Dr. Janell Wright discusses her extensive journey in public health, highlighting the impact of community engagement and the importance of addressing social determinants of health. She reflects on her international experiences, the stigma surrounding diseases like HIV, and the need for a more supportive healthcare system.
• Janell shares her journey to public health • Emphasis on understanding root causes of health issues • Importance of community engagement in healthcare initiatives • Challenges faced by patients due to stigma • Transitioning back to the U.S. and her work at the CDC • Encouragement for young professionals, especially women in the field • Networking and mentorship as vital components of professional growth • Personal anecdotes revealing the importance of humane perspectives in healthcare • Reflections on family influences and experiences growing up abroad
-special thanks to Advanced 3D for sponsoring this episode.
00:00:00.620 --> 00:00:03.810 Welcome to Season 10 of the Prosthetics and Orthotics Podcast.
00:00:03.810 --> 00:00:11.788 This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen.
00:00:11.788 --> 00:00:20.131 Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes.
00:00:20.131 --> 00:00:23.207 Tune in and join the conversation.
00:00:23.207 --> 00:00:27.310 We are thrilled you are here and hope it is the highlight of your day.
00:00:27.310 --> 00:00:34.213 So welcome to an episode of the Prosthetics and Orthotics podcast.
00:00:34.720 --> 00:00:47.777 This is not your typical podcast, and so my sister, dr Janelle Wright, has joined us, and she has actually moved back to the US.
00:00:47.777 --> 00:01:02.761 She resides in Atlanta and we'll hear a little bit about her journey, but she has spent much of her life and career outside of the United States, and so that's going to be an interesting thing to dive into.
00:01:02.761 --> 00:01:07.971 We may actually talk about some of our childhood too.
00:01:07.971 --> 00:01:09.474 That should be interesting.
00:01:09.474 --> 00:01:13.245 And then we go from there We'll probably dive in.
00:01:13.245 --> 00:01:27.114 Janelle has been with me on multiple trips to Guatemala, and so we'll share a little bit about the prosthetic stuff that's going on with Life Enabled and how that ties in with her profession as well.
00:01:27.114 --> 00:01:29.534 So, janelle, welcome to the show.
00:01:29.534 --> 00:01:32.305 Thanks, or should I say Dr Wright?
00:01:32.305 --> 00:01:34.346 I mean, I think I can say Janelle, right.
00:01:34.486 --> 00:01:36.778 Yeah, Okay, I'm just curious like where I should be.
00:01:37.641 --> 00:01:41.090 So we can look at each other, but then you can mostly look at the camera, yep.
00:01:41.090 --> 00:01:42.442 So I'm over here.
00:01:42.442 --> 00:01:47.905 You can kind of see we've kind of have a makeshift studio.
00:01:47.905 --> 00:01:48.786 I guess you would say.
00:01:48.786 --> 00:01:57.064 So if you have any questions for us, let us know and then we'll just kind of go from there.
00:01:57.064 --> 00:02:02.546 So you know, take us a little bit on your journey.
00:02:02.546 --> 00:02:06.370 So you probably have never listened to the orthotics and prosthetic podcast before.
00:02:06.370 --> 00:02:07.793 Right, I have actually.
00:02:07.793 --> 00:02:09.556 Oh, you have, I have.
00:02:09.556 --> 00:02:19.472 Okay, well, you do like podcasts, okay, so before we get into that part, then, what are some podcasts that you really like, that you follow?
00:02:19.793 --> 00:02:20.713 It's a very good question.
00:02:20.713 --> 00:02:38.596 Recently I've gotten into a lot of entrepreneurial podcasts that, quite frankly, I forget the names of them, but I like listening to them because they are talking about innovation and creativity and new ways of doing things, productivity, efficiency.
00:02:38.596 --> 00:02:41.080 So recently I've gotten into those.
00:02:41.080 --> 00:02:47.585 I've also downloaded some finance podcasts because I want to get a little bit more financially literate.
00:02:47.585 --> 00:02:49.826 This health where you're at now.
00:03:07.641 --> 00:03:25.092 So we have a very diverse audience and there's a lot of people that may be curious on how to make an impact, while they're not necessarily as a leader let's say it that way not necessarily as a clinician, so to speak.
00:03:25.092 --> 00:03:42.328 So a lot of times we'll have somebody on that's either a technician or some sort of vendor or something that they absolutely make a difference in people's lives, but they're not impacting them individually one-on-one.
00:03:42.328 --> 00:03:49.586 Now I know you do some of that, but you are have grown very much into a leader role where you empower others.
00:03:49.586 --> 00:03:56.329 So take us on your journey the multiple countries, some of the languages that you've learned, and then go from there.
