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Students Share "Talents" on Indian Reservation

By Atsuko Yamahiro, M2
(adapted from "The Beat")

Children at the Cheyenne River Youth Project play on the slide. Feinberg medical students spent their Spring Break helping out at the youth center.

When we left on Saturday, March 27, I didn't know most of my Alternative Spring Break (ASB) teammates well, so I just sat in the corner of the van. Andrew Su passed out next to me buckled up in his seatbelt, pillow against the window. I felt excited and anxious as we passed the Rock 'N Roll McDonald's, the last bits of Chicago passing away.

We split the 16-hour drive into two days, stopping only for gas and an intense hike into the Badlands. After arriving on Sunday night, we started our week's work at the Cheyenne River Youth Project, an after-school program for children ranging from ages 3 to 18. The program promotes healthy family environments for kids by providing clothes, medications, and toiletries to registered families. All 11 of us stayed in the "computer lab," which ironically lacked even a single computer, with our sleeping bags stretched out on the floor.

We spent our mornings doing chores: sweeping and mopping the gymnasium, sorting through piles of clothes in the warehouse (a storage area for donations), baking food for a fundraiser, and making dinner for the kids. After school let out in the afternoon, the teens and the younger kids streamed into the center. Many of them came because their parents were busy, or because they had nowhere else to go. The children trickled into the dimly lit gymnasium, looking like they felt at home, grabbing the ball and playing basketball. The first hour, I played basketball with a girl about 13 years old. She called me "Grandma." "What are you going to do about that Grandma?" "Your shots are bad, Grandma!" I was shocked. We had been warned that their culture was blunt and sometimes a bit harsh. But did I really have wrinkles already? A bit later, a boy called a young girl ugly, and she simply laughed and proceeded to play with him anyway. I asked her if she was hurt and if she wanted the boy to apologize. She responded, "He's my friend!"

Despite being called a grandma, I managed to give many piggyback rides throughout the week, which turned out to be the popular "it" game among the younger kids. When we played in the dusty playground outside, there was always someone asking for a piggyback ride. Sometimes lines even formed. We tried to keep up with the demand: Taylor Reif, Ron Li, and I competed against each other in a piggyback race, running around the slide and play set. "Go, go, go!" our riders yelled, as we tried to reawaken muscles that had been hibernating. While I felt like I had gone to war and battled my way through the day, I grew to love these young children, and I looked forward to their coming each morning.

Casey, a frequent piggyback passenger, had short brown hair that bounced when she ran. Her facial expressions were faint: her small eyes farther apart, her voice nasal and lips thin from fetal alcohol syndrome. But when I picked her up, she giggled in my ears. And when I pretended to make her fall, she shrieked in delight. We found treasures in the dirt: old beads, a plastic star, and we washed them inside and she held them like diamonds. Right after dinner, with her mouth still full, she would ask, "Can we go outside? Can you give me a piggyback ride?"

I learned a lot about my classmates throughout the week. Taylor is a master Play-Doh sculptor: the kids immediately would guess what he made. Dolphin! Llama! Eagle! Marisa Gallant turned out to be a master of making delicious and decadent dinners. Even after a day of being pulled in all directions by children and chores, she organized an evening meal: pasta night, chili night, quesadilla night, burger night. Andrew Su is a talented photographer, and some children asked to be photographed, sometimes stealing his camera to try test shots. During teen night, Beth Schweighofer inspired high school kids interested in college, telling them how they could do anything they wanted. Lizhou Huang knows how to make chocolate-covered marshmallows that could pass as gourmet: swirls of dark chocolate and decorations made of M&Ms. Those creations helped us raise money for the reservation as we drove door-to-door in a 6-inch snow storm on the last day.

