Gouverneur Health and UHS Alum Dr. Cartmill

After our morning at the soup kitchen, the scholars met with Dr. Kimberly Cartmill, a 2011 of Dartmouth Medical School and a UHS scholar herself! Dr. Cartmill first took the scholars on a tour of Gouverneur Health, an NYU affiliated clinic in Lower Manhattan. 

 Gouverneur Health is situated in Chinatown and has a strong community presence. Dr. Cartmill told the UHS scholars about how the community holds a gala every year to support the operations of the health clinic, demonstrating how a good relationship with the local community can help a health center to flourish. Gouverneur is dedicated to serving the local community, regardless of ability to pay or immigration status. They provide a wide array of services, including primary health care, pediatrics, behavioral health and rehabilitation services. They also have many providers fluent in Spanish and Mandarin, meeting the needs of their diverse patient population. Dr. Cartmill then joined the scholars for a lunch of Chinese dumplings and talked to us about the challenges and benefits to working in an urban setting, and her experiences during residency. We were grateful for her time, and it was wonderful to see a past UHS scholar living the goals of the program, providing an underserved, diverse community with such quality care. 

 


-Asha Clarke, UHS Scholar Class of 2016

NYC Rescue Mission

On our last day in the Big Apple, we spent the morning working in the soup kitchen of the New York City Rescue Mission. Donning hairnets, aprons, and gloves, we eagerly put our cooking skills to good use to help the soup kitchen prepare for lunch and dinner. 

The New York City Rescue Mission, America's First Rescue Mission, has been providing shelter, food, and resources to the people of New York City since 1872. With three floors and a capacity for 125 men, the Mission is currently expanding to add another three floors to accommodate up to 250 people, including women. It is scheduled to be completed by Mother's Day of this year. Lunch is reserved to current occupants, but dinner is open to the public and serves over 300 people. With so many mouths to feed, it was all hands on deck to prepare for the lunch and dinner services!  

The mastermind behind the menu is Candice. Her infectious smile and sweet demeanor reflected how much she enjoyed cooking at the Mission. The other established volunteers shared her passion to serve the homeless of NYC. We all worked to assist Candice in whatever way we could to prepare for both lunch and dinner. We split up into teams to cut crates of vegetables and fruits, clean, and serve food. Some people helped with cooking the lunch menu which included basmati rice and beans, chicken, and burritos. Candice kept the dinner menu a carefully guarded secret.  

After hanging up our aprons, we walked out of the kitchen with smiles, knowing that we helped feed those who were hungry that day. The environment at the New York Rescue Mission was so positive and supportive. With its efforts to expand, there is no doubt that the Mission will continue to do great things in the community.

-Tiffany Hoang, UHS Scholar Class of 2017

 

Alumni Dinner!

Friday evening, we had the pleasure of meeting and dining with 5 great Geisel alumni! -Dr Anne Mosenthal ‘85, Dr Margaret A. Satchell ‘95, Dr Sylvan Roger Maginley ‘05, Dr Jeff Schrager ’90 and Dr Kim Cartmill for an evening full of fun, laughter and wonderful experiences being shared over a smorgasbord of delicious food (I tried octopus for the first time!) 

I spent a great portion of the evening conversing with Anne Mosenthal, relative of Geisel’s beloved Dr Mosenthal and now a trauma surgeon and chair of the Department of Surgery at Rutgers. She talked about the joys of working in an urban environment particularly the VA system in New Jersey and the ways in which she was able to balance the demands of her job with raising her two children (one of whom is currently an Oberlin College student!).    

Dr Sylvan (Roger) Maginley now primarily involved in Diabetes research and global research partnerships was second to arrive. He gave us a glimpse into his experience as a student in Hanover and the myriad ways in which he sought to engage with and build community in Hanover.  

The moment of the night however, would come a couple of hours in when Dr Satchell overcome with joy by the Canadian Hockey team's fantastic run at the Sochi Olympics, broke into song (“Oh Canada our home and native land”) much to the awe and delight of every scholar. 

This was easily some of the most fun we had on our trip and always a pleasure to trade stories and laughter with the amazing Geisel alumni we encounter in every city we journey to.


-Inyang, UHS Scholar Class of 2016

Washington Heights Clinic

After a wonderful morning at visiting and speaking with many executive members of the Community Health Network, we set out to see how a clinic within the network operated first hand. We took the train all the way to Washington Heights, an area of Manhattan pretty far uptown. There, we met Jonathan Santos, the Health Center director for the Washington Heights Clinic. Jonathan was kind enough to not only show us the current clinic being used, but also the new clinic that will open in the coming months. 

            Jonathan had only been working at the clinic for a few months, but he was already doing great work. Through his oversight, the clinic had fulfilled a long-time partnership with Community League of the Heights (CLOTH). This was truly an amazing concept for us to learn about. The health clinic would be located in the basement of CLOTH’s 6-12 school, Community Health Academy of the Heights. The idea behind this is not only could the students who attended that school get health care from the clinic downstairs, but also gain exposure to working in the clinic, in hopes of one day pursing a career in the medical and/or health-related field. It was great for the scholars to see the beginnings of this budding partnership.

