Interning at the Health Brigade in Richmond, Virginia expanded my perspective of both poverty and charity by challenging me to see how various factors and situations may interact, creating a vicious cycle of poverty rooted in inadequate access to healthcare. I recall a memorable line on the Health Brigade’s website: “We are committed to serving the most marginalized populations in the community– not only those with few resources, but also those most oppressed and stigmatized.” This sentence encapsulates what I learned last summer through witnessing and participating in the Health Brigade’s endeavor to satisfy by this commitment. The Health Brigade treats uninsured patients, who do not qualify for Medicare or Medicaid, and have an income under 200% of the Federal Poverty Level. Everyone who meets those qualifications, which are evaluated through a financial screening process, may receive care. Furthermore, the Brigade provides prescription medication, mental health services, and social work services. It has a reputation for being a place where marginalized individuals are warmly received, and I had the opportunity to interact with individuals whom I generally would not, including members of the transgender community, incarcerated individuals, and undocumented immigrants.
“I believe it is reasonable to challenge everyone to see transgender individuals as human and deserving of a basic respect that recognizes the unjust discrimination,” writes Sutanto, who interned at the Health Brigade in Richmond, Virginia in 2017.
A driving force behind my pursuit of medicine is the desire to be present with people in their trials, given that many large and defining trials for people revolve around health. Interning at the Health Brigade gave me a taste of that future, and it was both humbling and exhilarating. There is something uniquely precious about being with people as they share their darkest moments and reminding them that they are still valued. I witnessed compassionate care, and the impact it has. The medical providers at the clinic work extraordinarily long hours, and not for high pay. They find greater reward in meeting needs that might otherwise go unsatisfied. I was inspire and helped to see and articulate a vision for my aspirations and future work.
Prior to this internship, I sorely lacked knowledge of the specific medical needs of the transgender community. However, through hours of obtaining vital signs and observing patient visits, my understanding of how to create an inclusive space for transgender individuals in our communities has grown exponentially. I listened to patients disclose their struggles and the discrimination they face in multiple facets of life because of their sexual identity, and I watched the healthcare providers respond with compassion. My perspective was broadened in learning how sexual identity can affect socioeconomic status, namely, individuals identifying as transgender face a higher risk of discrimination, which can undermine incomes. This deficiency leads to food and housing insecurity, which can wreak devastating effects on their lives. I was in a room with transgender individuals when President Trump announced that they could no longer serve in the military, and I looked into their eyes and saw anger, hurt, and fear. It gave me a glimpse into the struggles transgender individuals face every day and helped me understand the profound importance of policy. Words, actions, and kindness matter deeply. Despite potential controversies on this topic, I believe it is reasonable to challenge everyone to see transgender individuals as human and deserving of a basic respect that recognizes the unjust discrimination. Crossing the boundaries labels impose and straining forward towards understanding significantly diminishes poverty understood as a barrier to full opportunities.
I had the opportunity to visit the Chesterfield Women’s Detention and Diversion Center with the Health Brigade’s Health Outreach team where we taught an informational class on HIV/AIDS to a class of nine women through a grant from the Virginia Department of Health. I had been taught that people in prison were dangerous and should be avoided, because associating with them would be detrimental to my safety or behavior. I unconsciously adopted this mindset, but it was shattered when I sat with the women in our class. One of the most impactful moments for me was when the women had the chance to introduce themselves and share a few details about themselves. The diversity in professions, roles, and backgrounds was remarkable and helped me see these women as real people with real stories rather than merely as incarcerated women.
I met a patient who suffered from a life-threatening disease. An undocumented immigrant, this man was unable to find a physician willing to admit him to care and provide him with the medication he needed. He was forced to wait until a life-threatening crisis sent him to the emergency room for short-term treatment. The patient and his family were living in constant fear that he would not make it to the hospital in time the next time the disease worsened. His quality of life was severely threatened because he did not have access to medication that could control his disease and eliminate anxiety-riddled emergency room visits. I had the privilege of taking his vitals and looked into his kind eyes. As I shadowed the visit, the patient explained that he worked hard in manual labor every day, yet did not have money for his medication, which was thousands of dollars without insurance. I watched his expression transform into one of utmost gratitude when the medical provider explained that we could give him medication at no cost. That moment etched into my mind a beautiful example of what it looks like to come alongside someone in a dark hour and show mercy. It reminded me that a patient is far more than a list of symptoms; he or she is a human with life experiences and a deep story. I observed again how barriers to opportunity come in multiple forms and that health policies and practices can provide access to overcome some lost opportunities.
Over the course of the summer, the script I was given for patient intake became more than a routine; it was a way to show empathy, to tell marginalized people that their stories matter, and that they matter. Some patients were chatty; they opened up quickly and told me about their lives. Others were more reserved, answering my questions with one-word or grunts. Both impacted me greatly. In the chatty patients, I saw generosity and joy despite numerous struggles. In the reserved patients, I saw the hurt that years of systematic injustice inflicts.
Something powerful happened when I had the opportunity to put real faces to these groups of people, an experience that I wish everyone could have. I learned to listen to individual stories and allow myself to be moved by them. As a whole, our culture tends to label groups of people and designate them as “other.” These correlations between marginalized groups of people and low socioeconomic status are not random; they result from systematic injustice that puts people at greater risk for health and other threats. At the end of the day, these people lumped into groups are persons. When we see past the labels to their humanity, we are able to treat others with greater compassion. Illness affects all, regardless of socioeconomic status, criminal record, sexual partners, and education level, so providing medical care too all, whether in the form of charitable giving or government funding, ought to be a priority. I hope to spend the rest of my life serving the poor and forgotten as selflessly as employees at the Health Brigade do every day.