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With Dr. Angela Maria Pinzon Rondon and her family,
who hosted me during my stay in Bogotá, Colombia. |
I recently travelled to Bogotá, Colombia to spend time with one of our very talented former students, Dr. Angela Maria Pinzon Rondon, a physician who did her post-doc Ph.D in Maternal and Child Health here at the University of Maryland School of Public Health. I am interested in exploring the possibilities for collaboration and exchange between our school and the Universidad del Rosario, where Dr. Pinzon is a physician, teacher, and researcher. I want to share an experience I had on one of the days I was there, which I recorded in a journal style. I will likely follow up in other entries on other experiences I had while there. For the remainder of this entry, I will refer to Dr. Pinzon as Angela.
August 11, 2011: Angela designed our plans today to expose me to the efforts addressing public health in the high-risk communities of Bogotá.
We started the day by visiting Dispensario Santa Francisca Romana. Franciscan Nuns from Rochester, MN started this school almost 40 years ago for upper class children. Since that time, they expanded their efforts to the surrounding communities of need and focused on one specifically - El Codito. El Codito is a town of 38,000 people who are incredibly poor and underserved. More on El Codito later.
The Dispensario has become a wonderful primary care clinic to the community. Each Wednesday, they bus 100 seniors from El Codito to the clinic where they participate in group activities, receive needed primary care including dental care, and receive legal and other advice as needed. To serve the many seniors who need this kind of assistance, they've created a rotation strategy that ensures that all seniors can participate in these Wednesday sessions.
Disabilities of any kind limit the capacity of El Codito’s seniors to be mobile – and prevent them from being engaged socially or receiving services of any kind. By happenstance, we encountered a group of faculty and students visiting Bogotá from University of Alberta, Canada whose focus was on functional life challenges for people with disabilities. There were faculty and students from three disciplines - electrical engineering, occupational therapy, and rehabilitative medicine. They are working with the severely disabled in El Codito and searching for unique solutions to health care utilizing web and mobile technologies. This was a wonderful excuse for me to talk about something I am passionate about – the role of technology in health promotion – and we all toured the clinic facility together.
Visiting El Codito
Then we set off for our trip to El Codito where students and faculty from the Universidad del Rosario are working. Here’s a little background about El Codito.
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| A look down the hill side community of El Codito to the city of Bogotá below. |
Angela referred to El Codito (English translation – the little elbow) as an invasion city. It sits on a very steep mountain-top on the edge of Bogotá. Poor families started building this community on the mountain-side 35 years ago, essentially as squatters since no formal ownership transactions took place. It was originally built without necessary infrastructure such as sanitation, sewers, electricity, or roads. Over 35 years, some of that has been delivered, but it is still a very poor and underserved community. Many live in astounding squalor, without basic services, and with a high rate of gang-driven violent crime.
Because of the steep hill-side, poor infrastructure, and poor road structure, disabled people who need a wheel chair have almost no way of using one. So it is not uncommon for a physically disabled person to spend most of their time in bed for months or years at a time - unless someone provides services that address their issues. So, I set out with Angela and Sofia (a public health nurse that works in El Codito) to visit some of the people they serve, and to witness the depth of their commitment to public health. Before we left for El Codito, Angela paid to fill up the back of her truck with more than 20 bags of groceries, including chicken and other meats that she would distribute to each of her community people of need. She told me she never wants to go there without leaving something of value. This is one of her strategies for building community trust.
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| Most disabled people in El Codito are bed-ridden because of the lack of infrastructure needed to get around in a wheel chair. |
We first met an 80-year old man in an alley sitting in a chair. That's were he spends his day. He was an alcoholic thrown out of his home by his wife. This gentleman asked a friend if he could move in with him. Shortly after doing so, his friend died - so he's living in a room in a shack with his late friend's wife. She is not happy and wants him out. He has major health problems and has nowhere to go. He depends upon food and health service aid from the programs of the University - as does the woman he lives with. They have no gas in the shack so they've put a stovetop on some rocks outside the shack and burn wood and coal to cook on the stovetop. Before we left, Angela gave him two bags of groceries.