            Though much work still had to be done, the Community League clinic already did a great job of integrating the community members in their staff and reaching many families and teens to fulfill their needs. Primarily, Jonathan spoke of them as an advocate and resource for the community’s family planning needs. Through their Teen’s PACT program, many teens were getting involved in making PSA’s educating their peers about family planning options. The health center also had a “CINDY” program, where teens could anonymously come in for their sexual health and family planning needs anonymously, only being contacted via a postcard that read “Visit Cindy” so they teens would know if they saw this postcard, they were needed at the clinic. Through this program, safe sex practices and sexual health were being tackled on the forefront. The Scholars were thrilled to see what an integral part of the community the health center had become and hope to visit again next year when the school partnership is up and running.

Dr. Luis Molano and Clinical Care at CHN

We had the pleasure of meeting with Dr. Freddy Molano during our visit to CHN, and wow what a force of passion and inspiration  Freddy was! Freddy came to the United States from Columbia back in the 80’s started his HIV testing work in Manhattan but was soon shown a different side of the city when he and to travel to Brooklyn in order to test women, mostly sex workers, for HIV. His story of the women and men he met on during his time testing in Brooklyn were shocking and would have discouraged many people from the work that he was doing. However Freddy saw a need and ran with it. After a brief stay away from United States Freddy returned in order to continue HIV testing in the Bronx. It was here and working with women and transgendered individuals that Freddy was really able to explore and fill a need of the underserved NYC communities. 

 
Through his recollections of 25 years of working with the Community Healthcare network Freddy emphasized how important it was to ask an individual how they would like to be addressed especially with transgendered patients, a concept that is highlighted in our Year 1 On Doctoring class. Throughout his time with us Freddy communicated the need to not separate transgender care from mainstream care.This only continues to marginalize these individuals in society.  Many transgendered individuals wish to be mainstream in a way that transgender clinics often don't allow. Through his story Freddy was able to convey many of the intricacies and complications of health care for transgendered individuals. He emphasize that physician and care provider biased often leads to unnecessary questioning because of curiosity or not enough questioning due to embarrassment. As physicians it is our job to make sure that our questions are appropriate for care and do not convey any of our own discomfort with topics especially those relating to sexual history and sexual practices.

Our time with Freddy really stressed the need for caring physicians who recognize that gender identity and sexual orientation are the choice of the individual patient and are not dictated by genetics or societal constructs. His many recollections of his 25 year history working with the Community Healthcare Network demonstrated to us the importance and challenges of treating patients who are often marginalized by society, mainly of those who are HIV positive or transgendered. His path and journey working with the underserved was truly inspirational and provided a lot of insight for the Urban Health Scholars into issues that are not necessarily brought up in the classroom but are of extreme importance and becoming increasingly common in medical care especially in urban areas. 

-Hayley Jones, UHS Scholar Class of 2017 

Community Healthcare Network

The Urban Health Scholars kicked off Friday with a visit to the administrative offices of the Community Healthcare Network where we met with Dorothy Farley, VP of Social Services, and Elizabeth Howell, VP of Development and Public Relations.  The Community Healthcare Network (CHN) was formed in 1981 to strength the administration and management of 12 community based storefront health centers serving the underinsured and uninsured. At the time CHN was formed the centers provided basic family planning services, but they have since grown to provide primary care, mental health and social services in response to the growing needs of the underserved communities they serve.  CHN currently serves over 75,000 people in Manhattan, Queens, Brooklyn and the Bronx.  More than 96 % of CHN patients are people of color, many being immigrants.

Dorothy highlighted that during the development of the clinics into the comprehensive primary health care centers they are today, the clinics were quick to respond to emerging health needs in the community such as the AIDS epidemic and teen pregnancy.  Care and counseling for these health issues was incorporated in the regular flow of clinic visits in an effort to make the patients feel respected and comfortable receiving their care as opposed to ostracized.  Currently, CHN is working tireless to improve the care delivered to transgendered patients.  They are educating their staff around pertinent issues in caring for transgendered patients as well as working to increase health literacy in this population.

Elizabeth emphasized the strong mission that the clinics have to provide culturally competent healthcare and to respond to the needs of the community.  Most of the clinic administration, social workers and nurses are from the community which helps to achieve this mission. However, Dorothy mentioned that there are challenges in finding physicians from the community and they typically rely on hiring physicians from outside who speak the predominant language in the community.  A big challenge that results is that the hired physicians typically on work for 2-3 years as there loans are forgiven and then move onto other work, significantly hampering the ability of the clinics to provide continuity of care to patients.  When hiring for cultural competency, she looks for individuals who are respectful of patients and willing to make mistakes, learn from them, and actively learn more about the community they serve. 

Dorothy also emphasized the importance of team based care and improving health literacy in each of the clinics in meeting the diverse needs of their patients.  Most of the health centers have social workers, dieticians, health coaches and behavioral specialists in addition to physicians, nurses and physician assistants.  Through this team of players the health centers strive to empower patients by improving health literacy.  Health literacy is critical for patients to understand there diagnosis, follow a treatment plan and prevent future illnesses.  A hallmark of a successful health literacy program is to have the patient tell their understanding of their illness and treatment plan to a healthcare provide. CHN practices this in addition to providing clear informative illness brochures as well as access to a patient portal where patients may monitor their health record.

Looking into the future, CHN faces challenges in sustaining financial support for their clinics since over a third of CHN patients are uninsured and 75 % have incomes below the national federal poverty level.  Moreover, the rising rates of mental health illnesses in the communities that CHN serves is a current challenge facing CHN that they are striving to address in a culturally sensitive manner.

The Scholars enjoyed learning about the history of CHN and the ways in which each of the clinics responded to community needs. 

-David Whitehead, UHS Scholar Class of 2017