By Dr. Dipesh Navsaria
As I write this, I am on my 12th year of an annual visit to the Tribal Health Center of the St. Croix Chippewa Indians of Wisconsin with a team of medical students and residents. We spend a day and a half doing assessments of many children’s overall health and well-being so they may participate in Head Start, the federally funded preschool program. This began as a collaboration between the St. Croix Chippewa and Dr. Murray Katcher, a pediatrician who was the chief medical officer of the Maternal Child Health Bureau in Wisconsin.
Many opportunities exist to “travel” and contribute time, effort, and expertise throughout our country and world. There are legitimate concerns about trips like these — how meaningful is it to “drop in,” provide services, and then disappear, not to return for a long time? What happens in between visits? Is it helpful to have “outsiders” appear and make recommendations that may not be feasible locally? A pediatric kidney ultrasound that’s trivial to obtain in Madison may be a whole-day undertaking in a rural community, for example.
Finally, what expectations do those visiting bring? Even well-meaning individuals may arrive with a mindset that they have the knowledge, experience, physical resources, and finances to “give” to a place that “has little.” While differences certainly exist, this mindset ignores the local capacity and capabilities present, and dismisses the deep knowledge communities have of their own area and people. We can’t arrive with a “savior complex.”
Why, then, has this particular collaboration lasted so long? For one thing, it has helped immensely to have consistent, long-term involvement by the team leader (first Dr. Katcher, and now myself). I deeply treasure the relationships I have built with the leadership and staff of the St. Croix Head Start and Health Center over the years. That allows for a mutual respect and understanding, but also the trust that we are both working toward the best interests of the children and families we serve. That trust has been critical in productively working through the small issues that inevitably arise in such a busy, complex endeavor.
Another aspect of this event is that it allows the trainees I bring and the local staff to interact and learn from one another. The students and residents see not only the expected challenges of poverty, rural access issues, and the legacy of generations of racism and oppression, but are also pleased to find skilled, dedicated personnel, quality physical facilities, and other resources carefully tuned to meet local needs — resources that we are here to briefly augment, not replace.
Finally, it is a privilege and honor to be welcomed into the community, albeit briefly, as valued guests and to participate in a shared luncheon and cultural traditions.
For me, personally, I’ve had the fortune to train and develop expertise at the University of Wisconsin. It is gratifying not only to share that with our fellow Wisconsin citizens far away from Madison but to bring away an appreciation for the power and capability of their own people. This mutual engagement and understanding is, at its heart, an expression of the Wisconsin Idea. The fulfillment I gain is different from many other types of work I do, and holds a special place in my soul.
This is a fantastic example of community engagement done well — not a one-way transaction of “donation,” but rather a reciprocal development of trust, mutual respect, and learning from each other. In this, not only have the St. Croix Chippewa and numerous trainees benefited, but I myself have grown in a spirit of humility and collective impact, all in the service of the well-being of young children.
I am reminded of a wonderful quote attributed to the Aboriginal Activists Group in Queensland in the 1970s: “If you have come here to help me, you are wasting your time.”
“But if you have come because your liberation is bound up with mine, then let us work together.”
Indeed.
Dr. Dipesh Navsaria, MPH, MSLIS, MD, FAAP, is an associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health and also holds master’s degrees in public health and children’s librarianship. Engaged in primary care pediatrics, early literacy, medical education, and advocacy, he covers a variety of topics related to the health and well-being of children and families.