00:03:58.281 --> 00:03:59.682 Sure, I'm trying to think about.
00:03:59.682 --> 00:04:07.170 I think it's a really good positioning to think about.
00:04:07.170 --> 00:04:16.980 How do you think about public health versus clinical health, and is it a versus, or is it an and or or an and and?
00:04:16.980 --> 00:04:25.834 So I like to think of it as an and, because a lot of the things that you think about as a clinician, you are also thinking about maybe on an even a bigger scale.
00:04:25.834 --> 00:04:50.690 So when you're definitely thinking about prosthetics, orthotics, you're seeing a lot of people that may have had diabetes or have diabetes, or they have some other issues that have, you know, propelled them forward into, you know, a situation where they're going to need a prosthetic or an orthotic or whatnot, and you start thinking, well, what does this look like on a bigger scale?
00:04:50.690 --> 00:04:52.586 What does this look like for the population?
00:04:52.586 --> 00:05:00.629 So, what are some of those things that we can do to mitigate those issues that lead to the things that we're seeing in our clinics?
00:05:01.009 --> 00:05:02.132 And that is public health?
00:05:02.132 --> 00:05:03.125 It's thinking about root causes.
00:05:03.125 --> 00:05:03.709 It's thinking about health.
00:05:03.709 --> 00:05:06.002 It's thinking about root causes, thinking about population.
00:05:06.002 --> 00:05:16.132 It's thinking about the drivers of some of these things, is it, you know, what we call social determinants of health, and that's kind of a very jargony way of talking about.
00:05:16.132 --> 00:05:18.382 How does poverty, how does education?
00:05:18.382 --> 00:05:20.725 How does housing?
00:05:20.725 --> 00:05:28.805 How do all of these things interlink to create some of the factors that lead towards certain health outcomes?
00:05:28.805 --> 00:05:36.269 And so, as you're thinking about this as a clinician, you're also thinking about this on a larger level and sometimes you might think, oh my goodness.
00:05:36.269 --> 00:05:41.334 Well, what would happen if I actually went into a community and talked to them about diabetes?
00:05:41.334 --> 00:05:50.327 Would that prevent people from going into some of these, you know, having some of the impacts that it has had on their bodies, right?
00:05:50.327 --> 00:06:01.601 And so just kind of giving you a framework of what is public health, because I went to a comedy show one time and they invited me on stage and they're like, what do you do?
00:06:01.601 --> 00:06:02.603 And I said public health.
00:06:02.603 --> 00:06:06.329 And it was just like everybody, like nobody knew what that meant.
00:06:06.329 --> 00:06:14.411 Granted, this was before COVID, so I think a lot of people started to become a little bit more understanding about public health when COVID hit.
00:06:14.411 --> 00:06:19.339 But public health is a lot bigger than just infectious diseases and combating that.
00:06:19.500 --> 00:06:28.833 So, anyway, giving you a little bit of a history about, or just like a little bit of a background about, what public health is, and so my journey actually started there.
00:06:28.833 --> 00:06:48.185 I wanted to be a doctor, I wanted to serve patients and I was working in a rural community and every single day I was seeing the exact same thing over and over I was seeing gastritis, I was seeing diabetes, I was seeing hypertension and we just, you know, I was an intern, so we were just giving the same medicine every day.
00:06:48.185 --> 00:06:56.161 And I thought what would it look like to be able to go into this community and actually teach them about healthy habits, movement, you know, eating well?
00:06:56.161 --> 00:06:59.788 And my mom looked at me and she said that is public health.
00:06:59.788 --> 00:07:09.053 And so I pivoted really quickly actually, instead of going into medical school or clinical education, and I decided I was going to go into public health.
00:07:09.053 --> 00:07:15.653 And so maybe I'll stop there, as like that was my entry into public health and why I decided to go into public health.
00:07:16.160 --> 00:07:19.470 So that's, that's quite a journey and it's interesting to hear that.
00:07:19.470 --> 00:07:32.309 I mean, would you say and probably not many of our listeners actually know that we grew up out of the country, so that might be something that we touch on a little bit too.
00:07:32.309 --> 00:07:43.862 Do you feel like the way that we were brought up and the exposure in the way that we lived has shaped kind of you where you're at professionally?
00:07:45.004 --> 00:07:45.545 Absolutely.
00:07:45.545 --> 00:08:45.094 You know, I think that growing up we were seeing our father work in healthcare settings, cause he's an engineer and he was working on the electrical design and the electrical equipment that was in hospitals, and that was what I thought was, you know, serving, serving people, serving the community and so that's how I got into you know, serving, serving people, serving the community and so that's how I got into you know, let's serve the community by outreach on their health, and I think that's how you kind of got into that as well Serving underserved populations, vulnerable populations and so we got that in Ecuador and in Kenya, when, when we were there, and then also on some of the trips that um dad took around the world and he would come back with stories right, he came back with stories from um bangladesh, and I think that's where you got interested in prosthetics and what that could look like to serve a community and make people whole, um, by providing them a way of getting a limb that they lost.
