The summer of 2020 has been an extremely strange one for everyone and everything due to the covid-19 epidemic. For those, including myself, that have taken part in internships with the Global Health Initiative we have been working essentially on the front lines helping those in need as a result of this epidemic. My internship this summer has been through the Crooked Creek Food Pantry located in Pike township, IN. Crooked Creek is responsible for helping to feed those that are not capable of spending any excess earnings on food at the grocery stores. As it currently stands, Crooked Creek services an average of six hundred families a week in Pike township.As a result of covid-19, the daily operation of the pantry hasbeen altered greatly from their normal means of operation. For example, those that use the services of the pantry are no longer capable of doing their own shopping in person and must pick up any food received from areas set up outside to ensure that social distancing orders are maintained and the safety of patrons and the volunteers are ensured. To do this, preselected food items are set out on a table and patrons must take everything given to them. My job as an intern is to ensure that the day to day activities of the pantry canrun smoothly and successfully. These duties vary depending on the day of the week. Generally, we spend Mondays and Tuesdays working on organizing the pantry and restocking our supplies of food. Our largest contributors of the foodwe receive is given to us through Gleaners Food Pantry, and Midwest Food Bank. Also, due to covid-19, our government has increased their spending on TEFAP (The Emergency Food Assistance Program). These three supply chains are what allows Crooked Creek to maintain itsdailyfunction.Fortherest of the days in the week, we are handing out the food received earlier in the week to patrons. As described earlier, patrons no longer can do their own shopping to maintain social distancingorders. So, forthese days of the week, it is my job to ensure that all patrons receive all their food and that everyone receives the exact same food. Due to this internship, I have gained extremely important information that I will be able to use in the rest of my time in Healthcare. The most important information that I have gained is a deeper insight into how social determinants of health play a role in those that use the pantries services. By this I mean things like income, family, housing, lifestyle, etc. play a role on the health of an individual. For example, I learned that a close majority of patrons at the pantry are diabetic. I learned that this was due to the determinant of income because people that tend to make less money have less of an ability to choose healthy food options that will prevent any chances of becoming diabetic.
Cesar Mares ’22–This summer I had the incredible opportunity to intern with SOAR (Shaping Our Appalachian Region) and CDC epidemiologist Dr. Margaret Riggs, PhD, MPH, MS. SOAR is a non-profit organization based with the aim of addressing challenges and identifying opportunities for the development of Eastern Kentucky. It strives to improve education, economic outcomes and health in the Appalachian region. Dr. Riggs serves as a CDC liaison for SOAR and also performs a wide variety of roles for local health departments. She served as our primary supervisor and project lead during our time with SOAR. With appropriate adherence to CDC guidelines, the first week of our internship took place in Pikeville, KY. Keith Klein ’21, Kaleb Wood ’21, and I would spend this week getting to know the region and meeting with local health department leaders in the Kentucky River District and Pike County areas. Although initial plans were to perform public health work relating to diabetes, it quickly became apparent that there was a different need. Through discussions with leaders at the forefront of the COVID-19 response, we determined that evaluating how local health department services were affected by COVID-19 would aid these departments in future work. The project would be composed oftwo sections with one focusing on qualitative data through interviews and one focusing on social media analytics. After week one in Pikeville, the rest of the internship became a virtual endeavor. I led the social media analytics portion of this project and my role was to create a SWOC (strengths, weaknesses, opportunities, challenges) analysis of public health communications, specifically through the platform of Facebook, of local health departments. While a bit different from other work I have engaged in, I enjoyed it because of the research characteristic to it. Health department leaders stressed how social media became a powerful tool of COVID-19 education and health promotion. My analysis of these pages showed this to be true, with significant increases in total reach and engagement all across the counties of interest. In addition to the evaluation of data, I also performed interviews with health departments to gauge the usage of other forms of communication. I am appreciative of the number of skills and knowledge I have gained from my Wabash education as I never felt at a complete loss when presented with work I have never done before. The work that I performed with SOAR this summer exposed me to another facet of health. Public health practice is essential to healthy communities and an understanding of what goes into this practice makes one more appreciative of those at the frontlines of the COVID-19 response. I would like to thank the Wabash College Global Health Initiative, SOAR, and Dr. Margaret Riggs, PhD, MPH, MS for making this opportunity possible!
