Immersion is Vital to Understanding Health Challenges

By Kjersti Kleine, Furman University (2017)

Driving into Helena-West Helena, Arkansas was like nothing I have ever experienced. As we drove farther and farther away from Memphis, Tennessee, the last town we passed before entering the Delta, I could feel my heart beating faster and faster. My little blue car was packed full of my belongings for the summer as I embarked on an adventure that would change my perspective about poverty and healthcare in America.

Kjersti teaching nutrition

My eyes had recently been opened to the complexity of healthcare and public health across the world through a school trip to Nicaragua to study maternal and childhood health. Having recently returned from that trip, I really didn’t know what to expect from the Delta of Arkansas. The differences in the American and Nicaraguan healthcare systems are vast, and I was excited to observe and experience rural healthcare in the country I call home.

I spent the summer working as a Health Education Program Intern at UAMS (University of Arkansas School for Medical Sciences) East, a health education center for the Delta area of Arkansas. I had never spent time in rural America, I had never been to Arkansas, and I definitely did not understand the culture of the Delta.

Helena-West Helena was once a thriving town where tourists flocked to get a taste of Southern culture and Southern food. With a port on the Mississippi river, Helena-West Helena was truly the place to be. After the Industrialization of farming and changes in the economy, many people packed up and left town. Gorgeous Antebellum style homes, a beautiful downtown infrastructure, and a rich Southern culture remained.

UAMS East, formerly known as the Delta Area Health Education center, serves the community in several ways including health career education for youth, nutrition programs, health camps for children, exercise and fitness programs, and diabetes education. With summer temperatures in the triple digits and soul food served at nearly every house, achieving and maintaining good health can be a challenge for many Delta residents.

I spent my time in the Delta educating children about how to make nutritious choices, educating elderly people on fitness, and educating youth about how to improve the health of Helena-West Helena by pursuing health related careers.

Pickles soaked in Kool-Aid, fried Okra, Coca-Cola Cake, and fried pie are just a few of the many foods that have become a part of the culture and diet in the Delta. When trying to educate people for good nutrition and health, these habits can be a challenge.

As a part of my job, I worked at the Helena Farmer’s Market every Saturday morning. The Farmer’s Market often consisted of at least 6 different booths where local residents sold crafts, homemade food, and some fruits and vegetables. At the UAMS East booth, I handed out recipes for healthy alternatives to some favorite meals.

I also planned and implemented a nutrition camp for children called Mission: Nutrition. At this camp, children tasted various fruits and vegetables that were new to them. They were very excited about tasting new foods, and most of them enjoyed the foods as well! I also educated the children about the five food groups and what to look for within each of those groups. My fellow intern and I taught them about reading nutrition labels, whole grains, low-fat dairy options, and consuming a variety of fruits and vegetables.

Helena-West Helena has difficulty keeping healthcare professionals in the area to practice. To address this issue, several UAMS programs introduce local children and youth to healthcare careers. From making play-dough with elementary school students to learning how to suture with high school students, it was exciting to teach local children about science and health.

UAMS East has several programs including Destined to be Doctors, Funology, CHAMPS, and MASH camps. Elementary school students can come to afternoon science camps to learn about the bones of the body, the importance of hygiene, and how to do fun science experiments. Middle school or high school students can come to camp to take field trips to the hospital, dissect various animal hearts and brains, and learn about educational paths to various healthcare careers. Without sufficient healthcare professionals in the area, those that are available are often overbooked with appointments and responsibilities.

Empowering youth at a young age to pursue careers in healthcare is a strategy that equips a community with sustainable positive healthcare outcomes. UAMS East follows up with former students to aid them in the health profession education process and determine which students pursue health professions. It’s so encouraging to hear that many students decide to study health and medicine after attending UAMS East’s programs.

I was astonished to hear and experience many of the same healthcare challenges I grappled with in Nicaragua. Although rural villages in Nicaragua and rural towns in America differ drastically in culture and history, I was amazed to observe many parallels. Both communities experience a lack of healthcare professionals, transportation challenges, a rich culture, pride for their land, deep religious ties, and unique challenges with food access.

Both Arkansas and Nicaragua have special programs to encourage medical students to spend time in rural areas to address specific healthcare needs. Both communities have created strategies to address the distinctive challenges they face. Both communities gave me a new perspective and a new understanding of healthcare and the complexity behind achieving adequate health for a community.

Living, working, and learning in the Delta was eye opening. My experience exposed me to the many social determinants of health people living in poverty face. Nutrition education for children is not traditional healthcare, but it is an important component in a holistic approach to health. Moreover, health education is not enough. If parents don’t have access to grocery stores with fresh fruits and vegetables, it will be difficult for their children to apply what they learn.

The complexity also goes beyond mere access to fruits and vegetables. Other social factors such as transportation, childcare, safe and affordable housing, and cultural habits are interconnected with the health of families. Without public transportation in Helena, clients aren’t able to access the wellness center to exercise. Without decent cooking supplies, clients aren’t able to cook health meals. It’s crucial that all of the components of healthcare work together to address healthcare disparities.

The most important lesson I learned this summer is both frustrating and important. I have been taught about the complexity of poverty in the United States and across the world, but it’s difficult to understand this challenge without being immersed in a community facing the effects of poverty. Whether in Nicaragua or in rural Arkansas, communities face distinctive barriers and challenges to adequate health. Coordinated initiatives from multiple angles are necessary to address these barriers to improve the health of a community.

If you would have asked me two years ago about what I wanted to do with the rest of my life, I would have said I wanted to go to Medical school so I could help people. Now, I have a deeper understanding of the complexities of the healthcare system and social issues in America. Focusing on strategies to prevent poor health before it becomes an issue is a critical part of our healthcare system, and it is a part that I am excited to tackle.

Living and working in the Delta was an experience like no other. I was welcomed into a community with open arms to learn about the culture and the people of the place I called home for the summer. I had the opportunity to live with and learn from a community that was so generous to me. While driving out of Helena-West Helena, I savored the goodbye smiles of my new friends, the beautiful country roads, and the love and community I had been surrounded by for the last eight weeks.

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