Scholar Reflections: Uloma and Matt

     

Community Partner: East Harlem Emergency Preparedness Coalition (EHEPC)

We had a really vague idea of what to expect when we agreed to work on the issue of Emergency Preparedness in East Harlem. What emergency measures were in place already? What was lacking? Who was responsible for it? And most importantly what was our role in all this?

It was very astute of our mentor to point out that our first role was to “read, observe and listen” Having had theoretical discussions of the importance of engaging the communities we advocate for, it was easy to see how this crucial starting point could be easily forgotten by well-meaning activists, especially as we had already started making our own theories, and, even more so, after we discovered the daunting amount of resources we needed to familiarize ourselves with.

We soon learned that there were more acronyms for organizations involved in East Harlem’s emergency readiness than we were ever going to be able to keep straight. We learned that Sandy’s disaster in 2012 had unearthed a lot of the lapses in the adequacy of the current measures. But we also learned that there was a coalition of CBOs (Community Based Organizations) that had recognized these gaps long before Sandy came along. Some of their members had even carried out research studies that showed that East Harlem, on a scale 1-9, was at level 2 for emergency preparedness. Moreover, they found that there was untapped potential for East Harlem CBO’s to better coordinate their resources to facilitate the Emergency Preparedness needs of the community as a whole, particularly as the Government was not going to do it all.

Our findings gave us more direction. It led us straight into the first board meeting of this fledgling coalition. Neither of us had observed the formation of a community board before but it was and continues to be an enlightening experience. Things were a little crazy during the first meeting. It entailed passionate personal recounts of the failed impromptu emergency plans during superstorm Sandy, discussions about government agencies that had failed in their role to protect the people from the disaster, talks about people and agencies whose interests had seemingly peaked after the storm, and also the foreseeable barriers to remedying the current problem.

After that meeting we got a better sense of the scope of East Harlem’s emergency preparedness problems and it became clear that there was no way we could tackle it all; certainly not all at once. Fortunately we have a great mentor who we suspect knew we were going to feel this way from the beginning and perhaps had even planned for it to happen. It was important for us to see the struggles that go into organically solving real life community problems. The process is very messy and requires a lot of attentiveness, patience and innovation. With her help, we’ve narrowed the scope of our immediate focus while keeping in mind the overarching goal.

The plan is to outline the systemic misalignments between the city organizations (Office of Emergency Management, OEM) and the community based organizations (CBOs) in East Harlem. The OEM is one of the most important components for creating and disseminating emergency preparedness planning information in the city. They have the expertise and resources to not only create generalized emergency plans, but to teach individuals and organizations how to create plans themselves.

Our first step is to understand the existing relationship between OEM and the CBOs and to see where it falls short. To do this we have reached out to the various city funding agencies and are researching the contractual requirements these agencies have with the CBOs they fund regarding emergency preparedness. For example the Department of Youth and Community Development (DYCD) requires that the CBOs they fund have an emergency plan and have regular drills. The DYCD also says that during audits of CBOs, they check that the emergency plan is in place and that the drills are actually run. The next step in this process is talking with the CBOs to figure out what they understand the requirements of their funding agencies to be and also to get their perspective on the adequacy of the provisions towards meeting their emergency preparedness needs.

The possibilities of how far-reaching the community’s grassroots efforts could be is very exciting and challenging at the same time. We think it could really make a difference in East Harlem and possibly even serve as model for others. We feel privileged to be able to contribute to this work and we look forward to the continued learning process.

HRSJ in the press again!

The Mount Sinai Human Rights and Social Justice (HRSJ) Scholars program was featured on the Mount Sinai Global Health newsletter.

Read HRSJ co-founder and Medical Student Marie Hennelly’s summary of HRSJ’s achievements to date!

