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According to the Greater Richmond Partnership, the Richmond Region has more than 4,100 physicians and 19 acute care and specialty hospitals with nearly 4,000 staffed beds. While Richmond has highly regarded health facilities, Richmond is home to significant health disparities across the community. Individuals living in Richmond's West End, near University of Richmond, have a 15 year difference in life expectancy from individuals living in the East End, just miles apart. Institutions, non-profits, local government, community organizations, and advocates work to create health equity throughout Richmond.

Michael Bonifonte
Michael Bonifonte

 

Michael Bonifonte
Majors: Computer Science & Chemistry

 

When I sent my application to the University of Richmond, I will admit that I knew just about nothing about the school. When the admission essay was “Tell us about spiders,” I just took that as some strange joke or psych out, and I nervously wrote something down about how most spiders aren’t harmful to humans, and the sad state of the American attitude toward them. I only found out the spider was the mascot months later when I received my admission letter in the mail, and, let me tell you, I felt quite dumb at that point.

What I did know about the school was that it had the Bonner scholar program. You see, my brother, now 31, went to a liberal arts school in Ohio and was involved in the program there, and always told me what he did there and how great an opportunity the program was. He actually met his now wife, my sister in law, through the program, and they’ve been together for about 10 years now, so it was kind of always double pressure. So, I looked up which schools offered the program, and sent applications to a few of them. Armed with the knowledge that UR had the Bonner Scholar program, they were offering me a ton of money, and the faulty assumption that Richmond was a coastal city (still disappointed by that one, thank my public school’s geography lessons), I decided to enroll.

Now, I’ve just been telling you about how little research I did into what was the biggest decision of my life, but I actually did want to join this program. In high school, I did a lot of volunteering. I was the treasurer or president of a few service clubs, I ran fundraisers, I sold cupcakes during lunch, went to conferences, did all of that. I worked at a soup kitchen every saturday for nearly three years. It was good, old fashioned volunteering. So, it was kind of a surprise when I came here and first heard the term “civic engagement” from the program. In the past 4 years, I think I’ve been coming to terms with the difference between the “volunteering” I did in high school, and the “civic engagement” I have done while here.

Coming from one of the worst performing high schools in my state and a less than well off family, the term civic engagement always seemed kind of.... pretentious, in a way. Why not just say volunteering? Language is powerful, there has to be a difference, right? As I’ve come to understand the divide, civic engagement is a “higher” form of volunteering. When I worked at the Capital Region Collaborative office, I wasn’t volunteering for them, I was civically engaging my community here. I did social media, communications, grants, anything and everything that needed to be done in a 2-3 person office. I can count on one hand the number of times I interacted with somebody outside of the office while there.

And it was important work, and I am proud of my time there. The spread of information, and assistance to other non-profits is an important goal. But, compared to my three years at the soup kitchen washing dishes, cutting vegetables, serving people, I think that there is at least a clear divide between volunteering and civic engagement, for better or for worse. And my point is not to say that one is more important than the other, or better than the other. On the contrary, I think that it is vital to have both. I could never have volunteered at the soup kitchen if there weren’t somebody in the background organizing their grants and food distribution, but they wouldn’t have gotten very far without volunteers.

When I was discouraged about my lack of fundraising results as a kid, my mom used to always tell me “You can give time or money, organizations need both.” I always thought that was a good way of putting it, but I would amend it slightly to cover the distinction I’ve been talking about. I personally seem to gravitate more towards volunteering, and I have greatly enjoyed my time at the Science Museum this past year, running workshops and challenges in The Forge, the Maker Space at the Science Museum. When I joined the Bonner Scholar program four years ago, the only “volunteering” opportunities seemed to be in education, and I am glad that today’s freshman have more options than ever on what they can do to help their community, and I know that the program will only continue in the future.

In my personal future, I am going to work to balance a corporate job with volunteering as much as possible. From what I have read, the community I am moving into will be just as welcoming as Richmond has been the past four years, and it will need just as much help. I know that striking the perfect balance between my work life and my volunteering will be hard, but I am looking forward to continuing my journey with civic engagement and finding that equilibrium.

