Every Tuesday, Beyond Boulders runs a five-question interview with either a first-year Schweitzer Fellow or a Schweitzer Fellow for Life (ie, a Fellow whose initial year with ASF has been completed, but whose commitment to lifelong service continues).
Today, we talk with Bartlett Steen and Matthew Wetschler, Kate B. Reynolds Schweitzer Fellows in North Carolina. Working with El Centro Latino, the UNC School of Medicine students have launched Los Coyotes, a running group for migrant Hispanic men that doubles as an informal focus group for health concerns in the community. Steen and Wetschler’s ultimate hope for Los Coyotes? That they’ll be able to step back from it — because it will instead be led by members of the community it strives to serve.
Why did you develop your particular project?
Resource-rich and resource-deprived communities often co-exist shoulder to shoulder. As individuals that find themselves in a resource-rich community, there exists the possibility of acting as a conduit between commodities to which we have access and a community without access to those commodities.
We started the program with the simple idea of trying to be conduits for resources. We tried to have few if any preconceptions as to the needs of the community, and in that regard, planned little as to the “intervention” we would pursue.
Instead we committed simply to being present and receptive — believing that the simple act of showing up consistently can speak more than even the most grandiose of plans. Beyond words, showing up week in and week out actively exemplifies our commitment, and from that a true foundation of trust is built.
The centerpiece of our program is running twice a week. This has obvious physical and emotional benefits intrinsically, and in that regard, even the most skeletal expression of our program responds to the Schweitzer mentality.
Our runs act also as something more, a cross-cultural medium and a way to learn about the difficulties of neighboring communities outside of surveys and formal “needs assessment” initiatives.
As our relationships develop and a sense of trust is strengthened, we hope to find current and authentic needs of the community to which we can creatively direct resources available to us as medical students. Our ultimate goal is to become silent conduits between two neighboring communities eventually stepping back to the role of co-participants in a program led by the community which it strives to serve.
What do you hope will be the lasting impact of your project on the community it serves?
We hope that the Coyotes will serve as a source of empowerment for the Hispanic community. Already in our second season, the runners are gaining a strong sense of pride, both through physical accomplishments as well as through a new identity that the group provides.
Several of the members have lacked consistent means of exercising since migrating from Mexico many years ago. Now, running several miles a week, each member is being proactive about his health — not only physical but mental health. Running has been proven to reduce one’s risk of depression. It makes the runner feel good about himself and about his body, with more energy and endurance throughout the week.
We hope that the runners in our group continue to transform themselves in positive ways, that running with friends affect not only their own lives, but the lives of their families and, on a larger scope, the life of the Hispanic community as a whole.
What do you think is the most pressing health-related issue of our time, and how do you think it should be addressed?
Access. Unequal distribution of health care is a form of injustice that disproportionately causes unnecessary suffering and illness in poor and underserved communities. The excellence of tertiary care, far from excusing our system’s shortcomings, only heightens the inequity. It is difficult for us to take pride in state-of-the-art technology when those who need access to it are deemed uninsurable.
Distribution of resources has been considered outside of the realm of medical responsibility – we focus our education on how best to treat pathologies – yet these decisions are being made daily by businessmen, analysts and lawyers. It seems to be the role of the modern physician to be frustrated with her place in the system – or the system as a whole – yet have no capacity or surplus energy to alter it.
The change must start at an educational level. We must educate future physicians to be versed not only in the classic fare of illness and its treatment but also in the language of business and law. We must have physicians instilled with the drive to advocate for the patient, and also the capacity to speak in the vernacular of statistics and economics. Until we as a medical community can competently participate in this aspect of health care, the system will form itself around values constructed by insurers and analysts and not those expressed by the oath that we take as physicians.
What has been the most surprising element of your experience so far as a Schweitzer Fellow?
The other day one of our participants told us about how in Mexico he used to work with youths that had drug and alcohol problems. He wanted to do something similar here in the local community. He had, without knowing it, essentially recited our original mission statement, created before even our first runner joined us.
Since our inception, the form of Los Coyotes has adapted to every new challenge – even the name was changed. We had envisioned our program helping the subject of a common narrative told to us of young male Latinos, isolated, unemployed, depressed and often drinking excessively. We thus far have not been able to gain access to this demographic – one theory is that without pre-existing connections to the Latino community, our group garners very little trust or legitimacy.
We have a small core of runners – all positive, healthy and active, many with a history of previous running. We still strive to grow our group and reach out to individuals that may feel isolated or have issues with alcohol. To be in the midst of racking our brains on how to do this, then have one of our runners under his own initiative tell us that he wants to use Los Coyotes to reach people having drug and alcohol problems is enthralling.
We feel that having Latinos creating programs for other Latinos is the only way that some of our original ideas will be materialized. Finding a person willing and excited about doing such a thing is probably a high point of our program thus far.
Our experiences thus far have shown us that every step will bring something unexpected and at times you may feel yourself drifting from the “plan”; however, flexible persistence and a broad adherence to core program values can yield other equally unexpected opportunities bringing you back “on course” and often with better understanding and greater capabilities.
What does Albert Schweitzer’s legacy mean to you, and how will you carry it with you once your initial year as a Fellow draws to a close?
The most inspiring aspect of Albert Schweitzer’s legacy is his firm belief in equality among human beings, accompanied by a determination to reach people of all nations. He saw himself as just one piece out of a giant puzzle of humanity, meant to work together with others towards a single common goal.
Keeping this in mind has been one of our greatest challenges so far this year. Working across a massive cultural barrier often creates the illusion that we have competing objectives for the group. As medical students, we want to see our members get into good shape, lose weight and lower their blood pressures. However, they are attracted to participate, not by the health benefits, but by the sense of unity and identity that the group provides.
Reminding ourselves of this is critical—that although we as leaders wish for the best with all of the runners, we may have a different concept of what that means for them and their families. Like Albert Schweitzer, we seek to admire and expand the culture with which we are working, rather than impose our own beliefs. As we continue to learn about and understand each other, we can do this more and more effectively.
Click here to read more about the Kate B. Reynolds Charitable Trust’s partnership with ASF.