@   I

                                                                                                                                                                                                                                                                                                                                       I

                                                                                                                                                                                                                                                                                                                                       i


             MH     Community Health Services/*/California
             MH     Students, Health Occupations/*//
             MH     California
             KW     20C
             PN   - Weiner, Tess
             CN   - California Student Health Project
             CN     Los Angeles CoUnty-University of Southern California Medical Center. Dept.  of
                    Pediatrics
             CN     United States. Division of Regional Medical Programs
             CN     United States. Social and Rehabilitation Service
             CN     University of Southern California. School of Medicine
             TI - California Student Health Project, summer 1968/G
             TC   - Department of Pediatrics, Los Angeles County-University of Southern California
                    Medical Center. Report written by Tess Weiner.
             IM   - [Bethesda, Md.,/Health Services and Mental Health Administration,/l
             CO     x, 84 p.:illus.
             GN - Project supported in full  by  U.  S.  Division  of  Regional  Medical  Programs
                    (Contract no. 43-68-1532) and Social and  Rehabilitation  Service  (Grant  no.
                    53-5132-5437) and the Rosenberg Foundation.
             GN     Sponsored by the University of Southern California School of Medicine.
             CP     02NLM,08HMS,01SSY:WA 546:AC2:Cl4c::1969
             CA     WA 546 AC2 C14c 1969:02NLM,08HMS,01SSY
             Yl     S/1 969/
             LP     Eng
             LA     Eng
             MT     CORPORATE NAME MAIN ENTRY
             RO     O:MED
             RO     C:MED
             RO     M:NMC
             DA     710317
             LR   -780426
             EL   - FULL LEVEL
             IT   - MONOGRAPH
             Ul   -1255501


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                   CALIFORNIA STUDENT HEALTH PROJECT
                   SUMMER 1968

                   DEPARTMENT OF PEDIATRICS
                   LOS ANGELES COUNTY-UNIVERSITY OF
                   SOUTHERN CALIFORNIA MEDICAL CENTER

                   Report W@tten By:
                     Tess Weiner, M.A.
                     Director of Education, Student Health Project, Summer, 1968
                   FacWty Director:
                     S. Douglas Frasier, M.D.
                     Student Health Project, Summer, 1968
                     Associate Professor of Pediatrics and Psysiology
                   Student Director:
                     David Snyder, M.D.,
                     Paul F. Wehrle, M.D.
                   Faculty Advisor:
                     Student Health Project, Summer, 1968
                     Chief Physician and Chairman,
                     Division of Pediatric and Communicable Disease Service
                     Hastings Professor of Pediatrics

                   This project was supported in full by
                   U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
                   Public Health Service
                   Health Services and Mental Health Administration
                   Division of Regional Medical Programs (Contract No. 43-68-1532)
                                                     and
                   Social and Rehabilitation Service (Grant No. 53-5132-5437)
                                                     and
                   The Rosenberg Foundation

                     This report does not necessargy represent the view8 of the Public Health Service


                                       "An ideal medical center would give to
                                       physicians and students a direct contact with
                                       the whole spectrum of these (biomedical and
                                       social) sciences, from the most abstract
                                       knowledge to its ultimate practical applica-
                                       tions. Such a center would provide a suitable
                                       environment for the birth of an idea, the
                                       establishment of its validity, the shaping of
                                       it in the form of a usable concept, the testing
                                       of its practical utility and limitations, the
                                       teaching of its theory and practice, the con-
                                       cern of -the moral and ethical problems that
                                       inevitably arise whenever technological
                                       innovations are applied to human beings, and
                                       finally the discriminating application of the
                                       new knowledge for the benefit of a particular
                                       human being as well as of the community as a
                                       whole. Ideally, the medical center should
                                       recapture the intimate relationship with the
                                       patient, symbolized by the traditional picture
                                       of th-. family physician; it should cultivate
                                       the rational approach to disease that has grown
                                       out of scientific medicine; it should be a forum
                                       of the soul, and the needs of society are inte-
                                       grated into a new science of human and social
                                       engineering."

                                                                        -RENE DUBOS,
                                                                        Man Adapting


                                                       PREFACE

                           The  following  report  has  been  prepared  by  Mrs.   Tess   Weiner   an
                      experienced sociologist, who served  as  the  Director  of  Education  for  the
                      1968  Summer  Student  Health  Project.  Her   background   in   medical   care
                      administration, particularly at the  Mount  Sinai  Hospital  Child  and  Family
                      Study  Center  and  as  the  Director  of  Health  and  Welfare  for  the   Los
                      Angeles  County  Headstart  Program  (EYOA)   provided   an   excellent   basis
                      for  appraisal  of  this  program.  Her  inherent  sensitivity  and  perceptive
                      nature, together  with  her  close  but  "nonadministrative"  involvement  with
                      the project has provided  an  unusual  perspective  for  a  different  form  of
                      evaluation for this project than was done in  prior  years.  She  has  captured
                      the essence of the successes and failures,  and  the  many  poignant  vignettes
                      included bring to the reader a  measure  of  sharing  in  the  experiences  and
                      frustrations of their authors.

                           As this report is reviewed, the dis  cerning  reader  will  recognize  the
                      resistance of the "over-organized"  health  science  student  to  a  structured
                      and regimented experience during  the  "vacation"  months.  He  will  also  see
                      the greater interest  in  what  is  now  called  community  medicine,  evidence
                      of increased student political activism and, as in prior years, the  individual
                      expression of student  attitudes  toward  various  social  problems.  There  is
                      also clear evidence of the present unwillingness  of  many  students  to  speak
                      for their colleagues; its counterpart, the lack of clear  definition  of  those
                      the group wishes as its representatives, is also shown.

                           The project was  mounted  with  an  aura  of  great  expectation  born  of
                      success  during  prior  years.  The  philosophical  divisions  and  changes  in
                      attitudes within the sponsoring  agencies,  the  students  and  the  preceptors
                      were  not  clearly  recognized.  Those  between  law   and   medicine   further
                      complicated the plan. The year 1968, itself, marked  by  political  conventions
                      and campaigns, civil disturbances,  and  assassinations  of  prominent  leaders
                      with  the  understandable  emotional  reactions,  added  further  problems   to
                      the successful pursuit of  the  project.  Perhaps  the  most  important  lesson
                      to be learned from this report is  the  need  for  organizations  contemplating
                      the  sponsorship  of  such  programs  to  develop,  -  in  advance,  a  central
                      organization with  the  needed  experienced  staff  who  can  participate  with
                      students in defining  the  reasonable  goals  and  methods  of  achieving  them
                      and an organizational structure which  will  withstand  the  sudden  and  often
                      unexpected pressures to be encountered.

                           These   comments   a.re not intended as an apology  for  less  than  optimal
                      performance  by  an  organization  composed  almost   entirely   of   dedicated
                      and altruistic individuals, but as an introduction to a detailed  and  thought-
                      ful report, best described by  a  truly  involved  participant  who  has  given


                      much of herself to the successes of the project. She has provided herein a
                      valuable and perceptive account of the program itself and insight into
                      many of the social forces which influenced its ultimate form.

                                          S. DouGLm FRASIER, M.D.
                                            Faculty Director,
                                            Student Summer Health Project, 1968.

                                            Associate Professor of Pediatrics and Psychology.

                                         PAUL F. WEHRLE, M.D.
                                            Faculty Advisor,
                                            Student Summer Health Project.

                                            Chief Physician and Chairman,
                                            Division of Pediatric and Communicable
                                            Disease Service.

                                            Hastings Professor of Pediatrics.

             v


                                                           Contents

                                                                                                        Page
                        PREFACE       ------------------               ------------------------------

                        ACKNOWLEDGMENT                        ---------------------------------------       vii

                        PERSPECTIVE              ------------------ --------------------------              ix

                        THE  STUDENT HEALTH  PROJECT                              -------------------       I
                            Background      ---------------------------------------------                   I
                            Summer       1968 -              ----------------------------------------       2
                            Excerpts From Application@WhSr They Came                                        3

                        SELECTION          OF          PARTICIPANTS                ------------------       7
                            Health Science Students                ----------------------------------       7
                            Law Students' Selection               -----------------------------------       7
                            Distribution of Students by Discipline and Race              ------------       8
                            List of Student Participants        -----------------------------               8

                        THE  PRECEPTORS                                                                     12
                            Background      -------------  I         --------------------------------     .12
                            Planning of Projects - - @   ------------  I       -----------------------      18
                            Student Selection from the Preceptor's Point of View -.. - ...- -  .-  .-       14
                            Student-School Relations           --------------------------------------       14
                            Student-Community Relations         --------------------------                  15
                            Distribution of Preceptors by Organization and Specialty                        16
                        FUNDING SPONSORSHIP7AND STAFF                           ---------------------       18

                        ADMINISTRATION  AND - ORGANIZATION                                                  20
                            Description     -------------------   ;--------------------------            @-20
                            Some Administrative Decisions - - -                                             22

                        A LOOK AT GOALS           -------  I- - - - - - - - - - - - - - - - - - -     ----------- 24

                        THE ROLE OF THE            UNIVERSITY -.                                            26

                        EDUCATIONAL PROGRAM                        ----------------------------------       27

                        THE          PROJECTS              -------------------------------------------      80
                            Los Angeles County       -----------------------------     I   ----------       30
                               Venice                 -----------------------------------------------       30
                               East Los Angeles Child @ and Youth Clinic                       ------     ;32
                               Bio-Medical Careers Project-Minority
                                 Group Admissions                  ----------------------------------       34
                               Los Angeles County-University of Southern
                                 California Medical Center        ----------------------------              36
                               El Monte     ---------------------------------------------                   35
                               Willowbrook Volunteer Health Center              ---------------------       36
                               South Central Los Angeles-The Watts Project,                                 37
                            Ventura County-Oxnard                                      --------------       39

                                                                                                                         v


                               THE PROJECTS-Continued
                                                                                                    Page
                             South Monterey County-Rural Health Project        -------------           43
                             Kings County Community Action Organization        -------------           44
                             .Tulare County Community Action Organization-Visalia                      45
                             Fresno County-The Fresno Project                                          45
                             Kern County-Bakersfield                                                   47
                             San Francisco County                                                      47
                             Imperial County-Imperial     Valley Project                               48
                             The Law Projects    - -----------------------------------------           49
                               Background                                                              49
                               The Law Projects by Steve Bingham                                       51
                             Blacklash and Backlash Blues       ------------------I----------          65
                       PROBLEMS MOST FREQUENTLY MENTIONED BY
                         STUDENTS        --------------------------------------------                  58
                             Personal Problems                                                         58
                             Health Problems    -------------   -----------------------  -             58
                             Community Problems        -----------------------------                   58
                       RECOMMENDATIONS             ------------------------ I  ------------------      59
                       Bibliography                      ---------------------------------------       62
                       APPENDIXES
                             A.   Preceptor Evaluation-South Monterey                                  63
                             B.   Preceptor Evaluation-Tulare County             ------------          65
                             C.   Recommendations by Students on Project
                                    Placements for the Future         --------------------------       68
                             D.   Some Questions from the Black Caucus      ----------                 69
                             E.   The Black Students and the Student Health
                                    Project-A Position Paper       --------------------                70
                             F.   A Letter from the Dean, Roger 0. Egeberg, M.D.                       71
                             G.   Goals and Directions, S. Douglas Frasier, M.D     - ------           72
                             I-I. Identity (Abby Krowitz's Diary)       -------------------- -         @73
                             1.   Martha Jackson's Letter           ----------------------------       74
                             J.   Suggestions for an Education Program from the
                                    Northern California Educational Committee                          75
                             K.   Major Activities Conducted by Students ,        --------------       77
                             L.   Institutions and Groups Contacted by Students.                       79
                             M.   Organizations  and  Institutions  Contacted   by
                                    Students    -----------------------------------                    81
                             N.   Final Conference Program and Workshops, August
                                    28-30, 1968          ---------------------------------------       82
                             0.   Renascence (Mike Albertson's Letter)       ---------    ------       84

             ,VI


                                              ACKNOWLEDGMENT
                            This case study on the student health project  of  1968  is  a  departure
                       from former years when students wrote  and  edited  the  final  report.  Their
                       fresh, sensitive style, unhampered by analytic jargon,  reflected  tne  honest
                       excitement of discovering their own strengths,  and  the  pain  of  experienc-
                       ing the pain of others.
                            In a very different vein, this report is being compiled  both  as  a  de-
                       scription of the Summer  1968  project  activities,  and  as  an  analysis  of
                       some of the problems the organization  faces  in  the  ever,  increasing  tur-
                       bulence of student activism. It will be neither as subjective  nor  as  poetic
                       in its compassion as the reports of  former  years.  This  is  by  way  of  an
                       apology,  since  dispassionate  analysis  sometimes  cools  the  passion  that
                       moves us to action.
                            To the social researcher, diagnosis and prognosis are no  less  important
                       to the achievement of health than to the  physician.  If  the  report  appears
                       to focus on shortcomings, if it reflects frustration, perhaps  it  is  because
                       we recognize that self-criticism is necessary now  so  that  we  might  better
                       understand how to define and  pursue  our  objectives  later.  But,  more  im-
                       portantly, the students who will be  called  upon  in  a  few  years  to  make
                       fateful policy decisions need to expand  their  judgments.  There  will  be  a
                       significant influx of students active in the process  of  change  joining  the
                       ranks of professionals within the next 10  years.  To  strengthen  their  com-
                       mitment to improving the profession which they  are  about  to  enter  is  the
                       challenge and privilege of those teachers  also  interested  in  modifications
                       in the health services.
                            For the Project Directors, S. Douglas Frasier,  M.D.,  for  the  faculty,
                       and David  M.  Snyder  for  the  Student  Health  Organization,  and  Paul  F.
                       Wehrle, M.D., faculty advisor, who entrusted the  writing  of  this  study  to
                       me in spite of our differences, I feel sincere admiration. It would have  been
                       infinitely more reassuring for them to have  authorized  a  descriptive  study
                       of the Student Health Project experience  rather  than  a  substantive  analy-
                       sis. Somewhere in their  decision  must  have  been  a  similar  thought  that
                       prompted John W. Gardner's statement:
                              "Many  Americans   have   a   sentimental   and   undiscriminating
                            view of change. They think it  is,  without  qualification,  a  good
                            thing. But death is  a  form  of  change.  So  is  deterioration.  A
                            society must  court  the  kinds  of  change  that  will  enrich  and
                            strengthen it, rather than the kinds  that  will  fragment  and  de-
                            stroy it * * *
                              "Renewal is not  just  innovation  and  change.  It  is  also  the
                            process of bringing  the  results  of  change  into  line  with  our
                                     "I (15)
                            purposes.
                            I also wish to thank Mrs.' Joan Bolt6 for help in  preparing  this  manu-

                                                                                                              vii


                    script, and for the many hours spent  in  analyzing  student  reports.  To
                    her Brian, 6 months old, a special thanks for contributing the  warmth  of
                    his trust.
                        My very special gratitude  to  my  husband,  -Beryl  Weiner,  for  his
                    stimulating editorial comments  and  painstaking  assessments  during  the
                    process of writing this study.
                        And, of course, a special word of thanks to  those  students,  faculty
                    members, and preceptors whose thinking is brought together in this  study.
                        For those among you who remain dedicated to  the  cause  of  improving
                    health care institutions, I hope this proves of some value.

                                                                         TF.ss WEINER, M.A.,
                                                                         Los Angeles, Calif.,
                                                                                May 1969.


                                                PERSPECTIVE

                         This report is being written as a protest of scientists is occurring  at
                    MIT  which  may  quickly  spread  to  science  departments  in  other   major
                    universities. The protest consists of a 1-day research stoppage  by  a  group
                    of students and faculty while  they  discuss  their  involvement  in  govern-
                    ment-related research used  for  military  purposes.  They  question  whether
                    their talents could not be put to better use in the  solution  of  the  major
                    problems of the cities, such as water and air pollution,  education,  health,
                    and welfare.
                         Within the last 10 years,  student  involvement  has  had  an  exuberant
                    rebirth after the dormant period of the 1950's  when  political  conservatism
                    victimized the Nation's intellectuals while  it  promised  rewards  to  youth
                    for  aggressive  mastery  of  technology  and  uncompromising  excellence  in
                    research. However, their research was not to be  used  so  much  to  investi-
                    gate the social institutions  as  to  serve  an  abundant  consumer-producing
                    economy.  Universities  sanctioned  a  competitive   search   for   knowledge
                    with ever-heightened standards of independent  scholarship.  But  the  system
                    of extending education, with practice deferred until later,  delays  achieve-
                    ment of autonomy. It fosters dependency.
                         Talcott Parsons, in the 1962 edition of Daedalus  (24)  "Youth,  Change,
                    and Challenge," traces the change in the concerns  of  youth  from  its  pri-
                    mary field of social justice at the turn of the century to that  of  meaning-
                    fulness in the 1960's. The desire to exert some influence  on  the  decisions
                    which affect their lives  has  been  the  demand  of  students  in  the  mid-
                    sixties. It invariably has been. called The  Identity  Crisis.  By  the  late
                    sixties, youth movements  have  become  more  organized.  They  have  focused
                    their attacks on a social system which they perceive to  be  inequitable  and
                    punitive to  disenfranchised  segments  of  the  population-minorities,  stu-
                    dents, and the poor.
                         As a lesson in the rapidity of social change, it is surprising  to  note
                    that as late  as  1962,  Kenneth  Kenniston  was  still  concerned  with  and
                    deploring the political apathy of students. In an effort  to  stimulate  some
                    participation, he stated:

                           "Young people,  by  exaggerating  their  own  powerlessness,  see
                         the system, whether at work in politics  or  in  international  af-
                         fairs, as far more inexorable and unmalleable than  it  really  is.
                         In short, an alienated generation seems too great a luxury  in  the
                         1960's." (18)
                    Kenniston, though concerned about general student  apathy,  called  attention
                    to the fact that even scholarly elites were  defecting  from  the  mainstream
                    of tradition:
                           "A surprising number  of  these  young  men  and  women,  despite
                         their efforts to get good scholarships  and  good  grades  so  that

                                                                                                           ix


                           they can get into a good medical school and  have  a  good  practice,
                           nonetheless view the  world  they  are  entering  with  a  deep  mis-
                           trust.
                                                                    ay  is  partly  manifest  in
                                    the sanity of young people tod
                           their awareness that their world  is  very  different  from  that  of
                           their parents." (18)
                     To that small but growing group  of  vociferous  students,  society  has  again
                     and again violated the trust and values so  necessary  to  achieving  maturity.
                     Erik H. Erikson puts the case of youth and its  need  to  trust  in  community:
                             "In youth,  ego  strength  emerges  from  the  mutual  confirmation
                           of individual and community, in the  sense  that  society  recognizes
                           the young individual as  a  bearer  of  fresh  energy  and  that  the
                           individual so  confirmed  recognizes  society  as  a  living  process
                           which inspires loyalty as it receives it, maintains allegiance as  it
                           attracts it, honors confidence as it demands it." (11)
                           quest for a revitalized society continues, as does the quest for        a
                        The
                        "philosophy" to guide action. In  that  tortuous  quest  some  choose  to  opt
                        out, some to "cop out," and some to search for new     models   of    behavior
                        and service to mankind.
                           Only  6  years  later,  in  1968,  Daedalus  published  another  issue   on
                        youth, titled  "Students  and  Politics."  By  this  time,  student  movements
                        had become prime  news  for  every  kind  of  media  and  countless  observers
                        of the scene, whether educators, journalists, or  political  analysts.  Not  a
                        day or evening's cursory glance  at  the  ubiquitous  tube  omits  reports  of
                        student activism, variously alluded to  as  revolt,  riot,  or  mutiny.  Some-
                        times students have been denied their share  of  self-determination  by  those
                        still believing in the theory of conspiracy, of 'goutside agitators", or  com-
                        muni@. This occurs in spite  of  the  Kerner  Report  statement  to  the  con-
                        trary.  What  is  not  understood  is  that  students  historically  have  had
                        enormous courage  in  pushing  for  social  change  all  over  the  world:  in
                        anticolonial struggles, in the spread of republican and radical ideas      in
                        India, Indonesia, Asia, and  Africa,  and,  more  recently,  in  France  where
                        students  successfully  involved  a  sluggish  labor  movement  in  a  general
                        strike. Seymour Lipset, in the 1968  issue  of  Daedalus  referred  to  above,
                        states that:
                              "Students were often the carriers of modern ideas of liberty,
                            socialism, industrialization, and equality of opportunity." (19)
                        Now new voices are being  added.  For  the  first  time  in.  modern  history,
                        young Sisters of Catholic orders are  signing  the  same  political  petitions
                        as minority group  students  attending  local  colleges.  By  Vatican  report,
                        one  thousand  priests  a  year  are  requesting  a  change  in  the  celibacy
                        lawsi Students, black, brown,  and  white,  are  pushing.  for  black  studies
                        departments  and   student   representation   on   faculty   committees.
                             Although mistakes in    .strategy occur  it  is  hoped  that  through  or-
                        ganizational  experiences  like  the  Student  Health  Organization  more  ap-
                        propriate strategies will be developed.


                                    THE STUDENT HEALTH PROJECT

                         BACKGROUND                                and   biological   warfare,   urban   vio-
            The  history  of  the  Student  Health   Project       lence,  drug  addiction,  and  war   were,
          has  been  adequately  documented  in   the   1966       in large part,  omitted  from  their  cur-
          and 1967 reports of  the  University  of  Southern       ricula.  Lack  of  this   subject   matter
          California  and  the  1967  Student  Health   Pro-       symbolized  to   them   the   failure   of
          ject  of  the  South  Bronx   and   Chicago.   The       their  teachers  to  come  to  grips  with
          three reports describe the birth  of  the  organi-       the  biosocial  issues  of  the  day."(35)
          zation in  June,  1964,  in  Los  Angeles,  at,th
                                                       ,  !   On   those   campuses   where   the    organization
          University  of  Southern  California   Schooi   oi  took hold, they developed  a  pattern  of  student-
          Medicine. All sum up  the  inadequacies  of  i)re-  sponsored  meetings  at  which   important   speak-
          sent  medical  education  in  similar  statements:  ers were invited,  followed  by  lively  debate  on
          the confinement  of  health  science  students  to
                                                       .. I   tne crucial issues of the time.  There  was  parti-
          teaching  hospitals  with  concentration  entireiy    I
                                                       .. ,   cuiar  emphasis  on  the  relevant  health  issues,
          on  clinical  theory  and  methodology  separating
                                                              such as  fragmentation  of  medical  care  and  the
          the students  from  the  community.  The  reaiiza-  need for  widely  based  neighborhood  health  ser-
          tion of many  health  science  students  that  the    .ces responsive to the needs  of  individual  com-
          social aspects of  medicine  are  largely  ignored  vl
          in the medical  school  curriculum,  and  the  in-  munities.
          terest in these problems  that  studIents   acquired   In  the  summer   of   1965,   concerned   health
          during  their  undergraduate  years,  plus   their  student leaders met in Chicago  to  discuss  possi-
          motivation to find solutions,Icombined  to   bring  bilities of formalizing the  organization  and,  by
          about  the  nationwide  Student   Health   Organi-  1966,  plans  were  under  way  to  submit  a  pro-
          zation. In the Chicago report of  1967,  the  case  posal to the Office of  Economic  Opportunity  for
                                                              a  more  extensive  program  during  that  summer.
          is stated:
                                                              Support  came  from  faculty  in  various  medical
                 "Within  the  past  three  years,   the      schools  and  from  the  Office  of  Economic  Op-
               students  active  as  undergraduates   in      portunity,  which  awarded  a  grant  of  $204,000
               campus  organizations  and  service  pro-      to  the  University  of  Southern  California-Stu-
               grams have  begun  to  arrive  at  health      dent  Medical  Conference   Project   in   Commun-
               science  schools.  They  have  been   un-      ity Health Resources for the poor. In  1966,  fel-
               willing to drop  their  concern  for  so-      lowships were provided  for  90  medical,  dental,
               cial  change  upon  their   entrance   to      nursing, and social  work  students  from  40  in-
               medicine.   Many   of   these    students      stitutions  in  11   States.   Fifteen   community
               chose  medicine  with  a  conscious   de-      workers  received  the  same  stipend  and  helped
               sire to study  man  rather  than  disease      guide  the  students  through  their  communities.
               alone.  They  soon  became   aware   that      The  1966,  University  of   Southern   California
               the course offerings  at  health  science      Medical  School  Student  Health  Project   report
               schools failed to reflect  the  contempo-      states:
               rary  ferment  in  medicine.  What   they
               had hoped  would  be  a  broad  and  pro-             "Concomitant      with     educational
               tean  experience  promised,   they   were           values,  placement  of  health   science
               sure, to be  narrowing  and  restricting.           students in  such  communities  also  is
               They  were   disappointed   that   topics           seen as  a  stimulus  to  public  health
               such as  abortion,  population  -control,           and  welfare  agencies  to  review   and
               poverty,  -racism,  euthanasia,  chemical           carefully  evaluate  traditional   meth-


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                 ods of provision  of  public  health  and            dents  began  to  question  the  relevance  of  the
                 medical  s'ervices  found  in  urban  and            private practice of medicine, the  social  distance
                 rural  poverty  areas.   Manpower   shor-            of   faculty   from   community   problems.    They
                 tages frequently prevent  or  delay  sys-            questioned.the  separation  of  different   profes-
                 tematic  reappraisal  of  existing   pro-            sional  schools  for   health   professionals   who
                 grams." (38)                                         would be required  to  work  together  at  a  later
                                                                      period. The whole structure  of  medicine  as  pri-
               During the  summer  of  1966,  the  project          pro- vate enterprise was the subject  of  constant  dis-
               vided an educational experience to  see  at         first cussion, in view of the need for public  access  to
               hand  how  the   system   of   health   services   works the human services.
               and   the   degree   to   which   health   has    become -Si-immer 1968
               specialized    and    bureaucratized.    As     students
               guided   patients   through   the   maze   of    welfare In  1968,  93  students  came  to  California  from
               and  hospital   departments,   they   noted   that   the many  areas  and   universities   in   the   United
               interest  and  responsibility   of   the   latter   were States.  The  distribution  by  school   and   geo-
               focused  not  so  much  on  the  study  of  the   person graphic  orgin  is  recorded  on  pages  8-11.   It
               as  the  study  of  his  isolated  problem;   the   stu- should be noted  that  the  political  climate  had
               dents   began   to   identify    with    the    patients changed since  the  first  students  came  in  1966
               whose  life   chances   gave   them   no   alternatives. and  1967.  "On  strike,  shut  it  down"  had  be-
               The  literature   of   the   students   reflects   their come  a  familiar  organizing  slogan  on  campuses
               frustration  with   the   unplanned   system   of   med- across   the   Nation.   Authority-rejecting   stu-
               ical   care,   a   system   which   spawns   more    and dents, increasingly  violent  police  actions,  and
               more   bureaus   sensitive   to   the   convenience   of rising  student  militancy   undoubtedly   affected
               the  profession,  rather  than  to  the  needs  of   the members  of  the   Student   Health   Organization.
               patients.                                              To  the  students,  continuation  of  the  war   in
               The  interr  ationship  of   health   and   illness   to Vietnam is a  clear  example  of  the  illegitimate
               other   urban   social   problems   was    a    powerful use of power  to  manipulate  people  and  the  in-
               learning  experience  for  most  of  the   health   sci- stitutions which serve  them.  Many  see  a  paral-
               ence  students.  Many   of   the   students   began   to lel in the use of power to control  service  insti-
               realize  that  we  are   not   applying   our   existing tutions in the cities. While  some  student  health
               knowledge  to  people's  most  basic  needs   in   plan- people saw  their  role  to  be  patient-advocates,
                                                                        er  than  social  change  agents,  there  was   a
               ning  for  the  general  welfare.   We   laminate   lay- r@th
                                                                      significant number  who  aspired  to  the  role  of
               ers  of  opaque  veneers   onto   antique   foundations,
                                                                      radical   reformer   in   support   'of   oppressed
               knowing   that   the   structure   will   never    serve
                                                                      ghetto minorities.
               modern    technological    requirements.    For     manyIEven   medical   students,    who    usually    are
               students the  times  call  for  a  set  of  ethics  res- identified  with  some  of  the  more  conservative
               ponsive  to  human  welfare,  not  to  a  welfare   sys- members  of  the  health  professions,  have  begun
               tem.   Rather   than   utilizing   intermittent    stop- to question the posture  of  many  of  the  profes-
               gap   measures   which   provided    more    and    more sional associations, medical  schools,  -hospitals,
               specialized  clinics  or   departments   to   fill   the
                                                                      and  welfare  organizations  which  do   not   take
               holes  in  the  system,  it  was  necessary  to  coordi-
                                                                      an agressive s,;and in  solving  the  health  prob-
               nate   and   perhaps   reorganize   so   new   solutions lems of the Nation.
               could  be  found  for   old   and   new   problems.   As And  so  1968  brought  a   curious   mixture   of
               McLuhan  stated,  we   attempt   to   apply   new   con- students  to  California,   not   unlike   previous
               tent  to  old  forms  and   the   malady   lingers   on. mixtures of  students  except  that  the  objective
                 Constant   assaults   on   emotional    health,    se- conditions  called  for  more  clarity  of  purpose
               cure  and  trusting  relationships,   and   ego-fulfill- than ever before. In  1968,  it  was  not  possible
               ment,  forces  people  into  the   despair   which   ac- for  students  to  have  widely  disparate   goals,
               companies poverty.    In   their   own   context    stu- from low to reasonably  high  levels  of  political

               2


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

          understanding,   varying  levels  of  investment  in   becoming better professionals, whatever their
          organizational  success,  and  wide  differences  in   specialty. One student explained  it  this  way:
          knowledge   about   their    profession-all    shel-
          tered  under  the  matrix   of   one   organization.           "Being  only  a  first-year  student,  I
          These differences, coupled  with  lack  of  interest        still look at  the  medical  profession  as
          in being  either  leader  or  follower@r  in  estab-        a   means   of    helping    humanity    by
          lishing an ad hoc  hierarchy  for  purposes  of  de-        treating people.  As  I  consider  the  at-
          cision   making-gave   rise   to    one    emergency        titudes  of  my  classmates,   this   seems
          after  another.  Structure  was  considered   synon-        to  be  a   major   philosophy   behind   a
          ymous   with   authority   and   control.   Students        good  majority  of   them.   Compare   this
          brought  different  definitions  of  program,   dif-        to the  junior,  or  senior  students:  The
          ferent  expectations  of  their  summer  work,   and        stimulus   in   most   cases   has   become
          a high degree of individual anarchy.                        money   and   the   method    has    become
          Excerpts from Application-Why They Came                     treatment   of   disease.   The    institu-
                                                                      tional  efficiency  of  our  physician  as-
             A  review  of  student  applications  bears   out        sembly line  called  medical  school,  iso-
          the  above-mentioned  variety   of   interpretations        lates  us  from  patients   our   first   2
          of student  health  project  goals  but,  more  par-        years, and fails to emphasize          any-
          ticularly, the variations in individual goals.              thing  about  them   but   their   diseases
             Some  who  came  were  primarily  interested   in        during our clinical years."


                              CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
               Hoping  to  improve  her   skills,   a   third-year    tiously stated:
               nursing student says:                                        "I can offer  my  sensitivity  to  people
                      "I believe that the  project  will  pre-             inasmuch as  I  am  aware  that  my  indi-
                     sent   a   challenge   for    educational             vidual  insensitivities   interfere   with
                                                                           the understanding of theirs."
                     growth,   personal-    development    and
                     also  a  better  preparation  for  future        In an  intense  personal  statement,   one   third-
                     work in community health."                       year medical student:
               Some of  the  students  felt  that  involvement  in           "Medical    objectivity    comes    from
               the  project  would  help  them   in   reorganizing
                                                                           experience  in  suffering   and   can   be
               the   medical  school  curriculum.  To   that   end
                                                                           gained  with  or  without   genuine   con-
               they discussed the need for change:
                                                                           cern  for  patients.  But  concern   feeds
                      "What  is   amazingly   pathetic   espe-
                                                                           my  strength.   I   will   make   personal
                     cially in a large city like mine is  that             contacts  with  patients  in   my   educa-
                     an   effective   program   in   community             tion.  Without  these  my  humanity   will
                     medicine  has  never   been   established             wither.  There  is  nothing  so   self-de-
                     at my school. I  know  what  medicine  is
                                                                           structive as an unvented soul.
                     about  and  I  know  too  that  when  the
                     only sick person I can see  all  year  is        A  young  nursing  student  attending  an   eastern
                     myself, then  I've  been  living  a  very        college  measured  her  present   resolve   against
                                                                      her earlier background:
                     sheltered existence.
                       It's  about  time  the   medical   com-               "I was  born  and  raised  in  a  South-
                     munity quits  kidding  itself  about  the             ern  white  family  and  all  my  life  my
                     excellent  medical  care  given  to   the             contacts   with   Negroes   and   minority
                     American people,  as  one  can  see  from             groups  were  almost  nil.   Three   years
                     the most cursory  look  at  any  hospital             ago  I  moved  to   New   York.   Here   I
                     emergency room.ty                                     have  been  allowed  to  attend  an  inte-
                                                                           grated  nursing   school   without   being
               There  were  others  who  spoke  with  poetic  com-
               passion and,  though  their  goals  were  not  well         ostracized.  This  association   plus   my
               defined, they wanted very much  to  be  a  part  of         work  in  the  South  Bronx  project   has
               change.  A  student  interested   in   the   mental         been an eye opener for me * * *Pt
               health field observed:                                                             ss "implicit" in  inte-
                                                                      Not satisfied by the progre
                       "Last  summer   I   visited   a   State        grated education,  the  young  woman  is  quick  to
                                                                      discern that institutions  have  to  be  reinforced
                     mental  hospital.   In   the   children's
                     ward  were  10   black   boys   and   one        by operational philosophy.  She  goes  on  to  say:
                     white  boy.  The  ward   room   consisted               "The    nursing    school    I    attend
                     of  one  wooden  floor  and  four  walls,             'prides' itself on  being  a  patient-cen-
                     completely  empty:  no  toys,  no  equip-             tered  school  and   many   lectures   are
                     ment.  The  windows  were   cracked   and             devoted  to  the  'whole  patient'.   How-
                     there  was  an  open  terrace.  The  'pa-             ever,  when  we  are   on   the   hospital
                     tients' were locked  in  there  for  most             wards,  we  are  cautioned  against   get-
                     of  the  day  with  nothing  to  do   and             ting too involved in  our  patients'  pri-
                     were  then  diagnosed  'aggressive,   ac-             vate  affairs  (and  to  our   instructor,
                     ting out behavioral  problems.'  The  in-             this  means  their   socioeconomic   prob-
                     stitution functioned to hide these  chil-             lems.) They tell us that this is  the  so-
                     dren   from   sight   and   remove   them             cial   service    department's    concern-
                     from public .  schools  which  could  not             not ours.  I  th.ink it is our  problem  be-
                     meet their needs."                                             ursing   should   involve    more
                                                                           cause n
                A third-year occupational therapy student cau-             than ministering  to  a  patient's  physi-

                4


                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

             Cal needs for the  time  he  is  hospital-        white liberal adults and  students  who  have  not
             ized, only  to  send  him  back  out  into        yet decided how  to  make  the  fight  for  social
             the  same  situation  that  was  responsi-        justice their fight. One summed it up:
             ble for his hospitalization in  the  first               "I am asking for  the  opportunity  to
             place."                                               work  with  the   Student   Health   Pro-
        There  were  those  for  whom  the  Student   Health       ject this  summer  to  experience  first-
        Project offered  an  outlet  for  political  action:       hand  the  conditions   confronting   the
                                                                   disadvantaged.   I   would    like    the
               "I  have  to  learn  how   to   approach
             practical social problems  so  that  as  a            chance to work with  people  in  the  mi-
             doctor I can  be  an  asset  to  the  com-            nority   community   on   an   individual
             munity  not  jiis4'   as   an   individual            basis,  and  to  show  by   my   presence
             healer, but  as  a  trained  organizer  in            that there  is  some  concern  for  their
             the   solution   of   sociomedical   prob-            problems  in  the  white  community   and
             lems."                                                thus dispel some of  the  general  antip-
                                                                   athy towards  whites  that  seems  to  be
        Another:                                                   growing in the ghetto."
               "It  is  the  type  of  action  SHO  or-        Though some of the  objective  factors  of  class,
             ganizes  that  strikes  me  as  the   only        age,  and  socioeconomic   indicators   were   the
             way   health   workers    and    community        same for the black students as  the  white,  there
             members  can  effectively  combine   their        was  one  major  difference-  The  black  students
             experience   to   provide   medical   care        had an unequivocal sense  of  identification  with
             and  community  action  at  a   grassroots        blackness. The white students  chose  to  identify
             meaningful level."                                vicariously  with   blacks,   migratory   workers,
                                                               Chicano farm labor  organizers,  or  many  of  the
        For many  students,  self-fulfillment  was  a  goai.   other descriptive terms  used  for  the  poor-dis-
        Among  this  group  were  those   whose   expression   advantaged,  deprived,   or   emotionally   handi-
        of   their   own   autonomy    superseded    project   capped. But  the  black  students  were  eager  to
        needs  or  community   cooperation.   One   student,   make their positions  known.  Witness  the  state-
        in the course  of  describing  his  own  motivation,   ment of one first-year black medical student:
        states:
                                                                      "It is  a  well-known  fact  that  the
               "I  find  the  Student  Health   Organi-            number  of  existing  Negro  health  sci-
             zation project  especially  appealing  be-            ence students is  very  small.  Realizing
             cause it appears that the  only  limit  to
             one's accomplishments     .are   his   own            this, I feel that  I  cannot  any  longer
             initiative and resourcefulness."                      rely on others to do this work."
                                                               Another medical student:
        A first-year social  work  student  who  felt  well-
        endowed  with,  the  power  to  solve  life's  prob-          "I think it is imperative  that  those
        lems confidently stated:                                   Black  Americans  who   have   had   more
               "Not  only do     I   have   the   basic            good fortune than  most,  must  begin  to
             knowledge  of  the  growth  and   develop-            provide  the  remainder  of   the   black
             mental  process  of  human   beings,   but            community   with   whatever   is   needed
                                                                   to  continue  the   movement   to   free-
             also   the   techniques   to   precipitate
                                                                   dom.
             change."  (Veni,  vidi,  sed  non  vici!!-
             Ed.)                                              A second-year nursing student  included  the  fol-
                                                               lowing essay in her application:
        Whatever  the   individual   goals   refiected,,they
        all  sought  personal  involvement.  Many   of   the          "I think I should be a  part  of  this
        students'  applications  expressed  the  guilts   of       project because I  know  what  it  is  to

                                                                                                                5


                               CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                     go  through  half  of  my  life   thinking              tually identify  with  me,.  this  will  be
                     that  all  white   people   were   smarter              my greatest reward."
                     and a  much  better  person  than  I  was,
                     that white  is  good  and  black  is  bad.        Another nursing student stated:
                     But then one  day,  in  my  last  year  of               "I  am  convinced  that  my   unique   ex-
                     high school, I realized  that  the  lowest              periences   as   an   Afro-American    have
                     mark in my report card  is  an  85  and  I              played a  decisive  part  in  the  formula-
                                                                             tion of  this  desire  to  work  in  under-
                     didn't study because  of  the  noise  that              privileged  communities.  I  truly   desire
                     five  little  children  can  make   in   a              to help my people in time of crisis."
                     three-room  apartment.   Can   you   imag-
                     ine  the  shock  and  surprise   that   it        A black law student makes clear that his goal
                     must be for  an  18-year-old  to  wake  up        is to reinforce what he is and who he will be,
                     and see that I'm  not  inferior  and  stu-        and perhaps points up the major goals of the
                     pid  and  being  black  isn't  the   worst        black students who participated:
                     thing in the world?
                      "I also know  that  the  fight  for  life               "There   are   various   reasons   why   I
                     in  the  ghetto  is  a   365-day-and-night              feel that  I  should  participate  in  this
                     struggle.  Your  guard   must   never   be              program.  All   of   them,   however,   are
                     let  down,  or  else.  I  consider  myself              wrapped  up  with   a   continuous   effort
                     lucky  because  I   had   someone   behind              to be black in a  constructive  way  -,  to
                     me,  pushing  me  on.  I  had  someone  to              emphasize   and   relate   that   blackness
                     identify  with.  I   hope   through   this              to one's interactions with people       and
                     summer  project  to  show  all  the  chil-              things, e.g., institutions.
                     dren that I come  in  contact  with,  that                "I  have  been  trained  at   educational
                     it can be done,  it's  not  an  impossible              institutions that  reflect  the  best  that
                     dream, I  am  a  living,  breathing  exam-              white  America  can   offer.   Too   often,
                     ple.  This  is  one  of   the   somethings              black   people   of   similar    experience
                     that are  lacking  in  the  black  commun-              have  used  it  to  escape  f   rom   their
                     ity, identity.  The  kids  of  the  ghetto              blackness.  This  history   is   clear,   I
                     from   time   they   can   remember   have              won't  go  into  it.  We  have   ended   up
                     nothing  more  to   identify   with   than              with  black   leaders   who   are   largely
                     dope   pushers,   junkies,   and    number              extensions  of  the  white   culture,   who
                     runners. These  are  the  only  people  on              are  psychologically  and   socially   dis-
                     the block who have clothes, a  Icar,   and              tant   from   their    own    constituency.
                     a decent place to live in. But I  hope  to              'Captive   leaders'    they    have    been
                     show  them  that  this   isn't   all   the              called',
                     world has  to  offer,  that  pushing  dope                gg* *  *  The  orientation  here  at  law
                     and  number  running   aren't   the   only              school is  toward  big  business  and  cor-
                     professions  that  are   open   to   them.              porations  and  money  and   Wall   Street.
                     With just a little more  effort  on  their              The  talk  is  of  fine  .  cars  and   big
                     part,  a  whole  new  world  can  open  to              houses.  The  rich  get  richer   and   the
                     them. It may not  be  as  easy  as  becom-              poor  get  poorer.  And  for   the   blacks
                     ing  a  dopepusher   or   number   runner,              who   follow    the    traditionally-dire@d
                     but  no  one  is  'promised  a  rose  gar-              routes here, the  roads  toward  the  pov-.
                     den.'                                                   erty   and   ghetto-stricken   are   hardly
                                                                             on the map.
                       "I know  what  it  is  to  have  someone                gl* * * It  i  the  effort  to  make  new
                     to look up to and count     on. If  I  can              maps  that  motivates  me  to   work   with
                     get  just  one  kid,  this   summer,   who              relating  my  life  to   such   experiences
                     will really build a trust  and  can  even-              as this summer project offers."

