2021 Week 5: Healthcare/Health Policy

CARLOS BURI-NAGUA | CENTRO SOL

Centro SOL’s Summer Scholars program is halfway done, which is insane to think about because time does go by quickly. The mid-way point is essential in my internship because most of the students have completed their research PowerPoint and abstract, which will either be presented at the CARES symposium or in front of Centro SOL’s staff and volunteers. As I prepare the students for their presentations, I am reminded of all the work that we did in the first three weeks of the program and the suggestions from my supervisor.

My primary responsibility for the summer program was to develop a research curriculum. While I had my introductory meeting with my supervisor, she suggested the following format for my lesson plans: SWABT, warm-up/introduction, presentation of new material, practice/application, and a deliverable. Looking back, I really appreciate the suggestion of having deliverables throughout the program. It was a great way to track their progress as the curriculum lead and for students to look at their work and create an outline for their presentations. I believe that because of the deliverables, students were able to format their presentation with more ease rather than having no centralized location of all of their work.

During my college experience, it has always been challenging to manage a workload, especially if the task seems daunting at first. When I think about my future profession, I remind myself that I need to take small steps; in other words, have my deliverables! It is imperative for me to break down larger tasks so that I don’t overwhelm myself, and I believe this helps me become more productive. Thus, I will try to carry a mindset to break large tasks into “deliverables.”

In addition, I have learned that it is crucial to be transparent with your work team; my supervisor and the other intern have been very supportive! In fact, my supervisor has provided many suggestions that have helped my projects and their overall progress. Whenever we have our one-on-one meetings, she always sets up a welcoming environment for me to ask questions. Also, the intern has been very helpful whenever I have questions as we work closely on running the zoom for the summer program. In the future, I hope to maintain an open, communicative environment with my colleagues.

JULIA BURLESON | BALTIMORE HARM REDUCTION COALITION

Before I started this internship, I thought that the best way to work at BHRC or any organization was to be as efficient in my tasks and knowledgeable about my work as possible. I saw myself as a worker first and foremost who could contribute the most by prioritizing my assignments above all else. I was therefore incredibly surprised when I started working at BHRC and found that they didn’t treat me like just a worker or prioritize efficiency above all else. Instead, the staff wanted to learn more about me as a person and cared about my life outside of work as much they cared about my experiences at BHRC. My supervisor was also never concerned about the speed of my work or if I was talking with my coworkers for too long, and she never treated me differently based on my work efficiency.

I’ve come to learn a phrase that encapsulates this environment: radical love. It’s a central tenet of harm reduction that means loving and valuing every person without requiring a certain level of behavior or performance. I see it in the outreach that BHRC does when they give out free safer drug use, sex, or hygiene kits. I see it in the interactions staff members have with people who use our services when they ask how someone’s day is, if they want any snacks, and how their loved ones are doing. While I expected the staff to show people who use our services radical love, I didn’t expect staff members to show me radical love for some reason. Maybe it’s because I expected BHRC to be like the other office environments I’ve been in where the quality and speed of my work were more important than me as a person. Maybe it’s because I’m still trying to give myself the same radical love that I would give to other people.

Either way, I’ve learned that radical love is a quality I want to bring to my future workplaces and interactions. I want to prioritize making every person I interact with feel seen and accepted. Everyone deserves to be treated with compassion and humanity, even if the interaction is short and seemingly insignificant. Radical love is a quality that will help me make stronger connections to my peers in my future workplaces and deeper relationships with the communities I work with after the summer ends.

KOYE OPUTA | EPISCOPAL REFUGEE & IMMIGRANT CENTER ALLIANCE

Good things take time on Monday. And then a little more on Tuesday. And then a tiny bit more on Wednesday. I am accustomed to sitting down and completing a project—or at least a first draft—all in one go. This served me well in early high school and has remained effective for some tasks, but it has failed me when it came to long-term writing projects or the dynamic, team-based workplace.

