Description

Eastern South Dakota is home to nearly 50 Hutterite colonies whose primary source of income is agriculture. Since 2012, Avera St. Benedict Health Center, a Critical Access Hospital in Parkston, South Dakota, has been providing healthcare services via mobile clinics for 8 Hutterite colonies in the town's surrounding areas. In 2014, the Center experienced a drastic increase in the amount of Hutterites receiving services from their emergency department for farm-related injuries. Because Hutterites do not typically utilize medical or emergency care services, this raised concern among some of Avera's medical staff.

In order to decrease farm-related accidents, Avera St. Benedict's staff started "Safe Farming, Safe Living," a program that educates Hutterite colonies on farm hazards and promotes safe work practices. The program also provides general and agricultural health education in a culturally-sensitive manner. In the summer of 2015, Safe Farming, Safe Living was held at each of the 8 Hutterite colonies in places like schools, dining halls, machine sheds, and butcher shops.

Funding for Safe Farming, Safe Living was granted by the Great Plains Center for Agricultural Health at the University of Iowa. Local organizations who donated money and gifts-in-kind include agribusiness representatives and the South Dakota Department of Game, Fish and Parks.

Services offered

Safe Farming, Safe Living trainings include:

• Hands-on demonstrations, training using visual and written materials.
• Information on agricultural health topics including skin cancer prevention and screening, zoonotic diseases, eye protection, heat/cold stress, and sun safety.
• Education on the proper use of car seats for children.
• Safety tips on topics such as livestock and grain handling, firearm and tractor safety, and All Terrain Vehicle (ATV) operations.
• Safety equipment, like ATV helmets, car seats, and life jackets, are donated to assist in the adoption of safe practices.
• Local Hutterite teachers serve as interpreters for young children whose first language is German.

In 2016, CPR, AED, Basic Life Support, First Aid, and Field Trauma training was added as part of the Safe Farming Safe Living program for adults. Two training sessions were held on each of the 8 colonies to certify agricultural workers in CPR, AED, and First Aid. Along with general farm safety practices, children were taught basic First Aid and EMS activation.

Lessons were taught with workbooks, materials, and hands-on methods including the use of mannequins for CPR and AED training. Farm emergency kits for field trauma were made for each of the colonies, and special instructions were given on how to best utilize them.

Results

As a result of Safe Farming, Safe Living, many colony members have voiced the importance of the knowledge gained. Below are some specific outcomes:

• More than 450 Hutterites participated in a Safe Farming, Safe Living training.
• No major life-threatening agricultural injuries have been treated at Avera St. Benedict since the program began in 2015.
• 88% of participants stated they were confident in identifying farm safety hazards.
• 92% of participants expressed that the tractor safety activities were especially helpful.
• There was a noticeable increase in the use of car seats and ATV helmets within the colonies.
• 176 people were certified in Basic Life Support (CPR/AED/First Aid).
• 205 children participated in First Aid, accessing EMS, and reinforcing of farm safety.

Other related results:

• 49.7% reported they were very confident in their ability to provide CPR if needed, compared to 1.7% post-training.
• 26.8 reported they were very confident they could use First Aid if someone is injured in a field pre-training, compared to  5.6% pre-training
• 2.3% reported they were very confident they could use an AED if needed pre-training, compared to 40.2% post-training.

Several nurses from Dakota Wesleyan University, training with Avera St. Benedict Health Center, helped with the program. This gave the nurses a new understanding of the Hutterite culture and practical experience working with people outside of the clinical setting.

Future trainings may include hearing testing, and the use of hearing protection equipment.

For further reading:

• Outreach to Hutterites in South Dakota, Great Plains Center for Agricultural Health

Challenges

Safe Farming, Safe Living reported that they have had very few barriers due to their strong relationships with the Hutterite colonies. The hardest part was choosing a day for the training that would maximize participation. Since farming is the major industry of Hutterite colonies, a summer day between planting and harvest was ideal. Depending on the day, some livestock owners and their families could not participate due to the demands of their occupation.

Replication

This type of program would be easily replicable for any agricultural or educational group or events. Success will depend on your ability to build relationships, the investments you make in their communities, and your efforts to understand the lifestyle of those you are trying to serve. If you come from a rural community, your rural audience will be more likely to welcome and learn from you.

Staff who worked with this project had agricultural background, making it easier to relate to those in attendance.

Contact Information

Melissa Gale, LPC, Clinical Quality
Avera St. Benedict Health Center
605.928.3311
Melissa.Gale@avera.org