Brian Arnold knows his way around highways and navigated our group with ease from Chicago to South Dakota. We were all grateful that he was willing to drive early in the morning as the rest of us slept. Nick is a great basketball player and a good instructor, managing to teach the kids while still playing fairly. Every time we walked into the gym, he would be there with a group of teenagers, sweaty and focused on the game. Ron Li is a master ping-pong player, willing to take on any challenger. Ron and Matthew Turner made a good a capella duo in the car, and we harmonized and sang along to "The Lion Sleeps Tonight." Matthew always had something positive to say: about someone's cooking, about a jog we took in the morning, or the treats we made for the kids. Mariel Rosati was loved by the girl who called me "Grandma." That was enough of an accomplishment.

It was strange to be back in Chicago after a week at the reservation. I felt myself going through slight culture shock. Instead of the young girls giggling in my ears, I now hear sea gulls screeching as I run by the lake. The reservation has only one small cafe in the town, while we have a dozen restaurants in one block. Dogs roamed around freely at the reservation, some with burns and scars on their heads and body, while everyone here jogs and walks their meticulously groomed and pampered pets. At the reservation, young children basked in our attention; here I see young girls with dolls from American Girls' Place in one hand, their parent's hand in the other.

I don't know where to go from here, and I don't want these emotions to fade away. For now, I know I feel lucky to be part of a group of such amazing people. Together, we can use our skills to get the children who should be laughing every single day to giggle, so that they get piggyback rides every day from someone who loves them, and so they can achieve their dreams, just as Beth told them.

Hope is Abundant in Cheyenne River

By Ron Li, M2
(adapted from "The Beat")

The walls of the youth center in Cheyenne River were covered with paintings made by the kids, news clippings of youth center events, thank you posters from past volunteer groups, and a large painted banner that said "Follow Your Dreams."

A lonely trailer parked on the edge of the road, across from a small building with a sign saying "Cultural Center." Next to it, an open field stretched toward the setting sun behind the hills in the distance. A serene tribute to nature, but tainted by the artificial colors of plastic bags, scrap metal, and fast food wrappings. A 1980s Chevy pickup truck roared past, leaving a trail of dust that blended with the dried mud already covering the vehicle. As the sound of the engine died away, all that could be heard was a stray dog digging through a toppled trash can next to a house with boarded windows. With the setting sun, the painted letters on a rusted water tower – "Eagle Butte, SD"– gradually faded away.

More than once I have heard the word "hopeless" used to describe conditions in impoverished American Indian reservations such as Cheyenne River, which we traveled to during Alternative Spring Break (ASB). With a population of 619, Eagle Butte is its largest town and houses the tribal headquarters. Ravaged by poverty, gang violence, alcoholism, family instability, and some of the highest suicide rates in the country – particularly among youth – Cheyenne River, which is home to the Lakota people, is a testament to the legacy of institutionalized discrimination and the abuse of power by the United States government.

As late as the 1960s, Lakota children were forcibly taken away from their families at a young age and sent to government boarding schools as part of an assimilation program. Separated from their family, culture, and homes, they were stripped of a safe environment growing up, deprived of any parental figures, and in some cases, sexually and physically abused at the schools. And pushed to the most remote parts of the country with the least fertile land, the economy on the reservation suffers. With social instability, economic deprivation, and negligence by the U.S. government and media, the Lakota people are thrown into a vicious cycle of poverty and violence.

This was the Eagle Butte that I read about, heard about, and finally saw as we rolled into the empty Main Street late Sunday evening. But as we walked into the youth center, something changed. The Cheyenne River Youth Project (CRYP), a community youth center founded in 1988, is affectionately known as "The Main" by the community, as it provides a safe, fun, and enriching environment for children. Even though it was closed when we arrived, the center was full of life. The walls were covered with paintings made by the kids, news clippings of youth center events, thank you posters from past volunteer groups, and a large painted banner that said "Follow Your Dreams." We would later make our contribution with posters containing information about colleges and our own thank you poster that proudly displayed the Northwestern Wildcat.

Behind the tragic stories lies a narrative different than the one I had known. It is one of hope. Wiyaka Chasing Hawk, the youth center's Wellness Coordinator, talked excitedly about future programs he is planning for the kids, and he listed the things he needed to get done before the next week's community basketball tournament. He spoke passionately of the power of traditional American Indian spiritual medicine and how it helped his mother fight and win her battle against cancer. He eagerly gave me the phone number of his father, who is a leader in spiritual medicine and travels across reservations to advocate for the responsible and effective use of alternative treatments.

