The bridge is an important symbol in many health endeavors, local and global. It signifies caregivers connecting with their patients and, on a greater scale, it exemplifies the concept of bringing together people from different backgrounds and cultures, the provision of needed services and the sharing of ideas and experiences that are at the heart of such efforts. However, for Dr. Lanny Smith and those involved with the nongovernmental organization, Doctors for Global Health (DGH), the bridge means much more.
Dr. Lanny Smith"We – members of the community in Morazán, El Salvador and DGH volunteers – worked with the United Nations High Commissioner for Refugees to actually build a bridge," explained Dr. Smith. "It was something the people of Morazán wanted and needed, so we set about working with them to make it a reality."
He continued, "Multiple community requests to the government for a bridge had gone unanswered, even though over a 20-year period, more than 20 people had died in what the locals called ‘Little River' while attempting to swim across – their only way to get to school or work. The bridge is known as the Jaime Solórzano Memorial Bridge to honor the memory of a chemistry-pharmacy student who lost his life crossing Little River, and it is a shining example of local and international solidarity."
Ultimately, the bridge facilitated the construction of schools, daycare centers, a health center and many other structures. It also permitted transportation by bus and for health emergencies. "The combining of local and international resources from so many places, all coming together for a common purpose – essentially a bridge to peace – is at the root of the philosophy of DGH," said Dr. Smith.
The formation of DGH came about while Dr. Smith was working with the French humanitarian group Medecins Du Monde (MDM) in El Salvador soon after the nation's 12-year civil war had ended. "MDM responded to the invitation of a local group organized by the guerillas, located in Morazán, near the eastern El Salvador border with Honduras. Our project was called ‘Building Health Where Peace Is New,'" he explained.
The international solidarity program welcomed medical students and professionals from around the world that would join the MDM effort for varying lengths of time, ranging from a few months to years. Among the institutions supporting its students' participation in the program was Einstein.
Children in La Presa kindergartenThe first Einstein student to take advantage of the opportunity was Steve Miller, class of 1996, who arrived in 1994 and spent 14 months working with Dr. Smith, during which time he helped his mentor establish DGH.
"You might ask why we would form an organization while working for another?" said Dr. Miller. "Most paramount was the feeling that we were encountering situations that needed sustainability, rather than the shorter-term solutions being offered. Because of its structure, there were certain time limitations to what MDM could do."
He added, "One thing that sets DGH apart from a lot of other health-related organizations is its openness to embracing students of all kinds, from all walks of life. Another is providing longer-term voluntarism, remaining a community's partner for however long may be needed."
At the heart of DGH's efforts and central to its mission is the concept of "liberation medicine." In the syllabus describing the seminar on "Health, Human Rights & Liberation Medicine" that Dr. Smith teaches, he notes: "Liberation medicine is the conscious, conscientious use of health to promote social justice and human dignity."
Dr. Smith elaborated, "It means using studied action to seek ways for making a concrete, positive difference in people's lives by accompanying them in the process of attaining their own freedom and life-improvement, not ‘liberating' them."
He added, "DGH works with its local partners on themes and projects prioritized by the local group, whether they are strictly within the definition of physical health or within a broader definition more consonant with mental or social well-being. For example, we've assisted with promoting women's rights in Kenema, Sierra Leone, establishing a women's cooperative in Chiapas, Mexico and preventing poisoning by pesticides in Santa Marta, El Salvador."
Guided by these principles, DGH works locally and internationally at the synergy of health, human rights, education and art. Its membership consists of volunteers who are healthcare professionals, medical and other interested students, and other professionals, such as lawyers, educators and artists.
"We're not all doctors, but all our members are interested in health and human rights," said Dr. Linnea Capps, DGH president and CEO. "We use health as a way to help people in their liberation struggles."
Dr. Charles Moore gives a tour of the City of Refuge Healing Community Center, during the 2010 DGH general assembly, in Atlanta.As he visits DGH's numerous sites in El Salvador, Mexico, Guatemala, Nicaragua, Uganda and Burundi, Dr. Smith's lanky six-foot frame could seem imposing. Instead, he is known for assuring the communities who invite DGH to work with them that they are the lead partners in determining their specific needs and goals.
"When he's around the campesinos, he squats, making himself smaller so that others feel bigger and more empowered," noted DGH board member Dr. Jennifer Kasper. "He also listens intently to what the campesinos think and want."
"Lanny is a natural teacher and healer. He has been one of the most influential people in my life, both in my development as a physician and as a human being," said Dr. Miller. "Through our work in El Salvador, he helped me to appreciate the importance of integrating social factors into the understanding of acute illness, chronic illness and community health. I've applied those lessons in treating my own patient population at the county hospital in Oakland."
"Lanny has such a dynamic personality and illuminating passion that one can't help immediately recognizing him as kin in the social justice world," agreed Dr. Sara Doorley, who learned about DGH at the end of her third year of medical school, where she had been active in developing a global health group. Searching online, she came across information about DGH's upcoming conference in Oakland.
"I applied for and received a scholarship to attend, and my attendance completely changed the trajectory of my professional career and personal development," she said.
