From a public health perspective, we in Oregon have nowhere near the number of cases as our northern neighbors in Washington, although with delayed testing it is hard to tell exactly how many people are infected. But as we continue to follow the pattern of disease spread that has been demonstrated in Wuhan and Italy, we can presume that things will only escalate from here. And with it, inequities will be laid bare.
This is a question that I have been asked dozens of times over the last several weeks. Ever since the World Health Organization (WHO) and U.S. Department of Health and Human Services declared the COVID-19 outbreak a public health emergency, news media has integrated COVID-19 into the news cycle constantly.
During our August delegation, we learned from Puerto Rican experts in their fields and acting first responders about implementing lasting social change since Hurricane María. Each expert’s lecture seemed to revolve around relief, recovery and resilience.
The health impacts associated with structural violence prevent vulnerable populations from gaining access to basic needs. This is due to injustices embedded within institutions and social structures that exist in today’s society.
Developing skills of cultural competence requires an open heart and mind — and often an uncomfortable examination of personal biases. It takes time, but along the way physicians gain greater humility and compassion, which translates to expanded access and higher-quality care for patients.
On Wednesday, September 20, 2017, after an already uncharacteristically volatile hurricane season, Hurricane María made landfall on the island of Borikén (“Puerto Rico” in the indigenous Taíno language).
Outside apartment 13C the street is empty. It is early in the morning, and yet sounds echo from the metal shop beside the lake, roosters crow, and the children upstairs patter back and forth across the tiles. I roll up my yoga mat, shaking dead cockroaches from its rubbery bottom. Through the grated windows I catch a glimpse of Lake Victoria, shimmering out from the cluttered shore of shanties and deconstructed docks to eventually blend with the blue of the morning sky.
Like most people, I watched the Ebola plague tear through Africa two years ago with a feeling of helpless horror. I saw the victims dying by the thousands on television, all eulogized by the same stark words: “No cure.” There seemed to be some unstoppable and malevolent force in the universe, seeking not only the destruction of human life, but hope itself.
I recently returned from a medical outreach trip I went on with other students from my school. We traveled to the state of Gujrat in India and treated patients from a very rural population. Medical outreach trips are an excellent experience for medical students still in their pre-clinical years because they allow you to see firsthand the information you are learning and apply skills you have been taught.
One such opportunity was presented to me the same week of my acceptance phone call earlier this spring: a fully-funded trip to a previously unattended region of Nicaragua with a volunteer medical brigade. It was led by physicians from my institution looking to recruit our entering first-year medical school class to help lead the trip.
Ana and I sat at that table for a few hours, enjoying each other’s company and stories told in choppy combinations of Spanish and English, some laughs of word-finding frustration spattered throughout. We talked about her daughter and grandson who lived with her, the colorful birds that were caged in her open-air courtyard, and the fact that I had come to Antigua from North Dakota to work with the God’s Child Project. As fond as I am of this memory, now that eight years have passed, I look back on my time in Guatemala with some degree of uncertainty about my intentions. I was what many would call a ‘voluntourist.’
I was on a plane heading towards Santiago, the capital of the Dominican Republic. From there, I would take a two-hour bus ride to Mao Vallerde, where we would be working at for most of the week. I was going on a global health trip through Jose’s Hands, an organization that sponsors medical students interested in going on mission trips. For this particular trip, they had partnered with One to the Other Ministries, a Tulsa-based ministry that has been doing mission trips, both medical and non-medical, since 1986. This being my first global health trip, I had no idea what to expect other than the usual warnings of tropical diseases endemic to the area.