Because Health is a Human Right
By Yael D Sherman 08PhD
After a tour of service with the Peace Corps in South Africa, Brandon Johnson 12N 14MN realized he couldn’t continue his career as a web developer.
“I sat down and reevaluated my life and where I wanted to go,” Johnson says. “The health care field just felt right. The model of nursing fit my personality and personal convictions when it comes to health and medical issues.”
He began searching for a school that could provide him with a foundation in civic leadership and found the Nell Hodgson Woodruff School of Nursing.
“When I compared Emory to other schools, the defining characteristic and deciding factor was the emphasis on social responsibility,” he says.
Johnson is able to pursue his dream of becoming a family nurse-midwife through support from the Helene Fuld Health Trust. He is the recipient of a Fuld Fellowship, which provides full-tuition scholarships for second-career students with a desire to serve vulnerable populations.
Since the fellowship was established in 2002 with a $5 million grant, it has supported more than thirty-five students who are committed to serving those most in need. The Fuld Fellowship helps teach students that nursing is about more than health care—it’s about serving others.
Johnson hopes one day to return to the village where he and his wife, Rachel, served while in the Peace Corps. With Emory degrees in nursing, he will be able to provide much-needed medical services.
Emily Bearse 12N 13MN arrives at the hospital at 7:45 a.m. on a Monday for her first extended shift. During the day, she assists with two C-sections. In the middle of the night, she is awakened to attend a delivery. Disoriented and trying to remember her clinical training, she experiences a burst of adrenaline when she walks into the room and faces the laboring woman. She focuses on the task at hand.
“Everything is on. I want to be there for the mom and encourage her to push the way she naturally wants to push. At the same time I’m thinking about what I need to do with my hands to help the baby come out,” says Bearse.
That night Bearse delivers two babies—two of the forty births required by the Nell Hodgson Woodruff School of Nursing for graduation.
Driving home the next morning at 6:30 a.m., Bearse reviews the births in her head: the women’s laboring positions, how she placed her hands and applied pressure, and the amazing moment when she handed the baby to her new mother.
“Every woman is different. Every birth is different,” she says. “It is an incredible honor that the woman lets you be a part of that.”
A nurse-midwife graduate student, Bearse hopes to combine her nurse-midwifery expertise with a public health perspective to make system-level changes that will help a large number of people. Already equipped with a master’s degree in public health, she was able to earn a bachelor of science in nursing with the support of the Woodruff Scholarship, a full-tuition scholarship with a policy and leadership component. During Campaign Emory, donors gave $225 million directly to scholarship support.
“The Woodruff Scholarship enables me to pursue the career I feel passionate about—serving vulnerable populations—rather than being constrained by debt,” she says.
Now pursuing her master’s degree in nursing with partial scholarship support, Bearse trains as a nurse-midwife at an Atlanta practice in addition to taking classes and working as a research nurse.
Two and a half hours after leaving the hospital Tuesday morning, Bearse attends midwifery class with instructor Kate Woeber at the School of Nursing. The class discusses the mystery of labor physiology: Why do women go into labor? Is it a hormone that the mother or the soon-to-be-born baby releases? An interplay between the two? In contrast, the roles that hormones play in making the uterus contract and the cervix dilate and relax are well understood. Bearse explains that Pitocin—a synthetic version of the labor-stimulating hormone oxytocin—can be injected to induce labor by causing the uterus to contract. Those intense contractions, however, can lead to maternal stress and a spike in cortisol, which can stall labor. The debate over when it is best to induce labor—at forty-one or forty-two weeks?—is ongoing.
“You know you picked the right profession when you want to read the textbook, and you enjoy coming to class, and you want to soak up every bit of information coming to you,” Bearse says. “So I was awake for that.”
Her interest does not go unnoticed.
“Emily is just awesome. She’s so competent and easygoing. I know that she works very hard, but she makes it look easy,” says Woeber. “I love that she’s going to be a midwife. I think she’s exactly the kind of person that we need because she paints a clear picture about how birth and health impact the status of women and the health of people in a community internationally.”
Classes in genetics and embryology follow. Bearse learns about cystic fibrosis from a woman whose husband has the disease. The woman tells the class about the rigorous daily treatments, the medications, and the required high-calorie diet. In embryology, Bearse studies the formation of the kidneys.
When Bearse returns home, she reviews applications to help select the next class of fellows for the Global Health Corps. “It’s tough because they are all great. They are so motivated and active in social justice,” she says.
Bearse’s words about the potential fellows could describe herself as well. Says her roommate, Augustina Delaney 12N 17PhD, “I think she has a very strong sense of what is right and that providing patients with the highest quality care is an ethical issue. She is one of the most dedicated people I have met in the program. She works hard because she wants to provide her patients with the best care. She is committed to moving the field forward, and her passion inspires the people around her.”
