Madeline Van Gunten

Cleveland Department of Public Health, Cleveland

I entered the third floor of the Cleveland Department of Public Health at quarter to eight on a Monday morning in mid-May, feeling a little nervous and completely unsure of what to expect. My supervisor, the head of the Office of HIV/AIDS services for the city, graciously welcomed me inside. As he quickly breezed through names of associated offices, grants, and medical terminology, I attempted to retain the unfamiliar acronyms. I spent the remainder of day one reviewing application grants from organizations for HOPWA (Housing Opportunities for Persons Living with AIDS) funding. On that first day, I began to recognize the complexity and number of individuals and organizations involved in HIV prevention, just one office at the Department of Public Health. By the time of my final day in August, I had developed a much fuller awareness of the importance of local, state, and federal offices working in conjunction with business, non-profits, and other organizations on several levels, seven days a week to advance public health.

An estimated 1,106,400 individuals suffer from HIV/AIDs in the United States. About 2,840 individuals are infected in Cleveland alone. The disease has been stigmatized as a homosexual disease, and more recently an African American disease. However, in reality, the disease cuts across the boundaries of race, gender, sexual orientation, and socioeconomic status. HIV is not a death sentence as commonly perceived. On the contrary, if caught early, individuals can live for decades with the disease. For this reason, prevention is of utmost importance. The priorities of the Cleveland Office of HIV/AIDs services include reducing stigma, informing individuals regarding risks, promoting safer sex practices, getting individuals tested, and ushering individuals into treatment quickly.

Throughout my internship, I was granted numerous invaluable opportunities to observe the interactions that comprise public health. I spent the first couple of weeks sitting in on meetings with local HIV/AIDs organizations (such as the Regional Advisory Group), community members, clinic directors, and the Cleveland City Council. I also traveled to Columbus to attend an inter-organizational HIV prevention meeting at which the lieutenant governor and Congressional representatives were in attendance. I was inspired by the attendance at meetings and by individuals’ commitment to garner support for individuals affected by HIV/AIDs. Previously unsure of the definition of “public health,” my internship quickly illuminated this term in my mind. Public Health is nothing more than what it sounds: advocating and ensuring health services and support on behalf of the public. Public Health is not a simple process however, as it encompasses a vast array of divisions, departments, and levels.

I very much enjoyed the wide variety of tasks I was given. My work changed day to day and week to week. I spent the majority of the internship with HIV/AIDS prevention. I developed and distributed a consumer satisfaction survey for community members who attend the Regional Advisory Group for HIV prevention. The survey garnered a great deal of feedback that will now be used to better serve the needs of community members involved in HIV prevention. I was also able to interact with members of the community and local organizations by working the Department of Public Health’s table at the AIDS walk on Case’s campus. Additionally, I spent time preparing grant applications and requests for proposals for programs such as ARAP (AIDS Rental Assistance Program), CDBG (Community Development Block Grant), and other programs to assist HIV positive individuals with housing payments, food payments, transportation and other assistance. HIV is a debilitating disease, making it very difficult for affected individuals to work as well as to afford basic items after paying for health care and medicines. The grants were developed in close coordination with representatives from local AIDS organizations such as the AIDS Taskforce and the AIDS Funding Collaborative.

In addition to assistance with day to day coordination tasks, I was able to work with legislative projects during my time with the Cleveland office. I had the opportunity to branch out from AIDS prevention and delve into smoking legislation. I was asked to research new federal legislation regarding smoking, i.e. provisions involving restrictions to keep cigarettes out of reach for children, and to make recommendations for a local smoking legislation proposal regarding child restrictions. I was able to view federal legislation and to brainstorm how it could be applied at the local level in my own city. I was also able to sit in on Cleveland City Council meetings and to witness how my advisor and the head of the Department propose legislation and programs to City Council. In addition, I assisted with draft letters to Congressional representatives regarding support for a provision that would facilitate easier treatment for HIV. Lastly, I researched provisions regarding HIV in recent bills from the Ohio legislature.

The final major task I completed with the Cleveland Department of Public Health was with the Office of Epidemiology. I was asked to complete Continuity of Operations (COOP) Plan updates for 2009 for each division/unit. COOP plans are detailed plans of what would occur in the event of an emergency, for example a flood, fire, disease outbreak, or terrorist attack. I spent about two days completing Federal FEMA certification coursework online, which introduced me to the basics of COOP and the many aspects of a comprehensive plan. During the following weeks, I sent emails, made phone calls, and paid visits to the various department heads asking them to update their plans and offering assistance in the process. I also corrected the base plan, and completed a grid of essential supplies and resources.

Having entered my internship with a vague grasp of the term public health, I have exited with a much fuller understanding and appreciation of the importance of the many organizations committed to advancing public health. Promoting public health, regardless of which aspect, is a simple goal. The action behind the scenes between organizations and government levels is much more complex. Many individuals, including myself prior to that early morning in mid-May, remain unaware of the level of work, coordination, and communication that goes into ensuring public health. I am heartened by the large number of organizations that make public health their goal. Thanks to the generous Wellman Hill grant and the Case administration, I am happy to have been able to observe and to assist with the many processes carried out on a daily basis by the Cleveland Department of Public Health.