‘Healthcare’ Articles at WOW Fellowship Blog

WOW Blog Post 1- Getting Started at Ariadne Labs

This summer, I have the incredible opportunity of interning at Ariadne Labs’ Serious Illness Care Program. Ariadne Labs is located in Boston, MA and it is an organization made up of 150+ physicians, researchers, and analysts who pride themselves on improving outcomes of patients in health systems. Their work is oriented around quality improvement using universal guides to provide clinicians in order to minimize errors in care. They utilize a system known as the Ariadne Arc to design, test, and spread scalable solutions in health care.

Ariadne Labs Arc - Ariadne Labs

For example, these solutions include a conversation guide for Serious Illness Care clinicians, a surgical checklist for the operating room, and a BetterBirth checklist to improve the efficiency of the birthing process.

My specific tasks through this internship will change every 2-3 weeks, however for this first stretch, I am working on sorting qualitative and quantitative data from the implementation of years past. A major focal point of this organization is measuring whether the implementation of programs has benefitted the health systems that use them and improve patient outcomes in the long run. In 2018 and 2019, Ariadne Labs implemented the Serious Illness Conversation Guide to 22 different health systems and trained clinicians to engage in better conversation with their patients through the guide. My job is to help measure whether this implementation was successful for these health systems and gauge whether there was a lasting impact of improved conversation between clinicians and patients. Specifically, I am tasked to sort the 200+ pages of data into a meaningful way to produce a manuscript of our implementation outcomes. So far I have successfully sorted through almost half of the data and will work towards finishing the other half by early July. The impact of my work will allow the organization to gauge whether our guide is able to be used in healthcare settings and if any changes need to be made to the implementation process.

Second, I am also a member of the Patient Guide project team where, upon approval from the Institutional Review Board, I will be able to take notes and even facilitate interviews with Serious Illness patients and families on the “What Matters Most Workbook”. The purpose and impact of this project are to ensure that clinicians are aiming towards patient-centered care and listening to the goals and values of each patient before jumping to treatment options for serious illness. As of now, I am in charge of formatting the workbook so it can be more user-friendly and ensure there are no technical issues with filling out all the important information which is the basis for each interview.

As I embark upon this journey of improving patient outcomes one step at a time, I have three goals in mind. I would like to tackle the issues in health care delivery and how to create scalable solutions to combat inequalities. I hope to prepare for patient interaction as I work my way up to medical school and beyond. This opportunity positions me to prepare for conversations with patients surrounding their medications and diagnoses and generate a human-centered design process for this patient guide. I hope to be more aware of methods of conducting clinical research and tying it to creating notable solutions in healthcare while expanding my network of healthcare professionals. Lastly, contributing to the development of the quality of life for patients battling serious illness would be a tangible goal that I could attain by being a part of this transformative research initiative.

— Ayush Thacker, Experiential Learning Fellow 2021

Post 2: Learning and Understanding the Impacts of Socioeconomic Burdens in a Community

It was not until I got to Brandeis until I started to consciously think about socioeconomic issues surrounding different communities. Before my studies as a Health: Science, Society, and Policy major (Public Health), I understood the basic concepts of first- and third-world countries, developed- and developing-communities. While at Brandeis I took classes introducing me to a wide array of global health issues affecting communities in the world. I learned about the impact that Water, Sanitation, and Hygiene (WASH) programs and clean cookstove initiatives can have on low-income developing communities. I knew since before I arrived at Brandeis that I was privileged to be raised with opportunities that kids my age in Uganda would never dream of having.

My internship with Love4Bukwo Hospital is at a point of organizational development with which they are not at a fully operational point. Although Love4Bukwo is already built and the structure of the hospital has already been created there is still much to do. Working at my internship I have been primarily tasked with working to create policies that will be implemented upon the opening of the fully functional hospital. As I have researched and curated policies administered at the hospital, I have been able to understand how my work will directly impact the people of Bukwo.

At the beginning of my internship, I researched the socioeconomic conditions that people of Bukwo faced. This allowed me to really understand what it is like living there. Through previous courses on campus, I began slowly understanding what sort of socioeconomic differences are typically found in third world developing countries, specifically in Africa. While researching those that affect Bukwo, I learned how these burdens affect the citizens of this rural town.

Before Love4Bukwo began working on building a hospital, on top of dealing with communicable disease burdens prevalent to Africa or the Global South (i.e. Malaria and HIV/AIDS) the people of Bukwo had no way to readily treat health issues they may run into. The organization that I am working with is bringing healthcare to these individuals. Once operational, mothers will no longer be reliant on uneducated neighbors to treat labor complications, workers will no longer have to sacrifice their work for being injured and not treated, community members will no longer be dying during transportation to a nearby hospital sometimes over two hours away in Kenya.

Love4Bukwo Hospital is creating a means to bring first-world solutions to a developing low-income third-world community. The Love4Bukwo organization is not the ultimate solution to address all of the issues facing community members of Bukwo, Uganda. However, being a part of this organization and creating a solution to address even just some of the socioeconomic burdens that face the individuals in Bukwo is satisfying. I know that the research that I do virtually during my time with Love4Bukwo will change the lives of many individuals in the town once the hospital is up and functional. I am happy that although I was unable to travel and experience the culture and what it is like to live in Bukwo over the summer that I am still able to be a part of the initiative that fuels the organization: bringing affordable and accessible healthcare to the people of Bukwo.

Post 3: Finding Power in Coalition Building and Communal Growth

Hey everyone!

This week, I have been thinking a lot about how I define change and progress both personally and within the organization where I am working. In thinking about the goals of my organization–which are very much centered around social justice and health equity– it is always crucial to question where there are areas for continued growth and development, while also acknowledging the big and small strides and positive outcomes. This evaluation is key in assessing what could be the most effective steps to reach our goals as an organization.