Dario Falcone
Dario Falcone

 

Dario Falcone
Major: Physics

 

Self. It is what defines us and guides us. Stemming from no singular source, it exists as collection of us and our own experiences. Fluid and ever changing, self grows as our perception of the world grows. In this sense, self is, at all times, beautifully unique; an individual result of our own lives. Today, I aim to describe how my sense of self changed over the past four years and how my Bonner experience culminated with other aspects of my life to affect my present reality and shape my aspirations for the future.

My decision to come to Richmond was the result of impulse. A week before I graduated high school, my high school lacrosse coach called me and said the Richmond coaches were going to call and offer me a spot on their team. When this happened, I should to thank them and accept the offer. At this time, so much of my understanding of self revolved around the idea of playing a collegiate sport that I blinded myself to any other possibilities. Before this call, I planned to be a regular student at Ohio State. After this call, I was a Division 1 lacrosse player; attending the University of Richmond was just an afterthought of that result.

To say that I knew nothing about the University of Richmond would be a stretch, but not by much. I toured the school as a lacrosse prospect during the summer after my sophomore year of high school. With little to no students on campus, I saw the buildings and the campus and gained a better understanding of what life as a lacrosse player at Richmond might look like but I gained no knowledge of the student body, the city, or the sense of community that the university offered. I remember walking away from that day with a general sense of indifference toward the school. I could not tell you if the it felt too big or too small, or if it offered programs that interested me, or perhaps most importantly if it seemed like the kind of place where I could fit in and find my niche. To me it just seemed like just another school. Combining this perception with the little bit of reading I did online, I walked onto campus as a freshman lacrosse player without any idea of what to expect from the University.

I do not remember my exact hopes of my first semester of college, however I do remember them varying greatly from reality. Although worn done from the physical strain of Division 1 athletics and the emotional toll of life away from home, I think I struggled with anxiety the most. Whether family, friends, coaches, teammates, or professors, I could not shake a constant feeling of letting people down. Drained, yet struggling to find sleep, I spent a great deal of those first few months sick. Even with the turbulence of my first semester, I went home for winter break with the full intention of returning in the spring to play lacrosse. Then something changed. Over the course of break I flew to California to attend my grandfather’s memorial service. Through the celebration of his life I began to reflect on my own. Oddly enough, in these times of reflection the words that rang most true were those of a college football coach who had been recruiting me in high school, “College isn’t about the next four years, it’s about setting your path for the next forty”. Gradually, I began to accept the difficulties that loomed over my first semester and concluded that somewhere between high school and college I allowed to much of my understanding of self to be consumed by one thing; lacrosse. Within a week of returning to Richmond in January, I decided to quit the team.

I spent that spring considering schools to transfer to however my academic struggles of first semester did not afford me a great deal of options. At the same time, to make matters seemingly worse, a class in public policy began to deter me from my unofficial major of environmental studies. Although I enjoyed the class and still retained my passion for the environment, it quickly opened my eyes to the murky waters that surround building and implementing policy. Lucky, as one door closes, another seemingly opens and I began taking my first mathematics course at Richmond. I had taken basic calculus in high school, yet something about the idea of college mathematics seemed terrifying. As the semester progressed though, I found that my previous exposure to calculus had well prepared me and I began to thoroughly enjoy the material and its various applications. As I reflect on my college experience, I now realize how pivotal that first calculus class was. Not only did it show me that I could succeed academically at Richmond, it also provided me with a certain confidence and momentum so that when all the environmental studies classes filled up for the fall I did not hesitate to take a second calculus class and my first physics class.

I began my fall semester of sophomore year with the intention of getting my grades up to transfer in the spring. However, as the semester progressed these thoughts faded and I began to accept Richmond as my home. Instead of transferring that spring, I declared my major and minor. Feeling that physics and mathematics provided me the greatest tool set for after college, I became a physics major and a mathematics minor. Yet, despite the academic achievements I occurred over that year, as I left campus for summer break something still felt astray. Learning from the mistakes I made my freshman year, I worried that I was allowing too much of my identity to be defined by one aspect of my life and felt the need to broaden my horizons so I might expand my understanding of self. Then that summer, I received an email from the Bonner program seeking new members. Although I did not fully understand dimensionality of the program, on the surface it seemed like the perfect opportunity. Thinking back to the words of that college football, I decided that I wanted my future self to always feel invested in the people and places that I surrounded myself with. Yet, in my first two years I did little to expand my understanding of Richmond’s diverse campus or and the communities that make up the city of Richmond. Recognizing that this part of my life needed change, I applied.