                6


                                         SELECTION OF              PARTICIPANTS

                                                                   tually shared,  and  set  the  tone  for  the  pattern
           Health Science Students                                 of  behaviors  to  which   students   would   be   ex-
           As  in  the  previous  year,  the  application   form   pected to  comply.  It  was  to  be  an  intense  per-
           for   the   1968   Student   Health    Project    was   sonal  experience  validated  by  a  summer  of   ser-
           mailed  in  an   imaginative,   aesthetic   brochure,   vice.
           describing  the  various  projects   throughout   the      Law  students  were   screened   by   the   advisor
           country. Again, too,  the  student  response  to  the   and   cordinator   who   are    contemporaries,    the
           essay   question    "Why    Do    You    Think    You   advisor  having   graduated   from   law   school   in
           Should be  a  Part  of  the  Project?"  was  used  as   1967. The  relevancy  of  that  fact  is  merely  that
           a  major  criterion  in  choosing  the   participants   the  advisor's  youth  lent  acceptance  to  the  rule
           by  the  selection  committee,  composed   of   medi-   that all law  students  must  live  and  play  in  the
           cal,  dental,  and  nursing  students.  The   commit-   poverty   community   to   which   they    were    as-
           tee looked for several  attributes  in  their  selec-   signed.  Hence,   though   he   was   both   authority
           tion:                                                   and  intern,   the   advisor   also   became   comrade

             (1)  Students   with   some   previous   experience
                  in  community   organization,   poverty   pro-
                  grams,  and  health  related   agencies,   who
                  had   developed   a    commitment    to    the
                  goals  of  the  student  health  project,  and
                  therefore  were  able  to  "jump  right   into
                  the job."

             (2)  Students with  relatively  little  past  expe-
                  rience but  eager  to  learn  and  displaying,
                  in  their  application,  some  intention   and
                  promise  of  using  the  experience  for  self
                  development.
             (3)  In @ order to   ensure    heterogeneity    all
                  minority  group   applicants   were   accepted
                  and  a  balance  was  sought  between  a  wide
                  -range  of  disciplines  of  medical,  dental,
                  nursing, and social sciences. In additio
                  pref  erence  was  given  to   students   from
                  Calif ornia.

           Law Students' Selection

             The  philosophy  of   the   law   student   project
           very  much  dictated  the  kind   of   students   who
           would finally be a part of it.
             Early  in  the  spring  the  faculty  law   advisor
           and  law  coordinator  developed  a  central  philos-
           ophy  which  prescribed  the   quality   of   student
           community relations, the style  of  life  to  be  mu-

                                                                                                                        7


                              CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
             and  advocate.  Perhaps  the   many   roles   he   oc-     These  were  essentially  the  qualities   ascribed
             cu@ied O'ffered  greater  strength  to  his  position,   to  law  students  who  were  selected  by  the   law
             but  they   might   have   weakened   his   leadership   screening committee.
             had he not shared  in  the  daily  life  of  the  com-
             munity  with  students   and   been   less   sure   of   Distribution  of  Students  by  Discipline  and  Race
             what  he  hoped  to   accomplish   during   the   sum-     Out of  250  applications,  93  students  were  se-
             mer.                                                     lected for  the  1968  Student  Health  Project.  Al-
                The law project  will  be  dealt  with  at  greater   though this  information  is  not  complete  for  the
             length in another  section  of  this  report,  but  in   law  student  groups,  the  record  shows   that   at
             terms of the selection  process,  the  fact  that  all   least  59  students  were  from  California  and   56
             students were  to  share  in  the  life  of  the  cOm-   attended  California  Schools.  Of  the   93,   there
             munity   gave   support   and    cohesion    to    the   were  65  male  and  28  female   participants.   The
             group.                                                   average age was 23.6.
                All  applicants  were   personally   screened,   by
             the  faculty   advisor   and   law-student   coordina-               Distribution by Discipline
             tor,  and  though  this   method   of   screening   is
             largely  subjective,  there  were  very  specific  ob-                               Number        Percent
             jective  criteria  by  which  students  were   judged.   Medicine                        37          39.7
                The  project  judged  a  student  by:                 Law                             19          20.4
                                                                      Nursing                         14          15
                (1)  The extent of his political awareness;           Social sciences                 6           6.4
                                                                      Pharmacy   ----------------     2           2.1
                (2)  The  degree  to  which  he   understood   that   Dental hygiene                  2           2.1
                     his  technical  skills  were  second  to   his   Optometry                       I           1
                     ability to  work  with  established  and  rel-   X-ray  technician               I           I
                     evant community agencies; and,                   Occupational therapy            I           I
                                                                            Total ---------------     93         100.4
                (3)  The  degree  to  which  he   understood   that
                     autonomy     and     decisionmaking     rested
                     with  the  community  people,   not,the   stu-                  Distribution    by Race
                     dent.
                                                                                                  Number        Percent
             The  students  who  were   chosen   were   those   who   Caucasian:
             the  two  interviewers  felt  could   trust   in   the     White  --------  ---          67          72.
             community  and  build  trust  for  the  student   pro-     Mexican-American   ....       6           6.4
                                                                      Black                           18          19.3
             ject.  They  were  to  function  as   counselors   and   Oriental                        2           2.1
             friends  to  the  local  young  people  and   as   ex-         Total                     T3          @.8
             pediters   to   experienced   community    organizers.

             List of Student Participants
                           Student                                  Home                              School

                                                                 Medicine
             William      Bauer --------------      Brooklyn, N.Y    -     -----------  New York State University
             William Boyd    ----------------       @  Denver,  Colo -     ------------- University   of    Colorado
             Lionel Bodzin    ---------------       -I  Oak'Park,   Mich -     ---------- Wayne     State     University
             Robert Buker     ---------------   @  '.Mount Vernon     -------  7  ----  UCLA
             Joe Capell    ------------------       Fresno,    Calif -     ------------- University   of    Southern
                                                                                             California
             Noel Drury     ------------------      Los Angeles, Calif   -    --------  University    of    Louisville

             8


                               CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                               Student                              Home                               School

           Michael Duchowny           -----------  Bronx, N.Y    -           -------------- Yeshiva University
           Andrew         Fisher ---------------   Bartlesville,    Okla -         ---------- University of Oklahoma
           ,John          Gambin ---------------   Los   Angeles,   Calif.                University of California, at
                                                                                          Irvine
           Jerry        Ginsburg --------------    Los   Angeles,   Calif.                University of Southern
                                                                                          California
           Lloyd          Gordon ---------------   Paramus, N.J    -           ------------ New York State University
           Michael      Halperin                   Fresno, Calif  -           ------------- University of Southern
                                                                                          California
           Kirk         Holloman ---------------   Los   Angeles,   Calif.                Stanford University
           Duane         Iverson ---------------   Kent, Wash   -            -------------- Northwestern University
           Robert          Jones ----------------  lienver, Colo  - ----------            University of Colorado
           Phyllis         Klein ---------------   Bronx, N.Y..                           Yeshiva  University
           Alvin         Larkins           ------  New York, N.Y.                         Meharry Medical College
           Joseph            Lee ------------------- Los   Angeles,   Calif.              Meharry Medical College
           Edward            Liu       ----------  Detroit, Mich.                         Wayne State University
           John             Long ----------------- Beaver,  Pa  -            -------------- University of Oklahoma
           Robert Lundstrom                        Los Angeles, Calif. -                  UCLA
           Bill Mason          ------------------  N.  Hollywood,   Calif.                University of California, at
                                                                                          Irvine
           Walter        Maynard                   Los Angeles, Calif. -                  Meharry Medical College
           Robert        Montoya -------     ------ Los Angeles, Calif. -                 University of Southern
                                                                                          California
           Lovell         Mosley ------------------ Oakland, Calif -            ------------ Howard   University
           Robert        Peoples --------------    Los  Angeles,   Calif -           -------- University of Southern
                                                                                          California
           Don          Peterson ---------------   Los  Angeles,  Calif.                  University of Southern
                                                                                          California
           Arthur        Raehels -------------     Los  Angeles,   Calif -           -------- Meharr'y Medical Co' Ilege
           Barry            Rand ----------------  New York, N.Y    -            ---------- Yale University
           Don            Rogers ----------------  Los  Angeles,   Calif -           -------- UCLA
           Robert          Slama ---------------   Los  Angeles,  Calif.                  Temple  Universitk-
           Semeon       Tsalbins ------------      Brooklyn, N.Y.                         Yale University
           Lauren          Welch ----------------  Kansas   City,   Kans -          --------- University of Kansas
           Albert        Wilburn                   Los  Angeles,   Calif -           -------- UCLA
           Bernard       Wilkins ------------      Los Angeles,  Calif.  -                Meharry Medical College
           Michael         Witte ---------------   Fullerton, Calif -            ----------- Marquette University
           David     Wren      .----------------   San  Francisco,   Calif -           ------ University of California, at
                                                                                           San Francisco

                                                               Law
           John          Calmore -------------     Pasadena,  Calif -             ---------- Harvard  University
           Diana         Chapman -------------     San  Joaquin,  Calif.                  University of California, at
                                                                                          Davis
           Stephen         Cline -----------       Sacramento, Calif.,'@.                 University of the Pacific
           Bartley        Deamer                   San  Francisco,  Calif.                Harvard  University
           Martin    Eich    'er        ---------  Palo Alto, Calif.;@            ----------- Stanford University
           Steven Hei          --------------      Palo Alto, Calif -            ----------- Stanford University

                                                                                                                       9


                                   CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                                   Student                         Home                                School
                 Peter Janiak .@-. ------ -------      *                                  University of California, at
                                                 --    -----------------------
                                                       *                                     Davis
                 Nanette  Kripke                         ------------------------         University of  California,  at
                                                                                             Berkeley
                 Theodore      Lakey                   * --------------------------       University of  California,  at
                                                                                             Davis
                 Stephen Lindfeldt                     Sacramento,   Calif.               University of the Pacific
                                                       *
                 Keith         Lesar     --------        -------------       -----------  University of  California,  at
                                                                                             Berkeley

                                                       *
                 Leroy        Miller ------------------  ------------------------         Stanford    University
                 Philip    Nicholson           ------  * ------------------------         Stanford    University
                 Alan Rader        ------------        * ------------------------         Stanford    University
                 Ron         Romines ----   -----------* -------------------------        Stanford    University
                 Greg    Sager    .. ---------------   *          ----------------------  University of  California,  at
                                                                                             Davis
                 Sheldon      Sarfan                   * ------------------------         University of  California,  at
                                                                                             Berkeley
                 Jon         Steiner ----------------- Los   Angeles,   Calif.            University of  California,  at
                                                                                             Berkeley
                 Jacob      Weisberg                   Los   Angeles,   Calif.            University of  California,  at
                                                                                             Berkeley
                 *Information not available.

                                                                    Nursing
                 Maria      Gonzalez --------------    Los  Angeles,  Calif ----------    L.A. Valley College
                 Ruth        Hassell ------------   --- Chicago, III     ---------------  Wesley   Memorial    Hospital,
                                                                                             Chicago
                 Catherine Hunter      ------------    Vancouver,    British    Columbia  University of British Columbia,
                                                                                             Canada
                 Martha      Jackson      ------------- Charleston, South Carolina        Bronx    Community     College
                 Leona        Judson ---------------   San  Francisco,   Calif -   ------- San  Francisco  State  College
                 Norma          Kent ---------I------- San  Francisco,   Calif -   ------- University of  California,  at
                                                                                             Berkeley
                 Betty     Labastida                   Los  Angeles,  Calif -    --------- Cal-State, Los Angeles
                                           ----------
                 Claire McCamman       -----------     Los  Angeles,  Calif ----------    Cal-State, Los Angeles
                 Anita         Roper ----------------  New York, N.Y    -    -----------  Bronx    Community     College
                 Toni         Tayjor ------------------ San Diego, Calif -  ---   ------  San Diego State College
                 Fae          Thomas -------------     Vancouver,    British    Columbia  University of British Columbia,
                                                                                             Canada
                 Brenda Thompson       ------          Los   Angeles,    Calif -  -------- UCLA
                 Patricia      Wiley --------------    Los   Angeles,    Calif -  -------- UCLA
                 Bonnie        Zagon   ------------    Flushing, N.Y  -     ------------  Bronx    Community     College

                                                                   Dentistrly,
                 Frederick Collins            -------  San Francisco, Calif.              University of  California,  at
                                                                                             San Francisco

                 10


                                                              H PROJECT SUMMER 1968
                     CALIFORNIA          STUDENT          HEALT
                  Student                                  Home                              School
    Maria   De    Marco -------------      San   Francisco,    Calif - ------  University of California, at
                                                                                  San Francisco
    Richard Deatherage      -----------    Manhattan    Bch.9     Calif        University of Southern
                                                                                  California
    Dick DiBartolomeo       ----------     Santa    Cruz,    Calif -  --------- University of California, at
                                                                                  San Francisco
     Roy      Fogelman                     Los   Angeles,   Calif.              University of Southern
                                                                                  California
     Richard Fuentes                        Los   Angeles,   Calif ----------   Northwestern University
     Don Graham          --------------     Los   Angeles,   Calif ----------   University of Southern
                                                                                   California
     Steve Mascagno      -------------      Manhattan    Bch.,    Calif         University of Southern
                                                                                   California
      Stephen Sanders    -   ----------     Los    Angeles,    Calif             University of Southern
                                                                                   California
      John Trego     ------------------      Santa   Ana,    Calif - ----------  UCLA
                                                     So@Z      Sciences
      Margaret Carter (behavioral
         sciences)   -----------------       San  Jose,   Calif -------------    San Jose State
      Jane Hirschmann (social
         work)   --------------------        Los   Angeles,    Calif - --------   UCLA
      Alice Krowitz (clinical
         psychology)    ---------------      Brooklyn,      N.Y - ------------    University of Colorado
       Marta Steiner (political               Los  Angeles,  Calif.  -@ --------  UCLA
         science)    ------------------
       Deborah Tarnapol (social
         psychology)    ---------------       Cleveland,      Ohio -----------    Case Western Reserve
       Judith Varni (sociology)     ----      Watsonville,     Calif - ---------  University of San Francisco
                                                               Pharnw,y
                                               San   Francisco,   Calif - -------  University of California, at
        Eddie     Boyd -----------------                                             Berkeley
        Robert Zeiger    ---------------       Los  Angeles,   Calif -------- I--   Universityof Southern
                                                                                      California

                                                       DentaZ hygiene
                                                                                    University of -Hawaii
         Sherry Plumb     ---------------      N.   Hollywood,    Calif - -------
         Sally Westrick   ----------------  -  Van   Nuys,    Calif.
                                                                optmdry
         John     Bruce                                    es,    Calif ----------  L.A. College of Optometry
                                  ---------     Los Angel
                                                       X-ray technician
         Melo                                   Woodville,     Calif ------------   L.A. County General Hospital
              dye Tunis     -------------
                                                     occupational therapy
                                                                                          Jos
         Dale Kawagoye      --------------      Gardena,     Calif -- ------------   San     e State
                                                                                                                      11


                                                         THE  PRECEPTORS                                                  in one in-
                                                                                  ple and real problems. ,ONever,         ed          students
                                                                                           where   a   preceptor   encourag            .   et,
                                    BACKGROUND                                    tance,                      r   own    survey    proje
                                                                     and          s                                                    crea-
                                                     possible      s@s            to develop and execute thei         olvementi
              During    the    spring     of     1968,         site             se-        dents felt  a.sense  of  inv
                                    ptors were.sought:'by                         the    stu   onplishtnent.
           appropriate          prece                f        medical,         den- tivity, -and ace-
           lectio'n  committees             con'PosecL.n     southern,, and                                  unirner,     the      13receptors
                                     stude,nt@       I                            At  the  close  of   the   8            evaluation        of
            tal,     and      nursing                ing     to     a     committee        a letter requesting all               Student
            northern        California.        AccorcL vith                 community were  sent                   est to the    11       Only
                                    conferred                                     particular   subjects   of   inter  niversity.
            rner,aber,           they nitY    action     oriented     groups,     and      organizatiOll     and    'rJ replied.         Subse-
                  ers,        coTnTnu                    In       the        -main, Health          2        preceptors
            lead                    heal             les.                         three  of   the   3                                  ailed
             some         established    th       ag'c               ished                                   -n   interview    was    n"
                                    o  attach   students   to   establ                     tly, a request for a       f   acuity,   and   Stu-
             the   effort    was    t                                od         and quen            f    prereptorso
                  munity        organizers        who        underlItO dent       to   a   sample   o   felt   would   represent    a    varl-
             coTn                   c  with  the  goals  of  the   Stu                     8, who, it was
             were         syrnpgtheti                been        involved        in dent   opinions.   out   of    those    preceptors    'Who
                                    nd    ,Vho     had                                                                           d.
                                    -t a                                          ety     of                     y      interviews
              Health     Proj      ee revious     years.                                   12 %vere personall                          eats
              the     Project      in                    iated      by      -theirs replied,              displeasure     'with     stud
                                                          or       schools       to in  spite   of   .some.               jous       overiden-
                 The           precel                                unt         of undisciplined    behavior    and    vicar
              areas      of      ey-I                 d  the      arnO                        with    Tninoritiesp    and    despite     sonie
               which they                              More             influential tifle-ation     the    validity    Of    nonhealth-related
                                                     E                        their doubts        about                                Student
                                                     'how      closely            projer                                               rthy
               interest th          the   hoice    was                                     ts,   the   preceptors   hung   on   to   the     Of
               in           affecting ilosopbies     dovetailed     with         those              .   ations'   ideal   as   one    wo
               individual         'oh                                             Health Orgailiz       one    said:
                                    committee members-                                              . As
                Of   site   selection                ed   their    jobs    to    be perpetuating
                   Son,ie    p-receptors     interpret be available             when       iiin   the   I    g    run    YO    get    a    new
                advisors    or    facilitators,     to               supervi-                           On
                                    c                                                      breed    and    they    respond    to     something
                needed;       sorae       Ollsidered        themselves e        needs                                     at         currently
                 sors;  while   others,   more   in   tune   with   th                     that  is  different  from   'vvh e         -permitted
                                    oined    students    as     problem     solvers        exists,  but  Only  if  they  ar
                 of    students,    i                -  As  f   ew   students   had                                          -         y
                 in     a      mutual enterprise       .iiatilig     activities     in     to   deviate   from   what    is    currentl    the
                 bad    the    experience    of    ini               ex       prob-        norrn-iset    that    where    we're     at?"
                                                     ul  v  on  cornPI
                 any comniunity, partic  arl@                        and      would                                                    ey inter-
                                    predated their      entry                     ered              .@,that    the    only    constituen
                  lerns         which  exit,       preceptors        who        Off        it was felt ,                                     the
                  postdate  their                                      s       were                   fying    the    health    services    is
                                                     ructure to project                    ested in mOdi                  I  o fnd Ways to
                                    skills   and    st                                         group, and we have t
                  teaching          sful  than   others   %vhO   did   not   Tnaln-        student                               5  ears. The
                   more        succes                                                               during  the   next   10   or   I   Y
                                    rsonal    contact,               attitudes             help  them al preeeptors agreed thatthere is no
                   tain    close    p                se   diff   erent                     rnoreliber                 animation Dedicated to
                      As    a     con                e   preparations    made    by        other  formal   health   org    an be a part of,
                   toward         the                varied.          Somewelcorned        change which the students C                 Organiza-
                          preceptork;                                on     student         therefore,      the      Student      Health
                                            plans,           depending                     and,                        in some form. But it
                    them with spee                                                Stu-                  Maintained
                                    and           der. standing;     Others      felt      tion must be               a health sciences orggll-
                           acceptance                e    their    own     projects        raust  be  maintained  as                   rless SDS-'
                    dents    ought     to     structur        eptoy;   and    still        ization   rather   than   a   "weak,    leade
                     pending approval frora the pree.                on-going  rou-                 -nital-affiliated    preceptor     stated:
                     others appliqued students onto                  little  oppor-        A     hos.
                     tine surveys which              afforded     them                     s    ppedi--
                          ity  for   inspiration   Or   exposure   to   real   peo-
                     tun


                    CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
           "The   students   provide    a    fresh,         formed of the  student  health  project's  expecta-
         sometimes     anarchistic,       sometimes         tions of the  summer  experience  and  be  involved
         nihilistic  attitude,  which   gives   the         in  planning;  that  student  health  project  mem-
         preceptor  and  establishment   persnn   a         bers should be  oriented  to  the  individual  com-
         reminder that he has  accepted  a  set  of         munities prior  to  the  summer;  that,  no  matter
         conditions  based  upon  the  flimiest  of         how  capable  students  are,  in  a  short  2-month
         foundations."                                      project, they are usually  unable  to  make  effec-
                                                            tive contributions; that it took too long for  stu-
    This.same preceptor, who had guided a group             dents  to  understand  both  the  agency  and   the
    in a large teaching hospital, continued on the          community;  and  that  white   students   have   to
    issue of leadership:                                    understand  that  the  black  and   brown   commun-
                                                            ities are only willing to accept  them  as  techni-
           "I  think  there  should  be   extremely         cians, not leaders, in their  revolution.  On  this
         dedicated  leadership,   with   guys   who         last subject, two of the  responses  of  preceptors
         know wl%ere  it's  at  and  who  are  pre-         are appended at the end of this  section.  Mr.  Ri-
         pared  to  work  their  tails  off  on   a         chard  Unwin  is  a  special  assistant  in  Tulare
         weekly  basis  up  until  the  time   when         County    Community     Action     Agency.     Miss
         the   project   is   ready-whatever    the         Eleanor  Foster  is  the  director  of  the   Child
         form, I still think the  project  is  very         Care Education 'Center  in  Tulare   County's   De-
         necessary.   But   the   Student    Health         partment of Education, Visalia.
         Organization is not  the  place  for  com-            In summation, the  general  feeling  of  precep-
         munity action projects.  It  is  a  crimi-         tors  was  that  there  can  be  no  change  unless
         nal waste of funds to  dissipate  the  en-         there is some influence, some  kind  of  systematic
         ergies  of  these   students   away   from         way  of  influencing   the   present   arrangements
         changin%r the health system."                      to become part of the past.
                                                               The  reactions  of  preceptors  can  be  divided
      Some  preceptots  made  the   point   that   people   into subject areas of :
      don't expect a  great  deal  from  a  demonstration      1. Planning of projects;
      project the first year, but  after  4  years,  they      2.  Student  selection  from   the   preceptor's
      had  hoped  that   the   student   health   project        point of view;
      would  exhibit  more   organizational   sophistica-      3. Student-school relations;
      tion.
         The  charismatic  student  leadership  who  ini-      4. Student-community relations.
      tiated  the  program  was  frequently  given  as  a   Planning of Projects
      reason  for  its  early  success  and  the  present
      lack of that leadership the reason  for,  the  cur-      All preceptors 'agreed that  students  and  pre-
      rent  frustrations.   However,   in   reading   the   ceptors must plan  the  contents  of  the  projects
      1966  and  1967  Student  Health  Project  reports,   earlier and with greater  specificity.  Preferably,
      it is evident to the author that  lack  of  organi_   projects  would  continue  year-round.   Continuity
                                                            would  be  maintained  through   rotating   fellow-
      zational structure was  and  has  continued  to  be
      a problem.                                            ships after a  given  period  of  time,  when  stu-
         From  the  interviews,  several  other  thought-   dents either go on  to  other  projects  or  gradu-
      ful  reactions  and   suggestions   emerged.   With   ate.  Regular  channels  of   communication   would
      the exception of  the  black  preceptors,  who  su-   be  established  for  preceptors   so   that   they
      pervised  black  students  in   ghettos   and   who   might stimulate each other's thinking.
      we're reluctant to discuss the positive  and  nega-      A  special  year7round   committee   should   be
      tive.aspects of either the  projects  or  the  stu-   formed, composed  of  preceptors  willing  to  meet
      dents assigned to them, all  preceptors  felt  stu-   with students  on  a  regular  basis  to  plan  and
      dents should  be  more  carefully  matched  to  the   analyze  projects  and  develop  a  sense  of  per-
      jobs  assigned;  that  preceptors   should   be,in-   sonal involvement.


                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
             People  in  the   communities   chosen   for   stu-   tivity training,  one  consultant  to  the  education
          dent   assignments   should   be   involved   in   the   program  offered  the   advice   that   the   medical
          preplanning  phase.  There  are  -certain   kinds   of-  school  administration  must   assume   the   respon-
          projects    which    would     interest     particular   sibility foreducating  the  students  to  social  and
          groups    in    the    community-planned    parenthood   economic  problems   which   affect   the   distribu-
          programs,   prenatal    programs,    dental    health,   tion of  medical  care  services.  One  of  the  con-
          health     education-and     many     others     which   sultants  who  participated   in   a   communications
          would  give   students   experience   in   organizing,   workshop  stated   that   the   universities   should
          in  health  needs  and  in   working   with   communi-   assume   some   responsibility   for   helping   stu-
          ties.  They  could  also  be  involved   in   programs   dents become "aware  of  the  gaps  in  their  social
          relating  to  middle-class   health   problems,   such   awareness".
          as drug addiction and alcholism.                         It  would  seem  that   a   program   less   vulnera-
                                                                   ble to quick  starts  and  stops  such  as  the  sum-
          Student Selection From the Preceptor's Point             mer  program,  might  be   more   possible   if   the
          of   View                                                school  administration  would  actively  seek   joint
             There  was  unanimous  feeling   that   the   value   sponsorship   with   the   community   in   a    pro-
          of  the  Student  Health  Project  is  really  in  its   gram    of    community    education    for    health
          sensitizing  effect  and,   therefore,   any   student   science  students.  The  university  as  an  institu-
          who  evinced  an  interest  in  working  in   a   com-   tion  has  allowed  itself   to   become   so   frag-
          munity   health   program    should    be    accepted,   mented that  it  does  not  even  take  advantage  of
          whether  or  not  he  has   any   degree   of   social   its  own  departments  or  the  experience   of   the
          awareness,  If  he  has,  he  will  probably  bring  a   community   which   surrounds   it.   To   be    made
          more  sophisticated  attitude  toward   learning;   if   aware of  the  possibilities  of  collaborating  with
          he has  not,  he  will  be  stimulated  to  learn.  In   the   departments   of   social   work,    sociology,
          neither case can the project lose.                       public  administration   and   education,   in   con-
          Student-School Relations                                 junction  with  truly  representative   grass   roots
                                                                   community   organizations,   would   offer   students
             Two  questions  which  continue  to  be  of  parti-   less   restricted   and   more   useful   educational
          cular interest to faculty and students are:              tools.  For  example,  the  department   of   pediat-
             (1) Would  it  be  well  for  students  to  confine   ricts  might  enjoy  some  benefits  from   cooperat-
                  their  activity   to   "their   own   communi-   ing with the teacher corps  or  other  title  I  pro-
                  ties," of which the basic  unit  is  the  med-   grams   under   the    Economic    Opportunity    Act
                  ical school?                                     which   affect    the    physical    and    emotional
             (2)  Is  the   Student   Health   Organization   ha v- growth  of  thousands  of   youngsters.   These   ex-
                  ing an.  effect  upon  medical  school  curri-   POsures   might   offer   the   nation   a    greater
                  cula?                                            chance  than  we  now  have  to  develop  young  sei-
                                                                   entists  guided  by  their  humanistic  as  well   as
             There  was  general   agreement   that   the   stu-   scientific  interests.  To  those  students  who  are
             dents  can  have  an  impact  on  school   policies   demanding  this  kind   of   social   education,   it
             through  participation  in  curriculum  and  policy   .would offer a direct route.
             committees  of  the  schools.  But,  although  most
                                                                     Perhaps,  then,  a  young  doctor  could  see  him-
             faculty people felt  that  preceptois  should  come   self  delivering   health   care   in   revolutionary
             from  the  faculty,  all  were  in  agreement  that   ways.
             student activities should not be  confined  to  the     A   practical   measure   recomniended    by    one
             medical  schools.  Whether  this  was  in  self-de-   f  aculty  person  was  that  medical  schools   pro-
             fense we could not tell, but  their  feelings  that   vide medical  care  for  a  defined  segment  of  the
             @students could best learn  by  working  in  struc-   population, 20,000 to 30,000 people, by    .  develop-
             tured  projects  in  the  community  seemed   genu-   ing  a  model  health  service  administered  by  the
             ine.                                                  medical school faculty and the students.
              After  being  involved  with  students  in  sensi-      Almost all preeeptors thought the          project

             14


                   CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
     could be  immeasurably  improved  if  there  was  a    participation  in  the  community  should  not  be
     f  ull-time   person   administering   student-com-    the responsibility of the  university  nor  should
     munity  programs.  That  person  should   be   uni-    it be regarded as related to their  health  educa-
     versity based but have  a  background  in  the  so-    tion.  The  Student  Health  Organization   should
     cial as well as health sciences, in  order  to  un-    be  concerned  with  the  community   aspects   of
     derstand  both  the  educational   and   the   com-    medicine.
     mu-nity aspects of the program.                         In  contrast  to  most  faculty   people,   there
      It  was  suggested  that   preceptors   might   be    were a  few  who  felt  strongly  that  preceptors
     paired   off-one   knowledgable   in   the   health    should  be  community  agency  people,  with   the
     field  and  the  other  in  community   skill@work-    latter having some informal  relationship  to  the
     ing  with  a  group  of  students  around  specific    faculty. As one member put it:
     projects.
                                                                  "Faculty  people  hang   in   the   ivory
     Student-Community Relations                                  tower-they're  part  of  academia.  It's'
      With the  exception  of  four,  all  faculty  pre-          a lot  different  being  in  the  commun-
     ceptors  believe  that  the  preceptors  should  be          ity.'f
     university-attached    rather    than    community-
     based  people.  One  professor  in  the  School  of    This same preceptor said:
     Public Health stated:
                                                                      you  had   effective   preceptorships
           "I  would  think  that   any   preceptors              at the  community  level  and  the  black
          who are selected,  if  they  do  not  have              students said 'Go  to  hell',  no  matter
          a  university   appointment,   should   be              what was  said,  an  effective  preceptor
          very  carefully  reviewed   and   approved              would   be   responsible   for    working
          by  appropriate  faculty  of  the  univer-              things   out   and    coordinating    the
          sity, if it is to be  a  university  spon-              work."
          sored program."
                                                            One preceptor from dentistry stated:
     To show the variations  in  the  faculty  opinions,
     one  physician  connected  with  a  medical  center           I'Students  frequently  resent  the  in-
     in San Francisco, commented:                                 stitutional  rigidity   of   institutions
                                                                  such  as  health  departments  or  infor-
            "I do not  believe  the  Project  should              mal  community  agencies.,  and   precep-
          be  used  to  educate  educators  in   any              tors  from  these  agencies   are   some-
          didactic way. I  believe  university  fac-              times fearful of the  students,  but  one
          ulty should serve as  preceptors  only  if              of  the  important   experiences   gained
          they  work  in   conjunction   with   com-              from this type of exposure is  that  this
          munity  preceptors.  I   believe   commun-              rigidity  is  what  is  preventing  prog-
          ity preceptors  do  not  necessarily  need              ress.)?
          to work with faculty.  If  a  student  has              .  "Under   these   circumstances,   what
          a  community  preceptor,  that  work   re-              the students do  is  not  nearly  so  im-
          lationship  alone  will  be  educational."              portant that they be  frustrated  in  the
                                                                  doing of it,  because  nothing  could  be
      In  response  to  a  general  question   about  stu-        more misleading than      success  in   a
      dents  involved  in  nonhealth  related   community         summer project."
      agencies,  several  faculty  members  stated   that
      the distinction must  be  made  between  their  ed-    -The  degree  of  community  involvement   in   pre-
      ucation  as  professionals  in  the  health  fields    planning  came  up  frequently,  and  as   mentioned
      and their  interest  in  community  life.  Students   .previously,  all   concerned   were   adamant   that
      should -be  given  every  encouragement,  but  their  -the  community  should  be  involved   in   preplan-
                                                                                                               15


                                 C LIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
            ning. One community organizer in the San Joa-                          had  a  highly  successful  program  in   1967,   but
            quin Valley, in answering general questions                             was  dissatisfied  with  the   1968   relationships,
            about student-community relations, went so far                           states:
            as to state:
                      "No project  will,  come  into  Visalia                                 "We're    kidding    ourselves    if    we
                      again, unless there is a  committee  of                               think    that    inexperienced     students
                      local people from the barrio  who  have                               who  in  many  cases   are   still   under-
                      a say in what that project will be  and                               graduates,   can   come   into   a   ghetto
                      who will participate.  Students  should                               community   and   establish    a    rapport
                      be  chosen  by  a  panel  of  community                               and  deal  effectively  with   the   system
                      members  plus  faculty  and   students-                               -that's  just  a  little   too   much.   We
                      but  the  community  should  have   the                               have to  realize  the  students  are  going
                      final say about a  student  worldng  in                               to  be  gaining  most  of  the   knowledge,
                      its community. I see  a  change  coming                               and  the  community  is  the  one  that  is
                      about in the barrios."                                                going  to  be  supplying   it-the   invest-
                                                                                            ment  might  come  out   4   or   5   years
             A black preceptor in northern California, who                                  later."

              Distribution of Preceptors by Organization and Specialty
                                                                                                                                                   Rural
                                  Name                                       Orgaulation                           Specialty                       or
                                                                                                                                                   urban

                 Counties:
                      Jacqueline Campbell           ----------- Private                   ---------------------------- Dental hygienist          -------- Urban.
                      Max Schoen             ------------------ U.S.C.  School   of   Dentistry ----------         F, B--------------------        Urban.
              El Centro:
                      Jeff Ghelardi          ------------------ Economic     Opportunity     Corporation     --      C-----------------------      Rural.
              Fresno County:
                      James Aldridge            --------------- Model Cities, Fresno                ----------------C----------------------        Urban.
                      Joe Tee           ----------------------- North     Avenue      Community -----------        C----------------------         Urban.
                      Harold Williams            -------------- Community Medical Planning Pro-                    c----------------------         Urban.
                                                               gram, Fresno General Hospital.

               Kern County:
                      Gary Bellow            ------------------ Western    Center     for     Law     and     Poverty, D,F            -------------------- Rural.
                                                               U.S.C."     California      Rural      Legal      As-
                                                                 sistance.
                      Jerry Cohen            ------------------ Farm       Workers        Organizing        Committee-D----------------------      Rural.
                      LeRoi King            ------------------- Rural Development, Bakersfield                 -----C-----------------------       Rural.
                      Jackie Wallace            --------------- Multi-Service Center, Bakersfield                  C----------------------         Urban.
                Kings County:
                      Angelo Alessandro            ------------ Hanford       Community        Action        Organiza-D----------------------      Rural.
                                                                tion.
                      Larry Lezak           ------------------- Hanford       Community        Action        Organiza-D----------------------      Rural.
                                                                tion.

                Los Angeles County:
                      James Bates            ------------------ South       Central        Multi-Purpose        HealthC-----------------------     Urban.
                                                                   Center.
                      Thomas Brod             ----------------- USC-L.A.    County    Medical     Center     ---     E-----------------------      Urban.
                      Jay Friedman            ----------------- UCLA  School  of  Public  Health  -  -  @.   -   -   -B----------------------      Urban.
                      Arnold Kisch            ----------------- UCLA    School    of     Medicine           ----------- E, F          ------------------- Urban.
                      Raymond Kivel             --------------- South       Central        Multi-Purpose        HealthE----------------------      Urban.
                                                                   Center.

                    16


                        CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                                                                                                           Rural
                       Name                                                                 Specialty                       or
                                                              Organiation                                                  urban
           Tony Salazar        ----------------- El   Monte Teen Post         ----------------A-----------------------     Urban.
           Arthur Stein        ----------------- USC-L.A. County Medical Center          ----C-----------------------      Urban.
           Lou Smith        -------------------- Operation Bootstrap         ----------------A----------------------       Urban.
       Merced County:                                                                                                      Rural.
           Art Jenkins       ------------------- Economic opportunity Corporation,          c  ---- ------------
                                                 Merced.
           Mae Lopez -         ----------------- California Rural Legal Assistance          A--       -------------------  Rural.
           Denny Powell   -------     ---------- California  Rural  Legal  Assistance  ----   D                            Rural.
       Oakland:
           Nelson B. Smith       --------------- East     Oakland     Neighborhood     ServicesC                           Urban.
                                                 Center.
       Oxnard:                                                                                                             Urban.
           Armando Lopez         --------------- Grass Roots Operation                      A
       San Francisco:                                                                                                      Urban.
           Arnold Gilbert       ---------------- Comprehensive   Care   Program    for    Chil- E, F     --------------------
                                                 dren   and   Youth,    Mount    Zion    Hos-
                                                 pital.
       Southern Monterey County:                                                                                           Rural.
           Stuart Allen        ----------------- Rural Health Project                       c
       Tulare County:
           David Brooks        ----------------- Salud Clinic, Woodville       --------------E ----------------------      Rural.
           Chuck Gardinier        -------------- AFSC-Farm Labor Project            ---------A         ------------------  Rural.
           Eleanor Foster       ---------------- Child-Care Center, Visalia        ----------c ----------------------      Rural.
           Leon Mirviss        ----------------- AFsc   -----------------------------       E  ----------------------      Rural
           Richard Unwin         --------------- Tulare   Community   Action   Agency   ---   c----------------------      Rural.
           Code: A@mmunity organizer.        B-Den      C-Admi      tor.   D-Lawyer.        F-Physii    F-Professor or teacber.

