Entering into the New Year: Reflection on the France-Merrick Civic Fellowship
Happy New Year!
As I sit here, writing this blog entry in my parent’s home in Perry Hall, MD, it is hard to believe that I have gone through…
11 months of the COVID-19 pandemic
8 months of “zoom university” at Johns Hopkins University
and 3 months of senior year, along with a year-long fellowship.
This year, I am one of seven fellows of the France-Merrick Civic Fellowship, where I am spending the 2020–2021 school year collaborating with Baltimore organizations in the non-profit, private, and government sectors in order to explore the intersection of healthcare and immigration in Baltimore City. I was inspired to explore this focus area due to being the daughter of immigrants. My mother and father immigrated from Mysore, India, and I as grew up, I observed and learned how barriers to accessing high-quality healthcare differed for my mom and my dad, as well as for me and my brother. And as I grew to be an active member in Baltimore, I observed and learned how access to healthcare can differ among undocumented immigrants, asylum seekers, and refugees. As a natural-born citizen and daughter of highly educated immigrants, I feel that I have a moral responsibility to take the time to deeply understand the immigrant experience through the healthcare system and work to advocate for policies and programs that ensure equitable, sustainable access to healthcare.
While the topic of immigration and healthcare is quite broad, I have had the help of amazing, inspirational mentors, Misti McKeehen and Astoria Edwards, to narrow the focus: how do adult immigrants access and experience healthcare in Baltimore City? I tackle this question by participating in a set of coordinated activities, including direct service projects, training and reflection sessions, and professional development opportunities designed to catalyze my future service and engagement efforts.
Overview of France-Merrick Civic Fellowship
Every week, I attend weekly reflection sessions with six other inspirational, amazing France-Merrick Civic fellows. The fellows and I participate in two key types of workshops: professional development workshops and reflection workshops. In the professional development workshops, our mentors or each of us fellows share a skill and discuss how we can gain and strengthen the skill such as time management, organization, elevator pitch, or project planning. One of my favorite professional development workshops was practicing our elevator pitch! This skill is so important in networking with prospective partners, but it can be difficult to achieve through email or a ZOOM call during a global pandemic. But thanks to the supportive, close-knit nature of my team of fellows, we practiced our elevator pitches in a ZOOM call and shared feedback on how we can sharpen our elevator pitch in an email, phone call, or ZOOM call.
In the reflection workshops, we start the meeting with an article, movie, or lecture that we can observe and take notes on how such a material makes us feel. We further the discussion to bigger questions: How does our work with our partners reflect this issue? What we can do to move the conversation forward in the process of planning and implementing a project? To supplement these two workshops, there are special opportunities to engage in meetings and workshops outside of the fellowship, such as the Civic Sessions, web-events hosted by Baltimore City organizations, or participating in an Intersections meeting. In the Intersections meeting, I meet one-on-one with the other fellows and explore the intersection of our focus areas. For example, by exploring the intersection of immigration/health care and people with disabilities with my colleague Shanice Guthrie, I have seen how federal policies impact access to resources within Baltimore, and likewise how policies within Baltimore protect access to resources for immigrants with disabilities.
Making Connections and Partnerships within Baltimore
Even though the service projects did not start until September 2020, a critical amount of work began in May 2020. After the spring semester ended, I was assigned to the task of building connections with my fellows. Yes, my “homework” was to do ZOOM calls with the fellows to watch movies, play online board games, or just virtually catch up over tea! From June to August 2020, while participating as a Peer Mentor for the Community Impact Internship Program, I spent time outside the remote internship to explore the intersection of healthcare and immigration in Baltimore City by researching organizations in Baltimore, listening to podcasts, reading and articles books, and attending webinar events relevant to the focus area. Then, from August forward I reached out to organizations to be a primary site of work or conduct an informational interview to their perspective on the immigration and healthcare issues in Baltimore.
One of the challenges I faced early in the fellowship was finding a primary partner site. Doing the fellowship during the COVID-19 pandemic can be challenging for organizations to take on another intern or provide resources for their training. And because my focus area was so broad, it was difficult to find what exactly I desired out of the partnership with organizations. When I was most lost in the process of making partnerships, I found strength by working with my wise mentor, Astoria Edwards, the Compliance Specialist at the JHU Center for Social Concern. With her 12 years of experience in the healthcare industry and over 15 years of experience in project management and community outreach, she sat with me on ZOOM calls and challenged me to tackle tough questions central to my focus area of immigration and healthcare:
What aspect of healthcare wants to explore? Navigating through healthcare? Accessing Healthcare? Or accessing resources critical to healthcare such as transportation and housing? Are there policies for immigrants’ health? What policies are in place at the federal, state, and local levels? What organizations are advocating for them?
These questions led me to focus my partnerships, informational interviews, and research on how do adult immigrants access and experience healthcare in Baltimore City? With this question in mind, I went forward seeking partnerships that gave me opportunities to get involved in projects that help me to answer this question.
