meets people where they are.

Providing care to seasonal workers is challenging. The World Health Organization (WHO) notes that migrant and seasonal workers often experience isolation, frequent relocations, and limited access to consistent health care. These experiences make it difficult to maintain medical records or follow treatment plans. MMHP addresses these challenges with four mobile medical units, three behavioral health vans, and a multispecialty team of providers, traveling across Maine to support workers during blueberry, apple, egg, Christmas tree, tree-planting, and broccoli harvests, as well as year-round dairy, aquaculture, and seafood processing jobs.

CEO Amelia Rukema highlighted the program’s impact: “The model we have works wonders. It is really the closest thing to health equity in action that I have seen in this country. We meet people’s needs where they are, eliminate barriers, and provide quality care at low or no cost.”

Eligibility is simple: patients must currently work — or have worked in the past 24 months — in agriculture or seafood processing. MMHP is federally funded as a federally qualified health care center (FQHC). Workers interested in care can contact MMHP or ask their employers whether the program visits their worksites.

Healthcare services include treatment for workplace injuries, vaccinations, screenings, and management of chronic conditions such as diabetes and hypertension. The backbone of MMHP consists of 40 part-time doctors, eight nurses, one full-time nurse clinical coordinator, and eight year-round community health workers. During peak seasons, the program hires six additional community health workers to support its operations. As clinical coordinator Harden Wisebram noted, “Community health workers are integral to our work — providing transportation, coordination, translation, and, most importantly, care and respect for patients.”

Trust and relationships are central to MMHP’s success. Workers often notify MMHP when they arrive in Maine, eager to schedule visits. “We usually hear from migrant patients as soon as they arrive at a farm and want to know when we can come out,” Rukema explained.

Dr. Blanas, who has been with MMHP since 2019, said he values being part of a “dedicated team of passionate healthcare providers who make it all possible.”

Beyond mobile medical care, MMHP helps patients access specialists, coordinates care at future worksites, and helps secure prescriptions. Partnering with more than 50 local providers, the program ensures clients receive care at low or no cost. MMHP also collaborates with the Migrant Clinicians Network to manage ongoing healthcare needs.

MMHP’s holistic approach extends beyond medicine. Staff assist clients with access to healthy food, safe housing, and winter clothing. Coordinating “warm hand-offs” to organizations such as Mano en Mano, Pine Tree Legal Assistance, Immigrant Legal Advocacy Project (ILAP), Preble Street, and Maine Needs, MMHP integrates interpreters and community health workers to meet broader needs.

Health education is a cornerstone of MMHP’s model. Workers learn about heat stress, pesticide safety, and disease management. Behavioral health services are also available through three specialized vans staffed by four bilingual social workers, offering private counseling in Spanish, Haitian Creole, and Jamaican Patois. These services are often unavailable in communal living situations.

Rukema emphasized the program’s wider impact: “We frequently hear from patients that MMHP providers treated them with the most dignity and respect they have ever received. The healthier our farm workers are, the more fresh fruits, vegetables, fish, and seafood there are for our communities. Our entire community benefits when MMHP’s clients are healthy.”

By bringing comprehensive healthcare directly to Maine’s agricultural and aquaculture workers, MMHP demonstrates how accessibility, trust, and equity can transform lives — one farm, one harvest, and one patient at a time.