interviews
Call It What It Is
by LaShyra Nolen
July 1, 2020
This interview with LaShyra Nolen, Harvard medical student, and the first Black woman to become class president, was conducted and condensed by franknews.
frank | You've written and spoken about your experience within a dual reality – of being both a medical student at Harvard, and a person committed to your own identity and equity.
LN | The dual reality is you're training at the best medical school in the world, but there is so much suffering going on in your community. And whatever knowledge you gain still isn't going to necessarily translate to the improvement of the condition of Black people. For example, I could go on to become the best surgeon in the world. I could save the life of a Black patient. But they can go outside, drive home, get stopped by a police officer, move too fast, and get killed.
That is the dual reality. You're learning, but you're not necessarily getting to the root cause of the suffering of your people.
You always have to think about it from both of those perspectives, that of a student and that of a Black person in America.
In addition, you go into class and you are expected to maintain professionalism. You are expected to just talk about the science and to talk about the assignment at hand – when that same morning you watched yet another police lynching of a Black man. You're trying to deal with those emotions, and you have no idea how it's going to be taken if you say, "Hey guys, I'm really not doing that well. Another Black man was killed. Racism is pervasive in our country and we're all complicit in it." It is a challenge that all Black professionals have. You have to walk in and put on this face, even though internally you are dealing with the turmoil and hurt of your community.
What does this moment feel like at Harvard, as a student?
As a medical student, I feel like I can speak out more than my mentors or faculty members who are more ingrained into the system of medicine. Academic medicine is very hierarchical. The higher up you go, the more you have your hands tied, and you can't speak as much truth because you're trying to move up to an associate professor position so that you can finally start to use your voice. I know that there's a risk that comes with speaking up, but I, personally, can no longer just pretend like everything's okay, and allow people to continue to suffer in silence. Even the most brilliant people have been complicit in racism, and some of them genuinely have never even thought about it.
They've grown up in a bubble, their entire lives, and all this is happening and they're just like,
"Oh my gosh, I'm a good person. I'm not racist." And you kind of have to be like, "No, but you really are though."
These brilliant people who are excellent in their field, are just now realizing they're complicit in this system.
Again, I am happy that's occurring, but I'm always just like, look how much it took for us to get here. NASCAR is just now removing the Confederate flag. Suddenly now I have Juneteenth popping up on my Google calendar. I'm like, what?
My classmates and professors have really been amazing actually. We are all from different backgrounds. Some are fourth-generation physicians, and some grew up on reservations and are bringing medicine to indigenous folks. All of them realize that the system needs to change, and they have been so supportive. Beyond just talking the talk and posting the black box on Instagram, they've been reaching out to me saying, “Here are the notes from class today. I got this recording for you because I know you've been putting in work on the advocacy front.” That's true allyship to me. I've really been pleasantly surprised and happy to see the support that I've gotten from my classmates.
There has been a widespread acknowledgment that COVID is affecting communities and people of color at much higher rates. I am curious if you think there has been an appropriate conversation around why that’s the case?
I think that in order to understand that we have to look at our history, and at policy. The original ill was, of course, chattel slavery. This country has not valued Black lives. The policy reflects that, and policy ties into our healthcare. That history of systemic discrimination is important to look at to examine the current landscape of COVID-19.
Redlining decided where people live in this country, and which communities our government and our local city councils were going to invest in. Black communities were not invested in. As a result, Black communities have not had access to the basic resources that they need to survive and thrive. They don't have access to healthy food. They don't have access to safe places to exercise. They are exposed to environmental pollution. They have less access to education. I mean, then you look at who is more likely to be an essential worker - Black people are overrepresented.
It doesn't end there. Once people get into the clinic, they have to deal with the biases and systemic racism in the hospital system. There are studies that have shown there are medical students and residents who still think that Black people have a higher pain tolerance.
We can take maternal mortality as an example of treatment differences. Black women, at all income levels, are dying disproportionately compared to white women. When they get to the hospital, doctors don’t believe their pain. I mean, it happened to Serena Williams. It is safer for Black women to not engage with the healthcare system because of the violence and harm it causes.
How do you think mistrust of the medical system compounded the COVID crisis?
