University of Cincinnati Department of Family and Community Medicine

Maria Hovey, Summer 2010

My summer internship with UHP has provided me with invaluable experience relating to treating the underserved. Throughout the internship I have noticed barriers to healthcare that would otherwise not have crossed my mind. It is easy for doctor's to preach nutrition and healthy living, but when someone doesn't have a fridge and the only lifestyle they have ever known is one in which everyone drinks and smokes, it makes these goals unrealistic to the patient. Transportation is also a huge obstacle to getting healthcare and to maintain a healthy lifestyle.

The part of the internship that had the biggest impact on me was working at the River Downs Race Track. Here we treat the workers on the backside of the racetrack. This includes the jockeys, the trainers, the groomers, the walkers, and everyone else that works with the horses behind the scenes. These workers generally earn less than 2,000 dollars a month, with some earning nothing or under 500 dollars a month. The people here, contrary to what the public might think, work harder than anyone I've met before. They are up as early as 4 am taking care of the horses and the stalls and will work all day if needed. If they take time off, they risk losing their job. Many times they might get ripped off by the owner of the horse and not get paid at all for the labor they put in. Needless to say, this makes living a healthy and happy life pretty difficult. Lack of transportation compounds many of the issues they face as well because the racetrack is not located close enough to any stores or doctor's offices or any other homeless resources they could access if they lived closer to the center of the city. This makes treating people that live here very difficult too. We came across many people that were addicted to nicotine or alcohol but we cannot help them because there are no resources close enough to where they live to refer them too. Luckily we were able to bring them medications and provide most other health care needs at the racetrack. If they did need to be reffered to another physician, we had the ability to call a taxi and a translator if needed.

Parts of the internship were also very difficult because of the great amount of need. It was difficult to imagine people living in the 8x10 foot cement rooms they called dorms. When we initially saw them, there were just holes in the wall where they could put plywood or an airconditioner, but no real window. I was very happy to see that windows had been installed by the end of the summer. Otherwise the workers rely on the kindness of people such as the racetrack chaplain to find them furniture and carpet to make the dorms as much of a home as it can be. There was also a lot of violence and addiction that plague the workers at the racetrack. Since there are so many issues that are faced by the workers, it is sometimes hard to be satisfied with only being able to provide some medical care, although making small contributions in the lives of these people is better than nothing at all. There were also people that displayed much gratitude to us for the work we provide that helped me to feel more satisfied with the work we did.

Overall I thourouhly enjoyed the summer and learned a lot from the experience.