UNE Students share their Experiences on the third and final day of the 2018 DownEast Rural Health Immersion

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Before returning to Portland the students spend the morning at Schoodic Point of Acadia National Park. Off in the distance is Cadillac Mountain.

Ten UNE health professions students recently participated in a weeklong rural health immersion to Washington County in Maine.  The immersion experience is a part of a pipeline program with Maine’s Area Health Education Center (AHEC) program and UNE’s Center for Excellence in Health Innovation (CEHI) to address healthcare provider shortages in rural Maine.  This is the sixth immersion experience that the Maine AHEC and CEHI have provided for UNE students but the first time that a group has traveled to the DownEast area.  In March a group of 10 students traveled to Piscataquis County; last Fall a group of 10 students traveled to Oxford County and Carroll County in New Hampshire for a long weekend immersion; in May of 2017 a group of 13 medical, pharmacy, dental, and nursing students traveled to Maine’s midcoast region of Knox and Waldo Counties for a weeklong immersion; in March of 2017 medical and nursing students participated in a weeklong immersion in Franklin County; and in May of 2016 a group of 15 medical, pharmacy, and dental students participated in a weeklong immersion in Aroostook County.  Throughout the immersion the students are purposefully split into interprofessional teams so that they can learn the roles and how to communicate effectively with other disciplines in order to learn the skills necessary to provide high quality team-based care and improve patient outcomes.  The students experienced a variety of clinical, community, and population health activities in rural and underserved communities in Washington County, including Calais, Eastport, Lubec, Campobello, and Machias.   Below are reflections from one team after the third day of the trip on Friday, May 25, 2018.

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The students pose with the staff at Eastport Health Care, who warmly embraced the group of students.

Sammuel Stratton, second year osteopathic medicine student

Could I do what Ben Okafor, PharmD, has done? It takes a special kind of person to move halfway around the world and risk everything to start a business in a place seemingly opposite from everything you know and against current industry trends. Ben is originally from Nigeria, Africa’s most populous country. He came to Washington County, one of Maine’s least populous counties, to establish Eastport Family Pharmacy in Eastport, a community of approximately 1,300 year-round residents. At a time when most pharmacies are owned by one of a few mega-corporations, Eastport Family Pharmacy is independently owned and operated by Ben. Despite the superficial differences with the commiunity, Ben found a deeper connection. In Eastport, as in Ben’s Nigerian culture, family and community are everything. Ben saw a need and an opportunity in Eastport. He left the security of a salaried pharmacist’s position and cashed out his 401K retirement funds to take a risk on establishing Eastport Family Pharmacy and he never looked back. Because of his steadfast commitment to his community, Ben and his pharmacy have been embraced by the people of Eastport and have found success. Would I be able to find the courage to risk everything like Ben has in order to follow a dream? Reflecting on Ben’s inspiring story I am more likely to say “yes” when the opportunity is right. I am more likely to risk it all for an opportunity to follow a dream.

An hour-long meeting with the staff at the Eastport community health center was not the place I was expecting to be rethinking my life’s plans. Coming in and out of an engaging and deep discussion at Eastport Health Care I found my mind racing: how could I convince my wife to consider moving down east to Eastport? what am I thinking—I still have at least six more years between school and training? when would be a good time to at least have my wife and son visit Eastport? Hadn’t I already convinced myself that I wanted to live someplace warm in the future? It is the sign of a special kind of place that gets you consider turning your life upside down to be part of the magic that is happening there. Following the community circle at Eastport Health Care, my one word is: “inspired.”

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The students met with Ben Okafor, PharmD, independent owner of Eastport Family Pharmacy.

During the DownEast rural health immersion, the days were long and packed with meetings but the energy levels and spirits were high. From one day to the next the meetings and the discussions were continually deeper and richer. People were genuine and generous. The connections made us feel like they were with people you have known since forever and the friendships feel lifelong. After only four days how is it that one can feel like it has been always and will be forever? The answer is in the openness of the communities to embrace us during our rural health immersion and in the openness of the students who let themselves be changed by the experience. A four-day period is short; it is approximately one three-hundred-sixty-fifth of a four-year medical education, or in other words it is almost no time at all. But this relatively insignificant amount of time will hold tremendous significance for me throughout the remainder of my medical education, training, and into my practice. There is real value in connecting with people on an individual level. Listening to understand not only demonstrates respect for the other individual but also makes it more likely that you learn something from the interaction.

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Before having lobster rolls for lunch the students toured Quoddy Bay Lobster in Eastport.

 

Grace Kim, third year pharmacy student

Each experience during the DownEast rural health immersion was filled with a tremendous amount of indescribable emotions that I have never felt before in my life. It was a mixture of joy, grief, regrets, enlightenment, and courage all together. But these words alone cannot truly describe several heartaches, and excitement through this trip. It was heartwarming to be so welcomed everywhere we visited, and I’m leaving feeling full of knowledge with empowerment over just a few days spent in Washington County. Then I started having few lingering thoughts in my mind. What would I have done if I were in their situation? Will I be able to provide the same health care with equal amount of passion and unlimited love towards the community? How would I be able to return my services and knowledge to the community? And would I even be adequate enough of a pharmacist in the end to even their community?

The answers were found in several different visits of health care sites in Eastport Community. We first visited Eastport Family Pharmacy owned by Dr. Benjamin Okafor, who showed how grateful and privileged he was to give back something for the Eastport community. It was shocking to listen to him speak about the services that he provides for his patients, regardless of some burdens that he might go through to provide those services to them. He was a true passion and dedication to his profession, and portrayed a love to his “own home.” All the community needed was a single heart of dedication to create innovation in the form of an independent family pharmacy. It was a true courage that we all saw through the visit to his pharmacy, and it re-inspired so much neglected insightfulness that health care professional students often forget through our busy schedules. It was a moment of enlightenment and recognition at the same time to reframe why we decided to pursue health care careers.

