Public health has long been a concern for rural America. In Nebraska, 34 counties have no hospitals within their borders, 14 of which don’t even have clinics. The 2019 floods and COVID-19 pandemic have highlighted where Nebraska struggles health-wise. However, this summer, the University of Nebraska Medical Center and the University of Nebraska–Lincoln’s Rural Fellows program are teaming up to combat this issue.
“There’s always been a need for healthcare in rural environments,” said Helen Fagan, program coordinator for the Rural Fellows. “But I feel like COVID sped it up and made the need even more pressing. Our hope is our Student Fellows from UNMC will help meet that shortage.”
“It’s exciting to give our students the opportunity to be physically relocated through the Rural Fellows program,” said Laura Vinson, the service learning programs coordinator at UNMC. “The College of Public Health is grounded in public health practice, and this experience will provide students the opportunity to build their practical skills and enhance their ability to partner with the community to address the public health needs that impact them every day.”
While healthcare traditionally refers to individuals’ physical wellbeing, public health works on a community-wide scale. Food accessibility, hike and bike trails, and mental health services are just a few facets of public health. At UNMC all Master of Public Health students participate in an Applied Practice Experience (APEX), where they work with communities and produce products that will improve general overall health. Vinson said the philosophy behind APEX aligns perfectly with the Rural Fellows experience.
“This public health practice experience is an opportunity for students to really immerse themselves into public health work,” she said. “A traditional internship is tipped more toward the academic benefit for the student, whereas APEX is focused more on service-learning that’s meant to be mutually beneficial and developed from the needs of the participating community.”
“It’s kind of a win-win situation,” said Fagan. “It helps address some of the rural health shortages, and it opens opportunities to students who may be interested in public health but haven’t thought about it through a rural health lens.”
This year four APEX students are also serving as Rural Fellows.
Master of Public Health (MPH) Emphasis: Epidemiology
Hometown: Rajahmundry, India
Before Dwarabandam came to Wakefield, the community already knew it had public health needs, said Megan Weaver, director of Wakefield Progressive, a community economic development organization. But those needs were unknown.
“We are conducting a study right now in order to have a good look at what the city needs,” said Dwarabandam, “in terms of housing, economic stability, health status, health access, education, neighborhoods and built environments. Our main goal is to address those needs.”
In addition to compiling information and responses from the study, Dwarabandam is also helping organize two events in July—a street market and an international food bazaar. Wakefield held a food bazaar in 1977, and thousands of people from the surrounding area attended. Dwarabandam and Weaver are hoping to recreate that kind of success.
“Health isn’t just physical,” said Dwarabandam, “it’s mental, social, economical and environmental. All of it comes down one thing: having peace of mind.”
MPH Emphasis: Epidemiology
On the western edge of the state, Kimme works with Valeria Rodriguez, co-founder of Empowering Families, a non-profit dedicated to building stronger communities through civic education and individual empowerment.
“I’m doing an assessment of barriers to mental healthcare for minorities, specifically immigrants and queer youth,” said Kimme. “There’s a great deal of stress on youth in these communities.”
Kimme spends his days contacting schools to discuss their resource options and studying applicable laws, such as special visa processes for immigrant youth who are in the U.S. without parents. He then is condensing that information into brochures and pamphlets that can be given out as an informative and helpful resource.
“I think the big thing is letting them know that there is support out there,” said Kimme. “Even if my materials and brochures aren’t exactly helpful, they’ll know that there is help out there, that they matter, that things can be a little bit brighter.”
MPH Emphasis: Maternal and Child Health
Hometown: Brazzaville, Republic of the Congo
After three years of working as a physician in her home country, Mabiala-Maye decided to stop working with individual patients and focus on making medical decisions that could help entire rural communities. That is the focus of her work on childcare accessibility.
“The issue in Valentine is every time they have workforce come in,” said Mabiala-Maye, “the families, most of the time, cannot stay because they don’t have high-quality childcare. So that’s why they want to build a community childcare center.”
The first step, which Mabiala-Maye is pursuing, is a needs assessment survey. She is polling residents on what would encourage them to use the center—cost, hours, amenities and location, for example. Once the assessment’s answers are compiled, step two will be helping create the business and budgeting plans.
When it comes to health, “in addition to being without disease,” Mabiala-Maye said, “you need to have a safe environment. You need to have a good place for your kids to grow.”
MPH Emphasis: Emergency Preparedness
“I’m organizing what’s called a personal preparedness activity for the Alliance Recreation Center (ARC) and their summer camp, which they do for K-5th grade,” said Pulver. “I created a lesson plan and outline for that, and it’s going to focus on personal or family pet preparedness.”
Pulver’s project stems from the ARC’s role as a community center and Chelsea Herian’s, ARC’s board chair, desire for it to meet more than just recreational needs. But Pulver’s plans go beyond childhood education. He is working with ARC's executive and operations directors to put together continuity plans for local companies as well.
“Basically it’s a type of emergency preparedness plan for businesses,” said Pulver, “and it’s primarily focused on reducing any disruptions to operations and mitigating financial impacts.”
For Pulver, disaster preparedness is a community endeavor. “I call it social capital,” he said, “which is basically the ability for everyone in town to know each other and rely on each other. It’s a big positive in the rural aspect of disaster resiliency.”
Learn more about the Rural Fellows program on Rural Prosperity Nebraska’s website.
Learn more about the APEX program on UNMC’s College of Public Health website.