Reflecting on the 2 years: Perspective from an Alum

I listened to an episode of the podcast “Hidden Brain” last week about parenting and they used a metaphor I want to share. The idea is that there are 2 styles of parenting, one is the carpenter and the other is the gardener. According to Allison Gopnik, a psychology and philosophy professor at UC-Berkeley,

The "carpenter" thinks that his or her child can be molded. "The idea is that if you just do the right things, get the right skills, read the right books, you're going to be able to shape your child into a particular kind of adult.”

The "gardener," on the other hand, is less concerned about controlling who the child will become and instead provides a protected space to explore. The style is all about "creating a rich, nurturant but also variable, diverse, dynamic ecosystem."”

I don’t parent. But I do spend a lot of time thinking about career goals. So when I heard this, I thought, “the fellowship is totally a garden.”

We arrive at Fellowship orientation after having gotten through grad school by doing all the right things. We read and critiqued the articles, nailed presentations by using a bunch of buzzwords, and networked with all the right people. But then we got to the Fellowship, looked around, learned that there are people who don’t like chocolate, and other people who only have like 2 cousins, and realized that sometimes things just don’t make logical sense.   

For someone who has historically found success by doing what I’m told, accepting that achievements aren’t always linear hasn’t been easy. But it’s been necessary. Perhaps I’m alone on this one, but for me, the Fellowship is where I learned that careers aren’t always like Legos, they are more like flower beds. What I once saw as building blocks, I now see as seeds. This idea works for me, not just because I have already seen some flowers from my Fellowship seeds, but also because my preceptor, Mary, is a gardener.

I’ll back up. As a new Fellow, I immediately wanted to take a class. Like I said, I have deep rooted ideas that taking a class leads to knowledge which means success. Do x and get y. Mary was in support of me sitting in on a GIS class so I could learn mapping skills, so by the end of August, I was back in the classroom. About halfway through the semester, I realized that this wasn’t a good use of my time and that knowing abstract concepts about satellite images wouldn’t do too much for me or my work. Also Google eventually gave us fusion tables, so who needs a GIS class anyway? When I talked to Mary about this and asked how she felt about me abandoning the GIS class, she told me about how she once took a master gardener class and found that knowing plant taxonomy wasn’t helping her keep her greens alive. She said that sometimes, it’s better to just do the work. And to me, that’s what the fellowship is all about. Getting your hands dirty, moving from concepts to actions, trying, failing, and just doing the work. 

When I look back on my time as a Fellow I think about things like that GIS class. Ideas I had and things I started, finished, or decided to walk away from--- which isn’t easy for me. Everything I did was a seed planted. There were a lot of false starts, or things that felt like one-off projects, with nothing building off of each other. At the time, it felt discouraging. Despite our efforts to find “the thing” I would do, the project that I could make my own, Mary and I ended up scattering seeds. In the moment, it felt like I was just running up against a bunch of bad luck. A couple of small grants we applied for weren’t funded, there was no clear direction to take when trying to build structured community partnerships, one training was enough for another group and no follow-up was needed, and so it went. I never found my thing. But by the time I left the fellowship, I left with a portfolio of work that carried me into the job I have now. In trying to take on large projects, I left with about 3 pages of small projects that hit all of the CALs and landed me a job that, after 6 months, I can confidently say that I love.

As a Fellow, I worked with Community Health Workers (CHWs). Sure, the grant we applied for wasn’t funded, but I was welcomed into their meetings and built relationships that had me creating program materials, helping with survey recruitment, then designing and presenting a poster with a CHW at WPHA.

Earlier this year, I facilitated an HIV training at the Mexican Consulate office here in Tucson with CHWs who work on the US-Mexico border. I even got to do it in Spanish. Prior to that, I conducted HIV trainings with CHWs and healthcare professionals from a couple of American Indian tribes in Northern Arizona. It is because of the work I did with Sherri Ohly and the CHWS in WI that I understand the crucial role CHWs play in engaging people in care.  

While spending time in these tribal communities, I thought about the Lac du Flambeau tribe who welcomed our Fellowship community into their work in my early days as a Fellow. After that first Fellowship meeting learning about tribes in Wisconsin, I tried to find a way for Fellows to partner with one or several of the tribes, with little success. But here I am, building partnerships with other tribes in a very different place, but who face some of the same challenges I learned about in Northern WI and then in all of the meetings that followed in which I was tested on cultural humility, patience, and bureaucracy. As much as I can understand these issues from the lens of a white lady, I think I get it. And that’s because of the Fellowship.

It is also because of the Fellowship that I’m able to have conversations about pronouns and  gender identity, which is great because I’m currently coordinating and helping to facilitate sex positivity trainings with HIV care and service providers.

I could go on and on. The data visualization lessons we had in Fellowship meetings and the poster and fact pages I made with CHWs gave me design skills that my team here has come to rely on, and I love that. I’m also able to answer questions about state health departments. And this time around, I was on the application end of the grant cycle instead of the review side. Turns out it’s helpful to have reviewed applications at the state level. The monthly Fellowship meetings I planned gave me an understanding of event planning tasks that I use every day. My participation in the WI Women in Government seminar, all of Alan’s storytelling sessions, and helping to create a podcast gave me the boost I needed to go to an op-ed workshop for women. I’m working on drafts of op-eds and, more personally, essays and stories for a local monthly storytelling event for women.

