Listening

During my second week of Health Corps service, I found myself hitting the ground running, becoming immersed in the basics of home visiting. My site supervisor Sharon and I had just finished a visit with an overwhelmed, young mother of six kids with special needs. The newest addition to the family, a baby girl, had been having difficulty eating due to painful regurgitation. Her mother had spent the majority of our visit expressing to us her frustration with a doctor who wouldn’t listen to her when she said her daughter was in pain.

As we left the house, Sharon provided me with simple, yet essential advice: Listen to your patients.

These four words have served me well over the course of my service year. As a case manager, I am welcomed into the homes of people who are often voiceless in the face of greater systems: hospitals, welfare, insurance, school. I have the unique position of being independent of these; I am there to support and advocate for them as they gain confidence in their ability to take on the world. I am often the one person in their lives who will just sit, listen, and help as they try to make sense of their situations.

My experiences as an advocate, working with families both at home and in the community, will undoubtedly prove invaluable as I pursue a career as a physician. I’ve seen first-hand how easy it is for families to get overlooked, usually because they are not confident speaking up for themselves. I’ve seen how, when dealing with health care, we are not just the diseases or conditions we have, but rather a product of our environment and upbringing, both of which inform how we handle treatment. I’ve seen how it takes patience and understanding to reach the next level of partnership with my clients, the level where the underlying worries and motivations come to surface. These are all lessons I will carry with me when I start my medical school path in August.

I will listen.

Name: Claire Hartung
Position: Community Health Outreach Associate, La Salle Neighborhood Nursing Center
Degree: French and Francophone Studies, Carleton College ‘11
Why did you join the health corps: As a future physician, I wanted to gain experience in public health while serving my community.
Favorite thing about Philly: The music scene, and the food!

More Than Just an Advocate

Upon becoming a Patient Advocate with the Philadelphia Department of Public Health, I understood that I would be helping uninsured patients apply for and receive medication at lower or no cost.  However, I did not realize that a patient advocate means much more to most patients.

On a Monday morning, I called my patient and explained to her that the Prescription Assistance Program could help her with her asthma medication.  “So, you’re saying I can get my inhaler for free?” I assured her she could.  “Wait, the expensive medication that helps me breathe better – I can get that for free?!” Once again, I assured her that I could help.   The sound of relief in her voice made me smile.

A couple days later, this same patient walked into my office.  As we were filling out the application together, she revealed how she has not had medical insurance for years and how her asthma has gotten worse.  She was frequenting the ER more and more as her inhalers were difficult to afford.  A couple weeks later, I enthusiastically notified her that her medication has arrived. As she came to pick up her inhalers that same day, I realized the true meaning of an advocate.

A patient advocate is someone that a patient can trust and rely upon.  An advocate can be the difference between going to the ER and staying healthy.  Seeing my patient smile, receiving her hugs, and hearing about her improved quality of life is the best reward for being a patient advocate.

Name: Reena Palanivel

Position: Patient Advocate at Health Center 3

Degree: Biology

Why did you join the Health Corps: I joined PHC because I wanted to gain experience in healthcare as well as serve an urban population.

Favorite thing about Philly: Philadelphia Eagles and the Ben Franklin Bridge

Hard at work!

A Difference You Can Measure

Over the past few months of serving in the Philadelphia Department of Public Health, I have interviewed hundreds of patients for Medical Insurance eligibility. Of these patients, the ones that stand out the most are the ones who know this benefit is available, but for some reason have had applications continually denied. In all cases, specific information is needed by the County Assistance Office to determine eligibility for Health Insurance. In most cases there has been a miscommunication in what information was needed, which results in a denied application. My position requires me to know the proper information needed and collect that from the patient. It is quite obvious from the start that some patients have been through this process before.

The process of applying for insurance takes approximately 6 weeks, and to have that wait end up with a denial is both frustrating and demoralizing for the parents of these children. This is particularly true for single parents with multiple children, which brings one specific case to mind. The single parent of three children who was also going to school while working two part time jobs came to me for assistance. She had already sent two separate applications to the County Assistance Office, but those applications were denied. After an interview I had her return the proper documentation, and submitted them on her behalf. After 6 weeks we received a letter that stated that the children were now enrolled in free medical insurance. The look of relief on that mother’s face was priceless. With so much on her plate I know that she now has one less thing to worry about.