She continued, "Lanny has a way of bringing diverse groups of people together and inspiring each of us to work towards a better society. When I left the conference, I felt so inspired and rejuvenated in my commitment to humanitarian service that I returned to medical school in Ohio and delayed my graduation a year so I could volunteer with DGH in Santa Marta, El Salvador."
During her travels, Dr. Doorley learned about a fourth-year medical course, Research-Based Health Activism, an elective overseen by Einstein-Montefiore's Dr. Aaron Fox (class of 2004) for which Dr. Smith teaches the liberation medicine section. Soon after taking the course, she became a resident in social medicine at Einstein-Montefiore.
"I spent four years working with Lanny and other Montefiore staff, becoming well-versed in caring for the vulnerable patient population in the Bronx. That diverse, international population of patients taught me more than I could have imagined."
Dr. Doorley, who is now a physician in San Jose, California providing medical care to the area's homeless population, also worked with Dr. Smith and Dr. Ramin Asgary to further develop the immigrant health clinic they had established at the Bronx's Highbridge Community Center. "I had the unique opportunity to work with Lanny and others to develop and implement a community health program focused on using the strength of community health workers to both improve access to care and break down barriers to healthcare for the immigrant population."
Dr. Gloria Fung, class of 2008, recalled Dr. Smith's influence on her own career choices as well. "Physicians who are truly committed to social and health equity are few, and it has been rare to meet individuals who are also as passionate about and committed to health and human rights as Lanny."
As a student volunteering with DGH, Dr. Fung traveled to Porto Alegre, Brazil and Kisoro, Uganda, each of which offered experiences that have inspired her continuing work with vulnerable populations in the States and abroad. She noted, "Through Lanny's mentorship, I learned that health ought to be approached from a more holistic perspective that prioritizes prevention and primary care, and should consider the effects of socioeconomic determinants on one's well-being."
Following is an assortment of quotes from colleagues and DGH members concerning the organization and Dr. Smith's leadership. A number of the quotes have been translated from Spanish, and many of them reflect "congratulations" that were offered to Dr. Smith and DGH upon reaching their 10th anniversary. The words - and their sentiments - still ring true today, six years later.
Gallery of Quotes...She added, "This was particularly important at Einstein, since the communities we take care of in the Bronx often face challenges with access to healthcare, education and economic opportunities.
Dr. Fung also was among the Einstein students who completed a global health rotation at Highbridge Community Center, the local DGH site where training was provided to community health workers. "The rotation offered invaluable experiences where we were able to witness the dire health conditions and the challenges of access to care in resource-poor settings."
"When it came down to providing care, Lanny was famous for having an infinite line of patients waiting to see him," recalled Dr. Dooley. "They waited without complaint because of the incredible connection that they each had with him and the great level of dignified patient care that he provides."
"In relation to my practice and the work I envision with DGH volunteers, healing is a process of affirming human dignity," offered Dr. Smith. "To heal is not the opposite of death, but it does work to minimize suffering and prevent the loss of life that disease visits at many levels."
The idea to pursue medicine as a career did not occur to Dr. Smith until he was in college. An English major with aspirations of becoming a writer, "I realized that I could do more to address the injustices and inequities in this world as a doctor."
His awareness of, and interest in, helping those less fortunate was instilled early in life. "Before I was in kindergarten, I can remember going with my parents to a local housing project where we would help out," he recalled. "They instilled intolerance for racist attitudes and jokes in me and my brothers, as well as a commitment to making a positive difference."
He also took part in youth projects through the local Methodist church, traveling each summer to a community where he and other teens would work with the local residents building houses and helping to set up sustainable programs. It is these experiences from his youth – including participation in the Boy Scouts – that shaped his approach to global health pursuits.
"I really enjoy the chance to teach medical students and residents, especially at the juxtaposition of local South Bronx and the global – when most people in the South Bronx, or their parents, were born abroad," he said. "Most humbling is finding that even with principled, hard work, positive change often comes very slowly, at both the individual and the community level."
He concluded, "We want our graduates to be catalysts for social change, dealing with problems and issues such as health disparities, the public health impact of climate change, how we care for the frail elderly, physically disabled and chronically ill, and access to affordable healthcare for poor, underserved and marginalized populations in local communities, in communities across the nation and in nations beyond our borders."
For its "Sweet 16," DGH will hold its annual general assembly at Loyola Marymount University, in Los Angeles, California at the end of July. The event will feature keynote addresses by America Bracho, M.D., executive director of Latino Health Access and by Theresa and Blasé Bonpane, founders of the Office of the Americas. The three-day meeting also will include panel discussions on Health and Human Rights of Migrant Communities, the Right to Food and Food Justice and Nuclear Reactors, Weapons, War & the Health of Our Planet, as well as a tour of Father Greg Boyle's Homeboy Industries and skid row, and an update on People's Health Movement-USA, whose own annual meeting will take place just prior to the DGH general assembly. For further information about DGH, visit http://www.dghonline.org/.
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Posted on: Tuesday, June 07, 2011