They Leave Their Kidneys in the Fields: Illness, Injury, and Illegality Among US Farmworkers by Sarah Bronwen Horton (review)

At first blush, California's Central Valley may not seem the stereotypical example of anthropology's classic distant field site. Yet, despite its vital agricultural and economic significance for the state and the country, this vast expanse of land stretching between Los Angeles and San Francisco remains so shrouded in mystery—even for most Californians—that it might as well be halfway around the world. In They Leave Their Kidneys in the Fields: Illness, Injury, and Illegality among US Farmworkers, anthropologist Sarah Bronwen Horton provides an intimate contemporary portrait of the lives and adversities of Mexican and Salvadoran migrant farmworkers in this "other" California. Horton offers a thoughtful and meticulous study of the ways in which policies and their implementation affect the bodies and lived experiences of those they are intended to help. This skilled intermingling of ethnography, policy analysis, and social theory will be an example for political and medical anthropologists as well as scholars of work, immigration, and food. In turn, this book is important reading for students, scholars, health professionals, policy-makers, and broad publics interested in understanding and supporting the lives of those who (often anonymously) produce the food that nourishes most people in the United States.

Based on 16 months of ethnographic fieldwork conducted over nearly a decade in the Central Valley town of Mendota, Horton's book is a detailed indictment of the political and economic conditions that produce illness and death among farmworkers systematically injured by the agricultural labor hierarchy. Drawing on her fieldwork, Horton provides vivid accounts of the bodily violence farmworkers experience through their own words—the worn down cartilage and knees, the arthritic fingers, the hypertension, the "dried up" kidneys (14), and the "burned up" bodies (31) that lie at the heart of today's industrial agriculture. Yet, we are also introduced to the multiple ways in which farmworkers endeavor to survive within a system that is, to say the least, disinterested in their livelihoods beyond their utility as bodies on the fields.

The book's introductory chapter draws readers into the health crisis impacting farmworkers and examines the prevailing models guiding public health responses. Similar to Klinenberg (2012), Horton conducts a "social autopsy" (30) of the epidemic of heat illness, the leading cause of death among farmworkers. Horton challenges dominant narratives that suggest that heat-related death is due simply to uncontrollable "natural" circumstances or to a lack of knowledge leading to poor choices and unhealthy behaviors on the part of those who have died. The first two main chapters proceed from Horton's work to make sense of a deadly conundrum facing policy-makers. Nearly twice as many farmworkers died in California during the three years following the 2005 passage of laws mandating the provision of cool-down breaks, water, and shade than died in the three years preceding the law. Through thorough investigation, Horton shows how a narrowly conceived occupational health approach that overemphasizes individual behavior is insufficient for explaining this phenomenon. The book seeks a different approach by engaging in what she describes as a "social epidemiology from the ground up" (8) that centers farmworker's narratives and lived experiences while examining the policy-influenced structural factors impinging upon them. Throughout the final chapters of the book, Horton deftly combines an expansive view of the legal terrain that, often unwittingly, sabotages the well-being of migrant farmworkers alongside ethnographic descriptions of the many ways in which farmworkers experience, navigate, and respond to these policies. In the concluding chapter, Horton calls anthropologists and the broader public to engage in "pragmatic solidarity" (Farmer 1992) with farmworkers and pinpoints a number of policy areas that her research suggests are critical sites for needed reform efforts.

Horton illustrates the multiple fields of influence and power—political and symbolic—that combine with catastrophic effect to produce heat death among farmworkers, despite the 2005 regulations put in place...