Gray ’20: Works with IRHA to Bring Healthcare

Nathan Gray ’20 — This summer, I have been able to continue my exposure to rural healthcare through my internship with the Indiana Rural Health Association (IRHA). As one might guess, the IRHA is focused on aiding the access and quality of healthcare available to rural communities in Indiana. During this internship, the IRHA staff have exposed me to a variety of their different initiatives and have brought me in on tasks and projects that developed specific skills I had identified an interest in cultivating.

Primarily, my work has been on their Crossroads: Partnership for Telehealth grant which is done in conjunction with the Richard Lugar Center for Rural Health. This grant helps provide a telehealth platform that rural clinical sites can use to expand access to behavioral healthcare services to their rural communities. On this grant, I’ve helped with roll out and implementation of the equipment and program at partner sites as well as promotion of the program with potential partners. Additionally, Abraham Kiesel and I will be helping with Community Health Needs Assessments in a number of counties around the state later this summer. These assessments provide important information for provider systems and hospitals about the pressing healthcare needs of their communities. I’ve also been lucky enough to have some exposure to data analysis and grant writing.

My experiences with the IRHA this summer require me to employ an interdisciplinary set of skills and knowledge about health systems that I have gained through my time at Wabash and during other GHI-sponsored internships. In addition to honing and adding to my healthcare professional skillset, I expanded my professional network tremendously through my participation in the IRHA annual conference and partner meetings across the state. I would like to thank the Global Health internship for this opportunity.


Kelly ’21: St. Joseph County Department of Health Intern

Patrick Kelly ’21 — My internship at the St. Joseph Department of Health has truly been a fantastic experience. I have been able to tackle my own project while also experiencing and observing the many facets of the health department. I would like to give a special thank you to the Global Health Initiative, Jill Rogers, Dr. Eric Wetzel, and Dr. Sam Milligan, for the opportunity to participate in this awesome internship experience.

Communication and Provider List

At the health department, I have been creating a list of local primary care physicians in St. Joseph County. With this list containing physicians, clinics, and contact info, we are hoping to improve communication throughout the local public health infrastructure in St. Joseph County. I have also been researching best–practiced communication methods for different providers and different health departments. Later this year, we are hoping to develop a monthly newsletter from the St. Joseph County Department of Health with updates about health in the county.

School Camps

I have also been able to visit lower end elementary schools with the health department team and give healthy living lessons. Educating young people about healthy living is super important when thinking about the longevity of the community and public health because there is a huge correlation between education and health outcomes in a community.

Community Health Program

I’ve also had a great opportunity to participate in a community health program led by Dr. Mark Fox and Dr. Joe Kotva where we are focusing on the social determinants of health. I participated in a “neighborhood survey” in South Bend of about eight different neighborhoods, and we presented to the class to see the difference in each. We were looking at things like access to education, employment, transportation, food, healthcare, decay, parks, common spaces, and community protection. It was very interesting to see how these factors affected health outcomes. We also noticed big differences amongst the neighborhoods and the disparities in health equity. It was truly fascinating to see how it correlated with life expectancy. We looked at a map of life expectancy and saw a difference of 13 years, but only 3 miles apart, which is super interesting to think about.

I’ve learned that a community plays a huge role in improving public health. It is not just the health department or the doctors, but the community as a whole needs to team up to make an impact. We have also split into different groups to come up with a community need to improve public health, and have the opportunity to present this information to other community members.


Borland ’22: Behind the Scenes at the Montgomery County Health Department

William Borland ’22 — My name is William Borland, and for the past eight weeks, I have been an intern at the Montgomery County Health Department. My responsibilities in the office have included the continued development of the Drug–Free Montgomery County (DFMC) website, as well as designated driver and “brew”-master for the vector control unit known as the SWAT (Surveillance of Water and Airborne Transmitters) team. With these roles, I was able to contribute to the pursuit of general health and welfare for the populace of Montgomery County.   