Copy this link into your browser to read the article: http://campaign.r20.constantcontact.com/render?llr=httnvbkab&v=001JO9rJ3gjxX7WuPPA_oqGG0L4C8-aqtx45eYw0cN-4uzCdbIwyOamGNiQsDoLSpcPSGyFAb6nJV83kk5ut4baSxpFXuJqv0FAtDVPXnC8tnv4Q-AUoyAobtx0sK1eU66Z

Scholar Reflections: Elie Adler and Joshua Uhr

 

Finding our Grassroots

“We’ll shake your hand this time, but just so you know it’s going to be hugs next time.” Janet and Gloria, our contacts at SMART University, got straight to the point. Our first meeting with SMART, Sisterhood Mobilized For AIDS/HIV Research and Treatment, exemplified the core values of the organization.

SMART is the definition of a bottom-up, grassroots, and community-based organization. Founded by a woman of color with HIV as a space to educate and empower women living with HIV in East Harlem, SMART directly touches the lives of people in the community that it serves. Its official mission is to provide comprehensive HIV treatment education and a supportive peer community to ensure that women and youth living with or affected by HIV/AIDS are able to live longer, healthier, and empowered lives. On a personal level, Janet and Gloria described how impactful SMART can be on the lives of women who participate in their programming. These women—most of whom have experienced sexual abuse, domestic violence, racism, sexism, and other forms of oppression throughout their lives—emerge not only with the knowledge that will help them care for their health but also with an improved sense of hope, self-worth, and community with other women.

But these transformative results are hard to measure. That is where we come in. Given the reality of the funding/grant-making world, SMART needs concrete program evaluation to make a case for more funding. How can we capture the changed attitudes, increased empowerment, and sense of community that SMART cultivates? This will be our project this year.

Most of the research we are exposed to as medical students is highly controlled and driven by a research team that is often removed from the community context. We hope to challenge this model. By using the tools of Community-Based Participatory Research (CBPR), we hope to partner with SMART in this research project, ultimately giving SMART the tools to conduct internal program evaluation. We hope that this approach to research will mirror the community-based and context-specific values that SMART embodies. It will be a challenge, but we are honored and thrilled to be working with a grassroots organization that empowers local women and builds community.

“We’ll shake your hand this time, but just so you know it’s going to be hugs next time.” Janet and Gloria, our contacts at SMART University, got straight to the point. Our first meeting with SMART, Sisterhood Mobilized For AIDS/HIV Research and Treatment, exemplified the core values of the organization.

   SMART is the definition of a bottom-up, grassroots, and community-based organization. Founded by a woman of color with HIV as a space to educate and empower women living with HIV in East Harlem, SMART directly touches the lives of people in the community that it serves. Its official mission is to provide comprehensive HIV treatment education and a supportive peer community to ensure that women and youth living with or affected by HIV/AIDS are able to live longer, healthier, and empowered lives. On a personal level, Janet and Gloria described how impactful SMART can be on the lives of women who participate in their programming. These women—most of whom have experienced sexual abuse, domestic violence, racism, sexism, and other forms of oppression throughout their lives—emerge not only with the knowledge that will help them care for their health but also with an improved sense of hope, self-worth, and community with other women.

   But these transformative results are hard to measure. That is where we come in. Given the reality of the funding/grant-making world, SMART needs concrete program evaluation to make a case for more funding. How can we capture the changed attitudes, increased empowerment, and sense of community that SMART cultivates? This will be our project this year.

   Most of the research we are exposed to as medical students is highly controlled and driven by a research team that is often removed from the community context. We hope to challenge this model. By using the tools of Community-Based Participatory Research (CBPR), we hope to partner with SMART in this research project, ultimately giving SMART the tools to conduct internal program evaluation. We hope that this approach to research will mirror the community-based and context-specific values that SMART embodies. It will be a challenge, but we are honored and thrilled to be working with a grassroots organization that empowers local women and builds community.

 

Scholar Reflections: Vir Patel and Laura Krinsky

 

Our ultimate goal for the project is to update Policy Work Group reports to examine community reintegration of formerly incarcerated individuals returning to East and Central Harlem, with particular attention to housing, discharge planning, employment, and women incarcerated because of crimes related to domestic abuse. The report contained a series of policy briefs on discharge planning, employment and reentry, families and reentry, and access to health care and reentry. In pursuit of this goal, our first step has been to read and understand the existing literature and policies related to the project.