Unlike most Bonners who began their journeys as freshman, my exploration into Bonner life did not start until a third of the way through my first semester junior year. In turn, the way the program came to affect my life is perhaps different than most Bonners. I think freshman year there is a desire to define one’s self and thus naturally, for individuals who start the program as freshman, Bonner plays a greater role in shaping their lives. In my case, I was not looking Bonner to help define me, but rather to gently guide who I already was to a more illuminated version of self. I spent that fall volunteering with Learning Through Technology and Language and Higher Achievement. At the same time, I had the unique opportunity to take a class on the evolution of American mathematics. Although the first portion of the class focused on the rise of research level mathematics in American, the second half of the course was open for each individual student to research an aspect of American mathematics that interested them. Given my curiosity in the Space Race, I decided to focus my attention on the turbulence in mathematics education reform from WWII to the early 70’s. As the semester tolled on, my Bonner experiences began to mix together with my research and I found myself examining American education through a different lens.

After WWII, there existed a known need for reform to American mathematics education yet this need fell on the deaf ears as the country celebrated in the prosperity that followed the end of WWII. Then in 1957, the Soviet Union launched Sputnik into orbit sending a wave of fear over the American people. At the heart of this terror lay the fundamental idea that intellectual inferiority, especially in S.T.E.M related fields, puts a country in a poor defensive position against foreign attack. To quell this rising panic, American politicians poured massive amounts of money into American mathematics education reform. While these reforms ultimately proved helpful in subduing the short-term anxiety within the American public, as source of positive change to the American education system they were a complete failure. Why? Because education reform should not be response driven, especially as it pertains to S.T.E.M education. When education reform is implemented with the perception of a solution to a current issue, it allows for political agendas to manifest themselves in education. In turn, like in the case of the reform that followed the launch of Sputnik, there exists a lag supportive infrastructure leading to a general sense of confusion and eventual failure. As I finished up this class and my first semester with Bonner I saw a change in my understanding of self. Beyond learning physics and mathematics, I wanted to play a greater role in supporting the institutions that worked to gradually improve the public’s, and especially children’s, understanding of S.T.E.M material. Recognizing this passion, I applied to service sights whose main focuses were education, although I was disappointed to see there were no service partners whose focused primarily on S.T.E.M education.

Over the course of that winter break, every service site I applied to rejected me. Rather than feeling worried, though, I gained a general sense of relief. I could now try to find a sight more aligned with my S.T.E.M interests. Within a few days, I discovered the Science Museum of Virginia and within the next few weeks, with the help of the Bonner staff, I began volunteering there as my full-time sight. My role within the museum revolved around helping to facilitate and design S.T.E.M related workshops for the museum guests which I thoroughly enjoyed. Unfortunately, due to my late induction into the Bonner program, the struggle of managing Bonner commitments and academics, and the general difficulty of translating college level physics and mathematics into workshops for children, I failed to accomplish as much as I would have liked at the Science Museum. However, that only gives me greater motivation to continue my commitment to service the future.

Although abbreviated, I never felt that this shortage of time belittled the impact the Bonner program had on me. In fact, I think it came at the perfect junction in my life. As a freshman and sophomore, I needed my own time to discover who I wanted to be outside of lacrosse. Once realizing physics and mathematics were my passions, the Bonner program helped me to understand that these passions did not necessarily have to always live inside the classroom. Sometimes, in the world of physics it is easy to feel untethered in a swirling sea of mathematics and theoretical thought. Bonner taught me that by applying the complexities of higher level mathematics and physics to better service my community I could find a sense of grounding while also being a source of meaningful good. With the outbreak of COVID-19, like much of the class of 2020, I am not sure what my future holds, but thanks to the Bonner program, my professors, and the team at the Science Museum of Virginia I feel prepared and eager for whatever challenges lie ahead.

Gibran Merchant
Gibran Merchant

 

Gibran Merchant
Major: Psychology

 

Luca O'Brien
Luca O'Brien

 

Luca O'Brien
Major: Healthcare Studies

 

Life was difficult growing up in a household without a father and a single mom working two jobs. My mom is an Italian immigrant and was raised with a strong work ethic working on her farm as a kid. My mother taught the importance of a hard work ethic and what you can achieve with dedication. She also taught me to be appreciative of what I have and to give back to others that are less fortunate than us. I have faund memories of volunteering with my mom and sister at Ronald McDonald house in Orlando where we would cook and serve meals to the guest there. I always enjoyed talking to the guests and listening to their life stories and struggles they have gone through and offer my support and sympathy. Since then community service has become an important aspect of my life and I was excited when I was accepted into the Bonner program during the summer before my first year at Richmond.

