For the past 18 months, Emma Hartswick, one of the student interns profiled in this article, has worked with the Public Health Council as an Upper Valley Social Entrepreneurship Fellow from the Dartmouth Center for Service. She has been a real asset to our work and we look forward to having her back on staff after what sounds like a wonderful summer in Boston. — Alice Ely

Article Written By Charlotte Albright (Used with Permission)

Twelve students spent the summer in Boston on the front lines of public health. As participants in a 10-week program sponsored by Dartmouth Center for Service in partnership with Dartmouth Partners in Community Service, they interned in community health centers and other nonprofit organizations, serving the city’s most vulnerable populations—people living on the streets or in shelters, refugees, and low-income families.

“All of our internship programs seek to develop leaders capable of meeting social challenges in either the public or private sector,” says Tracy Dustin-Eichler, the assistant director for nonprofit careers at the Center for Service. “Boston is a hotbed for innovative solutions to pressing health care problems.”

Learning How to Help

Intern Emma Hartswick ’17 began most workday mornings at a foot clinic run by Boston Health Care for the Homeless in St. Francis House, a daytime shelter that offers a wide range of social services. Interns and local nursing students do triage, caring for tired and damaged feet, which can flag more serious health problems that might otherwise go undiagnosed—especially in homeless people.

In a small, windowless room with a few chairs, soaking basins, and a supply cabinet, Hartswick greeted clients and posed a few basic questions—names, ages, health issues—before offering socks, anti-fungal foot powders, and soothing  creams.

A middle-aged man limped in, sat down, took off his shoes, and soaked his feet in a basin as Hartswick rummaged in a drawer for white cotton socks. He said it was exhausting, walking the streets of Boston in all kinds of weather, using a cane.

“They help take care of my feet here,” he explained. “They take my blood pressure, too, and I appreciate the kind words they have to say.”

Hartswick also worked in two other community health clinics, doing intake assessments and providing child care for patients.  A sociology and biology major, she’s thinking of attending medical school and is considering a master’s degree in public health.

“I am really interested in the social determinants of health, in the intersection of somebody’s life circumstances and their overall wellbeing,” Hartswick says. She often chats with homeless people as she walks through Boston Common to St. Francis House. “People assume they are unemployed, but a lot of them are working—they just can’t afford housing,” she says.

Connecting Students and Alumni

In addition to placing students in clinics, the Center for Service connects them with Dartmouth alumni working in medicine. Each intern is paired with an alumni mentor. Once a week, the 12 interns, who lived in dorms rented from Boston University, gathered for a dinner seminar, either to make presentations and share stories about the places where they are working, or to listen to a talk by a leader in health care or public policy.

“Local alumni are key co-educators with us in this program,” says Dustin-Eichler. A larger alumni group, called Dartmouth Partners in Community Service, provides funding and mentoring connections for this and other internship programs.

In a downtown office building one warm night, the interns met Joshua Greenberg ’86, vice president of government relations at Children’s Hospital, and Jay Gonzalez ’93, the CEO of CeltiCare Health Plan. Both men have been forceful advocates for broadening access to affordable health care in Boston.  Gonzalez served as budget chief for Massachusetts during the governorship of Deval Patrick, chairing the board of Health Connector, which was a model for the Affordable Care Act. He traces twists and turns in his career path, advising interns to consider public service.

“If you have the chance to work in government,” he advised the students, “do it. And if you can prove you can take on any responsibility, you will get it, and then some. The opportunity to really have an impact on people in the public sector is unlike anywhere else.”

Seeing Policy in Practice

Some of the interns are more interested in health policy than in hands-on care. For example, at DotHouse Health, in Dorchester, Arvind Suresh ’19 and Yingna Wang ’17 updated patient and provider lists. They also worked on an app to help patients find social services.

The interns shadowed doctors, which, for Wang, was eye opening, especially regarding the impact electronic medical records are having on medical practice.

“I think it’s really important for policy people to understand what doctors do on a daily basis, and I will take that understanding with me as I pursue a career in public health,” Wang said.

Suresh gathered data about a device being used on a trial basis to determine an infant’s height. As each baby lay on a tabletop measuring board, Suresh watched a nurse use sliders to mark the head and feet. He was trying to learn whether this method is more accurate than the clinic’s current practice of using markers and paper to measure babies.

“I am learning so much about public health from different perspectives. We’re also seeing what are the most important issues that we can take on in the future,” Suresh says.

That future will present challenges as public health care workers try to meet the needs of an increasingly diverse population. About one-third of the clients at DotHouse are of Vietnamese descent. There are also many Spanish speakers.