I thought the first stop was a poor area until we got to the second stop. This was to see a 17-year old boy who was hit in the neck by a stray bullet when he was 11. He has been paralyzed since that time and in bed most of that time. There is actually no way to get him out of bed without building infrastructure. But in the shack he lives in with his elderly mother, there is no wall or footing structure that would support such infrastructure, and the space he lives in is not large enough for a wheel chair to move.
Having said that, he was a delightful man who did not complain. He enjoyed seeing Angela who he's known for several years. Angela talked with him about his care, tested his arm strength to assess whether he was doing his prescribed exercises and then we left a few bags of groceries. No matter how many pictures I have seen of the world's poor who need our attention, I have never seen anything quite like this setting and this young man. I later found out that he has an interest in law - so part of the commitment to this boy is to have law students visit with him on Saturdays to spend time with him and talk about law. I’ve provided two photographs here – the first is the view entering the shack where this young man lives and the second a view leaving the shack.
Our next stop was on the steep side of the community. We had to climb down several flights of makeshift concrete stairs that no one would consider a staircase. When we got to the level we were looking for we entered another shack where a women in her 30's was in bed, two children were in the shack, and an elderly woman was there also. The women in her 30's fell from a roof when she was 12 and became completely disabled. She has basically been mostly in bed for 26 years. Angela talked with the woman, did a basic assessment, asked about medications, and watched as the 15 year-old administered an insulin shot to the woman. Several more bags of groceries, several more tears of thanks, and we moved on.
We were led to the next stop by a 10 year-old who brought us to a home on the side of the mountain. As we entered, we were met by a young woman whose 11 year-old son had cystic fibrosis. It was a dramatic case because they had been unable to get needed medication and other services. Angela and Sofia again assessed the situation, decided what was needed and made a promise that it would be provided. Several more bags of groceries were left.
Angela and Sofia took me to two clinics that serve El Codito. At the first, we met a woman who was a community leader. During the conversation, Angela turned to me and said I should sit down because there was an unanticipated problem that had to be dealt with. The woman asked Angela and Sofia to do something about her 18-year old daughter who was an alcoholic since her father started her drinking at 12 years of age. Her drinking was getting much worse and she asked that Angela and Sofia attempt to get her into a program. Angela agreed and the woman asked the daughter to join us. Angela was not able to do much but to discuss the importance of getting help - and then promised to accommodate an appointment with psychological services in the program Angela is part of. The girl agreed to follow-up if psychological services contacted her with an appointment time. Two more bags of groceries left, and on to several more stops like these before leaving El Codito.
Saturday 8/13 - Returning home
I'm on Continental Airlines flight 1004 about 90 minutes from landing and reflecting on the week I just had. It was an incredible experience and I hope it will not be the last time I travel to Colombia. But there are some things I'm taking away.
I am reminded that the students who go through our programs can also be great teachers and mentors. Dr. Angela Maria Pinzon Rondon is an incredibly accomplished physician-researcher and the kind of public health she practices comes from the heart with the skills of a formally educated practitioner who also has years of experience. She is a remarkable human being who taught me a great deal; and I'll look forward to continued lessons in the future. I have for some time thought about retirement built on teaching service-learning courses in order to contribute to making a difference in underserved communities. This trip convinced me that I can't wait until retirement to do this kind of work.
I also have to figure out a way to create more opportunity for our students to have experiences that result in their having out-of-the-ordinary learning experiences that go beyond the typical classroom.
Today’s blog entry is about technology, one of my true passions. I’ll begin by sharing some information about a new report on mHealth, the practice of medical and public health supported by mobile devices. Then I will provide an overview of a very unique person and a speech he recently made, and I will close with information about an event I attended in Washington, DC at one of the most impressive technology settings I have ever seen.
