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Daufuskie Island: a step back in timeby Cindy AbolePublic Relations The day trip to legendary Daufuskie Island off of South Carolina's coast marked a defining point in the education of several dozen health care students who were miles away from home and familiar classroom surroundings. Its intent was to introduce basic health care through real-life experiences and interaction with people. Its results helped to teach a modern generation the values of multiple rural cultures and its impact on communities located around coastal South Carolina. But going rural doesn't mean losing sight of modern conveniences, such as high tech medical equipment or the Internet, as these students in health administration, dentistry, medicine, nursing and physical and occupational therapy learned. All that this rural health practicum experience requires is that participants possess an open heart and healthy respect for cultures. “The story of Daufuskie Island is bittersweet to me,” said Sabra Slaughter, Ph.D., chief of staff, Office of the President at MUSC and former South Carolina Area Health Education Center (AHEC) executive director. Slaughter referred to the many high and low points which the island residents have struggled with, including economic independence, education and property rights. Slaughter recently returned to the remote barrier island serving as leader and guide to a small group of South Carolina Rural Interdisciplinary Program of Training or SCRIPT participants. In the mid-1970s, Slaughter spent five summers meeting and talking to the island's inhabitants, black and white, as part of a rural research project dedicated to improving health care and education for underserved communities within the southeast. One of four Friday community trips planned in the curriculum, the annual trip to Daufuskie Island is a treat for the senses. Daufuskie's long-standing history as rich farmland and unspoiled beauty has charmed visitors. The trip began under overcast skies on a humid, June morning as a small group of SCRIPT students, faculty members and participants boarded the ferry that would take them across a portion of the Intercoastal Waterway to the remote island destination. The 15-minute boat ride allowed the group to meet and mingle, a rare opportunity for these busy students and teachers. The boat safely docked at Haig Point Landing, one of three upscale golf plantations now located on the five and one-half mile island. The group was greeted by an elderly African American resident, Lawrence Jenkins, the tour's bus driver and island guide. Driving through the lush dwellings and manicured greens of Haig Point Plantation was a stark contrast to the island's more rustic undeveloped side. Throughout our tour around the island, Jenkins was quick to point to locations of former shanty dwellings, stores and businesses which once bustled with life under a protective thicket of moss-lined oaks and majestic pines. From memory, Jenkins can recount the names of former friends and neighbors who've farmed, raised families and yielded to a more self-sufficient lifestyle for generations. As the tour marched forward, the group was introduced to island resident Yvonne Wilson, one of many Daufuskie natives who've returned home to their coastal roots. She spoke candidly about the island's struggles for attaining adequate health care which relied solely on rotating clinics and visiting physicians. She also wanted to share and teach the same family principles and values to her own children that were first established as a little girl playing in the island's untouched shoreline or interacting within a close African village-like community. “Growing up here, people really cared for each other,” Wilson said.
“If anyone didn't have food, neighbors would share anything they had—crabs,
grits, bacon, anything in their cupboards. Today, I'm not sure if people
are just as caring. Life on the island has become more dollar-oriented
since the changes on the island .”
But Engler's experience wasn't solitary. Another 30 or so SCRIPT students have shared similar tales of appreciation or experiences that have made an impact to patients they have served or the community they've lived in. College of Medicine student Rachel Peck was able to use her fluency in Spanish to help communicate needs with small immigrant populations while working in Chelsea, a small town located between Beaufort and Hilton Head Island. The daughter of a nurse practitioner in Seneca, S.C., Peck enjoyed everything SCRIPT had to offer her. As part of the Beaufort/Jasper/Hampton Comprehensive Health Center, Peck was able to assist permanent Hispanic residents with medical care through this volunteer community service. “This was my first clinical experience,” Peck said. “I really liked learning about the primary care aspect of this program. Through SCRIPT, I was able to see and experience the values of interdisciplinary teamwork between medical personnel and other team members including social workers, human resources specialists, work-man's comp representatives and others. It was very important to me.” This year's SCRIPT hopes to continue attracting talented students from MUSC and other statewide institutions. Approximately 32 participants were enrolled in the spring 2000 practicum program which began in mid-May. The five-week summer practicum follows from mid-June to July. Funding for the program is generated from grants received from the Bureau of Primary Care and the Robert Wood Johnson Foundation's Southern Rural Access Grant. Part of SCRIPT's curriculum during the first week introduces students to cultural diversity issues and other aspects of rural life. Sometimes the discussion challenges the understanding of cultural belief systems including the use of home remedies and other folklore. On Fridays, students meet to attend field trips or discuss their weekly activities in a modified problem-based learning session. To stay connected to faculty and provide other resources for learning, students toted laptops or were setup to access the World Wide Web. “SCRIPT is an extremely positive experience,” said Diane Kennedy, associate director of Low Country AHEC and SCRIPT faculty member. “People can read about it all they want but it's the experiential learning—the ability to work and talk with their peers and ask questions to other health care professionals —that's the key to this brand of learning.” To help strengthen this year's efforts, SCRIPT organizers plan to extend its efforts upstate to South Carolina's Catawba and Pee Dee areas, a region that boasts extreme poverty among American Indian and Caucasian residents. According to Kennedy, the expansion will hopefully increase statewide participation with students and preceptors. This fall, Kennedy and Catawba-Wateree AHEC community-based education coordinator Laurie Patenaude will be recruiting students and talking to key advisors at MUSC, University of South Carolina, South Carolina State University, Frances Marion University and Clemson to promote the SCRIPT experience. The dates of SCRIPT's spring and summer 2001 practicums will be determined in early Oct. The expansion of SCRIPT in the upstate region is expected to have a positive effect on the program statewide and regionally. In turn, students learn to recognize the unique, multi- cultural health needs of indigent populations of the Lowcountry and upper South Carolina. “The SCRIPT experience not only exposes students to the demands of their work on a long-term basis,” said Slaughter. “It also allows them to work in a different setting beyond the traditional medical facilities and tertiary care centers connected to health care. It brings focus to the awareness of many distinctive roles which will help provide access to care for everyone in South Carolina.” 2000 SCRIPT Participants
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