HEALTHCARE & HEALTH POLICY

VICTORIA CHEN - CHASE BREXTON, WEEK 3

A support group is simultaneously the most vulnerable and the most resilient place. Not only is this a place where people go to share their darkest moments and relive trauma, but it's also a place of tremendous strength, growth, and community. When I was welcomed into the TransCare Focus Group this past week, I didn't think it would be a super volatile place. Yes, people would talk about their horrible experiences with facing explicit discrimination by health care providers. And yes, people would re-emphasize the importance of using correct names and pronouns. But I didn't expect it to be a place of healing as well. Seeing the participants bond over the judgement and stigma that they are forced to face every time someone mis-genders them is truly heartbreaking. And having to deal with that when you're coming into a clinical environment just makes it that much worst. Rather than feeling dejected by the health care system's general neglect for people of trans-identity, these participants are making an active choice to speak about their positive experiences and help compose a list of necessary provider competencies. It's truly unbelievable for me to see the resilience that shined through in that room.

As I continue into the rest of my internship, I want to keep building these small, but meaningful relationships with people from the community. A large part of my work is learning how to be a supportive ally--both in the office and out. But I've realized now that the answer is simple: to treat everyone with the same respect, love, and compassion that I want for myself. All of the other details (such as learning the constantly changing terminology) can be worked out as they come along.

 

LUCINDA CHIU - JOY WELLNESS CENTER, WEEK 3

“Hey, be careful around here, okay?” My parents and friends did not tell me this when I informed them I would be walking to and from the shuttle stop to the Joy Wellness Center, part of Shepherd’s Clinic, this summer. My supervisor at the center did not tell me this as I left the clinic to go canvas the surrounding area of Northeast Baltimore. The volunteers from Civic Works Real Food Farm, whom I was handing out mobile farmers market flyers with, did not tell me this as we went door to door. Rather, a young boy sitting on his stoop said this to me as I stuffed my final flyer into the door handle of his neighbor’s house.
I have spent the majority of my three weeks at the Joy Wellness Center in the clinic, helping with administrative tasks, teaching classes, and tending the local garden. The Blue Jay Shuttle picks me up in front of Charles Commons and drops me off in front of Hopkins’ Eastern campus. From there, I take a short walk through Baltimore City College’s campus and then down the steps along The Alameda until I reach the clinic. All I know of the neighborhood next to us is from the staff in the clinic. I know that I am not allowed to leave the clinic by myself at night, and to always lock the back door behind me when I go out to garden.
Tuesday was my first experience walking through and spending time in a neighborhood where more houses are boarded up than lived in. The first few I went to, there were steel security storm doors to place the flyers in. As we continued, more and more houses just had wooden planks covering the windows and entrances. As I rounded the corner, I handed a flyer and a calendar of all the free classes we offer at the Joy Wellness Center to a couple sitting on their front porch. We conversed about the amount of stress in the neighborhood, and looking around, I could see the difficulty of remaining optimistic in this environment. Before I left the husband told me, “Don’t bother going to the rest of the houses on this side of the street. Nobody lives there.”
Since coming to Baltimore, and from our reflection session during the first week of the internship, I have continued to hear of the housing crisis in this city. Many of our patients come to us from Northeast Baltimore. Canvassing the neighborhood has allowed me to catch a glimpse of the issues they may face firsthand. In addition to being referred to the center for stress management, another major portion of our patients have Type 2 Diabetes. We often call them to schedule private diabetes self-management or nutrition consults. Sometimes they pick up the phone sounding tense and oftentimes do not show up to their appointments. Walking through Kirk Avenue and The Alameda for just a couple of hours has helped me better understand where some of our patients come from and how an appointment, as much as it is for their benefit, can add to their stress. Though I cannot help them find better housing or relieve their mental health issues, I can remain compassionate and understanding when scheduling their appointments and when talking with them at the clinic. I can help them realize they are not alone, that there is a network of providers here to support them.

POONAM GUPTA - STAR TRACK, WEEK 3

Week 3 has gone really well! Something that I’ve definitely grown to appreciate this week is the complexity of community partnerships and the vast network of organizations that make up specific coalitions or collaborations. Since my direct supervisor is actually the Community Mobilization Coordinator, or basically the person in charge of our various community collaborations, I’ve been accompanying her on several of her meetings. We’re part of two different transgender alliances, a Baltimore Police Department LGBTQ awareness coalition, a PrEP collaborative (a drug with new funding that can prevent HIV), and most likely several others that I don’t know of yet. Going to these meetings, it’s really exciting to see lots of familiar faces around the table from places like Chase Braxton, Harriet Lane Clinic, etc. My experience with Health Leads left me with the thought that the resource landscape in Baltimore is extremely disconnected, but there’s a great deal of communication that I didn’t know existed between organizations. The different backgrounds coming together in shared goals of LGBTQ and racial justice (as cheesy as that sounds) really gives me hope for a more unified front in what I thought was a more fragmented community.
However, another more jarring realization has been that these various social justice non-profits aren’t always interested in collaboration, and a lot of times this comes down to funding or even ideology differences. Two organizations can be allies for the same cause, yet have completely different target populations and thus stray away from working together. Non-profits, as I remember from orientation, are businesses as well and have their own branding and services to offer the city. Measures of success are extremely important in turn for writing grants, which then ensures future success. Thus, these collaborative are sometimes a double-edged sword in terms of where labor and compensated work time will go. This especially happens when several organizations offer the same services in the same location.
This isn’t to say that I now have a completely different opinion of the non-profit world and that I now equate them with big corporations. However, the business model of funding and growth will be relevant in any setting, and realizing this has given me a greater appreciation for how regardless of this mindset, the focus will always come back to serving the community and their mission statement. In Star Track, one of the greatest things to watch is how adamantly they stick to this, especially in terms of being inclusive, what language they use, and what images they’re portraying. A lot of thought goes into everything Star Track puts out and I’m excited to see how this will play into all we do for Pride in the coming weeks.