I think it all comes back to this conversation of access, right? When COVID-19 first hit, the testing centers were predominantly located in affluent communities, and a lot of Black communities were left without access to testing. The lack of Black physicians and Black health care professionals means that when Black patients come in and say they have COVID-19 symptoms, they are less likely to get treatment compared to white people.
If you know there are no testing centers in your neighborhood, you know there is no representation in the hospital, and you know that you are going to be discriminated against once you walk in that door, you know your life is being devalued. That knowledge prevents Black people from seeking care from our healthcare system. With anecdotes of horror coming from your community, of course you are going to be nervous to trust the healthcare system.
What does a better understanding of investment into public health look like to you?
I think we need to turn all of the conversations that we've been having into public health initiatives. Racism was declared a public health emergency in Boston. That is the direction I think we should be moving in.
We need to move beyond equality to think about equity. We need to recognize that not everyone is on the same playing field. We need to truly make sure everyone's specific situation is taken into consideration. We do that by investing in those communities, and by looking at how we make sure they have access to good education, access to health care, access to housing, access to good food. Improving the conditions where people live, work, pray, play will improve their healthcare outcomes and our healthcare system.
Of course, we need things like the physical exam, but often patients go into that physical exam with preexisting chronic diseases caused by disparate suffering. Going as upstream as possible will lead to better healthcare outcomes and in the long run, improve healthcare costs. Even if investing in public health didn't improve healthcare costs, I still think that it's the moral thing to do. I think we're too driven by what's going to save money in our country. We need to do what's right.
Everyone deserves to have the basic resources they need, to live out a viable, joyous life. Right now we are doing nothing to guarantee that.
Someone said to me once, we’re too focused on raising the ceiling and not at all focused on raising the floor in the American healthcare system. Do you feel like this starts as a medical student?
I can definitely speak to that culture. As a medical student, I'm really passionate about community activism. I am passionate about making sure that everyone has access to healthcare, and ensuring that we're teaching medical students anti-racism so that they don't go out and further harm communities. I can spend two years doing that – serving on committees, writing up reports, and changing curriculum at my institution. But my peers who are spending the same time publishing papers on very specific proteins and disease processes might have a better chance at residency.
In medicine, you're not incentivized to do work that you don't get credit for. You always want to be able to publish, and activism isn't always publishable.
It has been the responsibility of Black students, students of color, and indigenous folks to improve their institution. They do the work so that they can thrive and survive, and so the next generation can do the same. But at the same time, they still have to do everything they have to do as a medical student to get to the next level. I'm literally trying to improve the very environment that I'm suffocating in, while also trying to handle everything else that medical students are expected to.
There was a letter early on from public health officials advocating for protest as it’s needed to fight racism within the healthcare system. Does that feel new or was it already a part of the conversation?
I think it's always been a part of the conversation for those who have been oppressed.
But that is what is special about this moment. We literally had a global pandemic that exposed the disparate suffering of Black people across the country, across the globe. And then on top of that, you have back to back to back killings of Black people. It's heartbreaking that it took this much for us to start having these conversations, but we are having them, and people can’t run away from them.
There are no distractions. We're not going to get anywhere if people don't name systemic racism for what it is.
We need to say Ahmaud Arbery. We need to say Breonna Taylor. We need to say their names, and we need to name the issue at large.
Big-name organizations are just finally starting to realize that this is something that they need to get on board with. It’s hard to know if it's really genuine or not. I think that people don't want to be on the wrong side of history. Regardless, learning is still happening. I'm very happy that anti-racism is becoming the status quo and that we are having these conversations. We need to continue to push the envelope to get people things they need to live a good life.
interviews
Swipe Out Hunger
by Rachel Sumekh
May 16, 2019
This interview with Rachel Sumekh, the founder and CEO of Swipe Out Hunger, was conducted and condensed by frank news.
frank: How did you find yourself doing this work?
Rachel: I'm 27 years old. I live in Los Angeles, which is also where I'm born and raised. I'm a first generation student, both my parents are Iranian immigrants. I was always a student leader. I was student body president in high school – but suddenly in college it became cool to care about leadership as opposed to it being a nerdy thing. I had a friend [Bryan] who posted on Facebook inviting other students to come take action and end hunger with our meal swipes and I messaged him saying, "Hey, I have a background in Photoshop, I will help make the flyers so that students can come donate their meal swipes." He's like, "Cool, come on this day, we're going to move a bunch of food."
