Duke’s Role in Addressing Community Health Disparities

About

Aneri Tanna

In post-modern approaches to anthropology, there is a large focus placed on taking a critical eye towards the workings of power. The emphasis on looking at power not only within the community observed but also between the ethnographer and the observed is one that I believe is essential to ethical ethnographic fieldwork.

Being a Duke undergraduate myself indicates a position of privilege in Durham. Through this portion of the ethnography, I wanted to examine Duke’s role in Durham during COVID given the disparities in socio-economic status and resources between the Duke community and the Durham community.

Native American, Black and African American, and Hispanic individuals have all faced a higher rate of COVID-19 cases, hospitalizations, and deaths across the United States. These minority populations have borne a disproportionate burden of the pandemic due to social determinants of health (SDH). SDH are defined as conditions of the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

The first section of this ethnography looks at the actions that Duke as a privileged university has taken to address health inequities during the time of COVID. The second section examines a few of the initiatives that members of the Duke community including students, faculty, and staff have founded and supported to address such health inequities.

This page also serves as a resource page with links to the US University Report Card by UAEM, Duke and Durham vaccination and testing site information, relief fund information, and support organizations and their initiatives.

Duke as an Institution

Testing & Vaccines

Access to Duke's COVID Testing and COVID Vaccinations

Duke Health has provided easily internet accessible testing and vaccination appointments for individuals regardless of affiliation with Duke.

Duke Health Testing: Available only to individuals with COVID symptoms. Current Duke patients should schedule an appointment with Duke Virtual Urgent Care. Non-Duke patients should call the hotline below or find other North Carolina testing sites.

Duke Health COVID-19 Hotline ( available 8:00am to 8:00pm) 919-385-0429

Duke Health Vaccines: COVID-19 Vaccine Scheduling is available to all through Duke Health. Additionally, individuals can find other North Carolina vaccination sites.

Biomedical Research

Commitments to Global Equity and Access in Biomedical COVID Research

Universities Allied for Essential Medicines (UAEM) is an international organization composed of a network of university students advocating that privileged universities have an opportunity and a responsibility to further global access to public health, particularly focusing on access to medicines.

They recently released a US University Report Card which “grades the top 60 U.S. research universities on their commitment to open access policies, innovation in biomedical research for neglected health needs, student empowerment through global health education, and transparency in research endeavors”.

Within this 2020 report, they included a new section focused on scoring universities for their COVID-19 Biomedical Technology Commitments. Duke University received a grade of F in addressing the question: “Has the university publicly committed to any open science frameworks that increase access to COVID-19 related health technologies?”

While Duke has signed AUTM’s COVID-19 Licensing Guidelines which outline a licensing strategy for rapid pandemic response by licensees, this report found that Duke as an institution has made limited commitments to open research, technology, and science frameworks to promote equitable global access to important research pertaining to COVID-19.

Relief Funds

Duke Student Assistance Fund, Duke Health COVID-19 Response Fund, and Duke-Durham Fund

Duke Relief Funds begun with $9 million in seed funding from Duke University. These three funds are intended to “provide assistance for the most vulnerable members of our university and local communities.”

The Duke Student Assistance Fund (DSAF) for the assistance of Duke undergraduate, graduate, and professional students distributed above $5 million in grants in to over two thousand students from April 2020 to August 2020. While the fund is no longer open, Duke has created a resource list for student assistance.

The Duke Health COVID-19 Response Fund was run through Duke Health and divided into three parts: COVID-19 Area of Greatest Need Fund, COVID-19 Care Support Fund, and COVID-19 Research Support Fund. Overall, the fund intended to support “scientists and caregivers …, care for those affected, and thwart future outbreaks”. Information on the provision and allocation of funds does not seem to be available.

The Duke-Durham Fund started with a seed of $5 million from Duke University in order to “provide funding and technical assistance to non-profits, small businesses and community-based organizations affected by the pandemic”. This fund was also divided into a few areas: Emergency Relief for the Community, The Corporate Partnership for Durham- COVID-19 Recovery Fund, Durham Small Business Recovery Fund, and Emergency Relief for Carteret County. More information for these funds can be found on the Duke-Durham Fund website linked above and at the individual fund websites if applicable (also linked above).

Resources:

Duke-Durham Fund: Contact form for the grants team (bottom of the website)

City of Durham and Durham County Small Business Recovery Loan Fund: Application, English webinar, and Spanish webinar

Emergency Relief for Carteret County: Deadline to apply has passed but questions about the fund can be directed to carteret-emergency-relief@duke.edu

Duke University and the Duke Community

Institutionally Duke has extended monetary and public health resources to the broader community, yet minimal pledges were made to equitable sharing of research findings. Information has not been available on institutional steps taken to address health disparities in the community due to COVID. However, this work has been taken on more individually by members of the duke community who are recognizing and mobilizing to address needs of the greater North Carolina community.

