Tuesday, January 25, 2011

Out in the Rural

As salaam alaikum,

My most recent career aspirations, specifically working in a community health center for some part of my career, were inspired by this film, entitled "Out in the Rural" (1970), about one of the first community health centers in the country.

Out in the Rural from Luis Manriquez on Vimeo.

For more information about the CHC movement in the United States, visit the NIH's "Against All Odds" exhibition, specifically the section of community health, subsection "On Common Ground."

I'll include below the email that I sent to family about it, which gives a little bit of background about Dr. Jack Geiger, who also is one of the founding members and former president of Physicians for Human Rights, and how he became involved in this movement. Seriously, masha'Allah!

A little background...

Dr. Jack Geiger, as a medical student, traveled to South Africa and was part of a rotation in a small clinic in a rural, Zulu tribal reserve called Pheola in Natal, based in the only medical school in the country at the time that would train blacks. Headed by two South African physicians and founded in the 1940s, years before the Apartheid government would shut it down, it employed what its founders called community-oriented primary care (COPC). These centers were set up to be care for the people, by the people, run by the people...taking communities and focusing not only on their needs and their assets, empowering them to be able to run their own health center, thus encouraging education and entrance of the youth into the very lucrative health field. It also addressed many of the social determinants of health, including poverty and racial discrimination, through programs within the center.

Geiger came back to the United States and completed his training, writing a thesis about this COPC model and deciding that this should be put in place in the United States.

In this world where so much depends on opportunity, right place and time, his interest and work in community-centered care coincided with Johnson's War on Poverty, and Geiger's model for providing health care for the poor was what was used to begin the community health center movement (CHC) in the United States.

With my classmates, I visited the first CHC in the United States, which was set up at the Columbia Point projects in Boston, MA in 1965. It is now called Geiger-Gibson after its founders and after Columbia Point was torn down. Columbia Point were projects built on a landfill where low-income blacks were separated by highway from low-income whites, very much in Boston fashion. Large trucks hauling trash sped up and down Mt. Vernon Street to the nearby dump at the time, resulting in the death of a little girl who was attempting to cross the street. Just as the community banded together, mothers hand in hand to stop the trucks from running their streets, the community was able to band together and make up an essential part of their community health center, including the clerical staff and practitioner staff, many people coming back to be medical assistants, nurses and physicians in the center in their old neighborhood.

The one featured in the film followed a similar model of home-grown staffing, in addition to a variety of needed social programs.

Community Health Centers still exist. Here's a link to the National Association of Community Health Centers: http://www.nachc.org/.

Here in Boston, there are 25, and I think more than 50 statewide. These not only provide health care for the uninsured and underinsured, but it provides quality, comprehensive primary care for anyone in the catchment area. I visited 7 different centers in Boston, and each have social programs in place as well. One had an obesity program for young people. Another had a special diabetes program. Yet another had an affiliated charter school for the black youth of Boston (who make up the majority of Boston Public Schools), whose college graduation rate is 7.4%. The school had a college graduation rate of 73% and a high school graduation rate of 100%.

I'm very excited to share information about these centers with you. These things have been around now for more than 45 years and have survived various challenges, including the Reagan administration, to be a social project that has unwavering bipartisan support. At a time when my generation barely knows what activism is, these centers were born in the time of and facilitated by the Civil Rights movement that is only taught indirectly and blandly in schools. The people who started these things are still running these things and are looking for new leadership.

So, here we come...
I also showed this documentary to B, and he was inspired by Dr. Geiger, especially in his thoughts for what he wanted to do with his career. I was, too, very much so, in a similar way. He's going to be at Tufts for the Physicians in Human Rights student conference in February. For several reasons but mainly because of time constraints on commitments, I haven't really done anything with PHR, but considering Dr. Geiger is aging and has cancer and this may be one of the few times I can hear him speak in person, I may put down $40 and haul myself over to Tufts and hear him and the other speakers. I don't know.


  1. You should do it. I find that I always come away with a memorable teaching point from the various lectures I've attending. Even when I walk in late....sometimes it is just one salient point or question from an audience member that becomes food for thought for months on end and helps to form my decisions. It is like God intended for you just to hear and understand that one thing.

  2. You know, sis, I may just do it... :) It'll be two weeks from Saturday, iA...