Jennifer spoke of her vision for the tribe, the successes she has had with her community center, and urged us to tell their story in our own communities. "Give us a chance, and we'll show everyone what we can do," was her message that night. The staff at Indian Health Services proudly showed us their plans to build a newer, larger medical center that will, for the first time, have amenities such as a staff break room and a Healing Room that patients can use to practice spiritual medicine.

After a bit of coaxing, a 13-year-old boy who had spoken earlier of wanting to get drunk and shoot up gangsters in Las Vegas, sat down and worked through some of his math homework. He answered all of the problems correctly. I patted him on the back and said, "That's awesome man, you're pretty sharp. Keep up the good work." He looked down and smiled.

During our brief stay at Cheyenne River, we did not save anyone's life or make any large, sweeping impacts. But for one week, we had a chance to live among the members of the community, work with them, and share stories with each other. And the message that resonated with me from the kids, the youth center staff, the nurse who gave us a tour of the local hospital, and the local grocer who bought cookies from our bake sale fundraiser, was one of hope, enthusiasm, and love for the community. "Give us a chance, and we'll show everyone what we can do."

A Golden College, A Golden Idea

By Ron Li, M2
(adapted from "The Beat")

Dr. Robert Golden, mentor of Feinberg’s Golden College, with high school juniors from the Perspectives High School (PCS) outreach program.

There were a few high school students sitting in seats during Structure-Function late last school year. As part of a ten-week outreach program at Feinberg, ten teens attended Dr. Cochard's Cranial Nerves lecture with their mentors, M1s from Golden College, to get a taste of medical school. Later that day, these high school juniors from Perspectives High School (PCS), an inner- city charter school, worked through an anatomy dry lab exercise to explore the heart's chambers and the muscles of the lower limbs.

To their great excitement, although with a mix of apprehension, their mentors later showed them these anatomical structures in cadavers. Many of them pointed out the soleus and gastrocnemius muscles they had learned earlier. Some listened intently as one of the mentors explained the anterior drawer sign as a way to diagnose a torn ACL. Evidently, they knew many athletes in their school who had torn ligaments. One student actually identified the optic chiasm in the head, a structure Dr. Cochard had taught that morning in lecture -- a feat impressive even for a medical student.

Led by College Mentor Dr. Robert Golden, a steering committee of five M1s—Meg Dowling, Bara Fintel, Brittne Halford, Ron Li, and Tony Ljuldjuraj—and the valuable support of Lauren Taylor and Dr. Elizabeth Ryan from the Department of Family and Community Medicine, the outreach program pairs PCS high school juniors interested in medicine with a medical student mentor from Golden College. The program helps expose high schoolers to a variety of experiences that an academic medical center offers, including hospital tours, a suturing workshop, a healthy-eating nutrition lab, and aspects of the Feinberg curriculum, including lecture, lab, and problem-based learning (PBL). The students recently worked with their mentors to present learning issues from a mock PBL case that dealt with sickle cell anemia, a disease that many of them have seen in their local communities.

Golden College has integrated this program into an academic service-learning project as part of College Curriculum Focus (CCF), a class in the M1 curriculum. But ultimately, the project is at heart about service. It is about helping bright, motivated high school students realize their potential and giving them opportunities that inspire them to follow and achieve their dreams. It is about transcending boundaries and strengthening relationships between Feinberg and the Chicago community to which we all belong. It is about answering the wish of one PCS outreach program participant who wrote, "I would like to end the outreach program on a good note and be able to take home new information from Northwestern to my brothers and encourage them to stay in school; that college is the way to go."

Camp Wildcat Heads to the Woods

By Andrew Haynes and Melissa Weinrobe, M2s

Campers on the Camp Wildcat trip did all kinds of fun outdoor activities, including roasting marshmallows to make s'mores.

