Befriending My Veteran Health Partner

By Linda Nguyen

When I began medical school, I signed up to volunteer with Veteran Health Partners (VHP), an organization that pairs medical students with veterans in the Recreational Control Facility (RCF) of the local Veteran Affairs (VA) Hospital. Veterans in the RCF unit have conditions ranging from spinal cord injuries to paraplegia, many of whom live there as long-term residents. As a Vietnamese-American daughter of refugees from the Vietnam War, I owed it to myself to get to know some of the honorable veterans who served.

I was paired with a veteran who did not participate in any group activities or get out of bed most days. When I arrived at the VA to visit him for the first time, I was nervous. Would he find any interest in talking to a medical student? I took a deep breath, then knocked on his door.

“Hello sir! This is Linda, your student volunteer,” I said.

“Come in.” he said.

I walked in slowly, just enough to peek past the curtain and see the veteran sitting in the hospital bed. He had white hair, wore glasses, and seemed to be in his eighties. He smiled warmly and attempted to turn down the volume of the TV screen. I asked if I could help, and he said that he could turn it down himself. We shook hands and I pulled over a chair to sit facing him.

He started off the conversation by saying, “So tell me about yourself.”

I replied, “I’m a first-year medical student who moved here last year from California. In my free time, I love hip hop dance and cooking.”

He thought that my educational path and hobbies were wonderful. He then apologized for not being able to fully face me or turn down the TV volume. I assured him that it did not bother me. He shyly remarked how sometimes it is hard for him to remember the exact word he wants to say. I encouraged him that he could try to describe whatever word he was trying to say, and that I would do my best to listen and understand. This alleviated some of his apprehension, as I saw him relax and feel more comfortable around me.

Eventually, the nurse peeked his head into the room to say that visiting time was over. As I was leaving, I smiled to myself and thought, “I think I made a new friend today.”

Our monthly visits continued, and eventually we gave each other permission to ask anything we wanted about the other person. I was curious to hear about his experience serving in the Vietnam War. I learned that he was traumatized by many of his experiences during his service. I was the first Vietnamese person he had interacted with since the war.

I told him about my own family, that my parents had to flee the country to ensure a better future for their children. They are eternally grateful to veterans who fought in the Vietnam War, and see them as heroes. He listened to my story intently. Afterwards, we both looked at each other in silent agreement, in awe that decades later, a veteran was becoming friends with a Vietnamese-American.

This has been a meaningful year for me with VHP, transitioning from a member to a president role. As we near student organization board transitions, I am proud of the work that my board and I accomplished this year to improve the operations of VHP and make this a more positive and rewarding experience for both the veteran partners and medical student volunteers. Even as I took on this leadership role, I maintained my monthly visits to my paired veteran partner.

The most rewarding part of volunteering this year was being able to meet his entire family during Christmas. It warmed my heart dearly to hear how much his family valued my visits with my veteran partner, and how excited they were to meet me. My veteran partner invited me to stay and watch the family exchange gifts, and I offered to take photographs of the family for their family photoshoot. I felt so welcome. My veteran partner went so far as to call me an “honorary” family member.

I still visit my veteran partner every month and will continue to do so. I think the most important lesson I have learned while volunteering with VHP is reminding myself that sometimes the most meaningful service that you can do is listen to someone. Make them feel heard. That their needs and wishes matter. I saw the impact it made when I was mindful about what it was my veteran was concerned with at the time, whether it be the ability to turn the pages while reading books, getting to step out of bed, speak, etc. I am lucky to be a part of whatever sparks joy in a patient that day.

 

Linda Nguyen, MA, is an aspiring physician-bioethicist, currently pursuing an MD at Loyola University Chicago Stritch School of Medicine. She currently conducts clinical research on advance care planning and has a background in education, student affairs, and diversity and inclusion work.