With the goal of making equitable maternal healthcare accessible to low-income families, as well as black and brown folks, Ancient Song Doula Services wears many hats as a community-based organization. It is important to note that this lack of access to healthcare, resources, food, and housing stems from a much larger root cause: anti-blackness. Because of this, reaching our goal as an organization is not solely about providing resources to our communities, but also involves taking action around the systems and institutions that first put these barriers in place. Given the immense nature of this multi-faceted goal, what one could consider an “immediate success” becomes difficult to measure, making endurance and consistency key in this work.

At Ancient Song Doula Services, we are constantly multi-tasking, taking on different roles, planning for community outreach events and reaching out to other organizations for support and/or partnerships. We are always looking for different opportunities to spread the word and collaborate with other social justice collectives because it is crucial to identify the intersection of different movements, whether it be birth justice, food justice, or environmental justice. It can be very stressful–especially for a small organization–to take on such a wide range of tasks, but this is why we stress the importance of collaboration and solidarity.

” A Day of Solidarity” held at the Schomburg Center for Research in Black Culture. Click on the image to watch the full panel

So, what does change or progress look like for me? Progress, I’ve learned, is very much rooted in and driven by coalition building and communal growth. Recently, my supervisor was a panelist in an event called “A Day of Solidarity” held at the Schomburg Center for Research in Black Culture, where the panelists engaged in a conversation around the recent policies regarding the separation of immigrant families and discussing ways to take action. One of the main topics discussed was how crucial it is for communities to gather in support of each other, stand in solidarity as allies, engage in dialogue and, most importantly, listen to each other. Listening and trusting one another gives marginalized identities agency over their own narrative and experience. At Ancient Song, we often practice this is, as we not only hold events by and for the community in collaboration with other organizations, but also center our workspace around physical and mental wellness. In this way, I’ve learned that, as an organization, listening and building trust and community allow us to constantly assess and reassess the needs of the communities we serve so that we can continue to evaluate our methods for change and be that much closer to reaching our goals.

There is power in unification, as it is crucial not only for the healing of marginalized identities, but also, in standing firmly against or for a movement and demanding action. This is progress.

One step closer to the world of medicine

This summer, I have the opportunity to work in Dr. Lichtman’s Immunology and Cardiovascular research laboratory of the Brigham and Women’s Hospital Department of Pathology.

I have never worked in a lab before. In my mind, I thought working in a lab would be similar to my experience in college’s lab courses. However, the first day I came to the lab, I was amazed by how basic science research can potentially lead to huge development in the medical field in terms of diagnosis and treatments for patients. As the post-doc, Eva, I work with briefly explained to me the projects that were going on in the lab, I realized that I needed to read and self-study much more so as to be able to understand the research and ultimately to be a part of it. My impression about the lab during the first week is that doing research is challenging, but at the same time very intriguing and that I would be able to learn so much from not only my supervisor but also from other talented people in the team. The picture above is me (right) and one of my coworkers who is actually a Brandeis alumni (left).

As I get a better idea of the lab, I have set some goals for this summer:

Regarding academic goals, I want to establish a solid background in basic immune system functions, and how such immune responses can cause diseases. In preparation, I have discussed the basic science underlying this project with Dr. Lichtman and spend a portion of my free time on the weekends reading and taking notes from the textbook he published and recommended to me. I was surprised to learn that the book is also used as a learning tool in many medical schools!

Furthermore, I also aim to master the molecular techniques used in the lab and in day to day research, such as immunohistochemistry and tissue slicing on the Cryostat. This will allow me to not only make progress in my project but to effectively assist other team members in their research by generating accurate data.

Thus, I will learn how to use empirical scientific research in order to contribute to the medical field by learning from the PI and other team members.

Considering career goals, I plan to pursue a career in medicine that includes patient care and clinical or lab-based translational research. As I work in a clinic-based laboratory as a summer research internship, this experience will also allow me to explore different aspects of medicine. As I will attend department conferences and seminars throughout the course of the summer, I will be able to develop a more well-rounded understanding of medicine and the interconnection between its different aspects. I can furthermore establish a professional network at Brigham and Women’s Hospital by meeting with the professionals such as physicians, researchers and educationalists who make enormous impact on people’s lives and on the community in their everyday work.

As for my personal goals, I hope this summer experience will help me to grow intellectually, think scientifically, and be able to contribute to important work relevant to human diseases. I look forward to emerging myself in the Longwood medical area – a hub of biotechnology, of research and ultimately of medicine.

-Phuong Anh (Phoebe) Le-

Post 1: Doulas Crucial in Ending Racial Disparities in Maternal Health

Hi everyone!

My name is Marleny and I am a rising junior and STEM Posse Scholar at Brandeis University. This summer I am an intern and co-coordinator at Ancient Song Doula Services, a Brooklyn, NY-based and low-cost doula service.

As a reproductive justice organization, our goal is to serve families of color and low-income families who do not have access to doula care. Through a collective of several services and resources for parents of color and low- income families, we ultimately aim to bridge racial disparities in maternal health by addressing racial and implicit bias.

In New York City, the maternal mortality rate, for example, is 12 times greater for Black women than for white women. Given that systematic oppression is a social determinant of the high Black infant and maternal mortality rate, shifting tasks and responsibilities down the hierarchy of the healthcare system are both necessary and ideal for the survival of marginalized communities. For these reasons, the most crucial aspect to birth equity is free and low-cost doulas services such as Ancient Song Doula Services.

Given that there have been recent opportunities for reform within maternal health as New York’s governor Andrew Cuomo proposes a state doula pilot program that includes Medicaid reimbursement as well as a Maternal Mortality and Morbidity Review Committee, Ancient Song also centers their work around political reform and advocacy for the marginalized communities it serves. Prioritizing the reimbursement of community-based and culturally-relevant doula services through Medicaid is key to bridging racial disparities in maternal health, so we have been gearing most of our attention towards this lately.

A lot of my responsibilities, as of now, include community outreach, writing testimonies to present to the city council, planning events to gain momentum for our #ourtimeisnow campaign for birth equity, and creating promotional material to share with the community and with other local and national organizations.

