Looking for opportunities to give yourself to?

We often blog about medicine being a calling…one, to which practitioners are motivated by God’s tug on their life to pursue.  P.K.Lee - MSF in Sierra LeoneUnfortunately, “a not-so-funny thing happens on the way to the forum.”  Their motivation to practice medicine shifts.  As one of my colleagues often states, “many go into medicine to do good, yet come out of medicine to do well.”  Here is an opportunity to do good…and, possibly get back to that original “calling.”

Doctors Without Borders/Médecins Sans Frontières (MSF) helps people worldwide where the need is greatest, delivering emergency medical aid to people affected by conflict, epidemics, disasters or exclusion from health care. On November 6, 2014, medical and non-medical professionals are invited to a late afternoon presentation from 5-6:30 in Vanderbilt University Medical School’s, Light Hall, Room 208,  to learn more about how they can join Doctors Without Borders’ pool of dedicated aid workers. For readers outside the Nashville, Tennessee area or otherwise unable to make the meeting, more information about opportunities can be found at this link:  http://www.doctorswithoutborders.org/work-with-us

 

No magic solution…

The Siloam Institute offers clinical rotations to nearly 40 health professional trainees annually. Their rotation at Siloam helps them to deepen their understanding of how to engage persons living in poverty, work cross-culturally, and learn how to integrate behavioral health and spiritual care into their practice of medicine.

Click the video below to watch Samaiya Mushtaq reflect on a particular patient encounter stating, “I did not offer them a magic solution to their health problems, but I think they felt a little more healed after that visit.” Samaiya is a fourth-year Vanderbilt medical student who plans to pursue a residency in psychiatry.

Taking a lesson from impoverished nations

Photo Credit: Lwala Community Alliance

Photo Credit: Lwala Community Alliance

Siloam’s Community Health Immersion students worked to train refugee lay health workers for a more effective outreach to the refugee families in Nashville.  This work drew much of its inspiration from successful community health worker programs found in impoverished nations.

In a guest blog at Huffington Post, comments made by James Nardella (Lwala Community Alliance) resonate with our experience here in Nashville.

James writes:  “Scale and efficiency are important to moving health care goods and services….  But, when it comes to addressing the root causes for poor health in many places, scale can be a distraction. Delivering goods and services alone will not motivate people toward health seeking behavior.”  James goes on to point out that, “…health-seeking decisions are made at the family level.”

Read the full post of James’ excellent blog Heirloom Healthcare for the Poor by clicking here.

Lay health workers trained by Siloam students

“I‘m too much glad to see you because you are Nepali.” Greetings like this one from a Nepali man bring joy to 19-year old Anita Nepal who loves helping people in the Nepalese community of Nashville.  Anita, born in a refugee camp in Nepal to Bhutanese parents, was recently trained as a lay health worker by pre-medical students participating in Siloam’s Community Health Immersion program. Nashville’s Nepali community – mostly made up of refugees from Nepal and Bhutan – appreciate the cross-cultural understanding that Anita brings as she teaches within her community on the health topics she recently learned.

“Many of the Nepali people do not understand the health care system in America,” says Anita who works full-time in housekeeping at a local hospital. They struggle to know how to make appointments to see a doctor or how to get medicine from a pharmacy because as Anita says, “… in Nepal there were no appointments or prescriptions…you just show up and ask for what you need.”

“I learned many things – I can help many…”

For Siloam’s six-week Community Health Immersion program, pre-medical students were recruited from around the country to live in a refugee apartment complex in southeast Nashville where they trained nine lay health workers like Anita from the neighborhood. Training topics included preventative care like oral health, nutrition, and exercise, along with health navigation topics like how insurance works and the difference between an emergency room and a primary care clinic. Beyond learning how to teach lay health workers, the pre-medical students also explored how to see the vocation of medicine as a calling and to see how to care for patients as whole persons as Jesus did.

The pre-medical students’ work with the lay health workers is making a lasting impact.  The oral health topic alone made an immediate impact on Anita’s family of five who were resettled a year ago in Nashville after spending 21 years in a refugee camp in Nepal. “We did not know about dental floss or how many times each day to brush our teeth or for how long,” Anita says. “Now we do. I learned many things – I can help many Nepali and Bhutanese people.”

