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‘Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States’ reviewed by Jason Johnson Peretz

posted on February 22, 2025

Research Summary: Migrant Farmworker Health and Structural Suffering

Category: Ethnographic study; medical anthropology
Author & Publisher: Seth M. Holmes, UC Press (2013)
Research Focus: Health experiences and vulnerabilities of indigenous Triqui migrant farmworkers from Oaxaca across Mexico-U.S. border and agricultural regions
Methodology: Participant observation, field notes, interviews with farmworkers, immigration lawyers, healthcare providers, farm management, and community members across four field sites
Evidence Grade: Strong—rigorous ethnographic analysis grounded in sustained fieldwork and interdisciplinary perspectives (anthropological and medical)
Key Findings: International economic structures create cascading bodily, emotional, legal, and economic vulnerabilities affecting workers and healthcare systems across the migratory circuit
Scope: Examines ethical dilemmas at all levels of farm hierarchy and healthcare provision; addresses language, ethnicity, and citizenship as determinants of structural suffering
Critical Innovation: Maintains reflexive analysis without postmodern paralysis, centering the possibility of alleviating suffering through more respectful, egalitarian approaches

‘Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States’ by Seth M. Holmes (UCPress, 2013)

It is likely that the last hands to hold the blueberries, strawberries, peaches, asparagus, or lettuce before you pick them up in your local grocery store belong to Latin American migrant laborers. How might we respect this intimate passing of food between hands?

 

A timely, eloquent, and analytically rigourous examination of how the poor suffer, anthropologist and physician Seth Holmes’ ethnography examines the experiences of indigenous Triqui migrant farm workers from Oaxaca, Mexico, as they cross the Mexico-U.S. border, arrive in Washington state, and return through the Central Valley of California. Holmes’ rich ethnography also incorporates perspectives from immigration lawyers, health care workers in the U.S. and Mexico, farm executives and management, and members of local, settled communities along the way.

The book’s seven chapters and appendix, replete with field notes, cover multiple aspects of migrant health experience. Holmes primarily uses data drawn from participant observation, with occasional government and economic statistics. Photographs, a map of the migration route, and two very useful charts on the labour hierarchy of the farm (p. 51), and the interaction between resources, ethnicity, and health among farm workers round out his presentation. The account closes with an overview of possible ways to mitigate the impact of structures which impose suffering on people according to language, ethnicity, and citizenship.

Throughout, Holmes maintains a level of reflexivity which neither dominates the narrative analysis nor mires the work in a post-modern paralysis of navel-gazing. Instead, Holmes allows his reflexive stake in the work to drive the narrative dynamically forward:

As an anthropologist and a physician, I am concerned both with theorizing social categories and their relationships with bodies and with the possibility that suffering might be alleviated in a more respectful, egalitarian, and effective manner. (p. 114)

Holmes carefully presents an inclusive view from multiple community members at all four of his chosen field-sites (Washington, California, Oaxaca, and the Mexican-U.S. border), whose politically charged views on immigration underscore the different responses to migratory labour present in each region, Mexico included. In doing so, Holmes highlights not only bodily and emotional, but also legal and economic vulnerabilities present throughout the migratory circuit. The study thereby contributes to understanding how international and regional economic processes do not simply promote particular forms of injustice and cultural blindness, but create ethical dilemmas at all levels of the farm hierarchy and for healthcare providers in Washington state, California, and Oaxaca.

At stake in Holmes’ account is precisely the ability to see these flows of suffering and constraint at all levels, moving beyond dichotomies of ‘exploitative farm execs’/ ‘good migrants’ and ‘legal business’/ ‘illegal job stealers’ in order to untangle the threads woven by structural violence. Holmes notes that ‘structural violence is not just a simple, unidirectional phenomenon: rather, macro social and economic structures produce vulnerability at every level of the farm hierarchy’ (p. 52). Holmes thus analyses not only the manner in which workers’ bodies suffer, but also how migrant workers come to suffer: the lines by which violence is produced via global markets, international treaties, internal displacement, and hierarchies of citizenship and language.