I believe that throughout my time as a Bonner scholar I have come to gain a greater understanding of my identity and what kind of person of service I am. Throughout my time volunteering at Crossover Health Care Ministry I have found that I enjoy helping others directly, especially with issues related towards health. Health and fitness are such important parts of my life and I feel fortunate that I grew up in a city that places a heavy emphasis on fitness and health. It is because of the fitness culture in Orlando that I started working out and learning about proper nutrition and fitness.

I wanted to take this passion and be able to apply it to my service and I have made efforts with multiple projects at my site to show my interest in this area. Unfortunately, my site does not have the proper resources to support these projects even though they would have liked to. One of the projects that I worked on that was almost implemented was the nutrition for depression pamphlet I created. The aim of the program was to help patients see the connection between diet and depression. I understand now that I can only help them the best way they see fit and this may not align with my project goals. With the experience of the trial and error of implementing health programs I realized that this is the type of physician I want to be. I want to be able to work with people with their nutrition and fitness goals and is why I am choosing to attend chiropractic college in order to be a chiropractic physician. I feel my service has helped me realize what I really am passionate about and that I want to live a life of service by helping people with their health in a holistic manner.

I have seen many complex issues with patients at crossover but the most difficult one that the clinic had to deal with recently was the transition of taking people with medicare/medicaid. The clinic had to go through a screening process to get all the people that were eligible for these services applying so that the clinic could get federal funding and help with the clinic expenses. The issue was that there are so many patients that don’t have social security or don’t have the right income information or other difficulties. Most of the patients applying are very low income and do not have all the proper documentation or face other issues to get care. I was working with the clinic on screening all the eligible people and I can say that it was a very difficult experience and caused a lot of stress and frustration at Crossover. Despite the difficulties, the clinic was able to get all the eligible patients enrolled.

I have also seen many structural issues at Crossover since I have been there and have been fortunate enough to have the skills needed to fix some of these issues at crossover. I have done many construction related jobs at Crossover like dissemble and assemble cubicles, organize office spaces, move furniture, and much more. I feel like the office handyman and I am happy that I have found a way to help crossover on top of my normal duties in the pharmacy. I have painted over 6 patient rooms since I’ve been at crossover and I have seen a real change in the way that providers and patients interact. A cleaner looking and more inviting atmosphere makes a difference when the day is already very stressful. I get a smile on my face every time someone passes by and says the patient rooms look great. I know that when I leave crossover I will have left a mark on it through the hours and effort I’ve put in and of course all the new paint I put on.

I am thankful for the Bonner scholar program showing me the true meaning of service. My civic engagement has shaped who I am today and made me think about how I would like to give back to the community once I am a chiropractic physician. I have already discussed this in my Justice and civil society class and I would like to allocate time in my clinic to help those that are low income and do not have insurance. I think it would be reasonable to donate about an hour each day to seeing these patients and informing them on how they can prevent certain back issues and be more self sustainable with their health because they do not have insurance. For me I would find a lot of value with this method of civic engagement because I am using my passion to help people with health in a positive way that gives back to those that can not see a physician for whatever reason.

I would also like to become involved in a project that is called waves for change, that teaches low income youth surfing in order to teach them skills that will aid them in life and form a community of youth that support each other in a positive way. Because I will be in Daytona Beach for the next 4 years in Florida I thought that it would be a key opportunity to try and start a community service aspect for the surf club that they have at my graduate school. I am looking forward to continuing my civic engagement in ways that will allow me to embrace my passions like watersports and also give back to those that are less fortunate.

Ahkar Phyo
Akhar Phyo

 

Ahkar Phyo
Major: Biochemistry & Molecular Biology

 

Back when I started Bonner freshmen year, you know what, just thinking about the 10-hour weekly commitment seems like a chore. Like who wakes up before the sun even rises to go to downtown Richmond when most students are sound asleep? At first I thought, this is just some task, I just check off the list, something you just do, you know. But, throughout my four years working with different sites, I now see that each site is more so like a living ecosystem of others we can help and are essentially connected to both you and I in some way or another. From my sites, I was able to find self-passions and learn more about myself and be one more step further in being connected to my community.

