Shubha Nagesh, Adekemi Adeniyan and Hope Rhodes-Pretlow (Atlantic Fellows for Health Equity U.S. + Global)

Imagine a world where all people feel free to share their stories, fairness reigns and everyone benefits from optimal health. Through the fellowship, three passionate health care professionals from thousands of miles apart – India, Nigeria and the United States – found themselves in a classroom and immediately recognised their shared passion for children’s health. The Fellows believe the support and resources they receive from the program fellowship, the wider Atlantic community, and the Atlantic Institute reinforces the importance of working together to address health inequities: “Nothing for us, without us!” 

All three, who graduated from their program a few months before the pandemic, are addressing COVID19-related health inequities in the communities they serve.

COVID-19 and Children With Disabilities 

Shubha Nagesh writes:

It is increasingly reported that COVID-19 has disproportionately affected Persons With Disabilities (PWD) in various contexts: adults, children, men, women, elderly, those at home, those at nursing homes, urban, rural, high income, and low income. This carries enhanced risks and consequences for them, and anxiety. Adults have lost support services, care givers, allowances; while children feel disconnected from therapy and intervention.), those in nursing homes (comprise a large majority of deaths), women (access, health, education, employment, violence) and many more have been affected. Families are bearing the brunt of loss of lives, loss of care, loss of support and are at their limits as they provide care, day after day with no clear end in sight. 

I have seen firsthand that the families of children with disabilities feel abandoned and left alone as they have become their child’s therapist or interventionist, as well as carrying on with their own paid work and domestic duties.

As a lawyer living with disabilities, Gregory Mansfield, commented: “It just won’t do anymore for diversity groups to say, “We’ll get to disability next time.” It’s always next time. Next time is a euphemism for never. Disability is diversity. Not next time. Now.”

In these times, compassion, empathy and solidarity stand out as effective means to inspire and encourage families to persist in their efforts towards their child’s developmental progress, even as they engage in online intervention services. This pandemic presents an opportunity to improve the quality of life for PWD as the ‘world struggles to fit into a new avatar’, challenging what has been the status quo in how they are treated. The intersection between ability, opportunities and equity is complex and needs to be understood to create a better world for everyone. The fellowship has helped me to understand, respect and value the populations for whom I want to create a better world.

The Atlantic Institute has awarded Shubha a solidarity grant to develop a short movie, set in the Indian context, to talk about the challenges of COVID19 and solutions for families whose children have developmental disabilities and how they can best manage interventions at home.

COVID-19 and Pediatric Oral Health

Adekemi Adeniyan writes:

There is no doubt that the COVID-19 pandemic has severely affected dental care services worldwide. The prevalence of tooth decay among rural Nigerian children has been a major concern for dental practitioners. Accessing oral healthcare for children living in rural communities has been even more challenging during the pandemic because parents are enduring increased financial pressures, transportation problems and language barriers, among other factors.

Furthermore, the oral health school programs have been halted. My monthly rural school program to educate children on tooth brushing and other aspects of oral health is on hold until schools reopen. This situation denies many children the opportunity to learn about their oral hygiene and spread the message. 

This has been a wakeup call for me and the people I work with. Being part of the Atlantic Fellows has reinforced my resilience and promoted a ‘can do attitude’ that I am trying to pass on to colleagues where I work/. My fellow Fellows have taught me the importance of creating a positive and self-motivated awakening while carrying out my work caring for the rural population and under-served children. 

A crisis like we are seeing right now can often wear one out. Having a community “with whom you can walk the talk" goes a long way! The fellowship has provided leadership skills to help me navigate the challenges of health systems in order to move the needle on change.

Adekemi Adeniyan has received a solidarity grant to provide oral healthcare services to rural communities in Nigeria. She is using a teledental kiosk that links via the Dentalcare mobile app to regional dental clinics and local dentists. Under the project, children are also getting specially created comic books that teach them all about keeping their teeth healthy.

COVID19 and High Risk Teens

Hope Rhodes-Pretlow writes:

In the District of Columbia, the capital of one of the wealthiest countries in the world, children of color are more likely to live below the federal poverty level and experience long-standing health disparities. The pandemic threatens to make this situation even worse, so children and their families experience an even greater widening of the economic gap, educational attainment gap, food insecurity and housing instability.  

Teens and young adults represent a patient population that may benefit from targeted outreach during COVID-19.  Adolescents vary in their attitudes toward and compliance with quarantining and social distancing, disrupted daily school and work routines. Difficulties engaging with friends; and changes to parental supervision all compound stress among adolescents.  An increased risk for depression and suicidality for youth has serious implications when they can't get to use mental health services due to social distancing recommendations.  Adolescents as a group also experience unique barriers to health care, particularly for sensitive and confidential health concerns, that make existing socioeconomic barriers even worse.    

The Health Equity fellowship stresses the importance of considering the historical context for existing inequities. In addition to COVID19, the US is grappling with various forms of overt and covert racism against people of color, which forms the foundation for many health disparities.  I am currently coordinating the use of medical mobile units to address declining pediatric vaccine rates in Washington, DC, bringing history provided by ancestral voices of the past alongside community voices of the present into healthcare discussions to ensure that communities' needs are met in culturally effective ways.    

Dr. Rhodes has received funding through the DC Mayor’s office of Community Affairs to leverage the voices of teens and young adults to implement and evaluate a teen-focused social media campaign, “COVID and Beyond”. The funding also helps connect teens from neighborhoods disproportionately affected by COVID to health services.