00:08:45.794 --> 00:09:09.806 Yeah, so, but going back to your side of things, so you, that's something that you wanted to get into and make a difference, and really we're talking about some of the basic essentials of health really around the world and how to be healthy essentials of health really around the world and how to be healthy.
00:09:09.806 --> 00:09:12.934 Take us a little bit on your journey, like countries to countries.
00:09:12.934 --> 00:09:13.697 What did you actually do?
00:09:13.697 --> 00:09:29.876 And then I think it's really interesting how you embrace the cultures as you've gone, like you've dove right in and I think so I'd love to hear some of those stories too, because you know, it's not just Spanish speaking.
00:09:29.876 --> 00:09:46.514 We were around Spanish speaking, but you were in many other places that are different cultures than, like, south American culture, Central American culture, where thoughts are different, news is different, all that.
00:09:46.514 --> 00:09:55.513 So I'd love to hear some point to point with where you've been and then kind of how it's come full circle now at the end.
00:09:56.441 --> 00:10:02.100 So I started out doing internships, as I mentioned, and trying to figure out what I was going to do.
00:10:02.100 --> 00:10:12.865 So I did an internship, actually moving back to Ecuador to work with a public health nurse that we knew growing up, and I thought this will be a great opportunity to learn a little bit more about public health.
00:10:12.865 --> 00:10:25.065 And that's when I was introduced to working with HIV patients and learning that it's a lifelong disease, learning that it is a huge impact on not just the individual but the community.
00:10:25.065 --> 00:10:29.874 And so from those internships I got a master's in public health.
00:10:29.874 --> 00:10:32.447 You may have heard of it an MPH.
00:10:32.447 --> 00:10:35.801 There's a lot more schools that are providing this education right now.
00:10:36.142 --> 00:10:47.673 It's a two-year degree and in the middle of that I did an internship in China because I thought, you know, I've done Africa, I've done South America, let's go to Asia.
00:10:47.673 --> 00:11:02.283 And so that was a completely different culture and got to work in Western China and was working with them in their aid center and just got to experience a very different side of the HIV epidemic in Asia.
00:11:02.283 --> 00:11:13.785 From there I finished up my degree and I applied to a lot of fellowships and if you are thinking about public health, fellowships are the way to go, or internships just to get your foot in the door.
00:11:13.785 --> 00:11:17.160 It's just a great way to get exposure in a lot of different ways.
00:11:17.160 --> 00:11:24.514 So, out of the I don't know 30 fellowships that I applied for, I got one and they gave me 24 hours to decide.
00:11:24.514 --> 00:11:37.191 I was on a vacation with Aunt Becky, actually, and they called me and they said you have 24 hours to decide if you're going to Vietnam for this public health fellowship with the CDC.
00:11:37.191 --> 00:11:40.985 And I was like, absolutely not, that's crazy, I'm not going there.
00:11:40.985 --> 00:11:44.202 And I remember dad calling and saying you are going.
00:11:44.202 --> 00:11:51.902 And I thought no, I don't want to go, I want to stay in North Carolina, I want to work for one of the organizations here.
00:11:51.902 --> 00:11:56.592 And dad was like, no, you need to experience something totally different.
00:11:56.592 --> 00:11:58.904 You need to go, chase your dreams.
00:11:58.904 --> 00:12:03.664 And that's a pivotal moment actually just having that encouragement from family friends.
00:12:03.664 --> 00:12:15.207 So I did it and that was the 2008 and started my journey on working on the PEPFAR program, and PEPFAR stands for the President's Emergency Plan for AIDS Relief.
00:12:15.207 --> 00:12:32.054 It's the biggest public health endeavor that the United States has provided for one disease across the world and, as of right now, just as a plug for that, 7.8 million people's lives have been impacted by PEPFAR.
00:12:32.054 --> 00:12:36.769 And so I started in Vietnam and I started working there and I was there for four years.
00:12:37.291 --> 00:12:52.000 I learned Vietnamese to the degree that I could order, I could travel, I could read some, I could interact with people, and Vietnamese is not an easy language to pronounce but the grammar is actually fairly I wouldn't say simple, but easy.
00:12:52.000 --> 00:13:02.548 And, just you know, just got into that culture a little bit more and then from there I went to Kazakhstan and that is in Central Asia.