 

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Students tour Raye’s Mustard in Eastport with Kevin and Karen Raye.

Then, after a short walk from the pharmacy, we visited Eastport Health Care Center. With warm welcome, the visit to Eastport Health Care Center started with a brief introduction, and taking a moment of silence. The shift in dynamics and the mood in that very moment in the room brought core reason, and empowerment. It implanted a meaning of what true health care needs to be. Everyone was able to engage and to form immediate bond to as of who we are, and what we are responsible as of future health professionals. Then, after listening to a poem written by John O-Donohue, “What Dreams Did I Create Last Night?”, it consolidated every little piece of the trip together.  As health care professional students, we get trained to be precise, accurate, and knowledgeable at all times, and to provide the optimal health care to the patient, this is true. We do receive education on science, and information that will be necessary in practice. But there is so much more to providing quality healthcare than just the basic sciences. And those simple things often slip or get pushed aside as we move from one block to the next. The love and adequate attention to each patient that was portrayed by EHC will not only create special bonds with patients, but also accelerate the rate of changes in health care society in better way. The approach may be different in each health professions, but holistically, we all share the same goal-  true patient centered care with collaborative teamwork. With constant exposure and awareness, which was emphasized throughout our rural health immersion, then better future and health care services will be provided to every single patient.

Answers were always there. Lingering thoughts that I had been having the first two years of my education were suddenly cleared out once I realize that it only needed one little change in mindset: That it is my passion, and everywhere I go will be my community regardless of geographical areas. That small change of thought brought courage, and passion, and I am sure it did for all other students that participated in this trip as well.

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The students met with a panel of community guests in Eastport to get a better sense of what its like to live in a rural community.

Christina Renodin, second year osteopathic medicine student

As a future health care provider, cultural competency and patient sensitivity is a necessity. Throughout our exploration of Washington County, our group of interprofessional students discussed this topic often. I appreciated the continued conversation we engaged in as developing cultural competency is a dynamic process that occurs along a continuum. Having been exposed to many aspects of rural health care including a local critical access hospital, multiple federally qualified health centers, dental offices, and a privately-owned pharmacy within rural areas, these experiences allows us to broaden our own understanding of the needs of diverse populations encountered in rural areas. This rural health immersion helped us to develop how we, as future health care professionals, may respect and appropriately respond to diverse populations. This theme continued in our visit to the Eastpoint Health Care where we spoke with staff about how they strive to meet the needs of their patients with creative solutions. This was a commonality we met through our trip, how rural health care providers wear many hats both in their health care field and as an engaged community member.

One of the most rewarding experiences of our rural health immersion was engaging in conversation with local community members of Eastport, ME. Here we spoke with a legislature, a business owner, a police officer and port authority director, as well as individuals who moved to Eastport later in life. Much of our conversation was about the needs of the community and how providers who decide to work in a small community, such as Eastport, may address those needs. This meeting was enlightening as we had spent a majority of our immersion meeting with health care providers. Our students connected with the community during this meeting because we were able to hear real life adversity faced within the community. We discussed how the port authority was working to increase business through the port, the community’s limited access to health care, as well as the high cost of health care and health insurance. The most compelling element conveyed to our students was the true sense of community within Eastport and how hardworking the coastal town was.

Our rural health immersion in Washington County concluded with a reflection on our immersion and with a visit to Schoodic Point. It was breathtaking to see hightide and watch the changing of the tides. This capstone moment gave us one last chance to connect as a group and appreciate all the beauty and wonder rural Maine has to offer.

Cody Hutchins, third year pharmacy student

Being raised in a rural area during a time where my family and I had to jump from town to town every year was all the experience I needed to know exactly what a move to Washington County would consist of, or so I thought. Moving to this place where there are more lobster traps than people, I thought would mean moving to another sprawling community that provides no chance of making connection. Here my Bostonian shoes stand before a creaking dock in Eastport, the most eastern corner of the United States, as a cool ocean breeze runs down my spine; it gives me the sense that nine months of cold weather and winter driving in this foreign place will only add to the time I will have to myself and myself alone.

It’s Day 3 of the DownEast rural health immersion. It has only been a couple hours since the sun crept over the blue edge of the Earth and chased off the morning mist over the harbor, and I am having an experience that is shifting my perception of what it means to live in a rural community. Our interprofessional team of students hop out of the UNE commercial van and walk through the front door of Eastport’s only pharmacy. My first impression is that the single aisle of medication really fails at masking the identity of the tiny laundromat that the pharmacy was repurposed from, but the trusting smile behind the counter quickly and successfully completes the illusion. The smile belongs to the pharmacist Ben Okafor, PharmD. Ben is from Africa and seemingly as out of place as my shiny shoes on that work dock or this aisle of medication in this used-to-be laundromat. Ben welcomes us with his charisma and shares with us his core values. He explains to us that if your business works hard for the community the community will work hard for your business. Ben drives a great distance to hand deliver prescriptions to people in their homes and in return people from great distance come to Ben entrusting him with their health.

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The students enjoyed having breakfast at Karen’s Diner in Calais each morning.

Witnessing how the small community of Eastport has sought out and taken to Ben makes me believe that finding friends and belonging is just part of Washington County’s allure. It seems that the cold does not isolate people here, it huddles people together. Ben’s story changes my fear of being lost to Washington County to a sense of hope in finding a true tight knit community. I leave this experience and Washington County with a new appreciation for rural communities and their capacity of giving oneself belonging. Maybe my feet will look less out of place in front of that creaky dock when I return with my Bean boots.

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