More than anything, these four past years of service has shown me the impacts I can have on the lives of the people in the community. Take for example my service at VCU. Through my first couple of times there it seemed very repetitive work. Helping people around the hospital, greeting them, transporting patients, and some restocking to everything else. People were helped but it seemed as if nothing really was impacted. Like as if my service was just there and somewhat unnecessary. But, one day I learned that this wasn’t the case. Out of every hundred people I help at VCU, maybe ninety-nine would just go about their way as if they did not really need me. But what I learned was that, that one person that is truly affected by you is honestly all that matters. Imagine this scenario, after weeks of just people asking for directions some lady mistakenly comes to the desk you are at and thinks its an emergency room. The staff at the desk can’t leave the desk and it takes too long to have someone come and get her to take her to the ER. What do you do? You grab a wheelchair and help her get there of course. She was having very bad stomach pains and was hyperventilating. I couldn’t do much at the time, but doing something is better than doing nothing. When I was helping her, I struck a conversation and asked her name and what was wrong. Then I talked to her and had a conversation with her to calm her down as the path to the ER was many minutes away. She was breathing heavy, but all I wanted to do was to keep her comfortable, and when we got to the ER she was so exhausted she couldn’t talk. As I remembered her name and her principle complaints, the ER was able to check her in quickly as I told them. What did I learn from this? That even if you are doing hundreds of repetitive work that somewhat helps someone, but have the chance to make a great impact in the lives of others in times of dire need, then waking up early in the morning and sacrificing your good time was all worth it. This is in sense fighting against the bystander effect we have learned in our classes.

Over the years I one thing that I understood about my identity, was not that I volunteer in sites because they align up with my beliefs and rank of importance like healthcare for VCU and education for RVA future centers, but it was rather I found how impactful I could be to someone’s life. Looking at it in a utilitarianism point of view, my time loss is nothing compare to the impacts I can make in the lives of others. My few hours lost was nothing compared to the half hour more the lady could have been in the lobby in pain. And that is what I learned about my identity, that I don’t do it for the hours, or for checking things off a list, or to help the people who barely need your assistance. But, I rather do it because when you are in the position of power, to help someone get through dark times in their lives or life obstacles, is the right thing to do. When you can help anyone in anyway where their gain trumps your minor loss, it is the only logical decision. Even if it is a single person. It is essentially the quote, “Evil prevails when good men fail to act.” Don’t be a bystander and not help because someone else could do it. I learned that you always must be an active citizen and always give full effort whenever you can help people. Even if you are helping with patients with directions, ask them how their day was, or just try to make their day that much better. Little acts of kindness and actions may go a long way. Experiences like this is what shaped me. Not the big repetitive parts of service I do, but it is these little experiences that has taught me the most important aspects of service. Looking back to my identity, at the beginning of freshmen year, I just thought of as volunteering as something you pass the time or do minor tasks, which is generally true. But, through this experience I have seen how sometimes, we are given the chance to go above and beyond to help those in need and that is what service truly in my opinion is.

Through these service experiences I have improved much in the areas of active citizenship and the constant drive for lifelong learning. Throughout my four years of service, I have learned the importance of being an active citizen rather than being a passive one. Being involved in your community gives you not only a sense of belonging but also a connection to everyone, especially those different from you. I feel like now a day’s people associate with those similar to them and in turn force themselves and the other half to be separate. But with active citizenship and being involved in the community from all walks of life I am given the opportunity to help those different from me and not only help them but also learn from them. This brings me to the biggest point. When I try to relate my academics to my experiences at UR, I really can’t, and that I believe is the point. That these meaningful experiences in serving others, teach us what we can’t learn in class and that is important. Throughout my time I have developed professional skills in the workplace and in social environments, but most of all I have greatly improved my communication skills with diverse populations which I hope will help me with anything I do in the future, because I believe that excellent communication is key when interacting with those different than you. From my service I have seen the impact I can have on others with small random acts of kindness. After graduation I hope to continue the act of active compassion and service of others in my community, that is where ever I may be, I know that if I have the ability to dedicate my time, if only a few hours a week, to help those less fortunate, it is of utmost importance I am an advocate of that service. I leave here and in the years to come, I hope that I have built upon the idea of active citizenship and practice a life of learning, constantly engaging with my community and try to make everyone’s day just a little brighter every day.