00:13:02.548 --> 00:13:05.673 And if you're wondering where that is, it is literally in Central Asia if you look, and it's just like right in the Asia.
00:13:05.673 --> 00:13:07.583 And if you're wondering where that is, it is literally in Central Asia If you look, and it's just like right in the middle.
00:13:07.583 --> 00:13:09.628 It's the ninth largest country in the world.
00:13:09.628 --> 00:13:33.899 And so I covered the region of Central Asia with Kyrgyzstan, tajikistan, uzbekistan, turkmenistan and Kazakhstan, and there I learned Russian because I just like talking to people, so I and it's easier to pronounce the language, but it's actually the grammar is very, very difficult, but fell in love with that region.
00:13:33.899 --> 00:13:48.990 It is a wide open, you know outdoor space, and just loved climbing the mountains and experiencing very cold winters, experiencing very hot summers, but there I got exposure to a very different environment for public health.
00:13:48.990 --> 00:13:52.522 The social determinants, as I mentioned before, are very different.
00:13:52.522 --> 00:14:19.432 Their culture is very different, the things that they care about and the way that they live is very different, but they care so deeply about their families, they care so deeply about their health and so you know, working on a diplomatic level with them to respond to the HIV epidemic there, which is primarily driven by people who inject drugs, which is a vulnerable group and it's a stigmatized group.
00:14:19.432 --> 00:14:29.975 So working on that got me a little bit closer to understanding you know what is important in public health and how do you address kind of root causes of public health.
00:14:30.539 --> 00:14:36.480 From there I went to Ukraine and I worked there for a year and I worked on health reform.
00:14:36.480 --> 00:14:45.115 I took a break from HIV, started working on some health reforms and working with the government on primary care and secondary care and looking at policies.
00:14:45.115 --> 00:15:05.392 What does it look like to create policies at a national level to promote health, to identify these root causes of health issues that they're facing and try to work with the primary care to have better access for these people to come and get treatment.
00:15:05.392 --> 00:15:14.092 From there I went to Guatemala and in Guatemala I was there for five years and just recently returned from Guatemala.
00:15:14.092 --> 00:15:16.967 I was continuing to work on HIV.
00:15:16.967 --> 00:15:23.288 But if you can remember, four years back we did have a COVID epidemic and that's where I was when COVID hit.
00:15:23.288 --> 00:15:33.783 And because I was covering all of Central America, I was working on the COVID epidemic and providing modeling and epidemiology and advice for the governments there.
00:15:33.783 --> 00:15:58.159 We did a laboratory, you know, providing laboratory tests, and provided again the epidemiology around the modeling of the epidemics and it was very interesting to see how globally, what was happening with the COVID epidemic and we were able to model that out and kind of predict what might be in Central America or coming up in Central America.
00:15:58.921 --> 00:16:14.017 But for the majority of the time that I was there, I was working on HIV and working with the governments in Central America on issues like migration and how does health impact or how is health impacted during migration?
00:16:14.017 --> 00:16:16.881 How is health impacted by?
00:16:16.881 --> 00:16:23.107 You know, actually, you know some of the climate change issues that are happening and whatnot too.
00:16:23.107 --> 00:16:31.821 So that's been my journey and after 16 years I said I am ready to return to the United States and be closer to my family.
00:16:31.821 --> 00:16:44.716 So I worked really hard and got a job at headquarters in Atlanta CDC and I'm working there now covering five countries in Africa as kind of a overall regional associate director there.
00:16:44.716 --> 00:16:54.754 So now I have a whole new portfolio in Africa and learning Portuguese and French now, so that is going to be a whole new adventure.
00:16:55.659 --> 00:17:11.183 So I mean, that's quite the tour, and it's a lot of languages, so let's see you touched so obviously English, Spanish, Russian, Vietnamese, Ukrainian, a little bit of Ukrainian, Ukrainian.
00:17:11.183 --> 00:17:13.087 Um, what's in Kazakhstan?
00:17:13.087 --> 00:17:14.250 Russian?
00:17:14.250 --> 00:17:14.971 Okay, Russian.
00:17:15.212 --> 00:17:15.313 Yeah.
00:17:16.701 --> 00:17:17.241 I didn't learn any.
00:17:18.044 --> 00:17:19.788 Yeah, I didn't, yeah, I don't.
00:17:19.788 --> 00:17:21.030 I did not learn Kazakh.
00:17:21.192 --> 00:17:23.268 So now, now it's Portuguese and French.
00:17:23.750 --> 00:17:25.219 Now it's Portuguese and French Now it's Portuguese and French.
00:17:25.239 --> 00:17:27.086 Okay, that's a lot of languages.
00:17:30.305 --> 00:17:37.814 So, food-wise, it really runs the gamut of good food.