Name: Joe Mortimer
Position: Insurance Specialist, Health Center 10
Degree: Exercise Science, University of Pittsburgh ‘12
Why did you join the Health Corps: My career goal is to be a Physical Therapist; but I wanted experience in a different health related field. Learning about and working with health insurance is certainly something that will help me in the future no matter what career path I choose.
Favorite thing about Philly: Being born and raised in this sports-loving, hardworking, blue collar city. I also love cheesesteaks and scrapple.

A Visit from Our Funder CNCS

This past Wednesday, December 12^th the Philadelphia  Health Corps (PHC) played host to visitors from the Corporation for National & Community Service (CNCS).  CNCS Chief Operating Officer Robert Velasco, Chief Financial Officer David Rebich, Deputy Chief Financial Officer Rocco Gaudio, and Bernard Brown, State Program Director for CNCS’ PA office toured District Health Center #2 in South Philadelphia.  This was a great opportunity for the PHC to highlight its successful partnership with the 8 Ambulatory Health Centers run by the Philadelphia Department of Public Health – a major safe net health care provider for uninsured and underinsured Philadelphians.  PHC members Jean Lee, Chase Kwon and Maraia Bonsignore spoke about their desire to give back to communities through service and their efforts to help enroll uninsured Philadelphians in health insurance and free medication programs.  Dr. Tom Storey, Director of Ambulatory Health Services remarked that the 18 PHC members serving at health centers have not only helped save the city millions of dollars each year on medications for the uninsured, but they have actually expanded patient access to medications that are critical to treating chronic disease.  The PHC also highlighted the service of members at other host sites, including members who are providing nutrition and fitness education to youth, coordinating health care for newly arriving refugees and offering case management services to families in Philadelphia.

NSC Thanksgiving Dinner

To help celebrate the great American tradition of Thanksgiving with Philadelphia refugees, the Philadelphia Health Corps served at the Nationalities Service Center on one cold Saturday afternoon. The event was a buffet style dinner, complete with heaps of turkey, mashed potatoes, stuffing, and warm gravy to top it all off. Much of the food had been carted over from a local Presbyterian church, where two chefs had been cooking in a basement kitchen like their lives depended on it. The process was rough and hectic, involving boiling water, shouting, and many cups of coffee, but the results were delicious. Several Health Corps volunteers helped prepare and clean, while others struggled food down a busy street back to the Service Center, so that turkey and stuffing were always there for the next hungry mouth.

Back at the Service Center, a crowd of refugees had been forming. The air was filled with all the smells of a Thanksgiving feast mingled with the sounds of languages from around the world. Health Corps volunteers stood behind trays of food, armed with serving spoons, as a column of people readied their plates for a taste of American cuisine. The meat and vegetables went quickly, though the candied yams remained mostly untouched, perhaps an acquired taste for a sweeter tooth. While the adults were still busy eating, the children participated in different activities like a cakewalk – a form of musical chairs played as dessert – and flipped through picture books that volunteers handed out. In the end, everyone left with high spirits, food in their stomachs, and a feeling that right now, giving every thanks to more peace and happiness, was a pretty good place to be. We felt that way too.

A Race to Healthcare

As I stand there trying to act out “X-Ray” to one of my clients, I realize that most of my job has to do with understanding. My service site for the year is the Nationalities Service Center (NSC), a non-profit organization that works to resettle refugees coming in from all over the world. Specifically, I serve on the health team, a small piece of the NSC pie that’s in charge of teaching refugees how to navigate the American healthcare system. A feat of which, even as a US college graduate, I still have trouble with. But with the refugees it’s no easy tutorial or gentle walkthrough. It’s a race.

From the time they touch down in the US, the clock has begun to tick. In the first month they are vaccinated, tested, and retested for diseases I’ve only heard about in Biology lectures. They go from specialist to specialist in hopes of being properly diagnosed and treated for the many chronic, infectious, and mental health conditions that they’ve probably contracted after spending up to 20 years in refugee camps. By month four we can all but hope they are healthy enough to work and find a job, because by that time NSC can no longer afford to pay the rent on their apartments. All this leads up to the inevitable eight-month finish line, where they are no longer eligible for Refugee Health Insurance and must purchase their own. Oh, and if that’s not enough of a challenge, from day one most of the refugees cannot read, write, or speak any English.