We had students donate swipes. After the swipes drive, we had all this food, but barely anyone showed up – except for me and Bryan. The pivotal moment of what really got me into this work was watching him. Instead of saying, "Wow, we have thousands of pounds of food to move, and only two of us on this hot June day in L.A., let's reschedule," he's like, "Cool, we told the school we were going to do it, and now let's do it."
We spent the next five hours moving food across UCLA's campus to the food closet. In my mind what it meant to be a leader changed, and the power of one person to take a stand that seemed really unreasonable, not easy, and unknown, was very inspiring. I decided from that point on I wanted to provide that opportunity for people. I still feel that moment.
Today, Swipe Out Hunger is a national nonprofit that operates on 75 universities and colleges; each of those campuses are committed to ending college student hunger, and that work is led by college students. They reach out to us, say they want the program, then we train them on how to write proposals, how to negotiate with the university, how to organize their campus, how to market the resource – and then they go and make it happen. A bad policy is waiting for a student to say it needs to be changed, a student to know how to organize, and a student to know how to clearly demand what they need. We want to build a movement that makes it easier, with each added campus, to make a basic statement – no one should be able to make money off of food on campus until everyone has access to food.
How does the program work logistically?
The core program, is in the meal swipe drive; essentially, a program that allows students at the end of each semester to stop by a table, say they have extra meal swipes on their meal plan, and donate. Freshmen, and often sophomores, who live on campus, are required to buy a meal plan. They get 10, 20, or 25 meals a week. If you don't use all those meals they don't roll over. Typically at the end of the semester they're completely unredeemable unless you want to buy a water bottle in exchange for a whole meal.
We provide students with an alternative. Stop by one of our tables, say you want to donate your meal swipes. It takes about 30 seconds. The university then takes the funds from students' accounts and puts them into a communal fund. There's a partnership set up between dining services and the social services office on campus; with the person who interfaces with students that are food insecure, and electronically moves the credit from the general swipe fund into the account of a student who's food insecure. That student, just like everyone else, can swipe into the dining hall and have access to more nourishing dining hall meals. That's the core of our program.
It involves a lot of stakeholder buy in. To get started you need to have a meeting; the first meeting should have the dining director, students, dean of student life, and a basic needs coordinator, or the person who manages a food pantry, and whoever would be in touch with students who are food insecure. We train those core people and you're able to establish a swipe program.
In addition to that, we've written and passed millions of dollars in legislation that has funded anti-hunger programs on campus. We push for Swipe Out Hunger programs, we push for legislation that gives more money to schools, and the way we support campuses in spending those dollars is twofold. One is SNAP programs; getting more students enrolled in SNAP and getting more campuses to accept SNAP. Then secondly, strengthening food closets; food cloests are a reactive solution, but they're also an incredible resource for an everyday student to grab what they need, take it home, and have access to food. How do we make sure food closets have really good hours, are centrally located, have good produce, and that student volunteers who are running the closets can get a stipend or something?
How do food closets work?
There’s a big range. On some campuses, like UCLA for instance, access is not regulated. Anyone can walk in, get food, and walk out, there's no check in. There are other campuses like UC San Diego, UC Davis, where it's a point system; you're allowed to get three or five points worth of things. You're able to come to a certain amount and pick up what you need. There's a huge diversity, some are very well stocked and very well resourced, and funding for them comes in a variety of ways. It's, as you can imagine, a very easy thing to fundraise for if the university decides to fundraise for it.
A lot of campuses don't want to be known for having homeless students and hungry students.The reason we have such stunning and robust dining halls is because when a parent is on a campus tour and they're helping their child decide where to go to school, if a school has a beautiful dining hall, that's what a parent who's paying full freight, full tuition is going to want their student to experience. A full tuition paying student wants to live the life of college in the movies. So that's what they prioritize.
There's a tension between that and schools also saying, "Yeah, also we have a bunch of hungry and homeless students." We hear many campuses who won't even fundraise for basic needs, even though it's an amazing way to mobilize their alumni. Traditionally, pantries are funded through parent circles, community events, and student fees. Many campuses receive student fees to fund their pantries.
What percentage of students on university campuses, on average – I know there will be a wide range depending on school – are experiencing hunger?
What sort of legislation are you focused on?
