A Letter Home from students on the IHP Health and Community: Globalization, Culture, and Care Track 1 Spring program:
The IHP Health and Community Track 1 Spring program began its comparative journey to explore concepts of health, well-being, and community cross-culturally in the distinct U.S. city of New Orleans. During the launch, we prepared ourselves to critically examine not only systems of care, but also our own perspectives, seeking to understand our own worldviews and how these shape our experiences. In addition, we began building our own traveling community of support. From webs of interconnection to celebrations of diversity, we initiated sharing our hopes, fears, and life stories with one another. We also created community standards to guide our interactions both within and outside of our mobile community for our four month journey together.
With its unique culture and history, New Orleans provided an ideal setting to start our experiential journey. In addition to building our own learning community and orienting ourselves to the IHP experiential model of education, we were able to begin exploring our program themes stateside. From guest lectures to NGO site visits, we learned about the meaning of community to the inhabitants of New Orleans as well as about the context of health services in this community that was decimated by Hurricane Katrina in 2005.
A great deal of our education about New Orleans, Hurricane Katrina, and the health system in the city came from our guest lecturers. Our first guest lecturer, Brian Burton, gave us a crash course on the Affordable Care Act. While some of us had background knowledge on the bill, this lecture was particularly illuminating because it addressed the real life implications of the ACA for the people of New Orleans. The state of Louisiana has struggled to provide access to healthcare for all of its citizens. However, Dr. Diana Davis and Dr. Cassandra Youmans reminded us that access to health care, even if possessed by a New Orleans resident, is not the only prerequisite to good health. A variety of factors such as lifestyle choices, genetics, socioeconomic status, and environment all impact health in various ways as well. For example, the leveling and renovation of dilapidated buildings after Hurricane Katrina caused the underlying soil of many areas to become filled with lead. Many of those who live on these properties are low-income and African-American populations. In this sense, access to health care becomes only one of several issues families face with regards to health. As we continue our journey, we will continue to observe how these factors come together in reality to shape the health of those in India, Argentina, and South Africa.
In addition to the invaluable insight we gained from our guest speakers, we also had the opportunity to be participant observers in New Orleans. To gain a greater understanding of place, our group split up into six different groups to explore different neighborhoods in New Orleans – Treme, Mid-City and Marigny (triangle). Each neighborhood varied in how the residents interacted with each other and how they perceived each group of IHP students. How we were perceived as individuals by each community was very telling of how New Orleans was and still is affected by Katrina. We were assumed to be tourists, researchers, local students, or housing surveyors looking to buy land. Our perception of each neighborhood and New Orleans rapidly changed with each new local or resident we spoke to. Although New Orleans seemed very foreign to many of us at the start of the program, we started to understand the strong implications of history, culture and music to NOLA locals. In addition to speaking to members of the community, we also observed and noted the availability of and access to fresh food, transportation and medical facilities to dive deeper into our understanding of community and health in New Orleans. Our neighborhood visits allowed us to understand the communal celebration and values put into the history of the city because it showed exactly how much Katrina has become engrained into New Orleans, shaping and affecting the neighborhoods and the community as a whole.
To further our understanding of the effects of Katrina, we visited various NGOs in the areas most devastated by the hurricane – the upper and lower 9th ward. The difference between the upper and lower 9th ward was stark and powerful. The upper 9th ward had been an empty lot before Katrina while the lower 9th was densely populated and full of music and culture. When the levees broke, the lower ninth ward was flooded up to the roofline and today is still largely unpopulated due to the devastation. Habitat for Humanity built home after home in the upper ward and apart from the large problem of respiratory issues relating to the drywall, the area has been a successful model with many musicians living in what is called Musician’s Village. Habitat also assisted in the construction of The Ellis Marsalis Music center. This center provides a site for children to go for after-school programs and learn to play an instrument, connect with community, and receive mentorship from the great musicians of the area. The lower 9th ward, however, is still home to a small number of families. With the initiative “Make it Right,” Brad Pitt helped build homes in this ward, but unfortunately most of homes were not built with the weather conditions in New Orleans in mind. The eco-conscious glass-infused wood has rotted in many of the houses and few of the homes have covered patios to protect against the strong rainstorms in this area. Both of these NGO efforts had some success as well as lessons learned that revealed the challenges associated with rebuilding.
Our NGO day was an invaluable opportunity for us to meet representatives from local grassroots organizations and/or development NGOs that were trying to make an impact within the various communities of New Orleans. Hurricane Katrina was an important topic of discussion, particularly for understanding how these NGOs felt they had some ripple of change with the locals they worked with, but also how the demand for their services and interest in their work changed in its aftermath. Our respective groups visited the site of an NGO during the day, where were able to see their work and how the larger agenda of their organization functioned in a physical setting. At night, we had the additional opportunity to again split into groups, and dine with an individual representative on a more personal level, coming from a range of backgrounds and professional disciplines and approaches, of a different local organization. This person-to-person interaction nicely supplemented the other kinds of information on New Orleans we were receiving from our country coordinator, guest lecturers, student-facilitated neighborhood visits, and traveling faculty-led class discussions.
As a result of our experiences in New Orleans, we gained valuable insight into the importance of understanding personal and community narratives before implementing programs and offering help. Through our explorations, we discovered that high risk groups in many parts of the parish of New Orleans have not benefited much from top down programs that are disconnected with the root causes of the problems people face. Grassroots organizations like Common Ground Relief have helped people rebuild and feel supported because they deeply understand where the people are from and why they have felt abandoned time and time again.
Although our time in New Orleans was brief, our various lecturers and site visits provided us with extraordinary opportunities to hear from community leaders in both the medical and public health fields. Surprisingly, however, we learned a great deal from the locals that we interacted with on a daily basis, whether on a bus ride or on the street or in cafes and restaurants. The people of New Orleans exude a pride that few of us have witnessed within our own communities at home, in their culture and in their ability to withstand Hurricane Katrina, socioeconomic difficulties, and racial tensions. As we spoke to locals and interviewed them about their communities, we began to understand that this pride significantly impacted their appreciation for what is referred to as “local knowledge.” We heard from residents of the Lower Ninth Ward, who were devastated by over 20 feet of flood waters during Hurricane Katrina. These residents passionately contested that several national NGOs did not consult with the communities in the re-building process and, thus, added to their burdens rather than providing relief. Clinicians who were involved in their patients’ communities were more equipped to address the societal and behavioral health conditions that these populations faced and continue to face. The historical isolation of the city from the rest of the nation, its unique culture, and the effects of the hurricane have intensified the people’s trust in their own neighbors and have unified the city as it continues to face hardships. As a group, we have grown to admire this deep sense of community and are looking forward to experiencing a similar trust in local knowledge in the cities that we will visit in India.
Our short, yet informative, two weeks in New Orleans laid an invaluable foundation for our semester together. Only from a solid understanding of our local context can we begin to explore topics of health and community beyond our borders. We were all moved by the resilience and passion of the community of New Orleans that we had the privilege to connect with. We also truly valued the opportunity to get to know our classmates and build bonds that will challenge and support us as we move together to India. Though we have learned an immense deal of information from our time in New Orleans, we are just beginning our journey of experiential learning. We hope that our time in India, South Africa, and Argentina is as academically and socially fulfilling as these first few days in New Orleans!
Team New Orleans
Ashley, Faiz, Rachel, Noam, Wayne, Bridget, & Leah