In summary, the post-fellowship life is full of color. Like in a garden, I’ve found that with the Fellowship, timing and pace don’t always work the way you expect them to, and that’s ok. You can plant two things right next to each other and they will grow in different directions at a different pace. You can’t control the weather or which way the wind blows, just as much as you can’t change who becomes the president, whether or not your work will be funded, who leaves your organization, or who might randomly drop in on a Fellowship meeting unexpectedly. So no, you can’t always control things. But you can plant seeds, be patient, and grow through what you go through. And then one day, you’ll find a blossom from something you forgot you even planted. For those of you in the middle of your Fellowship, know that growth is happening, even when the seeds feel scattered, the conversations feel random, and the buds are hard to see. The longer I work in public health, the more I realize the value of the Fellowship. I learned and grew more than I realized I would. And I hope that the Fellowship community and the CPDU sees some fruits from my time as a Fellow too.  

Thank you all for being there and creating a supportive, rich environment that allowed me to explore my interests and find my way on the path, even if that path took me somewhere unexpected. Thank you to my cohort for your unconditional kindness and support over the past two years. And mostly, thank you Mary, for always showing up and showing me how to do the work.

All my love from Arizona,

Britt

Britt Nigon, MPH 2016-2018 cohort (Preceptor - Mary Pesik, DHS)

Outreach Coordinator. Arizona AETC & Petersen HIV Clinics

Infectious Disease. University of Arizona College of Medicine

Learning Community Reflections: Tribal Health

“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.” – Lilla Watson, Aboriginal activists group, Queensland, 1970s

In September, our learning community ventured up to northeastern Wisconsin for an engaging two-day monthly meeting where we learned about the culture and health of the Menominee and Oneida tribes.   

An important theme was the powerful role that the US history of colonization and systematic oppression of native communities has played in causing the current health concerns of these communities today. Just as salient was the resilience and innovation of the Menominee and Oneida peoples and how they incorporate their culture for improved health and wellness. Jerry Waukau and Diane Hietpas of the Menominee Tribal Clinic explained how compulsory boarding schools, in which Indian children were forced by law to attend government and church run schools for assimilation, caused loss of language, culture, disrupted family ties and community structure, and often resulted in child neglect and abuse (aka ACEs) which is at the root of some of the cyclical family trauma in community. The work that the clinic and its partners are doing around culturally appropriate and person-centered trauma-informed care is making a huge difference in the community, has drastically improved their high school graduation rate, and led to their Culture of Health Prize recognition by the Robert Wood Johnson Foundation. At the Menominee Cultural Museum, Dave Grignon informed us of the success of ongoing family culture camps in improving substance abuse issues in the community. He also told us about the unjust Termination (I.e. loss of sovereignty) of the Menominee Tribe in 1961 and the major losses of land control, jobs, access to health care, and wealth that resulted, taking a major toll on their quality-of-life. I find it an atrocious abuse of power how the Federal government has stopped recognizing the sovereignty of tribes or forced them off of their land whenever the existence of the tribe was inconvenient for government or corporate profits.

Fellowship Learning Community learning about food sovereignty, heirloom seeds and community rebuilding from Menikanaehkem.

Fellowship Learning Community learning about food sovereignty, heirloom seeds and community rebuilding from Menikanaehkem.

Personally, I was most inspired by our visit with the grass roots, culture-centered group, Menikanaehkem. I was moved by their guiding philosophy when planning community events, which is, “Is this event going to bring hope, belonging, meaning, and purpose to this community?” As a way to resist the deficit-minded, consumerism culture of our time, this group is refocusing on their traditional cultural practices, values, and spirituality that guided their way of life for thousands of years. Guy Reiter of Menikanaehkem embodied that traditional spirituality with his peaceful presence and conviction to do what is best for the community. He verbalized this mindset when he said things like, “the creator loved us so much that he gave us our language and culture,” “we’re adding to the beautiful story of our people,” and “what matters more than everything is that we connect with each other right here in this moment.” It was easy for me to see how reconnecting to a mindset of gratitude, beauty, and connection with the land and their ancestors can build personal and social resilience and improve the health of their community.

Our discussion with Menikanaehkem has got me pondering. In many ways, Menikanaehkem is the opposite model of governmental public health: grassroots vs. hierarchical institution, culture vs. science, personal connection vs. systems and processes. How should authority, decision-making power, and resources be distributed among these models? How can our rigid institutions be more responsive to the needs of the people in the way that grassroots movements are? What can governmental and academic agencies learn from grassroots groups, whom are closest to the largest inequities, about how to improve the social and physical environment of the communities we live in and serve? How can those of us who work in governmental public health support or collaborate with grassroots groups like Menikanaehkem in a way that honors their history, expertise, culture, and way of life?

Mr. Dave Grignon at the Menominee Cultural Museum as the Fellowship Program is hosted by the Menominee Indian Tribe of Wisconsin.

Mr. Dave Grignon at the Menominee Cultural Museum as the Fellowship Program is hosted by the Menominee Indian Tribe of Wisconsin.

I don’t anticipate having all of the answers anytime soon, but we were able to discuss that last question a bit more than the others. During our visit with Menikanaehkem, one memorable piece of advice was that “if you don’t understand us, recognize our strengths, and know your own, then you can’t help us.” Melissa Metoxen from the Native American Center for Health Professions (NACHP) and the Oneida Reservation gave similar advice. She said that the key to working with tribes is to enter into relationship with members from the tribes. That means building trust over time by putting the tribes’ interests first, meeting face-to-face, and working hand-in-hand.

~ Cory Steinmetz