Additionally, while we continue advocacy at such a crucial time, I am responsible for coordinating our third annual Decolonizing Birth conference called “Decolonizing Birth: Addressing The Criminalization of Black and Brown People within the Healthcare System,” which is being held September 22-23. This involves looking for sponsors, keynote speakers, and reviewing proposals for prospective workshops. My internship requires a high level of responsibility and I am really enjoying my time at Ancient Song for the second year.

The work I am doing is super important and falls in line with my career goals. By the end of the summer, I hope to have improved my ability to manage my day to day tasks and become more familiar with the policies that have been and will be put in place to address the disparities in maternal health. I am looking forward to sharing my journey at Ancient Song with you all this summer and I am looking forward to what is to come!

Wrapping up

Throughout my internship I have learned so many valuable lessons. The most important one is that you have to be flexible, creative, and reflective because everything is a learning process. Working at a relatively new start-up has also reinforced this. The programs OSW runs are extremely new and depend heavily on the audience. For example, the program we run in downtown Oakland is extremely different from the program that we run in Alameda because there are two different, distinct demographic groups that attend each one. The people who attend these events are receptive to different movement coaches, music, and food, so we have to be extremely aware of what different people need and be flexible enough to change our program to fit their needs while still providing the same support.

At the end of one of our programs last week, my bosses came up to me and said, “We’re never letting you go. You have to stay and become head of HR and our operations director. You can’t go back to Boston.” Honestly, that meant so much to me because it showed me that I am actually making a difference. As an intern, I sometimes feel as though I am learning a lot from the organization and the experience, but that I am not giving back as much as they are giving me. This showed me that I was wrong. Now that I am taking this time to reflect, I think I helped the organization branch out and make connections with different providers in the area, find potential new interns for the fall (to replace me), and create a fluid transition when they shifted their main program to a module system earlier this month.

As I have written in previous posts, my internship is not a typical internship. My bosses push all of the interns to step outside of our comfort zones with projects, be vulnerable with them and each other, and be confident in everything that we do (whether or not we feel that way inside). I wish I had known this about the organization beforehand because I believe it would have taken me a lot less time to open up to them and become comfortable doing these things. I think I would have been a better intern from the very beginning instead of half way through.

My advice to any future interns at Open Source Wellness or people seeking an internship in healthcare or nonprofit work is to be open to new experiences and different types of people. A career in social justice or health care both involve working with people who have backgrounds that are completely different from yours and from each other. Be open to them and what you will learn from one another. Also, make connections and be authentic. Oftentimes, when people are struggling with difficult health issues, they are embarrassed or distressed about their situation. It is extremely important to connect with them on a personal level and share your own story and struggles so they know they are not alone and have nothing to be ashamed of. Finally, be passionate. A career in public health or community health is not easy because change happens slowly. Only people who are truly passionate about healthcare and community health will have the patience to make lasting change.

Here are the only two photos I have at work:

(The interns practicing taking each other’s blood pressure)

(Me taking a patient’s blood pressure during our program)

Thank you for keeping up with my summer journey!

My New Skills

Over the past eight weeks my internship at Open Source Wellness has allowed me to grow and learn so much in a short amount of time. I believe this is mainly due to how small and young the organization is. The OSW staff is composed of the two founders, four undergraduate interns, and one graduate student intern, and officially started running programs in October of 2016. Due to this structure, I am given a lot more responsibility than most interns at larger organizations are given. I have gained numerous skills because of the uniqueness of start-up culture.

First, I have strengthened my organizational and leadership skills. During our Tuesday night events, I have been tasked with helping coordinate and organize the event, and with leading the meditation portion for two weeks. Although these tasks were daunting at first, I have seen that I can take on challenges that are typically out of my comfort zone and still succeed. At Brandeis, I am a coordinator for Big Siblings through Waltham Group. As a coordinator, I am in charge of running and leading multiple events. I believe my responsibility to help run OSW events and leading the meditation sessions have helped me gain both the skills necessary to organize the logistical aspects and have the confidence to lead the actual events.

Second, I have strengthened my professional networking skills. One of my main jobs has been to reach out to healthcare providers to form referral partnerships with them. I call, email, and meet with them to explain the program we run at Open Source Wellness, and urge them to refer their patients to us. Through this task, I have gained extremely valuable networking skills. I now know how to speak with professionals on an individual basis, and I have gained more confidence when I speak with people who are much older than I am and who have a lot more experience than I do. This will help me in the future with my networking skills because I will know how to communicate professionally and be Pleasantly Persistent.

Third, I have learned how to understand and relate to people who are different than I am. Many of the individuals I work with live in a low-income, re-entry housing community, and are mainly people of color who have been incarcerated or homeless. This is a very different demographic than I am used to working with and that I, myself, can relate to. Through this experience, I have found ways to connect to people who are extremely different from me. I have seen firsthand that most people struggle with the same health issues, regardless of their backgrounds, socioeconomic status, or ethnicity.

Lastly, I have also learned a lot about myself in the workplace, including my strengths and weaknesses. I have discovered that it is difficult for me to draw boundaries when I am asked to do something that goes beyond my capabilities or job description. I find that when a superior asks me to if I want or can do something I say yes, almost automatically, even if I cannot. I have been pushing myself to stick to my boundaries and communicate with my supervisors when I am unable to do something. Here is an interesting article about crossing boundaries in the workplace. I also found out that it takes me longer than most people to become comfortable in a work environment. It took me a few weeks to get to know the work environment at OSW before I became comfortable, personally and professionally.

Furthering Social Justice

Open Source Wellness officially began running their first event in October 2016 and their second event this past April. Considering it is an extremely young organization, the founders have many goals and milestones they want to achieve. Their main social justice goal is to reach more people in low-income communities.