Cameron Martin ’21–This summer, I am interning at the Montgomery County Health Department in Crawfordsville, Indiana. My main project for the summer has been to promote the new vaccination program at the health department. I have made posters, updated the website, and written a newspaper article about the vaccination program and the importance vaccinations in general. With the other interns, I have been on restaurant, home, and pool inspections. A big project for all the interns is vector control with mosquitoes. We go out and set traps around the county to catch mosquitoes, look at what species are at each site, and then send them to the Indiana State Health Department to see if they are carrying any diseases such as West Nile and Zika. I have learned a great deal and have gained an appreciation for all that health departments do around the county. Before working at the health department, I did not realize how many things the health department is responsible for. As a student who is currently applying to medical school, the health department has allowed me to see how much doctors can benefit from working with their local health departments. They can greatly influence a community’s health by working on preventative carein medicine by reducing risk factors, encouraging safe environments, and educating the community about different health issues and what people can do to help. Currently, the health departments are essential, and being able to intern during a pandemic has been very rewarding because I get to see all the things the health department controls and regulates. Also, with all the racial injustice protests going on around the country, the health department is taking a new look into the social determinants of health. They are looking at ways to combat them so that any person, regardless of race, ethnicity, gender, or social class, can achievethe same quality of life and health. Overall, I have learned a lot in the internship, and I believe that I will continue learning new things about the community and how the community’s health is managedas the internship continues.
Michael Armbruster ’20 — As a Crooked Creek Food Pantry intern, I would like to thank Stephen Claffey, the president of the pantry, for providing this internship and Wabash College and the Global Health Initiative for offering this position as well as providing funding for this phenomenal internship. During this internship, I have really seen the face of poverty and what generational poverty can do to people. It has been an eye opener to see poverty in action nearly every day. From stocking our shelves with food that is donated or bought, to helping each person who comes in to pick out their food, to recruiting volunteers, there is much more to running a food pantry than I previously thought. For some people who come to the pantry, they do not get much human interaction and simply taking the time out of our day to talk to them and help them with their food selection means a lot to them. One specific example for me was when I helped this very elderly Spanish speaking lady pick out her food. Not only was she elderly, she was alone and did not speak any English. For me to take to the time to speak to her in Spanish and be patient with her as she looked at nearly all the food in the pantry really gave her a smile and happy day. After helping her with all the food shopping, she gave me a hug and told me “Thank you and God bless”. This shows that just having the patience to help these people means a lot to them and helping them when they might be down on their luck might just be the motivation they need. Working in this business really shows you how much people out there need help and how grateful they are to receive this kind of help as well. Another experience, as a whole, is experiencing people who have great attitudes about coming to the food pantry to shop. While most people who receive food from the pantry are grateful, some people really go above and beyond my expectations on how grateful they actually are. When people come in and have great attitudes and have fun while they are shopping really lifts themselves up but me as well. Poverty is a very tough thing to experience and living in poverty must be much worse. However, for some, attitude is much more important and them having a good attitude allows them to have a better life. I am incredibly grateful for this opportunity to work at the pantry and to learn and see the face of poverty in person. I have definitely grown and matured immensely from this internship.
Hunter Wakefield ’22 — This summer I have had the pleasure to be working at Crooked Creek Food Pantry in Indianapolis. The pantry serves the residents of Pike township in Marion country and a small portion of Washington township. The location of the pantry has been classified as a food desert, so the need for food is high. With only two exceptions there are no grocery stores for miles around the pantry which means many of the nearby residents struggle to get access to food that they need for proper nutrition and a healthy lifestyle.
Every day at the pantry brings new challenges as we deal with fluctuating numbers of volunteers day by day. At times we had more volunteers than we knew what to do with and other days we would try to do the work of 2-3 people at once. Volunteers are the most important resource for a nonprofit organization and an inconsistent flow of volunteers is the pantry’s greatest challenge. The leadership here at Crooked Creek food pantry is extraordinary and they helped to make even the hardest days as easy as possible despite the lack of volunteers. The other interns and I have worked to tackle the volunteer problem. To do this we have gone out into the community and contacted local businesses, schools, and churches to create relationships between the pantry and its community. Not only has this experience making connections been invaluable, but we hope that our efforts will bring in more volunteers for the pantry.
The most powerful observation I’ve made for myself during this internship is that the reasons for why people come to the pantry were often different from what I’d expect. Before working at the pantry, I always assumed people came to food pantries because they couldn’t afford food or didn’t have easy access to it, but I’ve since learned that there is almost always more nuance to each person’s situation. For example, many cannot afford food because of new medical expenses. Another common situation I often see is that retired folk come to pantry because they no longer have enough money in retirement because they have to care for their grandchildren. Whatever their reason for coming the guests of the pantry are all in need of the little bit of help that the pantry provides.
My experience interning at Crooked Creek Food Pantry is one I’m truly happy to have gotten the opportunity to have. I’ve gotten to meet many wonderful volunteers that I would’ve never met otherwise. If this internship is an option for students next summer I will strongly recommend it to anyone who has a love for community service and working with many interesting people.
