Pennsylvania Department of Public Health

Student Interns:

Jacob Kalmanovich, Nidhi Khadke, Viliami Tillage, Nicholas Young

Jacob Kalmanovich - "Community of Health Center 10: A Narrative about Difficulties, Togetherness and Strength"

Togetherness, was the first word I was given when I asked “How would you describe this community. My site is Health Center 10, a city health center placed right in the center of Northeast Philadelphia in order to best serve its community. While this community is largely an immigrant population who speak a variety of languages including Portuguese, Spanish, Russian and Hindu, togetherness is the first word that was used to describe it with family being a close second. Togetherness and family are the first two words used for many reasons. Other than family being important to every person individually, the community itself comes together and acts as a family that help each other. Even the staff at the Health Center are like a family that help each other through issues that may come up. Every patient who comes into the clinic have their own difficult circumstances that they are working through. They are recent immigrants working through the dubious citizenship process, single mothers with multiple kids to take care of plus a job, fathers working multiple jobs to feed their family, kids of all ages doing their best to grow up healthy, and the list goes on. Everyone’s difficult circumstances are unique, yet they all do their best to come to the clinic.

The third word used to describe this community is hardworking, which brings me to my next point. Despite the challenges they face every day, they keep moving forward and persevering in order to give themselves and their loved ones a better life. They continue to do this despite the pandemic, which has only made matters more challenging and complicated. Many of the patients who visit this facility require insulin for diabetes or eliquis for blood clots. Due to the fact that there aren't many nutrient-rich foods in the area, maintaining cardiovascular health is very important and increasing knowledge of how to do it can be helpful. The only thing the pandemic has done is made the journey to get healthier food longer and more expensive. Either the nutrient-dense food is too far away or too expensive. There is only so much the Health Center can do without the need to address the lack of resources, despite the fact that it employs resource navigators, benefits counselors, a section called WISEWOMAN (Well-Integrated Screening and Evaluation for WOMen Across the Nation), and the PAP office which tries to get medication for free and gives out samples to try and hold them over. Oral health and Tobacco are also very important, and thankfully the health center also employees Dentist, smoking cessation programs and med-assistant treatment if necessary.

Tied to the difficult that the pandemic did in terms of price and distance, another thing it added to the community is stress. Now parents/any adult has to work more and harder hours to afford what they need to take care of themselves and their family. They are doing this over the potentially looming threat of a COVID-19 infection and the effects that can have. Many don’t have the luxury to take a “sick day” or a “day off” those days can be the difference between being able to afford groceries for two weeks, or rent. There is so much fear stemming from this pandemic that affects everyone. Over the recent month, another thing that impacted the community is all the shootings. They have become so frequent that the general consensus from the community is that they are just tired from it which is the saddest part. Instead of being scared, they are tired just because of the sheer amount that goes one. Imagine, the mental impact that are going through their heads when they started to become “tired” from the shootings instead of scared. All the desensitization they must have went through. The fact that the people in the community are still pushing through it shows resilience which is the 4th word used to describe the community.

This is the community around the Health Center. A community filled with a diverse group of immigrants that are respectful and autonomous. A community of adults, children, mothers, fathers, grandparents and so much more doing their best to put their best foot forwards. A community that exudes togetherness, family that is hardworking and resilient. A community I am honored to serve.

Nidhi Khadke - "Miss. C"

This summer I had the opportunity to work as a Patient Advocate at the City’s health centers. Below is the story of a member whom I found quite inspirational, Miss C., a Lawyer at the health center, and she is the founder of Philadelphia’s Legal Aid Law Service program. Miss C. splits her time between the health Centers 3 and 4 throughout the week.

What do you want people who do not know about your community to learn about it?

I want them to know that people are a lot more open, friendly, and amazing. People are diverse, open, and kinder than we think they are, and Philadelphia is quite a warm and inviting city.

What is great about your community (what do you love about it)?

I love that there are people here from diverse backgrounds and ages and that brings a wonderful mix and richness to the community.

Will you share a favorite memory of living in this community?

Once at my church, I met a woman who had a lot of difficulties. She had a seizure during coffee hour. I got to learn more about her at that time, she had no sort of identity proof, and she neither had any insurance to treat her nor a social security number. It was quite difficult to get her treated as she had no source of identity proof even to get admitted to the hospital. At that time, I realized the importance of community spirit. People at the church warmly welcomed her into the group and decided to help her as they did everything in their power to get identity documents for her and managed to get her treated as well. This makes me realize that together all of us can achieve a lot more by helping the community and spreading the sense of well-being all over.

What are the resources and strengths of your community?

The resources are the Public Health Centers, Legal Aid Law Community in Philadelphia, and quite a few Domestic violence resources. The strength of the community is that they have a sense of wanting to work together which I find quite heartwarming.

How have the events of the past month affected your community?

The pandemic has instilled fear and anxiety among the community members, and it seems to have taken away the sense of hope. The rising violence cases in the city have made it more difficult as people find it unsafe to live in this environment. I think The Trump era negatively directed the community as it inflamed the right-wing extremists.

How has covid-19 affected your community?

It harshly affected the community as people lost jobs and homes. There was a lack of hope for the young people. It was a divisive time with a lot of financial and career stress and there were almost no public gatherings which resulted in a lack of togetherness feeling.

What does cardiovascular health mean to you?

There is a big problem in this country with a lot of processed food which is jeopardizing the health of the community. People consume a lot of processed and fast food which directly affects cardiovascular health.

What resources in your community promote heart health/stress?

We have Farmer’s Market for healthy fresh food, people could utilize this resource. Have more meet-up groups so that people in the neighborhood can come together to exercise.

How have the events of the last month affected you?

Having daughters, the Roe. Vs. Wade's overturning was very upsetting. I am not pro-abortion, but I am pro-choice, I feel people should have the opportunity to decide what to do with their bodies, this is another form of right-wing extremists taking over. That was stressful and concerning to me recently. Also, all the violence going on around the world worries me. I feel the world is not going in the right direction and hope for betterment.

Viliami Tillage - "Something's Not Right"

Something’s not right.

I feel it in my bones

I feel it in my soul

My stomach aches

Something’s not right.

I toss and turn in my bed

I cannot sleep

My work is harder than ever

Something’s not right.

I lost my job

The lights are off

My water has run dry

Something’s not right.

My pains grow worse

I need to see a doctor

I begin my hour-long commute

Something’s not right.

The doctor confirms it

I need medicine

Maybe I can return to work

Something’s not right.

I have no money

I have no insurance

I have no documents

Something’s right

I sign my name

I get my medicine

I feel better

Something’s right

My pains lessen

I can sleep

I can work

Something’s right

The lights are on

The water is flowing

Balance is restored, for now…

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This piece is meant to represent the struggles and vulnerability of the patients we serve through the Patience Assistance Program (PAP) experience. It is not meant to be an exhaustive representation, as the uniqueness of each patient experience could never be fully captured in one place. Rather, I hope that this poem highlights the value of programs such as PAP within a broken healthcare system.

Nicholas Young- "Pursuit of Complete Health"