Eastern AHEC Rural Health Immersion - Student Reflections: Kaylee Meyers
Healthy Acadia has served as Maine’s Eastern Area Health Education Center (AHEC) since 2023. Our service area includes Washington, Hancock, Waldo, and Knox counties.
Maine AHECs provide community-based clinical training experiences to health professions students; encourage Maine youth to pursue careers in the health professions; offer training and continuing education programs to practicing health professionals; and develop public health approaches to address current and emerging community needs.
As part of this program, Healthy Acadia and community partners work together to create rural health immersion opportunities for health professions students to learn more about rural and underserved communities, including Rural Health Immersions (RHI) for Care for the Underserved Pathways (CUP) AHEC Scholars. and community-based experiential learning opportunities for non-CUP scholars.
We will periodically publish guest blog posts from AHEC Scholars who chose to share their experience with the program.
Guest post contributed by Kaylee Meyers, UNE COM Student. Kaylee participated in our June 2023 RHI and reflects on the experience.
On the morning of June 5th, we set out to the Passamaquoddy Health Center in Indian Township before they opened to get an overview of all of the different services offered. Upon arriving we were immediately greeted by the friendly staff of the Passamaquoddy Health Center and given a tour of their impressive building. Personally, never having been to a rural health center, I was not sure what to expect. However, I was pleasantly surprised by the wide variety of services being offered from primary care, dental care, a lab, minor surgeries, urgent care, pediatric care, and even a WIC office. Additionally, it was evident that the staff had gone above and beyond for their community to ensure that any barriers to receiving care had been eliminated.
One tactic that was employed by the dental center that really shocked me was the transportation program. This program includes a bus that will pick students up from school, take them to their dental appointments, and drop them back off at school with a note home describing the treatment that was done. The staff mentioned that this practice has dramatically cut down on the number of no-show appointments and takes the burden off the parents to get their children to the dentist.
While visiting the Passamaquoddy Health Center we also learned about how health care services are provided to the tribal community and how costs are covered. This topic was one that I had no prior knowledge about, so it was interesting to hear how Indian Health Services is operated. We learned that when treaties were signed back when colonizers were taking away land from the tribal communities, all members of these communities were promised free health care in exchange.
The sad reality however is the Indian Health Services operated through the federal government only covers about 48% of the costs of the Passamaquoddy Health Center, leaving them to search for more funding from other avenues. Additionally, the health center must then run on a priority basis where only certain diagnoses can receive the full funding needed for treatment. This puts council members and decision-makers in the community in a difficult position to decide which members of the community they can cover treatment for and which they have to deny due to lack of funding.
One Tribal member even joked about having to deny her own mother coverage for a health care service she needed. While this financial climate is not optimal, it was clear the Passamaquoddy Health Center is staffed by hard-working, smart, and creative people who will stop at nothing to ensure the members of their community are being cared for.
After leaving the health center we had the honor of attending a very humbling training done by Liz Neptune, a Passamaquoddy citizen titled Strengthening Relationships with Cultural Competency: Increasing Understanding of the Passamaquoddy Tribe. This training left me speechless as the history of the Passamaquoddy Tribe was recounted and the implications of that history on the tribal community in the present day were brought to light.
We learned about the detrimental actions of the European settlers on the Passamaquoddy Tribe and the death of 90% of their population from the diseases alone that those settlers brought. Liz shared personal stories of Tribal members whose children were taken from them and sent to residential schools where they were forced to forget and abandon their own culture and history. Sadly, many of these parents were never able to be reunited with their children.
We also heard about the current battle with the Federal government for recognition and their ongoing disrespect for Tribal Nations. One fact that really stuck with me is that rather than the Department of Health and Human Services providing services to Tribal communities as they do to every other citizen in the United States, it is instead the Department of Interiors that handles the Tribal Communities.
Liz Neptune stated the only reason for this separation would be to continue the narrative that Native Americans are “less than” and not as deserving as other American citizens. I was moved to tears to hear that after so many years, this narrative is still allowed to exist today. Additionally, this narrative is prevalent in the life expectancy and health disparities present in the Passamaquoddy community. With the average life expectancy of a Passamaquoddy member being 53, and multiple health disparities being far worse than any other ethnic or racial group, there is a great deal of work to be done to repair and mend these systemic injustices that are plaguing these tribal communities today.
The training with Liz Neptune also shined a light on the Passamaquoddy Health Center and why some of its operations run the way that they do. For example, at first, I believed the reason for providing the bus for children to attend their dental appointments was to eliminate the barrier of transportation. However, this was not the case.
In reality, it was shared that many members of the Passamaquoddy community had experienced dental trauma at the hands of non-tribal members. Therefore, whenever they would have to visit a dental office to take themselves or their children to their appointments, many would have a trauma response and found it difficult and almost impossible to make those appointments. Therefore, the van allows those parents to be completely removed from the appointments and not have to be re-traumatized when taking their children to appointments.
This was a grim and heartbreaking lesson to learn about, but I believe an incredibly important lesson to learn. As future providers, there are so many things we do not understand, but it is important to try to grow our understanding and knowledge of the history of a community if we want to provide the best care for them today.
The lessons I learned this morning are ones that I won’t ever forget. I will be forever grateful that the Passamaquoddy Tribe welcomed us onto their land and were kind enough to share their history and those incredibly important lessons with us.