So clearly, understanding is extremely important in my position. I find myself waiting for the universal “Ah-Ha” moment on their faces after pantomiming telephone numbers. I constantly have to remind myself not to fall for that horrible logic that simply repeating the same word louder will definitely make it more understandable. Then they look at you and say what I’m almost sure is “I have no idea what this tall skinny kid is saying but he sure looks funny.”  Whoever said that communication was mostly nonverbal has never tried to explain deductibles without using words. But then it comes – the point of understanding. I’ve been sitting there for 5 minutes trying to explain, “come back next Tuesday” and dreading having to call back the phone line interpreter, when all of a sudden they nod their head and say “Tuesday!” I try to fight the urge to grab hands and jump in circles chanting Tuesday.

It’s getting easier though, and after the first few days I began finding words that most of my clients know.  Now, I am starting to realize that certain groups excel or have trouble at understanding certain concepts. It’s actually quite ironic in that the more I understand the people and the cultures I am helping, the more it helps me become understood. I imagine this is what National Health Corps is really all about. By performing our service, we are not only becoming more aware of the problems faced by so many people in the US, but we are also building a foundation in which we can actually address and solve these problems more effectively in our futures.

Name: Jarett Beaudoin
Position: Refugee Health Associate, Nationalities Service Center
Degree: Global Politics and Economics, University of Tennessee
Why did you join the Health Corps: To gain an understanding of the different social and health-related problems in the US.
Favorite thing about Philly: The Museums!

Even monkeys deserve our care!

Enjoying Service in Philadelphia

“The best way to find yourself is to lose yourself in the service of others.” ~Gandhi

This quotation has so much more meaning to me now that I have started my year of service in the Philadelphia Health Corps.  I’ve learned so much about myself already and it’s still just the beginning!

So far it’s been a wonderful experience exploring a new city and learning a new job.  My host site is the Abbottsford Falls Family Practice and Counseling Network.  I work in the Dental office as a Dental Care Coordinator.  I’m serving as the liaison between primary care and dental care while assisting in bridging the gap between the two and teaching patients that oral health care is connected to overall health and wellness.  After all, your mouth is the gateway to the rest of your body!

Everyone at my host site is very friendly and extremely grateful that I’m here to help serve them and their patients.  It’s nice to feel so appreciated and welcomed by the staff.  I’ve met so many people that are willing to support me in my learning process and want to share with me things they have learned from years of working in the healthcare field.  I couldn’t be more grateful for this.

We hold classes and support groups here at the health center and seeing patients come together and support each other has been my favorite part about working here so far.  I’ve spoken about the importance of dental care at the Parenting classes held here at the health center to both new mothers and prenatal patients.  I’ve also spoken about the connections between diabetes and periodontitis (advanced gum disease) at the weekly Diabetes support group meetings.  I find this work very rewarding and fulfilling because I can directly see how this information is helping our patients.  By engaging with them and answering their questions I feel like I am truly helping them.  A patient who had not seen a dentist in a number of years booked an appointment after listening to me teach about the importance of dental care.  Now that is helping someone in a direct way and it made me feel great!  I hope to explore more Health Education opportunities throughout the year and continue to serve in this way.

Aside from my individual work at my host site, I’m really enjoying getting to know the other members of the Corps.  They all inspire me to keep growing, giving back, and serving.  Having that support system in place has been wonderful.  It’s nice to have other members to share your experiences with, be it challenges or rewards.

I’m a member of the Service Committee and my fellow members and I have been working hard to find outside opportunities to serve the wonderful city of Philadelphia!  We are scheduled to serve at the Habitat for Humanity ReStore project in December and I’m really looking forward to it.  I also volunteered at the Career Wardrobe Boutique, a recycled clothing store, and had a fantastic experience with the staff there.  They do some amazing work to empower women in the workforce and I found it very inspiring.

Overall my experience as a member of the 2012-13 Philadelphia Health Corps has been a wonderful learning experience and unique growing opportunity.  I’m excited for what the rest of the year will bring!

Name: Melanie Wall
Position: Dental Care Coordinator
Degree: Bachelor of Science in Business Administration, Northeastern University, Boston, MA
Why did you join the Health Corps: To help and serve people who need it.
Favorite thing about Philly: The view of the Ben Franklin Bridge at night.

Melanie(left) and fellow service cohort Erin in a joyous embrace on the Delaware River Waterfront after a gratifyingly successful day saving the world as AmeriCorps members.