Valerie Sato
Valerie Sato

 

Valerie Sato
Major: Biology

 

Throughout my college journey, I have grappled with the task of learning who I am, what I stand for, and how I will make an impact on my community. At the University of Richmond, I have been made greatly aware of my socioeconomic status, race, and upbringing. Because of this, I strived to push beyond those categories in order to find myself immersed in an area of society that I could thrive in.

My freshman and sophomore year, I was a refugee resettlement assistant at Catholic Charities. At this organization, I came into contact with many parents and employment-eligible children who were in search of a job that would sustain their family who just arrived in the United States. I was able to listen to clients’ dreams, hopes, and aspirations as they began their new life in the United States. These goals ranged from becoming a firefighter to working in a pharmacy. At Catholic Charities, I was able to learn about my own skill of listening with empathy and how I could translate these skills into a career in the future. Through this experience, I have been able to gain more insight to what I am most passionate about, which is providing an individual the means to get to where they want to be in life.

This past semester, I was taking an Uber back to campus. I normally don’t go beyond small talk with drivers, however, this driver struck up a conversation and started to talk about how he was from Afghanistan. He discussed how he came to America 8 months ago on a Special Immigrant Visa, and how he is doing well, and is now trying to solidify his place here in the Richmond community. I got super excited and immediately asked if he had ever heard of Catholic Charities. Lo and behold, he actually went through the resettlement program with Catholic Charities and knew everyone in the same department that I just interned at last year. Seeing a client fully integrated into society was crazy to me, as I only saw clients in the space of Catholic Charities. This encounter was a great look into how the work impacted the clients beyond what I saw from the inside of the organization, as much of my interactions with clients have been working together to fill out job applications. My whole internship experience at Catholic Charities has pushed me to continue to interact with purpose and empathy with patients at my current site, which is VCU Health.

This site has truly opened my eyes to the disparities in healthcare. In the medical psychiatry unit at VCU Health, I’m able to work as a Care Partner with a population that has the potential to be immensely different from the rest of the hospital. Individuals in this unit are expected to verbalize their feelings, and become a vulnerable, open book in order for their healthcare team to understand them and their current situation. Additionally, we have individuals ranging from the richest of the rich to individuals who are homeless, and have no one to turn to after leaving the hospital. I have assisted many patients who have expressed their concerns of not having any way to pay for their hospital stay, and that the stress stemming from being unable to afford the healthcare they are receiving is ultimately inhibiting their ability to heal. Through these conversations with patients, I have reaffirmed my position that no matter what background you come from, healthcare is a right that should not be compromised based on a lower socioeconomic status. I also believe that working to lower costs of treatment and increasing access through affordable insurance plans would ultimately encourage individuals to seek out healthcare, rather than straying away due to the costs attached to it.

Aside from the inequalities of healthcare, the biggest takeaway from working in psychiatry is that healing happens through empowerment. Of course there are medications and procedures that can cure a patient of a physical and mental illness, however, empowering an individual to take the reins and work towards their dreams takes that individual to a new headspace that can transform their perspective on life. In medical psychiatry, this empowerment can be as little as encouraging a patient to stand up and walk to the dayroom to watch TV, or to take a shower and get dressed in their own clothes, rather than wearing a hospital gown. One example that immediately comes to mind is a patient that was admitted when I first began orienting on the unit. This patient was catatonic and rarely moved to get out of the bed, unless it was to use the restroom. After receiving a few rounds of electroconvulsive therapy, her condition was much improved, however, she still laid in bed all day and had little to no motivation to get her day started. The nursing team started to encourage her to get out of bed, get showered, attend group sessions, and spend some time in the dayroom to interact with the other patients and watch TV. Her affect improved greatly over a few weeks, and she seemed to be much more driven. In this case, the ECT treatments ultimately solved the psychiatric disability she had, however, encouraging and empowering her to start the day is what allowed her to become more independent and active before she was discharged from the unit.

