2017 Mt. Sinai Tour
Once again, students from the Icahn School of Medicine at Mt. Sinai made their annual pilgrimage from New York to Nogales in March. During the 2017 Mt. Sinai service learning visit, students shared an action packed week of discovery and a taste of health care practice in Arizona’s rural border communities. Hosted by SEAHEC for nearly a decade, students from the organization known as “Medical Students Making Impacts,” return to Nogales each spring to meet with local health professionals, visit health care facilities and provide service to local communities. The goal is to learn about the challenges and rewards of practicing in this unique rural setting, while offering health education and screenings. For the medical students, many of whom are from urban backgrounds, the experience is an eye opening one. For SEAHEC, it is an opportunity to introduce potential future health care providers to the professional and educational opportunities inherent in serving rural Arizona communities.
“… the trip did make me far more interested in the idea of returning to Nogales for some part of my training, or maybe even later in my career,” one student said, reflecting on the week’s activities. Erin Sol, SEAHEC’s Program Coordinator for Student Training Opportunities organized the tour, which ran from Sunday, March 26, 2017 to Friday, March 31, 2017. It took the students from the border at Nogales, up the historic Santa Cruz River Valley and across the desert to the Tohono O’odham Nation. The group’s itinerary was packed with activities that provided insight into the context of providing health care services in rural border communities:
Sunday, March 26
The students arrived on Sunday and met with Phillip Williams MD, a pediatrician at Mariposa Community Health Center (MCHC) for a tour of MCHC and lunch.
Monday, March 27
The students began their introduction to Nogales at SEAHEC, for a welcome and introductions by SEAHEC Executive Director, Gail E. Emrick, MPH. Ms. Emrick also provided overview of immigration and border health issues. MCHC’s CMO, Eladio Pereira, MD met with the students at SEAHEC for a talk on Provider Patient Care in Rural / Border Communities, after which they joined Daniel Judkins, RN, MS, MPH at the Morley Pedestrian Border Crossing for an overview of Nogales history.
They also visited SEAHEC’s Nogales Future Health Leaders Club. There the Mt. Sinai students showed the FHL club members how to measure blood pressure, how pupils react to light, and how lungs sound. They concluded the day back at SEAHEC sharing their reflections with Ms. Emrick & Dr. Pereira.
Tuesday, March 28
In the morning, the Mt. Sinai group collaborated with students from the UA Rural Health Professions Program (RHPP) to conduct a health fair at the Nogales Senior Center. In the afternoon the students broke into small groups to explore local health service delivery.
Two students visited a local radio station where they helped promote upcoming health fairs, and two students visited MCHC, where they shadowed a case manager to learn about Maternal Child Health Services delivery. Four students visited Santa Fe Ranch. The Santa Fe Ranch Foundation partners with Santa Cruz Training Programs, Inc. (SCTP) to support their training and employment programs. SCTP provides a range of support services to the families developmentally disabled adults from our community. The ranch has developed a farm animal exhibit where SCTP clients can visit and interact with the farm animals. The Mt. Sinai students helped complete some repairs for the animal exhibit.
Another four students traveled to Rio Rico Fire District Station #3 where they learned about the Fire District’s innovative Community Integrated Paramedicine Program (CHIPP) from Tangye Beckham, CEP Lead – Community Integrated Paramedicine Program & Jennifer Jeong, Firefighter/EMT Operations Lead -Community Integrated Paramedicine Program. SEAHEC has been working with local fire departments to help reduce 911 calls by scheduling home visits to community members with chronic diseases. In May 2015, SEAHEC helped the Rio Rico Fire Department obtain a three-year federal grant to implement CHIPP. The day closed at SEAHEC, where the students shared their reflections with Dr. Philip Williams, MD.
Wednesday, March 29
The students kicked off the day with another health fair, this time at Bowman Senior Residence in downtown Nogales, Arizona.
After wrapping up the health fair, the students crossed the border into Nogales, Sonora for a tour of the local Instituto Mexicano del Seguro Social (IMSS) facilities. IMSS administers Mexico’s national health services delivery system, and maintains health care facilities in every state. The tour enabled the students to meet with some of the top health care providers in the state of Sonora, and learn about innovative strategies Mexico is using to address public health needs. The students also visited La Fantastica Daycare. Run by a “maquiladora,” or assembly factory, the daycare facility provided a look at how Mexican cultural norms differ from those in the US about access to childcare for working parents.
Thursday, March 30
The students traveled to the Tohono O’odham Nation, where they met with Tribal Council Vice President Verlon Jose and Tribal Legislative Council Member Louie Lopez. Mr. Lopez presided over a traditional blessing for the group and Mr. Verlon introduced the students to the Chukut Kuk District, one of four non-contiguous regions of the Tohono O’odham Nation. The students toured the Clinical Health Services facility there, provided by Peter Reding, MD. Afterwards, Bernard Siqueiros, member of the Tohono O’odham Museum and Cultural Center, organized a tour of the museum. The group finished off the day by taking a windshield tour of Sells with Tashina Machain, SEAHEC’s Future Health Leaders Program Coordinator.
Friday, March 31
On their final day here, the group traveled to Arivaca, Arizona, to visit with staff from the humanitarian organization People Helping People in the Border Zone (PHP). Back in Nogales, the students visited the Border Patrol station and talked with Agent Lenny Queriapa. An “Appreciation Cookout,” lunch was held at SEAHEC, sponsored by Mt. Sinai’s Icahn School of Medicine as a thank-you to SEAHEC and partners for organizing the service learning experience. Afterwards, the students met with Ms. Emrick and Philip Williams, MD to share final reflections.
The final reflections session allows students to debrief, share experiences, and internalize lessons learned during the week’s journey. Students often express surprise, and are energized by what they have discovered.
One student contributed the following insight:
“I’m really uplifted by all of the providers that we met – from doctors to nurses to paramedics to general healthcare staff – and how they were so passionate about their community and helping their community. Once I get settled and have a place to call home, I really hope to be able to feel and foster that. I just feel really inspired and look forward to that time when I can be a part of that community.”
Often, students encounter a reality that challenges their ideas about life in rural border communities. One student reflected on a “prior misconception that I had…” about local people’s attitude toward immigration.
“I was expecting the people around here to be either fearful or maybe hateful towards people who are coming illegally but the people that we have met here are either really sympathetic toward migrants who are coming illegally or even apathetic but I haven’t met anyone who is really determined to stop them, including border patrol…” the student told the group.
The final evening, a farewell dinner was sponsored by MCHC at Las Vigas Steak Ranch, a landmark eatery in Nogales, Arizona. Asked about the week’s impact on future plans, one student commented,” This experience made rural medicine a VERY real potential in my future goals.”