                                                                                                                                 17


                                FUNDING SPONSORSHIP AND STAFF
          The    University     of     Southern     California   tion.  The  area  coordinators  screened,   selected,
          School   of   Medicine   sponsored    the    Student   and  developed  the   sites   where   students   were
          Health  Project  of  California.  Funds  came   from   placed.  This  process   of   development   necessar-
          the Social Rehabilitation  Services  and  the  Divi-   ily had to be done  early  in  the  year  with  those
          sion  of  Regional  Medical  Programs  of  the   De-   people  in  the  areas  who  would  be  served,   and
          partment   of   Health,   Education   and   Welfare.   therefore,  could  not  involve  the   students   who
          The  University   of   California   at   @   Angeles   were to eventually  work  in  those  areas.  This  is
          Medical  School  supported  four  students  in   the   a  matter  of  logistics  and  cannot  be  helped  at
          project.                                               the present  stage  of  planning,  but  it  would  be
          In  addition,  there  was   a   small   grant   from   well  to  consider  how  individual  students   might
          the  Rosenberg  Foundation  awarded   to   the   law   be  helped  to  determine   their   own   placements.
          students who  participated  in  a  rural  legal  as-   The odds are  that  there  would  be  a  better  mar-
          sistance  program  and   focused   their   attention   riage of student and community objectives.
          on a variety of legal  problems  related  to  health    The  State  was  divided  into   regions,   northern
          and welfare.                                           and  southern,  for  administrative   purposes,   but
          The   faculty   adviser   was   Paul   F.    Wehrle,   major  policy  and  financial  decisions  were   made
          M.D.,  professor  of  pediatrics  and  chairman   of   from the Los Angeles office.
          the   Department   of   Pediatrics.   The    faculty    Because   the   project    was    funded    directly
          director  was  S.  Douglas  Frasier,  M.D.,  assist-   from   Washington,   neither   Dr.   Donald   Brayton
          ant professor  of  pediatrics  and  physiology,  De-   nor Dr.  Donald  Petit,  areas  IV  and  V  directors
          partment   of   Pediatrics.   Other   members    who   of   Regional   Medical    Programs,    respectively,
          were  temporarily  attached  to  the   summer   pro-   were  engaged  in  the  planning  for   funding   the
          ject  as  faculty  advisors  were  Peter  Haberfeld,   Student   Health   Project.   However,    they    did
          LL.B.,  law  faculty  advisor,  and   Tess   Weiner,   have  more  than  a  peripheral   interest   in   it.
          M.A.,    educational    director,    and     Harriet   From  time   to   time,   the   student   staff   ap-
          Sprouse,   R.N.,   P.H.N.,   educational   director.   proached Dr.  Petit  for  advice  and  support,  edu-
          The  administrative   assistants,   Kathleen   Bren-   cational material,  and  resource  people.  In  every
          nan  and  Barbara  McClaurin,   were   a   part   of   instance,  there  was   genuine   cooperation.   How-
          the permanent staff.                                   ever,  in  the  main,  the  local  Regional   Medical
           The  basic   student   staff   consisted   of   the   Program offices had little  daily  contact  with  the
          director, David Synder, a fourth-year        medical   project  and,   therefore,   their   reactions   were
          student at  the  University  of  California  at  Los   largely dependent on secondary sources.
          Angeles,  the  educational  director,   Robert   Vi-     In  an  interview,  Dr.  Petit   agreed   fundamen-
          netz, a  third-year  medical  student  at  the  Uni-   tally  with  other  faculty  members   that   student
          versity  of  Southern  California,  and  seven  pro-   projects  should   be   health   oriented,   and   if
          jectIcoordinators,    Barbara    Hastings,     R.N.,   funded   by   Regional   Medical   Programs,   should
          John   Prueitt,   John   Bruce,    Steve    Bingham,   be  pertinent  to  heart,  cancer,  and  stroke  dis-
          Norma  Kent,  Hugo  Ferlito,  and   Helen   Salazar.   eases. He mentioned that the      .     Comprehensive
          Unfortunately,   the    administrative    assistant,   Health Care  Act  would  be  a  more  flexible  vehi-
          Karen  Chappel,  and   one   of   the   coordinators   cle for  student  research  and  activity  since  the
          who had  been  instrumental  in  the  early  organi-   act   makes   provisions   for   demonstrations    of
          zational  phases  of  the  project  had   to   leave   new  models  of  health  care,  methods   of   elimi-
          early.                                                 nating   duplications,   and   Mling-in    gaps    in
           The  project  was   organized   and   directed   by   service.
          the  members  of  the   Student   Health   Organiza-      Dr.  Brayton,  at  UCLA,  had  less  contact  with

          18


                     CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
        the summer  students,  as  the  SHO  headquarters    ious  kinds  of  unorthodox   community   resources
        were at the  University  of  Southern  California    which might be useful in  the  solution  of  health
        Medical School. However,  immediately  after  the    problems, the gathering  of  data  for  the  devel-
        summer  project,  Dr.  Brayton  reported  an  in-    opment of  new  guidelines  for  health  care  sys-
        creasing  interest  of  the  UCLA   students   in    tems  and  the  building  of  community   relation-
        some closer relationships  with  the  RMP  organ-    ships  which  would  afford  RMP  deeper  insights.
        ization. Dr. Brayton reacted by  suggesting  that    Some   of   the   basic    incongruities    between
        area  IV  RMP  (UCLA)  would  be  able  to   lend    RMP  and  SHO  were  discussed  at  that   meeting.
        itself to a certain degree of student training in    The  students  found  RMP's   commitment   to   the
        the coming  years,  but  any  plan  would  amount    present   structure   of   medicine    incompatible
        to "an  RMP  preceptorship  wherein  the  student    with their own  goals  of  modifying  those  struc-
        would  be  exposed  to  the  organizational   and    tures; students  believed  that  RMP  should  iden-
        planning problems  inherent  in  the  development    tify  and  build  networks  of  relationships  with
        of  Regional  Medical  Programs."  Adequate   and    community  groups   who   were   not   particularly
        suitable skilled staff  would  have  to  be  made    iTi the mainstream of  health  care,  and  students
        available for organizing such a program.             were unwilling to be officially tied  to  any  gov-
        In  July  1968,  two  communications  were   sent    ernment  group  which  might  threaten  their   or-
        from the  training  consultant  in  the  Washing-    ganizational  autonomy   or   acceptance   in   the
        ton office of RMP. The first indicated that   the    poverty communities.
        most significant contribution of  students  would     In consideration  of  the  above,  it  would  seem
        be to  gather  information  about  urban  commun-    that  if  RMP's  purpose  is  to  more  effectively
        ity  organization  problems  pertinent   to   RMP    spread  knowledge  of  new  modalities  in   health
        programs. These would  include  the  present  ef-    care, it would  be  well  advised  to  involve  the
        fectiveness  of  voluntary  and  public  agencies    students  in  a   jointly   sponsored   RMP-commun-
        now  operating  in  the  inner  city.  The   memo    ity  preceptorship  program,  while  at  the   same
        stated:                                              time  strongly  protecting  SHO's  rights  to  make
                                                             independent  judgments  and  affiliations.  A  well
             "From  the  students   we   should   be         planned  year-round   program   might   be   devel-
           able  to  learn  which  of   these   have         oped  by   a   committee   of   the   two   groups.
           problems,  what  the  problems  are,  and         Through  the  establishment  of  this  kind  of   a
           which   organizations   are    effective.         cooperative   relationship,   both    organizations
           Further,  we  should  learn  the  reasons         might satisfy their own  needs  and  the  needs  of
           for certain  agencies'  ineffectiveness."         the communities for education and service.
                                                               Although  the  Regional   Medical   Programs   in
        The second  communication  was  an  invitation  to   Washington  funded  the   Student   Health   Organ-
        a  joint  1-day   RMP-SHO   Conference   in   Chi-   ization directly in 1968,  there  would  appear  to
        cago  in'July.  At  this  meeting,  Dr.   Manegold   be an advantage in  involving  the  local  RMP  or-
        reiterated  RMP's  concerns  about  the  disparity   ganizations  in  support  of  the  above  mentioned
        between  accumulated  knowledge   in   the   tech-   year-round  planning.  Surely  in  the   geographic
        nology of medicine  and  the  imperfect,  unsyste-   areas where they  function,  the  recognition  that
        matic  distribution  of  that  knowledge.  It  was   problems  of  local  origin  need  local  solutions
        his judgement that if  it  could  be  worked  out,   would be  a  determining  influence  in  the  deci-
        RMP  and  SHO   might   share   certain   informa-   sion to work  with  students  who  are  a  part  of
        tion. The information included a  survey  of  var-   those same local areas.

                                                                                                               19


                                                                     RGANIZATION
                               ADMINISTRATION AND 0
                                                                    sistant and secretary,  all  other  staff  members
              Description                                           were  summer  workers.  The   project   directors,
              The   summer   1968   project   terminated   in    suc@ educational  directors,  law  project   directors,
              a  state  of   disorganization   that   many   partici- and coordinators did not take an  active  role  in
              pants,  students,  staff,  and   preceptors   came   to the project  until  the  middle  of  May.  Routine
              question  the  legitimacy  of   the   project   itself- decisions were  attended  to  by  the  two  perma-
              Nonetheless,  as  mentioned  in   the   section   deal- nent oflice  people  with  occasional  supervision
              ing  with  preceptor  reactions,  despite  the   disap-
                                         projects           persists. from one  of  the  project  directors.  Day-to-day
              pointment, hope for future                            decisions,  which   didn't   seem   crucial   when
              Faced  frankly,  it  is  a  moot  point  whether   this weighed  individually,  became  cumulatively   ir-
              hope  should  be  nourished   or   quietly   smothered. ritating when consistently  handled  in  a  casual
              Perhaps  the  best   way   to   begin   a   description man-ner.  Complicating  matters   was   the   fact
              of   the   administration   is   with   an    anecdotal that the project office was located at  the  'Uni-
              story.  It  describes  the  last  hours  of  the  final versity of Southern Calif  ornia  while  the  stu-
              conf  erence  held  in  Santa  Barbara  late   in   Au- dent director and several  coordinators  were  en-
              gust.  Days  and  weeks  were   spent   in   finalizing rolled on  other  campuses.  Students  who  called
                                                                  the          .  genuine   emergencies    were    al-
              physical arrangements and program for                 .the office with
              200   people   expected   to   attend.   However,   nei ways met  with  warmth  and  concern.  The  office
              ther   students   uninvolved   in   the    arrangements staff were often  helpful  to  those  who  arrived
              nor the  staff  who  did  the  planning,  felt  obliged without money or  lodging,  but  little  was  ever
              either  to  -adhere  to  the  program  or  to   subst'- done to dispel their sense  of  impotence.  Groovy
              tute  another  more  meaningful.  On   the   last   af- promises  were  made  with  groovy  hopes  and   a
              ternoon,  the  final  full   group   meeting   at   the oroovy  ,wow  !,,-and  months  after  the  project
                              v    in    total    frustration,    and                           s  were   still   dan-
              conference dissol ed                                  terminated,  many  loose  end
              the  students   began   departing   en   masse.   While gling.
              the  project  directors  were  quietly   leaving,   ap- A  good  part  of  the   problem   was   lack   of
                         demoralized    as    the    confused    stu- know-how  and  curiosit  about   ordinary   office
              parently as   ally    confused    members    of     the                     'y                ful    for
              dents and equ                                         procedures which have proven success
              staff,  the  project  secretary  was   busily   reprod- years. Material was  frequently  undated  so  that
              ucing    the    position    paper    of    the    black a  retrospective  look  at  the  project   through
              students  11  in  the  temporary  hotel  office.  Corn- written material  becomes  difficult.  The  office
              mu-nic-ation  and  coordination  has  been   so   lack- was  a  vast  reservoir  of  rniscellanea-hundreds
              ing  that  she  was  unaware  that  the   students   to of  copies  of  outdated   memos   and   equipment
              whom  she  planned  to  distribute   the   paper   were that had long ago  outlived  its  usefulness  were
              already   leaving   in   disillusionment.   The    sum- being  saved  at  the  expense  of  scarce   space
              mer   program   terminated   in   quiet    despair-like needed for current staff use.
              a  routed  army  in  disarray,   its   wounded   devoid Staff  meetings  became  another  instrument   of
              of  the  courage  supported  by  their  cause,  and   aargument  and  confrontation.  As  a   consequence
                             searching  in  vai-n   for   an   expla-                            structure  for  vent-
              few stragglers                                        the organization  provided  a
              nation.                                               ing  individual  psychological  needs.  Vulgarized
                This  story typifies    the    daily    misadventures              up   techniques,   repeated   ques-
                                                                    sensitivity gro
                                                 -al  staff  .   With
              of the blithe but ineffectual centr                   tioning of individual motives ,precluded     adher
              the exception  of  the  f  ulltime  administrative  as- ence to  simple  -agendas.  The  differences  were
                                                                    never  neutralized.  Nor   were   they   channeled
                See Appendix E, "A Position Paper."

              2 .0


                                                                        CT S-UMMER 1968
                     CALIFORNIA STUDENT HEALTH PROJE
        Positively   to   optimize   the    objectives.    General their  relations  must  develop  through   mutually
        problem    solving    techniques    might    have    taken acceptable sanctions, no  matter  how  loosely  ap-
        into   consideration   the   weighing   of    alternatives plied. We could carry this out to the  logical  de-
        and deciding on priorities.                              terminants   of   a   bureaucracy-the   most   com-
        And    thus,    while    the    well-intentioned     staff plex  form  of  groups  within  groups,  with  many
        was   highly   motivated,   they   were   too    inexperi- goals,  hierarchies,  systems   of   communication,
        enced   to   man-age   a   project   of   such   magnitude and  patterns  of  authority.  Whatever  the   form
        and  complexity.   As   a   result,   they   reacted   de- all these take, one  of  the  most  basic  require-
        fensively  to   suggestions   or   requests   for   infor- ments common to all  groups  is  that  responsibil-
        mation   as   if   an   orderly   approach   smacked    of ity must be assumed  or  delegated  to  someone  or
        the   "establishment"   and   violated   the   spirit   of a group of someones.  The  most  simple  group  re-
        the project.                                             quires  some  patterned  division  of   labor.   In
        Other   general    meetings,    having    to    do    with larger organizations, job  descriptions  serve  the
        planning     educational     programs,     the     opening purpose  of  explaining  what  is  expected.  Other
        and   closing   conferences   or   matters    of    policy 'requirements  are  the  built-in  authority   that
        were   held   when   necessary.    Probably    the    most must  accompany  responsibility   and   some   form
        consistently    constructive    meetings     were     held of  feedback  or  accountability  for  purposes  of
        before  the   summer   program   started.   At   the   in- evaluation  and  continuity.  All  of  these  ideas
        stigation  of   the   project   directors   many   discus- can safeguard the  rights  of  individuals  if  ap-
        sions   were   held   about   the    educational    policy plied in a flexible,  commonsense  way.  It's  what
        and   program.   For   a   variety   of   reasons    which sociologists call structure.
        will  become  evident  in   the   report,   students   did The   exercise   of   authority    posed    another
        not  respond  favorably  to   the   program,   but   none- problem.  Unf   ortun'ately,   neither   the   @ff,
        theless,   a   good   deal   of   thought   had   preceded whose  position  gave  them  authority,   exercised
        the summer project.                                      it, nor did the larger group reognize  the  staff's
        Some    of    the    faculty    and     advisory     board authority as  legitimate.  Without  the  former,  a
        members    behaved    toward    the     student     health vacuum  is  created  and  without  the  latter,  no
        project   more   like   parents   of   unwanted   children leader can function.
        -acknowledging   their    parentage    but    unable    to If  a   short-term   project   is   to   have   any
        cope  with   their   own   feelings   or   the   character strength, it cannot tolerate this  vacuum;  nor  is
        of   the   'children   who    developed.    Perhaps    the there time to  correct  major  administrative  mis-
        analogy   would   be   more   suitable    if    it    were takes. Direction  not  only  implies  coordination,
        drawn   of   the   parent,   who   unable   to   see   the but  the  ability  to  arbitrate  between  opposing
        child   grow   up,   forever   infantalizes   him.    Both and  competing  factions  and  securing  the  coop-
        comparisons   are   variations   on   the   same    theme. eration  of  the  group   in   setting   standards.
         The   whole   concept   of   group    process    is    at There  is  no  question  that  the  combination  of
        stake   here.   There   is   a   difference   between   -a the  black-white  confrontation  and  the  demoral-
        group   and   an   aggregate.    The    smallest    group, izing effects of;guilt  and  nihilism  would  miti-
        two,  four,  or  six,  has   the   same   basic   require- . gate against -the. success of  the  strongest  of
        ments   as   a   larger   one.   A   bunch    of    people leaders. But  the  misfortune  of  the  summer  was
        standing on   a   street   corner   is    an    aggregate. that problems  heaped  upon  others,  and  lack  of
        They  might  all  walk  into   a   department   store   or organizational stability precluded the  ability  to
        waiting  room,  but  are   still   an   aggregate.   Some- take  the  blows-and  respond  with  a  new  strat-
        thing  has  to  happen   to   make   them   a   group.   Aegy for survival.
        form   of   communication,   no   matter    how    simple, There  was  an  ideal  of   participatory   democ-
        must   occur.    They    have    to    acknowledge    some racy.  Everyone  spoke  the   words,   and   nobody
        relation  to   each   other.   Someone   has   to   assume seemed to say that the  prerequisites  to  partiei-
        leaders hip.   Some   issue   must   mold   them   into   apatory   democracy   are   a   highly   disciplined
        group.   Some   form   of   social   control   to   govern group of  individuals  able  to  focus  sharply  on
                                                                                                                   21


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
            interests  and  issues,   with   sufficient   control    emphasis  than  that  geared   to   urban   problems.
            mechanisms    to    insure    participation.     Some    The   educational   program   will    be    discussed
            mechanism   for   making   decisions    and    making    more f ully in another section.
            them stick is also essential.                            Another  area  of  concern  was  the   relation   be-
            Whether   from   the   East,    Middle    West,    or    tween   preceptors   and   students.   The   decision
            West,  students  seemed  to  perceive  structure   as    was that  flexibility  in  judging  each  problem  on
            restrictive  and  authoritarian,  rather   than   in-    its own merits  would  be  the  rule  of  thumb,  and
            strumental   to   cooperation    and    coordination.    independent solutions  were  to  be  arrived  at  be-
            They  conf  used  participation  in  decisions   with    tween  preceptor  and  student.  It  was  hoped  that
            the  implementation  of  them,  which  require   del-    serious  disputes  could  be  mediated  by  coordina-
            egation in order  to  achieve  minimal  goals.  As  a    tors  whose  f  amiliarity   with   communities   and
            result it  would  have  been  easy  to  predict  that    rapport   with   preceptors   provided   them    with
            everyone  would  make   unilateral   decisions,   and    special insights.
            all  the   King's   horses   and   all   the   King's    Other   major   decisions   -reached    during    the
            men                                                      planning  stages,  were:  (1)   That   any   unfilled
                                                                     places  would  be  filled  by  black  or  brown  stu-
            Some Administrative Decisions                            dents,  and  (2)  the  orientation   program   should
                                                                     emphasize   the   organization   of   medical    care
                                                                     .systems,  provisions  of  various  categorical   aid
             Considering  that  health  science   students   have    programs,    and    an    analysis    of    community
            little free time  and  are  forced  into  rigid  pat-    health  resources  in  areas  where  projects   sites
            terns  of  curriculum  and  long  hours  of   concen-
            trated study, it was difficult to  establish  regular    were located.
            oaeeting times.                                          .Against  the   backdrop   of   increased   national-
                                                                     ism  and  racial  pride   in   the   Mexican-American
             Student  leaders  and   faculty   had   held   meet-    community,  on  April  15   the   staff   invited   a
            ings  devoted  to  developing   proposals   and   re-    Mexican-American   member   of   the   Los    Angeles
            quest for  funds.  But  by  spring,  it  became  nec-    County   Commission    on    Human    Relations    to
            essary  for  students  to  anticipate   problems   of    discuss  methods  of  working   in   East   Los   An-
            organization   on   the   assumption    that    funds    geles,  an  area   largely   populated   by   Mexican
            would eventually be made available.                      people. He cautioned  against  the  effects  of  stu-
             In  March  of  1968,  45  people  responded  to   an    dents who try to organi   in
            invitation to  a  special  meeting  of  students  and                              ze  '  an   area   unfamil-
            advisory  board   members.   The   purpose   was   to    iar to them,  particularly  in  view  of  their  lack
            arrive  at  some  general   agreements   about   site    of community organization skills.      He      warned
            selection,  student  selection,  the  education   and    that  community   trust   takes   longer   to   build
                                                                     than  one   summer   and   by   inference   suggested
            orientation  program,   methods   of   relating   the    that  students  confine  their  activities  to  their
            San   Joaquin   Valley   and   northern   California,                                                of
            and  the  advisability  of  involving  the  Neighbor-    special health science skills in support         oth-
            hood  Youth  Corps  as   trainees.   Based   on   the    ers who were indigenous to the community.
            unsuccessful  experience  of   the   previous   year,     At  another  staff  meeting   a   highly   respected
            the  students  decided  not  to   include   the,Youth    and   much   admired   black   community    organizer
            Corps   students.   Committees   were   formed    for    and  advisor  to   the   Student   Health   Organiza-
            each of the other tasks.                                 tion   suggested   that   the   orientation   meeting
                                                                     and a good  deal  of  the  time  of  the  educational
              In that same month        an    educational    task    program  should  be  devoted  to   black-white   sen-
            force was  formed  to  respond  to  the  requests  of    sitivity sessions of  "telling  it  how  it  is"  and
            both  urban   and   rural   educational   committees.    "finding out where  it's  at."  Due  to  the  naivete
            Because  many  students  were  active  in  the  rural    of  the  staff,  including  both  faculty  and   stu-
            San  Joaquin  Valley,  inhabited  mainly   by   Mexi-    dent  members,  there  was   not   real   understand-
            can-American  farm  laborers,   students   felt   the    ing of  how  much  an  issue  this  would  become  as
            educational   material   might   have   a   different    the summer went on.

            22


                                                                                   R 1968
                     CALIFORNIA STUDENT HEALTH PROJECT SUMME
        Faculty  advisory  people  who   were   interested      b.  Attendance  at  the  weekly   educational
      in  didactics  were  pushing  for  their  positions,          programs  shall  be  mandatory  for   all
      community   organizers    for    encounter    groups          student health project students.
      and  confrontation  as  a   method   of   education,   3. Students are invited  to  attend  Joint  Pre-
      and  the   students   and   staff   were   uncertain      ceptor-Staff  Policymaking          Committee
      about which  way  to  go  in  a  short  summer  pro-      meetings.
      gram.                                                  Those who  were  present  approved  the  minutes
        During  the  orientation  session   in   Yucaipa,2   with the exception of Dr. Brod."
      from June  23  to  June  26,  the  black  and  brown
      Student  Health  project  students  formed  a   cau-        Preceptors                 Staff
      cus  to  challenge  the  organizational   structure,   David Swimmer, M.D.      David Snyder
      particularly the ratio of white  to  minority  staff   Arnold Kisch, M.D.       Tess Weiner
      positions and the  ratio  of  minorities  on  policy   Max Schoen, D.D.S.       Robert Vinetz
      committees.  On  July  11,  a  meeting  was   called   Jacqueline Campbell      Hugo Ferlito
      to im  lenient  an  important  demand  of  the  June   Jay Friedman, D.D.S.
         . p
      23  Yucaipa  meeting  of  the   black-brown   caucus   Tony Salazar
      -this  provided  that  preceptors  were  to  be  in-   Thomas Brod, M.D.
      cluded on  the  board  where  staff  decisions  were
      made'  At  the  July  11  meeting,   the   following   At this  point  in  an  already  explosive  situa-
      decisions were made:                                   tion, an action  was  taken  by  the  student  and
        411.   A   joint   preceptor-staff   policy-making   faculty directors that turned out to be  more  in-
            committee  is  hereby  established   for   the   flamm-atory  than   illuminating.   They   changed
            Los Angeles Region.                              the word "decision"  to  "proposal"  in  the  min-
            a.   The   membership   of   this    committee   utes on the grounds  that  the  northern  Califor-
                 consists of all  Los  Angeles  preceptors   nia group had to agree  to  any  decisions  before
                 and   Student   Health   project    staff   they could be  made  binding.  Their  premise  was
                 members.                                    that all  decisions  must  be  uniform  throughout
            b.   Voting  powers   shall   be   distributed   the State. Since  the  northern  California  group
                 equally   between   black,   brown,   and   was never asked to act  on  the  proposals,  those
                 white  preceptors  and  staff   according   involved in the original meeting  felt  that  they
                 to the 1/3, 1/3, i/3 principle.             had been  stripped  of  their  power  through  the
             c.  Formal meetings  shall  be  held  once  a   illegitimate use of it by the  directors.  It  was
                 week  for  the  next  3  weeks;  thereaf-   unfortunate that by that act  the  directors  ren-
                 ter, every other week.                      dered  the  new  policy  committee  impotent   and
         2.   The   Joint   Preceptor-Staff   Policymaking   lost the good will of some of the preceptors.
             Committee  hereby  instructs  the  staff   to
                                                               The reason the  last  meeting  is  recounted  is
             institute   an   educational   program   com-   merely to describe  in  some  historical  way,  if
             mencing forthwith.
             a.  The  educational  program  shall  consist   not exactly  in  chronological  order,  the  enor-
                 of     ekly  meetings,  the  content   of   mous  amount  of  conflict  situations  which  the
                     we
                 which shall  be  the  responsibility  of-   staff  had  to  face  during  that.summer.   Hope-
                 the educational committee.                  fully, this  le'ngthy  analysis  can  be  'Used   to
          See Appendix F, letter from ROgir 0. Egeberg. dean,  University thwart  any  repetition,  if  and   when   another
        of Southern California Medical School.               project is launched.

                                                                                                              23


                                                A LOOK AT GOALS
              About  three-quarters  of  the   way   into   the    vice  organization.  And  though  that  recurrence
             summer, the faculty  director,  Dr.  Douglas  Fra-    only indicates how difficult a problem it is,  the
             sier,  became  alarmed  by   the   many   problems    implicit assumption that it was  possible  to  in-
             which   remained   unresolved.   The    perturbing    tegrate difficult' ideologies  of  students,  com-
             frictions  between  staff  members,  conflicts  in    munity, and funding  agencies  is  a  Utopian  no-
             goals,  and   inadequate   communication   between    tion. By Utopian, we  mean  that  a  situation  is
             coordinators and students in the  field,  contrib-    incongruous with the historical and  social  real-
             uted to mounting  dissatisfaction.  There  were  a    ity which exists in  a  given  present.  As  Mann-
             series of  interminable,  indecisive  meetings  to    heim  once  said  of  18th  century  values,  "The
             which  the  students  reacted   with   belligerent    idea of Christian  brotherly  love  for  instance,
             criticism and faint  support.  No  new  leadership    in a  society  founded  on  serfdom,  remains  un-
             developed.  By  their  own  assessment,   students    realizable." (20)
             experienced   a    slowdown-some    were    angry,     There   are   many   organizations   which   suc-
             some  guilty.  The  cohesion   of   former   years    cessfully  serve  the  goals  of  more  than   one
             seemed to  give  way  to  -an  immobilizing  para-    group.  Many   have   made   important   contribu-
             'noia.                                                tions  to  science  and  industry  and  have  used
              It was at this point that  the  faculty  director    their  multipurposes  to  stimulate  growth.   The
             felt  compelled  to   pose   the   question   "Who    high-quality hospital  ,vhich  serves  the  triple
             should set the goals ?" 3in a paper  sent  to  all    functions  of  teaching,  research,  and   medical
             participants. In substance,  he  stated  that,  if    care  is  more  often  superior  to  the  hospital
             the three  interest  groups  (students,  community    which only  gives  medical  care.  The  demonstra-
             groups,  and  funding  agencies)  would  reconcile    tion school is  frequently  a  better  educational
             their goals,  the  organizational  problems  might    institution than the ordinary  school.  The  prob-
             be lessened.  Further,  that  the  goals  of  Stu-    lem with  measuring  success  solely  by  achieve-
             dents,  community  groups,   and   funding   agen-    ment of goals is that  goals  become  subjectively
             cies, if not  polarized,  were  surely  not  inte-    defined, idealized  symbols,  and  cannot  readily
             grated. It was the director's suggestion  that  if    lend themselves  to  dependable  social  analysis.
             students  had  independent  interests  from   com-    Perhaps that is why so  m-any  students  and  fac-
             munity  and  funding  agencies,  it   was   urgent    ulty felt unable to cope with the reality  of  the
             they recognize that fact. It  was  equally  urgent    Student   Health    Organization    summer    1968
             that the  Student  Health  Organization  work  to-    project.
             ward  common  objectives  with   these   agencies.     Implied in the director's  search  for  satisfac-
             The  only  reference  to  goals  by  a  sponsoring    tion of mutual goals  is  consensus.  But  in  the
             group had been  issued  earlier  in  the  year  by    wish for  congruity  and  consensus,  the  contri-
             the Washington office  of  regional  medical  pro-
             grams. It.was  an  unspecific,  too  comprehensive    butions of  conflict  to  change  are  overlooked.
             paper  called  "Work  Scope"   which   summed   up    Consensus  and  conciliation  are  certainly   Ac-
                                          t                        ceptable and easier  methods  of  settlement,  but
             the  goals  of  Regional  Medical  Programs,   the    not often possible.  Conflicts  produce  organized
             achievement of  which  would  require  high  level    subgroups  from  which  power  ploys  become   in.
             medical  and   community   organizational   skills
             -and months of planning and training.                 evitable. If  successful,  they  frequently  shift
               Actually, .the theoretical question  of  congru-    the organization in  another  direction.  In  that
                                                                   case, several alternatives open up  for  the  less
             ity of goals comes up for analysis in  every  ser-
                                                                   organized  groups.  They  may  form  other  groups
               2 See Appendix, Douglas Frasier M.D., "Goals  and  Directions." retaining the old objectives,  develop  tangential

             24,


                        CALIFORNIA STUDENT HEALTH PRQJECT SUMMER 1968
        ones, or cease to exist. But what  is  important  is    With  these  factors  in  mind,  our  analysis   of
        that the conflict suc ceeds  in  forcing  a  new  pla- whether   an   organization   has    succeeded    or
        teau-whether  or  not  it  satisfies  the  needs  of   failed should not  be  based  solely  on  attainment
        the  members  or  contributes  to  a  better  situa-   of idealized  goals.  Rather,  evaluation  might  be
        tion,  obviously  is  not  always  predictable.  But   based on reality  factors  such  as  cumulative  ac-
        the recognition of the value of  conflict  to  prog-   complishment   in   education   and   service   over
        ress is important.                                     time,  evolution  of  organizational  structure,   a
         In the case  of  the  student  health  project,  it   subjective  evaluation  by  the  members  of   their
        seems that  there  has  been  a  shift  in  interest   own  effectiveness,  attitudes  and  value   changes
        and  emphasis  from  the  1965,   1966,   and   1967   by  objective  and  subjective  indices,  or   other
        projects  from   identification   with   established   measurements   or   combination   of    measurements
        health  agencies  toward   more   militant   commun-   the  group  agrees  to.  Such  changes  woul   prov-
        ity  action  groups.   This   has   paralleled   the   ide inputs and resources  for  conversion  to  still
        growth  of student  militancy  against  the  politi-   higher levels of adaptation.
        cal  and  military  institutions  in   the   nation.     From the  foregoing  it  must  be  api>arent  that
        Some  of  the  health-science  students  have   been   the   organization   was   bombarded   by   problems
        deeply  touched  by  these  movements.   The   major   on  all  sides.  There  were  internal   administra-
        problem  of  the  summer  1968  program   was   that   tive  problems  and  external  political  pressures.
        -no one was  sufficiently  skilled  to  convert  the   It was -an election year of intense  political  con-
        conflicts   into   positive   accomplishments.   The   fusion  with  four  candidates  polarized  on   dif-
        United  States  was  born  in  conflict  and  unfor-   ferent issues, the  assassination  of  two  national
        tunately  is  still  settling  major   disputes   by   heroes,   and   widespread   campus   protests.   To
        armed  conflict.  Yet  we  expect   rational   prob-   top it off, the student health project's final  con-
        lem-solving  to  find  mature  expression  in   con-   ference   was   being    addressed    by    Eldridge
        sensus.  We  continue  to  look  for  agreement  be-   Cleaver  as  the  radio  and  TV  blared   out   the
        tween ideas  and  conduct  and  fail  to  understand   treachery  of  the   Chicago   police   during   the
        that conflict is the  fulcrum  for  the  balance  to   Democratic  convention.  Put  in  this  context,  it
        be achieved.
          Because  the  author  feels  that  we   have   too   is  not  difficult  to  understand  why  things  did
        long neglected  the  role  of  conflicts  -and  have   not  go  as  smoothly  -as  they  had  in   previous
        not given  enough  study  to  the  art  of  negotia-   years.
        tion, this paper takes issue  with  the  search  for
        goal  consensus  as  commendable  as  it   may   be.               "The  word  progress  is  ex
        This is strictly the author's bias  but  raises  im-        tremely   ambiguous.    It    means,    of
        portant  questions    for    accomplishing    social        course,  moving  forward  on   a   certain
        Change.  The   paper   takes   issue   not   because        road,  but  not  necessarily   the   right
        there were not real  differences  in  the  goals  of        road.  It  denotes  a  continuous   expan-
        the three interest     groups,   but   because   the        sion  of  knowledge,  but  is       almost
        director poses their  incompatibility  as  the  rea-        meaningless with regard to         better-
        son for failure. Perhaps  it  would  be  more  real-
        istic  to  start  out  knowing  incompatibility  ex-        ment  of  the  human   condition,   unless
        ists and  going  on  from  there.  Accepting  handi-        the  goals  to  be   reached   are   stat-
        caps is a  good  way  of  starting  a  game  if  you        ed." (8)
        acknowledge they exist.                                                                -RENF,        DUBOS.

                                                                                                                  25


                                       THE ROLE OF THE UNIVERSITY
              In  all  likelihood,  the  University  viewed   the   terested  in  promoting  change.  That  means   the
              student health  project  as  a  maturing  organiza-   University  would  have  to  invest  more  imagina-
              tion then in its  fourth  year.  It  assumed  there   tion  in  planning  their  sponsorship.  The   stu-
              had  been  learning  from  negative  as   well   as   dents too  would  have  to  accept  the  charge  of
              positive experiences,  and  this  was  not  an  un-   planning   projects   with   reasonable    judgment
              warranted   assumption   considering    that    the   and  follow  through.  It  is  not  an  unwarranted
              students had been active for 2  to  3  years.  Per-   assumption to  expect  that  students  will  be  in
              haps  the  University  failed  in  not  making  its   conflict  with  universities,  health  institutions
              own objectives clear to itself or students. In  in-   and  other  groups  from  time  to  time.  That  in
              terpreting its role as one of a facilitator  rather   and of  itself  should  not  mitigate  against  the
              than a change  agent,  it  staodapart  rather  than   Student  Health  Organization   seeking   alliances
              become  involved  in  a  mutual  enterprise.  Under   with   those   professional   and   nonprofessional
              ordinary  circumstances  people   have   a   chance   groups who offer  the  best  solutions  for  health
              to test out their learning  before  taking  over  a   care delivery.
              leadership role. But the  objective  political,con-    Nineteen  sixty-nine  and   the   seventies   will
              ditions in 1968 were  quite  different  from  other   no  doubt  produce  some  forms   of   student-com-
              years,  and  consequently  conditions  for  leader-   munity relationships.  What  is  to  be  hoped  for
              ship were also different.                             are  thoughtful  and   more   refined   models   of
              No  one  at  the  University  or  elsewhere   could   community  education   and   service   which   will
              have predicted  the  events  of  the  summer.  Even   permit  the  university  and  students  to  have  a
              if the University  had  stepped  in  with  creative   constructive  experience  in   community   develop-
              and  imaginative  shock  troops,  the   probability                    nity medicine.
                                                                    ment and commu
              is that they could  not  have  changed  the  direc-                                  m  the   wounds   of
                                                                     When people are so fresh fro
              tion  very  much.  But  sensitive  and  resourceful   a moving experience,  it  limits  the  implications
              supervision  might  have  responded  to   the   as-   that can be  drawn,  but  in  retrospect,  some  of
              saults  on  the  organization,  handled   the   @e-   the positive  elements  come  through.  This  resi-
              destrian needs of  students,  and  offered  secu@ty
                                                                    liency is now being exhibited in the initiative  of
              to -a badly battered  staff.  Organizations,  ilice
                                                                    4t-hose students who have decentralized  the  local
              people, have a life and  death  cycle.  If  an  or-
                                                                    organization  into  three  separate   organizations
              ganization is to prosper, it  must  be  given  pro-
                                                                    attached  to  the  major  medical  schools  in  the
              per  nutrients  and  a  chance  to  mature  through
                                                                    area,  the  University  of  Sou.  ern   California,
              learning opportunities and successful coping.
               As  to  the  coming  years,  it  matters  not  who   University  of  California  at  Los  Angeles,   and
              sponsors  the  students   in   the   future-whether   the University of California at Irvine.
              it  be  departments  of  community  medicine,  vol-     Already  they  have  begun  to   make   contribu-
              untaky  or  government  agencies.  Discipline   and   tions to  the  number  of  minority  group  student
              control  must  reside  in  both  sponsor  and  Stu-   admissions  and  to  define  other  objectives  di-
              dents. If the sponsor is  the  University,  it  has   rectly related to the original  objectives  of  the
              to make itself accountable  to  students  in  their   student  health  projects  of  the   past   several
              acceptance of students  as  developing  adults  in-   years.

              26


                                           EDUCATIONAL PROGRAM
           During  the  previous  summer,   the   faculty   ad-   the  three   educational   directors   were   to   be
          visors,  preceptors,  and  students   had   expressed   available  resources  to  preceptors  and   students.
          concern  over  the  lack  of  an   organized   educa-   Beyond   their   own    limited    knowledge,    they
          tional  program  to  supplement  the  field   experi-   were  expected  to  develop  a  bank  of   additional
          ence.                                                   resource people  who  could  be  called  on  to  sup-
           At   the   March   1968   Student   Health   Organi-   ply  information  when  needed.  They  were   to   be
          zation  meeting,  the  minutes  show  that  the  stu-   from a large  variety  of  fields  such  as  connnun-
          dents  agreed  that  this  year   special   attention   ity  organizing,  child  care  experts  in  education
          would be given  to  the  study  of  the  organization   and health, and physicians, dentists,   and    public
          of medical  care  institutions,  the  f  unding  pro-   health  nurses  familiar  with  the  organization  of
          cesses, Federal, State, and  local  health  care  ju-   public health programs.
          risdictions and  responsibilities,  and  the  various     That  the  program  did  not  come  off   satisfac-
          kinds of health careavailable  to,  as  well  as  the   torily  was  due  to  the   general   problems   men-
          gaps, in services  to  the  poor.  In  addition,  the   tioned  earlier:  disinterest  in  formally   striie-
          educational   committee   gradually    refined    its   tured  programs,   which   is   understandable   con-
          scope   to   include   workshops   in   communication   sidering  the  overly  structured  life  health  stu-
          skills,   a   study   of    community    organization   dents lead, and the inability  of  students  to  dis-
          methods,  plans  for  a  session   on   racism,   and   tinguish   between    authority    and    authoritar-
          later,  sensitivity   training   groups   if   monies   ianism.  The  lack  of  authority   of   the   educa-
          were  available  and  there   was   sufficient   need   tio-nal  directors  was  another  major  barrier   to
          and interest.                                           success.  Individual  volition  was  the   only   au-
           Three  educational  directors   were   attached   to   thority but a mobilizing force was absent.
          the project:  one  was  from  the  field  of  medical     Attendance  at  educational   sessions   was   vol-
          sociology,  another  was  from   nursing   education,   untary,  and  needless  to  say,  summer  is  a  good
          and the  third  was  a  third-year  medical  student.   time to go to  the  beach  or  to  explore  new  vis-
          It  as  unfortunate  that  the  three   people   were   tas. If a didactic  program  is  to  be  included  in
          never able  to  work  out  a  unified  program.  Each   the  student  health  experience,  it  would   appear
          had  autonomy  and  seemed   unable   to   relinquish   one  day  a  week  should  be  set  aside  for   that
          some of it.  The  intent  was  that  the  educational   purpose.
          person  from  the  field  of  sociology   would   add     To  mix  a  metaphor,  the  staff  was  snowed   to
          some  knowledge  from  the  behavioral   and   social   the point where it lost  its  own  volition  and  the
          sciences,  and  together  with  the  student   direc-   snowball  effect  took  over.  Rather   than   recog-
          tor,  contribute  a  balanced  program  of  readings,   nizi-ng  the  boycott  of  the  educational   program
          films,  discussion  groups,  role  play,  and   other   as  another  evidence  of  protest,   and   therefore
          techniques  suited  to  the  particular   educational   terminating  the  program,  those  of  us  who   were
          goal.  The  educational  person  from  the  field  of   involved  became  lemmings  and   went   quietly   to
          nursing  education  was  to  use  her  knowledge   to   our  demise.  The  author,  who   was   involved   as
          give  support  and   guidance   to   student   nurses   one of the educational  directors,  shares  the  res-
          who  have  long  suffered  from  a   low   self-image   ponsibility   for   not   shifting   gears    quickly
          in  relation  to  physicians.  The  hope   was   that   enough to either termi  nate  the  educational   pro-
          behavior  would  change  as  we  upset   the   tradi-   gram  or  drastically  modify  it.  With   some   de-
          tional roles  which  institutions  foster  in  physi-   fensiveness, it  must  be  stated  that  the  project
          cians, dentists and nurses.                             directors  and   the   educational   directors   fre-
            In  addition   to   organizing   formal   programs,   quently   attempted   to   seek   suggestions    from

                                                                                                                     27


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
            students,  who  were  really   disinterested   in   project  has  many  potential  advantages  and  ob-
            any formal program. To the  degree  that  we  did   vious built-in disadvantages, what  is  crucial  is
            not respond to their  capacities  and  interests,   to focus on the process of  education  in  all  its
            the goals of the educational  .program    failed.   forms. Otherwise we  may  only  finally  achieve  a
            The students, however, also failed in their  con-   less committed,  partially  defeated  student  ,vho
            sistent lack of response either  to  the  program   perceives the  problems  as  so  enormousas  to  be
            or  requests  for  program  suggestions.   Conse-   insurmountable.  To  some  degree  the  future  be-
            quently, part of their confusion on projects  re-   havior of the student will be  conditioned  by  the
            sulted from their  ignorance  of  simple  answers   outcome of the  conflicts  between  his  principles
            to what appeared to be  large  insoluables.  Per-   and his self-interest. If the  Student  Health  Or-
            haps what it indicates is  that  the  concept  of   ganization  can  help  in  unifying  the   struggle
            measurable education in sequential steps  is  ir-   between these two pulls, it will  make  a  signifi-
            relevant'for  the  summer-just  as   the   summer   cant   contribution.   Camus(5),   in    explaining
            program is no longer relevant.  If  students  are   that  reasons  for  revolutions  are  inbedded   in
            required to use their own  potential  in  dealing   the  conditions  of  their  times,  and  in  modern
            with  persons  and  problems,  and  if  possible,   times in western educated man, reflects:
            offer solutions within  a  reasonable  time,  the          "Actual  freedom  has  not   increased
            development of those skills  also  constitutes  a
            good  basic  education.  But  there  remains  the        in  proportion  to  man's  awareness  of
            fact that  without  some  basic  knowledge  about        it. We can only  deduce  from  this  ob-
                                                                     servation that rebellion is the  act  of
            how to approach some of  the  problems  they  en-
                                                                     an educated man  who  is  aware  of  his
            counter, the students can  only  stumble  blindly
                                                                     own rights. But there is  nothing  which
            onto solutions. In so doing  they  quickly  incur
                                                                     justifies us in saying that it is only a
            the  wrath  of  the  communities  in  which  they        question of individual  rights.  *  *  *
            work and insure defeat for themselves. It is  ev-        what is at stake  is  humanity's  gradu-
            ident from  student  reports  that  students  who        ally  increasing  self-awareness  as  it
            were better prepared,  either  from  past  summer        pursues its course."
            experiences or intellectual  interest,  had  more
            realistic  expectations  of  themselves  and  the   In the  interests  of  documentation,  though  none
            summer experience.                                  Of  the  educational   programs   were   well   at-
             Since a  project  such  as  the  student  health   tended, some of the sample programs follow.
                                                       Sample Educational Programs-1968
            June   13 --------------- Staff  meets  at  Urban  Training  Center  with  four   community   organizers
                                       from minority communities.
            June   15 --------------- Communications Skills  Workshop.-Part  of  staff  and  volunteers  take  1-day
                                       training workshop to learn discussion  leadership  techniques  in  order  to
                                       build cadre of leaders.  Led  by  Paula  Menken,  UCLA  specialist  in  com-
                                       munications.
            June 21-24     ----------- Orientation program at Yucaipa,                 P'
                                                                        Calif. *See  Ap  endix  for  program.
            July 14 - - L   ----------- Infor=Z  Su@j  Evening  "Problem   Clinic".-Dinner   and   beer   (The   "Pro-
                                       blem Clinic" was a gimmick developed to  give  students  a  place  to  share
                                       problems, to ventilate anxieties, and erhaps to  pool  solutions  to  mutual
                                                                             p
                                       problems.)
            July   28                The  Political  and  Social  Forces  in  Health  Care:  Who  Has  the  Power?-
                                       Evening with  three  experts:  Lester  Breslow,  M.D.,  president,  American
                                       Public  Health  Association,  professor,  UCLA  School  of   Public   Health

            28


                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                                  David Solomon, M.D., chief of medicine at Harbor General Hospital
                                  Austin  Chinn,  M.D.,  project  director  of  Rehabilitation,  Research  and  Train-
                                     ing Center, University of Southern California School of Medicine.
         July 20     -------------- Trip  to  Salitd  Clinic,  Woodville,  Calif.-David  Brooks)  M.D.,   director;   an
                                     independent  health  clinic  near  Visalia,  a   small   farm   labor   community
                                     inhabited  by  mixed  ethnic   groups,   poor   whites,   Mexican-American,   and
                                     some black families.
         August    11 ------------ Community   Organization    and    Development.-John    Davis,    sociologist    and
                                     representative  of  the  Black  Congress;   Jerry   Inglis,   Community   Service
                                     Department, Los Angeles County.
         August    18 ------------ New  Career.-  in  Health-Legal   and   Attitudinal   Barriers   to   The   Use   of
                                     Semi-Professionals  (canceled  because  of  lack  of   Attendance   at   previous
                                     sessions).
         August    23 ------------ Racism-FuU-day    Session.-Open    discussion    between    students,    preceptors,
                                     faculty-Nathan   Cohen,   dean,   UCLA   School   of   Social   Welfare;   Harold
                                     Jones,  M.D.,  black  psychiatrist  from  Youth  Development   Center   -,   rep-
                                     resentative   from   United   Mexican-American   Students;   and   all    student
                                     health project  fellows.  (Cancelled  because  of  threat  of  boycott  by  black
                                     SHP students.)
            Suggested     Alternative     Program.-     (These   education-the  relation  of  complex   social   prob-
         were   discussed   for   future   programs   if   SHP   lems to individual health problems.
         should consider year-round activity.)                     The   Concept   of   Community   as   a   Process.-
            The    Development    of    Alternative    Systems   What  are  its  functional  borders?  What  are   the
         and  ModeU  For  Health   Care   Facilities   through   factors  in  its  togetherness?  What  are  the   ob-
         the  Case  Study  Method   With   Role   Play   Tech-   stacles  to  change?  What   would   accelerate   its
         niques.  -Students  to  develop  the  cases  out   of   progress?
         their experiences.                                        The  alternatives  are  listed  here  for  the  re-
            The   R@tiowhip    Between    Law    and    Health   cord.  They  may  be  suitable   for   study   in   a
         -Legal   Barriers   to   Health.-Members    of    the   year-round program on community medicine.
         UCLA and U.S.C. School of Law.                             There  were  many  pieces  of  important   litera-
            The  Responsibilities  of  Public  Health   Insti-   ture  sent  to  students  or   given   as   handouts.
         tutions   in   1968.-State   Department   of   Public   They covered  a  variety  of  subjects  such  as  Fi-
         Health and Child and Youth Clinic, Los            An-   nancing   Health   Care,   The   Economic    Opportu-
         geles County Department of Public Health.               nity Act,  The  City,  material  on  New  Careers  in
            The    Urban     Condition.-Population     shifts,   the   health   professions,   community    organizing
         black  capital,  white   exodus   tax   rates,   land   methods.  There   were   others   too   numerous   to
         rate,  automation,  jobs,   industry,   housing   and   mention.