The organization was founded by two psychologists, Liz and Ben, who came up with the idea behind Open Source Wellness while they worked in different health clinics in Boston. They continuously saw patients who were referred to them by doctors who told the patients that they needed to change their eating habits, exercise more, or reduce their stress to combat the chronic health conditions they were facing. Wealthier patients could hire a nutritionist, personal trainer, or join a meditation group. However, people who lived in low-income communities went back to their same lifestyle because they did not know how and did not have the means to change the way they ate or acted. Through these experiences, Ben and Liz decided to open a “behavioral pharmacy” to help people make major lifestyle changes at little or no cost. Their doctor could write a prescription to go to Open Source Wellness to get support in making lifestyle changes. Even though this is their mission, Ben and Liz have been struggling to reach this demographic.

Below are pictures of Liz and Ben:

To combat this issue, the other interns and myself have been reaching out to providers, including clinics, doctors’ offices, and community centers in low-income areas in an attempt to form a referral partnership with them. We have been giving them free spaces that are reserved for their patients in our month-long program upon their referral. By reserving certain spots for their patients, we are creating a scarcity of spaces that they can fill which will incentivize them to fill the spots. Hopefully, once they see how helpful the program is for their patients, they will start sending more people. Some of the clinics we have been speaking with seem extremely interested in our mission, so we started talking with them about running an event in their clinic. These would be solely for their patients or members and would happen in the clinics or centers. West Oakland Health Center and Project Open Hand are two of the groups that we have been meeting with.

If the clinics followed through with their pledge to get their patients to sign up for our July cohort, which starts on July 11^th, that is what progress would look like. It would also include one or more of the new clinics or centers allocating money to OSW to begin an event in their building, exclusively for their patients.

Provider outreach has been my main long-term task as an intern at OSW. I have spent countless hours emailing, calling, and meeting with doctors and administrators to tell them about the program that OSW offers, and to speak with them about creating a referral partnership.

Bringing Brandeis Knowledge to Oakland

During the spring semester at Brandeis, I took the course Narcopolitics with Professor Brian Fried. Through this course, I learned about the correlation between drug use and incarceration rates. A recurring issue that we discussed throughout the course was the elevated rates at which children of formerly incarcerated persons are likely to be incarcerated when compared to children whose parents have not experienced incarceration. This comparison shocked me at the time. Currently, I am witnessing the reality of this fact and it is extremely unsettling.

Here is a link to an article that explains the cycle of intergenerational incarceration.

Many of the individuals I work with at Alameda Point Collaborative, a low-income housing community, were previously incarcerated or homeless. The people who attend events through Open Source Wellness are mainly in their fifties and sixties, and many of them have older children who have also been incarcerated. One of the women who regularly attends our events explained her experience with incarceration. She described her long struggle to move past this difficult time in her life because of the legal, social, and emotional restrictions she experienced. Now, her son faces a long prison sentence. She spoke about her inner struggle about the best way to support him, and if she chooses to support him at all. She does not know if she can deal with the responsibility of trying to get him released early or if she is willing to support him when he is released because she feels she put a lot of effort into trying to break the cycle of incarceration. She said she understands that it is more likely for her children to be sent to prison, because she did, but she hoped her children would break the statistic.

Above are pictures of the community garden and kitchen where the residents of APC grow and cook the food that they serve at our events.

Many of these individuals have been incarcerated for drug offenses. There are strong genetic links and environmental factors that influence drug use. The children of parents who have drug or alcohol addictions often begin their lives with a hereditary vulnerability in addition to the impact of their parent’s drug addiction. Additionally, the loss of parental role models for long periods of time during a parent’s absence due to imprisonment negatively impacts breaking the cycle of incarceration. I recently read an article about recent research that proposes that 40%-70% of people in the prison system have Antisocial Personality Disorder (APD) which the researchers contest has a strong genetic link, further adding to the cycle of incarceration.

In Professor Fried’s course I learned about the unfairness of U.S. drug laws and the impact they have on the cycle of incarceration. With this knowledge, I am more informed about the challenges facing individuals who were incarcerated, especially the difficulties encountered in breaking the cycle of incarceration. My role at the Open Source Wellness program, is to help run the weekly event by facilitating a group discussion in a weekly women’s circle. I feel as though my increased understanding of incarceration in the U.S. is helping me support these women in a way that is meaningful and helpful to them.

My First Month at Open Source Wellness

Oftentimes I feel this sense of knowing that an opportunity is exactly right for me. In April, as I was looking for internship opportunities, I had that feeling when I found an internship listing at Open Source Wellness.

OSW is a nonprofit located in Oakland, California that aims to function as a behavioral pharmacy, to support patients when their doctors prescribe lifestyle changes to combat chronic health conditions. Patients are often told to make difficult changes in the way they eat, exercise, or manage their stress without any support from the health care system or their community. OSW helps patients make those changes by creating events where participants can practice healthy behaviors through a movement session, mindfulness/meditation session, and a healthy meal while connecting with people who are making similar changes. The picture below describes OSW’s four principles and the new cohort model.

Here’s a quick video introduction: Open Source Wellness in 60 Seconds. Also, their fantastic website.

After interning for a month, I know that initial feeling about OSW was correct. The first day that I went into the office, the co-founders, Ben and Liz, started our day of training with a game of hot seat. Then, they went straight into training us to do customer discovery in low-income neighborhoods to better understand the demographics of the target population. Finally, we (the other intern, Adam and I) attended their public event which left me feeling energized and on top of the world. Ben ended the night by saying, “at OSW you should never be comfortable, coasting is not an option here.” Now, I may have only had one other internship, but I don’t think is how most first days unfold.

Here is a picture of the interns (Adam and I started a month before the other two – Liza and Kelliann – who started on Tuesday!)

Now, I help run the Tuesday night event and for the past two weeks I have been leading the mindfulness/meditation session. Although it seemed daunting at first, I think leading people in an area that is relatively new to my life has pushed me to be more confident doing something out of my comfort zone.

Additionally, I help run two events at a low-income, re-entry housing community called Alameda Point Collaborative. On Thursdays, OSW hosts a “block party” where they blast music to draw people out of their houses and out onto the dance floor. This is followed by a five-minute meditation/mindfulness session and a vegan meal that is prepared by community members, using produce grown in the community garden. On Saturday, I help run a women’s circle that connects women who are struggling with similar issues to create social support to find solutions to those issues. The session includes light movement, mediation, and a salad.