When a partnership was not possible, I took the opportunity to conduct informational interviews with organizations like the Maryland Commission on Civil Rights, Mayor’s Office on Immigrant Affairs, and Esperanza Center Health Clinic. Through the interviews, I gained perspective on the processes adult immigrants go through to access healthcare on the federal and state level. I also learned how Maryland is unique in handling the healthcare system compared to other states. By studying the barriers organizations faced in advocating for immigrants’ access to healthcare, I became aware of the present and future challenges organizations face in preserving immigrants’ access to affordable healthcare services.
At the beginning of the fellowship, I questioned how the COVID-19 pandemic exacerbated disadvantages for immigrants. I learned how low-income immigrant families and work acquaintances often share residences to save money, with up to ten to twelve people living together in a two-bedroom apartment or numerous families in one house. So, by the time patients were contacted for their positive test results, most household contacts were already sick. In addition to this, years of anti-immigrant rhetoric and policy, that has excluded immigrants from safety nets, as led to the immigrant community to be hesitant to accept alternative housing (such as hotels) or healthcare services during the COVID-19 pandemic [1].
Now I question how the systems and structures have adapted to the global pandemic and listened to the feedback from immigrant communities. From interviewing an expert in the Esperanza Center Health Clinic, I learned how most clients, which include immigrants, do not have primary doctors. The lack of a primary doctor means a lack of regular check-ups, leading to missed opportunities to detect illnesses or long-term health complications. And during the COVID-19 pandemic, it is even more difficult for immigrants to access these tests, as well as check symptoms of COVID-19. The Esperanza Center has historically provided healthcare services and resources for any individual, regardless of health insurance. When the COVID-19 pandemic struck, the Health Clinic at the Esperanza Center experienced a massive increase in patients, as well as high demand for nurses, physicians, and personal to meet the increase in demand for services. As they worked to adapt to remote work, telecommunications, and services that are adapted to COVID-19 guidelines, they set up and established a call-center hotline for the Esperanza Center. The call-center is organized in tiers, connecting callers to appropriate services and resources, with the highest tier connecting the patient directly to doctors and COVID-19 testing. Now, their call-center is being used in Baltimore and the state at large, connecting hundreds of people a day to resources, services, and programs.
My First Partnership: Baltimore City Health Department
The persistent networking, emailing, and outreach to organizations led me to partner and work with the Baltimore City Health Department on the B’More for Healthy Babies.
B’More for Healthy Babies is an innovative initiative to reduce infant mortality in Baltimore City through programs emphasizing policy change, service improvements, community mobilization, and behavior change.
Working with Stacey Tuck, I have been gaining a very unique perspective on how adult immigrants access and experience healthcare, specifically reproductive health, in Baltimore City. My first project was to assist in revamping the home-visiting strategy. The home-visiting program is a central part of the B’More for Healthy Babies initiative that uses an evidence-based approach to provides resources, education, and support for moms.
In this assignment, I compiled findings from qualitative feedback surveys to illustrate demographic information such as the mean, median, and mode ages of participants, the number of first-time moms versus repeat moms surveyed, or how many mothers have been in the home-visiting program for less than six months versus at least six months. By compiling demographic information, I can see trends of what factors cause an increase or decrease in participation. By categorizing clients’ causes for signing up for home visiting and clients’ expectations of the home-visiting program, I have found correlations between the two questions.
While the findings are yet to be finalized and published in the strategy report, I have found the project to be insightful to the question of how adult immigrants access and experience healthcare in Baltimore. Of the many reasons clients participated in the home-visiting program, one reason stood out to me: an immigrant mother wanted to participate in the program to find emotional support and access resources to aid her in the journey of motherhood.
Reading this feedback from the survey made me think of my own parents. As first-generation immigrant parents, they had no family in the United States to aid them in the surprises that parenting can bring. After my brother was born at GBMC, my parents were mainly on their own to find resources and advice to raise their first child. By the time I was born, my parents had a small, close network of friends to provide advice and resources to raise their second child. And given the clashing cultural values of being Indian and American, my parents faced a challenging time deciding on what resources — ranging from education to health — would best support their children’s success.
So, I imagine resettling in Baltimore City with no network of friends or family to support oneself through pregnancy can be overwhelming and expensive. But through programs such as the B’More for Healthy Babies, immigrants can access educational workshops, resources, and a strong network to guide them through the journey ahead.
Looking Ahead: Entering the New Year with Perspective and Curiosity
As I enter the New Year, I look forward to the upcoming projects with the Baltimore City Health Department. I also look forward to my new partnership with the Baltimore branch of the International Rescue Committee, where I will be serving as a Case Management Intern. Through the perspective of a government agency and non-profit organization, I hope to gain a deeper understanding of how adult immigrants access and experience healthcare in Baltimore City.