Her classmate, Erin Graham 12N 13MN, agrees. “Emily is one of the smartest people that I know. She is extremely driven and detail oriented. She will work on a problem until she solves it.”
Bearse first encountered the problem of health inequalities in middle school. Volunteering at a soup kitchen and an agency that provided care and housing to people living with HIV/AIDS, she was deeply affected by the hardships borne by the people she cared for. She planned to become a doctor, but after starting on the premed track at Miami University in Ohio, she decided medicine was not the best fit for her, and began to explore public health instead.
During a trip to Ghana after her junior year of college, Bearse volunteered at a hospital, witnessing firsthand the uneven access to care, the structural and systemic issues underlying health disparities.
“Health is a human right, because it is one of the most basic, but universal, needs and desires we have in this world,” says Bearse. “All people deserve the opportunity to live up to their potential, and a tremendous part of that is having the opportunity to be healthy.”
Concentrating in international health, Bearse earned an MPH from Boston University and returned to Africa—Zambia and Malawi—for two public health internships. She helped implement new maternal health programs that enabled women to give birth to healthy, HIV-negative babies, and recruited and trained peer educators to educate women in their communities about HIV.
“Working in maternal health grants me a unique opportunity to reach women and create positive change. For some women, pregnancy may be the only time when they come into the health system without necessarily being sick,” says Bearse. “We need to take advantage of this opportunity to empower women with knowledge about their health and how to maintain their health. If you do that, women will be better able to ensure the health of their families.”
As she worked alongside nurse-midwives and mothers, Bearse came to the realization that she wanted to pursue nursing and specialize in nurse-midwifery.
Drawn by Emory’s commitment to service, global health, and leadership, Bearse applied to the School of Nursing.
As part of the Woodruff scholarship, Bearse participated in a policy seminar taught by Associate Professor Marcia Holstad. Working with Jacqueline Muther, an HIV policy advocate at the Ponce de Leon Center, Bearse wrote a policy brief comparing the Ryan White Care Act, which provides care and services for people with HIV, to the Affordable Care Act. She pointed out areas of duplication and where there were gaps in the two acts.
Bearse’s depth of analysis and clear presentation impressed Holstad, who proudly points out that Muther uses Bearse’s policy fact sheets when she goes to Washington and lobbies legislators.
“The purpose of the Woodruff program within the School of Nursing is to groom the selected scholars to be leaders. We help them get on that path by investing in them for the future,” Holstad says. “Emily will be a leader because of her passion for women’s health and health policy.”
Bearse works as a research nurse in a vitamin D and HIV study one day a week. Given that many patients with HIV suffer from vitamin D deficiencies and associated health problems such as low bone density and poor cardiovascular health, the study investigates whether increasing vitamin D can prevent those problems. She conducts the study visits, talking to patients about their health and medications, recording their vital signs, and drawing blood.
Her thoughts often return to her time as a Global Health Corps Fellow at the Clinton Health Access Initiative in Malawi, where she worked with women who walked ten miles to the nearest health center only to find it had run out of HIV medications. She saw pregnant women come to the health center and discover that they were HIV positive. She counseled women who lost their babies because they did not have access to medicine to prevent HIV transmission. By helping HIV-positive pregnant women access and navigate the health care system, she ascertained their needs and designed programs to meet those needs.
The challenges that patients with HIV face in the US and in African countries are not that different, Bearse says: It’s hard for patients to get to their appointments because they don’t have transportation or because they are working hard. Many forget to take their medications because they are so busy with the daily tasks of survival.
In the US, though, health professionals have the luxury of performing a scientific study on vitamin D; in many African countries, they are concerned just with getting the basic medications.
Bearse also works in the nurse-midwifery practice’s office one day a week. She enjoys meeting with a mix of patients including teenagers and pregnant women. She explains that much of the time the teens want birth control for reasons unrelated to sex (such as acne or painful periods), but that she still makes sure to have a conversation about sex and the fact that hormonal birth control will not protect you from STDs.
“What I learned in Africa from seeing the results is that abstinence only works until you have sex—until it doesn’t. If you don’t have anything else in your tool kit, you’re vulnerable,” she says. “The second you’re not abstaining, you’re at risk and you need to be ready for that.”
Health care, Bearse says, is a tool of social justice.
“I have been given every opportunity in my life to be healthy, to access health care, and to live my life to my potential, and I think it would be unjust to restrict that right from anyone,” she says. “I believe that I have the ability through skills and knowledge that I have—and still am acquiring—to try to make this right more of a reality for all people.”