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.

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.

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.

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.

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!

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.

Samuel Marksberry ’21 – As an intern at the Montgomery County Health Department, my main role has been with the vector program. That includes doing mosquito surveillance around the county by collecting, typing, and sending mosquitoes to the state health department in order to be tested for West Nile virus. I’ve also worked with the education side of public health by writing articles about food safety and nutrition for the local newspaper and designing activities for kids at the local health fair. The other piece of my role at the health department is learning the structure and responsibility of how the department influences positive health in the community. I have also participated in food, pool, house, and septic inspections.

Sam Marksberry ’21, left, and Owen Doster ’20

My most powerful experiences have been when I tagged along on some of the house inspections. I have observed poor air quality, human and animal feces, stuff piled to the ceiling, or dirt everywhere in a home. These conditions are factors that play into deeming a house unfit for human habitation because they all have a negative impact on health. Through my liberal arts education, I am able to piece together the many components that play into an individual’s health. Rather than just assume some people are, for lack of a better word, dirty, health is more than what can be seen on a house inspection. In my Global Health class with Dr. Eric Wetzel, we discussed that many factors such as education, socioeconomic status, family, and experiences are what make up someone’s health. I have learned that to truly help someone, it is important to practice empathy and understand where an individual is coming from. Helping someone can be tricky at times because it can be difficult to figure out what would be most beneficial to them, but listening and caring make improving someone’s situation less difficult. My experience at the health department combined with my education at Wabash has given me another lens to view the world, a lens that is focused on understanding others.

Matthew Hodges ’19 – As a pre-med student with a primary care focus, I tend to frame preventive care at an individual level. When I think of preventive health measures, I generally think of proper diet, adequate physical exercise, reducing high-risk behaviors, and receiving routine checkups, vaccinations, and examinations. While these factors are undoubtedly important and play a key role in public health, there are so many preventive measures beyond the scope of individual lifestyle choices that are absolutely vital to a healthy community. Working at the Montgomery County Health Department this summer, I’ve had the opportunity to see a small fraction of the work that goes on behind the scenes to keep our community healthy.

Matt Hodges ’19 laughs with Sam Marksberry ’21 while picking up mosquitos

Many of the health department’s responsibilities are things that we don’t think about; we simply take them for granted because they have been done so well for such a long time. Food inspection and sanitation specifically come to mind. When we sit down at a local restaurant and order our favorite menu item, we assume the food is clean and won’t make us sick. When we look down at our plate, we generally don’t ask ourselves at what temperature the meat was cooked, whether or not there was cross-contamination in the kitchen, if everyone was wearing a hairnet, or if the freezer was cold enough. Fortunately, Adrianne Northcutt has already asked all of these questions so we don’t have to. Similarly, the whole appeal of indoor plumbing is that we don’t have to think about what happens after we flush. That isn’t magic – it’s a man named Don Orr. Don personally inspects every septic system in the county to make sure they meet standards that prevent a whole host of unpleasant sewage-related problems.

Without people like Adrianne and Don, it would only be a matter of time before diseases and health issues that primarily exist in history books and developing countries come back to bite us. Working at the health department, I’ve learned the importance of a sound, well-regulated infrastructure. Many of the societal comforts we take for granted are in fact substantial victories for public health.

Hunter Jones ’20 – I was hired by the Montgomery County Health Department through a grant specifically to create materials aimed at helping those who had recently experienced an overdose due to opioids. In this capacity, I began by creating an updated list of substance abuse treatment centers and resources in the area. However, in doing this, I was shocked to find how disorganized and incomplete current local and national resources were. This led me down the path of creating a new website for Montgomery County to create a centralized and inclusive resource for substance abuse treatment, prevention, and information in our community. I am currently working with the health department to submit a grant to fund this website and thrilled when thinking about how much potential this resource has.

Owen Doster, Hunter Jones, Sam Marksberry, and Matt Hodges at the local health department.

I attribute a lot of my success in my role at the health department to my time spent in a liberal arts environment because it has taught me to not only identify a problem but also take the steps needed to establish a solution. Wabash has equipped me with the tools to view a problem through a critical lens and walk my way around a problem in order to create a well-rounded response. My liberal arts education has also been critical when observing discussions from different community members and other organizational efforts to combat the opioid epidemic. As with all issues of this magnitude, there will always be differing opinions on what the best answer is. The most important tool Wabash has given me regarding these discussions and plans is the ability to take a step back and see a problem through a bigger lens than my own experiences to help establish a versatile solution.