Through these experiences in Bonner, I have found and reaffirmed my place in society. After three years of trial and error in finding my interests and passions, I know that there is one aspect of society that I will commit to, which is to strive to be a continuous contributor to the efforts in increasing healthcare access and health education to those who may need it the most. Especially considering the current pandemic and worldwide measures that have been implemented to curb the severity of COVID-19, the research, access to healthcare, and overall education of the virus have been emphasized to reach all populations. It is my hope that I will be able to join the force to keep the motivation going to ultimately reach everyone with affordable healthcare and reliable health education in the future.

Ana Shimeall
Ana Shimeall

 

Ana Shimeall
Major: Biology

 

Drive five minutes in one direction from the University of Richmond and you will reach Westover Hills, a picturesque, southern neighborhood that boasts an average life expectancy of 83. Drive five minutes in the other direction, and you will find yourself at Gilpin Court, a housing project whose residents are projected to live only to 63. When I heard about these drastic inequalities in my new community during my freshman year, I knew it was an issue that I wanted to dive into as a Bonner Scholar. In high school, I worked at the Baltimore City Health Department and saw similar socioeconomic differences lead to gaps in health outcomes and was reminded of a mantra that Dr. Leana Wen, the commissioner, often repeated: “there is no such thing as a non-public health issue.” As a result, I chose Crossover Healthcare Ministry as my Bonner site. Crossover is a free health clinic for those who slip through the large gaps in U.S. healthcare coverage, many of whom are undocumented Spanish speaking immigrants from Latin America. When I arrived for my first day, I thought that maybe my high school Spanish would be enough to get by. I quickly realized that would not be the case as I observed the front desk staff, Gina and Eleanor, running around the clinic, talking to three patients in Spanish, English and Spanglish all at the same time - I was overwhelmed to say the least.

Tired of sheepishly calling Gina over to “ayudame con Español”, when it came time to find a summer service site, I knew I wanted to work in Latin America to immerse myself in Spanish and gain cultural perspective to better understand where some of my patients were coming from. As a result, I pursued an internship with FNE International in Nicaragua during the summer of 2018, working in a clinic for children with complex conditions. FNE is an NGO that recognizes the need for specialized healthcare for kids who lack sufficient coverage under the public system, but also believes in implementing this care in a sustainable manner through collaboration with local resources. Rather than treating a brigade as a one time opportunity to receive healthcare, FNE keeps records on the patients and follows up on them in between brigades with Nicaraguan medical teams, supplemented by interns like myself. Therefore, the incoming doctors in each brigade have information on the patients before they arrive in the country, allowing them to analyze patient cases preemptively and efficiently treat patients upon arrival. While I was in Nicaragua, there was severe political violence perpetrated by the government’s continuous attacks on unarmed university students protesting dictator-like actions by the nation’s president. I watched as group after group dropped out of the health brigades to come, leaving us, the on-site team, with patients relying on help that was not going to come. A week later, I was urgently evacuated from the country, becoming probably the only UR student to ever cause the Office of International Education to activate their emergency insurance. I was extracted from my small town by a makeshift Nicaraguan “SWAT” team and taken to an abandoned road where we took off in a plane the size of a car, the only way to reach the airport in Managua without encountering roadblocks and militants by driving. I entered the summer with a desire to become more culturally adept, but left questioning where ethical intentionality fit within global health. I couldn’t help but think about how I had the privilege to leave when the conditions were not ideal by the sheer luck of being born in America, while the people born into circumstances lacking healthcare infrastructure and an increasingly absolutist government in Nicaragua had to stay and face their reality. Why are we entitled to this decision, when they are not even given the choice?

My experience in Nicaragua sparked my passion for the intersection between global health and social justice and inspired me to dive deeper into the study of health systems to learn how to develop a health infrastructure that lifts the most vulnerable populations like undocumented immigrants in America and medically complex children in Nicaragua. As a result, I went abroad to study medical practice, policy and ethics in Denmark, a country with efficient healthcare and impressive outcomes. After dedicating my efforts to serving individuals lacking medical care around the world, I was shocked to find that in Denmark, there were no gaps in coverage. By connecting concepts in my policy and culture classes, I realized that the implementation of cost-efficient policies that enabled universal coverage, like assigning physicians and deemphasizing annual visits, was facilitated by the deeply ingrained Danish reverence for the collective well-being over individualistic ideals. Learning through the collectivist, Scandinavian lens opened my mind to approaches that were not considered in my American courses and convinced me of the importance of striving for a comprehensive, globally informed view.

