“The idea that some lives matter more than others is the root of all that is wrong with this world.”
– Dr. Paul Farmer

This past Sunday, I attended a training for the Prison Education Program at Cal Poly Pomona. The program is led by the amazing Dr. Renford Reese. After reading Michelle Alexander’s The New Jim Crow: Mass Incarceration in the Age of Colorblindness and learning about the realities of the prison system in this country, I knew I needed to find a way to help. PEP aims to reduce recidivism rates in prisons by providing inmates with guidance and resources to pursue their goals after leaving prison.

At the training we, of course, discussed the logistics of the program, safety precautions, etc. But my favorite part of the training was when Dr. Reese brought up this idea of umbuntu. Umbuntu is the South African philosophy of ‘humanness’ and is ‘the belief in a universal bond of sharing that connects all humanity.’ Many of the struggles people face daily are structural and money needs to be used to create infrastructure to combat these injustices, but as Dr. Reese said during our training ‘Words are free. And if we believe that words have the power to hurt people, we must also believe that words can heal.’ And that’s what PEP is all about – creating a sense of umbuntu and recognizing that if anyone in our community is hurting, we are all hurting and we must actually do something to help.

Dr. Farmer’s quote (above) has always resonated with me and after reading his book Pathologies of Power, where he describes his experience with working with the Russian prison system to get second and third line antibiotics for Russian inmates who were infected with tuberculosis, I realized that it was so important to be an advocate and activist as a physician. Before even starting this journey of medicine, I made a commitment to remain socially aware and to never use the title of ‘doctor’ to excuse me from fighting for the rights of others. If anything, I believe that physicians have an even bigger responsibility to be advocates for those facing injustices, particularly when it comes to health care.

On Monday, I went to the California Institution for Women, where seven of my classmates and myself will be teaching a health awareness class. Because this was an introduction class and we were meeting the women who enrolled in our class for the first time, we kept the session relatively unstructured. We introduced ourselves and shared a bit about our background and then asked them to share why they were interested in the class and what they hoped to get out of it.

Having never been in a prison before, and having seen too much ridiculousness on TV, I didn’t really know what to expect and was naturally nervous. But I floored by how invested all these women were in bettering their health and learning more about how to care for themselves and their loved ones. We wrote down a list of topics they’d like to hear about over the next couple months. They shared so many personal stories about challenges they face with their own health and their families. We learned about their health care experience within the system and were able to fill in some of the communication gaps between the care they’ve been receiving and the distrust they have towards the providers within the system.

One of the first years asked them to share what being ‘healthy’ meant to them and it was so clear that they had a better understanding of health than many of the practicing physicians I’ve worked with in the past:

• Health is encompasses physical, mental, emotional, intellectual, spiritual aspects. If one isn’t healthy, it throws you off entirely.
• Health is a part of a continuum. You don’t wake up one day and say ‘I’m healthy! I’m done.’ It’s something you have to work towards every day.
• Waking up each morning and just having the energy to face the upcoming day.

We also asked them about their long term goals and they’re so passionate and motivated to change the world when they leave prison. A few of them want to work with at risk youth and start group homes, others would like to become lawyers, provide resources and counseling for women in abusive relationships, start assisted living homes in areas that really need them. It was so amazing to see how these women have taken their own life experiences and figured out a way to use that to make a difference in the lives of others.

So as Dr. Reese said during our training, we must ‘live with a sense of urgency.’ We have so much work to do in this world and we can continue to put it off and pretend that we always have next year to get started but we don’t.

Before we finished the class, I thanked them for sharing so much about their health care experiences and being honest about what was missing because the gaps in health care exist outside of the system too. I thanked them because in those two hours we spent together, I learned more about how to provide effective health care for future patients than I could have ever learned in studying various pathways and memorizing structures. And after meeting with these extraordinary women one thing is clear: as hard as I will try to help empower them in seeking the health care they deserve, I know I will come out of this experience learning so much more than I can ever hope to teach.