This is the social injustice that Open Source Wellness is addressing. The organization is attempting to help people in low-income, formerly-incarcerated, and formerly-homeless communities find ways to address and prevent chronic health conditions by changing their behavior.

One of my major tasks over the past month has been to research and contact organizations, community centers, and individual health care providers in the Bay Area to create referral partnerships. Through this, I have made a few strong connections, yay! I also accompanied Ben to a meeting at a large health center to discuss a potential partnership. It was an extremely successful meeting and it showed me the importance and benefit of provider outreach. Ben would like me to eventually conduct these meetings on my own!

Being able to have those conversations and make strong connections on my own, and confidently giving people advice about their health and what they can do improve their health are my goals for this summer. Throughout the past month, I have started implementing those skills and am well on my way to accomplish those goals. These past few weeks have showed me that I truly need to keep pushing myself into uncomfortable spaces because great things really.

Lucy Miller-Suchet

Completion of Internship at AIDS Action Committee

During my eight weeks at AIDS Action Committee (AAC), I was able to learn and grow immensely from my interactions with coworkers and our clients. I am proud to say that at AAC I was able to meet all of my learning goals that I defined at the beginning of my internship. An academic goal that I had was to be able to use information that I had learned in my public health classes to further examine the health disparities that clients at AAC faced. Through the “Getting to Zero” training series that AAC facilitated, I was able to learn more about the root causes of HIV/AIDS not only through a scientific model, but also through a public health lens that focused on social, psychological, political, and economical perspectives of the disease.

Ribbon — Artwork in AAC’s entrance lobby

A personal goal I had was to learn more about real estate and the housing market. Learning the housing search terminology and the procedures for obtaining property information was the most challenging, but also the most rewarding part of my internship. Towards the end of my internship, I worked on a draft for a “Housing Search Guide” that would be able to help guide future interns and employees in AAC’s housing program. Creating this guide was a rewarding experience because I had the chance to collaborate with my coworkers to create something that would benefit future AAC employees: people who all share the common goal of being social justice advocates for those living with HIV/AIDS. I am thankful that I had the opportunity to work in the housing department, as I was able to see first-hand how large the need is for access to safe and affordable housing and how acquiring this housing can drastically improve quality of life, especially for those who are sick.

Additionally, a career goal I had was to learn how to best educate and advocate for people living with HIV/AIDS and other chronic illnesses. Attending the “Getting to Zero” training and helping to facilitate housing search groups provided insight on some of the most pertinent needs of AAC’s clients. One video that I watched during the training was HIV: The Goal of Undetectable, which highlighted the mechanism of how HIV acts in the body and helped me better understand how HIV treatment works. The videos and brochures presented to us during trainings were informative, engaging, and simplified enough for people of various educational backgrounds to understand. For additional information on HIV/AIDS that I used as part of my trainings, click here.

Brochure from one of the "Getting to Zero" trainings on Young Adults and HIV/AIDS. — Brochure from one of the “Getting to Zero” trainings on Young Adults and HIV/AIDS.

Working at AAC helped me to clarify my career goals, as I was able to see a wide range of services that AAC provides. Though I worked at AAC’s Boston site, I had the chance to visit Youth on Fire, which is AAC’s program in Cambridge that helps homeless youth, and I also worked at AAC’s Cambridge site in Central Square, where I got to visit the Needle Exchange Program that focuses on harm reduction for intravenous drug users. By seeing such a wide range of services and being able to engage and relate to such diverse groups of people, I relieved that my interests in public health are indeed very broad. The one commonality between my experiences is that I learned that advocacy is a field that I am definitely interested in gaining more work experience in, and that I want to pursue further opportunities in HIV/AIDS and public health.

One bit of advice I would give to a student interested in interning at AAC is to take advantage of the wide range of services provided here and try to experience different parts of the organization even if they are outside of the department that you are working in. This was crucial for me, and as a result, I was able to network with a wider range of people who still shared so many common interests with me. Another piece of advice would be to keep an open mind. I had a few misconceptions about HIV/AIDS and harm reduction at the start of my internship and some of the educational outlets that AAC provided me with were able to shift my understanding of different concepts and allowed me to view topics such as HIV/AIDS treatment, sexuality and contraception, drug use, and other harm reduction topics in a new light. I encourage students interested in learning more about HIV/AIDS to use internships as an educational tool by and taking advantage of hands-on opportunities to learn from diverse groups of people.

Picture in AIDS Action Committee hallway.

Ngobitak Ndiwane, ’16

Ate logu, East Timor!

See you later, East Timor! The 9 weeks I spent in East Timor went by so quickly. I cannot believe that summer is over!

Over the course of my internship, I shadowed many of Bairo Pite’s staff. I followed the doctors around during their rounds and when they went to examine the patients. They discussed treatment plans amongst each other and let the nurses know of any changes on the patient’s status chart. This is how rounds typically run in the morning and in the afternoon. Some days I hung out with the laboratory staff. I watched them run lab tests. I have also worked with the clinic manager at the clinic organizing in her office and the stock room so we know what supplies we have.

Slides of sputum stained by the Ziehl–Neelsen method to identify TB

Me looking at the stained slides. The bacteria for TB would show up bright red (amongst the blue) if the sputum is positive.

At the clinic, I learned how to use an EKG machine. I admit that I cannot truly read the EKG results, but I know where to place the electrodes and run the test. With the medical students, I also learned and practiced taking blood pressure with a stethoscope and blood pressure cuff. Sometimes to check on a patient, I took their blood pressure. Sometimes I helped take patient histories; I asked them how they were doing and ask if they have certain symptoms in Tetun. I learned how to assess the patient by looking and examining the patient’s hands, face, and just getting a general look at the status of the patient to see if they are breathing heavily or any other acute problems that needed to be looked at. Other tasks I did included taking patients to the National Hospital to get chest x-rays or to get consultations with the specialists working there. I let the patient know where we were going and accompanied them for their visit.

