Helping no hablo espanol doctors distinguish embarazo (pregnancy) and esforzarse (muscle strain) from escalofrios (chills) is the easy part.

Surmounting the cultural barriers between foreign-born workers and the medical help they need -- that's the real challenge for Cornell University students in the Cornell-Finger Lakes Migrant Health Program.

Now preparing for its second year in health clinics, hospitals and migrant worker camps around upstate New York, the student-run program began as a language translation service. It grew faster than an Empire apple in the summer sun.

"Especially in Latino societies, there is a stigma associated with going to a psychiatrist. Some of these people desperately needed mental-health care. But the care providers didn't understand why the patients were hiding their problems," said Miguel Unzueta, a Cornell

pre-med student in 1996 who stayed on after graduation to administer the migrant program.

A state- and federally funded Migrant Health Care Program was already in place in the rural New York counties where migrant laborers from Central America and Puerto Rico spend summers picking strawberries, corn, apples and other crops or working in the packing plants. Based in Rushville, N.Y., the migrant health program staffs medical and dental clinics in a seven-county area and sends patients with more serious problems to nearby hospitals.

But what should have been a 15-minute clinic visit was taking much longer because the doctors could not always understand their patients, and the Spanish- and Haitian-speaking patients weren't comprehending the doctors' questions and instructions.

"I knew we had plenty of bilingual students at Cornell to translate Spanish. We were a little surprised to find students who speak the Haitian Creole dialect," said Eloy Rodriguez, the Cornell professor of environmental studies who launched the student program.

With a smorgasbord of financial support -- from the Cornell Public Service Center, Faculty Fellows in Service Program, Latino Studies Program and the Committee on Special Educational Projects -- the first year's student volunteers received extensive training, then headed to the clinics. Soon, clinic sessions that once dragged on past midnight were wrapping up at 10 p.m. because patients could communicate their problems.

The training required before students participate in the summer program covers everything from social and psychological issues to medical terminology and basic medical skills, such as CPR and blood-pressure testing. Cornell nutritional sciences student Yvette Cruz was glad she paid attention during training when a clinic patient suddenly went into labor last summer. Cruz held the woman's hand, instructed her and the father-to-be on the way to the hospital and, after five hours of labor, helped deliver a healthy baby girl. They Cruz began to cry with happiness; it was the woman's turn to console her.

And the students' help doesn't stop with medical problems. When weather delays the ripening of crops and hungry workers resort to fishing from the lakes, the students usually are able to round up emergency sources of food and supplies, Unzueta said, pointing out a migrant labor fact of life: Workers are paid by what they harvest, and if no crops are ready that week, they get nothing.

The Cornell students can't resist doing research while they work the clinics, and they have been examining the prevalence of injuries and disease among the workers and worker families they serve. Besides undiagnosed psychological problems, they are finding a high incidence of cataracts, primarily due to diabetes, in workers in their late 20s and 30s. Eye injuries seem to be an occupational hazard for agricultural workers, the students note, and they also are recording higher-than-normal levels of diabetes, as well as sexually transmitted diseases (STDs) and AIDS.

"Of course the tests for STDs and AIDS are confidential, but once there is a positive result," Unzueta said, "we counsel and we emphasize, 'What about your family?'"

Some of the cross-cultural misunderstandings are as basic as food preferences, the student-administrator of the program said. There is no sense advising patients to eat pasta if their dietary tradition has no pasta. But providers of so-called modern medicine should also recognize the resistance of patients who prefer their culture's folk medicine practices, Unzueta said.

"We try to bridge the gap and get both parties to meet in the middle," he said. "Sometimes the best we can do is listen, so we let the patient tell us what their problem is. In the process, we're learning compassion for people who are not getting the help they need."

"The students have been a great help," said Jerry Ruiz, outreach coordinator at the migrant health care program. "Most of our clients at the clinics don't speak English, and if we had to send them on to the hospital, they weren't able to communicate.

"They really mix well with the patients," Ruiz continued. "The Cornell students come from such a variety of backgrounds that they are able to understand -- culturally -- what the workers and their families need. And of course the students are able to get some clinical experience even before medical school."

Rodriguez, who is the James Perkins Professor of Environmental Studies in the Division of Biological Sciences at Cornell, said he started the migrant program because he recognized a second need, beyond that of the migrant workers: Too many pre-med students who follow the biological sciences curriculum were not getting the practical experience that would enhance their future education and careers.

In fact, many pre-med students are diverted each year to careers in research, the researcher noted. "Some still want to be medical doctors, and I say: Let's encourage them and help them be the best." Furthermore, the hands-on experience the students are getting in the migrant worker clinics, Rodriguez said, is more impressive to medical school admissions officers than laboratory research experience.

It worked for Yvette Cruz, who now attends medical school in Puerto Rico. And for Miguel Unzueta, who, after taking a year off to serve as assistant director of the Cornell-Finger Lakes Migrant Health Program, is heading to medical school in California with first-hand knowledge of what patients need.

This year's contingent of four students, who are now in training, are about to find out as well.