Our packed school bus pulled away from the city: thirty kids, thirty first-year medical students, and enough supplies to survive on a desert island for a week, though sadly, we were departing only for a weekend. Luggage consumed the last four rows of the bus, as everyone crammed in (windows down) to make enough room. Paul Bottone, our president and fearless leader, broke the ice with a little sing-along. Although the generation gap was apparent—the campers didn't know the words to the Backstreet Boys, and we couldn't sing along to Justin Bieber—everyone had a good time. Two hours later, we pulled into Camp Tuckabatchee in Ottawa, Ill., and the weekend had begun.

Our mission at Camp Wildcat, a student-run group that works with the non-profit Chicago Youth Programs (CYP), is to provide positive recreational activities for a group of underprivileged, at-risk Chicago children. Our signature event is a weekend-long camp outside of the city that exposes these kids to camping activities and the outdoors, experiences typically inaccessible to them. We had worked with many of the kids during Camp Wildcat's science fair, the Halloween party, and through CYP's year-long tutoring program, but many were new faces.

The kids, ranging from age 10 to 12, stepped off the bus, were split into cabins by age, and were introduced to their weekend counselors. As I walked around to the different cabins, I heard some girls complaining about the camp being dirty and the bathrooms being gross. One asked me why there wasn't any electricity. Many of the boys were quiet, as if they didn't want to be the first one in the group to open up.

Quickly, however, the conversations changed. People started to find out more about each other and became more comfortable with their temporary roommates. Each cabin made a contract of behavior and came up with an off-the-wall name for their group, ranging from the "Sandy Knuckles" to the "Papa Smurfs." Human knots scattered the campground as kids and counselors alike worked together to free themselves from the tangle of arms they had created. Smiles filled everyone's faces as the campers adjusted to their new surroundings.

Medical student Ana Agarrat (right) bonds with two young campers from Chicago Youth Programs.

Camp flew by in record time. The weekend was filled with a giant color war pitting two teams of kids and counselors—Yellow vs. Green—against each other in a range of events. Activities included relay races, water balloon tosses, pie eating contests, and capture the flag. A long, final relay race involved a mummy wrap (campers wrapped a counselor in toilet paper), a search through fortune cookies for one with a clue, and a stacked-can rubber-band-shooting contest. It ended with the whole team passing M&Ms by sucking on a straw and weaving everyone's body through a set of hula hoops. In a limbo contest later that night, the unexpected winner was our very own Andrew Haynes. The 6'3" underdog somehow managed to beat kids who were multiple feet shorter.

Camp wouldn't be complete without a few other unique experiences. Paul Bottone, who had a brief stint as a park ranger before medical school, led a nature hike. He taught the kids about the importance of recycling and ended with an interactive game about the nutrient cycle. Timi Wusu started a camp-wide water fight as he single-handedly attacked a group of kids by the kickball field. Natasha Kennedy-Paesler helped each kid tie-dye a camp T-shirt and Joy Beissel managed to teach the basics of Salsa dancing to the group. Each night everyone gathered around the campfire to sing, eat s'mores, and tell stories. All of the cabins presented a skit on the last night. We heard from a 12-year-old future pop singer (and Justin Bieber clone) and watched as a few of the girls fed their counselors peanut butter and jelly, or rather smeared PB&J all over their faces.

Despite a few disciplinary troubles and a quick trip to the hospital for pink eye, the weekend went as smoothly as we could have hoped. And as Sunday afternoon approached, everyone was sad to say goodbye. Kids were talking about how they wished they could stay for a whole week or even an entire summer! If they were in 4th or 5th grade, they may have the chance to return next year. Otherwise, they will simply have to remember and cherish their weekend at camp. Each kid took home a hand-made picture frame with a cabin picture as a reminder of their time at Camp Wildcat. Even the boys were excited to decorate a picture frame with their camp names (and flowers), which I considered a personal success. Everyone packed onto the bus for the journey back to Chicago. After the kids were dropped off, and still today, I hear medical students saying "That was the best thing I did all year!"

