In Fresh Fruit, Broken Bodies, physician and anthropologist Seth Holmes attempts to demonstrate how social, economic, and healthcare inequalities cause profound yet preventable suffering for undocumented migrant farmworkers in the United States. He does so by accompanying a group of Indigenous Triqui families from Oaxaca, Mexico, for 18 months as they cross the U.S.-Mexico border, work on the Tanaka Brothers Farm in Washington’s Skagit Valley, and return to their hometown of San Miguel.
Holmes begins at the U.S.-Mexico border, where he shows how U.S. immigration policies deliberately create extreme danger and suffering for poor migrants. The problem is structural, not individual: the migrants are going to the U.S. because international economic policies like NAFTA have disrupted their local economies and left them without work. Now, their livelihood depends on migrating to the United States, just as the American economy—especially the agriculture industry—depends on their labor. However, the U.S. government mistakenly tries to change individual migrants’ behavior by making it more and more dangerous to cross the border. In the face of extreme heat, rattlesnakes, Border Patrol agents, robbers, and armed American militias, hundreds of migrants die every year. After reaching the nearest town to the border, Holmes and his companions spend a night with a group of strangers in a dingy apartment, ride through the desert for hours in a packed van, run past a dozen barbed-wire fences, and hide out in river beds as helicopters circle overhead. Ultimately, though, the Border Patrol catches them—they throw Holmes in jail and deport all his companions back to Mexico.
In his second chapter, Holmes outlines the fundamental concerns that drive his research on the Tanaka Brothers Farm in Washington state. He explains that the American agriculture industry distributes work, wages, and worries based on an ethnic-racial hierarchy. In this hierarchy, white U.S. citizens are at the top and undocumented Indigenous Latinx migrants are at the bottom. Holmes decides to live and work with undocumented Triqui migrant workers in order to try to understand their suffering, but since he’s a middle-class white man, he ends up “out of place” in the hierarchy. As a result, the farm’s administrators treat him with dignity and view him as an equal, while they treat undocumented workers as subhuman animals. Holmes also explains the two crucial concepts that frame his discussion of immigration, agriculture, and healthcare: structural violence, which is the way social hierarchies cause concrete physical and mental suffering, and symbolic violence, which is the way people convince themselves to accept social hierarchies as natural, normal, or just.
In his third chapter, Holmes paints a detailed portrait of the Tanaka Brothers Farm’s racial, ethnic, and citizenship hierarchy, which leads to a rigid hierarchy of labor, power, pay, and physical suffering. At the top, the farm’s white and Asian American executives struggle to stay competitive with their overseas competitors and feel they have to underpay their workers and constantly cut costs in order to survive. Next, the administrative assistants, crop managers, and supervisors—who are white and Latinx U.S. citizens—help manage fruit production and coordinate between management and the fruit pickers. While many treat the workers kindly, others are openly racist. A crew of white teenagers responsible for weighing berries makes minimum wage and gets to hang out in the shade all day. Finally, the vast majority of the farm’s workers are undocumented fruit pickers from Mexico, who live in tiny, unheated shacks without running water. But they’re also segregated by race and ethnicity: Spanish-speaking mestizo workers have the highest-paid work picking apples, while Indigenous Triqui people have the worst jobs. For $20 a day, seven days a week, they pick strawberries from dawn to dusk, bent over in a painful and unnatural position, with no breaks to eat or use the bathroom. They endure constant racist abuse from their supervisors, but they can’t complain, lest they be deported. Holmes joins them two days a week and can barely stand the constant, excruciating pain he feels in his entire body. Holmes concludes that, while everyone in the hierarchy feels powerless, overworked, and constantly worried about something, those at the bottom suffer far more in every respect.
