Farmworkers play a vital role in the United States economy, but this population faces serious threats to health and barriers to care on a daily basis. Fast-moving public health crises — from natural disasters to COVID-19 — only magnify those disparities. Courtney Peragallo, a student in the UNC Gillings School of Global Public Health’s online Master of Public Health (MPH) program, wants to change that.

Through academic study and hands-on service, Peragallo started laying the groundwork for her public health career as an undergraduate student. She pursued a double major in public health and Spanish and minored in global health. In her spare time, she gave back as a peer health educator and began studying for the Certified Health Education Specialist (CHES) exam.

She also interned with Manos Unidas, a public health nonprofit. Funded by the North Carolina Farmworker Health Program  (NCFHP) of the North Carolina Department of Health and Human Services’ Office of Rural Health  and stationed within a federally qualified health clinic, Manos Unidas provides health services, resources and bilingual education to farmworkers and their families living in North Carolina.

As an intern, Peragallo worked directly with Spanish-speaking farmworkers. She interpreted for patients at a dental clinic, did community outreach and conducted hundreds of health assessments. Things took a turn in September 2018, when Hurricane Florence devastated the area, including the farmworkers’ community Peragallo served.

“After Florence, I helped mobilize many communities of farmworkers by co-organizing food and clothing drives in areas that were affected by the storm and assessing immediate need during a crisis,” Peragallo says. “During my time as an intern, I also developed a CHES competency-based safety protocol for outreach staff that ultimately fielded my work in emergency preparedness.”

Peragallo’s atypical internship experience shed light on some important knowledge gaps and areas for growth. Mastering the Spanish language was an important part of engaging with the farmworker community, but it was just one piece of the puzzle. She’d need to refine her cultural competency skills, too.

“It opened my eyes to social justice and how to build trust in communities where you are considered an ‘outsider.’ In virtually every camp, I was the only native English-speaking female out of a camp of 50 to 100 native Spanish-speaking men from Mexico. This taught me a lot about cultural humility. I had to take mental notes on how to better assimilate and become accepted into these communities. It helped me so much to empathize and better serve them.”

None of this, Peragallo says, happens overnight. Many farmworkers don’t trust traditional health care institutions and practices, and they worry about their personal information getting into the wrong hands. When public health practitioners don’t take the time to immerse themselves in the communities they serve, even the most evidence-based interventions can fall apart. Sustainable, long-term change demands a higher level of communication, trust and humility.

Once Peragallo graduated from her bachelor’s program, she continued working in farmworker health, most recently conducting a project on behalf of the Office of Rural Health as an emergency preparedness coordinator. She is now helping Manos Unidas expand their capacity to better serve farmworkers in the southeast region of North Carolina, supporting them through the challenges posed by COVID-19.

As Peragallo gained more experience, she started thinking ahead — and thinking big — about the kind of impact she wanted to make in public health.

“Down the line, I want to continue serving global populations. I want to be a leader within the global health field and impact policy decisions that will protect communities of color,” she says. “This requires significant leadership skills — specifically, advocacy, grant writing, strong communication, public speaking and the ability to present findings in a way that communities, funders and policymakers are all able to understand.”

She knew an MPH would provide all the skills she would need to solve systems-level challenges. The next step? Choosing the right program.

“I knew that I wanted to be on the front lines. I also knew I wanted to belong to a school of global public health. Global health is my passion.”

The Gillings School was Peragallo’s dream school — as a Harry Potter fan, she says, “It was like my Hogwarts.” She also was confident that earning an MPH would advance her career, but she wasn’t sure it made sense to start the program such a short time after finishing her undergraduate degree.

When she was tempted to push back her start date, her father’s advice changed her mind.

“My dad is the type to tell it like it is and constantly reminded me that one year quickly turns into two, and before you know it, it feels too late to go after your dream. I knew I had to make my education a priority.”

She also earned an MPH@UNC fellowship, which motivated her to begin the program right away.

Peragallo chose to pursue the MPH Leadership concentration because she wants to think more critically about what it means to make a difference within a global population. “In light of the pandemic, leadership skills are critical,” she says. “The character building and refinement of key public health skills [in this concentration] are unparalleled.”

Those skills are ideal for someone like Peragallo, who wants to make sure she understands how to help underserved populations at local, national and global levels. She’s especially interested in evidence-based practice — in the future, she’d like to pursue a career at the intersection of data and policy.

Getting to know the other students in the program confirmed her sense that she’s in the right place. Whenever she has been assigned group projects, each team member has brought different skill sets and experiences to the table.

“Working together in a group setting, sometimes you may feel like you aren’t a good fit. I have never felt that here.”

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