00:17:37.814 --> 00:17:43.192 Where, would you say, has been the best food that you've experienced?
00:17:44.362 --> 00:17:45.567 I love Vietnamese food.
00:17:45.567 --> 00:17:48.566 Vietnamese food is unbelievable.
00:17:48.566 --> 00:18:01.951 It's very light, there's a lot of salad, there's a lot of different flavors and for meat eaters I'm actually a pescatarian, so for meat eaters there's a lot of different types of meat.
00:18:01.951 --> 00:18:04.548 There as well, they use the entire animal.
00:18:04.548 --> 00:18:07.348 So lots of adventures in that.
00:18:07.348 --> 00:18:14.432 In Central Asia there's what's called shashlik, which is a barbecue, and people love that.
00:18:14.432 --> 00:18:33.325 And you know, in Ukraine they had a conglomeration of a lot of the different foods across the post-Soviet Union and I will say Georgian food from Georgia, the country of Georgia, not the state, is bar none the best food, I think, in the world.
00:18:33.325 --> 00:18:34.686 So not the peaches.
00:18:35.588 --> 00:18:35.788 Right.
00:18:35.808 --> 00:18:36.309 Not that one.
00:18:36.309 --> 00:18:44.276 Okay, and I will say, when I got to Guatemala I thought we're going to have some tacos.
00:18:44.276 --> 00:18:48.309 It's right next to Mexico, but let me tell you, when that border hits, there are no tacos.
00:18:48.309 --> 00:18:54.133 There are some, but it's a very different than a Mexican taco and the spices that they have in Mexico.
00:18:54.599 --> 00:18:55.965 So yeah, yeah.
00:18:56.560 --> 00:19:02.529 Well, interestingly enough, I've never had Vietnamese food, so we're going to have to go get some Vietnamese food.
00:19:03.539 --> 00:19:04.481 OK, they have meat there.
00:19:04.481 --> 00:19:05.624 I'm not a pescatarian.
00:19:05.944 --> 00:19:07.106 They definitely have meat there.
00:19:07.106 --> 00:19:08.789 Yeah, Lots of lots of pork.
00:19:09.351 --> 00:19:10.333 Well, very cool.
00:19:10.333 --> 00:19:36.230 Well, let's um, I'd love to hear some of the, you know, kind of the highlights of how public health and the, the programs that you've been involved with, have like what you've seen, like, uh, the way people live or or give them a better quality of life, and then, uh, and then I'll ask another question after that.
00:19:36.230 --> 00:19:38.623 I have another question in mind, but I'd like to.
00:19:38.623 --> 00:19:39.526 I'd like to hear that part.
00:19:39.926 --> 00:19:45.656 So working on HIV is, again, it's a lifelong.
00:19:45.656 --> 00:20:07.034 It's a lifelong disease that people need to take um, um, uh, a medication for right now, every single day and so, but in the United States right now, and some of the Western countries, they have some injectables which is, you know, every other week or every other month, or you know, it's not as much as every day.
00:20:07.034 --> 00:20:17.180 The reason why I'm saying this is what we have strived to do in a lot of the programming that we are doing now is there's really really good medication for HIV.
00:20:17.180 --> 00:20:28.698 There's very good prevention biomedical prevention for HIV as well and so it's getting access for people in the community or where they live versus coming to the clinics.
00:20:28.698 --> 00:20:42.730 And so my whole thing is demedicalization of HIV as a chronic disease, and so it destigmatizes it a little bit more and it provides a better quality of health or a quality of life.
00:20:42.730 --> 00:20:43.131 Why?
00:20:43.131 --> 00:20:51.537 Because people aren't going to have to constantly be taking a medication every single day or going to the clinic every single month for the rest of their lives.
00:20:51.537 --> 00:21:09.193 So I think one of the things that I've seen is, as we've worked with ministries of health and governments on policies around demedicalization of a very, very highly complicated what was a very complicated disease is changing people's lives.
00:21:09.193 --> 00:21:14.307 They're more adherent to the treatment is changing people's lives.
00:21:14.307 --> 00:21:38.682 They're more adherent to the treatment, they're more willing to live their lives in the communities, because once you have a suppressed viral load I know that's kind of a technical way of saying it but once you don't have an undetectable amount of the virus in your body which we can test for, you don't transmit HIV, and so people are much more confident in their lives and they're able to live a normal, happy life with those medications.
00:21:38.682 --> 00:21:43.031 And I would say that's probably the biggest thing on a larger scale.
00:21:43.031 --> 00:21:48.166 Once people experience that in their lives, they're able to live their lives.
00:21:48.207 --> 00:21:51.031 Because when you get HIV, it's not only you know.