                                                                                                                    29


                                                      THE PROJECTS

                                                                      omissions, it  is  due  to  those  reasons  enumer-
                  Introduction
                                                                      ated, plus  the  fact  that  the  projects  in  the
                  In some  parts  of  the  country,  the  projects    Black  ghettoes  did  not  report.  There  was   an
                  planned in advance for the publication of  their    attempt  to  collect  data  at  the  beginning  and
                  reports. A  staff  historian  or  evaluator  was    end  of  the  summer.  Questionnaires   were   dis-
                  made a part of the staff at the beginning  which
                  permitted an objective  evaluation  to  be  kept    tributed at the  orientation  session  at  Yucaipa,
                  and later compared to  the  subjective  logs  of    and at the  closing  session  in  Goleta.  Some  of
                  students. While the project was in  process  the    the students  cooperated,  but  many  rejected  the
                                                                      instruments as irrelevant. As a  result,  any  con-
                  historian was  able  to  investigate  individual    clusions based on the  analysis  of  the  question-
                  communities  and  -relate  demographic  material    naires would be unreliable and incomplete.
                  to deficiences in health care in these  communi-     The  f  ollowing  summaries  attempt   to   report
                  ties.  Whether  this  information  was  gathered    some of  the  salient  impressions,  and  sometimes
                  only for the official student health project re-    hopeful   and    sometimes    poignant    anecdotes
                  port or was used  to  enrich  the  understanding    about  the  summer  projects.  The   excerpts   are
                  of student fellows, we do not know. If it in fact   from synopses of project  goals  written  prior  to
                  was used  to  supplement  the  students'  knowl-    the  summer  by  the  area  coordinators  and  from
                  edge about the areas in which  they  worked,  it
                                                                      final  reports  of  students  who  worked  in   the
                  would have added much  meaning  to  their  jobs.
                                                                      projects  during  the   summer.   Thirty-nine   re-
    f             In former years,  the  California  area  coordi-
                  -nators summarized their  own  perceptive  feel-    ports  representing  46  students  were   submitted
                                                                      out of a total of 93 participants.  There  were  16
                  ings about the various ways the  students  lived
                                                                      health-science projects and 10   law  projects   in
                  in the communities in which  they  worked,  a  d
                                                                 n    California.
                                                            t
                  the intensity of some  of  the  relationships  a       o  matter  how  exhilarated  or  weary,   joyous
                  developed;  how  some  of   the   teams   worxea    or  despondent,  the  message  that  comes  gallop-
                  along well as  a  part  of  the  community,  and    i.ng through all of the  student  reports  is  suc-
                  how  in  some  communities,  students  were  too
                  uncomfortable  to  weave  themselves  into   the    cinctly stated by one Yale medical student:
                  life of the community. Characteristically, there        "I DID NOTHING, BUT, I LEARN-
                  is a description of the sharp  contrast  between        ED A LOT."
                  the students' ability to deal with complex intel-   Los Angeles County
                  lectual concepts, and their inability to  under-
                  stand the  complexities  involved  in  the  perpe-    There  were  seven  projects  in  the   following
                  tuating cycle of poverty.                           six areas  in  Los  Angeles  County:  Venice,  East
                                             ious  problems   such    Los  Angeles,   El   Monte,   Watts,   Willowbrook,
                  This year, because of var
                  as replacements in area, coordinators,  illness,    University   of   Southern    California    Medical
                  the fact  that  one  coordinator  had  to  leave    Center.
                  early,  and  other  problems  mentioned  in  the
                                                                                            Venice
                                                 s  were  received
                  body of this text, no summarie
                  from coordinators.  Unfortunately,  no  one  was      Venice is a   poor   beach   community   on   the
                  assigned in advance to plan for the  preparation    west  side  of  Los  Angeles  Coun@y.  There   have
                  of this report. Therefore, we are  writing  this    been  some  tensions  between  the   Negro,   Mexi-
                  retrospectively, without the possibility of ver-    can-American, and poor  whites  who  live  in  sep-
                  ifying material with participants who  have  de-    arate parts  of  the  ghetto.  A  hippy  community,
                  parted.. If there are gross  errors  or  serious    a  small  group  of  university  students,  and   a

                  30


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

          group of elderly  Jewish  residents  also  live  in        to include provision for operating  at  a
          Venice. It has  been  a  retirement  community  for        loss in spite of patient fees,  with  the
          elderly  Jewish  people  long  before   World   War        hope that any  such  loss  could  be  un-
          11 and has remained so to this day.                        derwritten  by  sympathetic  local   com-
            Three students,  two  in  medicine,  and  one  in        panies."
          dentistry,  worked  in  Venice  during   the   sum-          "Other  features  of  the  clinic  were
          mer. One law  student,  a  student  health  project        to  include  medical  students   furnish-
          fellow, worked  on  a  separate  project  which  he
          organized. The goal of  the  students  was  to  es-        ing  transportation  and   'patient   ad-
                                                                     vocacy' for patients,  as  well  as  fol-
          tablish  a  Venice  Health  Clinic  in  cooperation
                                                                     low-up visits to  those  treated  at  the
          with  the  UCLA   Medical   and   Dental   Schools.
                                                                     clinic in their homes.  Treatment  itself
          The ground work for  this  project  had  been  laid
                                                                     would  be  administered  solely  by  den-
          the previous  summer.  The  Venice  project  was  a
                                                                     tists and  physicians,  however.  It  was
          prime  example  of  effective   preceptor   support
          combined  with  constructive  experiences  for  the        understood    that    Venice    residents
          students. The project was  well  defined  and  pro-        would  be  selected  preferentially   for
                                                                     any staff positions at the clinic."
          vided  consecutive  challenges   which   were   met
          by  consistent  faculty  and   community   involve-          "A  biproduct   of   our   summer   was
          ment.                                                      an extensive list of  over  50  important
            With  the  help  of  three  faculty   preceptors,        resource people in t e     nice    commu-
          Arnold  Kisch,  M.D.;  James  Freed,   D.D.S-   and        nity. This also  has  been  submitted  to
          Jay  Friedman,  D.D.S.,  the  students   wrote   and       the student health office  for  any   fu-
          submitted a  proposal  for  the  dental  clinic  to        ture workers in Venice."
          the  Regional  Medical  Programs  Area   IV   Divi-  John Trego, the dental student assigned in
          sion at UCLA. While  in  the  process  of  develop-   Venice states:
          ing additional support for  the  clinic,  the  stu-          "We  have   support   of   the   Health
          dents were  able  to  build  a  good  rapport  with
          antipoverty  agencies.  The  Venice  State  Service        Council, the  Service  Center,  and  most
          Center offered office space  for  the  project  and        everyone we have  talked  to  in  Venice.
                                                                     We  have  dental  equipment  donated   to
          the Venice  public  library  cooperated  in  publi-
          cizing  and  making  space  available  for  evening        install in the clinic.  We  have  a  com-
          meetings.  Probably  the  single   most   important        mitment  from  UCLA  to   make   this   a
          contribution students  made  was  in  bringing  to-        satellite facility. We have funds  avail-
                                                                     able  through  a  state  grant.  We   are
          gether  the  University   (UCLA),   the   Los   An-
                                                                     now  waiting  on  word  from  the   Serv-
          geles  County  Health   Department,   and   commun-        ice  Center  director  in  Sacramento  to
          ity people  who  formed  the  Venice  Health  Coun-        allow us free  rent  on  a  room  in  the
          cil.  That  the'project  had  sufficient   momentum
                                                                     Service  Center.  These  last  two  items
          to carry on  from  year  to  year,  indicates  that        -funds and  space,  will  decide  whether
          it is possible to build the  kind  of  bridges  be-        the clinic can  be  started  and.  when."
          tween  the  community  and  the  institutions   who
          serve it, which  will  permit  them  to  consummate           I  know  this   summer   has   attuned
          projects  beneficial  to  both.  -This   sense   of        my opinions  of  myself,  my  profession,
          achievement  was  reported  in  the  statements  of        and of people in  poverty  situations.  I
          some  of  the  students.  Bob   Buker,   third-year        don't think I will ever  forget  the  ex-
                                                                     periences I have  had  and  the  concepts
          medical student with a  sense  of  personal  urgen-        I have learned this year. I hope to  sat-
          cy worked  in  the  program  in  former  years  and        isfactorily  incorporate  these   'ideas'
          stated:
                                                                     into my future  goals  in  dentistry,  to
                 "Ultimately,    the    model    (dental             please myself  and  to  help  the  people
               clini@Ed.)   we   proposed   was   forced             that need it."

                                                                                                               31


                             CALIFORNIA STUDE.NT HEALTH PROJECT SUMMER 1968

            The law  student,  Jon  Steiner,  who  was  placed         The  community  needs  training   programs   for
            in  Venice  because  he  had   previously   worked      auxiliary health personnel,  and  a  cheap  shuttle
            at the Venice public library in  a  tutorial  pro-
                                                                    service to and from clinics.
               t, was fully  justified  in  complainiii-  that         According  to  one  student  who  lived  in  the
            .Jec
            he  had  no  preceptor  nor  any   project.   How-      community, it needs sanitation  services  too:
            ever,   his   familiarity   with   the   community              "My  apartment  costs  $80   a   month,
            helped him to flounder  less  than  most  students           has  13  broken   windows,   and   houses
            might have, and after a period  of  searching,  he           the U.S. headquarters  for  the  Interna-
            attached himself to the  local  Venice  branch  of
            the  Los  Angeles  Neighborhood   Legal   Services           tional Termite Command."
            office. With the cooperation  of  that  ofnce,  he
            was able to organize a series of classes on  legal         The East Los Angeles Child and Youth Clinic
            problems which affect  the  poor,  such  as  land-         East  Los  Angeles  is  a  sprawling  area  east
            lord-tenant   relations,    garnishment/attachment
                                                           I I      and  north  of  the  center  of  Los  Angeles   and
            problems,  consumer  fraud,  and  welfare  rivnts.
                                                                    composed    predominantly    of    poor    Mexican-
            He was  encouraged  by  how  much  could  be  gone
            by  students  if  a  plan  had  been   implemented      American  families.  The  Child  and  Youth  Clinic
            before the summer:                                      is -t  demonstration  project  which  represents  a
                                                                    joint  responsibility  and  collaborative  effort   of
                   "Many times,  a  phone call to a                 the  Los   Angeles   County   Department   of   Health
                collection agency could serve to re-                and  the  Children's  Division  of  the  Los   Angeles
                lease a garnishment of wages and                    County-Univei-sity     of     Southern      California
                save a possible lost job."                          Medical Center.  It  opened  early  in  1968,  and  is
                                                                    a new  clinic  model  for  Los  Angeles.  It  provides
            For  the  projected   Venice   Community   --%Iedical   comprehensive  services   for   children   under   19.
            Center, it  is  hoped  the  clinic  will  incorporate   Some  of  the  original  data  to   substantiate   the
            three  basic   personnel   elements:   residents   of   need for the clinic  was  collected  by  project  fel-
            the  Venice  area,  interested  physicians,  and  in-   lows  in  the  summer  of  1967.  Great  impetus   was
            terested medical students.                              given   to   the   establishment   of    the    clinic

                                    tin 0

            32


                           CALIFORNIA STUDENT HEALTH PROJECT SUMAIER 1968

           through  the  combined  efforts  of  the   adminis-    Steiner, conducted a  survey  of  families  in  the
           trator of  the  Los  Angeles  County  General  Hos-    area through the  use  of  a  questionnaire  devel-
           pital  and  the  Los  Angeles  County  Health   De-    oped  at  Children's  Hospital.   They   chose'   a
           partment.                                              group  of  families  who  had  been  seen  once  at
             Five  students,  from  the  fields  of  medicine,    the clinic and had been rejected  for  future  care
           dentistry, psychology,  social  work,  and  politi-    for one of several reasons;  either  they  did  not
           cal science were assigned to the  clinic  with  two    meet  the  poverty  criteria,  had   other   health
           general  objectives:  (1)  To  develop   meaningful    coverage,  or  were  not  in  the  catchment  area.
           educational  experiences  for  four   high   school    Thirty-eight  families  were  interviewed  for  the
           students  participating   in   the   project;   and    study.   The   researchers   wrote   an   excellent
           (2)  to  communicate  their  perceptions   of   the    paper  on  their  findings  which  they   presented
           community's needs to the staff of the clinic.          to the clinic and their preceptors at the close  of
            Three   of   the   students   worked    throughout    the summer.
           the  summer  with  the   high   school   teenagers.     The  two  girls  had  many  reactions   to   their
           They conducted  classes  on  sex  education,  biol-    experience:
           ogy,  anatomy,  and  mathematics.  They  made   use
           of slides, films, and  medical  and  dental  equip-          "Located  in  the  heart  of   a   pov-
           m-.nt. They took the teenagers on field  trips  and        erty pocket and  making  efforts  to  re-
           encouraged  them  to  ask  questions.   A   special        spond  to  the  community's  real  needs,
                                                                      the clinic is  bringing  health  services
           understanding was established:
                                                                      closer to the people.
                 "But  the  important  thing  was   that                       The clinic  personnel  must  re-
              they  asked,  and  we  listened,  and  re-              main  constantly  aware  that  they   are
              worked   the   rest   of    the    program              working in an  area  where  social  path-
              along with  their  desires.  I  had  hoped              ology,  as  well  as  medical  pathology,
              that this  would  happen,  but  we  really              is a problem. It  is  the  responsibility
              had to  wait  until  they  were  ready  to              of the professional  staff  to  recognize
              talk to us. As it was, it was  like  pull-              and respect the cultural differences  be-
              ing  teeth  to  get  them  to  talk  about              tween  themselves  and  their  patients."
              what they wanted."                                        "Those  interviewed  saw   the   clinic
              July  23d.-"Pat   started   the   session.              only as a place  to  bring  children  for
              We  talked  about  lung  dieseases,   su'ch             emergency  treatment.  From   these   re-
              as   asthma,   emphysema,   cancer.,    We              sponses,  we  question  the  adequacy  of
              discussed   pneumonia   and    TB,    then              the explanation  of  the  services  being
              the  mechanics  and   symptons   of   left              offered by the clinic. To  these  people,
              heart failure.  We  showed  a  film  about              a referral slip is the carte  blanche  to
              smoking   and   they   know   the   danger              health care. This  is  evidenced  by  the
              signals of cancer.  Then  we  got  into  a              fact that thirty-two of  our  cases  came
              discussion  of  the  common   cold.   From              to the clinic by a referral  from  either
              there  we  went  to   viruses   and   then              the  County  Hospital,   public   school,
              DNA,   and   then   the   structure    and              Health  Department,   or   Project   Head
              function  of  RNA  in   the   cell   (DNA-              Start.   Many   times   an    interviewee
              RNA-Protein).  We  also  had   a   discus-              would question ff  she  could  return  to
              sion  of  coding,  computers,  and  binary              the clinic without a referral slip."
              numbers'  They  can  compute   in   binary                                   JANF, HmsciiMANN.
              numbers now."                                                               MAP.TA STEINER.
                                            BILL BAUER.
                                                                       "People in East     Los   Angeles    are
           To  achieve  the  second  goal  of   the   project,        poor, yet this is  the  only  thing  they
           two   students,   Jane   Hirschmann   and    Marta'        know.  How  can  they   lift   themselves

                                                                                                                33


                              CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                   up  without  power  when  even  we                   @Vith  this   information,   the   team   prepared
                   who are not poor, cannot buck the sys-            recommendations  for  a   minority   group   recruit-
                   tem? N@lhat's the answer?"                        ment  program  at  three  medical   schools:   U.S.C,
                                             iNIARTA STEINER.        Stanford,   and   the   University   of    California
                                                                     Medical  Center  in  San  Francisco.   They   submit-
                   Bio-medical Careers Pro@ect-Minority              ted  several  models  of  their   suggested   program
                             Group Admissions                        to  the   Admissions   Departments   and   Deans   of
                                                                     medical   schools'   and   disseminated   information
               This   project   was   aimed    at    laying    the   about  the  program  to   students   in   the   three
             gi@oundwork    for    increasing    minority    group   schools.  The  model  programs   would   permit   mi-
             admissions  into  medical  and  other   health   sci-   nor@ty  group   students   at   various   levels   of
             ence  schools,  and  for  the  establishment  of   an   achievement  to  enter  medical  school.   In   order
             organization  to  encourage  high  school   students'   to  compare   their   methods   of   approach,   they
             in  poverty  areas  to  enter  the   biomedical   ca-   contacted    Student    Health    Organizations    in
             reers field.                                            Boston,  Chicago,  and  Detroit,  who   had   already
               Three  students,  two   medical,   one   sociology,   made   some   progress   in   facilitating   minority
             worked  on  the  project   throughout   the   summer.   group admissions.
             They  gathered  two  classes  of  statistical  infor-     The  students  felt  encouraged  by  the   response
             mation from nine California medical schools:            to their efforts during the summer.
               1.  The   number   of   minority   group   applica-     In  the  past  year,  minority  group  applications
                   tions  and  admissions  in  the  nine   schools   at  UCLA  have  risen  f  rom  nine   to   35,   from
                   in the past 3 years.                              which eight  will  be  admitted.  At  U.S.C.  15  mi-
                                                                     nority  group  students  have  fulfilled   admissions
               2.  The   number   of   minority   group   students   requirements.
                   admitted since 1960.                                Though  progress  is  slow,  the  evidence  contin-

            34


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

          ues  to  indicate  that  pressures  from   students         medical  staff  and  become   patient   advo-
          do have some impact.                                        cates.
             Los Angeles County-University of Southern          The students  on  this  project  had  much  to   say
                      California Medical Center                 about about SHP in general:
             The   Los    Angeles    County-U.S.C.    Medical          "The   most   obvious   deficiency   is
          Center is the largest medical  institution  in  the        the  project's  lack  of  leadership.  It
          United States.                                             had been difficult to identify the  staff
             Four  medical  students  were  assigned  to  the        because  of  the  shunting  of  responsi-
          hospital  with  the  goal  of  making  some   rough        bility  from  one  persoh   to   another.
          appraisal of the  medical  care  received  by  some        Confusion  and  indecisiveness   in   the
          selected groups of patients.                               leaders  about  goals  and  methods   has
             The  students,  who   had   relative   autonomy,        led to confusion in the project.  *  *  *
          decided to walk through     with   patients    from        Absence  of  direction  prevents   effec-
          moment of arrival, to treatment  by  a  doctor,  to        tive  leadership  in  the   present   and
          receipt of prescription  drugs.  In  their  survey,        prevents  development  of  project  sites
          they interviewed  patients,  doctors,  nurses,  and        that  can  be  maintained  into  the  fu-
          administrators.  After  compiling  their  findings,        ture.  An   organization   cannot   exist
          they  made   valuable   recommendations   for   im-        only for the present. It  needs  a  sound
          provements about  relatively  simple,  but  p.roba-        sense of the future to be  able  to  grow
          bly very useful aids to  dispel  the  usual  confu-        and   become   more   effective   as   it
          sion felt by  patients  in  such  an  enormous  fa-        grows.
          cility. They suggested a  brief  pamphlet  be  pub-                                     BILL MASON.
          lished  in  English  and  Spanish  describing   the
          Walk-In Clinic, its  procedures  and  the  care  it                       El Monte
          provides. They  also  suggested  the  placement  of     El  Monte  is  a  city  of  approximately  65,000
          bilingual personnel in those areas  of  the  hospi-   residents in the San Gabriel Valley  in  the  east-
          tal where  there  is  a  large  amount  of  patient   ern portion  of  Los  Angeles  County,  with  about
          contact with hospital personnel, such  as  the  In-   55  percent  white,  over   40   percent   Mexican-
          formation  Desk,  Walk-In  Clinic  desk,  and   the   American, and the balance Oriental.
          clinic Registration Desk.                               Two  students  were  assigned  to  the  El  Monte
             They found treatment in Unit I    ' the    Acute   Teen  Post  to  attempt  to  establish   a   Dental
          Ward, was  excellent.  They  suggest  that  in  ad-   Clinic for  the  area.  Although  they  tried  very
          mitting  rooms,  medical  wards,  and   out-patient   hard  and,  in  fact,  made  some  headway  in  in-
          clinics,  the  following  changes   would   enhance   volving local residents and a  local  dentist,  the
          personal service:                                     students were unable  to  achieve  their  aim.  The
             1. Screening  of  patients  should  be  done   by  San Gabriel Valley Dental  Society  is  a  conserv-
               an RN or P.H.N.                                  ative organization which  has,  in  the  past,  op-
             2. That there be a special  area  set  aside  for  posed  other  antipoverty  or   government   subsi-
               the  refilling  of   prescriptions.   (Average   dized  programs.  The   students   received   prom-
               wait for a large  number  of  patients  was  3   ises of  help  from  dental  supply  houses  and  a
               hours, 13 minutes.)                              local real  estate  agent,  but  without  the  den-
             3.  A  bilingual  pamphlet  in  English  and  in   tists, could go no further. They feli  very  disil-
               Spanish  describing  Unit  1,  its  procedures   lusioned and bitter, and  their  experience  in  El
               and the  care  it  provides,  and  in  general   Monte tended to  dramatize  the  need  for  greater
               what patients may expect.                        SHP  activity.  What  they  found  fortified  their
             4.  Nursing  personnel  should  pay   more   at-   belief s.
               tention  to  the  human  factors  in   nursing     The  two  students  made  many  efforts  to   in-
               rather   than   be    task-oriented.    Nurses   volve local people, but not only  were  they  unfa-
               should  be  invited  to  attend  rounds   with   miliar with the area,  but  they  also  lacked  su-

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                               CALIFORNIA STUDENT HEALTH                   PROJECT SUMMER 1968

               pervasion  from  health  professionals  who   could         joy-at  first.  It  was   he   who   first
               have  guided  them.  Their  preceptor  was   either         swayed our clinic to  its  present  objec-
               too busy or  unable  to  direct  them  to  adequate         tives, but he was  the  first  tonight  to
               professional  or  community  resources.  The  local         try to cut our project  to  ribbons  along
               Health Center  dentist  feared  socialized  dentis-         with the  school  nurse.  And  the  people
               try,  the  PTA  was  squeamish   about   supporting         themselves  (six   women)   disliked   the
               a Dental Health Clinic if they did  -not  have  the         project   because   the   community    was
               support  of  the  Health   Department,   the   area         asked  to   help   the   project   through
               coordinators were not able  to  teach  any  special         participation  and  financial  help-as   I
               organizing skills, and to top it off, no  one  ever         already   expected,   these   people   are
               circularized  any  representative  groups  in   the         lazy   slobs    that    want    everything
               community  before  the  decision  was  made   about         handed  them  on  a  silver  platter   and
               organizing a Dental Health Clinic.                          f or f ree."
                 According to their reports:                          Esperanza  Gonzales,   a   SHP   community   worker
                      "Four out of  13  dentists  we  invited         at  the  El  Monte  Teen  Post,  after  a   meeting
                   showed   up.   We    had    a    community         with some of the local dentists wrote:
                   meeting  and  five  people   showed   up."
                                                                             "I  also  know   that   these   dentists
               Don  Graham,  the  dental  student,   wrote   about         lie to you  in your f  ace.  I  only  wish
               his deep resentment:                                        I had the nerve  to  tell  them;  although
                      "We  finally  seem  to  know  where  we              I  did  try.  Dr.  Kean  says,  'I'm  sure
                   are  going-at  least  where  we   are   at              that  the   dentist   and   myself   would
                   for  sure-nowhere!   We've   gotten   some              gladly  like  to  work  on   poor   people
                   good  leads  and  are  on  the  track  and              and  ease  them  of   their   pain.   Mrs.
                   have   appointments   to   make   appoint-              Gonzales  seems  to  give  the  impression
                                                                           that there are a lot of little  youngsters
                   ments  to  find  where  we  will  be   re-              going around in  pain.  If  so,  he  says,
                   ferred  to  next.   Primarily,   we   need
                                                                           bring them  to  us  and  we'll  take  care
                   dental  health  statistics  and  are  pre-
                   pa@ed  to  make  any  sacrifices  or   at-              of  them.  We  have  always  done  a   lot
                   tacks to remove or lift  these  facts  out              of  charity  cases,  the  doctor  and  I.'
                                                                           Well, all I can say  is,  they  must  have
                   of the 'system'.
                                                                           gone to  jungle,land  for  charity  cases,
                      "I f eel as if I am being  used  for  a
                                                                           cause I never heard of one."
                   purposeless   purpose   and   resent   the
                   arrogance    or    ignorance     (probably               Willowbrook Volunteer Health Center
                   both)  of  the   SHO   coordinators.   You           Three  students  were  assigned  to  the  Volu-n-
                   may  rationalize  by  saying  we   planned
                                                                      teer Health  Center  in  the  ghetto  community  of
                   these   meetings   with    Dr.    Schoen's         Willowbrook,  which  is  adjacent   to   Watts   in
                   office to let  you  explore  more  avenues         South  Central  Los  Angeles.  They  were  not  as-
                   of possibilities, but it was all an  acei-         signed any specific task or  given  any  particular
                   clent. Just as I  believed  we  were  get-         goal  other  than  working  with  Dr.  David  Swim-
                   ting  somewhere,  I  learned  that  I   am
                   deeper in  nowhere.  I  don't  know  where         mer,  the  director  of  the  Health   Center   and
                   'I am at'  what  I  have  done,  or  which         their preceptor "in doing  whatever  is  needed  to
                   way  to  turn,  or  what  to  do  next.  I         make  the  Health  Center  work."  This  they   en-
                   know  I  am  not  at  all   pleased   with         thusiastically   began   to   do,   teaching    NYC
                   what I have done so far, however.                  youths  to  take  temperatures,   blood   pressures
                      "At our meeting to form a          den-         and  pulses,  and   on   occasion,   the   students
                   tal council,  the  only  dentist  was  Dr.         pitched  in   on   the   maintenance   work.   They
                   Kean, which was a great shock          and         made great efforts to enlist  outside  support  for

               3G


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

          the  Health  Center   and   achieved   some   measure    to have them in our games,
          of success.                                              but you replied.:
               In their final report, these  students  detailed
          problem  areas  in  the  Center  and   made   sugges-        They are only wind-up birds
          tions   and   recommendations   for   the    improve-    who strut on scarlet feet
          ment  of  its  health  care  delivery  system.   How-    so hopelessly far
          ever,  the  unexpected  consequences  of   a   summer    from our curled finger.
          with  this  kind  of  involvement  are  often   mani-
          fested  in  the  sudden  awareness  that   one   must    I had moved to warn you,
          experience one's self  and  one's  values  before  he    but you only adjusted your hair
          can truly experience others.                             and ventured:
                                                                     .Their wings are made of glass and gold
                      "This     summer's      experiences          and we are fortunate
               has  me  more  confused   than   ever.   I          not to hear them splintering
               honestly don't know how  it  is  going  to          against the sun.
               affect my 'career'. I am  torn  over  just
               how involved  I  should  get,  or  whether          Now the hollow nests
               there is really a  cause  to  be  involved          sit like tumors or petrified blossoms
               in. I get the  feeling  that  people  must          between the wire branches
               first  face  themselves   before   jumping          and you, an innocent scientist,
               into a 'movement' or any cause."                    question me on these brown sparrows:
                                          JOHN GAMBIN.             whether   we   should   plant   our   yards    with
          John Gambin  and  Steve  Sanders,  the   two   stu-      breaderumbs
          dents, felt this  was an exceptionally                   or mark  them  with  the  black,  persistent  crows
                                                        good
          placeIment,  and   that   they   received   constant     whom we hate and stone.
          friendly  support  and  advice   from   Dr.   Swim-
          mer, a resident interist  at  Harbor  General  Hos-      But what shall I tell you of migrations
          pital. But their  awakening  to  problems  was  not      when  the  dimmest  flutter  of  a  coloured   wing
          without cost to their peace of mind:                     the precige ghosts of departed summer birds
                                                                   still trace old signs;
                "I   feel   that   individuals    seeking          or of desperate flights
               a large  chunk  of  the  'capitalist  pie'          when the dimmest flutter of a coloured wing
               exploit their  'brother'  with  calls  for          excites all our favourite streets
               unity  and  identity  while  really   pri-          to delight in imaginary spring.
               marily   concerned   with   personal   ad-
               vancement.                                                             -LEONARD COHEN
                                                                                      Selected Poems, 1956-68.
                "Possibly  we  disrupted  the  lives   of
               the  boys  our  age  by   trying   to   be                  South Central Los Angeles-
               friends  with  them   and   then   leaving                        The Watts Project
               them stranded  at  the  end  of  the  sum-          Thousands  of  words  have   been   written   about
               mer."                                               Watts  by  people  "in  the  system"   and   people
                       THE SPARROWS                                doing battle  with  the  system.  There  have  been
                                                                   descriptions,   explanations,   and    lamentations
        Catching winter in their carved -nostrils                  from  all  shades  of  opinion.  Watts  as   Harlem
        the traitor birds have deserted us,                        has  countless  numbers  of  Federal,  State,   and
        leaving only the dullest brown sparrows                    local  measures  meant  to  reduce   the   symptoms
        for spring negotiations.                                   of  poverty,  to  tranquillize  the  pain,  and  to
                                                                   tnaesthetize the anger.
        I told you we were fools                                   Watts,   a   community   in   South   Central   Iks

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                               CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

              Angeles,  was  the  center  of  the  1965   Los   An-      The  two   preceptors   who   planned   the   pro-
              geles  revolution,  usually  referred  to   as   "The   gram  and  gave   tight   supervision   were:   James
              Watts  Riots."  The  people  of   Watts   know   some   Bates,  community  organizer  for  the   South   Cen-
              of  the  things  they  want.  Jobs  that   go   some-   tral   Multi-Purpose   Health    Center,    an    OEO
              where,  a  good  education  and  day   care   centers   Health  facility,  and   Lou   Smith   of   Operation
              are just a  few  of  the  things  that  are  high  on   Bootstrap,   an   aggressive   voluntary    self-help
              their priority list.                                    organization  dedicated   to   the   development   of
                So  much  has  been   written   about   the   char-   black-owned   and   operated   businesses.    Accord-
              acteristics of  Watts,  that  this  report  will  re-   ing  to  one  student,  tempers  in  the  summer  de-
              frain  from  the   usual   comparisons   of   eastern   manded   tight   supervision   and   self-disciplined
              and  western  ghettos  or  from   giving   an   aval-   workers.
              anche  of  statistical  data  on  infant   mortality,     It is not possible to  report  the'  students'  in-
              morbidity    and    unemployment    rates,     school   dividual reactions  to  the  project  since  none  of
              dropout  rates,  life  expectancy   charts,   average   them  submitted  a  final  report  to  SHP  and  only
              income, or number of AFDC families.                     one  responded  to  the  request  for  an  interview.
                There were five  project  sites  in  South  Central   John  Bruce,  an  area  coordinator  in   the   South
              Los Angeles, with  a  total  of  10  students,  seven   Central  and  El  Monte  areas  is  a  man  who   can
              black,   two   Mexican-American   and   one    white.   make   many   objective   observations   by    reason
              The  purpose  of  the  projects  was   to   establish   of his African heritage.  He  talked  about  his  re-
              voluntary  medical  disaster  stations   for   treat-   cent  identification  with  the  black  man's  strug-
              ment  of  injured  persons  in   case   of   tensions   gle  in the United States:
              erupting  in  the  area.  Important  to  the   estab-           "The  differences  I  notice  in  South
              lishment  of  these  stations   was   the   plan   to        Central from  most  of  the  countries  of
              utilize  doctors  and  nurses  and   health   science
                                                                           Africa  and   Europe   where   there   are
              students to  teach  first  aid  skills  to  community        ghettos, is that in those places there  is
              residents  and  thereby   build   up   a   corps   of        hope-there  are  ways   of   getting   out
              trained  first  aid   technicians   in   the   commu-        and here there is not."
              -nity. In  the  course  of  training,  the  community
              people   would   be   brought   into   contact   with   When  he  discussed  the  method  used  to  gain  ac-
              available  health  resources   and   learn   how   to   ceptance   and   trust   with    community    people,
              make  use  of   them.   Teenagers   were   also   in-   Bruce stated:
              cluded with other residents.                                   "It  helped,  of  course,  to  have  the
                The  plan  was   carefully   conceived   and   doc-        same  color.  Also  there  had  been  some
              umented  before  the  student  health  project   peo-        involvement  before  the  project   began.
              ple  arrived.  Groundwork  had  to   be   laid.   De-        We  had  meetings  with  the   people   in
              cisions  about  the  most  strategic  locations   for        the  community,  with  the  woxnen,  Black
              disaster  stations,  transportation  of  both   work-        Congress,  and  other   groups.   By   the
              ing  peronnel  and  possible  victims   had   to   be        time  we  came,  they  were  waiting   for
              arranged,   and   cooperation   was    sought    from        us-we  met  originally  with  older   peo-
              related   social    agencies,    health     agencies,        ple, for we  realized  that  younger  ones
              churches,   community   organizations,   and    indi-        were  much  more  militant  than   we   by
              viduals.    Channels    of     communication     were        middle-class standards."
              worked  out  and  dry  runs  were   made   with   SHP   Later  on  he  mentioned  that   it   was   important
              fellows after they arrived.                             that  the  people  in  the  community  realized   the
                It  was  understandable  that   professional   per-   students   were   interested   in   their   survival.
              sonnel  as  well  as  community   people.might   feel   Bruce  was  adamant  that  faculty  people  and   the
              antagonistic  to  young,  bright,  privileged   black   universities in  the  area  represent  special  local
              students  and,  therefore,  the  roles   of   student   interests  and  therefore  cannot  relate   well   to
              health members were carefully limited.                  community  needs,  although   he   sees   no   reason

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                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

           the  federal  government   cannot   support   local   tically of  the  Wedneday  sessions  when  he  and
           programs.                                             students  would  "sit  around   and   rap"   about
                  "I don't think  universities  and  sim-        books, their projects, the people  in  the  commu-
                ilar institutions can  provide  the  type        nity, about strategies and  political  imperatives
                of person we  need  as  a  preceptor  who        related to the Black Revolution. As  is  the  case
                understands  and  can  be  receptive   to        of most teachers, Bates felt that  he  learned  as
                the community. But there is  a  role  for        much  from  the  students  as  they  learned  from
                these people. Dr.  Kivel  and  Dr.  Lieb-        each  other  and  the  community.   According   to
                erman,  both  white  physicians  at   the        John Bruce and -Bates, the  spirit  of  trust  and
                Health  Center,  worked  with   us   last        exploration  set  a  tone  which  encouraged  stu-
                summer  by  providing  technical   advice        dents to accelerate  the  process  of  their  per-
                when we needed it,  and  it  was  a  very        sonal growth as well as deepen  their  philosophi-
                valuable service."                               cal   commitment.    Attendance    on    Wednesday
                                                                 afternoon was expected.
           In a totally pragmatic   way,   Bruce   stated that     There is no question  that  the  project  served
           the  black  person  aware  of   the   urgency   for   a  critically  important  purpose  for  the  black
           change  will  realistically  face   the   fact that   students. Most aspiring  professionals  leave  im-
           there  'are  not  enough  black  professionals   to   poverished areas as soon as they are  -financially
           solve the problems.  But  he  attempted  a  defini-   able to leave. Watts  is  no  exception.  The  SHP
           tion of what the  relationship  ought  to  be.  The   offered a way for  the  community  to  be  visible
           white  professional   has   to   provide   services   again to some of  the  younger,  more  aware  stu-
           against the  background  of  dealing  with  a  sub-   dent  professionals  who  hopefully  might  return
           culture on its own terms.  He  has  to  accept  the   once they have graduated.
           fact that he is  in  a  culture  partially  strange     In addition to changes in specific  individuals,
           to him, and that  he  is  going  to  have  to  work   there was the effect of pride  in  group  identity
           with the people  in  the  way  the  people  present   which captured  the  black  students  and  offered
           their  problems,  not  the  way  the   professional   them  a  chance  to  work  within  a  ghetto  com-
           predetermines it.                                     munity  in  a  cooperative  working  relationship.
             As  to  the  integrative  aspects  of  the  black   Al  Wilburn,  a  third-year  UCLA   medical   stu-
           power  movement  in  helping  to   strengthen   the   dent, who  was  one  of  the  student  fellows  in
           self-definition  and  self-determination  of  black   Watts  last  summer,  is  currently  involved   in
           people, Bruce stated:                                 the  faculty-student   committee   on   admissions
                  "The  black  students  saw  their  role        policies at the  UCLA  medical  school.  The  com-
                more or less  as  a  mission.  They  were        mittee is working  hard  to  increase  the  appli-
                involved and  sensitive  and  took  Watts        cants from  minority  group  students  and  there-
                on as their community."                          by to increase  the  number  of  black  and  brown
                                                                 students who are admitted.  As  a  result  of  the
           Bates  in  another  way  stated  that   the   black   work of this committee  there  has  been  a  sharp
           students  were   more   politically   sophisticated   increase  in  the  number  of  applications   this
           than the whites,  that  the  whites  really  didn't   year. UCLA  had  35  applications,  out  of  which
           understand the fact the  black  students  were  not   eight people qualified for admission,  as  against
           permitted to keep logs and  that  the  request  for   10 applicants last year.  USC  has  had  a  corre-
           them  was   interpreted   as   counterrevolutionary   sponding rise.
           by  the  black  community.  With  the   amount   of
           surveillance  and   police   interference,   anyone   Ventura County-Oxnard
           with a  pad  and  pencil  is  personna  non  grata,     Oxnard is the  center  of  a  rich  agricultural
           according to Bates.                                   area  in  Ventura  County,  about  forty   mi   es
             The  catalyst  in  the  Watts  project  was   the   north of Los  Angeles.  There  are  a  large  num-
           bull  sessions  held  every  Wednesday   with   Jim   her  of  poor  Mexican-American  families  in  the
           Bates and  the  students.  Bates  spoke  enthusias-   area,  conservative   land   owners   with   large