To build off of this experience during the rest of my time at Brandeis I will continue to promote the Bairo Pite Clinic with Project Plus One on campus. I will share my experiences to club members and to members of the community at activities such as the Millennium Campus Conference. I am continuing to pursue a career in healthcare and learning more about global health. I want to learn more about the politics involved and examine the differences. I also want to learn more about the current policies of disease treatments such as the WHO guidelines for tuberculosis (TB). I hope to return to East Timor to the Bairo Pite Clinic (in the processing of becoming a hospital) with more knowledge and education.

If a student is interested in an internship at the Bairo Pite Clinic, I advise them to take advantage of the opportunities available. Because a lot of people visit the clinic, there are a whole range of cases to learn from. There are also mobile clinics (scheduled doctor visits and health education to villages in East Timor) which students can go on. The people that organize the mobile clinics do really great work and it is a great opportunity to see how and where most people of East Timor live. I believe they will have the ability to really make the internship their own at the BPC. My advice for a student interested in this field is to not be afraid of saying no to things that they are not comfortable doing or that they do not know. They do not want to cause more harm than good and it is important to be honest.

My concepts of social justice have been enforced. With the sad and violent history of East Timor, they need healthcare to repair some of the damage and to help East Timor rebuild and stand up strong again. Listen here for an interview Dr. Dan, the founder of the BPC, recently gave a few weeks ago during a trip back to US about his experience. However, I have learned, like with all things, change takes time. It would take time for East Timor it implement changes and to learn what would work for their country and what would not.

Alice Luu ’14

Thanks for the Memories, FIMRC!

I had an amazing internship experience at Foundation for International Medical Relief of Children Global Headquarters. Summer went by so quickly! Looking back to my first day at FIMRC, I got lost finding the office and was anxious about not knowing anyone. In two and a half months I’ve grown into a more self-assured worker, and made friendships and connections that will last a lifetime.

I remember feeling overwhelmed at the beginning of my internship when I received my first assignment: compile 16 months worth of numerical data for FIMRC’s sites in seven countries. At Brandeis I’m used to getting detailed guidelines for projects and assignments, but this task was so open-ended that I didn’t even know where to start. This project challenged me to make decisions and be a self-sufficient problem solver, effectively fulfilling my learning goal of becoming more independent in the workplace.

Admittedly, I did not initially see the connection between crunching numbers and FIMRC’s mission of improving pediatric health around the globe. When I first learned about FIMRC, I imagined people digging wells in exotic locations, giving health education lessons, and delivering medical supplies. Working at headquarters exposed me to the extensive coordination and planning that is required to make things happen on site — it’s a lot of work! I have a new-found admiration for the administrative work that nonprofits do.

Now that I understand the operations side of a nonprofit organization, I want to learn more about what happens in the field. For as long as I can remember, I’ve wanted to work in a foreign country. Reading reports from the field, working with photos from FIMRC’s sites (check out FIMRC’s Flickr page — it’s amazing) and talking to staff members in Costa Rica and the Dominican Republic made my itch to go abroad much stronger. I’m excited to study Community Health and Social Policy in South Africa next Spring as my first real exposure to working in healthcare in a another country.

My fondest memories of FIMRC include the wonderful people I worked with. My supervisor and the other staff members were an incredibly passionate and tight-knit bunch who were eager to help the interns reach our goals. I would encourage future interns to interact with other interns and staff members as much as possible, especially because everyone is so helpful. Also, be sure to take advantage of FIMRC headquarters’ awesome location in center city Philadelphia. Eating lunch and sharing with my intern friends in Rittenhouse Square was one of my favorite memories!

After my internship I am much more aware of the health problems that plague the people in nine communities across the world. Learning that over 20% of kids in Peru suffer from stunted growth as a result of malnutrition, among other statistics, was shocking and heartbreaking. To me, social justice means seeing as many kids as possible obtain the healthcare they desperately deserve, and FIMRC showed me how a nonprofit organization achieves this goal. FIMRC is a small organization with a big impact, that is effectively “doing” social justice. To me, Margaret Mead’s quote sums up FIMRC perfectly: “Never doubt that a small group of passionate, driven citizens can change the world. Indeed, it’s the only thing that ever has.” With persistence and passion, real change will happen, a lesson I know I will remember at Brandeis and beyond.

-Erica Granor ’15

Diak ka lae?

Diak ka lae is used in Tetun, the local language of East Timor, for “How are you?” The literal translation is “Good or bad?” In response, people usually reply “diak”, meaning good, or “lae”, meaning bad. Diak ka lae is one of the many Tetun phrases and words I have learned here in my time in Dili. Although I am far from being fluent, I know enough phrases to understand some of the patients and to get a basic patient history. As I go on rounds with the doctors and follow up with the patients, I am getting more comfortable in a health care setting. Most importantly, I am also getting comfortable interacting with the patients. Being familiar with the language is one big step in communicating and interacting with patients and their families at the clinic.

bpcsign2 — Bairo Pite Clinic sign outside clinic gates

After spending over a month at the Bairo Pite Clinic, I am definitely seeing how a health clinic in a developing country like East Timor operates. I work almost daily with the staff and volunteers in providing health care for its patients. I observe and interact with a variety of staff members vital in running the clinic. However, the BPC is steady changing as health care in East Timor progresses. As I am working, I am witnessing the failures of the system and the improvements being made. I believe this knowledge I am gaining is important in becoming better informed as a future primary care physician.

Since I have started working at the clinic, I have been exposed to many medical procedures used to diagnose and evaluate patients. As I am picking up the language here, I am also becoming familiar with the medical techniques and tools being used during these examinations. I am able to understand why these techniques are being used when a doctor uses them and I am able to provide these tools when a doctor needs them. These skills would be useful in the future for work in a health care setting and for facilitating patient care.

n952 — Me and other volunteers with our N95 masks (masks that protect us from TB) on

I am most proud of everything that I have learned so far at the BPC and the fact that I am able to make myself useful around the clinic despite my lack of knowledge. Most of the volunteers at the BPC are medical students with some medical experience. In the beginning, I was worried that I would not be able to get the learning experience I need or be able help out. However, the doctors and medical students have been very willing to explain and teach me if I had questions. This in return helped me understand what was going on and be able to help them and by extension, help the patients.