Lay Health Workers and CHI Students pose outside their apartment - 2014 - cropped

Pre-medical students and lay health workers pose outside following a training session. Lay health workers include (L-R) Samson Sarki from Bhutan (in turquoise), Paulos Ezekiel from Eritrea (in purple), and Anita Nepal from Nepal (in blue and red). Pre-medical students (L-R back row) include Will Davies, Stewart Goodwin, Kenny Namkoong, Frances Cobb, Caleb Huber, Will Tucker, along with Reinie Thomas (kneeling), and Lauren Roddy (in blue on right). Pre-medical student Chelsea Travis is behind the lens!

Off with a bang!

It has been quiet this week since our nine CHI participants (7 pre-meds and 2 directors) left town after spending an exciting six-weeks with us on a Community Health Immersion.  As we celebrate our nation’s independence this weekend, let’s also celebrate the ministry of presence that our freedoms allow us to carry out.  Check out this video that the students put together as a celebration of how God is moving in their lives as they prepare to be future physicians:

Rich in Poverty

Guest blogger Will Davies, one of seven students in this summer’s Community Health Immersion, writes…

I thought it was another normal day at Siloam.  The health care providers were supplely moving about the clinic, tending to each of their patients (including any unscheduled walk in patients).  Interpreters were turning the confusing syllables of patieLoneliness - blackednts who spoke no English into relatable language for the health care providers.  And as if the administrative staff had personally learned from God, himself, when he formed the world, they too brought all sorts of chaos into order.

It’s here that our team has seen how Siloam isn’t just restoring the health of those who live in financial poverty, but they are bringing down the Kingdom of God to their patients, helping restore different types of poverty as well.  For we live in a world stricken with poverty.  Relationships with loved ones, our self-image and worth, the creation around us, and our relationship with God can all exist in poverty.

And our CHI team has been lucky enough to join with Siloam and fight against these different types of poverty.

 “…a refugee…sat hunched over from pain…”

Two weeks ago I found myself in a clinic room with two people: a refugee, and one of Siloam’s health providers whom I was shadowing.  What could have been a simple check up was made trying, for our patient, a refugee who had no insurance, has no family in the States, and to make matters worse. . . spoke no English, sat hunched over from pain caused by constipation.

Yes, medicine could help this patient, and I’m sure it did.  But he needed more.  In fact, the physician’s prescribed treatment was instructed to his case worker:  “Find some people to stop by his apartment, spend some time with him, and help cook him a healthy meal!”

You see, it wasn’t a problem of financial poverty.  This patient suffered from poverty of all sorts of other relationships!  Having been in the states less than two weeks with no family, no friends, and no one to be with, there was plenty of room for restoration.

My having grown up in a financially blessed family, society, and Church, it is easy to view poverty in one way: the lack of material possessions.  As a church, it can be easy to give materials away to the poor, pray blessings over them, and call it a day.  This method of help is easily measured and has a nice ring to it: “We went to this poor area of town, gave away certain material gifts that can help improve the resident’s lives, built a certain amount of homes for them to live better lives in, and oh ya- we also provided them food because they were hungry.”

“…he called his disciples to a life of greater financial poverty…”

Those are good and needed things. . .but only sometimes because this type of aid only helps with financial poverty.

What about the relational poverty that our neighbors are living in?  As Christians, we are called to love people relationally as well as financially.  It’s not glorious to forsake your own life, fight for other people’s lives spiritually, and equip others to do the same.  But that’s what Christ did.

When Christ called his disciples, he didn’t walk up to them, seeing that they were poor, hand them some extra change, or even build them a better house!  In fact, he called his disciples to a life of greater financial poverty!  What!? Wow.  And asking them to live life with him, he revealed to them who God was.  He fought for their lives spiritually, and because of it, the poor became rich, and followed him.

“…he happens to live in our neighborhood!”

Will Davies is a rising junior at the University of Tennessee. He is among seven pre-medical students committing their summer to a Community Health Immersion in Nashville.

Will Davies is a rising junior at the University of Tennessee. He is among seven pre-medical students committing their summer to a Community Health Immersion in Nashville.

So last week, as our group was rewinding after a day at the clinic, the same patient from the clinic happened to run into us because he happens to live in our neighborhood!  Wow, it’s amazing how the Lord sets things up.  As we invited him into our house, he looked much better than previously, but still spoke no English.  And it’s here where our CHI team was able to start to love him, know him, and bless him.  We are not great at it, but it’s a beginning.  And as we will get to know him more over our next few weeks, I pray that the spirit of God will move through him and us, and our poverty of relationships will be restored.

