Perhaps the most inspirational examples of service to the underserved are the passionate and motivated students who came to the UC Berkeley School of Public Health seeking training in order to be more effective at helping people. Many of them have already seen the limitations of narrowly focused treatment without regard to the larger context, and are seeking broader methods. They want to be the best they can be at changing the world, and are already making an impact as they learn.
In a way, Matthew Goldman’s commitment to providing medical care to the homeless population in Berkeley is not unusual. Every student in his 16-person UC Berkeley-UCSF Joint Medical Program (JMP) class also volunteers at the Suitcase Clinic, a student-founded and run organization offering free health and social services to underserved populations. And more than 100 Berkeley undergraduate volunteers, many of them public health majors, constitute the backbone of Suitcase. In addition, physicians from the community, residents at Highland Hospital, and JMP faculty members donate their time to treat patients.
Though the mere fact of his service is not unique in a community so dedicated to serving the underserved, Goldman stands out when you consider that he is simultaneously pursuing a master’s degree in public health, attending med school, and conducting thesis research on models of health delivery reform. Amidst this intense training, he and his colleagues still find time to give back to the community.
“Generally speaking, the JMP tends to recruit very social-justice-oriented students,” Goldman says, “and Suitcase aligns very naturally with those values. We have a lot of excitement and enthusiasm in engaging these medical needs.”
Goldman began his work at Suitcase doing patient intake, which includes getting the patient’s clinical history and assessing needs. “Doing intake was great,” he says. “And it was some of the most valuable clinical experience I’ve had. At Suitcase, we’re the first people that the patient’s going to talk to, and that’s really fun and exciting. You hear some pretty amazing stories, and it’s really rewarding to get to engage with these people.” In his second semester, Goldman will be coordinating the Youth Clinic, which he chose partly because he feels the youth homeless population—generally older teens or adults in their early twenties—have the greatest need for accessible, non intimidating services. “That community will hardly seek services from anywhere,” he explains. “At the Youth Clinic you can just drop in, no appointment necessary. It’s a safe environment, it’s relaxed, there’s food and a free foot washing service. Youth Clinic is unique in its openness and I think it has a good reputation in the young homeless community.”
Considering that youth treated at the Suitcase Clinic for minor infections or other concerns might otherwise end up at Highland Emergency Room, the Suitcase Clinic provides a cost benefit to society in addition to much needed service. Yet Suitcase, like many nonprofit organizations, struggles with funding and long-term stability. As coordinator of the clinic’s mission—another volunteer role—Goldman hopes to put his interest in health policy to work creating a more stable future for Suitcase. He’d like to see the clinic flourish for another 20 years and beyond, providing services for the homeless and training for JMP students long after he’s become a successful practicing doctor with a commitment to social justice and a love of health policy.
Another student who embraces health policy is Fisayo Oke, who is getting her MPH in health policy and management in May and can’t wait to dive right into hospital administration. “I hope to run a hospital in the future,” she declares enthusiastically.
Thanks to the Max Factor Family Internship, an annual scholarship that supports summer work for a student serving underserved populations in Los Angeles County, Oke found a hospital that’s a great fit for her. She worked in White Memorial Medical Center, a nonprofit teaching hospital in downtown Los Angeles, and was impressed with the environment she found there.
“White Memorial serves the inner city east L.A. community,” she says. “The population they serve is predominantly Latino and low income. What really amazed me about the hospital is, unlike a stereotypical inner city hospital, they are really focused on delivering the best quality care and using the most innovative processes. They’re not looking at their patients and thinking, ‘Oh, we can’t make much money from you, so we’re just going to give you minimal care.’”
Oke was inspired by the mission of White Memorial and the commitment of “every single person, from the physicians to administrators.” She has been invited by her internship supervisor to work at a sister hospital after graduation. “I was fortunate to be able to work there with the Max Factor funds, she says. “Now I’ve taken it from money to an internship to a potential career opportunity. I’m excited about the way it has all come together.”
Oke grew up in Nigeria and speaks frankly about family members dying unnecessarily due to lack of medical care. “In Nigeria there is a very huge class divide,” she says. “There’s a big difference between the ‘haves’ and the ‘have nots’.” When she moved to the United States, Oke expected things to be different, and better. But she realized that, in many ways, they’re not.
“There are populations here who face the same challenges that people that I knew back at home faced,” she says. “It’s the same. I want to do something about it. At least do my part to close that gap.”
Although she has long had an idea of what needs to change and what she wants to do about it, her time at Berkeley has helped Oke to better articulate her mission and have a greater understanding of the issues. She feels her class on on eliminating health disparities taught by lecturer Iman Nazeeri-Simmons has been especially valuable in giving her the historical and social context behind health disparities. “I thought my eyes were open prior to this class,” she says, “but I’ve realized that there are many underlying factors to the outcomes we see today. Now I’m even more motivated to make a difference in the lives of underserved people.”
Oke is very grateful for her time spent at Berkeley, although she almost didn’t apply, partly for fear of not being able to get in. She now works as a student ambassador with the School’s Graduate Recruitment and Diversity Services in order to encourage minority and disadvantaged students to apply to and attend Berkeley. “To me one of the ways to really help a community is to endow them with an education,” she says. “I talk to many students who come from underserved communities and let them know that, ‘Yes, you can get an education. Yes, you can do it.’”
For Geraldine Slean, a second-year JMP student, it was personal experience that brought disparities in care into high relief. Her parents come from an underserved background: Her mother emigrated from Peru to the United States with type I diabetes.
“Due to complications she actually lost her vision completely. She has been completely blind ever since I was a baby,” Slean recalls. “So she’s encountered a lot of difficulty in her medical care, which she has to receive regularly. There have been language barriers, cultural barriers, a lot of misunderstanding and miscommunication. And also insurance and economic issues; it’s been very hard for her.”
Accompanying her mother on her frequent doctor visits gave Slean an intimate look at doctor-patient interactions and how they can go wrong. “Both my mom and the doctor were not communicating directly, sort of coming at each other from different places and not quite intersecting,” she says. “I realized it’s very important to have doctors who are more empathetic with better language skills and cultural understanding, and a willingness to meet the patients where they are.”
Slean is committed to improving medical care for the underserved, especially Latino populations and those who have chronic diseases that need careful management. She was attracted to the JMP program due to its wide, interdisciplinary approach to medicine and health. She wants to see a more contextual approach to doctor-patient interaction, and hopes to bring in her undergraduate education in anthropology and Latin American studies. In her practice, she plans to view health through many different lenses: environmental, patient-centered, anthropological, and, of course, a public health perspective.
She is a member of the Program in Medical Education for the Urban Underserved (PRIME-US), which provides support to medical students with demonstrated interest in working with urban underserved communities, particularly in the Bay Area. “The benefit of the program is that through our preceptorships, clinical experience, and site visits, we’ve been exposed to great leaders in the field who have experience dealing with these populations and issues that really affect these groups of people,” she says. She also feels the program helps show students all the different facets to working with underserved populations and takes a broader look at what factors are contributing to health disparities. And she finds her fellow PRIME-US students and their stories very inspirational.
Slean’s thesis focuses on “diabetes distress,” a relatively new concept. “When people are diagnosed with diabetes, it’s such a complex disease with so many complications and comorbidities that people get really overwhelmed with all the self management that’s required,” she says. She believes that good physician-patient interaction is key to helping patients with diabetes management, especially for minority patients. After she graduates, Slean would like to continue to work with minority diabetics and try to promote behaviors that help patients achieve good self management.