In the following chapter, Holmes shows that the farm’s hierarchy metes out physical pain, which is a clear example of structural violence. He looks at three men as examples: Abelino, Crescencio, and Bernardo. After years picking berries, Abelino develops knee pain so severe that he can’t walk or work. Whenever his supervisors scream at him, Crescencio gets unbearable headaches, which only go away with heavy drinking. He worries that he might take out his frustration on his family, although he’s never been violent to them in the past. And Bernardo, an older Triqui man who spends part of the year in Oaxaca and part in the U.S., has had severe stomachaches ever since Mexican army officers kidnapped and tortured him, mistakenly believing that he was involved in a local militia.
Next, Holmes looks at how the U.S. medical system mishandles Abelino’s, Crescencio’s, and Bernardo’s pain. Abelino’s doctor ignores his reported symptoms, forgets his name, and decides that he “[does] not know how to bend over.” She sends him to a physical therapist, who ultimately sends him back to work, even though his pain doesn’t improve. Meanwhile, Crescencio’s doctor decides that he’s an abusive alcoholic who needs to unlearn a traditional sexist culture and should be thrown in jail if he doesn’t. She sends him to therapy, which he can’t afford. Finally, Bernardo’s doctor doesn’t call for an interpreter and misinterprets his story. Convinced his chest hurts from an old boxing injury, she refuses to give him medicine and sends him home with a $3,000 bill.
Holmes explains these deep miscommunications, pointing out that doctors learn to conceptualize disease as an objective biological problem caused by defective body parts, rather than a holistic problem with an individual, which can involve social, political, and economic causes as well. As a result, doctors often ignore patients’ judgment and blame them for their own suffering, especially when they come from marginalized groups. When dealing with migrant workers, doctors often overlook cultural differences, or else exaggerate them based on racist assumptions. This leads them to perpetuate structural violence. But Holmes points out that doctors also suffer from structural violence: the pressure to be profitable leaves them stressed out, overworked, and without key resources like medicine and language interpreters.
Holmes dedicates his sixth chapter to explaining symbolic violence, or the distorted ways of thinking that people use to justify and accept social hierarchies. Racism is a powerful tool for this symbolic violence: it enables white Americans to divide themselves off from migrants, avoid empathizing with migrants, and blame migrants’ suffering on supposed cultural inferiority. In fact, many white people simply assume that their own culture is inherently superior and believe that immigrants should be forced to assimilate to it. Again, this reverses cause and effect: by calling minorities inferior, white people justify forcing minorities into a subordinate position in the hierarchy of race, ethnicity, and citizenship. But this hierarchy is the real reason minorities appear to be inferior. For instance, white California and Washington residents tell Holmes they are disgusted by “dirty” Mexicans, but Holmes points out that migrant workers are often covered with dirt because they work on farms all day and don’t have running water to bathe in. In other words, their poverty makes them “dirty,” and because they are “dirty,” white people believe they deserve poverty. Holmes ultimately discusses three main forms of symbolic violence: normalization (or getting used to other groups’ suffering), naturalization (or deciding that other groups suffer because of their natural qualities), and internalization (in which oppressed people blame themselves for their low position on the hierarchy).
In his conclusion, Holmes asks how migrant workers, scholars, and activists can resolve the problems that he has outlined in his book. He admits that U.S. public policy and racial hierarchies are resistant to change. But as a social scientist, he believes it’s possible to fight structural and symbolic violence with the truth: migrant workers’ suffering is not normal, natural, or inevitable. Rather, specific policies and ideas cause it, and those policies and ideas can change through collective social action.
Holmes urges Americans to undo the bias in their language and public conversations about migration. For instance, the distinction between economic “immigrants” and political “refugees” doesn’t hold for the Triquis, and it’s prejudicial to call undocumented berry pickers “unskilled migrant workers,” while calling wealthy white migrant workers “international businesspeople.” Similarly, health professionals must learn to see the political, economic, and social causes of disease, not just the biological and behavioral ones.
Holmes concludes by arguing that scholars and readers also have to fight for policy change. They should join campaigns to fight for universal healthcare, legal status for migrant workers, and economic policies that support small businesses and local farmers, not massive transnational corporations.