In my first few weeks at ERICA, I took on most tasks with the assumption that I would finish it, or near its completion by the day’s end. My kind supervisor would smile and offer some variation of, “That’s nice, but I know these things take time.”

It seemed a feasible goal to design a website image within an hour until a comment from a staff member made me realize a generational disconnect with the graphic design, or when my supervisor wanted me to add a new element to the image. I knew how to work iteratively—so long as each iteration occurred within a couple minutes of the last one, and ensured that a first draft was completed by the end of the day.

It was not a habit borne of procrastination, just a habit I thought to be best. Until five-page high school essays became fifteen-page research papers. Until ten-page short stories became writing projects that could span upwards of 100 pages. Until my leisure-like interest in migrant life became ERICA where I felt a need to keep myself available for the next unexpected tasks, which were often thirty minutes away.

Forced by cramped schedules, I adapted an iterative process approach to my life—one that spanned more than 8 hours—with an overwhelming sense of defeat. However, acknowledging that a first draft may take three days to complete is not the same thing as accepting it.

It was not until I noticed my supervisor say to herself as she tweaked the placement of cheese in an auction wine basket for the fifth time—consequently achieving a stunning photograph—that I accepted that “Some things just take time.” Once I agreed to give things their due time, I found it easier to enjoy my work projects and found rest in interruptions rather than interference. Furthermore, the writing projects I pursued in my personal time were more enjoyable. When I stopped scorning the amount of time it took me to write a page freed a massive mental block in my head and improved the quality of my first drafts. Whether it was writing a short story or studying the statutes of the 1951 Refugee Convention, I found myself entering a flow state that was once rare due to my choppy university schedule.

When appropriate, I still seek to accomplish a task all at once. However, giving a project the time that it requires has restored a much-needed element of peace to my writing life, refreshment to my time with ERICA, and excitement for the next project to which I can apply this precious lesson of time.

INDIRA SUMMERVILLE | SHEPHERD’S CLINIC

At the clinic, there are many skills that I have gained that will be useful in the future. Some of those include organization, phone etiquette, and the use of various online platforms. However, I believe the most valuable things I have learned are more conceptual than practical. They are mostly seen in the characteristics of the staff and volunteers, as well as in the way that they work together. One of these characteristics is patience. In this line of work, patience is of the utmost importance, as our patients are often exceptions to our rules. By this I mean that there are often many accommodations that we have to make for our patients that extend our medical responsibility, and even may be outside of our rules and eligibility criteria. However, we still do the best that we can for them, and work through their struggles, which can often exercise a lot of patience, especially if our patients are non-cooperative. Patience has proven to be essential to the way that we treat our patients because some of our interactions can be extremely frustrating due to unforeseen consequences, and uncooperation, but exercising such patience is what ensures the continued health of our patient population. Another characteristic is consistency. The procedures we have in place are extremely important to our ability as a clinic to treat our patients. The staff and volunteers are reliable, and consistent in the way that we approach our patients, from reminder calls, to scheduling procedures, etc. Also, we are consistent in our dedication to each patient, trying endlessly to ensure that no one slips through the cracks, and we neglect to treat them with the resources we have.

Lastly, I have learned that it is okay, if not best to lean on other people in this job. I am someone who likes to do things on my own, and learn how to do everything so that I do not have to rely on others to get something done. However, at the clinic, there is no one person that takes care of everything. The clinic runs well because everyone has their own distinct role, with their own set of expertise that provide one layer to our treatment of patients. Even with staff and volunteers in the same department, or job, some have been in their position for a longer amount of time, and some are newer but bring a different set of skills. Regardless, everyone learns from each other, and the majority of the people at Shepherd’s are not afraid to ask the necessary questions and leverage the knowledge of others in order to provide the best care. Patience and consistency are both extremely important in both public health and medicine, which are two of my main career options, as they establish trust between me and the people I hope to serve in my career. I have enjoyed exercising both during my time at the clinic, and learning how to do so in this context will be very beneficial for me going forward. Learning that it is okay to lean on others has always been a struggle for me, but I have really been forced to do so as there is still so much that I have to learn in order to effectively carry out my duties, and questions that I ask everyday. Overall, I have learned a lot thus far, but exercising patience and consistency, while also learning and accepting that leaning on others is okay has been the most beneficial, and will likely be extremely important in my career.