Duke Community

Latin-19

Latinx Advocacy Team & Interdisciplinary Network for COVID-19

LATIN-19 is an activist team started in March of 2020 by concerned local physicians, nurses, researchers, educators, and community advocates to address the disproportionate burden of COVID-19 on the Latinx population in North Carolina. Many doctors and other members from Duke University are part of this changemaking initiative. LATIN-19, in partnership with organizations across North Carolina, has “served a critical role in advising and promoting Latinx community interests.” Some of their most significant accomplishments include advocacy with key stakeholders, developing and disseminating multilingual COVID-19 resources, and collaboration and capacity-building with member organizations.

Their monthly newsletter and weekly Wednesday meetings are accessible to all individuals who register. Through this pandemic, their mobilization of individuals and resources to support the Latinx community continues to be inspirational. Most recently, they have organized a walk-in vaccination clinic at Wheels Fun Park in Durham taking place on Thursdays from 9 a.m. to 6 p.m from April 15th through May 6th. More information, links to helpful resources, and registration for newsletters and meetings can be found on their website linked above.

Contact Form: http://latin19.org/contact-us/

Duke Mutual Aid

Duke Mutual Aid Community Fund

Duke Mutual Aid is a mutual aid network started by Duke students during the COVID-19 pandemic to support Duke and Durham community members who were in-need of financial assistance for housing, transportation, and food. The aim of this working group is to uphold the principles of Mutual Aid in building symbiotic relationships to provide a space where individuals can offer material goods or assistance to one another. Through this pandemic, Duke Mutual Aid has established a sustainable framework of collective care that has and will continue to bring the Duke/Durham community. Duke Mutual Aid has also compiled a resource list which addresses areas such as food, rent/housing, mental health, LGBTQ support, and more. Additional information can be found on their website linked above and on their facebook page.

Catherine's Insights

Catherine McMillan is a junior at Duke University from Charlotte, North Carolina who is studying history and minoring in education. Catherine is the co-founder and co-organizer of Greater Charlotte Area Mutual Aid (GCAMA), which is a youth-led nonprofit that was started last spring in response to the pandemic. Her co-founder is Joey Chong, a junior at Dartmouth and a close childhood friend of Catherine’s.

Like many students on Duke’s campus, Catherine was forced to go back home for the remainder of the semester. On returning, she says, “I didn’t want to just kind of sit back and be complacent when I knew that things are happening in my own community and that there was something I could do about it.” So, inspired by the wave of mutual aids sweeping across the nation, Catherine decided to bring together members of the Charlotte community through GCAMA. They have been working on various projects in partnership with other stakeholders during this time of crises including Coviad, Covid Chronicles, #GoLocalCLT campaign, Public Health Campaign, and Youth Forward Coalition.

Yet, this was not without its struggles. Catherine sheds light into the challenging bureaucracy which comes with running a non-profit. Her and her co-founder are critical of the nonprofit industrial complex. She explains that, “organizations justify their existence through the perpetual nature of these issues” which begs the question, “how do we actually get to the root causes, such that these organizations do not need to exist?” Another issue she discusses is the nonprofit space being “wrought with territorialism” due to competition in conditions of scarcity of resources, funding, and staffing.

Despite the difficulties, GCAMA has accomplished a great deal in its first year and is transitioning from being an organization that was made in response to the socio-economic crisis of the pandemic into an organization that “values relationships, shared resources, and sustaining the resilience of our communities”.

Conclusions

Duke University has offered open access to their testing and vaccination resources as well as its relief funds. Yet, the actions Duke has taken to actively combat health inequities appear to be lacking. The privilege of institutions like Duke warrants an ethical responsibility of using the extensive knowledge-producing capabilities to serve a greater purpose in the community. However, a given limitation of this critique is my position as an undergraduate student at Duke which inhibits my access in understanding the decision-making processes and difficulties of Duke’s administration, especially in a time of crisis.

Despite Duke’s level of engagement, members across the Duke community have stepped up, mobilized, and organized to care for their communities in a time of widespread need. This ethnography only highlights a few of the many ways in which the Duke community has supported the larger Duke/Durham community through the pandemic. There are many additional initiatives and individuals that have done inspiring work not addressed here. These projects on the ground are especially significant in bringing change not only on an individual level, but also as a push towards institutional change.

Catherine McMillan beautifully explains, “I think that there are a lot of things to learn from that moment, you know how to mobilize in times of crisis, how to find common ground as a community, how to find each other’s humanity, and to take care of one another.” This quote embodies the work done by Latin-19, Duke Mutual Aid, and the countless other organizations, projects, and initiatives which members of the Duke Community have taken on to address the demands of their communities.

A Collaborative Ethnography