Expanding My Concept of Health and Healthcare

By Jennifer Saccente, Washington and Lee University (2017)

“Well that will certainly be interesting…” This comment, along with a look of severe apprehension, was the response I got from several friends and professors when I mentioned I would be spending the summer in Helena, Arkansas. I felt myself starting to doubt my decision, but I stuck with my plan to work at University of Arkansas for Medical Sciences (UAMS) East.

Jennifer's health education work in Helena, AR, included leading  a camp, “Destined to be Doctors.”

Jennifer’s health education work in Helena, AR, included leading a camp, “Destined to be Doctors.”


I grew up in Arkansas, so I have a deep love for the state and its people. However, upon arriving in Helena, I realized it was nothing like my beloved Little Rock. The area is rural, surrounded by miles of soybean, corn, and cotton fields. There are no movie theatres, skating rinks, or any other form of family-friendly entertainment, only the Isle of Capri casino just across the Mississippi River. With its tacky neon pink and green paint, the casino provides a stark contrast to the farmland encircling it. Along with nearby Tunica, the Isle of Capri casino provides jobs and attracts tourists. However, its past is not rosy, according to several Helena residents: when the casino came to town, its owners bought out the locally-owned movie theatre and arcade and closed them. This left Helena with no safe place for teenagers to gather, followed by an increase in teenage pregnancy rates.

To understand Helena, one must first delve into its rich history. Once a thriving port city on the Mississippi River (sometimes likened to New Orleans), the industrialization of farming caused a major job shortage. The resulting exodus turned the downtown storefronts and ornate antebellum homes into a ghost town. Many of those who remain have either become successful industrial farmers or suffered from poverty relating to unemployment. Small-scale farmers cannot sell enough produce to lift themselves out of poverty, a problem I saw manifested in a man who sold his watermelons everyday down the street from my house. His were the sweetest, juiciest watermelons I have ever tasted, yet he does not make enough money to live comfortably.

Despite this situation, Helena residents were quick to tell me about the improvements in their city over the past few years: A new factory opened that is expected to employ 80-100 local workers. KIPP college preparatory charter school is expanding. A city pool was established. A coffee shop just opened – according to one source, it is Helena’s first coffee shop since the 1920s! I felt inspired by the optimism and growth around me.

Though I came to Helena with healthcare as my focus, my main lesson was the multifaceted nature of poverty. This came from an unexpected source – two young boys who lived in my neighborhood. They waited on our front porch for us to come home from work each day. We shared watermelon, played, and laughed. Through these afternoons, I learned so much about their lives. The boys are cousins who live with several other children in a household headed by a single woman. They have no supervision during the summer, so they wander our neighborhood all day. It startled me to think of the younger of the two, a second grader, having that much independence. Unanswered questions from my interactions with these boys remain: Why didn’t they attend the free camps at the Boys and Girls Club? What happened to the parents of the other children who live in their home? Why was the older cousin’s application to KIPP rejected?

These two boys are an example of a much larger problem affecting many children. Increased summer schooling and enrichment would ease the burden of childcare on the head of their household while decreasing the children’s boredom and combating an academic “summer slump”. KIPP provides two weeks of summer school in July, but this is not an option for children who attend other schools. Public transportation would also help children in similar situations. The public pool and Boys and Girls Club are wonderful resources, but since Helena has no form of public transportation, children are not able to take full advantage of them. Aside from childcare and entertainment, lack of transportation to the doctor, grocery store (which is in West Helena), or workout facility at UAMS East creates more barriers to optimal health.

UAMS East’s summer programming works to ameliorate the first of these issues, although transportation remains problematic. My role this summer was to facilitate camps for children of all ages. For younger children, we had half-day camps, “Destined to be Doctors” and “Funology,” in which we fostered their love of science through hands-on experiments and taught about healthy habits such as handwashing and dental hygiene. In middle and high school camps, students learned about pathways to health careers and heard first-hand from local professionals. We even took the high school group to Little Rock to tour the main UAMS hospital! A different type of camp geared towards middle school students focused on building interpersonal skills and goal setting. At the end of the summer, my experience as a facilitator culminated in planning and running my own camp, “Mission: Nutrition,” with my fellow Shepherd intern. We taught six to 11 year olds how to make healthy food choices and played physically active games with them. UAMS East’s health outreach expands into the community beyond its in-house education programs and fitness center. We taught “Cooking Matters for Kids” classes to children at the Boys and Girls Club and Forrest City Civic Center. In these classes, children prepared healthy recipes, including fruit smoothies and vegetable pizza. For senior citizens, a weekly “Classics” program provided age-appropriate workouts and education on diseases like Alzheimer’s.

Poverty’s multidimensional nature demands a complex solution. Through my internship at UAMS East, I focused on one just aspect of it, health education, but I was fortunate to see how agencies work together. Main Street Helena sets up a weekly farmer’s market, strengthening the community by bringing together a diverse group of people and giving small-scale farmers an opportunity to sell their produce and crafts. Local churches provide three meals per day for the entire summer, easing the burden on families whose children typically receive meals at school. The participating churches are spread throughout the area rather than being concentrated in downtown Helena, allowing for easier access. This coordination of agencies makes their services more valuable and is a huge step towards meeting the community’s needs.

I plan to continue my studies in science and healthcare, but now with a broader worldview about the complex issues that my future patients may face. My experiences in Helena taught me about non-medical issues that stand in the way of optimal health outcomes, including lack of transportation and education. Working in the field of public health showed me that it is essential to take the big picture into account when trying to improve an individual’s health.

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