One of the responsibilities as an intern at the MCHD is the SWAT team. As interns, our job was to regularly set traps that attracted insects with a special mixture of alfalfa and water that, to the bane of man and beast alike, reeks something awful. Caught mosquitos were labeled to the best of our ability and sent to the Indiana State Department of Health to be tested for various pathogens such as West Nile Virus, Malaria, and Chikungunya. The responsibilities of the SWAT team are an example of how the health department is on the front lines of prevention; the goal is to prevent the spread of infectious diseases rather than mosquito eradication.

My chief role, the development of the DFMC website, has a very similar purpose: prevention. Substance abuse is a topic that is readily discussed and researched, but resources are spread out over the expanses of the internet and tucked away in corners not regularly accessed by the community. My job was primarily to find resources for prevention/education, treatment, and recovery to compile onto an easy to navigate and centralized website. This way, all the services from Montgomery County, the state of Indiana, and the nation, can be easily accessible and easily distributed. The hope that Samantha (the intern coordinator) and I share is that the site will be a tool for emergency responders, law enforcement, and citizens alike to use to combat the ever-growing epidemic that is substance abuse.

My experiences at the MCHD have given me a much broader understanding of public health, and a deeper respect for it. I think a good analogy for the role of public health is to describe the health department as the offense, and any sort of practiced medicine as the defense. When thinking about community welfare and health, we tend to think about the short-term solutions, like getting treated for an infection or dehydration. What we don’t see are the underlying causes of these problems. We don’t see or think about the malfunctioning septic systems or lack of running water. We don’t see these same people working two to three jobs just to stay afloat, and not having the time or the strength to take care of home responsibilities. All of these things are just a portion of what is on the docket for the health department every day. The health department is the offense that provides resources, pushes inspections to identify disparities in living conditions, advocates for correct construction and facilities development and upkeep, and for the monitoring and eradication of hotspots that could lead to communicable diseases from mosquitos. All of these things are done under the radar to improve the quality of life for the citizens of Montgomery county. As we like to say, a good offense is the best defense, and the health department is the offense that works for the community.

Thank you to the Wabash Global Health Initiative for providing the funds and opportunity for me to experience the workings of a prime example of public health at work. I know the goings-on of this summer will contribute heavily as I look to find what my life will lead and am grateful for the lessons and conversations had along the way.


Martin ’21: Translates for Patients at the Montgomery County Free Clinic

Cameron Martin ’21 — I would like to thank the Global Health Initiative for giving me the opportunity to work at the Montgomery County Free Clinic. Over the summer, I had the opportunity to work as a translator and scribe for the clinic. The Montgomery County Free Clinic helps people who are unable to obtain health insurance and provides free dental and healthcare to these people. A large portion of the population who come into the clinic speak little to no English. Therefore, they require someone who is able to communicate with them in Spanish. Translating for the patients allowed me to be right in the middle of the healthcare experience, where I worked directly alongside doctors, dentists, and nurse practitioners. Having translators or other people who are able to speak Spanish at the clinic helps both medical providers and patients. While working as a translator, I have greatly increased the fluidity and ease in which I am able to have conversations in Spanish. I have had to learn many medical terms and phrases on the job because I have never heard many of these words. Medical Spanish is very different from conversational Spanish and being thrown into the middle of it has made me learn it much faster than I would have any other way. Each day I work at the free clinic, I learn a new word or a new phrase that I did not know the day before. My favorite part about translating is being able to talk to the patients in another language and hear their stories and listen to where they came from. They are always grateful to have someone who will speak to them in Spanish, and they are always helpful when I do not know a word or when something is unclear. I also help do some scribing at the clinic. As a scribe, I worked with the doctor in recording everything that was done during each appointment. This helped the doctors with their charting and allowed them to fully focus on giving care to the patient while I recorded everything. Scribing has taught me to think on my feet and strengthened my listening skills. Things happen fast during an appointment, and I was responsible for making sure it all was written down, and nothing was missed. Overall, my experience at the Montgomery County Free Clinic has been unforgettable. Being able to work alongside health care professionals and help people who would not be able to receive care if the clinic was not there has changed my perspective and outlook on life.


