Today we're interviewing Dr. Alwyn Cohall, a trained pediatrician who has dedicated his career to the health of the children of Harlem. Dr. Cohall is a Professor of Clinical Public Health and Pediatrics at Columbia University's Mailman School of Public Health and New York Presbyterian Hospital. Through the Harlem Health Promotion Center and Project STAY, Dr. Cohall is attacking all the major health problems faced by his community's youth. We sat down and chatted with him about his work and what inspires him to keep fighting.
Huffington Post: Why did you become a doctor? Did you imagine yourself being so heavily involved in the nonprofit world when you were in med school?
Dr. Alwyn Cohall: I grew up in Harlem, a community steeped in a rich heritage of cultural and political achievement. However, it is also a community beset disproportionately by health problems. Even as a child, I knew I had to do something to help better conditions for my family, friends and neighbors. Becoming a doctor was my way to help.
The initial phase of my career was fairly traditional; I trained as a pediatrician with an additional sub-specialty focus on adolescents and young adults. I took care of young people in a variety of hospital-based clinical settings. But I began to realize the importance of community outreach and engagement to provide primary care and health education services for young people in non-traditional settings such as schools, work site readiness programs, recreational centers and juvenile justice centers.
HP: Tell us about you work as Director of the Harlem Health Promotion Center. What are the organizations goals? How does it execute them?
AC: The Harlem Health Promotion Center is one of a network of 37 Prevention Research Centers (PRCs), created by the Centers for Disease Control and Prevention, and funded by Congress to address issues related to health disparities in communities throughout the United States. An important aspect of the work done by the PRCs lies in the concept of "community-based participatory research." In other words, researchers work with community stakeholders in a collaborative fashion to identify a problem, consider strategies to address the concern, and then develop and evaluate programs. We work with consumers, community-based organizations, faith-based institutions, health care organizations, public health departments and other governmental agencies to address issues of concern to the residents of Harlem.
One of the major projects we have been working on has been to harness the potential and flexibility of the Internet for health information, advice and support. Some of our previous studies indicated that a sizeable percentage of Harlem residents had access to the Internet, and were interested in seeking health information online. However, many were turned off by the high literacy level of the content they found, as well as the relative lack of locally-specific and culturally-relevant information. To address this, we worked with community partners to develop a unique website portal, GetHealthyHarlem.org, which provides consumers with health informative, advice and resources specific to the Harlem community. Some of the content is written by our staff, but we embrace the concept of "shared wisdom," and the site has the flexibility to allow consumers to post content which provides a platform for exchanging experiences and providing support to one another.
HP: What about Project STAY (Services to Assist Youth)? What do you do there and what does the organization stand for?
AC: In addition to hypertension, another major public health problem affecting our community is HIV/AIDS. Despite the tremendous pharmacological advances being made in treatment, over 40,000 individuals become infected each year. A growing number are adolescents and young adults. Project STAY started out of our experiences in providing primary care for youth in school-based health centers in the early 1990s. We were seeing a number of young people with sexually-transmitted infections, and decided to do a small pilot project to assess the extent to which they were also at-risk for HIV.
Out of the first ten young people with Chlamydia and Gonorrhea that we screened, four were also HIV+. None were symptomatic or aware of their condition. At that time, there were no specialized services for young people living with HIV/AIDS in our community. With the assistance of Cheryl Healton, we wrote a grant and received funding from the New York State Department of Health's AIDS Institute to establish a Specialized Care Center to provide comprehensive medical and psychosocial services to youth living with HIV/AIDS. From our original group of four youth, we now have close to 80 in care. The overwhelming majority are doing well, living active lives, are in school or working, and are able to envision an attainable future.
However, as well as these young people are doing, if they were able to be granted one wish, that wish would be to rewind the tape and prevent their HIV exposure. That leads us to the other component of our work, to identify high-risk youth and hopefully reduce their chances of becoming HIV infected. With support from the Robin Hood Foundation, as well as the AIDS Institute, we have developed an aggressive outreach program that annually reaches close to 2,000 young people in schools, juvenile justice programs, workforce development agencies and community-based youth development organizations.
We provide health education, individualized counseling, screening for sexually-transmitted infections and HIV, and linkage to care at our primary care clinic or Specialized Care Center. About 8-10 percent of the youth we screen are found to be positive for one or more sexually-transmitted infections. More often than not, these young people had no clue that they were harboring significant infections that could threaten their health and well-being. We are able to treat them, and their partners, and engage them in follow-up at our clinics for ongoing primary care, and mental health counseling, as needed. By doing so, we are taking small, but important steps toward lowering the community burden of disease.
HP: What do you get out of your nonprofit work?
AC: Tremendous satisfaction in helping people obtain the tools and resources and support they need to live healthier lives and achieve their dreams.
HP: How can people get involved in the work you do? What greater issues does your work seek to address on the local level?
AC: We are always looking for volunteers to help us with our health initiatives in the community. Additionally, while we are grateful for the support provided by federal, state and foundation resources, we are in need of additional resources to help us reach even more consumers. Guardian angels with deep pockets, please apply!
HP: Who are your heroes? Who inspires you?
AC: Most importantly, all my adolescent patients, whose tremendous resilience in the face of seemingly insurmountable odds inspire me to work just a little harder and smarter every day to make things a little easier for them.
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