00:21:51.031 --> 00:21:58.071 Some people think of it as this death sentence essentially I'm going to die and that's what it used to be before there was medication.
00:21:58.071 --> 00:22:05.076 Now there's not a cure for HIV, but there are these medications that are very, very effective and have minimal side effects.
00:22:05.076 --> 00:22:27.082 At this point, I think, on another level as well, of people that you know are impacted by HIV, a lot of people don't find out until much later, when they start getting some of the infectious diseases that are associated with a lower immune system, which is what happens when you have advanced, more advanced in the HIV disease.
00:22:27.082 --> 00:22:38.997 And so, you know, some people have lived, you know, five, seven, eight years with this disease without knowing it, and so one of the things that we've tried to do is get more access to testing for HIV.
00:22:38.997 --> 00:22:48.047 So then it impacts, you know, people taking more preventative care of their own lives and those around them, and that reduces the impact of HIV in a community.
00:22:48.047 --> 00:22:49.368 Impact of HIV in a community.
00:22:50.108 --> 00:23:10.971 And such, and we were actually just starting before the technical difficulties talking about the demedicalization Is that the words you used Of HIV and I wanted you to share some of the stories from what you have heard.
00:23:10.971 --> 00:23:21.709 And so one of my favorite stories is when you have gone in to some of these clinics and such and you hug on the patients, love on the patients and it takes people back a little bit.
00:23:21.709 --> 00:23:31.901 There is a stigma to having HIV and you have kind of helped ease that stigma some and then bring an education into that.
00:23:31.901 --> 00:23:36.912 So I'd love for you to share a little bit of those stories as well.
00:23:37.692 --> 00:23:54.586 Sure, you know, one of the things that stands out to me is we started a project in Columbia working among migrants, and a lot of them are impacted by HIV and a lot of them are impacted by HIV.
00:23:54.586 --> 00:24:29.108 Just the nature of migration and whatnot causes a lot of vulnerability among patients, and so I remember one of the first times we sat there and we had kind of a focus group where we had five to seven migrants sitting with us talking about their experience working with the doctor and the nurses in the clinic and just hearing them, listening to them, understanding what they had been through, understanding what their challenges were and giving them value, just by listening and asking good questions.
00:24:29.108 --> 00:24:32.395 And you know we asked them.
00:24:32.395 --> 00:24:33.657 You know, do you have any questions for us?
00:24:33.657 --> 00:24:38.314 Do you have any recommendations for improving our clinic and our services?
00:24:38.314 --> 00:24:48.509 And you know, I think that's part of it is bringing the patients in to design what we call a person-centered approach to service delivery.
00:24:48.509 --> 00:25:12.719 And they were able to give us really good ideas about how to improve the access by having the clinics open later, having the clinic open on Saturday, having a private area where they can get counseling, having a time where they can bring their families in and help them understand what they're going through in terms of education, and so I think that helped.
00:25:13.026 --> 00:25:30.766 Even the you know, the clinical staff at the site think about wow, how can we make this a better environment for people to come to and that they would want to bring their friends to and whatnot, because it is a very vulnerable time in their lives when they find out that they're HIV positive.
00:25:30.766 --> 00:25:31.359 So I think that comes to mind.
00:25:31.359 --> 00:25:32.356 I mean it was very impactful time their lives when they find out that they're HIV positive.
00:25:32.356 --> 00:25:33.105 So I think that comes to mind.
00:25:33.105 --> 00:25:34.750 I mean it was a very impactful time.
00:25:34.750 --> 00:25:38.830 We spent like two or three hours with them just listening to their stories.
00:25:38.830 --> 00:25:51.354 And maybe one thing I'll just add on that is it's important to listen to their stories as their stories and not my story, and not projecting what I would feel or what I would think or what I would do in that situation.
00:25:51.354 --> 00:25:57.166 It's not necessarily disconnection.
00:25:57.166 --> 00:26:04.333 It's connecting by giving them the dignity of what their own experience has been, what their own journey has been to get them to where they are, and giving value and dignity to that.
00:26:06.119 --> 00:26:13.432 Yeah, I mean, I think that's really interesting and I think it plays into some of the stuff that we do with the prosthetic and orthotic stuff in the clinic.
00:26:13.432 --> 00:27:06.353 There's also a stigma of having a limb that is lost or gone and being there, hearing that story, also being around other people that have had that, has been so impactful, and I think that's one of the things I think just healthcare in general is we forget the aspect of the human behind anything that's going on, and I think that's also a very important part of any of this, whether it's the HIV stuff, whether it's any of the myriad of sicknesses that you follow, but also things like people that have had an amputation, people with diabetes, any of those other things.