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                                  CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                 holdings, and  many  lower-middle  class  families        drones who  did  not  know  what,  where,
                                           'Oxnard is  sufficiently
                 from the Middle West.                                     or how to do much of anything."
                 distant from the  Los  Angeles  urban  complex  to
                                                                       But, as indicated  in  the  introduction  to  this
                 retain some of the  authenticity  of  old  Mexico.
                                                                       section,  the  contradiction  between   how   stu-
                 Parts of it are still struggling to remain  rural.
                                                                       dents perceive themselves  as  against  what  they
                   Seven  students,  two  medical,   two   nursing,
                                                                       learned  was  of  constant  interest  to  any  re-
                 one  dental,  one  clinical  psychology,  and  one
                                                                       porter.  Though  all  seven  students  in   Oxnard
                 social psychology, were  assigned  to  this  area-
                                                                       ieit  thwarted  and  anxious  the  whole   summer,
                 four in  Oxnard,  and  three  in  the  small  town
                                                                       they  report  sensitive  insights.  Slama   states
                 of Santa Paula, 9 miles to the east.  Their  goals
                                                                       of the high school students:
                 were:
                     1. To  aid  the  community  in  on-going   pro-          "We of the  SHP  were  originally  as-
                       grams-to  fill  community-perceived   needs.        signed  two   crash   kids.   Supposedly,
                                                                           these  two  high   school   pupils   were
                     2. To provide  students  with  educational  ex-       somewhat  interested  in   health-related
                       posure  to  the  problems  of  ghetto   com-        fields. My original two  counselors  were
                       munities.                                           girls; one wanted to be  a  teacher,  the
                     3. To  begin  an  alliance  between   students,       other a hairdresser.
                       health  professionals,  and  community  peo-          "The   spark   and   enthusiasm   which
                       ple to  improve  conditions  and  fill  gaps        these kids had was tremendous."
                       in community needs.
                                                                       The students were  perceptive  and  analytical  in
                 The  intent  of  the  Site  Development  Committee    centralizing  the  responsibility  for   services.
                 was  to allow for the greatest  latitude  and  de-    Claire  McCamman   a   nursing   student   working
                 cision making on the  part  of  the  students,  as    in Santa  Paula,  pinpointed  some  of  the  prob-
                 reflected in  their  description  of  their  aims,    lems and partial solutions:
                 written prior to  the  summer.  Though  there  was
                                                                             "No  health  center,  no  dental  care,
                 some  minimal  suggestion  of  suitable  projects,
                                                                           no  recreation   facilities.   There   is
                 the students still felt unanimous in  their  opin-
                                                                           no  documented  evidence  of   the   need
                 ion that they had  not  received  enough  guidance
                                                                                  The   Health    Department    uses
                 from the SHO Staff.
                                                                           the  lack  of  documentation  as  a  'cop
                   Robert  Slama,  a  medical  student   who   dis-
                                                                           out'.  The  SHP,   by   documenting   the
                 cussed  his  team's  problems  at  a  few  student
                                                                           need, would  provide  some  leverage  for
                 meetings, wrote:
                                                                           getting these  services.  A  major  prob-
                                had little to do  with  health             lem is terror  of  the  growers.  Politi-
                              part   of   my   disillusionment             cally, the  poor  Chicano  is  disenfran-
                             was  due  to  illusions  which  I             chised. The mayor of  Santa  Paula  is  a
                      had about what we would be doing.                    'brown-Anglo'  who  has  sold   out   his
                        "We  had  no   experience   ourselves;             people.  Unionism  seems  to  be  a  rea-
                                                                           sonable start  at  the  solution  of  the
                      as first-year  medical  or  dental  stu-
                                                                           migrant workers'problems."
                      dents, we were very much     in a  posi-
                      tion of having a lot to learn."
                                                                       Claire's  job  was  to  work  with  the  Community
                        "We  saw  a  community  that  had   as         Action  Agency  in  the   Summer   Youth   Program
                      little idea of what it should do  itself         to develop a Girls' Club. She and two  other  stu-
                      as a community, as we  had  of  what  we         dents, Cathy  Hunter  and  Alice  Krowitz,  taught
                      should  do  'ourselves  on  the  Student         classes  on  sex  education,  developed   informa-
                      Health Project.                                  tion  on  consumer  education,  publicized   their
                        ','Together, we made  up  a  group  of         classes, worked  on  health  education  with  high
                      idealistic,   enthusiastic   (sometimes)         school dropouts,  and  helped  the  La  Raza  Com-

                 40


                     CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
      mittee  for  Education,  a  group  committed  to  in-       two  community   workers   with   SHO,   to
      creasing   Mexican-American    college    admissions.       the  home  of  one  of  his  friends,   and
       The  reports  from  these  students   all   indicate       we  discussed  our  ideas  with   him.   We
      the Yucaipa o rientation   would   have   been    far       encouraged  him  to  have  a  house   meet-
      more  useful  if  students  could  have   been   cued       ing  and  invite  sortie  of  his   friends
      into  the  workings   of   the   communities   before       over to  discuss  the  ideas  we  had  pre-
      they  went  out.  However,  they  all  felt   Ventura       sented  to  him.  Thus,  we  arranged   our
      County  is  an  excellent  place  for  SHO  to   work       first  house  meeting  with  little  diffi-
      because  as   Bob   Montoya,   a   medical   student,       culty  and  proceeded  to  the   house   of
      stated:                                                     another   friend   to   try   for   another
            "It is isolated geographically and                    meeting."
          is small enough so that there is not a                                        DEBORAH  TARNOPOL.
          great big bureaucracy to face."                     Although  the  proposal  was  not  completed
      Deborah   Tarnopol,   social   psychology    student,   when the students left, enough enthusiasm was
      after  trying  in  vain  to  work  with  young  chil-   created f or the proposal that the work hope-
      dren  in  various  centers   and   nursery   schools,   fully continues.
      taught  reading  readiness  to   Head   Start   chil-          "The   next   day   I   met   with    John
      dren  in  Oxnard  with  two  NYC  youths.  The   lat-          and  he  was  in  great  spirits  and  re-
      ter,  under  Deboyah's  tutelage,  were  able   after          sponded   immediately   to   my    concern
      a  few  weeks  to  teach  the   children   themselves          about   replacements   for   Ricardo   and
      and  became  quite  involved  with  the  concepts  of          me. He  was  sure  of  himself  and  quite
      reading   readiness.   However,   Deborah   was   not          clear  about  his  plans   for   La   Raza
      entirely happy with the whole experience:                      Committee's  near   future.   His   strong
                                                                     feelings about  this  make  me  feel  that
             "The    next    day,    Wednesday,     the              e  understood  the  situation  much   bet-
            supervisor  of  the   Oxnard   Head   Start              ter. I felt that I  had  indeed  fulfilled
            observed    Armando    and    Lupe    doing              an honorable intention: to  leave,  or  to
            their  lessons  with  the  children.      I              help  leave  something   behind   in   Ox-
            think.   she   was   pleasantly   surprised              nard."
            both by  the  skill  of  my  two  kids  and                                   DFBORAH TARNOPOL.
            the  excited  participation  of  the  four-         Deborah  also  helped   a   Mexican-America-n   lady
            year-olds. She told  me  to  feel  free  to         with the written section  of  the  California  driv-
            train  any  interested  volunteers  to   do
            similar  things  in  the  classrooms.  This         er's  test,  and  ends   her   final   report   with
            sort  of  passive  cooperation  was   frus-         this:
            trating   because,   as   an   outsider   I                "So  I  said  goodbye   to   Oxnard   the
            couldn't  leave   behind   any   leadership              next day and  left  behind  Mrs.  T.  (with
            for  this  sort  of  Head  Start   program,              a  driver's  license),  John  and   Ricardo
            and  with   only   21/2   weeks   of   Head              (with   La   Raza   Committee).    I    had
            Start left,  the  time  for  training  vol-              learned  much  about  techniques  of   com-
            unteers had long passed."                                munity organizing."
        Deborah   also   became   involved    in    helping a    Again   and   again,   students    reflected    their
        committee  of  La   Raza   write   a   proposal   for    strong  convictions  that  they  "did  nothing,   but
        higher   education   for   Mexican-Americans.    They    learned  a  lot".  Richard  Fuentes,  a  dental  stu-
        encouraged  local  residents  to  have  house   meet-    dentwho  tried  hard  to  involve   Oxnard   dentists
        ings to discuss ideas  for  establishing  a  sebolar-    in private .practice  in  a  volunteer  dental   pro-
        ship fund.                                               gram, reported:
                "I   went   with   John,   one   of    the@              "I do not believe we helped the com-
                                                                                                                   41


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                 munity.   Some   individuals    may    have                 explained  the  others  were  away   on   an
                 been  personally  affe@d  by  us,  but   we                 emergency    meeting    in    @     Angeles,
                 did not get rid  of  any  problems  or  im-                 and  heard  what  they  had  to  say.   Then
                 prove their ability to  get  health  treat-                 I  brought  up  my  own  project   and   got
                 ment."                                                      a  slow  response  at  first.  They   didn't
                                                                             trust  me.  However,   after   10   minutes,
             However, he goes on to say:                                     we   really   got    going-ideas,    experi-
                   "I  have  made   up   my   mind   to   do                 ence,  suggestions,  offers  to  help   per-
                 the  best  in   order   to   get   Mexican-                 sonally, and  lots  of  literature.  It  was
                 Americans   and   Negroes    into    dental                 a valuable and productive meeting.
                 schools,  either  by  giving  them   infor-        Second week of summer:
                 mation,  or  later  monetary   help.   This
                 year   my   school   accepted   two   Negro                 "Visited    homes    today.    Walked    for
                 students,  the  first  time  a  Negro   has                 hours   and   hours   tracking   down    un-
                 gone there in over 20 years."                               wed   mothers.   One   moved,   three   were
             Robert   Montoya   worked    with    community    peo-          out,  saw   two   others.   Of   the   girls
             ple  in  the  Colonia   area   and   helped   form   a          I  saw,  the  fi-rst,  Betty,  was  in  some
             Brown Beret Chapter.                                            kind of  a  stupor.  I  got  the  impression
                 The three students  in  Santa.  Paula  decided  to          she  was  doing  nothing  with  herself   or
             form    a    Young    Mother's    Club    for    unwed          her life.
             mothers.  One  of  the  problems   was   finding   the  Third week:
             young   women   without   imposing   a   feeling    of          "My   project's    coming    along    really
             being special or different.                                     well.   Contacted    four    girls    today-
                 The  Club  was  started  with   a   small   number
             Of  young  mothers,  and  classes  were  held  on  sex          all  coming.  With  some   kids,   the   de-
                                                                             spair  is  so  obvious,  and   with   others
             education,  first  aid,  and  discussions  about  gen-          you  can  see  the  strength.  It's  beauti-
             eral   problems.   The   team   provided   transporta-          ful.  I  have  great  hope  that  the   kids
             tion  many  times  for  the  girls  and  visited  them                                        '   I    wants
             constantly   to   encourage   them   to   attend   the          will help each other. One gir
                                                                             to  go  back   to   high   school,   another
             club.                                                           wants  work.  I  sent   the   NYC   director
                 The  combination  of  a  profound  sense  of   em-          out there to  talk  to  her  (Alice).  Alice
             pathy,   love,   anxiety,   and    loneliness    which          is 17, lives in  a  labor  caxnp  at  Sespe.
             comes   through    in    the    following    excerpts,          Ten  little  kids   hanging   a-round,   all
             makes  one   feel   Holden   Caulfield's   ghost   has          dirty,   'ragged   and    nonsmiling.    One
             risen again. This  time  it  is  Abby  Krowitz,  older
                                                                             thing  about  poverty  kids  that  rips   me
             and  wiser,   female   clinical   psychology   student          up  is  the  vacant  eyes,  and  the  don't-
             from New York.                                                  hit-me look-the fear.
                     "Marty   McKeever,   of    Family    Coun-        Fourth week:
                   seling in 'Ventura,   is    so    great-alive
                   young,  interested,  and  the  possessor  Of               "When   interest   in    talking    lagged,
                   a   rare   working   combination   of   mind              I  switched  to  the  club  as  a   purpose-
                   and  feelings.  I  think  we  shall   become              f ul get-together. I  told  them  no  matter
                   good  friends.   Marty   delivered   me   to              how small it was,  it  was  their  club  and
                   the   Health   Department   where   I    met              I  had  done  my  share  and  they  had   to
                   two  public   health   nurses.   Man,   they              do   theirs.   They   looked    dumbfounded.
                   were   prepared   for   a   whole    meeting              I  offered  several  alternatives,  and.said
                   and   were   so    disappointed    that    I              I  couldn't  believe  three  girls  had   no
                   was alone. I  really  was  scared  at  first              ideas  about  doing  things.   Betty   spoke
                   and  gave   a   15-minute   talk   on   SHP,              up  and  said  one  meeting  a  week  wasn't

                 42


                    CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
          enough. I said  fine,  when  do  you  want         Two  students,  one   in   medicine   and   one   in
          a   second   one?   They   said   Thursday       nursing,  were  assigned  to  the  project   directors
          would be good and  it  was  settled.  Then       of   the   existing   health   team    to    ascertain
          another  girl  suggested  a  beach   party       whether  private   medicine   in   that   area   could
          and I  said  it  was  O.K.  with  me,  but       provide good medical care for the indigent.
          they had to  plan  everything.  They  took         The   nursing   student,   Martha   Jackson,   lived
          me up on it, and  we  are  having.it  Sat-       with   Mexican-American   families   for   the   dura-
          urday. They also  said  they  would  bring       tion of the project, working in  the  fields,  eating,
          any  unwed  mothers  to  the  next   meet-       sleeping,   laughing,   and   participating   in   the
          ing  and  their  other  friends   to   the       daily  life  problems.   She   observed   and   talked
          beIach  party.  I  was  very   happy   about     to  people  about  their  health  problems.  She  then
          this meeting.                                    related her findings  to  the  doctors  in  the  rural
           "There    were    times    during     the       health  project.   She   describes   her   experience:
          meeting  when   the   group   was   really              "My   job    was    to    'educate    the
          out of control. I was  so  personally  ov-            doctors'  to  the  Mexican  way  of   life.
          erwhelmed  by  the   stories   they   told            None  of  them  in  the  group  are   Mexi-
          that  I  couldn't  direct   it   anywhere.            can,  yet  a  large  percentage  of   their
          Also,  once  the  problems  really   began            patients   are.   This   has   posed   some
          to   become   real,   everyone   got   de-            problems  in  rendering   effective   medi-
          pressed,  and  although   I   focused   on            cal  care.  Aides  from  the  target   area
          the  positive,  the  negative   and   hell            are used as interpreters.  I  was  also  to
          that they  had  each  been  living  became            identify   health   problems   and    other
          too  much.  I  wanted  to  break   through            problems  that  might  be  indirectly   re-
          the defensive laughter  and  did  so,  but            lated to health,  such  as  housing  condi-
          when I  did,  it  was  a  hard  trip  back            tions,   working   conditions,   and    the
          from  the  dumps.  I  can  see  now   that            like."
          this   approach,   maybe    groovy    with
          psychological   problems,    just    won!t          At  the  end  of  the   summer   Martha   submitted
          make it when it's  a  real  baby,  a  real         lengthy reports  to  her  preceptor,  Stuart  Allan.
          marriage that fell  through,  and  a  real         She  felt  the   summer   had   been   very   worth-
          mess that they have to live with."                 while, but was not  sure  to  what  extent  she  had
                                                             affected the doctors'  attitudes.  But  we  want  to
      Part of Abby's report is  appended  at  the  end  of   share a letter she wrote  to  the  project's  direc-
      this section. In spite of its  length  we  took  the   tor at the end of  the  summer  in  lieu  of  a  re-
      liberty to include it for those  who  might  be  in-   port.  We  think  it  has  the  special  flavor   of
      terested. If moneys  for  this  project  could  ever   someone who has  lived  poor.  Her  sense  of  real-
      be  justified  by  the  degree  of  personal  growth   ity,  her  refusal  to  romanticize  the  poor,  her
      and education  added,  this  kind  of  searching  is   recommendations   for   the    future,    and    her
      in itself  perhaps  one  of  the  best  examples  Of   doubts  about  her  own  effectiveness  in  changing
      self-discovery,  and  who   knows   what   kind   of   attitudes of physicians, gives  her  letter  a  kind
      commitment, and to what, may result?                   of  Pinter-esque  quality.  Therefore,  we   include
                                                             it at the end  of  this  section,  following  AbbY's
      South Monterey County-Rural Health       Project       report.
                                                               Jerry  Ginsburg  made   a   study   of   how   the
          The rural health project  in  King  City,  south   rural  health  project  served  the  needs  of   the
      Monterey   County,   offers   comprehensive   health   community,  and  found  to  his  satisfaction   that
      services, social aid, education  and  retraining  to   they did indeed.
      approximately   10,000   indigent   people,   mostly
      Mexican-American  farm   workers,   in   King   City          "We have proved that local initia-
      and its surrounding areas.                                  tive  and  autonomy  can  develop  a
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                            CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                good  working  plan  that   provides   good             cess  *  *  *  if   the   programs   which
                services.                                               we initiated  are  continued  in  our  ab-
                  "The  rural  health  project   has   also             sence. This was my  joy  in  selection  by
                proven that  first-class,  readily  access-             the  KCCAO  of   Clarence   Gutierrez   as
                ible  medical  care  with  proper   facili-             a grassroots worker. It is  felt  he  will
                ties,   and   located   where   they    are             be  well  able  to   carry   on   programs
                needed,  can  give  the  indigent  a   per-             that have already been initiated."
                sonalized,     humanized,      nondiscrimi-          Robert also initiated a  health  screening  clinic,
                natory  or   segregatory   treatment   com-          and one day  was  set  aside  for  examinations  of
                pletely  different  f  rom  the  one   they          the  Indians  with  participation  from   volunteer
                have traditionally received."                        doctors from Fresno:
               Kings County Community Action   Organization               "The  clinic  ran  both   smoothly   and
               KCCAO  is  the  delegate  agency   for   the   OEO       effectively  through  the  afternoon   and
               programs  directed  toward  the  estimated  25,000       evening.  The   turnout   was   surprising
               low-income  people  in  Kings  County.  The  popu-       in  the  fact  that  over   three-quarters
               lation  increases  by  approximately  10,000  dur-       of  the   reservation's   population   got
               ing  the  summer  agricultural  season  with   the       complete   physical   and   eye   examina-
               influx of migratory workers.                             tions."
               The  three  medical  and   one   nursing   student    Another   student,   Michael   Witte,    associated
               associated  with  the  Community   Action   Agency    himself  with  the  Kettlemen  City  Child   Devel-
               were  fortunate  because,  either  by  design,  or    opment  Center,  and  after  defining  the   health
               the omission of  one,  they  encouraged  the  stu-    care  and  educational  problems  among  the   farm
               dents to define their own projects,  and  in  this    laborers, reduced his interests  to  nutrition  and
               instance some interesting  things  happened.          transportation.  Very  quickly  he  made   contacts
               Robert  Jones,   who   worked   with   the   Tache    with a drug company  in  an  attempt  to  obtain  a
               Indians on  the  Santa  Rosa  Indian  Reservation,    demonstration  supply  of  vitamins  to  distribute
               defined  existing  health  problems   and   worked    to the children.  The  local  public  health  nurse
               toward the establishment  of  a  recreational  fa-    cooperated in their distribution.
               cility for  the  Indians.  Although  the  facility     In  the  area  of  transportation,  he  hoped   to
               was not  completed  by  the  end  of  the  summer,    obtain funds to establish a small  scale  bus  sys-
               Robert  was  assured  that  the  work   would   be    tem to transport  people  to  the  various  clinics
               continued by the Community Action Agency.             operated   by   the   Public   Health   Department.
               Robert  worked  with  the   Tribal   Council   and    Again,  as  with  Robert   Jones,   Michael   Witte
               was instrumental  in  bringing  together  and  ob-    stated:
               taining assistance from  many  institutions,  both
               public and  private.  The  local  Naval  Air  Sta-          "I  will  consider   this   summer   suc-
               tion,  Standard  Oil  Co.,  and   local   Catholic         cessf  ul  only  when  we  can  create   a
               Church,  and  the  U.S.  Government  Soil  Conser-         viable  proposal  and  obtain  a   sponsor
               vation  Service  all  cooperated.   Grounds   were         for  it.  There  must   be.   someone   to
               razed by  the  Standard  Oil  for  the  recreation         carry this  project  on  once  the  summer
                                                                          has  elapsed  *  *  *  Perhaps  an  agency
               facility  and  the  Catholic  Church  was  helping         such  as  CCAA,   who   seems   enthusias-
               in making-plans  for  it.  Robert  recognized  the         tic."
               problem of half-finished  projects  and  was  par-
               ticularly  gratified  that  the  community  worker    Robert Jones, in his lament to the Indian who
               employed to carry  on  the  project  was  a  resi-    is locked in:
               dent  of  the  Santa  Rosa  Indian  Community  and           "To  children  poverty   is   the   dark
               niarried to a Tache Indian woman.
                                                                          rider  encompassing  them   before   their
                     "This summer will only be a suc-                     senses  can  acknowledge   its   presence.

               44


                   CALIFORNIA              STUDENT HEALTH PROJECT SUMMER 1968
        It  springs   from   everyday   life   and
        yields  acceptance.  For  with  the  chil-
        dren of the  poor,  there  is  -no  aware-
        ness  of  another  standard  until   their
        environment  has  made  them   a   captive
        of their own."
     Tulare  County  Community   Action   Agency-Visalia
      Two  nurses  -worked  in   the   Earlimart   Child
     Care Center,  which  had  opened  4  -,veeks  prior
     to their arrival.  This  was  part  of  the  Tulare
     County   Community   Action   Agency.   They    set
     up  a  dental  health  program  for  the   children
     and  held  first  aid  classes.   They   instructed
     teachers  how  to  be  aware  of  and  treat   such
     things  as  impetigo,  ringworm,  and  minor  abra-
     sions so the teachers could  continue  this  health
     program after the nurses had left.
           "The  assistant   teachers   were   able
         to  carry  out  these   procedures   quite
         well.  They  acquainted  themselves   with
         the first aid cabinet and all of the  sup-
         plies on hand."
                                    BONNIE     ZAGON.
     The nursing  students  also  arranged  for  an  im-
     munization  clinic  to   administer   DPT,   polio,
     measles shots, and tuberculin  tests  to  all  pre-
     school  children.  They  maintained  health  record
     files on each  child  so  that  the  public  health
     nurse serving the  area  would  not  have  to  -re-
     gather the information.
        In spite  of  her  own  personal  satisfactions,
     Bonnie  Zago-n's  final   report   cautions   about
     loosely defi-ned summer projects:                           time  have   been   sensitized   to   many
            "This  would   not   be   a   good   site            problems  that  I  was  unaware   of   be-
           placement  for   an   SHO   student   next            fore   entering   the    community.    The
           summer @' * *  I  feel  that  in  deciding            health  care  I  have   given   has   been
           on  future   site   placements,   emphasis            taught  to   community   people   and   is
           should  be  placed  on  plugging  in  stu-            most  definitely  an  on-going   project."
           dents to very structured projects."               Fresno County-The Fresno Project
      She again poses the same paradox of the bene-            The  Fresno  project  was  probably  rated   high-
      fits of negative experience to personal growth:        est  in  lowest  rewards  to  students,  preceptors,
             "I  have   spent   a   very   beneficial        and community.
           summer  in  working  with  a  rural   com-          Though  one  member  of  the  student  staff   had
           munity  and  feel  certain  that  I   will        come  to  an  agreement  with  one  of   the   three
           continue to give service in this  type  of        preceptors,  apparently  there   were   many   fuzzy
           area.  I  have  served  and  at  the  same        areas never spelled  out.  These  fuzzy  areas  con-
                                                                                                               45


                               CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

              cerned the actual  tasks,  the  methods  of  inter-         was   communication,    or    an    almost
              weaving students in  staff  projects  and  defining         total lack of it. I believe that this  ex-
              the limits of  summer  expectations.  The  lack  of         isted   with    the    Community    Health
              job specificity and content  of  tasks  were  obvi-         Planning  Project,  the   Student   Health
              ously a  detriment  to  the  establishment  of  any         Organization, as well  as  with  the  Stu-
              good relationships.                                         dents  themselves.  Through  this,   unex-
                The  project  consisted   of   four   preceptors;         pressed    complaints,     misinformation,
              three  of  these  connected  with   the   city   of         and  personality  conflicts  were  allowed
              Fresno  Community  Health   Planning   Project   in         to build  up  to  a  point  where  no  one
              the  Fresno  General  Hospital,  a  part   of   the         person  trusted  the  other,  and  resolu-
              model  cities  plan;  and  one  preceptor  in   the         tion  of  problems  was  not   attempted."
              North  Avenue   Community   Center,   a   neighbor-                                      FAE THOMAS.
              hood  settlement  house  fulfilling  the  needs  of
              black residents.                                         However, Miss Thomas ends her report on a
                Nine  students  were  assigned  to  the   general   more optimistic note:
              area.  They  were  representatives  of  almost  all           "Despite  the  problems   this   summer,
              of the  health  professions:  medicine,  dentistry,         I feel  that  I  have  learned  a  tremen-
              social  work,  health  education,  public   health,         dous  amount.  One  of  the  major  things
              and  nursing.  There  were  also  indigenous   com-         is  the  various  blocks  that  exist   to
              munity workers attached  to  the  projects  by  the         giving    comprehensive    health    care.
              preceptor.                                                  This  will  affect  me  when  I  am  work-
                The  only  value  at  this  point  in  describing         ing as  a  public  health  nurse.  I  have
              the ineptness of the  project  end  the  uncomfort-         also  had  some  practical  experience  in
              able  personal  relationships  which  resulted,  is         innovation    (although     unsuccessful).
              because it indicates again that  noble  intent  and         I hope that  I  can  learn  from  my  mis-
              high   spirits   cannot   forever   make   up   for         takes' My   understanding   of   some   of
              lack of sequential systematic steps  in  the  plan-         the  problems  of  the  poor  and   minor-
              ning process.                                               ity groups  has  greatly  increased  since
                The  students  were  to  explore  new   and   ex-         I  have  had  no  previous   exposure   to
              panded   methods   of    providing    comprehensive         this."
              care by taking  a  look  at,  the  family  medicine      Another student vividly describes the diffi-
              training  program,  a  neighborhood   health   cen-   culties of the project:
              ter,  and.  a  variety  of  training  programs  for
              health workers in the  allied  health  professions.           "My  placement   was   with   the   Com-
                Contrary  to  every  purpose  of  SHP,  the  pre-         munity   Health   Planning   project    of
              ceptors  attempted  to   reenact   that   situation         the   Fresno   General   Hospital.    This
              which  causes  some  of  the  most  serious   prob-         was   a   most   unfortunate    placement.
              lems  in  health  care  institutions-the  secondary         The  SHP  members   worked   in   a   team
              role of the nurse was  again  reinforced  by  plac-         approach  with  other   members   of   the
              ing  the  student  physician.at  the  head  of  the         planning  project  who  were  given   mis-
              student team. A  student  -nurse  comments  on  the         informed  ideas   of   the   SHP   workers
              problems of the project:                                    before  we  arrived.  We  were   to   have
                     "Thus  far  I  have  attempted  to   de-             led the teams, been  full  of  many  ideas
                   scribe  only  what  we  did  this  summer.             for  Fresno  (which  we   were   to   have
                   Obviously, this does not  sound  like  too             discussed  at  Yucaipa),  and   have   had
                   much. I should  now  like  to  attempt  to             the  power  to  fire   other   team   mem-
                   describe  what  I   feel   happened   this             bers!   Unfortunately,   none   of   these
                   summer and why.                                        prejudices  was  brought  out   into   the
                     The   one   major   block   to   success             open until the  sixth  week  of  the  sum-

              46


                   CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
         mer. It was at  this  time  that  project          Kem County-Bakersfield'
         workers  from   both   SHO   and   Fresno          Bakerfield is  situated  in  one  of  the  largest
         began to express  their  dissatisfaction.          cotton producing areas in  the  world.  It  is  in
         Our chief complaint  was  that  our  pre-          Kern County, a  county  oozing  with  the  earth's
         ceptor  had  not  strictly  defined   the          rich  bounty,  cultivated  and  tended  by   thou-
         goals  of   the   Fresno   project,   had          sands of Mexican  farmworkers.  It  stretches  for
         claimed  that  he  could  easily   obtain          miles of green, black,  purple,  and  orange.  The
         grants and  bend  the  ears  of  influen-          colors  sometimes  obscure   the   fertile   black
         tial people,  and  that  he  communicated
         exclusively   with   SHP   members,   ig-          earth's cotton, grapes, citrus, artichokes,  toma-
         noring  most  of   the   Fresno   workers          toes, and melons. Bakersfield is insular. It  sits
         *  *  *  It'  was  decided  by  the   SHP          comfortably in the vast San Joaquin Valley.
         members at  this  time  (end  of  August)          Five students,  two  in  medicine,  two  in  nurs-
         to  continue  their  work  in  their  re-          ing,  and  one  behavioral  scientist,  were   as-
         spective  communities   with   the   com-          signed to the  area  with  the  Economic  Opportu-
         munity  contacts  they  had   made,   but          nity  Cooperation  as  their  base  of  operation.
         to  disaffiliate  themselves   from   the          They  were  assigned  to   two   preceptors,   the
         Community   Health   Planning    Project.          rural area program supervisor,  and  the  director
         I felt personally relieved  by  this  be-          of the Multiservice Center.
         cause I thought  that  I  could  do  more          The  medical  students  worked   mainly   in   the
         good for Del Rey working f  or  Sal  Gon-          town  of  Wasco  near  Bakersfield-.  By   working
         zalez  than  by  bullshitting   my   time          through  an  existing  semiactive  Women's   Club,
         away with the Fresno project."                     they were able to  stimulate  enough  interest  to
                                MIKE DucHOWNY.              form a  Welfare  Rights  Organization,  which  be-
                                                            came  affiliated   with   the   National   Welfare
      Duchowny concludes:                                   Rights  Organization.  The  students   hoped   the
                                                            group would  be  able  to  maintain  itself  after
           "I  cannot  yet  say  how   this   sum-          their departure. In order to offer greater  assur-
         mer  will   influence   my   future   ca-          ance of that, the  students  attempted  to  enlist
         reer. I do know that  the  experiences  I          commitments  from  local  residents  to   continue
         had  this  summer  form  a  part  of   me          their support  of  the  Welfare  Rights  Organiza-
         that  cannot  express   themselves   very          tion.
         well on paper. I  am  returning  to  med-           One  of  the  medical  students   established   a
         ical  school  with  many  new  ideas  and          free medical clinic in the Wasco  labor  camp.  it
         with my old ideals reinforced."                    opened   every   Monday   and   Thursday   evening
                                                            the latter part of the  summer.  One  out  of  the
         In summary,  the  Fresno  projects,  which  are    six physicians in Wasco volunteered  his  time  to
      only briefly touched here,  suffered   from    the    the clinic.
      same  deprivation  as  other  projects-a  lack  of     One  of  the   nursing   students,   a   Mexican-
      definition. But it is  interesting  to  note  that    American  herself,  became  involved  in   promot-
      some of the  students  found  they  were  able  to    inga program of interest  in  their  own  heritage
      use their  skills  at  the  North  Avenue  Commun-    among   the   Mexican-Americans.   She    arranged
      ity Center in  developinga  Girl's  Club,  whereas    for  films  and  speakers  and  trained  two   NYC
      ,some remained at the  hospital  and  aided  in  a    girls to involve  people  from  the  community  in
      survey  on  transportation  needs.  A   few   held    the project.
      meetings  with  the  Kings  County  group  on  the
      Possibility of a county-wide  transportation  sys-    San Francisco  County
      tem to public health clinics. What is  pointed  up      In San Francisco,  six  students  from  the  San
      here is the  amount  of  innovation  that  charac-    Francisco  Medical  Center  operated   a   program
      terizes some of the student groups.                   in conjunction with the  Office  of  the  Dean  to
                                                                                                             47


                                CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                enable  economically   disadvantaged   high   school         Other  difficulties  resulted  from   the   pro
                students  to  gain   employment   in   health   care         gram    (SHP-NYC)    being    primarily     stu
                agencies.  Fifty  teenagers  were  placed  in  vari-         dent-administered.    The     Medical     Cente
                ous  hospitals,  including  the  Veterans'  Adminis-         SHP   students   were   frequently    unfamilia
                tration  and   San   Francisco   General   Hospital.         with  campus  policy  and   how   the   adminis
                The  teenagers  worked  26  hours   per   week   for         trators   operate.   This   inadequate    commu
                10  weeks  and  were   paid   from   the   Neighbor-         nication    caused     misunderstanding     an(
                hood  Youth  Corp's  funds.  The   work   experience         delays.
                was  supplemented  with   educational   and   social      However,  in  spite  of  the  problems   most   o:
                activities such as a  film  on  childbirth,  a  drug   the NYC  students  felt  very  positive  a@out  theii
                information  program,   a   film   on   former   SHP   experience.  In  a   questionnaire   distributed   at
                summer  projects,  a  meeting  with  black  students
                                                                       the  end  of  the  summer,  they  responded  well  t(
                and  medical  students  devoted  to   minority   re-
                                                                       their  jobs  and  supervisors.  A  number  of   there
                cruitment  and  admissions  policies  in   co   eges
                                                                       asked  to  remain  during  the  fall.  Since  funding
                and universities and  a  picnic  and  a  dance.
                                p                                      for the  NYC  program  was  severely  cut,  this  wa,
                       "Throughout   the   program   we   tried        not possible for  all  who  wished  it,  but  several
                      to   make   sure   the   students    were        have   been   absorbed.   Many    department    heads
                      learning  from  their   jobs.   and   not        were  very  enthusiastic  about  the  potential   and
                      spending all their time  on  routine  du-        ability  of  the  NYC  groupand  specifically   asked
                      ties.  Through  the  use  of   counselors        that the same student  be  retained  on  the  job  in
                      and  small  group  discussions,  we   en-        the fall.
                      couraged  them  to  discuss  their   jobs           The  SHP  students  felt  this  was  certainly  an
                      and  to  indicate  when  they  were  dis-        important  step  in  opening   the   Medical   Center
                      satisfied."                                      to employees in new careers.
                  Following  are  some  of  the  problems  the   San   Imperial County-Imperlal Valley Project
                Francisco project encountered:                            Imperial  Valley  is  a  large  agricultural  area
                  1.  Although  the  medical  students  had  antici-   in  Imperial  County   near   the   Mexican   border.
                      pated  hiring  students   interested   primar-   There  is   a   large   Mexican-American   population
                      ily in  the  health  sciences,  and  had  been   with   a    small    Negro    population    scattered
                      -assured  by  the  Unified   School   District   throughout the Valley.
                      that  the  students  would  be  screened  with      The   previous   summer,   SHP   had   a   project
                      this in  mind,  the  screening  was  not  dom-   operating out of  El  Centro,  which  is  located  in
                      pleted,  and  they  were  merely  assigned   a   the  rich  Imperial  Valley.   The   students   docu-
                      randomly  chosen  group   of   50   NYC   stu-   mented the need  for  a  dental  clinic  for  low-in-
                      dents.                                           come  children  and  had  laid  the  foundations  for
                                                                       the  location  and  personnel.  The   Imperial   Val-
                  2.  The  many  delays   and   confusion   in   the   ley  Community  Dental  Clinic  had  sent  a   letter
                      paying of salaries:
                                                                       in  October'of  1967  to  the  Imperial  County  Den-
                        "The  students   never   knew   when   their
                                                                       tal  Association,  reiterating  the  need   for   the
                      checks   were    coming    and    consequently
                      felt most  insecure  about  the  entire  situ-   dental  clinic  and  expressing  their  interest   in
                      ation."                                          participating.
                                                                          The   Site   Development    Committee    of    SHO
                  3.  Lack of  preparation  of  supervisors  in  the   felt that with such  interest  on  the  part  of  the
                      departments.   The   supervisors    did    not   local  dentists,  and  the   groundwork   that,   was
                      know  what   was   expected   of   them,   nor   done  by  students  the  year  before,  this  project
                      were   they   given   sufficient   orientation   could  be  carried  to  a  successful  conclusion  in
                      about  the  NYC  students  or  the  objectives   1968.
                      of   the   program   which   involved   'them.      Three  students,  one  from  medicine,  one   den-

                48


                       CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
      tal  hygienist,  and  one   occul3,ational   therapist    The Law Projects
      were   assigned   to    the    Economic    Opportunity
      Corporation  in  El  Centro.  The  director  of   that                        Background
      agency was their preceptor.                                 The   law   projects   were    exceptionally    well
        The  students  submitted  a   joint   final   report    summarized  by  Steve   Bingham,   the   law   coordi-
      in  which  no  mention  was  made  of   previous   ar-    'nator,  and  therefore,  his  report  is   reproduced
      rangements   for   the   dental   clinic.   They   de-    here in toto. It follows the  discussion  of  the  re-
      scribed  existing  conditions  of   poverty   in   the    lationships  between  the   law   and   medical   stu-
      Valley, of local citizens' groups,  of  the  possibil-    dents.
      ity of future  projects  with  these  groups,  and  of      As  to  be  expected,  feelings  about  the  contri-
      "waiting to be given things to do."                       butions  of  the  law  students  differ.  The  faculty
             "We   did    not    accomplish    anything.        director,  when  asked  about  the  role  of  the  law
           What   we   did   find   was    a    movement        students, stated:
           which  can   show   students   how   a   com-               14I think   the    law    students    were
           munity  can   help   itself.   This   was   a             on  o  a  good  thing,   they   might   have
           major find.                                               done  well  for  themselves,  but  I   don't
             "The   trouble   was   there   was   little             think  they  worked.  well  with  the   med-
           we    could    contribute.    Perhaps    this             ical  students.  In  large  part,  they  ig-
           was   because   of   our    situation,    but             nored   health   science   students.    From
           more  likely  it  can  be  remedied  by  giv-             the  first  appearance  of  the   law   Stu-
           ing   the   community   several   months   in             dents  on  the  scene,  they  were  destruc-
           which  to  decide  how  students   can   best             tive.   They   made   a   contribution    to
           add to their overall plan."                               their  thing,   not   the   Student   Health
        The three end their report:                                  Project, which  is  to  say  let  them  find
                                                                     their own funds."
             "Finally  we  can   say   that   the   sum-
           mer   was   a   vital   experience   in   our          On  the  other  hand,  Chuck  Gardinier,   a   well-
                              f health                          accepted  community  organizer   in   the   San   Joa-
           understanding o             .  problems,   in
           the   structure   of   the   functioning   of        quin  Valley,  whole   heart6dly   approved   of   the
           this  country,   in   ourselves.   The   sum-        law   student   project.   When   -asked   "What   was
           mer   was    like    intensive    sensitivity        the   most   important   thing   the   law    students
           training,   self-analysis,   people    watch-        did?" Gardinier tells  it  from  his  point  of  view:
           ing,  and  group  process.  It  is  a   major               "The   most    important    service    was
           experience  to  see  a   woman   crying   be-             taking  cases  to  court   and   they   beat
           cause  she  cannot  get   money   from   wel-             four   of   them   in   jury   trials.   And
           fare   because   her   daughter    needs    a             they   had   a   licensed   attorney   right
           special diet; it  is  frightening  to  see  a             here. They  did  a  lot  of  work  with  ju-
           county   (poor   farm)   hospital   run    by             venile  hearings  and  set  up  an  OR   (On
           frightened    and/or     sadistic     doctors             their     Own     Recognizance)      Program
           who  pride   themselves   on   the   cheapest             for  prisoners.  Those  are  in  just  legal
           care  in  the  state;  it  is  horrifying  to             terms.  The  other  service  they   provided
           see    polio    victims     come     crawling             was   being    in    the    community    and
           across  the  border  when   vaccine   is   15             available   twenty-four   hours    a    day-
           cents.                                                    they  related  very  well  with   the   guys
              "Perhaps   we   learned   something   this             from   the   barrio-the   law   center   be-
           summer."                                                  came  a  place  for  guys  to  drop  in  and
                                                                     rap.tt
                                     BARRY RAND
                                     DALE KAwAGoYE                 Gardinier explained why he felt the law stu-
                                      SALLY WESTRICK.           dents were able to develop that re a lionship:

