The #1 bus begins its route in the shadow of brick-lined buildings surrounding Harvard Square. This is where my Health Leads experience begins, on the #1 as it journeys down Mass Ave across the Charles River, through the Back Bay neighborhood, and into the South End. Just as the bus meets the crucial Orange line juncture on the T, I watch demographic and socioeconomic dynamics dramatically shift and the prominent landmark of Boston Medical Center (BMC) slowly rises into view.

The orange line, the #1 – these are but two of the many lines of transportation that deeply inform the geography of the communities and clients that I and my fellow Advocates serve. At BMC, our families hail from all across Greater Boston, from Dorchester to East Boston to Woburn and beyond. The physical geography of the city is intimately tied to the landscape of resources accessible to clients – one I am reminded of as sweeping views of the Boston skyline greet me in the OB/GYN clinic.

The musical call to prayer floats through the waiting room in Arabic from the cell phone of a patient sitting with her newborn child. Next to her, a couple converse quietly in Amharic.  I turn to the corner to the crowded Health Leads desk where one of my fellow Advocates in a bright blue polo shirt is communicating with a mother in Haitian Creole, using an interpreter over the phone. The diverse backgrounds and experiences of my clients never cease to fascinate me, and it has been a great privilege to listen to their stories.

A petite woman walks up to the desk, a notification letter from her utility company in hand. They will be shutting off her gas and electricity tonight due to her inability to pay the bills after becoming unemployed. She tells me about her complicated pregnancy and I discover that she a high-risk patient. I rush to collect signatures from her physician who is shocked that the patient did not tell her of the imminent shutoff during their appointment an hour ago. As my fellow Advocate and I fax in forms for a shutoff protection, I am confident in my belief that Health Leads can make a significant impact on health outcomes.

Amidst difficult times, I am endlessly grateful for the reliable web of community resources where I can consistently count on referring my clients. When concerned parents come to me with a need for clothes for their growing children, my first instinct is to send them to the innovative program at Cambridge Clothing Exchange. When food falls short for the week, the Two Dollar A Bag program hosted by Fair Foods offer families bags of fresh fruits and vegetables, often the first food group to be cut on a limited budget. And despite heart-wrenching circumstances of several generations living in a one bedroom apartment, and the realities of multi-year waiting lists for affordable housing, I am inspired by the unyielding determination many of these families possess.

Health Leads offers me the great privilege of listening to and participating in stories, witnessing both awe inspiring smiles and heartbreaking tears, and being connected to a communal spirit that is ineffably human. I joined Health Leads with a theoretically driven academic interest in understanding social determinants of health. When I leave it will be not only with a vivid understanding of holistic health care, but also with an undeniable understanding of what it means to be human.

Arifeen Rahman is a sophomore at Harvard College.  She has worked as a Health Leads Advocate at Boston Medical Center for the past year.



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