#UMNMCH student Dae Akre-Fens (MPH 2023) wrote this reflection on how her internship with the Indian Health Board and her interest in sexual and reproductive health have contributed to her career in MCH.
I never thought I would go to grad school. After finishing my bachelor’s in Cultural Studies and Women’s and Gender Studies here at the University of Minnesota, I spent a year teaching English as a Second Language with City of Lakes AmeriCorps in Minneapolis Public Schools. I didn’t know what kind of work I wanted to do, but I knew that would be a great jumping off point. Being in AmeriCorps was an amazing opportunity that showed me how much I wanted to engage in youth work, specifically with queer youth. As much as I loved working with my ESL (English as a Second Language) students, I felt the most impactful working with queer students in after-school groups. However, I quickly learned that a traditional education environment didn’t allow me the opportunity to engage with queer youth in the way that they need. Being restricted to a curriculum that legally doesn’t need to be medically accurate or include non-normative types of sexual intimacy meant that I often had to skate around more “sensitive” topics.
After taking a break from teaching to raise cows in New Zealand, I came back home to Minnesota right before the pandemic. During the lockdown, I realized that I wanted to pursue sexual health education and advocacy as a career. With oodles of extra time on my hands, I got my Master’s Certificate in Human Sexuality from the University of Minnesota, which inspired me to pursue a Master of Public Health (MPH). Our healthcare system and cultural climate do not protect or uplift women, BIPOC folks, or LGTBQIA+ populations. As a queer woman born through assisted reproduction and raised in a same-sex, interracial, inter-status household, I’ve seen how difference is stigmatized and alienated. Even though my parents surrounded us with other same-sex and interracial families, my brother and I were the only “test tube” babies among them. My conception and upbringing made me into the inquisitive and driven academic and activist that I am today, shaped by strong women and queer community, curating a deep passion to be an advocate for others.
Finding My Internship
When it came to thinking about my APEX, it was important for me to find a placement that would give me the opportunity to critically engage with marginalized communities and integrate comprehensive sexual health and reproductive justice. Working with the Indian Health Board (IHB) aligned with this interest. They have a commitment to community care that is focused on meeting people where they’re at and working to provide services and support that are best suited to their individual needs.
Community-Centered Care at IHB
Working with the Indian Health Board (IHB) of Minneapolis allowed me to learn about Native specific healthcare needs while learning about curating programming toward Native youth. My internship focused on preparing to put on a two-week summer sexual health education program for Native youth aged 11-17. Preparation included learning about Native culture and history in addition to gaining a deeper understanding of current issues facing Native people in Minnesota, such as high rates of STIs, teen pregnancy, and stark health disparities. For example, the average rate of STIs among Native adolescents and young adults aged 15-24 is 3.6-4.2 % higher than white populations. In terms of combatting this, one of the biggest takeaways from my internship was learning about how to tailor programming with a Native specific lens.
During my time working with IHB, all programming I was involved with included opening with smudging (the traditional practice of cleansing a space and/or person with sage). Additionally, our education materials incorporated traditional Native teachings and ideologies, such as the Medicine Wheel; a traditional tool used to highlight the interconnectedness of life. The wheel has four parts that can be used to represent life stages (infant, youth, adult, elder), life aspects (spiritual, emotional, intellectual, physical), elements of nature (fire, air, water, earth), or seasons (spring, summer, winter, fall). There are other variations of the wheel as well, but these are some of the most common. Framing lessons around the Medicine Wheel was a way to tie sexual health education to Native values while also teaching youth that their actions and responsibilities to themselves and their communities are all interconnected.
Culturally Informed Public Health
As public health professionals, it is vital that we know how to tailor education and outreach to specific cultural, ethnic, and religious populations in order to ensure that we can make an impact. How many of us know what tribes’ stolen land we inhabit? How many of us know what cultural and health values Native communities hold and how to cater health education to speak to these values? How many of us know what Native specific resources are out there to help connect Native patients to programming that may be more accessible and comforting? There are innumerable cracks in our healthcare system, but addressing the needs and centuries long systemic oppression of Native communities has continuously been overlooked and intentionally erased. As the next generation of public health workers, we have a duty to be better and more informed so as not to repeat the harmful cycles of the past.
Dae is a second-year MCH MPH student. Dae received her BA in Cultural Studies and Women’s and Gender Studies from The University of Minnesota. She recently completed her deployment with the Indian Health Board of Minneapolis. In her spare time, she spends a lot of time cross-stitching, which was her primary lockdown activity. After graduating, Dae hopes to work in reproductive justice advocacy and queer sexual health with a specific focus on queer youth work.
Lauren, Tingey, et al. “Protecting Our Future Generation: Study Protocol for a Randomized Controlled Trial Evaluating a Sexual Health Self-Care Intervention with Native American Youth and Young Adults.” BMC Public Health, vol. 19, no. 1, 2019, https://doi.org/10.1186/s12889-019-7956-x.
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