                                                                                                                    49


                                 CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                        "They   were   here   earlier-a   couple          To strengthen  the  convictions  of  some  toward
                      of  weeks.  Peter  (Haberfeld)  had   been        a career of social action,  they  indulged  in  ex-
                      making  continual  contacts  for   several        coriating  lectures,  challenged  the  students  to
                      months   and   already   was    acquainted        shape up and reject their flaccid  political  Stan-
                      with  the  guys,  so  when   the   project        dards. In  loosing  "their  cool"  they  also  lost
                      started, they already knew Peter."                their  humility.  They  arrogated   to   themselves
                    Apparently  from   the   community's   point   of   the authority to  set  moral  standards  of  behav-
                  view, the law  students  were  effective,  and  our   ior for all. At Yucaipa  they  almost  appeared  to
                                                                        set  up  a  Kangaroo  Court,  where   people   were
                  observations   and   the   reports   which   follow
                                                                        judged  guilty  or  innocent  by  their   knowledge
                                             s out.  Their  realistic
                  would certainly bear thi                              of the political process. To their credit, some  of
                  appraisal of the  productive  use  of  their  time,   the  medical  students  addressed  their  attention
                  their ability to  face  limitations  in  their  own   to their own interests and skills. The  resolve  of
                  skills, and their decision to confine  their  asso-   those  who  were  already   politically   sophisti-
                  ciations  to  on-going  community   based   Chicano   cated  was  strengthed   by   the   law   students.
                  organizations imposed functional as  well  as  geo-   There were  others  who  stood  apart  in  the  Yu-
                  graphical limits on them.  In  addition,  the  fact   caipa  countryside  hoping  to  be   rescued   from
                  that  law  students  were  expected  to  share  the
                  life style of  the  community  by  living,  working   their discomfort.
                                                                           A further explanation of     the  apparent   in-
                  and playing in it,  imparted  a  special  integrity   compatibility  might  be  found  in  the  different
                  to the project and  solidarity  to  the  group.  It
                                                                        kinds of personalities who      are  attracted   to
                  was   an   intense   personal    experience-Spartan   medicine  and   law.   Steve   Bingham,   the   law
                  at times-but one in  which  living  with  the  peo-
                  ple  and  sharing  their   frustrations   increased   coordinator, explained that  in  the  beginning  he
                  the possibility of being accepted by them.            did not see any  difference  between  the  students
                                                                        of law and medicine.  But  later  he  realized  how
                    But  their  relations  with  the  medicals   Stu-   self-selective the different professions are.
                  dents  left  much  to  be  desired.  Many  of   the           "Lawyers    are    argumentative    and
                  medical  students  echoed  the  faculty  director's         very  verbal.  Medical  students  have  a
                  statement. One  who  is  very  aware  of  the  con-         much    more    humanitarian    attitude-
                  scienceless society spoke for many  others  in  de-         in the positive  sense,  in  the  project
                  scribing his anger at the law students:                     sense-missionary.   The   law    students
                                                                              have more of a  political  way  of  deal-
                          "As  a  group,  they  were   more   de-
                                                                              ing  with  things.   Socially   concerned
                        structive  than  contributory.  I   think
                                                                              law students make  a  different  kind  of
                        they thought we  were  all  lost  in  our
                                                                              analysis  than  socially  concerned  med-
                        Ivory  Tower   and   didn't   know   what
                                                                              ical students. I think we  see  evil  mo-
                        was  happening  and   they   were   going             tivations  on  the  part  of  people   in
                        to be the ones  to  show  us  the  light.
                                                                              power  in  terms   of   what   they   do-
                        The  letter  they  read  to  us  in   the
                                                                              judge,    ranch,     legislator-conscious
                        wind-up  conference  about   being   emo-
                        tional  Mongoloids  and  being   entirely             design-we  tend,   as   political   human
                                                                              beings, to look at a  situation  and  an-
                        askew was  very  vitriolic  and  made  me
                                                                              alyze it in those terms, and  I  think  a
                                    ip
                        very angry.                                           medical student tends  more  to  look  at
                      To find an  explanation  of  what  happened  be-        the situation and    say  "it's  unfortu-
                                                                              nate that man has to live like  that  and
                   tween the two  groups  of  students  is  difficult.        what can I  do  to  make  that  situation
                   The law students  fell  ii"  the  trap  many  mili-
                   tants fall into, and it is that  confinement  which        better.
                   gives  them  comfort  but  robs   them   of   their    This is merely to emphasize that law and medi-
                   vision.                                                cine do operate out of a different set of inter-

                     50


                    CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
      ests  and  frames  of  reference,   although   both        the   participants   grew   tremendously,
      are involved in advocacy.                                  the  question   which   'remains   una-n-
       It  remains  for  interested   law   schools   and        swered  is  whether  the   projects   had
      medical  schools  to  work   out   projects   which        a beneficial effect on  the  communities,
      permit mutual  interests  to  become  better  inte-        or possibly a harmf ul effect. It was the
      grated.  After  the   summer   experience   Bingham        possibility of a  tension  between  these
      recommended  that  a  great  deal  of  pressure  be        two  objectives  which   was   constantly
      put on medical and  law  schools  to  get  them  to        raised last summer."
      incorporate    community    law    and    community         The  Law  Projects  by   Steve   Bingham
      health courses in the curriculum.
       Gary  Bellow,   attorney   and   preceptor,   for-     The   San   Joaquin   Valley    Legal-Medical    pro-
      merly  with  the  California  Rural  Legal  Assist-    ject  was  an  amalgam   of   individual   assignments
      ance  .  program  and  presently   with   the   USC    throughout  the  San  Joaquin  Valley.  It  is   easi-
      Western  Institute  for  Law  and  Poverty,  stated    est  to  explain  what  it  was  and   what   it   at-
      that  "most  of  the  law  students  learned   very    tempted  to  accomplish  by  discussing   each   loca-
      few of the insights  medical  students  could  have    tion  separately.  Preparatory   to   that,   however,
      given  them."  Bellow   suggested   that   supervi-    the  following   introductory   remarks   are   neces-
      sors who could themselves  relate  the  two  disci-    sary:
      plines would be part of  the  answer.  Bellow  felt
      that the law  students  suffered  as  much  as  the       1. The  overall  project  was  intended  to   place
      medical students from disorganized goals.                    law   students   and   medical   students   side
                                                                   by   side   in   widely   varied    experimental
             "There was  a  real  conflict  of  goals              programs,  all   hooked   in   to   "releva-nV',
           -whether  it  was   to   provide   service              "community-based",    and    "on-going"     Chi-
           for   as   many   people   as   could   be              cano      (Mexican-American)      organizations.
           reached  or  whether  it  was  to  produce              The    reasons    for     these     requirements
           change  or  whether  it  was  to  radical-                were:
           ize  the  students.  These  are  different
           concepts.  The   early   meetings   polar-               (a)    Summer    projects    cannot     succeed
                                                                         where  they  attempt  to  set   up   their
           ized  youths  depending  on   their   con-                    own   structure   goals,   programs,   and
           cept                                                                        t
               ,S.$,                                                     attempt      complete    them    in     10
       Peter  Haberfeld,  the  faculty   law   advisor   in              weeks.
       large  part  responsible  for  the  structure   of the       (b)   "Anglo"   urban-oriented   students   are
       law project, and the  leader  in  the  Visalia  pro-              incompetent  to  sally  forth   into   the
       ject, had  some  second  thoughts  about  the  early              world  of  the  poor  and  work   indepen-
       polarization  of  the  law  and  medical   students,              dently.
       but  in  a  letter  received  from  him  after   the          (c)  Because  of  a   well-founded   suspicion
       summer  he   evaluates   the   program   positively:              of  so  many   poverty   programs,   espe-
               "I  came  away  from   the   final   gath-                cially  federally   sponsored   ones,   we
             ering   with    satisfaction.    What    had                insisted  that  we   offer   our   limited
             seemed   to   be   complete   disorientation                skills   to   people   and   organizations
             had  finally  begun  to   crystallize.   The                which    enjoyed    wide-spread    commun-
             conflict  perhaps  blasted  people  into   a                ity  support  because  of  the  nature  of
             new  realm,   stripped   naked   of   former                what  they   were   doing.   The   initial
             cliches  and  grappling  for   a   new   un-                evaluations   were   based   on   extended
                                                                         discussions   with   recognized    commun-
             derstanding.   In   short,   I   came   away
             with a good  feeling,  but  little  specific                ity leaders throughout the Valley.
             analysis.                                                (d)  Our  decision  to  work  primarily  with
                "Though  there  is  little   doubt   that                chicanos  grew  out  of  a  feeling   that
                                                                                                                  51


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                    their    oppressed    condition    is    extreme a  credit  union.  A  couple  of  initial  meetings
                    and  also  a  hesitancy  to  try,  in   a   sum- were  held  during  the  summer.  in  addition   he
                    mer,   to   work    with    anglo    poor    who worked   with   a   chicano   community   organizer
                    would  be  initially   hostile.   In   addition, on  problems   of   working   conditions   in   the
                    virtually    every    organization    in     the fields. Because of the late harvest season  in  the
                    Valley  at  this  time  is   working   on   chi- northern  San  Joaquin  Valley,  it   proved   very
                    cano problems.                                 difficult to  operate  in  this  area  though  some
               2.   The   medical-legal   partnership    was    sue- meetings  were  held.  The  most  successful   out-
                                                                   growth of this effort  was  a  program  to  include
                  cessful  in  the  limited  areas  where   it   was farm  worker  legal  problems  and   solutions   in
                  attempted.  Because   of   a   general   lack   of the training  of  adult  education  persons,  work-
                  interest  in  what  we  wanted  to   do   by   the
                                                                   ing  for  the  Central  California  Action  Agency.
                  medical   students   at   the   orientation   con- Jack's  wife  taught  English  to  Portuguese  can-
                  ference,   we   took   only   those   few   (four) nery workers in Livingston.
                  who   shared   our    enthusiasm.    The    others
                  were  looking   more   for   clinic-type   experi- (Madera)-Semeon     Tsalbins     (medical      Stu-
                  ence.  It  is  interesting,  however,  that   jur- dent, Yale),  Ted  Lakey  (Davis,  law)  and  Leroy
                                                                   Miller   (Stanford,   law)   worked    under    Mac
                  ing  the  course  of  the   summer,   severai   oi Lopez  (a  local  community  worker  paid  by   our
                  the  separate   medical   student   projects   de- project).  This  team  was  given  much  assistance
                  veloped along the same lines as ours.            by  the  Madera  California  Rural  Legal   Assist-
               S. While  many   of   the   final   placements   dif- ance Office. Their emphasis was on  the  legal  vi-
                  f  ered  from  those   originally   planned,   the olations of farm labor  contractors,  who  are  re-
                  underlying    thinking    remained    the    same. quired  to  provide  toilets,  washing  facilities,
                  Our   reasons   for   choosing   different    pro- etc.,  which  the  grower  would  otherwise   prov-
                  ject  sites  were   varied   but   generally,   we ide  were  he  hiring  workers  directly.  A   very
                  felt  on  the  basis  of   further   study   after complete  'declaration  form'  was  prepared.   The
                  our  first  proposal   was   written,   that   the intent  was  to  document   violations   and   hope
                  criteria  in  No.  1   required   us   to   select that a few individuals would  be  willing  to  seek
                  other places.                                    legal help  from  C.R.L.A.  in  filing  complaints.
               The following projects were undertaken:             Due to  an  extreme  reluctance  to  sign  anything
                                                                   (fear of losing job, ete.), few  declarations  were
               (Merced)-Jack     Weisberg     (first-year      Boalt gotten initially. This led  to  setting  up  'house
               Hall). Jack initially assisted a budding        black meetings,'   small   informal   gatherings    where
               student  group  (some  high  school,   other   junior workers  could  get  together  and  discuss   their
               college)   who   were    attempting    to    organize problems.  This  is   a   technique   which   Cesar
               blacks  in  Merced  around  the   issue   of   police Chavez  has  used  extremely  effectively  in   his
               brutality.  This  issue  arose  following  a   police union  organizing  work.  The  students   spent   a
               invasion  of  a  black  dance,  resulting   in   many few  days  actually  in  the  fields  working,  and
               arrests.  Jack   and   several   law   students   at- then making  declarations  themselves  as  well  as
               tached  to  the  Merced  County.  Legal       Services meeting workers. In  the  future,  this  should  be
               office (two from Boalt  but  not  under our       pro- a major part  of  the  work.  By  the  end  of  the
               gram)  provided.what  legal  help  they could       as summer,  a  number  of  complaints  had  been   Med
               law  students.  Jack  found,   however, that       the with  the  Labor   Commissioner   in   Fresno   and
               student group was  too  new  to  really take       ad- the C.R.L.A. office may be able to use  the  infor-
               vantage of him,  and   the   black   -organizer   for mation gathered. This  group  got  off  to  a  very
               whom he was working had little time     to       work slow  start  and  suffered  some  lack  of   enthu-
               out  a  summer  program  for   him.   Therefore,   he siasm  because  they  did  not  live   where   they
               spent  part  of  the  summer  helping   a   community were working  and  thus  never  became  a  part  of
               group  in  South  Dos  Palos,  an  incredibly   poor, the chicano community.
               very  southern-looking  town  of  blacks,   to   form  (Del   Rey)-Sheldon   Sarfan   (Boalt),   worked

               52


                      CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
       with  Sal  Gonzalez,  a  highly   respected   organ-   without  all  the   stereotyped   attitudes   which
       izer  attempting  to  get  the  town  of   Del   Rey   most  poverty   legal   services   programs   have.
       incorporated.  Presently,  with  a   population   85   The office very quickly became a  focal  point  for
       percent chicano, it is ruled by an   anglo      Com-   community  activities.   Chuck   Gardinier,   known
       munity   Service   District   Board   appointed   by   throughout   the   Valley   for   his    organizing
       the  Fresno  County  Board  of  Supervisors.   Shel-   skills,  had  already  laid  some  groundwork   and
       ley did some  legal  work  in  connection  with  the   the  Center  was  able  to  become  part  of  that.
       incorporation  and  was  most  useful   in   helping   The result  of  taking  several  cases  (narcotics,
       to  formulate  the  feasibility  arguments   (suffi-   drunkenness,  etc.)  was  that  more  people  began
       cient  tax  base,  etc.)  to  be  presented  to  the   to come  by.  The  style  of  the  office  had  en-
       Local    Agency    Formation    Commission,    which   couraged young people to  drop  in  and  rap.  This
       must initially  approve  every  such  request.  Very   resulted in a high degree  of  trust  being  estab-
       recently,   this   Commission   approved   the   re-   lished, a very rare thing for  anglo  outsiders  to
       quest.  This  was  considered  a  very   surprising,   achieve in a short time. -
       major  victory.  In  many  ways,  Shelley's  assign-    The defense  work  in  court  caused  the  "estab-
       ment  was  the  ideal  model  we  would   hope,   to   lishment" to  become  very  "uptight"  and  a  good
       build  on  in  the  future.  His   special   (legal)   deal of hostility was  apparent.  The  office  even
       skills'  were  put  to  use  by  an  organizer   who   became the  object  of  a  County  Bar  Association
       knew  how  to  use  a   law   student   effectively.   financed investigation.
       Living  alone   in   Del   Rey   (population   800),    Besides  the  criminal  work,  other  results   of
       Shelly  became  a  part  of  the  community  he  was   the   summer   included   an   experimental   "O.R.
       working  with.  Except  in  Visalia   (see   below),   Project," that is  a  project  designed  to  enable
       one of  the  consistent  personal  failures  of  al-   prisoners to be released  on  their  own  recogniz-
       most  all   of   the   students-law   and   medical-   ance  without  putting  up  bail,  pending   trial.
       was  their  isolated  living  situations  and  with-   Local  youths  are  currently  running  this   pro-
       drawal   from   their   communities   during   week-   ject   themselves,   conducting   interviews    and
       ends.  In  addition  to  Sarfan,  two  local   women   making   recommendations   to   the   local   judge
       were  given  half-time  support  from  our   project   who has agreed to release the  first  100.  In  ad-
       funds  for   organizing   work   they   were   doing   dition,  a  not-so-successful  attempt   was   made
       under  Gonzalez'  direction  in  a  packing   house.   to  improve  the  juvenile  court   procedures   by
         (Visalia   Youth    Law    Center)-Peter    Haber-   having  a  law  student   work   with   the   over-
       feld   (Boalt   1967,   member   California    Bar),   staffed officials there.
       Keith  Lesar  (Boalt,  Law  Review),  Steve   Heiser    The   Youth   Law   Center   additionally   served
       (Stanford,   law),    Marty    Eichner    (Stanford,   as project  headquarters'  for  all  the  law  stu-
       law),  Jim  Romero  and   Jim   West,   local   com-   dents and  medical  students  in  the  San  Joaquin
       munity  workers,  Jeannie   Eichner   and   Marilyn,   Valley.
       secretaries.    The    Youth    Law    Center    was   (Porterville)-Phil   Nicholson   and    Ron    Rom-
       financed   by   the   Rosenberg   Foundation    (all   ines  (both  Stanford,  law)  had  'originally  in-
       other projects  were  funded  by  the  Social  Reha-   tended to work under  two  field  workers  for  the
       bilitation  Services  and  Regional   Medical   Pro-   Tulare  County   Community   Action   Agency.   Ron
       gram  of  the  Department  of   Health,   Education,   was  going  to  work  in  Dinuba  with  a  recently
       and  Welfare).  This  project  was  the   most   ex-   formed   community   group,   probably   on   labor
       perimental  and  probably  the  most   exciting   in   camp  Health  and  Safety  Code  Violations.   Phil
       terms of  its  potential  as  a  model  for  radical   was to work in Porterville.on  a  variety  of  com-
       lawyers  seeking   meaningful   roles   in   poverty   munity  issues-credit  unions,  irregularities   in
       law.                                                   the registration  and  voting  laws,  etc.  Because
          The office was set up in  an  old  church  build-   they  were   unable   to   work   under   the   two
       ing  on  the  north  side,  where  Visalia  chicanos   TCCAA   workers,   Phil   and   Ron   worked   with
       and  blacks  live.  The  purpose  was   to   provide   Jose  Aguilar,  who  had  done  some  farm   worker
       legal assistance  to  people  there  but  to  do  so   organizing. In addition.  to  helping  to  solve  a
                                                                                                                53


                              CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                 number   of   individual   problems    people    were    a  wide  variety  of   legal   problems.   This   job,
                 having  with  government   agencies,   they   did   a    while  somewhat  useful   to   CRLA,   was   more   in
                 very  effective  and  comprehensive  job   at   docu-    the nature of a  typical  legal  services  office  as-
                 menting  "field  violations"   in   southern   Tulare    signment  and  thus  was  not  the  kind  of   experi-
                 County.  Using  a   detailed   map   they   made   of    mental   project   most   of   the   other   locations
                 land  holdings,  they   would   visit   .   different    were. Some field work was done by them.
                 ranches   during   the    harvesting    of    grapes.    (Hospital    Project)    -Bart    Deamer     (Harvard,
                 Through  a  variety  of  techniques  (such  as   pre-    law)    and    John    Long    (Oklahoma,    medical),
                 tending  they  were  looking   for   someone),   they    spent  a  few   weeks   developing   a   comprehensive
                 were  able  to  visually  observe  lack  of  toilets,    questionnaire   designed    to    uncover    different
                 handwashing  facilities,  and  so  forth.  Affidavits    types of legal violations  in  the  'health  care  de-
                 were  prepared  and  presented  to   the   Industrial    livery  systems'  of  the  Kern  General  and   Tulare
                 Welfare   Commission   and    the    Labor    Commis-    County  Hospitals.   This   project   had   the   most
                 sion.                                                    potential  as  an  effective  medical-legal  job   but
                 In  addition,  they  were  able  to  be  helpful   to    suffered  because  John  arrived   in   California   2
                 the   United   Farm    Workers'    Organizing    Com-    weeks late and. Bart  had  to  leave  a  month  early.
                 mittee,  which  at  the  time   was   interested   in    About  30   interviews   with   former   patients   of
                 knowing  who  was  engaged   in   health   violations    these    hospitals    were    completed    and     the
                 in the  vineyards.  Phil  and  Ron  made  a,very  ef-    groundwork   laid   for   successful   followup   next
                 fective  team  and  provided  much  useful   detailed    summer.  The  reason   for   documenting   these   vi-
                 information   for   different   people   working   in    olations is to  put  pressure  on  the  hospital  sys-
                 Tulare   County.   Both   UFWOL   and    CRLA    were    tems  to  change  their  practices  and,  failing   to
                 pleased with the work they did.                          do so, to hope affected patients will sue.
                 (Hanford)-Steve         Linfeldt           (McGeorge,    (United    Farm     Workers     Organizing     Commit-
                 law)  and  Lonnie   Bodzin   (medical   school,   De-    tee    (UFWOC),    D-elano)-Ala-n     Radar     (Stan-
                 troit),   worked   under   a   young    lawyer    and    ford,  law),  Nan  Kripke  (Boalt),  and   Pete   Jan-
                 former  social  worker,  who  were  both   employe,-'    iak  (Davis),  did  a  combination   of   office   re-
                 by   the   Kings   County   Community   Action    Or-    search  and   fieldwork   under   the   direction   of
                 ganization.  A  plan  was  conceived  to  organize  a    UFWOC   staff   attorneys    Jerry    Cohen    (Boalt,
                 county-wide  welfare   rights   organization.   Steve    1965)  and   Dave   Averbuck   (Boalt,   1966).   This
                 and  Lonnie  spent  the   first   couple   of   weeks    legal   work   was    useful.    These    assignments,
                 learning  in  great  detail  about  how  the   entire    much like the Del Rey job,  fit  in  most  closely  to
                 welfare  system  works,   who   qualifies   for   how    our  concept  of   what   law   students   should   be
                 much aid,  etc.  The  laborious  task  of  contacting    doing.   Feeling   that   UFWOC   is   an    extremely
                 people,  finding  leadership,  and  explaining   what    important  social  movement   in   the   valley,   the
                 the advantages to su   ch   an   organization   were,    chance  to  place  three   students   in   their   law
                 took  most  of  the  summer.  A   budding   organiza-    office  working  under  close  supervision,  gave   us
                 tion  finally  evolved,   and   both   were   hopeful    the  opportunity  to   make   maximum   use   of   our
                 that  it  would   become   permanent.   Compared   to    legal skills for the  benefit  of  a  'relevant'  com-
                 some of the other  projects  this  one  had  the  ad-    munity organization.
                 vantage  @of  being   directly   organized   by   two
                 poverty  workers  who  had  sufficient   skill,   and      (Lamont)-Diana      Chapman      (Davis,       law),
                 knew  how  to  use  the  summer  students.   It   was    and  Lloyd  Gordon   (med),   began   on   a   housing
                 deficient  in   that   the   welfare   rights   group    survey in Arvin, t  try to get   .migrant      housing
                                                                                              0
                 really   should   have   been   organized   more   by    condemned,   because   it   housed   scab    migrants,
                 local people. But  by  the  end  of  the  summer,  it    being   brought   in   to   break    UFWOC    strikes.
                 was in their hands.                                      This  work  did  not  get  very   far   however,   bet
                   (California   Rural   Legal    Assistame    Office,    cause  it  was  impossible  to   get   into   people's
                 McFarlatW)-Steve      Cline      (McGeorge)       and    homes  to  ask  them   questions   which   they   knew
                 Greg Sager  (Davis,  law),  did  office  research  on    might   lead   to   tearing   down   of   their    own

                 54


                     CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

     houses.  Most   of   the   summer,   therefore,   was   city  of  good  organizations  and  good   organizers
     spent  doing  a  variety  of  jobs  for  the   Lamont   suggests  that  the   summer   project   should   not
     office  of  UFWOC.   This   included   strike   work,   restrict  itself  to  the  Valley  but  should   look
     field  investigations,  and  some   legal   research.   anywhere  organizers  are.  There  are  many.
     (Once  more  the  adage  was  borne  out   that   one   areas  where  we   did   not   look-Stockton,   Mays-
     must  hook  in  to  a   group   already   functioning   ville, Salinas, and the  urban  areas  as  well.  The
     that  is  doing  something  worthwhile,  rather  than   chicano  students  who  seem   most   interested   in
     attempt to create something new.)                       carrying  on  the  program   at   this   point   have
      This  completes  the   list   of   individual   pro-   Probably more interest in the urban areas.
     jects. It is apparent  in  a  number  of  cases  that     On   balance,   however,   I   think   the   summer
     the  students  began  on  one  thing  and  then   had   projects  was  extremely  valuable  as   a   way   to
     to  move  on  to  something  else.  As  a  result  of   experiment   with   new   models.   The   Visalia.law
     this shifting, if was  difficult  in  a  10-week  pe-   project,  especially,  has  been   the   subject   of
     tiod to accomplish  a  great  deal.  It  is  now  ap-   much discussion in  the  law  schools  this  fall;  a
     parent  that  the  original  project  selection  must   number  of  students  are  talking  seriously   about
     be more  thorough  and  be  definite  when  the  stu-   this  kind  of  community  law  practice  after   law
     dents  arrive.  Many  of  the  problems   we   faced,   school.
     such as the difficulty  of  obtaining  affidavits  in     The   students   who   participated   this   summer
     Madera   and   interviewing   migrants   in    Arvin,   have  by  and  large  remained  active.   The   Stan-
     could  possibly  have  been  anticipated  with   more   ford   contingent   has    organized    the    campus
     contact  work  in  the  beginning.  Furthermore,   it   around the grape  strike  issue.  We  at  Boalt  have
     is always risky  to  attempt  to  do  anything  inde-   been  working  on  different   Boalt   Hall   Commun-
     pendently. This had been,  in  fact,  a  basic  prem-   ity  Action  projects  and  have  some  contact  with
     ise  to  our  whole  program  but  in  a  number   of   the    Mexican-American    students    Confederation.
     cases,  we  in  fact  did  just  that  (e.g.  Porter-   In spite  of  all  the  administrative  and  program-
     ville).  (I  am  now  convinced  that  a  project  on   matic  problems  we  faced  this  summer,   I   think
     this  scale  must  employ  a  person  from  the  Val-   the  overall   project   was   exceedingly   valuable
     ley,  who  knows  generally  the   people   who   are   and should be continued.
     doing things  and  can  set  up  projects  with  them
     during  the  spring.  Such  a  job   would   not   be   Statistics
     full-time  but   could   be   on   a   consultant-day     (a)  Project  ran  from  June  24  to   Augst   30.
     basis.)                                                   (b)   Number   of   volunteer   students   partici-
      In  addition,   as   many   students   as   possible          pating.
     should  be  chicano.  If  anglo,  they  should  speak             5 Boalt students
     Spanish. They  should  be  willing  to  live  in  the
     communities  where  they  work   and   not   live   a             6 Stanford students
                                                                       4 Davis students
     campus-type   existence   in    an    air-conditioned
     apartment.  Their  summer  must  be  lived   in   the             2 McGeorge students
                                                                       I Harvard student
     community  where  they   work   so   that   the   di-     (c)   Impossible   to   measure   the   number   of
     chotomy of time spent      on  the   job   and   time          persons served by the project.
     spent  at  home  cannot  develop.   The   $800   sti-
     Pend can only be justified on  the  basis  that  stu-   Llillacklash and Backlash Blues
     dents have to earn  money  for  school.  If  this  is
     $6, the best way to administer it  is  to  keep  $500     There was    the  confrontation   at   Yucaipa   at
     for the student  to  give  him  at  the  end  of  the   the beginning of  the  summer  and  it  went  on  all
       mnier. He can easily live  on  $30  per  week.        summer.   Whites   overreacted   to    blacks,    and
                more   people   like   Sal   Gonzales   and  blacks defined every ine   pt  move  of  white   stu-
                nizations   like   UFWOC   will    be   the  dents  as  white  liberalism,  tokenism,   or   coun-
                ingredient  to  a   really   cohesive   and  ter-revolutionary.  The  lack  of   leadership   from
                 evant   summer   program.   The    se-ar-   either  black,  brown,   or   white   -was   apparent

                                                                                                                55


                                                                                            MMER 1969
                             CALIFORNIA                 STUDENT HEALTI-I       PROJECT       SU
                                               organized                meeting
                    from the start. At any well-
                                many    dis    arate    opinions,    it     is-
                    where there are            pto        integrate         the
                    crucial for someone to be able            s             and
                    knowledge, Put the issues clearly  in  fOcu
                                level    of    action.    Instead    of    that
                    agree on some  it            attitude,       a        Petu-
                    course there was a  you do i-Vt
                                dity    that    did    not    allow    for    a
                    lance and rigi             absence         of         humor
                    modicum of  good  will.  The
                    was frightening.           ess      there      are      two
                    When  people   feel   powerl          athy,              or
                    paths open: either resignation  and  aP
                    revolt.   The   politics   of   confrontation    isevidence
                    that  those  who  use  it  so  not  feel   powerless   any-
                                                      .nt       that       viO-
                    more. Frantz Fanon makes the pol          0
                    lence  is  therapeutic  and  creative   for   th   se   de-
                                nels   of    redress,    and    history    ree-
                    nied other chair            en     ri      ng      expecta-                                            s      of
                    ords that violence occurs wh     Si       le           want mentioned earlier in this report, the goal
                    tions and levels  of  education  make  peop               the   black   students   were   much   clearer    than
                                                                                              er   students.    The    brown    stu-
                    more of both- of the minority  groups2       the       ero- those of any oth             that    they     didn't
                    On  the  part                             power           dents were in such a minority
                    Sion of trust in   the   promises   of    the                       tcomes,   but   they   did   identify   with
                                generally      affected      minority      com- affect the ou
                    structure has Iminority     group     students.     it     has the black students.
                    munities  and nsify   their    demands,    and    in    the Black    students    were    welcomed    in     ghetto
                    led them to inte udents    affiliated    with     the     Stu- communities  as  advocates  and   teachers,   a   role
                    case of those St                                                                 ated as tok  '                -
                    dent  Health  Proect,  to  use  the  project   as   a   ve- understandably design             enism    if     un
                                  3            .     The     black     students
                    hicle for  their  own  anger              aff           and dertaken  by  white  students.   But   the   realistic
                     conspiracy  in  every  move  of   the   St               fact is  that  the  black  students  could  do  things
                    saw                ,,loped   a   kind    of    sick    gym-                  ate  for  whites  to  do  in  1968.
                    students. There d                         St         unani- that are inappropri    e   into    communities    in
                    bio  s   -wherein   white   students   almO               e   black   students   cam     ere more hi
                                                 sessive       guilt        and Th                                              ghly
                                       with  ob                               which thev did not live, w
                    mously  responde                 as    the    fact     that                    than   most    residents,    were
                    self-doubt. A simple example w                            trained and skilled               nity   for    educa-
                           a    inistrative   decision,    the    refusal    to used by-and used-the commu
                    a  Sloppy  dm              the    Watts    project,     im-             ice,  and  to  our  knowledge  left  the
                    provide  a   telephone   for       c            proportions tion and se'rv.                          At     this
                                                                                     ities when the project ended.
                    mediately took on giant symbol'                           commun                        whether       provisions
                    and was used  as  evidence  of  racism.   The         whole           is not known
                                               o  $4.  The   fa 't    is     that writingg it                        es   for    com
                    transaction    amounted    t                              were made for continuing the class
                    the   telephone   was    among    countless    other    er- munity  first  aid  workers  or  the   disaster   sta-
                                               as   standing   on    a    prin-      Granting that     its   a   totally   different
                    rors in lo-gic.  Someone  -w              is         moment tions.      lack  students  than   White   students@
                    ,,iple  which  escapes  the  writer  at  th               scene  with   b        about    short-term    projects
                     probably    any     other     moment.     However,     its from what is known                              Pro-
                    or          immediately    COitrasted    to     the     ex- the question remains whether this kind of
                    denial    was    travel     or     sensitivity      groups, ject  is  not  damaging   to   the   community   what-
                    penditures  on             ny  bearing  at   all   on   the
                    neither  of  which   had   a              ere    a     last ever the color of the student, s, in their effort  t(
                    telephone.   The   sensitivity   groups   w               situa- Minority group preceptor          on  of  thei@
                                        to ease the very tense
                                                                              fully control the design and executi
                    ditch stand to try         described  here.                                          protecting       theinselve
                    tions   which   have    been                              -class own     projects     while ear to   measure    thei
                     The    project    was    also    a    Way    for    middle             usion, app      ed
                                                a     otribution     on     the againt    illtr           independence   they    fok
                    black   students   to   make          residents.         As success by the degree of
                    streets and identify with ghetto

                    56


                      CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
     tered  in  the  black  students.   Gary   Bellow   and    Clinic,  few  students  achieved   the   goals   pro-
     Douglas    Frasier,    both    independently    inter-    jected for their projects. It  is  quite  clear  that
     viewed, felt  that  white  students  should  fight  to    even    seasoned    community    organizers     would
     work  in   every   community.   Bellow   was   clearly    have  not  been  able  to   accomplish   such   over-
     in favor of facing  up  to  the  conflicts  and  using    whelming objectives  in  so  short  a  time.  By  the
     them  to  develop  some   positive   outcomes.   Fras-    same  token,  no  seasoned   organizer   would   have
     ier felt the  project  was  used  effectively  by  the    approached   the   problems   with   such    naivete.
     law  students  and  the  black  students   for   their    The  area  coordinators,  in  establishing  the  pro-
     own   purposes   of   seeking   power   rather    than    ject goals  grasped  the  seriousness  of  the  prob-
     seeking   education    about    health    Institutions    lems,  but  their  inexperience  and  lack  of  thor-
     or in giving service.                                     oughness    combined    to    produce    unattainable
       There  is  no  doubt  that  the  preceptors  of  the    ends   and   ill-defined   means   which   for   many
     black students  succeeded  in  politicizing  the  stu-    people  spelled  built-in  failure.  This   lack   of
     dents, If  'the  SHP  helps  to  turn  the   tide   for   careful  planning  led  them   into   grandiose   vi-
     black  professionals  and  attracts   them   back   to    sions   of   potential   accomplishments   which   no
     ghetto  communities   or   public   health   medicine,    one  could  have   achieved.   The   summer   experi-
     much  will  be  gained.  What  the   long   term   ef-    ence  led  David  Snyder,  student   project   direc-
     fects  of  the  summer  will  be  upon  some  of   the    tor, to comment:
     other  young  health   science   students,   we   have           "During    the    summer,     and     now
     no way  of  knowing.  But  in  1968,  the  efforts  of         every  once  in  a  while,  I  stand   back
     the   white   middle   class   students    (and    SHP         and  look  at  the  situation   and   think
     members   are    characteristically    that)    evapo-         that  no  matter  how  incompetent   I   am
     rated  in  angry  accusations  of   white   liberalism         or how  little  understanding  I  have,  it
     -to  militant  whites  and  for  blacks,  the  equiva-
     lent  of  poison.  For  some  students,  the  self-im-         is  statistically  almost  impossible  that
     age of  the  confused  white  liberal  will  be  rein-         we  were   always   wrong,   so   something
     forced. For  others,  there  will  be  a  more  accel-         else  is  going  on  and  I  am  still  too
     erated  search  for  social  justice.  No  doubt   for         bound up in  it  to  really  separate  gen-
     some,  the  charge  of  white  liberalism   will   be-         uine  mistakes  I   made   and   where   it
     come  a  challenge   and   for   others   the   charge         was  impossible  to  do  the  right  thing,
     will  be  dropped  in'favor  of  a  more   comfortable         either   because   there   was   no   right
     retreat.                                                       thing  or  because  nothing  was   accepta-
        The  majority  of  the  health   science   projects         ble. By the  end  of  the  summer,  I  felt
     have  been   reported   in   humanist   terms   rather         you  couldn't  win  even  if  the   leader-
     than   analytical   terms.   Most    students    found         ship were all  black.  If  this  revolution
     themselves   anxious    and    sometimes    frustrated         isn't  consummated,  everything   else   is
     by  their  inability  to  accomplish  their   expecta-         just going  to  crumble.  Our  society  has
     tions.  With  the  exception  of  the  Venice   Dental         to solve this problem."

                                                                                                                  57


                                                                                                                 NTS
                          PROBLEMS MOST FREQUENTLY MENTIONED BY STUDE
                  Personal Problems                                              2. Inaccessibility  and  inadequacy   of   health
                          1. interpersonal relations.                            resources when they do exist.
                                                                                 3. In  rural  and   urban   areas,   absence   of
                          2. Problems of  suddenly  finding  oneself  in  a
                                                no   personal    attach-         transportation to  and  from  health  centers.
                          new, community with
                          ment.                                                  4. Ignorance  of  the  existence  of  health  re-
                          3. The inability to  connect  the  means  to  the      sources by  the  poor.  There  is  no  program
                                                                                 to  educate  them  to  the  existing  programs
                          goals.
                          4. The  lack  of  knowledge  about   interviewing      orresources.
                          and  survey  techniques,  how  to   interview,         5. Health manpower shortage.
                          what questions to ask, who to ask.                     6. Dearth   of   preventive   medicine   programs
                          5. Ambivalence    between    personal    autonomy      -immunization,   health   education,    family
                          and   organizational    structure-viewed    by         planning.
                          participants   as   the   difference   between         7. Inadequate clinical facilities  for  narcotics
                          freedom and restraint.                                 users.
                          6. Insufficient  supervision  by  the  preceptor,      8. Inadequate  medical  care  in  health  depart-
                                             et    between     preceptor         ments.
                          inconsistent  conta
                          and student.                                           9. Disinterest of  private  physicians  and  den-
                          7. Insufficient knowledge   or   orientation    of     tists in health problems of the poor.
                          participants  to  sites  or  comniunities   in
                          which sites were located.                              Community Problems
                          8. The  multiple  Student  Health  Project  goals
                                                                                 1. The  co-optation  of  minority  group   people
                          were  never  clearly  spelled  out  beforehand
                          to  either  preceptor  or  student,  both   of         into  the  power  structure  with   subsequent
                          whom  complained  of  the  other's   lack   of         harassment  and   rejection   of   their   own
                                                                                 people best described by one  student  as  the
                          understanding.                                         I
                          9. Little advance preparation  for  arrival   of       'Brown Anglos."
                          students in the community.                             2. The  wide  variations  in  interpreting   pol.
                          10. Inadequate    knowledge    about     community     icies of community action agencies.
                          resources.and  how  to  find  them  (on   part         3. Repeated  hiring  and   firing   of   personne
                          of students).                                          creates  confusion  and  makes   on-going   re
                                                                                 lationships impossible.
                          Health Problems
                                                                                 4. No  recourse  to  legal  protection  for  farn
                          1.  Insufficient health professionals  in   rural      workers  who  are  not  covered  for   welfar@
                          areas and urban poverty areas.                         benefits.