Embarking on the Hunger Games

Guest blogger Kenny Namkoong, one of seven students in this summer’s Community Health Immersion, writes…

$554.  9 individuals. 2 weeks.

Sounds like a reality show?  Well, these numbers are what we have to work with throughout the 6 week time period.  9 individuals of Siloam’s Community Health Immersion programs (CHI) have to work with $554 on average per 2 weeks.

First week shopping trip, the CHI participants find values at the local Aldi store.

First week shopping trip, the CHI participants find values at the local Aldi store.

In addition to living within the refugee community at the Highlands, the participants have to work with each other in order to survive the food budget set to imitate the food stamps that most of the families in the Highlands receive.  We also received $60 per person for personal spending for the whole 6 weeks.

…$1.47 per meal?

When we first obtained the gift cards containing the budget, I had mixed feelings.  I was excited to get underway with the program and start a new life with 8 others.  However, $1.47 per meal? How are we going to do that?  In addition to the budget, we were expected to include the four essential parts listed in MyPlate: grains, vegetables, fruits, and protein.  The task seemed impossible and daunting.  May the odds be ever in our favor.

The task seemed impossible and daunting.

The CHI crew gathers for "family meals" each evening.

The CHI crew gathers for “family meals” each evening.

On the first day of grocery shopping, the group decided to come up with a battle plan.  We could not just go out there and hope for the best.  One of us suggested that we go to Aldi, a grocery store frequently used by our neighbors.  We accomplished our first shopping with ease, spending about $100 on groceries for the meals for the following week.  However, as the week progressed, we began spending money on things that were unnecessary to our survival. I guess seeing the overwhelming choices presented at Walmart got us excited.  The spending spree stopped short thanks to some of our analytical members; they directed us towards “the light.” Despite cutting down on shopping at places like Walmart, which was surprisingly expensive, we still needed some assistance.

Thankfully, Siloam health community members came to the rescue!  The staff members took turns to help feed us once every week.  They kindly took us into their homes and fed all 9 of us, from pancakes and bacon to burgers and fries.  We got to enjoy the proteins that we direly desired.

…breaking bread in their homes,

they received their food with glad and generous hearts…

It reminded me of Acts 2:45-47, “And they were selling their possessions and belongings and distributing the proceeds to all, as any had need.  And day by day, attending the temple together and breaking bread in their homes, they received their food with glad and generous hearts, praising God and having favor with all the people.  And the Lord added to their number day by day those who were being saved” (ESV).  The last part especially rings true.  I believe the Lord will provide for the ministry of Siloam day by day for taking part in our hardships and those in the community.

…it is serious business…

On a $10-meal-for-a-family scavenger hunt, Davies gets the shaft on his suggestion of catching mice to add protein to their diet.

On a $10-meal-for-a-family scavenger hunt, Davies gets the shaft on his suggestion of catching mice to add protein to their diet.

Whether it is eating at the house of Siloam’s staff or just eating at home amongst us, the dinner times are a pleasure.  The enjoyment of the whole process seems to be present starting from buying groceries, eating together, and worrying about the next meal.  However, it was a great lesson for each one of us.  While this process is temporary for us, for those living in the Highlands, it is serious business.  Immersing in the meal budget helped me to see things from the inside.  For example, how will these refugees worry about buying nutritious food and exercising when thinking about next meals itself is a war.  Living on a food budget helped me internalize the attitude of the refugees and the point of view at which they approach us.  It brings a whole new meaning to holistic patient care.  Therefore, if I were to do this program again with the budget limitations, I would gladly volunteer.

Biopsychosocial… spiritual?

Guest blogger Lauren Roddy, one of seven students in this summer’s Community Health Immersion, writes…

Several of my friends and family have been astounded that a place like Siloam exists, where the individuals who need it most not only receive excellent health care, but also are treated as whole people, like the beloved children of God that they are.Whole Person Care

Why is it so hard for us to think of care in these terms? After all, as Christians, we are called to care for and love the poor, plain and simple. This is certainly not to say that those not of a Judeo-Christian faith tradition can’t or don’t have a heart for the poor, but we have specific Biblical instructions and moreover the framework to do so.

“…we are trained…to compartmentalize our lives.”