Alice Luu ’14

Many volunteers from all over the world hanging out in the administration office

11,817 Miles Later

The Bairo Pite Clinic (BPC) is a community health center founded after East Timor’s struggle for independence from Indonesia that left the nation’s health service infrastructure severely damaged. The BPC strives to provide primary health care to some of the poorest people in the world. Every day they serve over 300 patients from all over the country, and they are open until every patient is seen. The clinic is established and financed entirely by contributions and at times is aided by governmental and non-governmental organizations.

xxx place -- date — Patients waiting to be seen at the Bairo Pite Clinic

At Brandeis, I am a member of the Project Plus One Student Chapter, which supports the Bairo Pite Clinic. Being involved in the club, I became familiar with the clinic and its efforts to empower the local community to provide healthcare for its members. I also met with a few Brandeis students who have volunteered at the clinic in the past with the organization and I wanted to get more involved by travelling to the clinic. I applied to the clinic through their application process and was invited to volunteer for the summer.

At the BPC, I participate in rounds every morning at 8:00 with Dr. Dan, the director of the clinic, Dr. Simon and other volunteer medical doctors and medical students to see the in-patients. I spend time with the volunteer doctors overseeing assignments and assisting with the application of treatments, making sure the appropriate medications are taken as prescribed and helping nurses take vital signs and record information. I facilitate in patient admittance, in recording patient history, and in communicating and relaying information between doctors, nurses, laboratory technicians, and other staff members at the clinic.

After my first week of the internship, I am finding myself falling into a routine at the clinic. In the beginning, it was a bit disorienting trying to figure out the system of the clinic, locating which ward was what or where, and trying to help out in a capacity that I am able to. Now I find myself able to introduce and explain the clinic to new medical volunteers and understand some of my limitations and capabilities at the clinic. Every day I observe rounds in the morning and in the late afternoon. After rounds, the medical students are delegated tasks or follow-ups with patients. This week I was able to observe a few Ziehl-Neelson stains, which is a method to test patients for tuberculosis (a common illness in East Timor), a lumbar puncture, several electrocardiograms (EKGs), and diagnostic tests for malaria and Dengue fever. The medical students and doctors have been very kind and supportive, explaining many of these procedures to me and the results of these tests. I feel that just by being here for only a week so far, I have learned quite a bit.

For this summer, I want learn more about how health care in a developing country operates, and how it faces its problems, such as a limited supply of resources. Already by observing the doctors and the clinic, I am seeing the pieces to this puzzle. In addition, I hope to continue to observe and learn more medical procedures and medical techniques used at the clinic and be familiar with the tools used by these providers.

Alice Luu ’14

Picking a Major, Following a Career

When I was in high school, I remembered debating for a really, really long time what I wanted to study in university. I knew what academic subjects I was particularly good at, what I was really, really bad at, and what subjects I found to be especially intriguing. I was good at history, a bit of a struggler in the sciences, and deeply passionate about what I now understand to be sociology. Beyond this, I had it stuck in my mind that what I majored in undergrad must directly relate to what career I ultimately would take on post-grad. Balancing a profound excitement for social justice and the glimmering hopes of my self-proclaimed tiger mom, my attempts at channeling all of these thoughts and opinions into some kind of major caused me to be more confused than before. I wanted to take these pieces and lend into some sort of study – a life path that would ultimately bring me somewhere that made me happy on all of these fronts.

Chief Medical Officer for PIH, Dr. Joia Mukherjee, working one on one with a patient in rural Haiti.

But I was ultimately able to come up with a formal version of a major. Whatsmore, I came up with a potential career plan that fit all of my key points. I hope to one day work as an OBGYN (obstetrician/gynecologist) for an NGO that does long term health infrastructure development in Southeast Asia. I knew the what, I knew the how, and in knowing that this was a direction that made me happy, I knew a bit of why. But my ‘why’ was solidified in working with Partners in Health, a health infrastructure NGO, this summer.

Partners in Health operates with the following as a long-form mission statement; “At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When a person in Peru, or Siberia, or rural Haiti falls ill, PIH uses all of the means at our disposal to make them well—from pressuring drug manufacturers, to lobbying policy makers, to providing medical care and social services. Whatever it takes. Just as we would do if a member of our own family—or we ourselves—were ill.”

It was not until being faced by banners around the office that proudly served as daily reminders of this statement that I internalized the importance of long term health infrastructure. In the past, as I was formulating my future plans, I thought of working with organizations like Doctors without Borders; emergency medical relief programs. While Doctors without Borders certainly is an essential NGO, my heart finds more of a kinship with Partners in Health and their mission to structural development of healthcare infrastructure. With an organization like Doctors without Borders, crisis; be it war, a natural disaster, a civil conflict, or other emergency event, is required for a form of intervention. Once the crisis is nearly over Doctors without Borders tends to leave the area. I once read in a Doctors without Borders memory book “Hope in Hell” that some global posts are abandoned if the estimated time slated to complete the intervention surpasses a few years. It’s not a bad model. But to me, it feels that that short-term approach overlooks a crucial point – the crisis, whatever that might be, is often the boiling point for structural inequity within that nation. A natural disaster is so devastating because access to clean water was already so limited before it. War or civil conflict has such horrible, horrible consequences because of pre-existing structures of violence and unrest. Crisis is not the problem; it’s a consequence of a problem. In approaching healthcare with a full understanding and undertaking of structural violence, Partners in Health is different.

Patients under the care of Doctors without Borders, a crisis-prevention healthcare NGO.