                          58


                                          RECOMMENDATIONS

        As in an act  of  faith,  the  single  theme  be-    5.  Preference should not  be  given  to  students
      yond  all  others  which  thrums   its   waythrough        on the basis of  their  political  sophistica-
      the reports and personal  interviews  is  that  the        tion or prior experience,  but  on  the  basis
      Student  Health  Organization   should   and   must        of their commitment.
      continue. There  are  many  variations  in  opinion    6.  Some  self-education  should  be  a   require-
      as to how  the  organization  could  function  best        ment  for  student  participants.  A   reading
      and what it might do  to  maximize  its  potential.        list should be sent prior to the summer.
      Nowhere and by no one was  it  said  that  the  or-    7.  Students  assigned  to  projects  in  a  Mexi-
      ga-nization  has  ceased  to  serve  a  purpose  or        can-American   or   Puerto   Rican   community
      that it could not serve its purposes better  if  it        should   know    Spanish.    Other    students
      did thus and so. As is  evident  from  Michael  Al-        should  be  assigned  to  non-Spanish   speak-
      bertson's  letter,  (see   Appendix)   there   were        ing projects.
      students,  disappointed  from  the   summer   expe-    8.  Priority should be  given  to  minority  group
      rience, still eager to mend the  disabled  orga-ni-        students.
      zation.  To  some  degree  this  has  occurred.  At    9.  The  present  balance  of   medical,   dental,
      this writing there are  three  student  health  or-        nursing,  with  a   few   behavioral   science
      ganizations  operating   in   the   local   medical        students should be maintained.
      schools of  UCLA,  USC,  and  the  California  Col-   10.  Students assigned to  rural  areas  should  be
      lege  of  Medicine,   recently   transferred   from        prepared by  a  special  orientation  program.
      Los  Angeles  to  the  University   of   California   11.  Students  neither  have  the  time,  nor   are
      campus at Irvine, Calif.                                   they in school long enough  to  develop  loca-
        The   recommendations   which   follow   are    a        tions for projects or to  evaluate  them  over
      distillation as well  as  a  condensation  of  many        time.  Therefore,   though   students   should
      views. They  are  divided  into  subjects  for  the        participate  in  finding  suitable  locations,
      ease of the reader  and  for  those  who  might  be        they should not have sole jurisdiction.
      in position to work with one  or  more  aspects  of   12.  Each  student  should  receive  a  packet  de-
      the project at some future  date.  Because  of  the        scribing  what   SHP   has   accomplished   in
      subject matter  the  divisions  are  arbitrary  and        the  past.  This  should  be  broken  down  by
      in some  instances  overlap.  No  effort  was  made        area,   giving   pertinent   information   and
      to make  them  discrete  categories  nor  are  they        names  of  contacts  made.  This   would   de-
      arranged according to any priority.                        velop  some  continuity  in  the  projects.  A
                                                                 central file should be  maintained  with  this
      Students                                                   information.
        1. Students should    live in the       community   The  Health     Science     Schools-Recommendations
          where they work.
        2. Student  exchanges  with  other  areas  of  the  1. The  study  of   community   health   and   com-
          country  do  not  work  because  it  does   not      munity  law  should  be  required  subjects   in
          build  community   trust   or   enduring   pro-      all  professional  schools.  Medical   and   Law
          jects  in  which  the  community   can   expect      schools  should  jointly  sponsor  courses   for
          some follow-through.                                 both disciplines so each has an opportune
          Students  should  be  selected  by  a   commit-      to work on problems of mutual interest.
          tee  consisting  of  faculty,   students,   and   2. Community    medicine     departments     should
          community people.                                    include  courses  in   group   work   techniques
          Students should be  selected  by  personal  in-      and sensitivity training.
          terview.                                          3. If the  universities  sponsor  a  project,  they

                                                                                                             59


                                                                                        JECT SUMMER 1968
                                 CALIFORNIA         STUDENT         HEALTI-I          PRO      asis should be on year-round
                                                 ,Dn-going interest in         6.       The emph ven when students have to be
                        should    maintain    some    they should be                    projects. E        rogram changes
                                          - In turn,                                    rotated because of P
                        it or lot sponsor it     eir role in the Pro-                          n,   year-round   projects   have
                        held  accountable  for  th                                      graduatio
                        ject.                                 e for sensi-              more validity.
                               ols   should    be    responsibl                7.       Students should be given preference in
                4.      The schO                              in various                       where they f eel they have suit-
                        tizing  students  to  the   differences                         projects is and will be more comfortable,
                        ethnic and social class groups-       through a                 able skil                       skiiis they
                 5.     Schools  should   be   responsible    ant place-                (Some  students  complained   the arned few
                        central  office,  for   finding   relev The office              had were not  used  and  they  le
                        rnents   for    interested    students. d in the                new ones.)                    -going agen-
                                                 . 13erson traine
                        should be staffed by  a  .well as health Pro-          g.       Projects should be part of on
                                                                                               ardless  of  the  Purpose     of  the
                        behavioral   sciences   as                                      cies reg
                                                                                        agency. Students therefore would work in
                                                                                                            the capability Of con-
                        fessions.
                               ools,      students and funding sources                  agencies which have
                       6. The sch                                                                          organized by student
                                                    longitudinal  study
                        would     benefit     from            curs in the               tinuing any work
                        which   would    evaluate    what    Oc     have                workers.
                               io al  lives  of  students who                                      of projects dealing with riid-
                        profess  n                  alth projects.             9.       A new group                should be devel-
                        participated  in  student  he           begin to                dle class health Problems
                        All health science schools should   ,                           oped by some of the voluntary agencies.
                       7.                                ght eventually                                                 drug  abuse,
                        develop   a   program   which   mi         nships               Alcoholism,  heart  disease
                                    a-nginZ     attitudes,    relatiO                   home health care, and insurance plans are
                        lead  to   ch                                tists
                        and   behavior   between    physicians,    den
                                                 g schools should initiate              such examples.
                        and     nurses.     Nursin , help nurses develop a     10.      opinion was  divided  on whether  SHP
                                  s  v@ihich   Wil                                             evote its energies to nonhealth re-
                        program        e of pride in their profession by                should d                 ere many Who felt
                        greater     sens                                                lated prDjects. There w
                                                    f-image.                                                       Ility was a neces-
                        increasing  their   own   sel                                   that  work  ill  the  comTnu
                                                                                        sary Part of every students education and
                        Projects-Recomrnendations                                       that in itself is enough. There were those
                                                              d    be     scaled        who felt that the whole structure of the
                        1. The  content   of   projects   shOul                                                is in such bad shape
                                    feasible   goals.   They   should   have   a        medical care system
                          down to                                                       that students should not dissipate their
                                       and    ending.                                                               related to chang-
                               beginning         teams    should    be    0'rga-                  n   projects   not
                        2. working          project           mmer      Projects        energies 0
                          nized    long    before    the     Su earn    can    de-      ing that system.
                          begin  so  the  morale   of   the   tent    in    meth-                                  tions
                           velop   and   people   can   experim      eptors             Administration-Recommenda
                           od  of   working   together    with    pree                  The   organization   should    be staffed by a
                              s                                                         1.                                 n charge of
                           and        communities.                                      full-time   year-round   director i
                        3. All   projects   should    be    aTefully    planned.                      unity    relations.
                                                       alternatives       should        student-e-omm            iv located in ghettos
                                        o not work,                                     2. if st. dents are  prima-ri-.
                            If plans d                                                         u
                                                                                                  where minority groups live, the
                            be   tested.                                                or areas                           a member of
                                       on  of  project  goals  should  be   pro-
                        4.  A   definiti                                                year-round director should be
                                                 if  they  are   not   available
                                                                                               those   minority   groups.
                            vided   to    students                                      oneof
                                                              nning     process.                                 t be chosen With spe-
                            for      participation in   the   pla the     projects      S. The -Oordinators mus              background
                            Students        should understand                  s-       cific criteria. They must have a
                             and  should  be  given   an   opportunity   to   di        in community organizing         methods and ull-
                             cuss   methods   of   achieving    the    objective        derstand  how  to  work  in  communities.
                                                 f  the  students  and  pree-ep-
                         5.  At   least   85%    0                                      Choice should not be.baseddn seniority, but
                             tors  requested  that  Projects  be   more   strue-        expertise.
                               tured.

                        60


                        CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
       4.   Coordinators   must   be   selective    in    their       projects   in   advance.   Considering   the   time
            choice of sites.                                          involved,  it  may  be  necessary   to   think   of
       5.   Coordinators   should   be   expected   to   orient       some   financial   reward   to    those    agencies
            student  fellows   and   look   after   administra-       who undertake preceptorships.
            tive   problems    affecting    student    perform-   5.  Several  faculty  members   were   of   the   opin-
            ance, i.e. mileage, stipends, etc.                        ion   that   Departments   of    Community    Medi-
       6.   Educational   programs   should   be   carried   on       cine  could  best  administer   preceptorships   in
            all year by staff.                                        conjunction with outside agencies.
       Preceptors-Recommendations                                 6.  Federal  and  State  agencies  as  well   as   pro-
                                                                      fessional   societies   are   now   offering    ex-
       1.   Faculty   people   who   are   preceptors    should       panded  programs   for   field   study.   The   Bu-
            have  a   good   understanding   of   the   commun-       reau  of   Health   Manpower   and   the   Califor-
            ity  and  the  agencies  in  which   the   students       nia  Medical  Association   are   but   two   agen-
            work.  Though   faculty   people   are   liked   by       cies   involved   in   sponsoring   preceptorships.
            the  students,   faculty   preceptors   cannot   be       Recently   enacted   legislation    enlarges    the
            effective  if  they  do  not  make  an  effort   to       possibilities  of  financial   aid   to   students,
            make relationships in the community.                      thereby  freeing  them  for  more  time  in   corn-
       2.   Preceptors      from       community       agencies       munity  programs.  We  refer   to   such   legisla-
            should  be  helped  to  bridge  the   gap   between       tion   as   Public   Law   88-497,   the   Graduate
            student     organizations,     universities     and       Public    Health     Training     Amendments     of
            their  own  communities   by   being   fully   ori-       1964;   Public   Law   88-581,    Nurse    Training
            ented  to  the  objectives  of   the   universities       Act   of   1964;   Public   Law   89-290,    Health
            and  students.  This  would  help   them   to   as-       Professions    Educational    Assistance     Amend-
            sess   whether   their   objectives   coincide   or       ments   of   1965;   and   Public    Law    89-329,
            complement  or  are  in  conflict  with  those   of       Higher Education Act of 1965.
            the universities and students.                                "Medicine  and  public   health   do   not
        3.  A    new    model    of     "faculty-community-pre-         develop  or  function  in  a  social   void.
            ceptor-team"   could   probably   provide    excel-         They  provide  the   social   adaptive   me-
            lent  support  and  stimulation  to   a   team   of         chanisms  that   complement   the   biologi-
            students  as  well  as  cross-fertilize  their  own         cal  adaptive  responses   to   the   condi-
            knowledge, benefiting all concerned.
        4.  Preceptors   should   be   carefully   chosen    on         tions of life at  a  given  time.  They  can
            the  basis  of  their  philosophy  and  the  nature         fulfill  their  purpose,  to   improve   the
            of the projects  they  have  to  offer.  An  objec-         people's health, only  if  they  are  fitted
                                                                        to the  needs  and  resources  of  the  com-
            tive    and    respected    community     organizer         munity    a.s well as to the special condl-'
            should   be    hired    to    evaluate    community         tions  created   by   the   total   environ-
            leaders   and   potential   preceptors   in    each         ment."
            community.   On   the   basis   of   these   recom-
            mendations,   preceptors    should    be    chosen.                                     RENE DUBOIS,
            Preceptors  should   be   willing   to   plan   the                                     Man Adapting.

                                                                                                                        61


                                                                                BIBLIOGRAPHY
                   (1)  Peter  M.   Blau   and   W.   Richard   Scott,   "Formal    (17)  William   H.   Grier,   M.D.   and   Price   M.   Cobbs,
                           Organizations"     (Chandler     Publishing      Co.,             M.D.,  "Black  Rage"  (Bantam   Books,   Inc.,   Jan-
                           1962).                                                            uary 1969).
                   (2)   Henrik   L.   Blum,   M.D.,    M.P.H.;    Fred    Wahl,    (18)   Kenneth   Kenniston,   "Social   Change    and    Youth
                           M.S.W.;   Genelle   M.   Lemon,    P.H.N.,    M.P.H.;             In Amerca", Daedalus  (Winter 1962).
                           Robert   Jornlin,   M.S.W.;   and   Glen   W.   Kent,    (19)   Seymour   Martin   Lipset,   "Students   and   Politics
                           M.D.,   M.P.H.,   'The   Multipurpose   Worker    and             in   Comparative   Perspective",    Daedalus    (Win-
                           the   Neighborhood   Multiservice   Center:   Initial             ter 1968).
                           Experiences   and   Implications   of    the    Rodeo    (20) Mannheim,  "Ideology  and  Utopia"             arcour   ,
                           Community   Service   Center',   "American    Journal             Brace, and World, Inc.)
                           of Public  Health  and  the  Nation's  Health,"  vol.    (21)  C.  Wright   Mills,   "The   Sociological   Imagination"
                           58, No. 3 (March 1968)   '                                        (Grove Press, Inc., 1959).
                   (3)   David   Boesel   and   Associates,   "White    Institu-    (22)   Wilbert   E.   Moore,   "Social   Change"    (Prentice-
                           tions   and   Black   Rage",    Transaction    (March             Hall, Inc., 1963).
                           1969).                                                   (23)   Daniel   P.   Moynihan,   "The   Professors   and   the
                   (4)  Jerome   S.   Bruner,   "The   Process   of   Education"             Poor",   Commentary   vol.   46,   No.   2    (August
                           (Vintage Books, 1960).                                            1968).
                   (5)   Albert   Camus,   "The   Rebel"   (New   York   Vintage    (24)  Talcott  Parsons,   "Youth:   Change   and   Challenge",
                           Books, January 1954).                                             Daedalus (Winter 1962).
                   (6)   Eldridge   Cleaver,   "Soul   On   Ice"   (McGraw-Hill,    (25)  Mitchell   Sviridoff,   "Contradictions   In   Community
                           1968).                                                            Action",  Psychiatry  and  Social   Science   Review,
                   (7)    James    Drugoth,    "Drugoth"    (Skylight     Press,             vol. 2, No. 10 (October 1968 ) .
                           1965).                                                   (26)  Diana   Trilling,   "Liberalism   and   the   Revolution
                   (8)   Ren6   Dubos,   "Man   Adapting"    (Yale    University           of  the  Young",  Commentary,  vol.  46,  No.  5   (No-
                           Press, 1965).                                                     vember 1968).
                   (9)   Roger   0.   Egeberg,   M.D.;   S.   Douglas   Frasier,    (27)   Willard  Waller,  Ph.  D.,  "The  Sociology  of  Teach-
                           M.D.;  and  Paul   F.   Wehrle,   M.D.;   Lewis   Ira             ing" (Science Editions, 1965).
                           Rosenbaum,     'Student      Health      Organization    (28)   Melvin  M.  Webber,   "The   Post-City   Age",   Daeda-
                           (SHO),   A   Faculty   Appraisal,   A   Student   Ap-             lus (Fall 1968).
                           praisal',  "Medical   Opinion   and   Review",   Vol.    (29)   Norman  Zinberg  "In   Our   Image",   PiTchiatry   and
                           4, No. 11 (November 1968).                                        Social  Science  Review,  vol.  2,  No.  II   (Novem-
                  (10)  Ralph  Ellison,  "Invisible   Man"   (The   New   Ameri-             ber 1968).
                           can Library, 1947).                                      (30)   "The   American    Underclass:    Red,    White,    and
                  (11)  Erik  H.  Erikson,  "Youth:  Fidelity  and   Diversity",             Black", Transaction (February 1969).
                           Daedalus (Winter 1962).                                  (30)   "Community  Values  and  Conflict,   196711,   A   con-
                  (12)   Amitai   Etzioni,   "A    Comparative    Analysis    of             ference  report  sponsored  by:  City  of  New   York
                           Complex   OrganiziLtions"   (The   Free   Press    of             Commission   on   Human    Rights,    Lemburg    Cen-
                           Glencoe, Inc., 1961).                                             ter  for  the  Study  of  Violence,   Brotherhood-In-
                  (13)   Amitai   Etzioni,   "Modern    Organizations"    (Pren-             Action.
                           tice-Hall, Inc., 1964).                                  (82)   "Summer   Education   For   Children    of    Poverty",
                  (14)   Frantz   Fanon,   "The   Wretched   of    the    Earth"             a report  of  the  National  Advisory  Council  (U.S.
                           (Grove Press Inc., 1968).                                         Government Printing Office, 1966).
                  (15)   John   W.   Gardner,   "Self-Renewal,   The    Individ-    (33)  1966  Student  Health  Project'Report,   University   of
                           ual   and   the   Innovative   Society"   (Harper   &             Southern California.
                           Row, 1965).                                              (34)  1967   Student   Health   Project   Report,   University
                  (16)   Paul   Goodman,   "Growing    Up    Absurd"    (Vintage             of Southern California.
                           Books, July 1962).                                       (85) Chicago Student Health Project, Summer 1967.

                  62


                                                     A P P E N D I X E S

                                                           APPENDIX A

                                              Preceptor Evaluation-South Monterey
                      PROGRAM:          South Monterey County Medical Group Rural Health Project.
                      PRECEPTOR:        Stuart Allan, administrator.
                      STUDENTS:         Martha Jackson (we paid stipend); Jerry Ginzburg (SHO stipend).

                           A. The rural health project is one of about  50  Neighborhood  Health  Centers  fun  d
                      by OEO. In this case, the grantee  is  the  Monterey  County  Medical  Society;  the  South
                      Monterey County Medical Group  is  the  delegate  agency.  (This  is  a  private  group  of
                      about 10 doctors with clinics in King City, Greenfield, and  Soledad.)  The  project's  aim
                      is to provide completely integrated medical care to  low-income  folks  in  south  Monterey
                      County. We pay all medical costs; except  for  the  first  dollar  per  prescription.  Poor
                      folks use the Community Hospital and the  Medical  Groups  clinics,  and  the  three  local
                      pharmacies.
                           The "student team" was one nursing student and,  later,  one  medical  student.  Since
                      our program is strictly one of providing medical care and, since the students  couldn't  do
                      this, I assigned the nursing student to live with a  number  of  families  on  the  program
                      and write a health analysis of the  household.  This  is  fundamentally  aimed  at  educat-
                      ing the doctors of the medical group into the environmental (health,  job,  financi  ,  so-
                      cial) facts of life of this new group of clients that  they  are  seeing  under  the  Rural
                      Health Project. The Medical Student I asked to  do  much  the  same  thing  for  a  single-
                      man labor camp or, if that proved impossible, for the field crews, by  living  and  working
                      with  them.  The  students,  therefore,  were  never  really  "part  of"  the  program-they
                      have served as a special project on their own.
                        B. I have not yet decided whether my plan for educating  the  doctors  is  reasonable  or
                      not. The one report the nursing student completed was pretty good, included  all  sorts  of
                      things on diet and attitude towards health care, etc., which will be valuable to  the  doc-
                      tors if I can persuade them to read it. Her other report is now being finished.  The  medi-
                      cal student I have seen little of (he works with the field crews, then  camps  out  in  the
                      mountains during the night).
                           I am reluctant to attempt an evaluation  of  the  students,  since  they  have  worked
                      very largely on their own, with little guidance. The  local  poor  community  is  "undevel-
                      oped" as far as self-awareness or the "black-brown  revolution"  is  concerned.  There  are
                      stirrings in North County, still on the MAPA level, but  nothing  as  yet  here.  For  that
                      reason, I did not want any fooling  around  on  the  "community  organization"  theme,  and
                      discouraged the students from doing that (i.e., because there was no group  of  poor  folks
                      well enough  developed  to  use  the  students-our  projects  Consumer's  Advisory  Council
                      will be able to use some next year, perhaps, but not yet). Therefore, I can  only  evaluate
                      the finished product-the reports they write for the edification  of  the  doctors-and  only
                      one  is  in  yet.  The  community  was  not  hurt,  probably  not  helpedi  At   least   it
                      wasn't-- with, more than can be said for some projects.
                           C. As to student selection-the nursing student had  some  questions  about  that;  she
                      told me that last year she  applied  and  mentioned  being  from  a  low-income  background
                      and was not accepted; this year she didn't mention  this,  and  was  accepted.  I  wondered
                      whether this were coincidence, or whether SHO  felt  that  poor  folks  who  have  made  it
                      into professional schools have already left the  category  of  being  worthy  of  help  and
                      attention, and therefore concentrates on bringing hereditarily middle-class kids into  con-
                      tact with the poor. That might be reasonable, but I sort of felt it should be spelled out.
                           On staff-is it a tacit agreement that if no one mentions beards  and  long  hair,  the
                      poor will accept them? They don't. In our area, since it is, as I  mentioned,  "underdevel-
                      oped," witchcraft is still a going  business.  When  Jerry  Ginzburg  did  magic  for  some

                                                                                                                            63


                                   CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                               kids, their mother, already uneasy about his  appearance,  concluded  he  was  a  magician,
                               which is to say, witch. (This is secondhand information, but  I  know  the  family  and  it
                               figures.) Same goes for Tew Rosenbaum. Both  very  interesting  and  competent,  etc.,  but
                               in appearance, they might either alienate or charm  the  younger  poor  folks,  but  appall
                               the older ones. That might be all right, the older ones have pretty fierce  petit-bourgeois
                               leanings of course. But SHO certainly ought to be aware of the choice.
                                   On  improving  the  thing-the  ideal  would  be  a  poor  folk-student   board   making
                               placements with a local poor folk group. But, of  course,  anybody  can  work  up  his  own
                               list of poor folks. You could get a very good looking crew of junkies and  yet  not  really
                               represent that part of the poor  who  will  work  for  change,  for  example  (the  reverse
                               Uncle   Tom   phenomenon,    or,    how-to-achieve-wealth-and-fame-catering-to-the-college-
                               boy-urge-to-play-Che). I think you want to watch that.
                                   Another thing-stop sending all  those  memos.  Or  get  someone  else  to  write  them.
                               But, mainly, less  paper  in  the  mail.  The  Student  Health  Organization  must  bear  a
                               major share of responsibility in depleting the Nation's forests for pulp.
                                   Where you have a well-develdped group  of  poor  folks  who  can  use  medical  science
                               students, or law students, fine. Where you don't, I think you are  going  to  have  to  say
                               that you are trying to expose students to poor folks in order that  they  will  serve  them
                               better when they return as licensed professionals. That you want to  do  this  as  much  as
                               possible on the poor folks own terms-and  here,  I  think,  it  is  imperative  that  every
                               student have some kind of poor folk preceptor, as the  two  students  working  for  us  did
                               NOT  have  (my  own  fault  for  accepting  them  without  having  laid  that  groundwork).
                               But I don't see what else you can realistically expect to do beyond that .
                                   I hope these remarks are received as'friendly criticism. I hope to make it  to  Goleta.

                               STUART ALLAN, Administrator
                               Rural Health Project,
                               210 Canal Street
                               King City, Calif.

               64


                            CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                                           APPENDIX B

                                              Preceptor Evaluation-Tulare County

                       PROGRAM:          Tulare County Child Care Educational Program.
                       PRECEPTOR:  Eleanor Foster, director.
                            Four SHO  students  with  varying  degrees  of  relationship  to  us  worked  in  and
                       around the Child Care program this summer.
                            This program is by birth CAP and only recently moved to county schools. It  is  still
                       much closer to  community  identification  than  this  letterhead  suggests.  A  community
                       group primarily farm workers, initiates a child  care  center,  hires  for  it  and  makes
                       local Aecisions regarding its functioning. I believe child care is seen by  the  community
                       as a just return for their efforts, a right long overdue. It is not a demeaning  relation-
                       ship, and perhaps there is, or should be, a consideration for SHO in the choice  of  spon-
                       sors.
                            This past summer, two student nurses, a medical student, and  a  student  dental  hy-
                       gienist, through this and a related program, contributed directly to  the  communities  in
                       the area of their own science specialty. What they had to offer was  needed  in  the  com-
                       munities: Some of their services, the screening  of  vision  and  hearing  problems  among
                       the.children, the initiation of a dental clinic, the detection of a change in  the  anemia
                       pattern  of  the  low-income  children  following  a  diet  change,  will  make   a   long
                       range difference  to  health  and  even  lives  in  the  communities  here.  The  students
                       met  directly  with  the  parents  in  an  area  of  mutual  concern.  Some  of  the   re-
                       sults of the summer will be a growth in the students  themselves  who  will  have  changed
                       because of a genuine meeting with other persons.
                            Is this a small thing? Is SHO wanting to yank this out of its prograrii  and  pretend
                       to be something it is not? We honor the farmworker for his  skill  in  the  field  and  we
                       admire the integrity of his appearance and his  speech  and  his  spirit.  Can't  we  give
                       honor also to the student nurse for her skill, and admire  her  integrity  of  speech  and
                       her spirit and her appearance?
                            As poor strung out imitations of Cesar Chavez, these students  would  -not  have  had
                       validity. They could even  seem  contemptuous  of  a  whole  hard-working  population  who
                       has earned the right to strike by showing it had  a  contribution  to  make.  It  took  34
                       years of a search for honesty to make,Cesar; now he's  speaking  loud  and  clear  to  his
                       own people. But that these students should come in expecting  to  speak  out  about  some-
                       thing they have not experienced, to know the right way for others to go,  to  condemn  the
                       unsure? To speak for Cesar?
                            Certainly if the students have any sense of social history they  can't  help  but  be
                       caught up in the excitement and pertinence of the  social  revolution  going  on  here-but
                       they cannot make this particular history.
                         .  In answer to your question: Yes,  we  would  again  welcome  students  here  if  they
                       were working out their own authenticity-sharing  their  own  vitality  as  they  did  this
                       summer-making their own contribution in the  health  sciences  in  return  for  a  genuine
                       meeting with others and an education not to be duplicated in any classroom.
                            But they would not be welcomed as  dogmatists,  as  organizers  or  as  prophets.  We
                       need their help as health students-we do not wish it as the other.  They  would  have  too
                       little to offer-it would be too dishonest a role.
                       ErmNoR PosT=, Director,
                       Child Care Educational Program,
                       Tulare County Department of Education,
                       202 County Civic Center,
                       Visal@ Calif.  93277

                                                                                                                           65


                                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                     TULARE: COUNTY COMMUNITY ACTION AGENCY, INC.
                                                                                                   Visalia, Calif.,  July  18,  1968.
                                     DAviD SNYDER, Co-Director,
                                     California Student Health Project
                                     General Lab Building, Room 1G-24
                                     1200 North State Street
                                     Los Angeles, Calif.  90033

                                         DEAR  MR.  SNYDER:  I  am  writing  you  in  personal  response  to  the  current  challenge
                                     before the California  Student  Health  project  to  abandon  its  original  concerns  with  the
                                     problems of  the  medically  underprivileged  in  favor  of  a  more  inclusive  involvement  in
                                     the  revolutionary  aspects  of  community  change.  I  am  writing  you  also  as  a  preceptor
                                     of the present project to take  issue  with  your  formal  acceptance  of  certain  of  the  de-
                                     mands made by  a  so-called  "black  and  brown"  caucus  to  SHO  on  the  23d  of  June.
                                         As you are probably aware,  the  1968  student  health  project  can  trace  its  historical
                                     antecedents  back  to  1964  when  several  students  in  the  health   professions,   concerned
                                     over  gross  deficiencies  in  general  medical  education,  formed  what  became  the   Student
                                     Medical Conference.  In  the  summer  of  1965,  SMC  fielded  13  medical,  dental,  and  nurs-
                                     ing students into  the  rural  communities  of  California.  Their  purpose  was  two-fold:  Ex-
                                     pand and explore the potentialities  of  increasing  medical  and  health  services  to  migrant
                                     farm  populations;  involve  and  educate  future   health   professionals   in   the   enormous
                                     penalties paid by the poor for  a  segregated  system  of  medical  care.  Significantly,  these
                                     students saw themselves as uniquely qualified  by  virtue  of  their  specialized  training,  to
                                     involve  themselves  in  health  problems  as  health  professionals.  This  was  their  bag@om-
                                     plete, entire, and sufficient to a ten-week  tenure.  Not  surprisingly,  it  was  a  successful
                                     summer. In Tulare County, the  evaluatory  study  of  local  health  conditions  done  for  this
                                     Agency  by  the  SMC  intern  was  subsequently  used   in   planning   poverty   programs   di-
                                     rectly  related  to  the  medical  needs  of  low-income  farm  workers.  The  SMC  himself   is
                                     completing his medical training and intends to practice among the rural poor.
                                        Of course, this was 1965.
                                        By  1968,  SMC  had  grown  into  a  national  confederation  of   Student   Health   Organi-
                                     zations, able now to secure funding  from  the  public  trust,  obtain  sponsorship  from  pres-
                                     tigious  medical  schools,  and  enlist  the  interest  of  many  hundreds  of   students   from
                                     across the country. It  has  remained,  however,  in  its  involvement  and  impact  upon  rural
                                     California communities, essentially a summer program.-
                                        By 1968, this agency  had  also  grown  into  the  largest  and  most  respected  rural  pov-
                                     -ty  organization  in  the  State,  operating  19  community  action   groups,   13   year-round
                                      Id care centers, 4  low-income  credit  unions,  and  a  half-million  dollar  basic  education
                                     ay.    training program.  This  agency,  of  course,  operates  12  months  out  of  every  year
                                     in     -)unty, each year since  1964.  It  has  to  effective  community  organization  is  -not
                                     a 10-week show.
                                       Again,  this  year,  SHO  invited  us  to  sponsor  several  students  to   work   in   Tulare
                                     County. As  we  can  well  use  the  type  of  specialized  skills  available  through  SHO,  we
                                     agreed to  sponsor.  We  submitted  a  proposal,  approved  by  SHO  and  our  board  of  direc-
                                     tors, and we officially  became  a  preceptor.  Our  students,  as  intended,  are  now  working
                                     on health problems, as  health  interns,  and  are  proving  to  be  sensitive  and  sympathetic
                                     to  those  whose  resources  traditionally  isolate  them  from  the   mainstream   of   medical
                                     care, i.e.  the  poor.  We  hope  that  their  experience  this  summer  will  generate  commit-
                                     ment from concern, and that they will  eventually  use  their  medical  skills  in  the  service
                                     of the low-income community.  That,  at  least  in  theory,  I  had  always  though  to  be  one
                                     of  the  major  objectives  of  the  summer  project.  Apparently,  the  objectives  have   been
                                     radically redefined.
                                       To take the demands, already acceded to, made by the black and brown caucus:
                                            "1.  The  target  communities  being  black  and  brown,  it  is   therefore   nec-
                                       essary in  order  to  maximize  the  project's  relevance  and  effectiveness  that  the
                                       decision-making  staff  be  composed  of   one-third   black,   one-third   brown,   and
                                       one-third white*        Such  a  step  would  improve  such  areas  as   site   determi-
                                       nation and placement, applicant selection and recruitment, and orientation."
                                            Comment:  You've  got  the  base  for  a  good  blend   here,   all   right.   That

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                            CALIFORNIA STUDENT HEALTH PROJECT SUMMER  1968

                            "one-third, one-third, one-third" bit is an excellent way to maximize  your  rele-
                            vance. And certainly when it comes to an actual decision, a little  color  control
                            really helps. However, I question the need for the  one-third  white.  After  all,
                            the target communities are  only  black  and  brown.  And  you've  already  agreed
                            that student vacancies "must be  filled  with  black  or  brown",  so  why  white?
                            Having dealt with that "white one-third" myself on  your  staff,  I'd  say  elimi-
                            nate them. But then, I'd also shoot for  something  like  "one-third  intelligent,
                            one-third articulate, and one-third aware"  or  maybe  just  "three-thirds  compe-
                            tent" would suffice.
                                "2. The selection of applicants  must  be  reflective  of  and  responsive  to
                            radically oriented students, NOT missionaries and soul searchers;,i.e. these  stu-
                            dents should be oriented to  the  black  and  brown  revolution-not  merely  their
                            technical "thing" of health or law or social work."
                                Comment: Now this  strikes  right  at  the  root  of  the  fern.  Birth  of  a
                            new   breed-the   "health   radical".   Recruitment   poster    reads:    "WANTED-
                            FOR      SHO      SUMMER      STUDENT      PROJECT-HEALTH       RADICALS!       IF
                            YOU     OWN     A     HIP-POCKET     HUEY     NEWTON     READER,     SEND     SOUL
                            NOTES    TO    THE     NEGRO     NEUROSURGEON     ON     PEYTON     PLACE,     AND
                            GROOVE     WITH     ANGLO     INTEGRATION     OF      THE      LUNCH      COUNTERS
                            AT    TACO    TIAS,    YOU    MAY    QUALIFY    FOR    A     TEN-WEEK     CONTRACT
                            WITH     THE     REVOLUTION     OF      YOUR      CHOICE-BLACK      OR      BROWN.
                            REMEMBER   OUR   MOTTO@'IF   YOU    CAN'T    BE    A    PART    OF    THE    PROB-
                            LEM, YOU MIGHT AS WELL STAY HOME."
                                Of course it would be helpful to  begin  with  a  radical  medical  school  to
                            sponsor, a radical government agency to fund, and a  raft  of  radical  preceptors
                            to find someting for the radical students to do, but  then  you  can  bridge  that
                            gap when you fall in it. The AMA isn't in a rush.
                                     "3. This summer's project  should  have  present  preceptors  serving  on
                            the board where staff decisions are being made."
                                     Comment:  "I'm  sorry  but  that  number  has  been  disconnected.  Could
                            you hang up and dial again, please?"
                                     "4. Propriety commends  tht  John  Bruce  be  transferred  to  @  Angeles
                            immediately; he is married and it is ureasonably  inconvenient  to  place  him  in
                            Oxnard. Furthermore, it detracts from his effectiveness as a  black  medical  stu-
                            dent."
                                     Comment: Now this is the kind of  gut  staff  decision  that  could  cer-
                            tainly cause a preceptor  to  think  twice  before  disconnecting  his  number.  I
                            mean I wish I had been there,  you  know,  for  the  actual,  decision.  Just,  of
                            course, in order to maximize its relevance. John's  right  about  Oxnard,  though,
                            I've been there. You can go numb just from saying the name.
                                     "5. Present vacancies in  the  student  project-or  -new  positions  that
                            open-must be filled with black and brown."
                                     Comment: Amen, I say.  After  all,  who  wants  the  kind  that  melt  in
                            your hand?
                            To sum up: This agency feels that the current direction being  taken  by  the  student
                       health project is a distortion of its founding ideology, and is most especially  irrelevant
                       to the medical needs of this county. Responding to those needs is, in my  estimation,  the.
                       sole and exclusive concern of any student  health  interns  admitted  into  rural  communi-
                       ties on summmer projects. Students who insist  on  a  10-week  "involvement"  in  the  com-
                       plexities of community  organization,  end  by  interfering  with  the  process  of  social
                       change, at best, and may even destroy good  work  that  has  gone  before  them.  We  don't
                       iire 10-week organizers and we don't  accept  them  as  volunteers,  not  from  VISTA,  the
                       Boy Scouts, or SHO.
                            Yours truly,
                                                                                             RicH,uw UNwiN,
                                                                                              SHO Preceptor.

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                                     CALIFORNIA STUDENT HEALTH PROJECT SUMMER  1968
                                      APPENDIX C.-RECOMMENDATIONS BY STUDENTS ON PROJECT
                                                         PLACEMENTS FOR THE FUTURE

                                                                                                   Recommended
                                                                                            Site              Preceptor
                                 Name of site                                             Yes      No       Yes      NO
                                 Madera   ------------------------------------------       --      x                 x
                                 East Los Angeles Health Clinic (Pat Wiley)       ------   --      x          x
                                 El Monte Teen Post   -------------------------------      --      x                 x
                                 Venice (Lawless) Legal Aid Services      ---------------   x
                                 Oxnard area       --------------------------------------   x                        x
                                 Willowbrook Health Clinic       ------------------------   x                 x      --
                                 Earlimart Child Care Center    ----------------------     --      x                 x
                                 Venice Dental Clinic       -----------------------------   x
                                 Los Angeles County-general        ----------------------   x                        x
                                 Fresno General Hospital   ---------------------------     --      x                 x
                                 Imperial Valley      -----------------------------------   x
                                 King City Rural Health Project      --------------------   x                 x

                    68


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                                          APPENDIX D
                                     SOME QUESTIONS FROM THE BLACK CAUCUS
                           1. How do white Student  Health  Organization  people  'perceive  the  so-called  civil
                             disturbances in black communities? Riot  or  insurrection?  Nihilistic  or  an  epi-
                             sode in a continuing social struggle?
                           2. How do you  look  at  "nonprofessional"  health  workers,  e.g.,  aides,  LPN's  or-
                             derlies, etc.-those black people who form  the  underpinnings  of  the  huge  hospi-
                             tal bureaucratic and services structure and who are locked in at the bottom-
                           3. Do you favor unionization of hospital  employees  even  if  tfiis  threatens  tradi-
                             tional authority relationships with health "professionals"?
                           4. Is there any useful thinking among you  about  creative  methods  to  challenge  and
                             enlighten those black physicians who have been screwed in  the  past  by  the  white
                             medical guild structure and now stand a chance to  be  screwed  by  the  white  lib-
                             eral  establishment  which  condemns  them  for  not  being  sufficiently  community
                             minded?
                           5. Are black project participants used as fronts or as  escorts  into  black  communi-
                             ties?
                           Members of the black caucus are concerned about  SHO's  lack  of  a  theoretical  per-
                      spective on the appropriate role of white health science  students  in  black  communities.
                      Generally we ask these  questions:  Are  you  responsive  to  the  principle  of  community
                      and consumer control of services? Are you aware of the  extent  to  which  Black  Power  is
                      a viable concept in black communities? Are you going to be doing  political  organizing  in
                      black areas-probably not-who wants to get  killed,  but  is  this  a  reason  derived  from
                      principle? You must have an understanding of  why  black  people  no  longer  can  tolerate
                      your presence in the ghettoes@ven spiritually- It  is  not  that  you  are  racists  (which
                      you very well may be), but that we blacks are struggling for a sense of  identity,  mutual,
                      trust and control of our destinies as a group. It is a question of survival, the very  ess-
                      ence of which depends ultimately  upon  black  initiative,  black  support,  services,  re-
                      sources, skills, and action. Only in this way is there any hope for our  salvation.  So  it
                      really doesn't matter whether you identify with black militants, have a  radical  analysis,
                      have good hearts, and are clean  for  Gene-your  very  presence  in  black  communities  is
                      destructive and you cannot make yourselves relevant to us at all.
                           Obviously, if  these  dicta  were  adhered  to  literally  many  SHO  summer  projects
                      would collapse. As a compromise solution we offer  the  following:  The  only  roles  still
                      available for white students with respect to the struggle for liberation of  the  dispersed
                      black colony are those of the patient-advoca@ in the  context  of  white  service  institu-
                      tions, catalysts and liaison for community  groups  seeking  participation  on  boards  and
                      councils which control community services, and  research  analysts.  Ultimately,  those  of
                      you who are sincerely committed  to  social  change  must  examine,  confront,  and  expose
                      those white institutions (hospitals, medical schools, welfare) which by their  very  struc-
                      tural nature insure and perpetuate oppression, racism,  and  deprivation.  This  is  essen-
                      tially the,white radical position. It allows an opportunity  for  alliance  and  solidarity
                      with the black struggle. If white students on summer projects do  not  have  this  kind  of
                      understanding, the project is again into yet  another  summer  of  white  paternalism,  an-
                      other summer where mindless, selfless service finds its reward in  covert  palliation,  an-
                      other summer in the sun learning how the niggers live.

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                                       CALIFORNIA STUDENT HEALTH  PROJECT  SUMMER  1968

                                                                       APPENDIX E
                                         THE BLACK STUDENTS AND THE STUDENT HEALTH PROJECT
                                                                   A POSITION PAPER

                                                             Final conference- August 30, 1968
                                      In 1960, black infants were dying at a rate that exceeded the total population  by  66
                                 percent; the maternal death rate for black women  was  four  times  as  high  as  that  for
                                 whites; the life expectancy for nonwhites was  6  years  less  than  for  whites;  approxi-
                                 rnately 30 percent more whites have health insurance than blacks; and  only  2  percent  of
                                 this country's physicians are black. In light of such dismal reality, we, as  future  black
                                 health professionals, cannot afford to continue playing polite parlor games ivith the  stu-
                                 dent health project. For black students, SHP has served as  a  source  of  frustration  and
                                 an exercise in f utility. We joined the project with the hope that our collective  efforts,
                                 black and white together, would be responsive primarily to the'needs  and  desires  of  the
                                 communities  we  sought  to  serve.  While  possibly  lacking  understanding,  we   assumed
                                 that you at least had good will.
                                     We have been mistaken.
                                     The 1967 project's critical  report  has  apparently  gone  unread  b'y the  staff.  That
                                 report warned of the organizational pitfalls to  be  avoided-which  they  have  not:  "Res-
                                 istance to  sweeping  innovation;  dependence  on  revokable  funds;  perpetuation  of  in-
                                 group ideals to the exclusion of ideological renewal;  over-reliance  on  public  relations
                                 work to compensate for a deficit new activity; and, particularly, disregard for  the  needs
                                 and feelings of clients when these are in conflict with the inertia of  the  organization."
                                     While thus plagued by the interworkings of the project,  even  the  inertia  pushes  in
                                 the wrong direction. The SHP has fallen into the hands of  a  staff  of  ignorant,  middle-
                                 class whites who have been exploiting the  project  to  feed  their  own  needs  and  egos.
                                 Supposedly moving away from establishment ties,  the  SHP  staff  has  become  as  insensi-
                                 tive as the historical establishment that brought about  the  situation  as  it  is  today.
                                 Pockets are being generously filled on the pretext of helping to improve the  health  situ-
                                 ation in the ghetto. The rhetoric claims that  we  are  responding  to  the  needs  of  the
                                 ghetto people as perceived by those people, but behind the  closed  doors  where  the  deci-
                                 sions are made there hangs on those doors a whites only sign.
                                    In reality, the project exists only as a  stop-gap  adventure  for  many  white  middle-
                                 class students, and a token number of blacks  used  for  legitimating  purposes.  The  pro-
                                 ject is nothing but a reflection of the tired liberal mentality-an effort to  rage  quietly
                                 with dignity, "to tell the poor what to do with  their  poverty"  as  Le  Roi  Jones  would
                                 say. In terms of the communities, no basic  changes  are  made,  no  new  power  is  e3ier-
                                 cised. The summer ends and business as usual continues.  Students  return  to  school  with
                                 new insights, cleansed consciences, and an easy  $800.  The  ghetto  was  just  a  research
                                 project; and, like other cancers, there has been no cure found.
                                   This project has become an apolitical  social  movement.  Prof.  Richard  Flacks  of  the
                                 University of Chicago has pointed out  the  danger  here,  which  is  that  of  irresponsi-
                                 bility; "of a search for personally satisfying modes of life while  abandoning  the  possi-
                                 bility of helping others to change theirs; a situation in which one's  personal  needs  and
                                 hang-ups are increasingly acted out in  the  large  arena,  and  attempts  at  solution  of
                                 these take precedence over more collective concerns."  Thus  the  project  can  spend  over
                                 $10,000 for resort conferences and orientations, over  $400  for  individual  Spanish  les-
                                 sons, over $1,000 for sensitivity sessions; but merely to obtain a $4 phone,  the  students
                                 in Watts had to organize and bargain.
                                   The question should b e asked whether a project can  be  fostered  by  institutions  sub-
                                 stantially tied to a status quo interests and still be  responsive  to  the  needs  of  the
                                 ghetto. It should also be asked what role white liberals can play  in  this  effort.  White
                                 liberals characteristically embrace objectives, but shy away from militant means. It  is  a
                                 fact that when black voices grow militant  most  white  liberals  become  reluctant.  Para-
                                 doxically, some see this project forming  a  tighter  alliance  with  community  militants.
                                 Yet  the  community  NYCs  have  been  dropped,  our  preceptor,  Lou   Smith,   has   been
                                 deemphasized,  the  implementation  of  the  black-brown  demands  is  a  farce,  and  many
               70


                            CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                       white students fear that the project is becoming  merely  an  extension  of  the  black  and
                       brown revolutions.
                            It must be clear to all of us that blacks and whites live in very different worlds.  As
                       Carmichael  and  Hamilton  have  stated,  it  cannot  be  overemphasized  that  "these   two
                       groups operate from different vantage points and  different  concepts  of  what  constitutes
                       legitimacy. We shall have to struggle  for  the  right  to  create  our  own  terms  through
                       which to define ourselves and our relationship to the  society,  and  to  have  those  terms
                       recognized." And for those who need  reiteration,  Silberman  echoes  the  point,  "For  the
                       moment, at least, it is far more important that things be  done  by  Negroes  than  they  be
                       done for them * * *."
                            Hence, what is needed is a project  emanating  from  the  ghetto,  comprised  of  black
                       studen@to be integrated from  black  to  white  if  need  be-and  receptive  to  the  needs,
                       frustrations, and cries of the ghetto. This will be an alternative to the SHP,  not  a  paid
                       vacation for anyone merely to familiarize himself with  the  problems  of  the  ghetto,  but
                       rather an opportunity primarily for potential black  health  professionals  to  start  help-
                       ing their own people help themselves. As Loren Miller put it,  "To  liberals  a  fond  fare-
                       well, with thanks for service rendered, until you are ready to  reenlist  as  foot  soldiers
                       and subordinates in a black-led, black-officered army under  the  banner  of  Freedom  Now."

