Still wearing boots, Jamel, Mehdi, and Zohir exit a van labeled “Vineyard Work.” The three grape pickers head towards a peculiar camper van parked across from the Intermarché de Pauillac, where seasonal workers are shopping after their shifts. The van is identified as “Le Bus en +.” For nearly a year, this mobile unit (80% funded by the European Union) has enabled the Departmental Council to reach residents in Gironde living in areas with limited access to healthcare, particularly in Haute Gironde and Médoc. In the medical deserts on both banks of the estuary, this vehicle provides services for maternal and child protection, sexual health consultations, and more.
This versatile mobile unit can also be deployed as needed, such as following the Naujac storms in June to assist victims with their procedures. On Thursday, September 26, it is present to support seasonal workers during the harvest. Inside the vehicle, Fatiha, a digital advisor, and Coralie, a social and family economy advisor, attend to the needs of the three Moroccans. Jamel explains, “We are in France with a seasonal worker residence permit that allows us to stay for six months a year, and we would like to obtain a Vitale card.” They confirm that they are eligible for it since they contribute to the Mutualité sociale agricole (MSA) and have been in France for over three months. Using a mix of French, Arabic, and Berber to communicate, and sending the necessary documents via WhatsApp, they proceed with the application.
“Access to rights is central to our approach,” explains Cécile Huguet from the Castelnau-de-Médoc territorial integration center. “The first of these rights is postal domiciliation.” Without an address, it is impossible to open a bank account or initiate any actions. “We also provide services like tetanus vaccinations.” “We manage to identify individuals who would otherwise go unnoticed—people who live in trucks…”
At the back of the bus, near the “reception” area, a small alcove has been created for conducting gynecological consultations. A mini-laboratory is available for performing analyses, with the approval of the Regional Health Agency. The audience for Bus en + provides insight into the seasonal worker population. “Thanks to this initiative, we can identify people who might otherwise remain invisible, such as those living in trucks,” notes Stéphane Le Bot, a PCF elected official for the Nord-Médoc canton and vice-president of the Department responsible for agriculture. “There are many foreigners, especially Moroccans, as well as Spaniards, Romanians, and Bulgarians…”
This observation regarding sociological and housing issues aligns with findings from the precarious workers mission of Médecins du Monde, which has been active for a year in the adjacent Bus en + building. The NGO and the Department have collaborated to complement each other’s efforts in ensuring access to rights and healthcare.
“The Housing Puzzle”
“We know that, alongside those who play by the rules, there are slumlords, including in Pauillac. It’s no secret,” admits Stéphane Le Bot. “However, those who genuinely want to do things right are not professionals in hospitality. Perhaps the standards should be relaxed, in a derogatory and very temporary manner for the harvest,” suggests the vice-president. The focus is on the decree from July 1996 that prohibits accommodating people in tents at the operator’s premises. “In Médoc, we manage to host thousands of vacationers; we should be able to accommodate seasonal workers without issues concerning access to toilets and water,” continues Stéphane Le Bot.
This stance aligns with that of the National Association for Employment and Training in Agriculture (Anefa), which discussed seasonal worker housing in May. Will suspending regulations meant to protect workers from residing in tents prevent overcrowded accommodations or those hiding in trucks in the woods? In any case, the Bus en + presents another opportunity to raise awareness on this issue, according to Sophie Borderie, director of the Territorial Solidarity Center of Castelnau-de-Médoc. “Some claim there are no issues in Médoc since we don’t see them. But that is the exact problem: we don’t see them!”
Jamel shares a home with four individuals in Pauillac. When asked about comfort, he replies, “It’s okay… It’s work!” he philosophically summarizes. The next stop for the Bus en + in Pauillac is scheduled for October 10 from 5 to 8 p.m.
Bus en +: Bridging Healthcare Gaps for Seasonal Workers in Gironde
At the intersection of agriculture and healthcare, the innovative Bus en + initiative is making a significant impact on the lives of seasonal workers in the Gironde region, particularly as grape harvest season approaches. This mobile healthcare unit, supported by the European Union, provides vital health services directly to vulnerable populations in areas characterized by limited access to medical care.