Piesyk ’22 Focuses on Improving Public Health Through Community Engagement

Patrick Piesyk ’22 — First off, I would like to thank the Global Health Initiative, Dr. Milligan, and Jill Rogers for providing this wonderful opportunity. This summer, I was fortunate enough to intern for the St. Joseph County Health Department in South Bend, Indiana. For the duration of my internship at the health department, I was also able to participate in a summer program at the Indiana University South Bend School of Medicine. This summer program focused on community health and the social determinants of health. Dr. Mark Fox, the Deputy Health Officer at the health department and Dean of the IUSB School of Medicine, organized and taught the program alongside Dr. Joe Kotva, who is a professor at the IUSB School of Medicine.  

In addition to the program, I was able to gain clinical experience by volunteering at the Saint Joseph Health System Family Medicine Center. During my internship at the health department, I have experienced a variety of different things. For my major project, I researched ways to combat obesity while accounting for the social determinants of health such as education, income, food access, transportation, neighborhood, and healthcare. After researching and gaining knowledge from the community health summer program, I wrote a paper that included the obesity statistics for St. Joseph County and the nation, what St. Joseph County is currently doing to reduce obesity, and ways to improve these current strategies. Also, I included ways that other states and organizations across the country have had success in combatting obesity. Overall, I learned that government funding, policy changes such as an increased tax on sugary beverages, and donations are successful ways to combat obesity while considering the social determinants of health.

Along with my research, the majority of my internship has included attending elementary school camps. For the elementary school camps, I would assist in developing daily lesson plans and teaching these lessons. Since I interned for the public health education sector of the health department, our education primarily focused on nutrition, physical activity, mental health, sun and water safety, etc. For a typical lesson of forty-five minutes, we would give a brief presentation that was followed with interactive activities that emphasized the importance of the daily lesson. The summer camps we attended were free, so it was truly a great experience offering health education to students of a lower socioeconomic class.

Additionally, I also participated in a community garden camp for a couple of weeks. At one of the local community gardens, they offer a free children’s camp where they teach the students how to garden fruits and vegetables. At this camp, we would prepare a healthy snack such as watermelon slices, banana wraps, vegetable wraps, and would teach the children about the nutritional value and health benefits from eating these snacks. Every Wednesday afternoon, I attended a community health program, where I learned about the social determinants of health. On July 10th, we traveled to Chicago to see their efforts at improving the public health of the community. On the south side of town, we visited an urban garden which ultimately increased access to healthier food in an urban setting. Overall, throughout this program, I learned that poverty and the social determinants of health are all interconnected to an individual’s health. I also learned that someone’s environment can play a more impactful role in their health than their genetics.

Each Friday during my internship, I volunteered at the Family Medicine Center attached to the St. Joseph Hospital. My responsibilities included sanitizing exam rooms, stocking exam rooms with materials, and even rooming patients to take their vitals. I went through a one-day training for taking vitals such as temperature, blood pressure, heart rate, and respiration rate. Additionally, I shadowed nurses and doctors while volunteering at the clinic. I am especially grateful for this clinical experience due to my goal of becoming a physician’s assistance or pediatrician. Again, I would like to thank the Global Health Initiative, Dr. Milligan, and Jill Rogers for providing this internship opportunity this summer!


Kiesel ’20: Indiana Rural Health Association Internship

Abraham Kiesel ’20 — As an intern for the Indiana Rural Health Association, my first major project this summer was to convert physical screening tools to online tools using RedCap, which is a little more advanced version of SurveyMonkey. The screening tools will be used by Perinatal Navigators of IRHA partnering organizations to collect data about women’s pregnancy history as part of the Healthy Start Initiative. I worked closely with a staff member and was able to teach her more efficient ways of creating screening tools in RedCap. Together, we accomplished about two weeks of work in less than five days.  I have also assisted my supervisor Dr. Amnah Anwar with various tasks, including finalizing two grant reports necessary to continue receiving funding for her projects.