“Providers here are very aware of language and cultural barriers to health care,” said Wang. She and Suresh made sure that the practical tips about health and wellness they post on waiting room bulletin boards get translated into several languages.

For Suresh, managing that flow of multi-lingual information has deepened his understanding of the challenges patients in this clinic face—not just health problems, but other issues, like housing and employment, which affect their wellbeing.

“It’s extremely interesting to see how everyone here needs to think about all the things that other people need and prepare for that every day,” Suresh says.

The full list of summer community health interns:

• Yingna Wang ’17, DotHouse Health
• Aneeq Chaudhry ’19, Health Resources in Action
• Daniel Finch ’17, East Boston Neighborhood Health Center
• Emma Hartswick ’17
• Arvind Suresh ’19, DotHouse Health
• Wafaa Ahmed ’17, Codman Square Health Center
• Angela Liu ’17, Baraka Community Wellness
• Allessandra Ledoux ’17, Codman Square Health Center
• Noah Manning ’17, Health Leads
• Allyson Block ’19, East Boston Neighborhood Health Center
• Amrit Ahluwalia ’19, The Boston Living Center
• Margo Putnam ’19, The Women’s Lunch Place

Editor’s Note: Charlotte Albright is a writer in the Dartmouth College Office of Communications. This story was originally published on Dartmouth News, the college’s news website. The photograph is by Robert Gill, who also works in the Communications Office.

After Tropical Storm Irene, temporary Long-Term Recovery Committees popped up all across the state to help coordinate support for flood victims, and Upper Valley Strong (UVS) was one. When a localized flood hit the Upper Valley again in 2013, UVS immediately jumped in to coordinate relief efforts and support volunteers and homeowners. UVS aligned with Two Rivers-Ottauquechee Regional Commission (TRORC) as well as the Upper Valley Lake Sunapee Regional Planning Commission (UVLSRPC) to obtain disaster-related information and create a cohesive approach to response and recovery. Staff and committee members already had the relationships and local knowledge to quickly gather resources – from shovels and wheelbarrows to dig out, to new appliances for residents, and volunteers to assist. The disaster relief and recovery processes were efficient and fast, largely because UVS was already in place.

It was clear to UVS that the region needed a permanent group in place to maintain relationships, coordinate resources, and hit the ground running when a disaster happened. And so, UVS became Vermont’s first Community Organization Active in Disaster (COAD). COADs are growing in popularity across the Unites States. These voluntary groups consist of nonprofits, corporations, faith-based groups, and other organizations that can play a role in disaster recovery. COADs help coordinate local resources, oversee individual recovery, and support volunteers. They also coordinate efforts with other local, state, and federal organizations during an emergency.

UVS is unique in its alignment with the Regional Planning Commisions of both the New Hampshire and Vermont regions within the Upper Valley. Though these relationships present challenges in terms of establishing consistent funding between disasters and coordinating local operations during an emergency, UVS believes that partnering with our region’s RPCs makes disaster response more sustainable and effective. Perhaps most importantly, COADs offer disaster case management, which is required for people to receive money from organizations like the Vermont Disaster Relief Fund. “The value contributed to the community by COADs such as Upper Valley Strong during disaster recovery cannot be overstated” says Wesley Miller, the Upper Valley’s Public Health Emergency Preparedness Coordinator.

In many ways, their name speaks for itself – Upper Valley Strong is an organization that capitalizes on the inherent strengths of our communities to help people recover following a disaster. They not only support local agencies like the Upper Valley Haven, COVER, SEVCA and the Upper Valley Housing Coalition, but also train and mobilize a strong contingent of dedicated volunteers. According to Miller, “without the dedication and spirit of community shown by these volunteers, the crushing effects of disaster events would weigh on community members for a significantly longer period of time.  Upper Valley Strong has a long history and demonstrated capacity to support our local communities during these most challenging  times.”

UVS trainings provide volunteers with information about how to conduct themselves safely and effectively on disaster sites. These programs are available to corporations, groups, and anyone interested in learning more about helping their neighbors in times of disaster. As one UVS volunteer from Hypertherm, Pete Twarog, spoke about in a recent interview, we all see far off disasters on the news every day, but it is difficult to have a direct impact even when we feel drawn to help. What UVS works to instill is a “serve local” mentality. “Help out your neighbor. Your neighbor may be the next person who needs you, so be ready,” Twarog says. To learn more about how you can be ready to lend a hand when your community needs you, contact Upper Valley Strong, and check out their training promotion video.