Thinking about what I did this summer, and how that translates into what I want to do in the future, both in and beyond my career, I want to go back to what I ended up studying during my four years at Brandeis. I am currently a double major in Biology and International and Global Studies, making my way through the pre-health track. I’m also minoring in Peace, Conflict, and Coexistence Studies and Women’s and Gender Studies, supplementing both my global and clinical perspective with these essential lenses. I think about the full education I received by being an undergraduate at Brandeis and how that has effected and shaped my perspective on health, healthcare access, and the global community. And I think back on the summer that I spent at Partners in Health, in many ways the intersection of all of my academic passions at Brandeis. From the three or so months I spent at the organization, I learned a lot about the why of my intended career choice; both why I wanted to pursue the career path I did and why it made sense in the larger context of the world. As I finish my undergraduate career up this May, and begin another academic journey into medical school, I hope that I might take with me lessons of true, sustainable development work and an even deeper dedication to healthcare for the poor.

A PIH project; the layout for the new Zanmi Lasante Hospital to be build in rural Haiti.

“What I tell my students all the time is: you speak English, you have a passport, you have a responsibility to use those tools. Go see these places and talk about them. Write about them. Be an advocate. It’s a huge job, but the coolest thing ever is to change the world.”

– Joia Mukherjee, Chief Medical Officer of Partners in Health

See Paul Farmer, Ophelia Dahl, Joia Mukherjee and many, many other amazing people speak this weekend at the Millennium Campus Conference!

An article by Joia Mukherjee, “Structural Violence, Poverty, and the AIDS Pandemic”

Learn more about Partners in Health in this “Global Journal” article.

– Sarah Van Buren ’13

Boxes Beyond Boxes

“It’s constitutional!”

A loud cheer erupted from the break room at Partners in Health. Employees were laughing, hugging, shouting – excitedly calling friends and family.

“It passed! I know – I couldn’t believe it either. Hold on, I’m getting another call…”

The controversial passing of the Patient Protection and Affordable Care Act was celebrated at PIH.

In the kind of excitement and noise one would expect from a win at a football game, a hundred or so PIH employees celebrated the constitutionality of the Patient Protection and Affordable Care Act; affectionately Obamacare. As an organization that promotes health equity for all, focusing both in the United States and around the world, the idea that access to healthcare would become easier and more accessible for many in the States was a big win.

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In preparation for my WOW internship, I had set out a few learning goals for myself during my summer with Partners in Health. I had hoped that I might gain stronger insight on how non-governmental organizations with an international focus operate from far away. Partners in Health operates in twelve countries around the world in addition to hosting several programs in Roxbury, Boston. How was it that they could manage, evaluate, and amend so many programs that were so distant?

Boxes.

The response to PIH’s overwhelming number of programs in such demanding capacity is boxes. The entrance to the PIH office on Comm Ave is always a bit of a fortress as the receptionist’s desk is barricaded by mountains beyond mountains of boxes. In these cardboard boxes are everything that PIH clinics need; EKG machines, clothes, alcohol wipes, ultrasound machines. These boxes, shipped in from around the US, find brief refuge in our Boston office, before being sent off to the site where it is needed. Some of these materials are donated, others are purchased – in either case, the materials are always of high quality and are safely kept away under layers and layers of bubble wrap. There are uses for all materials that line PIH’s hallways, something that I am made aware of as I climb over these piles to get to my work area.

So, why the boxes?

Partners in Health, an NGO that prides itself on transparency and efficiency, is able to host all of its programs by keeping their overhead costs unprecedentedly low. With a whopping 94% of all revenue being rerouted to health-related programs, 6% remain to being distributed for administration and fundraising efforts. That 6% supports the entire Boston office in terms of salary of employees, the office and its ability to run smoothly, as well as PIH’s campaigns online and in person.

Ratio of PIH’s expenditures by direct programming, administrative costs, and fundraising efforts.

Having low overhead costs mean that PIH is strapped for space and funding. So in lieu of a warehouse or separate floor to store all of our materials, PIH chooses to store its materials around the office – making sure that the best medical supplies get to the its programs. Low overhead also means a lot of improvisation; mismatched chairs surround the tables in board meetings, clunky computer monitors donated from Harvard sit in rows. It’s all part of keeping the NGO honest and making sure that majority of donations get to the right place – where health infrastructure is in the most disrepair.

PIH’s income, largely based in fundraising and grant writing, charted against PIH’s expenditures.

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I think one of the interns I work with said it best when asked to describe what exactly the culture of Partners in Health is;

“We’re a bunch of serious development nerds, doing what we love.”

The best thing about any work or internship experience is when you find that the people in the office are just as academically obsessed with the same things you are. That’s what I am finding at Partners in Health. Every individual, both in and out of the office, is so committed, so dedicated to the fight for global health equity that many employees are here from early, early in the morning to very late into the night, simply because they feel so devoted to the work that they do. Volunteers dedicate weekends and evenings towards working on projects, many from home during their spare time. And the more time I spend at Partners in Health the more I feel myself growing, both in my knowledge of development work as well as my commitment to it.

One of Partners in Health’s recent campaign to raise awareness about HIV/AIDS treatment.

The rewards employees and volunteers reap from working at PIH is in the knowledge that we are each taking small steps towards global health equity. And in the face of big changes, like the passing of the Patient Protection and Affordable Care Act, we cheer with the excitement that the notion that healthcare is a human right is being recognized on a global scale.

My big question of how an NGO like PIH functions so efficiently in so many countries lies in these answers; low overhead, investment of most donations into programs for health infrastructure, and gathering dedicated employees who find engrained in their hearts the need for the prioritization of healthcare for all. In channeling this passion into sustainable programs for the poor, small steps on the path for global health equity are taken.

“Equity is the only acceptable goal… And that’s when I feel most alive, when I’m helping people.”

– Paul Farmer

http://www.pih.org/news/entry/reflections-from-nepal/

http://www.pih.org/news/entry/revolutionary-cancer-care-in-rwanda/

http://www.nytimes.com/2010/01/14/opinion/14kidder.html

– Sarah Van Buren ’13