One of her projects funded through grants is the Indiana Rural Opioid Consortium (InROC). At the annual IRHA conference, Dr. Anwar, a fellow intern, and I presented about InROC at our booth. We provided information to health professionals and students. A unique feature of our exhibit was a mock teenager’s bedroom; it contained 13 hidden fake drugs. We had a challenge in which participants searched the room to find as many drugs as they could in 45 seconds. Most participants found only a couple, and this alarmed them. It became a great conversation starter for them to learn more about substance abuse disorder.

In the future, I look forward to additional presentations regarding our mock teen bedroom that we will be bringing to a few hospitals. I am also eager to shadow administrators of Gibson General Hospital–my county’s hospital–to learn more about the administrative side of healthcare. I would like to thank the Global Health Initiative for this opportunity.


Hayhurst ’21: EMT for the Crawfordsville Fire Department

Neal Hayhurst ’21 — This summer, I had the opportunity to work as an EMT for the Crawfordsville Fire Department. First, I would like to thank Jill Rogers for organizing this for me and the Global Health Initiative for covering my housing costs. The time, effort, and money they have dedicated to me embodies the Wabash spirit and reminds me why I chose to attend this special college.

As an EMT, you meet people where they are. Patients don’t shower, dress up, and drive over to the clinic to receive the treatment we give. Patients sometimes need treatment in the middle of the road, in their car in a parking lot, or on the floor of a bathroom. These are all situations that I encountered this summer which required me to meet patients where they were. I guess you could say that our goal was to meet every patient at the starting point–whatever state of need they are in—and get them to our end point- the hospital in a stable or improved condition. The complicating part—the emergency part of emergency medicine–is that the EMT never knows what the starting point may be, which means it may be harder or take longer to get some patients to the end point and easier and more straightforward for others. Whether the patient is a man bleeding and in pain in the road, a man seizing in his car, or a lady who has fallen in her bathroom, we see each and every patient as deserving of our best work and our best effort to get them to the same endpoint. EMTs meet these people at their worst, their most vulnerable, and do what they can to heal.

The interpersonal connection between an EMT or paramedic and their patient is often just as important as a well-developed knowledge of emergency care. One of the paramedics that I worked with this summer told me that if you talk to a patient long enough and are truly interested in their story, they will tell you exactly what is wrong with them. I found that to be especially true in the context of older patients who can quickly become annoyed with poking and prodding and tests. It is so easy to become obsessed with data and the cold hard numbers and to consequently miss the easiest way, both for the patient and the care provider, to uncover the problem. It was fun to put the EMT skills I had learned into practice, but I think interacting with patients and learning how to connect with them and earn their trust was the most beneficial part of the whole experience for me as an aspiring physician.

 


Wilson ’19— St. Joseph County Department of Health in South Bend, IN

Chris Wilson ’19—This summer I am interning with the St. Joseph County Department of Health in South Bend Indiana, predominantly with the health education division. I am involved in a wide variety of activities including, but not limited to, co-teaching a lecture about nutrition to students at a local elementary school, participating in the Reducing Obesity Coalition, and helping to organize the Michiana Opioid Task Force Opioid & Addiction Summit. However, my main task is creating a lead poisoning and prevention education program. This program will be five weeks long and provides general information about lead poisoning, proper nutrition and hygiene to reduce the risk of poisoning, and home cleaning and remediation tips to prevent exposure to lead. Approximately 77% of homes in South Bend have lead based paint, which puts a lot of residents (especially children) at risk for lead poisoning. The purpose of the program is to educate families on what they can do to reduce the risk of lead poisoning, make their home lead safe, and prevent lead poisoning in the future.

I have learned a great deal in the short time that I have been here but one topic that really stands out is social determinants of health. While I had heard about them previously, I did not fully understand how social determinants of health effect an individual’s well-being. A person’s community and socioeconomic status are often as important as one’s genetics in determining overall health.

I plan to become a physician after Wabash so understanding how non-medical factors affect a person’s health is critical knowledge. This internship has provided a foundation of knowledge of how a patient’s community and education effects their health. Also, I have gained a deeper appreciation for public health and how medicine fits into public health. The opportunity to intern with the St. Joseph County Department of Health has provided me with experience in and knowledge of public health while also humbling me by allowing me to serve the community of South Bend.