What is Le Bus en +?
Le Bus en + serves as a mobile clinic specifically designed to cater to the medical needs of Girondins living in rural, hard-to-reach areas of Haute Gironde and Médoc. This unique service commenced nearly a year ago and has since been pivotal in supplying essential healthcare services such as:
- Maternal and child health protection
- Sexual health consultations
- Tetanus vaccinations
- Social services and family economy guidance
Supporting Seasonal Workers
On September 26, 2024, as seasonal workers conclude their shifts, the Bus en + made a stop in Pauillac, directly responding to the healthcare needs of workers like Jamel, Mehdi, and Zohir—three grape pickers who hail from Morocco. With a seasonal worker residence permit allowing them to reside in France for six months, their immediate need was assistance in obtaining a Vitale card, a crucial step for accessing healthcare services.
Access to Rights and Healthcare
One of the core objectives of the Bus en + is facilitating access to rights for seasonal workers. Cécile Huguet of the Castelnau-de-Médoc territorial integration center emphasized the importance of establishing a postal domiciliation. Without a fixed address, individuals face significant barriers to opening bank accounts and accessing various services. Key services offered include:
- Facilitating the healthcare registration process
- Providing information on local resources
- Connecting workers with legal guidance on employment rights
Beyond Basic Healthcare
In addition to regular health services, the Bus en + is agile enough to respond to pressing community needs. For example, following the storms in Naujac, the bus was deployed to aid those impacted by helping them navigate the complicated processes related to storm damage and recovery.
The Multifaceted Role of the Bus en +
As a mobile “Swiss army knife,” the Bus en + is not only vital for healthcare access but also serves as a conduit for social support. Stéphane Le Bot, a local elected official, highlighted the initiative’s role in identifying and reaching out to individuals living in precarious conditions, including those residing in makeshift housing like trucks or tents.
Understanding the Housing Landscape
The seasonal worker community is diverse, comprising individuals from various backgrounds—including many from Morocco, Spain, Romania, and Bulgaria. The housing crisis in this sector is underscored by the presence of slum landlords, with workers often facing substandard living conditions. Thus, there’s an ongoing dialogue regarding regulatory reforms that may help accommodate seasonal workers more adequately during harvest times.
Case Study: Challenges Faced by Seasonal Workers
Jamel, one of the grape pickers, shares insights about his experience. Although he lives with four other seasonal workers in a house in Pauillac, the comfort level is minimal. “It’s okay… It’s work!” he notes, emphasizing the pragmatic energy many workers possess despite the ongoing challenges they face.
Practical Solutions and Future Directions
Le Bus en + is committed to improving the living and working conditions of seasonal employees through:
- Regular health check-ups and vaccinations
- Legal support and advice on workers’ rights
- Enhanced outreach to undocumented or hard-to-reach workers
Community Engagement and Support
The collaboration between various organizations, including Médecins du Monde and the Gironde Departmental Council, fosters a network of support intended to uplift seasonal workers. The director of the Territorial Solidarity Center, Sophie Borderie, underscores the need for visibility regarding the struggles of these workers, aiming to dispel the notion that there are no problems simply because they are not visible.
Next Steps for Bus en + Services
Continued engagement with the community is essential. The Bus en + will return to Pauillac on October 10 from 5 to 8 p.m., further underscoring the initiative’s commitment to seasonal workers, providing them not only with healthcare services but also addressing their broader social needs.
Summary of Services Offered by Bus en +
| Service Type | Description |
|---|---|
| Healthcare Services | Maternity and child health consultations, sexual health services, general check-ups |
| Social Support | Guidance on workers’ rights, legal advice, and access to community resources |
| Emergency Response | Support following natural disasters and immediate community needs |
| Health Education | Information on preventative care, including vaccination programs |
