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Bursting the Bubble: Learning the Difference between Absolute and Relative Poverty

By Megan Gilpin

After graduating from Berea College in 2010, Ms. Gilpin began graduate school at George Mason University. She graduated in 2013 with a Master of Science in Forensic Science. She presented her graduate thesis work at the 66th Annual Meeting of the Academy of Forensic Sciences in Seattle, WA, and the research was published as an article in the Journal of Forensic Sciences. Ms. Gilpin currently works in government contracting.  She plans to return to school for another Master’s in Biological Anthropology and from there to a PhD in Biological/Forensic Anthropology.

Poverty is defined as “general scarcity, or the state of one who lacks a certain amount of material possessions or money.” Many people think that poverty is defined by one’s social status, but they would be incorrect. The concept of poverty is multifaceted, involving not only social but also economic and political elements. Growing up in southeastern Kentucky, I thought I knew what poverty was. When I was accepted into Berea College and began taking classes, I learned that there are many different types of poverty, the two main types being relative poverty and absolute poverty. My own personal experience growing up was an example of relative poverty, which is more dependent on social elements and measures of income inequality. I had not yet experienced a situation of absolute poverty, or complete destitution, where there is a lack of the necessary means in order to meet basic needs such as shelter, food, or clothing.

"SOME Medical is a fabulous program that not only provides medical services, but also dental, eye, mental health, and addiction treatment services to the homeless," writes Megan Gilpin, Berea (2012). "This program changed my life as I knew it, and my experiences as an intern will forever influence my plans for the future."

“SOME Medical is a fabulous program that not only provides medical services, but also dental, eye, mental health, and addiction treatment services to the homeless,” writes Megan Gilpin, Berea (2012). “This program changed my life as I knew it, and my experiences as an intern will forever influence my plans for the future.”

The professors on Berea’s campus were always encouraging students to do their best, work hard, and reach out to others, and I had an incredible support system in the Biology Department at Berea. I was approached by one of my biology professors who thought that the Shepherd Program was perfect for me and would give me an opportunity to get into the world outside of my social norms and help others using the knowledge that I had acquired at Berea College. Being a student at Berea was like coming home to a family you never knew you had, and once you found it, knew you could never live without. Berea students refer to this as the “Berea Bubble.” You never really know how strong and protective that bubble is until you are thrown outside of your physical and geographical comfort zone. When I applied for an internship with the Shepherd Poverty Alliance, my Berea Bubble not only burst but dissolved into thin air. The day after I arrived in Washington, DC, to start my internship, I learned firsthand what absolute poverty is, and how I could be a part of the solution to overcome it.

I was placed at So Others Might Eat (SOME) Medical Clinic. SOME Medical is a fabulous program that not only provides typical medical services, but also dental, eye, mental health, and addiction treatment services to the homeless. This clinic offers a complete range of services, including lab work, chronic disease management, and adult primary care. On average, SOME Medical treats 30 homeless adults a day. SOME’s dental clinic provides comprehensive, preventative, and emergency oral care and the eye clinic is one of the only free clinics in Washington, DC. SOME’s program offers more than fabulous medical care; it also offers dining room services, shower rooms, emergency housing, clothing, employment training. It also provides senior services and stability services such as single adult and family housing. To say that I am bursting with pride at having been a part of this program for even a short time would be a gross understatement. I was accepted into the SOME family with open arms. SOME staff are always glad to have extra help, and they had the patience of saints in teaching new interns the skills they would need to know in order to perform their duties. The patients at SOME are treated like family as well, and most have been coming to the clinic for years and would not think of going anywhere else.

Unlike other medical clinics that catered to the poor and downtrodden, 100% of SOME’s clientele were homeless, and the homeless population in DC is overwhelming. DC is home to approximately 90 homeless shelters, yet this is still not enough to house the population living within the city limits. The homeless stand outside the entrances to drug stores and various businesses and congregate around the fountain at the front of Union Station, hoping for handouts of money or food from those who are more fortunate. They sleep in doorways or benches in front of the White House with cardboard blankets, live under graffiti-riddled bridges on moldy, bug infested mattresses, and walk around the city aimlessly, carrying every object they own from place to place. For someone who has seen, at most, a handful of homeless people in their life, it can be an overpowering experience.