For my second Bonner summer of service, I returned to Latin America to work in a Peruvian health center. Through applying my new systems level understanding of healthcare to my on the ground global health work in Peru, I found a different set of challenges in health delivery. While Peru’s health infrastructure is relatively robust compared to Nicaragua, the Andes Mountains and Amazon Rainforest presented significant geographic limitations to care access, and the presence of native Quechua in remote areas introduced a language barrier that further impacted health outcomes. I had the opportunity to attend a couple local government meetings with my mentor to discuss the current state of public health measures set to address these impediments to health, and was impressed by the activism and awareness surrounding expanding access to care. In many ways, the Peruvian government’s efforts were years ahead of America’s. In 2007, Peru developed a social health program that gave the most at risk citizens access to basic healthcare for free, covering a fifth of the population. While it is by no means perfect, Peru’s dedication to reaching universal healthcare many years before the U.S. reinforced what I had realized in Denmark - stepping out of the complex of American superiority and learning how other countries address the same issues we face can provide us with innovative solutions. Developing a global view is one of the most important things we can do in the field of health.

My experiences interacting with health in Richmond, Nicaragua, Denmark and Peru, facilitated and ignited by the Bonner Scholars program, have revealed some trends in global health. First, I realized that Dr. Wen was right - all sectors affect health, and health affects all sectors. Lack of access to healthcare coupled with extreme social inequalities create a negative feedback loop that impacts all aspects of an individual's life. While the greater U.S. healthcare system largely neglects the social determinants of health, Crossover works to effectively address all the components of this cycle. At the beginning of this semester, I interpreted for a physician encounter with a patient who had just been diagnosed with diabetes. After the physician explained the medical side of her disease, she was connected with the diabetes care coordinator, a social worker of sorts that teaches patients how to make lifestyle changes that are most important for controlling diabetes, the general social worker, to ensure she would have access to the resources to implement care plans she received, and monthly follow up appointments with physicians and nurses in the clinic to check her progress. If any piece of this comprehensive care plan was missing, a component of the cycle of poor health and poverty would largely inhibit her ability to achieve good health. Second, the political climate in a country drastically affects the health outcomes of real people. At the height of the Trump administration’s border camps, I would read infuriating stories in the news of families being separated and held in unfathomable conditions and then go to Crossover and schedule a psychiatry appointment for a young mother whose family was being detained in those very camps. When Virginia expanded Medicaid, I saw hundreds of Crossover patients finally gain access to insurance. In Nicaragua, political violence led to the withdrawal of foreign NGO resources, leaving patients in a stressful uprising without their usual access to medical care. In Denmark, collectivist cultural ideals and political discourse enabled the implementation of universal healthcare because middle-higher income individuals were okay with their tax money being applied to provide a safety net for more vulnerable populations. While changes in government can sometimes seem disconnected from their people, my direct service has made it clear that politics often directly affects the most vulnerable individuals. Third, no person is more entitled to healthcare than any other person. It is simply the luck of the draw whether or not you are born into circumstances that include access to healthcare, and it is overwhelmingly out of your control if you face health complications during your lifetime. When I asked my Danish roommate what she thought about universal healthcare during my time in Copenhagen, she replied, “Well, I hope I never get cancer. If I don’t, I am lucky, so why wouldn’t I be okay with my tax money going to someone else’s care who was not so fortunate?” Overall, healthcare is a human right, and denial of healthcare should be seen as a violation of human rights.

Ultimately, I plan on attending medical school to acquire the clinical tools necessary to treat patients lacking consistent access to care. However, while this work is important, my time as a Bonner Scholar has shown me that operating solely at the medical level merely places a bandaid over the gaping wound that is the lack of universal access to effective healthcare. I want to learn how we can change existing political, medical, and societal systems to fulfill everyone’s fundamental right to a healthy life. As UR One Book author, Dr. Mona Hanna-Attisha, wrote in What the Eyes Don’t See, “Physicians need to be trained to see symptoms of the larger structural problems that will bedevil a child’s health and well-being more than a simple cold ever could.” For my patients from Crossover, Nicaragua and Peru, I strive to pursue a career in clinical global health by working with intergovernmental organizations, fighting to decrease the socioeconomic based divides in health outcomes I have seen between neighborhoods in Richmond and countries across the world.

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