I don’t think that the problem is necessarily that not enough health care providers are Christians, but rather that we are trained, in America in general but in medicine in particular, to compartmentalize our lives. Our work, family, and church are kept separate, and we are encouraged to leave all personal ideas, passions, and faiths at the door. How can we expect to help prepare individuals for their unique purpose as children of God’s kingdom if we don’t claim our place there as well?

I am grateful and blessed to be a part of the Community Health Immersion Program at Siloam this summer and to have the opportunity to shadow providers that bring their whole selves into a holistic model of healing. Patients not only have access to a Behavioral Health Consultant and to Pastor Doug, who make sure the patient’s social and spiritual needs are met, but they experience God’s love from the front door to the back.

I have witnessed providers over and over again spending a few extra moments to make certain that patients feel heard and that their unique experiences are validated. In return, the patients have a deeper trust in the medical expertise of the providers, and, sometimes, express a deeper hunger to know the Lord.

Roddy, Lauren - next to Compassion sign

Lauren Roddy is a rising senior at in the pre-medical program at Baylor University.

I challenge each of you to interact with others as whole people loving whole people. I pray that I can emulate what I’ve seen and learned so far in my future medical career, and I hope that everyone at Siloam knows that I want to be y’all when I grow up!

Globe trotting by knocking next door

Guest blogger Frances Cobb, one of seven students in this summer’s Community Health Immersion, writes…

“How many servings of fruits and vegetables do you and your family eat a day?

What are the biggest problems for you and your family?

For your community?

Do you exercise?

Has anyone in your family been sick in the last year?

Do you know where to go for healthcare?

Do you and your family have health insurance? ….”

 

These are some of the questions we asked refugee families in our Community Health Surveys (CHS). This summer as part of Siloam’s Community Health Immersion, nine of us went door-to-door completing the CHS among refugee families in the Highlands and surrounding apartment communities. Door Knocking at the HighlandsThrough the CHS we sought to assess basic wellness and identify community-wide issues encountered by the refugees in understanding the American healthcare system and in transitioning to life here in the United States.

When I first heard we would be going door to door interviewing refugees, I think my blood pressure and anxiety shot up. It sounded like an awesome opportunity to interact with the refugees and assess their health across different nationalities within our new community here at the Highlands, however I was mildly terrified of knocking on the doors of strangers and inviting myself into their homes.

When we first set out, I wasn’t quite sure what to expect, but what I encountered behind each door we knocked on was a generous, resilient family working against language barriers, childcare issues, financial burdens, and general confusion in their transition to a new culture.

In that week and half, it was like we were traveling the globe. I spoke with Bhutanese, Burmese, Rwandan, and Ethiopian families within our community. No one refused to answer our questions and many people went so far as to thank us for taking time to listen to them and trying to understand the difficulties they have encountered in transitioning to life away from their home country.

I was so encouraged as a volunteer and future healthcare provider by the generous and helpful attitude of the refugee families I had the pleasure of meeting. By interacting with them in their homes and taking time to sit with them, we were able to gain a better understanding of the health environment experienced by both newly arrived and established refugee families.

Additionally we had the opportunity to observe the aspects of the American healthcare system that cause confusion among these families and ultimately act as barriers to staying healthy.

CHI participants Will Davies and Stewart Goodwin with shoes courteously removed interview Burmese neighbors about their health status.

CHI participants Will Davies and Stewart Goodwin with shoes courteously removed interview Burmese neighbors about their health status.

 

“This is fun!” … a Selfie on day one

Today marks the first day seven pre-medical students stepped into another world – the world of Siloam.

Caleb captures morning devotionals with several of the CHI students.

Caleb captures morning devotionals with several of the CHI students.

These seven are participating in a six-week community health immersion.  The morning started early with breakfast and devotionals for Chelsea, Davies, Frances, Kenny, Lauren, Reinie, and Tucker.  Co-directors Caleb and Stewart round at the team.  They arrived at Siloam by 8:00 a.m. to be quickly dispersed among various roles helping with “Refugee Mondays.” One student called out, “This is Fun!”

While living in a predominantly refugee apartment complex in south Nashville, they will train refugee lay health workers to work in the community, they will shadow clinicians at Siloam, and explore a Biblical theology of health care.  Pay attention to the “fun” they will have as they come and see* what God has in store for them this summer.

*John 1:39, Holy Bible