Eric Lakomek ’21 — This summer I have had the pleasure to participate in an immersive learning experience funded by the Wabash Global Health Initiative with Frontier Nursing University and the Little Flower Clinic. I was given the opportunity to experience rural health firsthand at a homeless clinic in the community of Perry County, Kentucky.
Before, I begin to dive into what I was able to observe and complete this summer, I think that it is important to discuss a little bit of background on the area I worked and lived. The coal industry used to be the largest employer of the residents in the county. In 2012, when the mines started to close, thousands of individuals lost their jobs and their livelihood. This led to a sharp increase in the homeless population due to the fact that there just wasn’t anywhere else to work and make a decent living. From the grueling work in the mines, many individuals suffered from chronic pain and turned to pain prescriptions to cope. Eventually, this area became the posterchild for the opioid crisis. Perry County was recently ranked 4thin the United States for pain prescriptions with enough pills prescribed to supply each person in the county with 175 pills per year.
Working in the homeless clinic, I was able to see the most vulnerable population and how this directly affected them. I was able to learn about the many treatment methods used to combat the crisis. In addition, I was able to learn the day to day operations of a grant-funded primary care clinic. I worked with two amazing nurse practitioners, Vera and Allyson, who taught me so much about different conditions and how a practitioner must approach treating an individual holistically, due to limited resources available.
Most of my time was spent doing outreach with the case workers at the clinic. I accompanied them to farmers markets, community events, and also on home visits. It was extremely interesting to observe the approach of bringing healthcare into the homes and lives of others, rather than have them come into the clinic. I believe that this makes many of the goals for the patient much more attainable because they feel more comfortable in their home setting. There is a large distrust of medical providers in the area so bringing healthcare to the people seemed to open many more people up. This, in my opinion, helped reduce many adverse health outcomes because barriers could easily be identified.
While I was seeing patients and doing outreach, I also completed a community needs assessment and project based off of the results I received. As identified in the community needs assessment, heart disease is the number one killer in Perry County. Heart disease has many complications, but hypertension and diabetes are two leading root causes of this issue. Diabetes prevalence in Perry County stands at a staggering 16%. This may be in direct correlation with adult obesity rates of 40%. Both of these rates are significantly higher in this community compared to Kentucky and the United States.
Diabetes and Hypertension are two of the most common chronic conditions that are prevalent in the Little Flower Clinic. Many patients that come into Little Flower are living on low income and cannot afford to purchase the necessary items needed to manage their condition. Therefore, when they are diagnosed with having hypertension or diabetes, the only materials the patient receives are medications and glucometers through their insurance. If a patient presents without insurance or cannot afford to pay, then many aspects of managing their conditions are not met. This led me to provide diabetes/hypertension care kits. Patients were able to receive blood pressure monitors, weight scales, wristwatch pedometers, and pill cases. These items allowed the clinic to distribute necessary health management equipment to patients in need so that they can help reduce adverse health outcomes. In addition to the diabetes/hypertension care kits, I provided education to bring A1C levels, cholesterol levels, and systolic/diastolic blood pressure down. Recipe booklets and brochures were created to educate patients on affordable, healthy recipes to make for themselves.
After reflecting on my experience this summer, I can truly say that I have changed in so many different ways. I have become much more appreciative of the things that I have in my life. The cultural experience in Appalachia has opened up my eyes to and taught me so much about who I am as a person and future physician. I will never forget my experience this summer at the Little Flower Clinic and I will continue to recall upon the information I acquired to use to improve the lives of others in the future.
Cesar Mares ’22 — This summer, I am one of four students to participate in the junior medical school student internship with alumnus Sean Blackwell ’89 and the UTHealth McGovern Medical School in Houston. Each week, we rotate through a different department within the OB/GYN practice in both hospital and clinical settings. Rotations have included week-long stints in the Resident Clinic, Fetal Center, Obstetrics (labor and delivery) and Gynecology.
The OB/GYN practice is truly hybrid. It provides a steady balance of surgeries, patient visits and office work. I’ve witnessed a number of noteworthy surgeries performed by high risk fetal intervention specialists in the Fetal Center such as laser ablation surgery to treat Twin to Twin Transfusion Syndrome and a fetoscopic endoluminal tracheal occlusion (FETO) to treat a fetus with congenital diaphragmatic hernia. During my time here, numerous doctors have suggested pursuing surgery. While doctors will always be in demand, technological advances hint at a future where regular and uncomplicated patient care is completely digital. Outside of the OR, physicians effectively communicate diagnoses and treatments to their patients and fellow colleagues. Doctors provide the best care to their patients by practicing evidence-based medicine. Research reports, data charts and the most up-to-date statistics decorate the walls of the resident lounge. Attendings continuously praise residents who speak with numbers and research-supported facts. But patient care extends beyond the numbers.