The Triqui migrants remain the focus, because, as Holmes explains, ‘the suffering of Triqui migrant laborers is an embodiment of multiple forms of violence.’ Holmes traces that violence through ongoing land wars in Mexico; international economic forces pushing the younger members of the community to leave in search of work; the hierarchies of labour and housing present within the United States; and the missed educational opportunities associated with current structures of schooling in multiple states. As Holmes sums up, ‘due to their location at the bottom of the pecking order, the undocumented Triqui migrant workers endure disproportionate injury and sickness’ (p. 109).

As a Californian involved in public health, I appreciated how Holmes does not excuse medical workers for our oversights and misunderstandings in treating migrant workers. He critiques structures mandating clinical and economic productivity, and more important, details the limitations medical training in particular forms of thought places on the patient-practitioner interaction more broadly. In particular, Holmes underlines how such thinking actually furthers and normalises the violence experienced by those at the bottom of the labour hierarchy:

It is critically important for anthropologists as well as global and public health professionals to reframe suffering, death, and risk to incorporate analyses of social, political, and economic structures. In order to ameliorate suffering and death in the borderlands, we must focus together on the legal and political apparatuses that produce labor migration in the first place. (p. 26)

Holmes’ fieldnotes are direct and evocative, creating a sense of the lived context of migrant experiences. Particularly interesting are Holmes’ reflection on how, in many respects, his own Caucasian body did not fit the ethnic-citizenship hierarchies of the farm community where he immersed himself, breaking the ‘naturalisation’ that particular (Oaxacan, indigenous) bodies are suited only for particular types of work (picking fruit). In the context of his field site, Caucasian and Asian bodies fit in the upper hierarchy of owners and managers; Oaxacan bodies are slotted into back-breaking harvest work, and Mestizo Mexicans (both Mexican and U.S. born) fill in the middle ground.

While the work stays well within the bounds of medical anthropology, its applicability to other disciplines is strengthened because the ethnographic anchoring Holmes’ field notes provide allows enough detail for other researchers to use the theoretical lenses of their respective disciplines to analyse the same data. Holmes’ own primary analytical lens relies heavily on Scheper-Hughes’ and Farmer’s elaborations of structural violence and embodiment, though each chapter often presents a unique theoretical focus.

Overall, Fresh Fruit, Broken Bodies is a rich example of medical anthropology that’s theoretically sound, rooted in strong ethnography, and relevant to contemporary policy issues in North America and elsewhere. Those qualities make the book an accessible resource for clinical workers whose primary demographic are migrant workers; for legal scholars and policymakers who want insight into the reasons undocumented workers risk their lives to enter the US; and for activists who seek more just ways to address U.S. immigration policy towards migrant (but not refugee) labour.

This book will interest anyone concerned with food production and labour flows, and international development personnel wanting a broader view on how trade agreements potentially destabilise regions such that migration is the only viable response. It is also an excellent resource for teachers to assign those students The appendix on ethnography will be of particular use to anthropologists explaining their methodology to clinicians and others trained in more quantitative methods.

Despite the suffering involved in bringing produce to the U.S. and global marketplace, the author does not write to make the consumer feel guilty, but to broaden the reader’s perspective on the matrix of work, lives, and economies that bring such fruit to the table. Holmes’ aim to create an appreciation of ‘this intimate passing of food between hands’ has amply succeeds.

 

Reviewed by Jason Johnson Peretz, who holds an M.Phil in Medical Anthropology from Linacre College, University of Oxford, and an MAOM from the New England School of Acupuncture. He currently works in the Division of Global Health, HIV and Infectious Disease at the University of California, San Francisco (UCSF), and consults on projects at the intersection of Global Public Health Policy and Human Rights Law. Jason maintains an active involvement in promoting social justice through addressing the inequities caused by structural violence.

Correspondence to Jason Johnson Peretz.

You can follow Jason on Twitter (@JasonOxon), and see his personal webpage here.

Filed Under: Book Review

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