The legislation we advocate for is comprehensive. I was telling this story yesterday to another reporter, they asked me to tell them what we think the solution is. I was called by a legislator recently, she said, "I want to take Swipe Out Hunger onto every college campus in California. What's the bill I should write?" Our response was actually, "Swipe Out Hunger's great, but it's not the solution. I can help write what an effective bill would look like."
I've never written policy before, but I sent back a few ideas including one that would establish a funding pool to any campus that has three things. One is if they have a pantry or some sort of pop-up pantry; two, they should have at least one person trained in how to enroll students in SNAP; and three, if the campus has a meal plan they should give students a chance to donate their meal swipes, and then assign a campus point person to work with students to manage the pragrams. Legislation that we believe is effective has all three of those things built on existing resources in the community. There are food banks who know how to food bank really well – partner with the food banks. The staff already exists, all you have to do is train them in SNAP and that'll happen.
I don't want to be the next Feeding America, our entire model is not built on building a new building, it's built on integrating this into existing campus culture, resources, and infrastructure. When we think about policy, we want more funding to the existing system. We want more funding to schools so they don't have to have food be a revenue source, so they don’t have to prioritize full freight students over Pell students and vice versa.
Have universities been open or reluctant to working with Swipe Out Hunger?
The perspective that we, as Swipe Out Hunger, have on this issue is potentially the longest standing perspective. When we began this conversation in 2009 the response we were getting from the university was, "This is not a problem. Maybe there's a couple students who are going hungry, but this is not a problem." Then they started to say, "Okay fine, maybe it's a problem but it's not our problem." By 2014, we had gotten five campuses to launch.
In 2016 as an organization, we decided not to talk to a single campus who didn't also want to work on campus hunger.
Historically it was always students writing us, saying "I want to start this program." In 2017, half of our interest came from people on campus, administrators saying they want this program.
Social pressure came in 2016 – I credit this shift to Sara Goldrick-Rab and The Hope Center's research and leadership. This issue suddenly became a legitimate thing. It was out in the open and schools couldn't deny it anymore. They began looking for a solution. It became an opportunity to be innovative, to be advanced, and so we had schools reaching out.
This resistance goes back to the decision makers. You look at their LinkedIns, it's all Ivy League schools, private high schools. In large part, many have only spent time with people who've never been food insecure – or they wouldn't know it because shame keeps people who have faced food insecurity silent – so no wonder it's so shocking to them. They genuinely don't believe it. I look at the principles Bryan Stevenson speaks about – one of them is proximity.
The social pressure was huge. 2017 was pivotal.
How do students hear about you?
Almost 60% of the students we serve hear about the resource from a friend, despite it being in the campus newsletters, despite it being in flyers and so on.
All of our programs are run by student leaders. Our special sauce is that we're not just a resource but a resource run by your friends. Who's at the tables collecting swipes? It's other students. Who's helping get the word out, who's in the meetings with administrators deciding the program? It's students. We have universities reach out to us and say they tried to start their own Swipe Out Hunger program, but only had four students apply for free swipes. But it's because no students were involved in designing the program. What would have happened if you had a student tell you that the pick up hours for a meal voucher were off, or that the vouchers were only for the dining hall that's all the way across campus, which is only accessible for students who live on campus?
How do you communicate the importance of this issue to others?
I feel like we immediately dive into the issue without providing context on poverty in general. What I like to remind people is that in America, poverty has become so god damn pervasive it's taking center stage on our college campuses.
That fact that we require students to work 20 hours a week to be eligible for meal swipes, means that our social safety net has failed. The fact that we've defunded higher education means we're not setting up our students to succeed. The fact that families can't be there to support our students – in fact, many students are the ones supporting their families – means that as individuals we are so exhausted by the reality of economics in America, that even our social fabric is failing.
I invested my life in college student hunger because if students are able to get through college and have enough to eat, and feel like their campus was truly built for them, they're going to graduate and they're going to feel like the work force and society was designed for them. They're going to get a job. The lifetime earnings of a person change dramatically depending on degree.
I'm invested in this issue, rather than hunger in general, because if we can help students get degrees, it changes their lives and their families' lives. This is not just ending college student hunger because hunger sucks, this is a systemic way to look at how poverty tends to keep people in poverty. We tell people to pursue education as a way to get out of poverty, but even that advice is failing them because the education system in America is not set up for the diversity of people who are on campus today.