00:27:06.353 --> 00:27:19.641 There's a human behind that and I think, more than anything, that is the most important and I think that's what that sort of empathy also breeds success ultimately in the end.
00:27:20.384 --> 00:27:30.278 Absolutely, and we talk about public health as kind of a triad and there's actually a fourth part of that that we've started adding in but it's quality, cost and access.
00:27:30.278 --> 00:27:42.050 And so when we think about how do we improve access, how do we improve quality and decrease cost that's like the triad of public health, and I think what you're talking about is access.
00:27:42.050 --> 00:27:58.191 The person behind the issue being able to access services, being able to not just have to go two days on foot to go find a clinic, but have the clinic come to them or whatnot.
00:27:58.191 --> 00:28:11.068 So and these are some of the trade-offs that we manage in public health is, you know how much good can we get out of the resources that we have and bringing those services to the patients.
00:28:11.068 --> 00:28:18.670 But when they recognize how much effort is going into providing them services, there's a gratefulness behind it.
00:28:18.670 --> 00:28:20.070 There's a thankfulness behind it.
00:28:20.070 --> 00:28:23.491 I mean just thinking about the humanity of it.
00:28:23.752 --> 00:28:33.030 When COVID was happening, I remember when I got COVID and the nurse asked me you know, over the last five days, who have you interacted with?
00:28:33.105 --> 00:28:36.134 We need to tell those people that you have COVID.
00:28:37.526 --> 00:29:04.936 I just remember being devastated by that, that potentially that I was infecting them, you know, and that gave a lot of humanity and empathy and understanding for what people are going through when they find out that they have HIV or when they find out that they have an infectious disease and having to disclose to their partners, or having to disclose to their community or not, right.
00:29:04.936 --> 00:29:28.258 So it's just kind of that discussion and those are really really tricky discussions that we have to have with the patients and being there to not provide judgment, do it in a very neutral way, do it in a way that gives dignity to them, to their family members and to their partners, is a way that we can hard on the stigma and the shame around disease or around illnesses is something that really is an access barrier.
00:29:28.258 --> 00:29:53.406 The first part of public health or the first part of clinical health is really access, and so if you're breaking down some of these barriers from a human centered perspective and a patient centered perspective, you'll have a lot more success in your service delivery.
00:29:53.748 --> 00:30:11.213 Yeah, no, I think that's a good point I'd love for you to just share, you know, obviously it's not HIV but then your interaction just from a public health level with the and we'll narrow it down to, let's say, the amputee population or somebody that has had an amputation.
00:30:11.213 --> 00:30:12.577 What do you see?
00:30:12.577 --> 00:30:17.817 And you've been to a lot of different countries and there's need everywhere.
00:30:17.817 --> 00:30:26.078 How does that tie in to delivery of, say, prosthetic and orthotic care?
00:30:27.125 --> 00:30:56.990 I mean, I think a lot of the countries that I've worked in, lived in, you know, disabilities is a really tricky part of the conversation because there's so many other diseases that are impacting and there's so many other people that are, you know, that have amputations or that need support in that area.
00:30:56.990 --> 00:31:14.541 It's really daunting, right, Because even if you get a prosthetic limb or if you get an orthotic, you're still having to navigate some of these, you know, stairs or uneven terrain and stuff like that.
00:31:14.541 --> 00:31:29.314 And so you don't realize I was on crutches cause I broke my pinky toe, um, and I was even in my office and I was trying to figure out how to get into my office because I was on crutches and it's a push door and I thought how am I going to get into this office?
00:31:29.314 --> 00:31:54.099 Um, and this is just one example of something that people have to live with every single day that there is not that community level commitment to providing people with disabilities or are other abled with accommodations that would allow them to function as somebody else might.
00:31:54.585 --> 00:32:10.675 Yeah, well, I think that's an interesting point and I think one of the things that I've found interesting and probably you have now, with the crutches and all that is accessibility is a big deal and this world is not accessible, even here in the United States.
00:32:10.675 --> 00:32:24.208 I mean, I use the example when I went up and had to get dad because he had fallen at the airport and went into the airport bathroom and they had no handicapped stalls.
00:32:24.208 --> 00:32:32.778 Like it was a handicapped family stall, one of them on some hallway in newark and it's just crazy.
00:32:32.778 --> 00:32:38.913 And you know these ramps that go down and I mean they don't.
00:32:38.913 --> 00:32:44.270 When you're walking them, you know not a big deal, but when you're on something with wheels, that's something else.
00:32:44.270 --> 00:32:47.446 So I think that's uh, that's also very interesting.
00:32:48.249 --> 00:33:14.980 Um, well, and just maybe to that point, I think, from a public health perspective, it'd be looking at what does it look like to impact policy in development of buildings, cities, communities, in order to consider some of the disabilities and you know the abilities of other people, and so that's where you have.