Lessons Out of Africa

By Paul Bottone, M2
(adapted from "The Beat")

Paul Bottone spent his summer working in the city of Lomé, Togo, on West Africa’s Gulf of Guinea. He saw patients in the pediatric hospital.

Paul Bottone spent an eye-opening summer volunteering at a clinic in West Africa as part of a global health experience through the Feinberg School of Medicine.

In the city of Lomé, Togo—on West Africa’s Gulf of Guinea—almost all transit is by motorbike or on foot. The motorbikes are mostly taxis, often known as zemi-johns, that the Togolese take everywhere. It is not uncommon to see a man carrying a television or a family of four on a single bike. Helmets are rarely worn, and the lack of traffic laws compounds the danger of the sandy dirt roads.

Naturally, with these perilous factors—unpaved roads, absence of protection or restraint, aggressive driving practices—we were all wary of the motorbikes at the outset.

Ultimately, just one of my fellow volunteers was involved in an accident, and as she was uninjured, we began to wonder if the health threats were less than we had initially imagined.

Unfortunately, the true hazards of many things in our new country were often less obvious. I ultimately learned that in Togo, something as straightforward as a street—or a salad—could be harmful in more than one way.

I was at the Clinic Bien-Etre when I met a distraught young woman who had recently miscarried. She was prescribed a drug to promote uterine contraction, so that she could avoid infection, and after she left, the doctor explained that hers was not a rare situation. Pregnant women in Togo must ride motorbikes if they wish to travel in the city. The jarring movement of the rear passenger seat as the bike travels at high-speeds over rocky and pitted roads poses a serious threat to both mothers and early-stage fetuses. Accordingly, many pregnancies are lost on such rides and, as the doctor noted, the solution is not simple. Considering these transportation issues within the city alone, the prospect of changing these circumstances is daunting.

And there are other issues brought on by the roads that are similarly covert. When I arrived in the city, it had not rained for some time, and the roads were dry. June and July are rainy season months, however, and it was not long before the first downpour. Where there had been rutted streets, there were now stagnant pools, which initially seemed like just one more obstacle. Sitting on a porch in the evening, however, it was clear that the pools meant something else: a breeding ground for mosquitoes.

Since there are no storm drains and very few gutters along the streets, the floods came quickly and the water stayed for days or weeks, giving ample time for Anopheles mosquitoes, which develop in just one week and carry the malaria parasite, to drastically increase their numbers. Since these insects are most active at night, surrounding sleeping areas with nets impregnated with insecticides like Permethrin or Deltamethrin is the best way to prevent the spread of this disease. And yet even these simple measures, which can be acquired through my hospital for a few dollars, are not within reach for many families.

I came to realize that higher rates of malaria in the rainy season and miscarriages from bumpy rides on motorbikes have the same root as many more simple and highly visible health concerns in the country: deficient infrastructure. This means that such issues are pervasive even though treatments may be available; it is the foundation needed to prevent them that is not. And there are many instances—such as diseases from tainted water supplies—where the links between weak infrastructure and ubiquitous health problems are much clearer.

It was in considering and discussing this point with physicians and other healthcare professionals in Togo that I gleaned the most valuable lessons from my global health experience. "Public health" as an entity is not widely recognized in the region—although I did participate in a state-run vaccination program—and doctors there will nearly always cite the lack of medications and expensive technologies as the factors restraining care in their nation. But to me, it was clear that having an MRI machine or a cardiac surgeon at the hospital—neither of which could be found in the whole country—would not go nearly as far as fixing the roads in bettering the health of the citizens. And while this was an interesting, if not altogether surprising, realization, it was not a heartening one. A single philanthropist could buy an expensive machine, but building an infrastructure requires a political will uncommon in Togo.

That said, on an international level, the challenges are clear: countries like France and England are still very heavily invested in Africa. As long as it is more economically advantageous to have an undeveloped, dependent continent, there is small chance that they will be eager to act, unless countries like the United States, which have less direct investment there, pressure them to do so.

I can now say with more authority that time is of great importance in this issue, because I know that until things change, the Clinic Bien-Etre will continue to see young women who have lost their pregnancies because of bike-taxis.

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