Interns Esther Sherrard, left, and Trisha Tokuhiro, right, worked this summer with the Hamakua Asthma Camp's 7-year-old group. Members of the group were, from left, Michael Key, Kapena Aveiro, Mikela Chong, Kaylen Souza, Taylor Pira and Joseph Charbonneau.

Interns take health
care to rural areas

In the process, they learn a great deal
about interaction with communities

By Helen Altonn

Graduate medical student Kevin Kitagawa got some lessons about doctors and patients this summer on Molokai that he said he will carry with him for the rest of his life.

University of Hawaii

Bonnie Ngai, working on a master's degree in social work, and other students compiled interviews with residents into a booklet, "Pahoa Pride," to counter negative images linked with drugs in the Big Island community.

Tracy Barbieto, also a graduate student in social work, was on a team in Waimea, Kauai, that helped with immunization clinics and held a summer health fun program for intermediate school students.

The three were among 15 University of Hawaii-Manoa medical, dental hygiene, nursing, social work, psychology and medical technology students participating in the federally funded Quentin N. Burdick Rural Health Program.

They lived and worked for six weeks in multidisciplinary teams in Honokaa and Pahoa on the Big Island, Waimea and Lihue/Hanalei on Kauai and Kaunakakai. Each received $1,500.

"They contribute to the community, and each leaves something wonderful behind," said Rebecca Smith, head of the Parent Community Network Center at Waimea High School and rural project site coordinator.

This summer, for example, teams worked with boys and girls in Waimea to develop a cookbook of healthy recipes; helped to run an asthma camp for 24 children in Hamakua; developed an intergenerational walking program, "The Miles Club," in Kaunakakai; and devised a health game to entertain and educate children in Pahoa about safety issues.

The UH program, which just ended its third year, is conducted under legislation sponsored by Sen. Daniel Inouye and the late Sen. Quentin Burdick, D-N.D.

It has been renewed through June 2005 with $734,101, said Dr. Jan Shoultz, program coordinator and an associate professor in the School of Nursing and Dental Hygiene, which co-sponsors the program along with the Kauai Rural Health Association and University Health Group.

In the first three years, 58 UH students in health-related fields went to rural areas to assess health needs and develop projects to address them.

Nancy Golden, executive director of Nana's House, a family-support center in Waimea, said the goal is to give them a taste of rural life so they will choose to practice their profession in a rural area.

"Just living in a rural community is an eye-opener for some of them," said Bev Cypriano, Hamakua Health Center nursing supervisor and rural project site coordinator there.

"Many areas are medically underserved," she said. "We want to inspire them to have a good experience and want to come back."

And many do, she said, noting a social-work student previously assigned to Hamakua returned to work at a long-term care facility.

Ngai said Pahoa "was definitely different than anywhere I had been before. ... One thing I definitely felt was the warmth and kindness and love you get from total strangers."

High school students are nudged toward health careers with opportunities to work with the UH students, each receiving $300 from the federal fund, Shoultz said.

Cypriano said a Hamakua high school student inspired by the program in previous years is starting the UH-Manoa nursing program this year.

For two high school students who participated this year, she said, "All of a sudden, their goals skyrocketed. They are going to college, to be like them (the interns). They know there's a world outside this little rural community and outside the Big Island."

Only one high school student could be federally funded in Waimea, so the Waimea Baptist Church, West Kauai Rotary Club and community members paid for three more.

"The community is very tight there," Barbieto said., describing many cultural activities the students had with kupuna. The students also toured hospitals, taught kids health activities and went on a three-day Kokee hiking trip.

On the Big Island the Pahoa interns went to places where kids hang out and asked them questions on flash cards about sun, ocean, creature (jellyfish), dog and insect safety for prizes. More than 200 kids played the game, Ngai said.

"They (UH students) learned that providing health care involves not just a physician, a medical or nursing student, but medical technology and social workers have a role," Cypriano said.

Each group has built on work of students before them and carried out projects the community can continue to develop, Cypriano said. For instance, the UH interns obtained some equipment and started a community exercise gym in the old Hamakua infirmary, and residents have stepped forward to continue it, she said.

Smith said an intern started a "Girls Are Great" health-related curriculum three years ago in Waimea to help troubled sixth-, seventh- and eighth-graders.

On Molokai the four UH students worked on healthy menu choices and physical activities for seniors and youths, and had many cultural experiences, including two days at the Hansen's disease settlement at Kalaupapa.

Kitagawa said he learned from doctors there that "a broad spectrum of knowledge is needed to practice in rural areas," and physician-patient communication is important. "I realized how well people responded simply by having their doctor genuinely care about their well-being."

Ty Uratani, a dental hygiene student who shadowed two Molokai dentists, extended his stay to go fishing with new friends and caught a huge ulua, said Judy Mikami, site coordinator who heads Lamalama Ka'ili (Glowing with Health) community health services.

She said an intermediate school student "had a tremendous experience" interacting with the UH interns and may now consider medicine as she goes on to college.

University of Hawaii

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