Sunday, April 29, 2012


Starting in January I moved from Madison to Milwaukee to begin my 1.5 year long participation in the TRIUMPH program (TRaining In Urban Medicine and Public Health).  TRIUMPH focuses our learning on the needs of urban underserved populations and integrates public health into our clinical training.

There are 8 of us total, each person working with a local community partner on a variety of projects. I have been partnered with the Sixteenth Street Community Health Center (SSCHC) located on the near south side of Milwaukee.  They are a federally qualified health center with family docs, pediatricians, mental health specialists and more and they specialize in working with the Latino community.  In many ways it reminds me of SeaMar where I worked during Americorps.

(The TRIUMPH team!  A wonderful group of people.)

My role at SSCHC has evolved into two separate projects united by a common goal.  The goal is wellness promotion in the Latino community and specifically reducing obesity.  My first project assists a educational program run through the clinic called Healthy Choices.  It consists of 3 months of once per week 2 hour classes that each incorporate a main lesson ranging from why water is better than soda to the benefits of whole grains as well as introducing new types of exercise each session (yoga, zumba and more) and finishing with a healthy snack.  The program is targeted at the entire family and indeed there are 4 different curriculums for different age ranges (4-6 year olds, 7-11, teens, and adults) who all focus on the same message of the day but with age appropriate material.  The participants come to support each other and many a parent has said it is their child who begs to go and continues the family's participation!  

Graduates of the program feel they know how to eat healthier but do not know where to get healthy food at the best price.  My task was to visit 10 local supermarkets and find out which one's had healthy options and at what price.  After doing this I created a comparative shopping guide we now provide to the families and also gave several presentations on the results of the study.  The main findings were:
1) there is a great deal of variety in the availability and price of healthy food items in the neighborhood between different stores.
2) The supermarkets marketed to and most frequented by Latinos had the fewest healthy options and those they did have often had the highest price tag.
3) It is possible (theoretically) to buy healthier food and save money in the neighborhood (buying less meat is a key part).

(At one of the presentations.  I had to learn a few new words such as ajonjoli (flax seed) which was a tough one for me to pronounce!)

My second project is only just beginning and the goal is to increase bicycle use and appreciation in the near south side of Milwaukee, especially within the Latino community.  A dream of our team is to one day hold a Ciclovia.  For those who do not know what this is check out an example at the following link:
More on this project in the future.

Recent Life Highlights/News

Crazy rotation but I really enjoyed it.  Working in one of Milwaukee's large public urban underserved hospitals we encountered all kinds of extreme cases and I think I saw almost every major obstetrical (having babies) complication there is!  See my previous post from February for a story about one of them.

Am I in Alaska?:
First, let me set the stage with a little background info. Milwaukee sits on the western edge of lake Michigan and right through the middle of it runs the Menominee river valley. This symbolic rift divides one of America's most segregated cities, with the North being mostly African American and the south largely Hispanic. In bygone days the valley was the engine for Milwaukee's industrial powerhouse and as a result the river became incredibly polluted over time. Several decades ago the city decided to clean up the area and from past photographs you almost wouldn't recognize it now. The river meanders along forested banks and on land there are a plethora of new, greener, businesses and an awesome bike/walking path that goes from the lake many miles inland called the Hank Aaron State Trail (HAST).
(The HAST!) 

My first day biking on the HAST I noticed two people walking around in the shallows of the Menominee river. I had learned some of the info I shared above but still thought it not the brightest idea as I figured the river was probably none to clean after so many years of abuse. As I grew nearer I could see they were fly fishing and stopped to watch. This seemed rather futile as there couldn't possibly be any fish in the river. As that thought passed through my head I saw one of the men's poles give a heave and proceeded to watch them reel in some huge trout/salmon looking fish which I later came to learn was almost assuredly a cut-throat. I couldn't believe my eyes! It felt like I was in the middle of the wilds of Alaska!  Yet, a glance behind me revealed several sky-scrapers.  Definitely in the city.  Crazy.  So, if you want to come visit, don't forget your fly rod:)

Third Birkebeiner ski race: Due to a profound lack of snow this winter I skied exactly 3 times before the race this year. However, the cross training I got from biking the snow-free streets must have been enough as I did the hilly 50k course in my second best time (3:45 vs 3:30 last year and 4:05 my first year) which I was more than happy with.  XC skiing rocks!

Hanging out with my Grandfather: One of my original hopes when coming to Wisconsin was to reconnect with the substantial number of relatives on my mom's side of the family who call WI home. I have been able to spend time with many of them (all wonderful experiences - thank you!) but was really hoping to see my grandfather more. My new location in Milwaukee is just 5 miles from where he lives which as allowed us to get together on three occassions so far for such adventures as:  baking bread, watching Wisconsin in the March Madness tourny,  practicing knot tying, and the telling of many awesome stories (i.e. my Gpa recanting such incredible tales as how he was shot down in WWII, survived, was held prisoner, and eventually escaped).  I have an awesome grandfather.

(Preparing to chow down on one of the meals we created)

Bikes: Maybe it's because I'm working on a project to get more people biking that I've had bikes on the mind but for whatever reason I've been exceptionally excited about them and riding them all over. I've discovered an incredible network of paved and off-road paths/trails around the city and each weekend go out exploring more of them. On my last rotation (primary care) I had two clinics set at opposite sides of the city but I still wanted to bike. The round trip ended up being just over 30 miles but as my afternoon preceptor didn't start until 2pm I had enough time to bike the hour plus down to her clinic after my morning clinic. I think I might be in the best biking shape of my life from commuting so much! The downside of such high mileage with a pack on was lots of pressure on my wrists and "areas that don't like lots of pressure" so I recently got a rack and some panniers.  Best decision ever; I can't believe I didn't make the switch earlier!

I've also become enamored of cargo bikes recently.  They can carry so much stuff you don't hardly need a car anymore!

(A smiling lady I do not know on a sweet cargo bike)

If you want to see more check out this awesome video of cargo bikes: 

Plans: In early January 2013, bar any unforeseen roadblocks, I will be heading to East Timor for 6 months to work in clinic and small hospital.  East Timor is roughly 400 miles NW of Darwin, Australia in SE Asia.  At that time I will also be assisting a Maternal Child Health Project that trains skilled birth attendants to help reduce the staggeringly high maternal and neonatal mortality in the country.  In preparation I am learning as much Tetum as possible (the most commonly used local dialect) and luckily have been put in touch with two fluent speakers who have graciously been my informal instructors for help with pronunciation and tricky grammar.

Ita diak ka lae?

To learn more about the clinic see:

This video blew my mind.  Earth is an amazing, and fragile, place.  This video made that message hit home in a powerful way.

Thanks for reading!