   One of the biggest challenges that we have immediately felt in dealing with this has been the rather overwhelming nature of raw data, legalistic jargon, and shifting legislation. While numbers and research are out there, determining what is both useful and accurate in advocating for our population is quite difficult. However, it also represents an incredible opportunity to look at what the facts are, connect the dots between resources, and form a compelling argument that can sway opinions.

   Despite the many challenges that come with attempting to unravel the seemingly endless red tape of New York City Public Housing and prisoner re-entry, we are excited to tackle the project. Particularly during our first semester filled with Kreb’s cycles and table conferences, we often worry that the formal curriculum may not completely prepare us to be the physicians we want to be. However complex the process may be, we think that physicians must not only know the policies that we are trying to understand, but also how to effectively navigate them in order to advocate for patients. We are excited to develop an essential skill set, of navigating and understanding housing policy and criminal justice complexes, as well as neighborhood mapping, through this project.

   We also have very much enjoyed being welcomed by the Policy Work Group of Harlem Community Academic Partnership, a group of devoted advocates whom we have much to learn from. We have found it incredibly inspiring to hear from the members who take time from their own lives and careers to make up the PWG. #HRSJ

Scholar Reflections: Kamini Doobay and Emmett Kistler

 

As interns for the East Harlem Community Health Committee (EHCHC), we’re investigating how youth in East Harlem access mental health services.  Last year, our predecessor mapped out how youth in Harlem receive care as well as the various barriers that impede the process: a shortage of providers, complications navigating the insurance system, the persistent stigma attached to mental health, and an overall lack of awareness of mental health issues.  For our project, we decided to focus on mental health services provided in or associated with East Harlem’s schools.  In East Harlem, public schools serve not only act as important entry sites into the pediatric mental health care system, but some schools offer social work, early childhood counseling, support groups in addition to primary physical care in-house.  Furthermore, schools naturally serve as a natural point of interface for a child’s guardians, teachers, counselors, healthcare providers and other important life figures.  Although schools in East Harlem can be divided up based on the presence of school-based clinics and affiliated healthcare or education institutions, the range of services and who is providing them varies drastically from school to school.  We know that students can access mental health services through the schools, but the “how” of that issue is not clearly defined from school to school.  Over the next few weeks, we plan on diagraming and comparing the specific pathways by which students become patients once a mental health need is identified.

    We do not anticipate this task (or the pending diagram of schools) to be a simple one.  As one of our mentors frequently says about school-based health care, “There is no cookie cutter model.”  Schools across the street from one another may have radically different medical staff, abilities to provide mental health services, funding sources, and associated referral sites.  One challenge we anticipate is capturing sufficient detail of services offered by East Harlem’s many schools without getting bogged down in the many details of each program.  One way to tackle this challenge may be to categorize schools based on their funding source or associated referral site (Mount Sinai, Boriken Neighborhood Health Center, etc.)  Additionally, we hope that several interviews with key coordinators of pediatric mental health in East Harlem will help us refine our efforts and decide on how to organize the information we gather.

Scholar Reflections: Ruyan Rahnama

      During my senior year at UC Berkeley I took a course titled “Peace & Conflict Studies 126: International Human Rights.” As a Molecular & Cell Biology major, this class was a happy relief from memorizing cell signaling pathways and troubleshooting experiments. I learned about human rights declarations, international accountability, genocide, torture, refugee policies, and so much more. It planted the seed for a future of involvement in human rights work.

     I approached my professor from this course for a letter of recommendation when it came time to fill out medical school applications. I recently revisited the email exchange we had about the letter and found this excerpt:

     “I learned so much from your class (from Comfort Women to Genocide to the Haka!) and have tried to stay connected to human rights news since. I was particularly influenced by the lectures where the WHO and global health organizations such as Doctors Without Borders and the ICRC were discussed … I think a strong application is one that tells a coherent story and I hope that by incorporating all of my past and upcoming experiences I can do that.”

     The coherent story I wanted to tell was one of global consciousness. The intersection between human rights and healthcare was abundantly clear to me. I wanted to integrate what I had learned in his class into my future career.

