It's not that I don't think about writing a post for my blog. I do. A lot. In fact, there are 5 posts queued up in various states of edit waiting to be published. But there's some sort of writers block going on, and as I continue deeper into the work of visiting our targeted counties, my energy is focused on building relationships and recruiting primary care providers into ECHO so they can learn to treat and cure HCV. Busy-ness is one of the reasons for not writing. Another, probably more influential reason is the sensitive areas in which I work; healthcare, addiction, siloed entities, economic challenges, and more. Across the board in every county I've visited, I find good, hard working healthcare organizations doing their best to comprehensively care for the lives they serve. But they do so with less and less resources and in silos. Often, one entity has an initiative going on to tackle HCV, but they are not collaborating with others. Efforts are diluted. Despite the capacity to cure hepatitis C, limited resources and provider burnout are barriers to building the infrastructure necessary to tackle a new disease state. When I show up "selling" participation in our ECHO, I must help them see how critical their participation is. I have to convince them to change heir hearts and minds.
There's so much to say about each place I've been, but I'll keep this at a high level just to give you and idea of where I've been since my last post in November 2018. Most importantly, in each of these geographies many new primary care providers signed up to participate in ECHO in order to have resources and knowledge to help them treat and cure HCV.
Here's a map of all the targeted counties for this project.
Inyo is the big county on the map on the Nevada border. It's absolutely gorgeous with all the beauty that the high desert offers. I stayed in Bishop, probably the most populated town in the county. There's a very large tribal presence here and I worked with Toiyabe Tribal Health. Northern Inyo Healthcare is also there, so I recruited mostly within these two organizations, although I reached out to as many private practices as I could. When I left this place, a friend of the medicine man invited me to come to a sweat lodge ceremony. It was there way of saying thanks for the healing I brought to their community. I was not allowed to take photos, but it was a moving (and HOT) experience and I was honored to be invited.
I was only in Tuolomne County for about a week as I was headed to San Francisco to attend a meeting. It's likely I'll head back there at some point. One of our very active spokes, Gina Valente-Moore, DNP, is in that county and is one of our biggest HCV Champions. Coincidentally, she was giving a talk about screening the very day I arrived, so here's a photo of her speaking to a group of providers. Kind of noir, right?
I spent 3 months in Sutter County. I stayed in Yuba City, a more suburban location than the previous two counties. While Yuba City is suburban, much of this county is rural with many farms. There are miles and miles of rice fields, walnut groves, and ranches for livestock. There was excellent response and participation here, and I learned that several of the larger healthcare organizations already had initiatives underway trying to focus on the known HCV epidemic in their community. This county also struggles with a shortage of primary care providers and resources.
Lake County is beautiful. As you can see from the map on the left, a very large lake sits in the center of the land, and much of the rest of it is very rural. In California, Lake County has the largest burden of HCV disease (Humboldt is second) and in the United States, it is classified as the second in the nation for HCV prevalence and vulnerability. Just like in all the other places I've been, there's a tremendous number of people who use IV drugs (PWIDs), with meth being neck and neck with heroin. Just like any other area that is economically depressed, people resort to desperate means to deal with desperate times.
I will be in Lake County for approximately 4-6 weeks, and then will move on to Tehama and Shasta Counties.
I suppose one of the reasons I don't write more is because I feel like I'm coming into a community, uninvited (although usually welcomed) and it doesn't seem like the right thing to do to write about vulnerabilities. Even so, the problems are here, and I hope to be a part of the solution by helping communities build an infrastructure to combat the deadly but curable disease that is HCV!
I promise to be more visible in the future. In the meantime, good things are happening and every provider recruited into ECHO takes us closer to micro-elimination of HCV.