 

 

“¿Que Vamos a Comer?”/ “What Are We Going to Eat?”: Latina Prenatal Care and Access to Food During COVID-19

By Daniela Vargas

As a public health nurse, I work in reproductive justice, prenatal and postpartum care at a Federally Qualified Health Center (FQHC) in San Francisco. I am aware that my job comes with a high responsibility as I am assessing for social and structural determinants of health as women begin their prenatal care. In the wake of COVID-19, my work has become more critical as basic needs like food, shelter, baby supplies, legal support, mental health and safety are now even higher for Latina mothers than ever before. The barriers in accessing healthcare, food and shelter that were there for Latinx patients prior to COVID-19 became even wider gaps when “Stay at Home” or “Shelter In Place” policies were first enacted in the City of San Francisco along with eight Bay Area counties even before the State of California and other states followed.

The first question I ask the mothers coming into the clinic is  “How are you and how is your family?” The answer is usually “We are okay, we are doing the best we can,” as they hold onto their composure. My second question is always, “Do you and your family have food to eat?” And that is when many of the reactions of these mothers change. The eyes of these mothers say it all, often filled with tears telling me that they are happy to become mothers but that since the “Stay at Home” policies began, it has caused major instability preventing them, their partners or families from working. Many of these Latina mothers are immigrants from Mexico, Honduras, El Salvador, and Guatemala. Some of them are here as permanent residents but the majority are undocumented, either newly arrived seeking asylum or have been here for several years.

These Latina mothers talk about “Stay at Home” with me while mentioning how afraid they are to come to their visits and how they don’t even want to leave their homes even to get fresh air. My nursing visits that are spaced out for 30-minute slots, are now going over time with the complexities that Latina mothers are facing in the middle of the COVID-19 pandemic. I am used to holding the hands of patients or giving hugs when patients ask to give them to me but with social distancing, I have to stay 6 feet away and wear a mask. This has changed how I am able to provide human connection.

The one thing that has not changed, has been the ability to cry with my patients as they tell their stories of how COVID-19 has disrupted their ability to work and pay their expenses which they must do so  that they can prove to immigration officials that they can make it in this country. Many of them allude to the recently revised “Public Charge” regulation that has scared Latinx families from accessing services in fear that the federal government will not allow them to remain if they do so.. These mothers feel hopeless and scared that they might not be able to feed their families or pay back the rent money they owe since they haven’t been working. Latina mothers feel time is running out for them since they will have to take leave from work to care for their baby. For those who are undocumented, these mothers cannot apply for unemployment or get paid maternity leave.

Working with mothers and their babies while seeking prenatal care has other new challenges in the wake of the COVID-19 pandemic. Black, Indigenous and People of Color (BIPOC) birth workers have worked hard to integrate comprehensive and supportive structures in birthing for vulnerable populations such as Latina mothers. But with all focus going to COVID-19, many of those structures have been deeply modified or no longer present. Centering pregnancy or prenatal education sessions are being done remotely or cancelled. In-person prenatal services have been moved to telephone calls to prevent COVID-19 exposure. Prenatal education funding is also being rerouted towards COVID-19 efforts. Unlike elective procedures that have been put on hold due to this pandemic, prenatal cannot be paused. Instead of diverting from comprehensive prenatal education due to the pandemic, we need be providing more prenatal/postpartum educational services around pregnancy and COVID-19 and in-depth needs/health assessments with expecting Latina mothers about the insecurities they are facing and doing so in bilingual formats I feel that even more than ever, we have to be more vigilant regarding the health of Latina mothers, their babies and families.

Before these Latina mothers leave our clinic, they are given a bag of food, basic necessities, a small grocery gift card, and are enrolled in food access programs. I tell them, “if you need anything, please call me.” They respond, “Claro que si enfermera, muchas gracias,” translated as “Of course nurse, thank you so much.” They lean in to hug me but I have to pull back because of social distancing. Daily, I leave the clinic with my mask on and tears rolling down my face hoping that this pandemic improves so that the mothers I care for can feel safe to access the things that are most basic to all of us, most especially food.

Daniela Vargas, MSN, MPH, MA, RN, PHN is a DNP-Population Health Leadership student at the University of San Francisco School of Nursing and Health Professions and alumna of the graduate Bioethics & Health Policy Program at Loyola University Chicago. She works as a Public Health Registered Nurse serving the Latinx community in San Francisco, CA at a Federally Qualified Health Center (FQHC) and provides prenatal care and education as well as a comprehensive women’s health services to a primarily Spanish-speaking population, many of which belong to the Undocu community.