Team Abriendo Puertas has seen its share of ups and downs this semester, with more downs than ups. In fact, team AP never once saw an AP event occur at any of the three sites we worked with. As frustrating as this reality is, our semester working with the East Coast Migrant Head Start organization has taught us invaluable lessons about the perseverance, resiliency, and adaptability required to work in the field of public health. We have talked extensively in our classes about the wicked problems that plague population health, especially in rural areas, and our work with AP allowed us to see firsthand how discouraging these problems can be. Among the wicked problems faced by the ECMHS centers and the AP program are the lack of enrollment, the absence of accountability within the system, and the scarcity of resources.
Our largest barrier to successful implementation of the AP sessions this semester stems from an overall deficit in enrollment in the ECMHS centers this season. Low attendance has been cited by each of the three centers as a challenge. The centers work within limited means, and recruiting participation for such a beneficial program like AP is beyond the scope of their abilities. In addition, many families who have children enrolled in the Head Start program do not have the time or transportation necessary to attend superfluous meetings such as AP sessions. These factors ultimately contribute to cancelled meetings or not scheduling meetings at all. In addition, the AP system is designed in such a way that these cancellations are going unnoticed by those in positions of power.
On more than one occasion an ECMHS center director notified our group of a cancelled meeting, but when we spoke to our preceptor she was uninformed of the cancellations. AP is a grant-based organization, and thus they are required to complete certain tasks in order to continue to receive funding. If the centers are being forced to cancel sessions due to low enrollment, but they are not reporting it to the administrators, an accountability issue arises. Centers are not being held accountable for hosting these sessions, and thus they are freely cancelling them when attendance does not reach an “adequate number.” In one specific instance we drove to an ECMHS center for an AP session, and after waiting 45minutes only two or three parents had shown up. Rather than hosting a session, the center director went ahead and cancelled the meeting. It is disheartening to think that their learning opportunity was stunted due to low attendance, and even more disheartening to think that there is little that can be done to address this issue, especially since center resources are so scarce.
Often times, in addition to having a center head at each meeting, a translator is needed to relay messages between non-Spanish speakers and the primarily Spanish-only speaking parents at the ECMHS centers. Thus, hosting AP sessions requires a minimum of two employees to be in attendance. Here, the cost of paying these people serves as a deterrent to hosting events where attendance is low. Also, when events do include higher proportions of parents, outside resources for information are lacking. On one occasion, our group was asked to fill in for a local community college in providing an ESL lesson to parents because the grant could no longer pay for their services. In this way, valuable resources and time are being lost simply due to a lack of funding.
As a team, we were able to meet some of the needs of the ECMHS centers and provide invaluable services beyond the AP sessions to the parents in attendance. We have taught lessons in healthy eating, reading nutrition labels, dental hygiene, occupational hazards, and ESL, to name a few. We were able to attend one “Cooking Matters” class where parents were guided around a grocery store and taught how to compare unit prices, bargain hunt, and choose the most nutritional options. Our role changed from passive volunteers in a pre-existing program to active advocates and teachers of health for a vulnerable population of migrant farmworker families and we are blessed by the experiences and knowledge we gained along the way.
In the future, it would be beneficial for volunteers working with this population to recognize the wicked problems they face and fill in the gaps in anyway they are needed. Ultimately, team AP became team do-it-all, because the needs of the ECMHS centers and the parents in attendance varied. Volunteers working in this practicum must be sensitive to the needs of the centers and proactive in their attempts to be involved. With such an overworked administrative team, it would be easy for passive volunteers to be overlooked, and thus active participation and communication is imperative to continuing success of the student intervention. Although it may seem easiest to abandon the AP practicum in the future due to its challenges, there is a group of families who need our services, and in the nature of public health it is our duty to serve them to the best of our abilities.
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