GUEST COLUMN

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January 2009

Meet Our Featured Guest Columnists:
Mollie Dahlgren, M.D., and Michael Tees, M.D. , M.P.H.

co-founded the Tulane University chapter of the Student Physicians for Social Responsibility during their first year of medical school, in 2004. The group educates students and the local community about environmental health issues in New Orleans. They organize lectures and film screenings, contact government representatives about local environmental hazards, and develop community health programs. After Hurricane Katrina, the organization took part in Project Releaf, planting trees in areas of New Orleans devastated by the storm.

Q: What does "health and human rights" mean to you?

A: There are many aspects of health that we believe should be basic human rights including access to health care, protection from infectious epidemics and natural disasters and clean neighborhoods. Both have dedicated themselves to helping the local community and consider that a healthy environment is a basic human right. A community owns their environment, just as they own their bodies. The environment is not conventionally thought of as something individuals have any control over and conversely, as something that controls individuals. Ambient industrial pollution, for example, is an aspect of modern life that we have come to accept complacently. Yet the effects of industrial pollution can be profound albeit silent and invisible. In order for a community to take ownership of neighborhoods and demand regulation of pollution, first we must raise awareness that pollution exists and secondly that it affects us. The focus of our work has been on raising awareness of how health and environment interconnect in our own neighborhoods.

Q: How and why did you launch this chapter of the Student Physicians for Social Responsibility?

A: Founding the Tulane University chapter of Student Physicians for Social Responsibility (SPSR) began with the first Tulane "toxic tour" led by an upper-level medical student Sarah Koenig. The toxic tour speaker was Wilma Subra, a chemist and local activist, who showed us the NORCO petrochemical plant in the outskirts of New Orleans 2003. On that bus ride we watched as clouds of smoke poured onto neighborhood lawns and vats of waste sat adjacent to childrens' playgrounds. The potential for causing childhood asthma or learning disabilities living next to NORCO seemed an undeniable possibility. As burgeoning physicians, we were curious how these NORCO residents would present to us as patients in clinics and hospitals. We realized that our education in no way prepared us to address the effects of industrial pollution on health. Our one toxicology lecture in medical school focused on children ingesting Drano, not childhood asthma in the industrialized world.

One of the participants in this first "toxic tour" was Johanna Congleton, the state chapter executive director of the newly formed PSR-Louisiana, which was coincidental in that Mike Tees had already been working to form a student chapter of the national organization. With a newly formed alliance with PSR-La, the next week Mike held the first SPSR kick-off meeting. He opened up to the audience what types of SPSR projects would interest them including gun control, anti-nuclear proliferation or environmental health. Mollie approached Mike at the end of the first meeting to express interest in planning environmental health projects together. In the first planning meeting that month, Mike and Mollie began scheduling environmental seminars, working together closely for the rest of medical school. 

Q: Describe your work, the challenges and successes, within the Tulane University chapter of Student Physicians for Social Responsibility.

A: Our work has focused primarily on educating medical students on how industrial pollution can affect human health. We have had lunch time lectures on lead poisoning, industrial dumping, endocrine mimicry and the AIDS epidemic. We held film screenings for medical students including "Fenceline" and "Blue Vinyl". The most important part of work has been starting a yearly tradition of environmental health tours that bring medical students, law students and public health students to neighborhoods on the fenceline with petrochemical plants and illegal waste sites. Visualizing industrial pollution in our own neighborhoods has been our biggest success.

Some of the challenges we faced stemmed from starting a new chapter of SPSR. SPSR was not a recognized Tulane student government club and, therefore, we only now have become eligible for student organization funding three years later from launching. We overcame this obstacle primarily by holding joint events with the more endowed clubs, such as the American Medical Student Association (AMSA). We pooled AMSA money with PSR-La donations to fund our events. Hurricane Katrina was a large bump in our successes, as the school moved to Houston for an academic school year. However, we continued working towards our goals and even held a toxic tour in Houston, focusing on the "chemical corridor" south of the city.

Q: How might other students get involved in health advocacy?

A: Rather than accepting the status quo, getting involved in health advocacy begins with selecting an aspect of health that you find important. If you are interested in promoting healthy lifestyles, then start a nutrition class at a community health center. If you are interested in access to health care, then start your own free clinic. If you are interested in women's health, then hold a lunch time lecture on abortion in medical education. Likewise, if you are interested in environmental health, then hold a "toxic tour" at your school. If you have the passion, you already have the fuel; start the engine and you can get far!

Universities give us unique access to many intelligent and responsible adults, all accessible through emails and common locales, such as the cafeteria or coffee shops. You can always email or post a flyer with an idea on promoting health. It is also helpful to align yourself with a student organization that provides ideas and funds for your project. At Tulane, our student organizations were not unique in that many students, whether club presidents or members, would frequently work together, collaborating towards positive change.

Q: How has your involvement in the Student Physicians for Social Responsibility influenced your career plans?

A: We have both chosen internal medicine as a career path. SPSR has influenced our decision to pursue internal medicine because we now want to treat patients as a whole person. We know that a patient's environment, home situation and life-style affect their health. We have trouble separating patients into the pieces necessary to specialize in medicine. We want to be part of introducing the toxicology onto the list of differential diagnoses used to diagnose our internal medicine patients. We also look forward to participating in research linking toxic exposure, arms proliferation and tree deprivation to adverse health outcomes. Regardless of the field of medicine we and other members will chose, educating ourselves on the very common and uncommon toxins in our environment will produce physicians less likely to pursue the easiest diagnosis, but the most accurate. The patient is not just what one sees on exam; the world that surrounds them and they interact with when they leave the clinic or hospital is just as important.

Q: Your message?

A: Our contribution to improving health may have been modest. But if all of us complete a small project, then in summation we may achieve significant gains. We hope we have imposed on a generation of Tulane medical students that pollution exists and that our patients may be affected. We also hope that others in the healthcare community will begin to recognize that with increased interaction with the environment produces real affects on human health. If we work towards a healthy world, we could maximize the lives of not only our human species, but of all others.