 

JOYCE LIN - CHASE BREXTON, WEEK 3

This week was different from the last few because it was National HIV testing week. So instead of keeping busy with organizational work, everyone in the office focused their attention on getting as many people tested for HIV as possible.
Because I'm not yet certified to conduct the rapid HIV test, I set up camp in the lobby doing outreach and recruiting people to be tested. Though it got kind of boring by the end of the week, I enjoyed this experience because it allowed me to interact with the clients and patients of Chase Brexton, the people I had been addressing letters to for the last week or two. I was also able to do some outreach and encourage people to get tested and explain the benefits of regular testing as well as the mechanics behind the rapid HIV test. I felt like it was a good opportunity for me to display what I know and get to leave my cubicle for a few days. One minor downside that I saw in this week was that there was little instruction and guidance. I was stationed in the lobby by myself to set up a greeting table and told to tell people about HIV testing week. I enjoyed the freedom to be creative and do whatever I wanted, but it also would have been nice if someone had checked up on me once in a while or gave me some pointers so I wasn't just sitting alone doing my own thing downstairs from 9-5. From this week, I've gathered that I much rather work in an open setting interacting with people than in a cubicle behind a computer. It was a great time getting to know some of the patients who get treated at Chase Brexton and see them beyond their name, address, medical stats etc... I look forward to having more opportunities to interact with more people, to do more outreach and to learn more about Chase Brexton and its clients.
One thing that I really hope to find in the coming weeks is something that challenges me or brings me out of my comfort zone. So far, it has been a very low-key internship and Emily has been very "chill" with all of my tasks, but I have yet to do something or be in a situation where I can feel challenged or excited. If there's one thing I look forward to the most for the rest of the internship, its to find something or be in a position where I can feel slightly uncomfortable.

VIJAY RAMASAMY - STAR TRACK, WEEK 3

Man, this week was a lot.

I feel as though my blog posts are usually written more passively, as a fly on the wall whose gaze is colorlessly observant of my comings and goings at the clinic. More often than not my personal reflections tend to comfortably skim the surface of my experiences, carefully avoiding the intimate or less than graceful. But, as I left the city to enjoy a weekend with family and began reflecting on my week, I felt as though my walls of cautious inhibition were slowly crumbling, wading away as quickly as my naïve understanding of non-profit work.

Before I began work at the clinic, my perception of nonprofits was shallow at best. I had this rosy view of what these incredibly hard working people do, believing that besides a few bumps in the road, they would be able to serve and empower everyone that needed help. I believed deeply that every institution, whether it be public or private, was built with a foundation of morality that would support the work that non-profits engage in. I believed that modern public policy aimed at aiding the less fortunate, even if at times divisive and worthy of debate at a philosophical level, was written to be inclusive and protective of all people. I believed that in this day and age, common hurdles for organizations built to serve communities would be financial and logistical, not institutional and systemic.

There is something about not being able to aid someone who comes to you for help that makes your blood boil, your heart ache, and your soul search. At one of our health fairs, we had a young man come to us the desk and ask for help in finding health insurance. My supervisor and I, incredibly excited, immediately began the process of applying for Medicaid for the young man. I started asking him the basic qualification questions, almost resting my ears to the answers because of a foolish eagerness to get him signed up and insured. I got all the way up to the second question in the process before my supervisor stopped me. The young man was under 18 years of age so he would not be able to sign up without a legal guardian there to fill out a primary application.
My privileged world view, however, was unfazed as I quickly began asking him for his personal information to get him and his parent into the clinic to finish the application. It was then that he indicated that he hadn’t spoken to his parents in years, and he would not be able to contact them to get insurance. Since he was not orphaned or under the supervision of a social worker, he would not qualify for any special status. He would have to come to the clinic when he turned 18 in order to get any insurance or see a doctor. There was nothing we could do for him and he left, leaving no contact number or hope of future connection.

That was it.

Instances similar to this one happened multiple times during the week and the same empty and frustrating feeling of ineptness engulfed my soul. We were eventually able to help some of these individuals through diligent, persistent, and brilliant work by my colleagues, but others still fell through the cracks. These people were categorically denied the human right to healthcare and the right for their stories to be considered in the pages and pages of public policy that govern our land.

Man, this week was a lot.

Sincerely,

Vijay