00:33:15.644 --> 00:33:28.407 It's not necessarily market driven per se, but it's definitely something that, from a government perspective, you need to consider and you need to put those policies in place to protect the vulnerable in your community.
00:33:28.407 --> 00:33:40.364 And those are people you know, at CDC or at the national or the state level, that those are the people deciding on what the code is in construction.
00:33:40.364 --> 00:33:58.176 Those are the people that are pushing for something that might be a little bit more expensive in building because you have to build bigger stalls or you have to build, you know, ramps or whatnot, but those are the protections that public health considers and thinks about in terms of a population level.
00:33:58.176 --> 00:34:22.373 So that's why you have, in new construction, you have wider doors, you have ramps or you have elevators that are bigger, wider, whatnot, to accommodate some of those things, Not necessarily because it's more efficient or effective in terms of cost, but because it provides the ability for access for people that have disabilities or are other abled.
00:34:22.474 --> 00:34:34.534 Yeah, I think that's great and I think it's super important and knowing that, hey, there is potentially going to be a cost of that somewhere, it has to be borne by somebody.
00:34:34.534 --> 00:34:44.677 A lot of times that's where a government does step in, or some regulations around it, especially if it's a net zero type of thing.
00:34:44.677 --> 00:34:53.346 I'd like to go into just a little bit more on the professional side of things and some of your development and that sort of thing.
00:34:53.346 --> 00:35:27.822 I think this is, you know, it's more near and dear to my heart because I have a younger daughter Well, I guess she's a teenager now, but you know you have I don't know if pioneered is the right word, because there's definitely been people that have gone before you but you have blazed your own trail by diving in as a, you know, female in the workplace professional doctor, education, that sort of thing.
00:35:28.545 --> 00:35:34.416 What would you say to young female professionals getting into the field?
00:35:34.416 --> 00:35:51.451 And the other reason why I think this is super important, specifically for the orthotic and prosthetic field, because it's been dominated by males, but there's a significant amount more females coming into the field than ever before, which I think is fantastic.
00:35:51.451 --> 00:35:57.217 I think the care is also getting better because of that.
00:35:57.217 --> 00:36:35.181 But there are always barriers, right, and you have essentially noted the barriers, but you've never made an excuse not to level up, I guess because you're a female and not that it even matters and it shouldn't matter, which is kind of crazy that we're having the discussion, but I think it's important for professionals that are female to know some of the ways that you've gone.
00:36:35.905 --> 00:36:37.349 Yeah, it's really hard to know where to start.
00:36:37.349 --> 00:36:43.835 On that I would say this is a time in history where there are so many opportunities.
00:36:43.835 --> 00:37:02.422 There are so many opportunities for men, women, and there's more opportunities for men to go into what they call a pink collar job, like nursing, or for women to go into a more blue collar field like, maybe, orthotics and prosthetics.
00:37:02.422 --> 00:37:13.590 There's just every single year you see more and more people kind of diversifying what they're going into because they're passionate about it, of diversifying what they're going into because they're passionate about it.
00:37:13.590 --> 00:37:20.032 And I think the thing that I recognized the most when I thought you know, I don't think a lot about me being a woman in a professional setting, quite frankly, that much.
00:37:20.032 --> 00:37:36.952 But I do remember one moment where I was in a meeting with mostly men that were a decade, two decades older than me and I was looking around and I was feeling very insecure about it and kind of not confident.
00:37:36.952 --> 00:37:40.389 And I looked around and I looked at their faces and none of them cared.
00:37:40.389 --> 00:37:43.516 They didn't care, they just didn't care.
00:37:43.516 --> 00:37:47.846 They didn't care that I was younger, they didn't care that I was a woman, they didn't care, they just wanted somebody competent.
00:37:47.846 --> 00:38:04.856 And that's when I just realized, like these are all people too, and when I was comparing myself or thinking that they deserve this more than I do, it's kind of this like I mean not to get into like too much, like woo-woo or whatever, but like shame, right.
00:38:04.856 --> 00:38:10.458 Like shame is this, like very low state of being, and it reduces and removes all of your power.
00:38:10.458 --> 00:38:32.657 And so when you do have that and it creates this victim mentality of like well, because I'm this, because I'm this, because I'm this, I don't have this and it's just not the case, and so maybe I'm crazy, but every single day I wake up and I say I have all the resources available to me, I have what it takes to get to here, and that's not just for women, it's for men too.
00:38:33.005 --> 00:38:44.574 I feel like there's a lot of young professionals that have insecurities as well, you know, across the board, and so I think, if you, I just had to step into my power.