Like the definition of poverty, my job as an intern was multidimensional, and I learned a lot in such a short time and met some amazing people, including the staff and the patients that I had the privilege of helping. Not a few patients were wary about my arrival at the clinic, as they had gotten used to the staff and did not always welcome an outsider. Eventually, I was accepted by most of the patients who lovingly provided me with the nickname “Kentucky” as my accent was not nearly as inconspicuous as I thought. My duties as an intern included all the usual office work: making copies, calling various hospitals to schedule appointments for patients who required the use of more advanced machines such as MRIs and CT scans, and decorating the bulletin boards in each patient room with informative pamphlets on health care maintenance. All of these tasks were performed when I was not screening the medical as well as the eye clinic patients that came in for appointments or as walk-ins by taking their vital signs (blood pressure, heart rate, respirations, EKGs) and performing preliminary eye screenings such as color blindness tests, so that the doctors were ready to provide top-notch care when they saw the patient themselves.

As a biology student I was excited to learn that I could assist in the clinic’s lab performing various tests. I was not allowed to draw patients’ blood, for obvious reasons of liability, but I did get to perform dozens of urinalysis screenings as well as prepare Pap smear samples to be sent to a larger lab for consultation. I was also the first person in the clinic to try out the new tests developed for the H1N1 flu virus (Swine Flu) that, at the time, had the world on edge. I even had the opportunity to perform one pregnancy test. One of my other duties was to escort male doctors when they were performing routine Pap smears on women. I held a lot of hands and comforted a lot of nervous women as this procedure was performed.

I was able to connect with patients one-on-one to ask them about themselves and how they were feeling as well as why they were visiting the doctor that day. This connection with the patients gave me incredible insight into what it means to live in absolute poverty. Our patients were former drug addicts, current drug addicts, alcoholics; they suffered from HIV/AIDS, hepatitis, malnourishment, mental illness, and—the number one disease I encountered—diabetes. The amount of insulin syringes I filled and glucometer readings I recorded is unfathomable. Almost every single patient that came into the clinic was suffering from diabetes. When asked about why this was, the sole doctor at SOME stated that healthy food is expensive. Most homeless kitchens provide only what they can afford to buy, which is “cheap food” that leads to increases in diabetes in the homeless population in Washington and throughout the nation.

Our patients came from all over the world, a lot of them not knowing English. One of our patients, whom I will never forget, spoke only Mandarin Chinese, and after hours on the phone trying to track down a translator, we were told one could not be immediately provided. As luck would have it, I spoke a pitiful amount of Mandarin and was able to communicate with her on a very limited level. More frequently, SOME saw Spanish-speaking patients, with whom I could communicate much more comfortably. There were also patients from Macedonia or Nepal, with whom I could not communicate at all outside of hand gestures and body language. All of this created a priceless learning experience for me that I could not have found anywhere else.

The one thing I noticed while working with our patients was that most of the time, they wanted someone to listen to their stories and to connect with them. I was more than willing to listen. The patients would answer any questions I asked with no offense and ask questions about me. One of our patients, who asked for me regularly when she came in, wrote the medical staff letters every week, detailing how everything was going with her and hoping the best for all of us at SOME. This same patient kept small slips of paper with her name, telephone number, and a note to “call her anytime” in her wallet to give out to people she deemed worthy of her friendship. She gave me one and assured me that I could contact her whenever I needed to. I still have that slip of paper tucked away in my own wallet so that I do not forget her or my experience at SOME Medical.

Once I look back on my work with the Shepherd Program, I realized by bubble did not actually burst, it just expanded to include what I had learned and the people that I met. I have no doubt that this bubble will continue to expand, and will be limitless in terms of what I learn, not only about myself, but about others. This program changed my life as I knew it, and my experiences as an intern will forever influence my plans for the future.


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