VEENA THAMILSELVAN | KESWICK MULTI-CARE CENTER

This week at my internship we started a new project at the J Van Story Branch Apartments Health and Wellness Suite. JVSB is a set of affordable living options for older adults living under the poverty line and individuals with disabilities that opened in December 2020. The Health and Wellness Suite, which opened in May of this year, is meant to provide easy access to primary care, psychiatry, nutrition, and other therapies. Keswick, JH Hospital, MedStar, and Shepherd’s Clinic have all invested heavily in the apartments and wellness center to provide subsidized care and service coordination. This past week, my job has been to support the case worker and program director for the health and wellness suite through talking to residents, leading workshops, and doing promos for events. Throughout the process, I saw a lot of material that we learned during orientation about working for community interest and engaging stakeholders being put into practice. This past week, we held Keswick programming, which is primarily geared towards older adults, at JVSB. However, the demographics are more varied, ranging from 18 – 70+. Because of this, we found that some of the residents weren’t interested in easy movement, or line dancing events but would rather go to more informational events where they could access resources or useful items. After realizing this, we talked to the resident advocate of the building who was in charge of representing the interests of residents to the administrative staff in the building. She let us know that residents are usually out and about later in the afternoon and that our purely morning programming wouldn’t attract residents. Additionally, many of the residents were skeptical of outsiders coming into the building to host programming, so she suggested spending time building a rapport with residents so that they feel more comfortable getting involved in activities. I’m looking forward to this upcoming week to put this advice into practice!

MICHAEL VIDAL | ESPERANZA CENTER

In an undergraduate experience, there is limited opportunity to see lectures come to life. In Public Health courses, I learned the realities of the U.S. healthcare system, the health outcomes of immigrants, and the barriers to fair treatment. However, words fail to communicate the individual lives of those affected. Those with the lived experience become averages with standard deviations. Despite attempts to highlight immigrant health, the closed structure of a college classroom makes them invisible.

This academic perspective of health rights violations affected the way I approach advocacy. Through social media, amateur advocates call for systemic change. I joined in this call. Focusing on “big” changes while downplaying minor, community-level attempts to reduce harm. What does a minor improvement mean when the greater system still oppresses? In public health, we think about impact and reducing statistics. A program that helps a few is less attractive than one – typically costly, time-intensive, and controversial – program that changes the lives of thousands. While the obvious goal is systemic change, this requires a massive population shift that takes years of endless organizing and collective power to bring about.

This focus is positive if it informs intermediate acts as an “end” goal — but quickly becomes counterproductive in the exclusive. A single focus creates harm through making those – whom it ultimately hopes to help – invisible. Without intermediate step or immediate interventions, those currently harmed and oppressed are left without help or recourse. Academics teach us to focus on the aggregate, but the CIIP internship experience enables us to care for the individual.

In my placement at Esperanza Center, I have the opportunity to speak with those most knowledgeable of immigrant’s healthcare in Baltimore: the immigrants themselves. Here, the narrative is not “30% of undocumented immigrants receive medical care only during life-threatening scenarios;” instead, it is that Geraldo or Maria or Jean need medical care to support themselves, their families, and their communities. Esperanza Center works tirelessly to hear the voices of those that cannot speak without risking their home and health. These voices matter because they need urgent, immediate care to survive a system we create, propagate, and exist in.

With this lens, systemic change is still possible. But it works to reduce harm and violence now. I plan on incorporating this perspective into every interaction, especially into my medical career. I worried being a clinical doctor would be limiting. I’d see a patient, help make them feel better, then send them off. Nothing was addressed, and more people will enter my care because, systemically, nothing has changed. Yet, there is impact in this scenario. I helped one person, created relationship with them; and that is important.

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