Unity Garden Camp

The photo on the right is from our time at Unity Garden Camp. It’s a free camp that teaches kids about gardening, environmental sustainability, wellness, etc. We provided healthy snacks to this camp and had an activity/lesson. In this picture, the lesson was about eating a variety of fruits and vegetables. The activity was “Eat the Rainbow.” The kids would draw/write their favorite food of a certain color (e.g. drawing a banana in the yellow part of the rainbow, an avocado in the green part) within the corresponding color on a rainbow.


Whitaker ’19—St. Joseph Health System in South Bend, IN

Whitaker is on the far right, in the green.

Joe Whitaker ’19 – “Things are going really well in South Bend. I’ve been working with Latorya Greene on two major projects. For the first project, I compiled a list of all of the bars in St. Joseph County and I collected info regarding their smoking policies, their structural layout, and any thoughts they might have on going smoke-free. For the second project, I’ve been preparing Indiana Tobacco Quit-Line information packets and delivering them to all of the physicians in network. On Friday’s I work as a volunteer at the family medicine clinic in the St. Joseph’s Regional Medical Center. I do simple things like getting patient’s vitals, cleaning rooms, and restocking supplies, but it’s great to meet people and see the variety of patients that come through the door.

In addition to my two projects, I also do community outreach events where I educate St. Joseph County citizens on the dangers of all forms of tobacco and I help get signatures for a petition. The petition advocates for two things: an increase in the purchase age of tobacco products from 18 to 21 and an increase of the cigarette tax by $1.50. I’ve had to do a lot of

Whitaker on the right in green

information seeking to be able to defend these two proposals but in educating myself I’ve really come to believe in the work we’re doing here. The community outreach programs have really influenced the way I view public health and those individuals who can slip through the cracks of the healthcare system. Ultimately, I’ll take the information I’ve learned here and I’ll carry it forward with me as I begin my career as a health professional.”

Joe is interning with the St. Joseph Health System in South Bend, Indiana.


Equihua ’20 —What is it you want to do, again? Primary care? Pick something else

Artie Equihua ’20

Artie Equihua ’20 — When I was around three or four years old, I told my grandfather I wanted to be a scientist. This statement did not evoke the greatest response considering he probably wanted (and still wants) me to pursue a career in professional sports. However, my fascination with science and deep desire to help those who feel hopeless has crafted my current dream of becoming a physician. However, even a kid who has dreamed of working in healthcare for his entire life can become overwhelmed by the negativity associated with it. Most recently, I had a discussion with a primary care physician working out of North Carolina. In our conversation he mentioned he had always wanted to be a doctor because of his love for science and his ability to utilize it in order to help people, but the current system was not allowing him to care for his patients to the extent he wanted to. Shortly after this comment he looked at me and said, “Healthcare is going to hell. What is it you want to do, again? Primary care? Pick something else.”

This encounter with the primary care physician had truly shook me. How could someone with such similar aspirations become so depressed and resentful toward healthcare? I tried to formulate a response that would somehow change the subject, and I ended up blurting out what his statement had made me feel. I started with the story involving my grandpa. I explained how I had identical interests and why I wanted to become a physician, but I did not say I agreed with his current perspective. Instead, I explained that I often, too, feel very cynical about the industry that I hope to someday find a career in; however, there is so much innovation and change already occurring that it keeps me hopeful.

Unfortunately, I could tell that he had not changed his position on the matter. Perhaps, he believes me to be naive, but I can live with that. Fortunately for me, with each new daunting flaw that I hear about in healthcare, I am exposed to the innovative work of twice as many people who are dedicating their lives to solving current healthcare issues on all levels. With so much innovation and optimism radiating from individuals at Volunteers in Medicine, HealthLINC, NCHICA, DHIT, Duke, UNC, and many other organizations, it is hard not to feel hopeful for the future.

This summer Equihua is participating along with Nathan Gray in a Global Health Initiative internship with Wabash alumnus Dr. Todd Rowland (www.bridge2medical.com). This is his second blog post in the series of posts on exploring the world of health care and those trying to revolutionize it. The G. Michael Dill Fund makes this internship possible.