Physicians who serve in a diverse city such as Houston must be culturally competent. Societal habits and cultural norms are regularly mentioned in safety meetings and discussed with patients. Good doctors adopt a holistic approach with each patient. More importantly, good doctors love their craft. They are lifelong students of science and technique. Becoming a physician is not easy. The emotional and physical demands of this career are unappealing. Residency is by no means glamorous. Despite all of these things, every doctor I’ve encountered so far would not give up their job for anything. This internship has reinforced my decision to pursue medicine. On a much deeper level, my experiences here have reignited a desire to practice medicine in underserved populations.
Chris Wilson ’19 — In the few short weeks I have been a the Texas Medical Center in Houston, I have learned a great deal about medicine, healthcare, physician-patient interactions, and what it means to be a good physician. Healthcare is constantly changing; new technologies and medications are developed every year, and physicians must learn how to incorporate these new developments into their practice. I have seen firsthand how frequently and vigorously doctors and other healthcare providers read primary literature articles about new developments in their field. Also, I have witnessed cutting edge procedures, such as laser oblation surgery, that have revolutionized fetal care and women’s health.
However, the most valuable thing I have learned is how doctors communicate with patients. Patients visit doctors for a variety of reasons and often have questions about their health and bodies. The doctors that I have had the privilege to observe have not only clearly and concisely answered their questions, but have also reduce their patients’ stress by connecting with them in a very human way. Technology is great and improves our lives in many ways, but nothing can replace in person conversations between patients and physicians. While medications will continue to improve and more of our communication will be digital, face-to-face conversations between doctors and patients and alleviating patients’ fears will always be one of the most critical parts of healthcare.
Ben Grubbs ’20 — Observing situations involving high risk pregnancies can be tough at times and beyond rewarding at others. My very first case involved a patient with anencephaly, a rare condition that results in the lack of development of a skull during pregnancy, something I was not prepared for. The physician consulted the couple for the next hour going over every option and possible outcome so that the family understood the severity of the situation and could make the best decision for themselves and the child. Immediately following, I walked into the operating room to observe an in-utero spina bifida neurosurgery, only the 87thsurgery at this hospital and certainly an extremely rare surgery that few hospitals in the world have the capability of performing. I discussed with the surgeon afterwards as he reminisced on the first one he did just a few short years ago, dramatically increasing the life span of a young girl whose family he keeps in touch with. It was a roller coaster of a first day seeing these cases and left me excited for the rest of my six weeks here in Houston at Memorial Hermann Hospital.
My next experiences led me to the gift of life as I observed multiple caesarean sections resulting in the successful births of healthy babies. It is a moving sight to see the moment a baby takes its first breath and enters the world we have known for so long. You can’t help but imagine the life ahead of the child and think you may have been in that exact position many years ago. In a hospital on the leading edge of technology, there is always something new and groundbreaking going on whether it be research or surgery. It is promising for the future as we continue to correct conditions that were a sure death sentence at the turn of the 21stcentury with advancements from physicians that are compassionate about pushing forward the capacity of life and giving hope in situations where there is little. These experiences solidify my decision to enter the field of medicine and contribute a sliver to the progress of our world.
James Eaton ’22 — This summer, I had the amazing opportunity to shadow a variety of doctors in the high-risk OB/GYN department at Memorial Hermann Hospital in Houston, Texas. During my time at Memorial Hermann I was able to join doctors on patient rounds, conduct research, and scrub into many surgeries. This experience not only educated me about medical specialties I was fairly unfamiliar with, but also provided me with firsthand experience working in emergency situations.
I think one of the most surprising things about my time at Memorial was how diverse our patients were. The Texas medical center, which Memorial was apart of, is one of the largest medical centers in the world. Because of this, we took in many patients from a variety of countries, which allowed me to interact with people from cultural backgrounds I was not familiar with. More importantly, I witnessed physicians and residents taking the time to understand the cultural backgrounds of their patients in an effort to provide the best care possible. This experience highlighted how the best physicians attempt to make a personnel connection with each of their patients.
One of the highlights of my time at Memorial Hermann was observing an in-utero endoscopic laser ablation, which is a fairly rare and complicated procedure that can correct twin-twin transfusion syndrome. It was fascinating watching a team of fetal surgeons simultaneously map and coagulate placental vessels in real time, especially because they were using extremely advanced technology to do so. This experience, along with the many other surgeries I observed, has drawn me closer to the procedure side of medicine. I am very thankful I had the opportunity to spend a summer at the Texas Medical Center, which would not have been possible without the help and generosity of Jill Rogers and Dr. Sean Blackwell.