      It makes me so incredibly happy that Mount Sinai has offered me a way to do just that. I could not have asked for a more perfect opportunity than the Human Rights and Social Justice (HRSJ) program. It is personally very satisfying to know that the interests I expressed when I was first thinking of applying to medical school are the same ones I am now pursuing.

      My experience in the HRSJ program has been uniquely positive. The speakers that were invited to our elective course were exceptional. I feel lucky to have gained insight into their stories. They offered valuable pearls of wisdom, continuously warned us to avoid the trap of “this is how it has always been done,” and encouraged us to push boundaries to create a more liberal and relevant medical education for ourselves. I left each class feeling inspired and awakened to the realities of medical practice beyond what we were being exposed to in our traditional curriculum. It was hard to return to the necessity of Molecules & Cells after these classes. I wanted to read and research and do instead.

      This is why I am so excited about my project with Kevin. We are researching the challenges of providing interpretation services to torture survivors and asylum seekers at human rights clinics. We will be interviewing existing clinics and reviewing the literature to identify trends. We hope that this work will lead us to possible solutions that can be applied to the Mount Sinai Human Rights Clinic and all others facing similar challenges.

     I became passionate about this project very quickly. It may be because I had an existing context to work off of. My family moved to the United States from a country with a great deal of political turmoil. I have friends who were able to grow up here because their families obtained refugee status. The physician can play a key role in determining the outcome of an individual’s legal status, asylum process, and ultimately life. Our project is a special opportunity with so much potential to have an impact. I look forward to translating our eagerness into action in the coming semester so that we can take it there.

 

Scholar Reflections: Kevin Hu

     Medicine has a social mission. That’s the basic underlying proposition that set me on the path to becoming a Human Rights and Social Justice scholar.  In my application I said I wanted to, “deepen my commitment to becoming an agent of change.”  This, of course implies that there are things that warrant change in our society.  As an incoming scholar I grouped those things under the terms: human rights violations and social injustice. 

     I came in knowing that the largest international organization on this Earth with involvement of at least 50 member states in the year of 1948 had declared what I believe still constitutes the most globally representative consensus on social norms in existence known as The Universal Declaration of Human Rights.  But based on the way I was taught and raised by my local community of teachers, and adults in my life, I did not need The Universal Declaration of Human Rights to know that torture, denial of access to basic health care services, and continued disenfranchisement of groups of people based on their race, language spoken, gender identity, sexual orientation, or ability to pay is some serious bull—-.

     But how do we identify specific issues, set practical goals, arrive at a working definition of what is just and unjust, and then proceed to implement the necessary change to arrive at a better place?  That’s where HRSJ came in.  I knew about the HRSJ scholars program early on in the medical school application process because on of my fellow explorers in the areas of social justice and environmental health from college had a sister at Mount Sinai.  By searching her name I found out about the HRSJ scholars and from that point on I felt that there might be some value in becoming a part of this community.

      And what a community it has been. The best part about my first semester of medical school has been discovering, meeting, and engaging with different communities.  From PhD students from China, grad students looking to apply to medical school, service staff who just want a good game of ping pong, and finally my fellow medical students, being with all these incredibly amazing individuals has inspired my down work and pushed me to be a better person.  This could not be truer for the group of students dedicated to the cause of human rights and social justice who walked together with me through a semester reflecting, discussing, and debating how we could, as medical students and future physicians, address problems of injustice within our society.

      My partner Ruyan and I work with Dr. Holly Atkinson to investigate what the best models for delivering healthcare interpreting services are for asylum-seeking patients in the human rights clinic model. The project is off to a good start in terms of prioritizing it and implanting it into my life. What that means is that I did a good job staying on top of communicating with partner and advisors. That aspect has been really great.

      I can only hope for this semester – that instead of just being enthusiastic, I will be very productive as well. This means taking the time to sit down, ask tough questions, and trying to find answers. This means more data, more organization, more thoughts and analysis.

      In the end I hope that I can work well with my advisors and partners to help us all remember that how we treat the most vulnerable of our society is indeed a measure of our strength and sophistication as individuals and as a society.