Fighting COVID From Two Countries

During my first semester in 2019 at Columbia Public Health, I had been searching for ways to get involved in public health initiatives outside the classroom. Considering my previous global health experiences in LatinX communities with MEDLIFE, a non-governmental organization that empowers disadvantaged communities in their fight for access to equal healthcare and education, I was thrilled to hear about the Puerto Rico Fellowship at Mailman. The Fellowship was created in 2018 as a way to respond to the health needs of underserved communities on the island following Hurricanes Maria and Irma. What particularly drew me to this Fellowship was the inter-professional education component, providing the opportunity to work with students from Columbia’s Schools of Nursing, Social Work, International Affairs, and Teachers College as well as the Community Based Participatory Research (CBPR) approach. Previously, I did not have the opportunity to work with other healthcare professionals, but as an aspiring physician, I know that learning from others is an important skill that will help me lead a team in the future. The CBPR approach is extremely important because it allows the community to lead the researchers, which helps ensure equity and respect. Our project was driven by the needs of the community and all results from the previous cohort were reported back to them for practical use.

This project is exactly what public health should be about: actively listening to community members and empowering them with access to evidence-based information in order to live healthier lives.

Through my involvement with the Fellowship, I had the opportunity to work with students at Columbia University, allowing my cohort and I to bring multiple approaches to the work we were planning to do in Puerto Rico. The diversity of our team gave us several different perspectives and ways to collaborate in support of our community partners, Proyecto ENLACE, and the University of Puerto Rico, in a powerful way. ENLACE is a local organization that was put together to prevent involuntary displacement and gentrification, restore natural ecosystems in polluted and stagnant bodies of water, and build resilient, healthy communities in underserved areas of Puerto Rico. The sustainability of the partnerships that the fellowship built since 2018 between Columbia and local organizations was honorable, and I truly felt lucky to be welcomed into a team that placed such high value on equity.

Once in Puerto Rico, our cohort of Fellows would be following up on the preliminary findings from 2019, examining a high prevalence of asthma in eight communities of El Caño Martin Peña. This northeast region of the island had experienced environmental injustices and a lack of government support during and following Hurricanes Irma and Maria. Our qualitative research focused on the experience of pediatric and adult asthma as well as any unmet medical and psychological needs in coping with natural disasters. From December 2019 to March 2020, we devoted many hours to developing focus group guides, creating interventions for disaster preparedness, asthma prevention, and stress management to promote mental wellness, generating training videos for our Puerto Rican counterparts, and fundraising. We were preparing to hit the ground running for our data collection trip to Puerto Rico during spring break.

Then the unimaginable happened. Something that, despite all the expertise of perspectives, nobody on the team could have predicted: COVID-19. When the service-learning trip scheduled for March 2020 was officially canceled, our team was forced to re-evaluate our goals and plan accordingly. Abandoning our community partners was not an option, yet ENLACE informed us that it would not be possible to conduct the planned interventions and focus groups from a distance. I was disappointed because I was looking forward to having the opportunity to implement the work that my colleagues and I developed on the ground. More importantly, I felt defeated that all the effort we had put into preparing for data collection and interventions would not be put to its intended use. Frankly, I was worried that we would not be able to fulfill our mission. Many Fellows also felt the destruction of a community we had just begun to build. The opportunity to form long-lasting relationships through the bonding experience involved with a service-learning trip had been taken away. With all the changes occurring during the pandemic, a few Fellows decided to take some time off the project for personal reasons. After our MPH courses officially moved online for the rest of the semester and students were asked to leave campus if they could, I decided to return to my hometown of Montréal, Canada.

Despite all the instability, I was able to successfully adapt to working remotely, complete my coursework, and remain actively engaged with the Puerto Rico Fellowship. We were disappointed with the unexpected circumstances, but we continued our work and shifted the focus to capacity-building and serving the community’s needs during the pandemic. Our partners requested help with educating their community about limiting the spread of misinformation around COVID-19. We were, therefore, able to dedicate our time to generating educational infographics and myth busters in Spanish, while remaining committed to the tenets of CBPR. The flexibility and the willingness to persevere that our team exhibited was truly inspiring. After all, we were able to accomplish our mission of best serving the communities in El Caño Martin Peña and in a meaningful way that reflected the urgency of an unfolding pandemic. We also applied for a grant at the Center for Teaching and Learning, allowing us to design an online course in order to ensure uniformity of baseline knowledge for all future Fellows and Puerto Rican students, save time with training on the ground in Puerto Rico, and have more engaging and efficient in-person interactions while working in the field. Being able to honor our commitment to our community partners amidst a crisis was extremely fulfilling, and I look forward to being part of the Fellowship’s 2020-2021 cohort.

As the Fellowship moved online and I returned to Canada, I was called upon by a faculty member at Mailman to lead a project within the newly formed COVID-19 Student Service Corps (CSSC). CSSC supports health systems and their patients, workforces, and communities facing the realities of COVID-19 through inter-professional service-learning. My involvement with CSSC and the Puerto Rico Fellowship affirmed my passion for public health and medicine, as I saw students from CUIMC respond to the needs of their communities during the pandemic.

I found myself working on COVID-19 related projects not only in service to a community in Puerto Rico, but at New York-Presbyterian through the Student Service Corps, and as a volunteer in my hometown community of Montréal.

Although this crisis has presented many challenges, it also created an opportunity for students to practice public health in real-time. The mobilization of healthcare professionals around the globe and the high-quality work accomplished in such a short period of the time reinforced my devotion to this field. I continue to be inspired by colleagues and mentors who were ready to respond to the crisis and those who are still working hard today. Being engaged in the COVID-19 response simultaneously in three communities internationally was a great privilege. It reinforced my passion for the collaborative, ambitious, and selfless nature of this profession, which serves humanity and strives to improve health for all. There has never been a better moment than right now to be a public health student. I will forever be grateful for the knowledge, mentorship, and opportunities that the Mailman School of Public Health has granted me, which enabled me to engage in various forms throughout this pandemic and beyond.

Amelia Papadimitriou is a 2021 MPH student in the Department of Epidemiology. She earned her Diplôme d’Études Collégiales pre-university degree in Health Sciences from Marianopolis College and a Bachelor of Science in Microbiology and Immunology from McGill University. 

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