Bridging The Gap

By Javacia Harris Bowser

The Albert Schweitzer Fellowship is a program that’s all about bridging gaps. That’s what it takes to effectively and compassionately provide healthcare to underserved communities. Healthcare providers and professionals working in other areas of public health must bridge the gap between marginalized patients and the services they need. And sometimes to provide proper care they must bridge the gap between themselves and their patients too. 

Several current Fellows are learning firsthand that bridging these gaps requires community partnerships, communication, and commitment. 

Leanne Jeong and Kavita Kantamneni are addressing the need for breast health education specifically within the LGBTQIA+ community. Their project includes creating and using inclusive, gender-neutral breast cancer materials, educating patients on how frequently they should be screened for breast cancer, and teaching participants how to conduct a breast self-exam. 

Malia McDowell is helping Community of Hope Health Clinic with its free optometric clinic, which offers established patients free in-house eye care by licensed providers. Additionally, Malia is focusing on helping Hispanic patients overcome language and health literacy barriers to care. 

Shashank Tiwari is spearheading the installation of 20 digital air sensors in the North Birmingham community to monitor emissions of coarse, fine, and ultrafine particulate matter from industrial sources at a Superfund site. These sensors collect data crucial for assessing air quality. The hope is that this information will impact environmental management decisions for the area.  Shashank is also training volunteers to use the sensors and educating residents about air pollution.

Community Partnerships at the Cornerstone of ASF

Community partnerships are the cornerstone of the Albert Schweitzer Fellowship. The Fellows can’t implement their projects, they can’t begin to bridge the gaps, without the help of organizations that are already working in the trenches. 

Leanne and Kavita have been working with Magic City Wellness Center and the Gender Health Clinic at UAB.  They’ve also attended health fairs and Pride events. When Malia learned that Community of Hope Health Clinic was opening an optometry clinic she jumped at the chance to help. 

For his project, Shashank partnered with Greater Birmingham Alliance to Stop Pollution (GASP) to help with the organization’s ongoing initiatives to improve air quality in predominantly Black neighborhoods like North Birmingham. 

“It’s very important to have a community partner and their experience and their understanding of how to interact with the community,” he says. 

For Shashank, his partnership with GASP has been the key to communicating with North Birmingham residents. 

“I’m an international student,” says Shashank, who’s from India, “so you have a lot of barriers going into a community because you speak a different language, your presentation is different. There are cultural and social barriers.”

Furthermore, he’s working in a community that historically has been mistreated or ignored. 

“When you’re deprived for generations and you see your grandfather suffering and your grandmother suffering, you think the situation is never going to change,” Shashank says. “And they think that this person is coming only for data collection and for advancing their own career.”

But by working side-by-side with representatives from GASP, Shashank is slowly getting through to residents. 

Communication Is Key

When it comes to bridging gaps in healthcare and public health, communication is key. But sometimes having the necessary conversations with patients and community members can be tough. 

Malia’s determined not to let language keep her from serving. 

“I speak Spanglish,” she says with a laugh. “My Spanish is very choppy. I’m not fluent in Spanish at all.” 

And Malia has found that even with qualified translators on hand, Spanish-speaking patients can still face barriers. 

“Is the patient understanding their diagnosis and also their prognosis,” Malia says that’s a question she’s seeking to address. “Do they understand what they need to do for treatment?”

She’s creating bilingual handouts that explain basic eye conditions such as myopia, stigmatism, presbyopia. She’s also creating documents to cover health conditions that can impact eyesight such as diabetes and high blood pressure. 

Getting quality care – especially for members of the LGBTQIA+ community, may require having difficult conversations too.

“I think one of the biggest barriers is just people not being comfortable having certain conversations or not knowing kind of how to navigate those conversations,” Kavita says. 

That’s why she and Leanne have utilized the app Know Your Lemons to help make patients more comfortable talking about breast and chest health. This app features a host of resources including reminders for screenings and videos on conducting breast self-examinations at home. And the app uses mostly inclusive, gender-neutral language. 

Committed to the Cause 

Bridging gaps in healthcare and public health requires commitment because this race is a marathon not a sprint. That’s why sustainability is so important to Albert Schweitzer Fellows. They want the impact of their projects to continue long after they’ve completed their year in the program. 

“In bridging that gap, we are really focusing on working with the medical school curriculum so that healthcare providers use inclusive language when speaking with patients, making sure to ask for their pronouns and introducing yourself with your own pronouns, and just being more understanding,” Leanne says. “Working with patients at Magic City Wellness and the Gender Health Clinic, we have listened to their stories about how they’ve been discriminated against for their sexuality and how they have felt uncomfortable, especially in a healthcare provider’s office.” 

Leanne and Kavita want to rewrite this narrative.  

Similarly, Malia is working to develop a manual for providers who volunteer at the optometry clinic, a manual that covers both basic check-ups and protocol for addressing eye care emergencies such as off-the-charts eye pressure. 

“We want to make sure every patient is getting the same quality care,” she says. 

Shashank’s goal is to empower the communities he’s working with to be ambassadors for their own neighborhoods as they learn how to monitor air quality. 

“The idea is they will educate other residents or their friends and family so that they don’t always need to have expert input,” Shashank says. “The citizens will empower themselves. If they’re able to read the digital monitors and they notice that the quality of air is getting worse, they can contact a local authority, like the Jefferson County Health Department so they can take some action.”

Shashank, Malia, Leanne and Kavita all feel that their ASF projects are helping to prepare them for the work they hope to do in the future. Shashank says this experience is teaching him how to break down cultural barriers. Malia, who plans to work as an optometrist in rural Alabama, is making connections that she hopes will help her one day start a nonprofit of her own. And Leanne and Kavita are confident this project will make them better doctors.

“Kavita and I don’t personally identify as LGBTQIA+, so I think one important takeaway for me is that even though I don’t identify in a community, I can still do as much as I can to help that community,” Leanne said. “When I become a physician, I’m obviously going to meet patients from all walks of life that I don’t share a similar background with, and I can still try to provide the utmost care and support for all these patients.”