A criticism we heard recently from a residency program director in New York was that when his residents head to JFK airport to practice global health work in a remote area in Haiti, they pass several poor communities with limited health care on the drive over that would love their commitment. From where the global health movement has emerged, this criticism is very relevant.
Last month when Phuoc and I traveled to rural New Mexico and rural Arizona it was clear that our health provider friends were struggling to provide quality care to Navajo population in a way that is relevant and respectful to their culture. They were essentially practicing “global health.” Our colleagues who work all over the country in safety net hospitals trying to ensure quality care for poor populations are practicing “global health.” In our global health work, it is increasingly clear that global health is an orientation to health and health care regardless of geographic location. It is situating health in the context of poverty and the social determinants of health. It is deep solidarity with those that are suffering most.
In this context, it was a great joy to travel down to Sacramento today to the capital building to support SB 1005, a bill up before the California Senate that aims to provide all Californians, regardless of immigration status, access to affordable health coverage and care. On the west steps of the Capital building, we heard from undocumented immigrant after undocumented immigrant detailing the hesitation to call 911 when a mom complained of chest pain in the middle of a night, when a friend was beat down in the streets with blood pouring out, when a sister was internally bleeding – all for the fear of what it might cost. It was a beautiful amalgamation of the children of undocumented Thai restaurant owners, Mexican farm workers, and factory workers of many races. They were requesting the dignity of health care from the state they have committed so much labor to, and testifying to the physical, emotional and financial toll of suffering from an illness after avoiding primary care for as long as they can.
We then headed inside where Senator Ricardo Lara presented the bill to the Senate Health Committee. The room was packed, as many immigrants told their story. At the end of the hearing a long line formed of those wanting to add their voice to the chorus of solidarity for health for all. I added my voice too, as a physician from UCSF. It was clear many in the room of organizers and advocates were moved by health professionals standing in solidarity with them. Senator Lara thanked me afterwards.
The bill heads to the Senate appropriations committee where they will examine it on the merit of its economic impact. The fight will probably get stickier there. The entire day was immensely uplifting. It is so clear that from Sacramento to Sau Paulo to Zwedru, Liberia, to St Marc Haiti, it is the same struggle with a slightly different face. As the great naturalist John Muir (who was also an immigrant) says, “When you try to select any one thing out, you find it is hitched to everything else in the universe.” Global health folks realize that our struggle for health equity elsewhere is hitched tightly to undocumented Californians struggling for health care in our backyard. All of us who head to Haiti or India, or Uganda to fight for international solidarity, quality health care and health access must do a better job of bringing that struggle home. SB1005 is great opportunity to meet that challenge.
Dr. Sriram Shamasunder
Co-Founder of Global Health Core, UCSF
For more information on bill SB1005, click here.
For more information on the Undocumented and Uninsured movement and how to show your support, click here.