                                                                      UNr&wiTy OF SOUTHERN CALIFORNU,
                                                                            Los Angeles, Calif., June 25,1968.

                                                            APPENDIX F

                                                  A LETTER FROM THE DEAN

                       To the Participants in the Student Health Project:
                            I was grateful for the opportunity to talk briefly to you on Sunday  evening  at  Yu-
                       caipa, but the discussions that followed, even though it only involved a relatively  small
                       group, seem to require some further clarifir-ation on my part.
                            The aims to which this project has been  devoted  is  probably  three  fold,  and  it
                       would seem to me that if those aims are not kept  paramount  in  your  consideration  this
                       could well be the last year of your project. The purposes for  which  the  government  has
                       been willing to finance  these  summer  experiences  are:  (1)  To  help  future  doctors,
                       nurses, dentists, social workers and others interested in the field of health to learn  at
                       first hand the present methods of the delivery of health care to the  very  poor;  (2)  to
                       think about and discuss ways in which this could be improved; and (3)  to  show  by  their
                       presence to these poor their interest  in  them  and  concern  about  their  problems  and
                       through their efforts still as students to help correct them.
                            Since many of the poor are black and in California brown, it would  certainly  follow
                       that one should search out as much cooperation as one could get from  the  blacks  and  in
                       California the Spanish-American through committees in the  areas  in  which  you  will  be
                       working and through the  encouragement  of  black  and  brown  professionals  to  join  in
                       your project. A demand of 1/3, 1/3, 1/3, while it  was  ambiguous  would  seem  to  me  to
                       discard so many of the other qualities that might go into such an undertaking. Regar
                       less of my own feeling in this matter, I could not have defended active  student  partici-
                       pation in a grape strike, in organizing a protest against the  war  in  Vietnam,  and,  by
                       the same token, I doubt that I can help defend it if it becomes  as  militantly  antiwhite
                       as was expressed by a few people at that meeting.
                            I am sure that when you start working on  your  various  assignments  your  interests
                       will deepen as you learn of the patterns of health care  and  find  what  you  can  do  to
                       improve them. The discussions you have had at Yucaipa will  certainly  take  on  a  fuller
                       meeting. I trust that your hopes for the unity of man and your feeling of love  for  other
                       men that is such an impelling force in this effort continues to grow.
                            I look forward to joining you in the fall and hearing of your experiences,  what  you
                       have learned and what you recommend. I shall  certainly  be  interested  in  your  planned
                       structure for the future, in your efforts to  improve  communication,  but  I  would  hope

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                                     CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                 that whatever structure  you  create  is  given  some  semblance  of  authority  to  carry
                                 throuzh the wishes of the group for the succeeding year.
                                     I hope that your activities do not risk the continuing promise of  this  organization.
                                     I wish you well.
                                     Sincerely,                                         ROGER 0. EGEBERG, M.D., Dean.

                                                                     APPENDIX G

                                                              GOALS AND DIRECTIONS
                                     Nineteen  sixty  eight  marks  the  fourth  year  of  the  California  summer  student
                                 health project. As early as the orientation conference for this year's project  considera-
                                 tion was given to the California Summer  Student  Health  Project  of  1969.  The  salient
                                 demand of the black-brown caucus dealt with the  composition  of  a  policy  board  to  be
                                 organized by the end of this summer, presumably to plan and direct  next  year's  project.
                                 Additional discussions regarding a  1969  project  have  taken  place  since  orientation.
                                     This demand and these discussions ass
                                                                               ume  a  fifth  California   summer   student
                                 health project. A project should be based on a decision, not on an  assumption.  Before  a
                                 decision can be made for or against a project, basic questions  regarding  goals  must  be
                                 answered. Without goals there is no basis for determining the true purpose  of  a  project
                                 or, equally important, whether a project is a success or a failure.
                                 Who Should Set.Goals?
                                     Are the primary goals to be those of the  students,  the  community,  or  the  funding
                                 agencies? This is  the  Student  Health  Organization.  Students  must  define  their  own
                                 goals based on the fact that they have important and independent interests. If  a  project
                                 is useful in meeting student goals specific project proposals should be  developed.  These
                                 proposals must reflect these goals. The proposals should be  presented  to  the  community
                                 and funding agencies. If student goals are consistent with community goals   the   project
                                 is feasible. If student goals are consistent with agency goals the  project  is  fundable.
                                 This suggests negotiations from a position of strength based on specific  proposals  which
                                 may result in acceptance of a  project  by  the  community  and  funding  agencies.  Since
                                 each group should know what is involved, such  negotiations  should  bring  students,  the
                                 community and agencies together at the same time. A project cannot  succeed  if  the  stu-
                                 dents have one understanding with  the  community  and  another  with  the  agency.  Under
                                 these  circumstances  the  community  and  the  agency  have  no  understanding  of   each
                                 other. If all three groups see a mutual advantage,  the  maximum  realization  of  defined
                                 project goals is likely to result.

                                 What are Some Possible Goals?
                                     Is the major goal to be education of the student, the provision  of  services  to  the
                                 community or the performance of a task, such as the  gathering  of  information,  for  the
                                 funding agency? Can these goals be compromised?
                                     If the major goal is student education it must be recognized  that  ghetto  or  barrio
                                 communities and funding agencies are  being  used  by  the  project.  The  community  will
                                 expect services in return and funding agencies will expect the performance of  a  specific
                                 task. Students must recognize and accept these community and funding agency goa  I
                                 a project is to succeed.
                                     Services must fill community needs as perceived  by  the  community  and  not  by  the
                                 students or the funding agencies.  Although  more  difficult  to  achieve,  the  community
                                 must also recognize and accept both the student and funding  agency  goals  if  a  project
                                 is to succeed.
                                     Funding agencies do  not  write  blank  checks.  Although  considerable  latitude  has
                                 been given thus far for projects of the Student Health Organization, it is  unlikely  that
                                 this freedom can  continue.  A  return  on  funds  expended  will  be  expected.  However,
                                 funding agencies must recognize and accept student and community goals  if  a  project  is
                                 to succeed.

                  72


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                      Does the California Student Health Project have a Direction?
                           The initial funded project in 1966 consisted almost entirely  of  placements  with  the
                      providers of services-institutions and health  agencies.  Preceptors  were  members  of  the
                      establishment. Through these placements the student  came  into  contact  with  the  recipi-
                      ents of health  care-the  community.  He  frequently  identified  with  the  recipients  and
                      used the information obtained from his experiences in an attempt  to  influence  the  estab-
                      lishment. lie provided some services in an attempt to fill needs as  viewed  by  the  estab-
                      lishment. In the course of his work he became aware  of  the  inadequacies  of  the  present
                      health care system and hopefully resolved to remove  them.  His  initial  attempt  at  prod-
                      ucing change was directed at his school when he  returned  in  the  fall.  This  effort  en-
                      joyed significant institutional support as reflected in  curriculum  modifications  and  the
                      spread of Student Health Organization activities to many other schools.
                          In 1967 the project was a mix  of  placements  in  institutions,  agencies  and  commun-
                      ity organizations. An attempt was made to  organize  dual  preceptorships  for  each  place-
                      ment, with one preceptor representing the established  agencies  and  the  other  represent-
                      ing the community.  The  importance  of  filling  community  needs  rather  than  establish-
                      ment needs was  recognized.  Community  involvement  was  emphasized  by  the  inclusion  in
                      the project of Neighborhood Youth Corps  enrollees.  The  role  of  the  student  in  agency
                      placements was similar to that  of  the  previous  year.  Placements  involving  NYC  enrol-
                      lees frequently dealt with  the  problems  of  interpersonal  relationships  which  lessened
                      the ability to provide services. Again the major effect  of  the  project  appears  to  have
                      been that students became  aware  of  inadequacies  in  the  system.  This  recognition  was
                      not limited to the health care system. Efforts at producing  change  after  the  termination
                      of this project were again directed at schools and students continued  to  enjoy  considera-
                      ble institutional support.
                          In 1968 there has been further  identification  with  community  interests.  A  minority
                      of placements are with providers of health services and  the  majority  are  with  recipient
                      groups. Identification of the project with the  community  has  been  enhanced  by  attempts
                      at radicalization of the project by the  black-brown  caucus  and  the  relatively  indepen-
                      dent action of law student project  participants.  An  attempt  has  been  made  to  involve
                      preceptors (community representatives) in giving direction to the project as a  w  io  ,  as
                      well as to specific placements.
                          This incomplete historical review  indicates  a  trend  toward  community  interest  and
                      away from agency and institutional interests;  toward  identification  with  anti-establish-
                      ment groups  and  away  from  the  establishment.  'The  culmination  of  this  trend  would
                      seem to be complete alliance with  militant  community  organizations.  This  implies  work-
                      ing against rather than within the  present  system  of  health  care.  Indeed,  it  implies
                      working against the system without necessarily direct reference to health at all.
                          This may be an  appropriate  direction.  However,  it  must  be  recognized  that  along
                      the way the Student Health Organization and  its  project  will  lose  support  from  within
                      medical institutions, funding agencies  and  the  health  science  student  community  as  a
                      whole. More importantly, how much  have  the  students  themselves  controlled  this  direc-
                      tion and is the present direction consistent with the interests and  goals  of  the  Student
                      Health Organization? These  questions  cannot  be  answered  until  the  interests  are  de-
                      fined and definite goals determined.
                                                              S. DOUGLAs FRASIER, M.D., Faculty Director,
                                                                          California Student Health Project.

                                                           APPENDIX H

                                            IDENTITY (ABBY KROWITZ'S DIARY)
                         I feel that things are finally falling into place.- I am,begin-ning  to  understand  what
                      the situation is, what the possibilities are and the necessity  for  political  power  to  be
                      given to the people.
                         I am, for the first time, in touch with  my  own  cultural  heritage,  of  prejudice  and
                      persecution, and can grasp the significance of  my  childhood  experiences  and  my.father's

                                                                                                                           73


                                       CALIFORNIA STUDENT HEALTH  PROJECT  SUMMER  1968
                                 total development. I can see how the Jews, through a long tradition of being in  a  hostile
                                 society, developed the values and structures that they did.  Education  is  a  way  out  of
                                 the alums, a way of being listened to; credentials which are possible to obtain if you  are
                                 geared to do it from birth. I can't remember ever thinking I would not go to  college,  not
                                 do well in school, not be interested in learning things. My  father  made  it  a  point  of
                                 taking me to museums, and  getting  me  to  groove  on  things  like  how  are  atoms  com-
                                 posed, how do fishes survive, what are the stars made of. There  was  consistent  and  con-
                                 stant encouragement, and I responded. Also  the  kinship  organization  of  which  my  fam-
                                 ily was a member, when I was a child. Those  who  had  would  give  to  those  who  hadn't,
                                 and there was warmth, and  concern,  and  a  strong  group  which  functioned  to  get  the
                                 clan out of poverty. Now that we are out, there are no more meetings.
                                     So I am beginning to understand, to see, to  learn.  Every  day  is  a  memorable  one,
                                 but my memories are of conversations, and feelings which are hard to relate.  I  also  feel
                                 more that I want these people to know me, that I can trust  them,  not  with  my  problems,
                                 but with my most personal thoughts about life, myself, other  people,  love,  despair.  And
                                 we can all dance and drink and you know they will be there tomorrow.
                                     There is so much to read. I am impatient. So long have  I  evaded  issues,  because  of
                                 the fear that the truth would alienate  me  from  my  family,  my  own  passivity,  and  my
                                 own desire to have some security that the world is not a horrible place to be.  I  couldn't
                                 tolerate it any more and am now reading  about  Vietnam.  It's  hard  for  me  because  the
                                 story it tells makes me want to climb the  walls  and  scream  at  everyone  who  says  the
                                 war is good. It makes me want to shoot Johnson, or hide all  the  planes  and  guns  in  my
                                 backyard where I can watch them and be sure that no  one  gets  so  crazy  that  they  want
                                 to kill someone with them. War is so sick, especially colonial wars. So  r  read  about  50
                                 pages a day and take long walks.
                                    I often think how can I go back to my scholastic rut, now when  I  still  have  so  much
                                 to learn. I want to be in on it. So, being my usual insane self, I decided to  quit  school
                                 and go somewhere new next year. It is difficult to explain  how  this  is  related  to  the
                                 summer. I do not feel turned on to VISTA work. More to life  outside  of  school,  more  to
                                 people than to life, more to my own possibilities than people. I want to explore.  Asia  or
                                 Europe (actually the world but I can get to these  continents  free).  How  absurd  it  is-
                                 being alive.

                                                                     APPENDIX I
                                                          MARTHA JACKSON'S LETTER
                                   D@  DR.  FRAsiER:  This  is  in  response  to  your  letter  requesting  student  evalua-
                              tions of projects.
                                   I am not sure if I  can  give  you  a  cut  and  dry  answer  as  to  precisely  what  my
                              project was for the summer, but I think I can tell you  what  I  did  and  how  I  felt  about
                              it.
                                   You probably know by now what rural  health  project  in  King  City  is  all  about.  In
                              a few words, this project  provides  medical  services  to  indigent  patients,  mostly  Mexi-
                              cans, by a private medical group.  Costs  are  paid  from  OEO  funds.  The  area  covered  is
                              southern Monterey County. None  of  the  doctors  in  the  group  are  Mexican,  yet  a  large
                              percentage of their patients  are.  This  has  posed  some  problems  in  rendering  effective
                              medical care. Aides from the target area are used as interpreters.
                                  My job  was  to  "educate  the  doctors"  to  the  Mexican  way  of  life.  My  preceptor,
                              Stuart Allen, felt I could best do this by living  in  the  homes  of  some  Mexican  families
                              here, observing and participating in their daily  life  and  writing  about  what  I  saw  and
                              heard. I was also to  identify  health  problems  and  other  problems  that  might  be  indi-
                              rectly related to health, such as housing conditions, working conditions, and the like.
                                  I  lived  with  two  Mexican  families  in  labor  camps  during  the  summer   and   have
                              written detailed accounts- of these experiences. I also  worked  a  few  days  in  the  fields
                              which I also wrote  about.  T'he value of these papers  remains  to  be  seen.  I  do  not  know
                              what the doctors they're supposed  to  educate  think  about  them.  My  preceptor  seemed  to
                              think they were worthwhile and good.

               74-


                                           CALIFORNIA STUDENT HEALTH PROJECT  SUMMER  1968
                                      for the on-going Project come to  contain  a  specific  type  of  "revolution-oriented"  con-
                                      tent; and, that the process of conveying the material  which  involve  the  black  and  brown
                                      conscious people  from  the  communities.
                                          1. There will be compiled a  reading  list,  tapes,  films  and  prepared  talks  dealing
                                      %vith the more and more clearly formulated  philosphy  of  the  heretofore  "colonized"  peo-
                                      ples of this country.
                                          2. Discussion groups will  be  held  and  the  participants  will  include  students  and
                                      community people interested in adequately preparing themselves beforehand.
                                          3. Some of the readings would be chosen from  the  following  list:
                                          (a) Crisis in Black and White     --------------   Charles Silberman
                                              Autobiography   of   Malcolm    X------------
                                              Manchild  in  a   Promised   Land ------------ Claude     Brown
                                              Invisible Man   --------------------------     Ralph    Ellison
                                              Black Bourgeoisie   ----------------------    Franklin Frazier
                                              Sex and Racism in America       ------------   Calvin Hernton
                                              The Negro Revolution in America     --------  Brink
                                              Soul on Ice  ----------------------------     Eldridge Cleaver
                                              Negroes With Guns     --------------------
                                              Black Power    --------------------------     Stokeley  Carmichael   and   Charles
                                                                                              Hamilton
                                              Delano (and a  long list of others emphas-
                                               ing  the   "Brown   Revolution") ----------
                                       Wind-up Conference
                                       The proposal advanced by the group  which  met  in  Visalia  is  that  this  occasion  be
                                   regarded as for the benefit of the community people who are  to  be  invited  in  large  num-
                                   bers. The funds available are to be devoted as  much  as  possible  to  attracting  spokesmen
                                   for the black and Brown Revolutions, whose function will be  to  contribute  to  the  politi-
                                   cization of all participants.
                                       Relationshl'  Between Preceptor and Participant
                                                    p
                                       The preceptor, if he or she is not a person connected  with  organizing  efforts  in  the
                                   community, is to surround himself or herself with persons    so  associated.  This  relation-
                                   ship, it is suggested, will serve to ensure that student participants are involved in  activ-
                                   ities which directly contribute to the development of a power base  in  the  particular  pov-
                                   erty community. It is acknowledged that all communities  differ  as  to  degrees  of  organi-
                                   zation among the poor and  it  is  understood  therefore  that  the  student's  technique  of
                                   relating thereto must vary accordingly; but  the  emphasis  on  this  orientation  is  clear.
                                   The  persons  attuned  to  the  organizational  needs  of  the  community  are  to  determine
                                   the method of applying the  technical  skills  possessed  by  the  student.  The  student  is
                                   to maintain such a group of advisors in order  to  safeguard  the  wisdom  of  the  direction
                                   of his or her activities.
                                   IV.  Relationship Between Preceptor and Community Based Persons
                                   Serving  in  Governing   Capacity   for   the   Student   Health   Project
                                      Because the definition of preceptor has  been  vague  in  the  Past  and  because  it  ap-
                                   pears to satisfy different functions in different contexts, the  governing  board  is  to  be
                                   considered one composed  of  "community  people".  Where  a  person  known  now  as  a  "pre-
                                   ceptor" is also a community  person,  there  is  no  problem.  However,  when  the  preceptor
                                   admittedly has little or  no  connection  to  persons  engaged  in  some  form  of  community
                                   organizing effort, this board of advisors, perhaps four or five will  be  invaluable  in  di-
                                   recting the activities of the student and the project.
                                   V.  Train Students in Community Development
                                    An  underlying  assumption  of  all  projects  must  be  that  preprofessional  and  profes-
                                   sional skills alone are not valuable to the poor community, they  must  be  offered  in  con-
                                   junction  with  those  people  in   the   community   doing   community   organizing   Though
                                   students  are  not  to  be  considered  "community  organizers,"  they  are   to   understand
                76


                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                         the  function  and  problems  of  a  community  organizer  in  order  that   the   application
                         of their respective skills be as a supplement to such work.
                         Students  must  be  capable  of  examining  what  they  are  doing  in  order  to  be  certain
                         that their projects  are  contributing  to  the  organizing  effort  in  the  community  where
                         they are working.  The  emphasis  of  the  student's  activities  is  towards  basic  institu-
                         tional change, to contribute in a  variety  of  ways  to  building  a  power  base  among  the
                         poor  such  that  they  become  capable  of  paricipating  in  the   decision-Making   process
                         which affects their daily lives. The assumption is  that  the  development  of  a  large  body
                         of  enlightened  professionals  does  not  go  far  enough,  that  without  power  among   the
                         poor, the professional-patient (legal or medical) relationship reaffirms  the  latter's  sense
                         of inadequacy to deal with the problems affecting his life, that. it is  inherently  paternal-
                         istic and thereby perpetuates the cycle of poverty. It is  an  understanding  that  there  are
                         good and bad ways to  extend  services,  and  that  the  delivery  system  which  most  corre-
                         sponds  to  the  needs  of  the  poor  is  one  which  can  be  managed  by  those  heretofore
                         gtserved".
                         Students  are  not  to  be  organizers,  but  they  are  to  perform   organizing   functions.
                         The simple  gesture  of  involving  community  people  in  the  performance  of  the  students
                         "professional" tasks serves to promote continuity of that  f  unction,  and  thereby  develops
                         a power  base  within  the  poverty  community,  the  objective  of  all  "organizers".  There
                         are many other tasks essential to the organizing  e,ffort  which  the  students  may  perform,
                         and by working closely with the local  organizing  effort,  they  can  discover  how  best  to
                         serve that effort.
                                                              ADDENDUM
                         1. Unknown Youth            ---------------------------- Pat Heller
                         2. Health Needs of Mexican-Atnericans         ---------- Berkeley Press
                         S. Psychology of the Mexican         ------------------- Samuel Ram4Ds
                         4. Labrynth of Solitude         ------------------------ Octavio Paz
                         5. El Ser Todavia No Sier4pre        ------------------- Leopold de Cea
                         6. Center for Study of Democratic Institutions      ---- "Center"   Magazine    March,    1966
                         Artirle, Mexican-Am@can History
                           "La Mula no es Asigap             -------------------- Galarcia
                         7. Factoi*s in th6 Field     ------------------      --- Carey MeWilliains
                         8. Merchants of Labor          ------------------------- Ernesto GaZarza

                                                               APPENDIX         K
                                       MAJOR ACTIVITIES CONDUCTED BY STUDENTS

                         Health-Oriented
                            Identified health problems in  rural  areas.  Discussions  with  doctors  in  local  clinic  on
                         health problems from the patient viewpoint.
                            Assisted  in  urban  health  clinic,  teaching  routine  tasks,  such  as   taking   of   blood
                         pressures and temperatures to aides and doing general maintenance work at times.
                            Drew  up  bilingual  (Spanish-English)  questionnaire  for  health  clinic   in   urban   area.
                            Taught  dental  care  to  children  at  Child  Care  Center  (rural);  administered  first  aid
                         to children and taught  assistant  teacher  to  do  same;  took  health  histories  of  the  chil-
                         dren;  made  home  visits  to  encourage  parents  to  bring   their   hildren   to   immunization
                         Clinic; held meetings for same purpose.
                             Made  referrals  to  dentists  for  children   and   provided   transportation   to   dentisVs
                         office if needed.
                             Completed  a   lengthy   report   and   made   recommendations   for   improvements   on   the
                         services  provided  by  two  rural  hospitals,  interviewing  patients,  administrators,   nurses,
                         doctors, etc.
                             Gathered dental health  statistics  from  schools,  held  meetings  with  dentists,  etc.,  in
                         attempt to set up dental clinic in poor metropolitan suburb.
                                                                                                                                        77


                                         CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                         Encouraged dialogue  between  medical  school  deans  and  faculty  to  ha@n  process  of
                                   minority group students admissions.
                                         Conducted  classes  in  biology  and  medical  science  for  teenagers;  conducted  field
                                   trips to medical centers.
                                         Prepared  proposal  to  Regional  Medical  Programs  for  health  and  dental  clinic  in
                                   poor  suburb  of  Los  Angeles;  w6re  instrumental  in  bringing  together  UCLA  Dental   and
                                   Medical  Schools,  Venice  Service  Center,  Venice  Library,  and  Public  Health   Department
                                   to work on clinic. Involvement of  private  and  public  organizations  in  support  of  health
                                   clinic.
                                         Intensive study of health care delivery at large  metropolitan  hospital,  including  in-
                                   vestigation of reasons  for  lengthy  waits  by  patients,  and  recommendations  for  improve-
                                   ments in this and other areas.
                                         Intensive study  of  health  care  delivery  on  selected  families  serviced  by  metro-
                                   politan health clinic.
                                         Taught  and  administered  first  aid  to  organized   groups   of   youths   in   metro-
                                   politan ghetto.
                                         Use of films on health and health education in various programs.
                                         Demonstration films of medical  and  dental  equipment,  sex  education,  birth  control,
                                   etc., in various programs.
                                         Instituted Young  Mother's  Club  in  small  town,  with  discussions,  films$  etc.,  on
                                   health and health education.

                                   Nonhealth Oriented
                                         Set up meetings for Model Cities program.
                                         Picketed  in  Sacramento  with  farm  laborers  on   behalf   of   AB-182   (unemployment
                                   compensation extended to farm laborers).
                                         Worked with La Raza  committee  to  help  write  a  proposal  for  higher  education  for
                                   Mexican-Americans.
                                         Helped form Brown Berets' chapter in Oxnard.
                                         Helped  local  bilingual  people  to  understand  Department  of   Motor   Vehicle   Code
                                   for driver's test.
                                         Taught reading readiness to  Head  Start  children;  trained  two  NYC  assignees  to  do
                                   same.
                                         Group discussions  with  high-school  children  on  various  topics  geared  to  motivate
                                   them educationally; use of slides, films, etc.; guest speakers on va ous            pics-police
                                   relations, different cultures, etc.
                                         Conducted field trips to museums, beach, UCLA campus.

                                   Law Students
                                         Assisted in organizing blacks irf Merced around issue of police brutality.
                                         Helped black community form a credit union.
                                         Documentation of  legal  violations  by  growers  and  farm  labor  contractors  who,  by
                                   law, are required to  provide  toilet  and  washing  facilities-Safety  Code  violations.  Plan
                                   was to try to get a few people to file complaints, but  as  there  was  extreme  reluctance  to
                                   sign anything, the  students  sought  and  got  jobs  in  fields  and  then  made  declarations
                                   themselves. Preparation of  Affidavits  to  present  to  Industrial  and  Welfare  Rights  Com-
                                   mission on field violations. Taught local  community  workers  to,  file  complaints  on  their
                                   own behalf.
                                         Aided in an  attempt  to  incorporate  a  town  now  ruled  by  Anglo  community  service
                                   district.
                                         Set  up  Youth  Law  Center  in  Visalia  which  became  a  focal  point  for   community
                                   activities.
                                         Organized  Own  Recognizance  ptoject-prisoners  released  on,   or   without'having   to
                                   put up bail. This project has continued by local youths after students left.
                                         Drew up questionnaire designed to uncover  types  of  legal  violations  in  health  care
                                   in two rural general hospitals.
                                         I-rousing survey attempted in order to get migrant housing condemmed.
                                         Three   students   worked   with   United   Fannworkers   Organizing   Committee,   doing
                                   office research and field work,  usIing their skills in relevant community organizations.  :

                    78


                          CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                          Set up a Welfare Rights Organization countywide.
                          Office research on  various  legal  problems  and  some  field  work  with  California
                      Rural Legal Assistance Office.

                                                          APPENDIX L
                             INSTITUTIONS AND  GROUPS CONTACTED  BY STUDENTS
                          In contacting  agencies  and  community  groups,  the  students  showed  a  preference
                      for established institutions, in their attempt  to  forward  or  improve  the  program  in
                      which they were involved. Local  health  departments,  hospitals,  and  medical  societies
                      were among the first to be contacted, usually for information on local health services and
                      problems. Schools were used, mostly for data  gathering  purposes,  and  in  the  Los  An-
                      geles area, various departments of UCLA 'were used for specific information.
                          Voluntary agencies and private enterprises  were  contacted  frequently,  and  several
                      students  worked  quite  closely  with  them.  For  example,  La  Raza,  in  Oxnard,  sev-
                      eral students worked with a La Raza committee to formulate  a  proposal  for  higher  edu-
                      cation for  Mexican-Americans.  Dental  supply  houses  and  drug  companies  were  sought
                      out for equipment.
                          Community action groups were contacted to a much lesser  degree  than  either  of  the
                      above categories and were not used as extensively when contacted, with  the  exception  of
                      the Venice State Service Center, which students, after  consultation  with  the  director,
                      used as a base of operation in organizing the Venice Health Clinic.

                          LIST OF GROUPS CONTACTED BY STUDENTS HEALTH PROJECT-
                                                          SUMMER 1968

                      Children and Youth Services
                          Adolescent Creative Enterprises, San Francisco
                          Black Men For Youth, San Francisco
                          Catholic ServicL- Organization
                          Catholic Youth Organization
                          El Monte PTA
                          La Raza
                          Youth For Service
                      Community Action
                           merican Citizens Club, Calexico
                          A
                          Community Improvement Union, Venice
                          El Monte Community Center
                          Kings County Community Action Organization
                          Los Angeles South Central Volunteer Bureau
                          Mexie,an-Americans For Political Action
                          Project Action,.Venice
                          Project Adventure, East Los Angeles
                          Santa Rosa Community Center
                          Various citizens' groups, Venice
                          Venice Service Center
                          VISTA
                          Women's Club, Wasco

                      Educational
                          El Monte Schools
                          Local elementary schools,
                          Los Angeles City Schools-Offiee of Urban Affairs
                          Public Libraries
                          UCLA Law School


                                        CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                                        Employment
                                        Willowbrook Job Corp
                                        'FamilY Welfare Services
                                        Department of Public Social Service
                                        Ventura Family Counseling
                                        Health
                                        Fresno General Hospital
                                        Hanford  Health   Department
                                        Harbor Hospital
                                        Heart Association
                                        Kern County Medical  Society
                                        Los Angeles County Health Department
                                        Oxnard Health Department
                                        Red Cross
                                        San Gabriel Dental Society
                                        Santa Monica Health Facility
                                        Santa Monica Hospital
                                        Santa Monica Medical Aid Office
                                        Santa Paula Health Department
                                        UCLA Department of Preventive Medicine
                                        UCLA Inhalation Therapy
                                        U.S. Public Health Service
                                        University of Southern California Medical @Center
                                        Various dental Supply companies
                                        Various drug companies
                                        Venice Health Council
                                        Venice Family Planning Clinic
                                 Housing
                                        Kern County Housing Authority
                                 Indian Aftairs
                                        Bureau of Indian Affairs
                                 Private Entel-prise
                                        Standard Oil Company (in the Santa Rosa area)
                                 Recreation
                                        University Work Study Recreation Students
                                        U.S. Department of Forestry
                                Religious
                                        St. Peter's Catholic Church

                 80


                             CALIFORNIA STUI)ENT HEALTH PROJECT SUMMER 1968

                                                                APPENDIX M
                             ORGANIZATIONS AND INSTITUTIONS CONTACTED BY STUDENTS

                                                Education
                                   Elementary               Colleges
                     Community         and                   and                                       Public social            Private
                action              secondary            universities              Health                agencies             institutions
      Community            Im- El    Monte            UCLA:Law               Santa Paula           Dept. Public So-   St. Peter's Cath-
          provement     Union,   elementary             School                   Health De-           cial Services          olic Church,
          Venice                 schools                                         partment                                    Lemoore.
      Venice            Health L.A.   city            Department of          03inard Health        Bureau of Indian  Various drug
          Council.               schools-Offices        Preventive               Department           Affairs                companies
      Venice          Citizens   of urban               Medicine
          Group                  afflairs
      El       Monte       PTA                        Inhalation             L.A. County           Kern County            Various dental
      La     Raza                                       therapy                  Health De-           Housing                supply houses
                 meriean                                                         artment              Authority
      MexicAn-A                                                                  p                                                    Oil
          Political      Assn.                        University work        U.S .Public           Public Libraries       Standard
      American        Citizens                          study students           Health Service                              Company
          Club,       Calexico                                                                                               (Santa Rosa)
      Santa     Rose      Com-                        Recreation             Fresno General        U.S. Department
          munity        Center                          students                 Hospital             of Forestry
      Women's            Club,                                               Santa Monica          Red Cross
          Wasco                                                                  Health Facility
      Black      Men       for                                               Santa Monica          Heart Associ-
          Youth,           San                                                   Medical Aid          ation
          Francisco                                                              Offices
      Youth    for    Service,                                               San Gabriel
          San        Francisco                                                   Dental Society
      Adolescent      Creative                                               Kern County
          Enterprises,     San                                                   Medical Society
          Francisco                                                          Harbor General
      El      Monte       Com-                                                   Hospital
          munity        Center
      Black           Panthers                                               South Central
      Black           Congress                                                   Multi-Purpose
      Watts           Festival                                                   Health Center
          Committee
      United    Farm     Work-
          er's      Organizing
          Committee
      Venice           Service
          Center
      Project          Action,
          Venice
      Catholic    Youth    Or-
          ganization
      Catholic         Service
          Organization
      'o,    Corps
          Willoarook
      Venice            Family
          Planning      Clinic
      Kings    County    Corn-
          idunity       Action
          Organization
      VISTA
      Project        Adventure
          East   Los   Angeles
      L.A.    South    Central
          Volunteers
          Bureau

                                                                                                                                             81


                                    CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968
                                                                     APPENDIX N
                                FINAL CONFERENCE PROGRAM AND WORKSHOPS. AUGUST 28-30, 1968
                                              rning                                     Afternoon                      Even g
                                                   meeting.                                   address:          7:30-Panel: The
                                         10-       stration.                     Michael McGravey, M.D.           Revolution. Eliezer
                                                                              2:00-5:30-Discussion      groups:   Risco, Paul Jacobs,
                                                                                 "The  Student  and  the   Com-    Eldredge Cleaver or
                                                                                 munityll-  Question:   "Assum-   Bobby Seale.
                                                                                 ing  outsiders  can't   accom-
                                                                                 plish  anything   alone,   can
                                                                                 you  structure  a   worthwhile
                                                                                 summer   program?"   "If   so,
                                                                                 how do you choose  the  sites?
                                                                                 the students? "If not,
                                                                                 then .... ?"
                                                   group  reports  at   break- 2:30-5:30-Problem work-           7:30-E Teatro
                                                                                 shops:  See   attached   work-    Campesino.
                                        9:30-11:30- Discuss      groups:         shop descriptions.
                                           "The Professional and  the  Revolu-
                                           tion" Question: "Whatever you     I
                                           think about  the  Black/Brown  Rev-
                                           olutions, its a fact  you  have  to
                                           deal with. As a student, and  later
                                           on as a professional,  how  do  you
                                           work for the  liberation  of  Black
                                           and Brown people?"
                               0.        Pan  :  "Past  and  Future  Goals  of   Close.
                                           SHO"  Response  panel  of   cormnu-
                                           nity people.
                                         Followed by  General  conference:  To
                                           vote on  resolutions  generated  by
                                           workshops  and  discussion  groups.
                                         Bre         8:00-9:00 am.               Li     12:00-1:00 p.zr.          D        6:.00-7:00
                                                                                                                    p.m.


                           CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                      fINAL CONFERENCE
                                      PROBLEM WORKSHOPS-THURSDAY AFTERNOON

                           The problem workshops will discuss three broad topics:
                                1. SHP Site Development
                                2. Orientation and Education
                                3. Organization and Structure of SHP
                           Each workshop will meet as a whole  briefly  to  have  the  task  introduced.  They  will
                      break  up  into  small  groups  to  discuss  the  designated  problems  or  others  which  may
                      come up  in  the  course  of  discussion.  The  Workshop  will  then  reconvene  to  formulate
                      specific  recommendations  to  be  presented  to  the  whole  conference  on  Friday  morning.
                           The outlines which  follow  specify  problem  areas  which  must  be  resolved  in  plan-
                      ning  future  Student  Health  Projects.  Meeting  places  for  Workshops  will  be  announced
                      or  posted.
                      Workshop No. i-Student Health Project Site Development:
                           A.  How are the sites best selected? Who should select sites?
                           B.  What makes a "good" site?
                           C.  How structured should projects be?
                           D.  What kinds of tasks should students undertake?
                           E.  How should students be selected and assigned to projects?
                           F.  What should  we  expect  of  preceptors?
                           G.  Should projects be designed  to  be  completed  in  ten  weeks  with  minimal  "with-
                               drawal"  effects  on  the  community,  or  should  we  emphasize  ongoing  roles   in
                               communities in which we have projects?
                      Workshop  No.  2-Orientation  and   Education   -
                           A.  Preceptors:
                               How can SHP  support  preceptors  so  that  preceptors  can  make  the  best  use  of
                               students, and, in turn,  how  can  preeeptors  be  used  to  maximize  the  goals  of
                               students in SHP?
                           B.  Staff
                               What kinds of education  experience  and  expertise  should  the  staff  be  required
                               to have in order to:
                                   1. support students in the field;
                                   2.  provide  educational   programs;
                                   3. carry  on  administrative  tasks;
                                   4. understand community resources.
                           C. Students:
                                   1. What kind of orientation, what kind of topics, both as       to format     and
                                      content would be most useful for preparing students         to  go  into   the
                                      community?
                                   2. What sorts of educational programs would be most useful          during    the
                                      summer whether in the form of:
                                      a. A preplanned series of discussions, films, etc.
                                      b. Written materials on a variety of subjects related to:
                                         1. health care facilities;
                                         2. health care legislation;
                                         3. health care planning;
                                         4.   community    development;
                                         6. the culture of poverty.
                      Workshop No. S-Organization and Structure of the Student Health Project
                           A. Relationship of Student Health Project to USC. .
                           B.  Relationship  of  SHP  to  Federal  funding  agencie@i.e.   Regional   Medical   Pro-
                               grams, Health Education and Welfare and Office of Economic Opportunity.
                           C.  Function,  power  and  limitations  of  the  Policy  Advisory  Board-What  is   their
                               role in planning the project and on-going decisions?

                                                                                                                               83


                                      CALIFORNIA STUDENT HEALTH PROJECT SUMMER 1968

                                      D. Staffing patterns-Central and Regional
                                              1. Faculty Advisors
                                             2. Student staff
                                             3. Community workers.
                                      E.  Relation  between  San  Joaquin  Valley  and  Los  Angeles  projects-more  unity
                                         or two projects? Advantages and disadvantages of both approaches.
                                      P. Inter-site communications, cooperation, exchange  of  information  and  problems.

                                                                     APPENDIX 0
                                                  RENASCENCE (MIKE ALBERTSON'S LETTER)

                                     The California Student Medical Conference is in an organizational  crisis.  The  sum-
                                 mer projects have ended on a note of absolute  confusion  and  disillusioned  ideas.  The
                                 gestaff" is loosely organized and can no longer function as a-  unit  in  keeping  things
                                 together.
                                   @ We have been told that the goals that were set up at  the  beginning  of  the  summer
                                 are no longer adequate.
                                     There are some good concrete things that we can do as  an  organization.  I  bate  to
                                 see them lost in a muddle of rhetoric and red tape. For that reason there is  an  organi-
                                 zational meeting to be held on September 25 at 7:00 in the  lounge  of  Seaver  Hall,  at
                                 1969 Zonal Avenue, on the USC medical campus.
                                     The purpose of the meeting is to set up a director for the  coming  year  along  with
                                 an executive committee that is willing to assume responsibility of correlating and  coor-
                                 dinating  the  fragmentation  that  has  hindered  the   working   of   Student   Medical
                                 Conference.
                                     Also at that meeting there will be a discussion and possible  decision  on  where  we
                                 are going as an organization of student health professionals. It is  time,  finally,  for
                                 functional limits as to what we can do as an organization of this type, apart  from  what
                                 we do as individuals. Hopefully, it  will  not  be  a  battleground  for  the  airing  of
                                 personal philosophies for the sole purpose of  hearing  how  good  it  sounds:  but  will
                                 be a definitive work up of a set policy that we can  work  with.  Please  come  Wednesday
                                 evening. We are in desperate trouble.
                                                                                                 Michael Albertson,
                                                                                          Editorial-Board-Encounter.

                                 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
                                 PUBLIC HEALTH SERVICE

                                                                         U.S. GOVERNMENT PRINTING OFFICE: 1969 0-355-231

                  84


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                         U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
                                          Public Health Service