Leaving a Legacy of Hope and Change for Good
By Claire Aldous, RN, BSN
In the past five years as a registered nurse, I have had the privilege of working in various settings. These experiences have helped me understand what is unique in my current job at Upham’s Corner Health Center, a Community Health Center (CHC) in Dorchester, MA. I feel a sense of purpose in my role as a community nurse case manager that stems from the origins of CHCs in the Civil Rights Movement. In my work, I get to witness how CHCs fight against racial inequality in health care each and every day.
On the heels of Black History Month, what better way to celebrate Women’s History Month than to honor some women who continue to work towards this mission? Women who care for, treat, respect, fight tirelessly, and advocate fiercely for each patient regardless of their background or physical appearance.
In her poem, “The Hill We Climb,” poet and activist Amanda Gorman cautions,
It’s because being American is more than a pride we inherit.
It’s the past we step into and how we repair it.
. . . for while we have our eyes on the future, history has its eyes on us.
In the future, when Dorchester looks at the strong women who have worked at Upham’s Corner Health Center, their legacy will be one of hope and for having made changes for good. I would like to thank every single woman who works at UCHC. I wish I could tell you about each of them—I could write a novel the same size as the Affordable Care Act. However, I interviewed four women whom I would like to highlight below: Maria Barbosa, Adelina Alves, Dilza Pires, and Elise Henricks.
A Talk with Women at Upham’s Corner Health Center
Maria Barbosa – Medical interpreter
Time at Upham’s: Over 36 years.
Job description: A Cape Verdean native, Maria provides interpreter services for the clinic in Cape Verdean, Portuguese, and Spanish.
How she got started in community health: Maria initially worked at Upham’s lab, working on paperwork. She was responsible for calling patients in Spanish and Cape Verdean. A supervisor heard about Maria calling patients in the lab. Maria was then offered a job in whichever way she was needed so that they could keep her. For the next 15 years, she was trained and worked as a nursing assistant, family planning counselor, HIV counselor, and lead planning counselor. Approximately 20 years ago, she started taking classes to become a medical interpreter and has worked in this role ever since.
Favorite part about her job: “Oh! The people. I love the people that I work with. From the old to the new. I love the patients. The patients here are so grateful. They are so helpful to you, too, and that’s one of the things I learned here. It’s like a family. It’s like you’re working for this big family.”
Trademark: Maria wears earrings with pizzazz and fun shades of eyeliner every single day. She also regularly switches up her hair color and style. Maria says this used to confuse people—they did not know who she was.
Maria’s Goals for the Future: Maria would like to go back to school to further her education as an interpreter. When asking about her plans after retirement, she quickly responds, “I don’t plan to retire. I plan to work. I plan to work and help as many people as I can.”
Free advice from Maria for people starting out in a community health center: “Respect is the most important thing you can have. You have to respect everybody. . .You treat everybody the same because none of us is better than the other person. Respect is the most important thing. To your coworker, to your patient. To everybody.”
Dilza Pires – Lead Medical Assistant
Time at Upham’s: 7 years
Job description: Dilza is in charge of improving medical assistant (MA), nursing, and provider workflow. She also creates the MA schedule, orders medical supplies and PPE, keeps track of expiration dates, and manages the stocking of exam rooms. When the MAs are short-staffed, she helps cover for them. She also works directly with one of the providers as his MA. This involves triaging patients by taking vital signs and providing behavioral health screenings. Dilza also recently became certified to administer immunizations. In addition to this, she provides medication reconciliations, blood pressure checks, and much more. She also manages her provider’s mail and forms, which is a huge undertaking.
With the pandemic, some supplies have been on backorder. Dilza and her medical assistant team began a creative approach to make sure staff members have what they need and that supplies do not run out too quickly.
Dilza adds, “It’s not only triaging the patient. It’s giving them a quality care that I want the patients to get.” Dilza’s parents are also patients at the clinic andhe wants them to be among the patients who receive quality care. Dilza works closely with the medical assistants to listen to their ideas to improve workflow as well.
How Dilza got started in community health: Since she was 12, Dilza has liked being in the hospital setting. “It used to be my dream.” Her sister is also a family medicine doctor. Dilza started at Upham’s Corner Health Center to get experience after she got her MA license. Later, she worked for six months in a hospital setting but realized that she preferred community health, “Because we feel as a family.”
Dilza took care of her grandmother at home after she had a stroke. She says, “the care doesn’t come only when you come in the health center. It starts from your home. Then you come to the health center. You get a group of people who will take care of you. It starts with the medical assistants.”
Dilza adds that when she works with one provider, she gets to know the patients. When she gets to know the patients, they understand that she cares for them. And when that happens, she sees that then they care for themselves, too.
Trademark: Confidence. Dilza has unparalleled confidence in her medical skills and communication, which makes her a great leader.
Favorite part about her job: “It’s waking up, feeling that I am here to not only do the things that I like, but it’s working towards a goal that is helping patients, it’s helping [nurses], it’s helping providers. It’s working as a team. Because I like working as a team. I think I’m more proactive when I work as a team. Feeling that I am doing something better to help someone. . .waking up feeling happy that you like your job. You like what you do. And that you like coming here to work with people.”
Dilza’s Goals for the Future: Dilza is currently working on her prerequisite classes for nursing school! “I don’t like to be too comfortable in a position. I’m always trying to push myself to better myself. . .I think when you are too comfortable. . .you start to not do more for yourself.”
Free advice from Dilza for people starting out in a Community Health Center: “One thing that I teach my kids is even though [some patients] don’t treat you right, you have a right to stand up and speak up, and then be kind. You don’t have a right to do the same thing that they do, but you have that to empower people with your word when things are not going the way that you want.”
Adelina Alves – HIV and AIDS Program Manager, Nurturing Program Parent Facilitator
Time at Upham’s: 30 years
Job description: Ryan White HIV AIDS Program Manager/Community Engagement (see below).
How she got started in community health: When Adelina had graduated from the University of Massachusetts Amherst in business in 1990 and was looking for work, the CEO of Upham’s interviewed for their community outreach office. Adelina only intended to work there for a few months to find a job in business. However, one position within Upham’s led to another. Once she started as an outreach worker, she became a case manager with the OB, primary care, and pediatric services. Over the years, she became a health educator and became involved with community organizing and community intervention. Due to so much violence in the community, Adelina became engaged with the Boston Public Health Commission for trauma advocacy. She then moved on to infectious disease and is now overseeing the HIV and AIDS program. “I’ve had families that I took care of the mom, their children, now they’re having babies. It’s really amazing.”
Adelina is also deeply involved in surrounding community programs —within churches, local agencies, service departments, immigration services, and Boston public schools – all of which help Upham’s take care of its families. “It’s a lot of work holding hands with many, many other community partners. Because obviously, no one can do this alone.”
“Within a year and a half [of working within community health], I knew that I couldn’t just leave. We would have these cases [that] were really sad, sad, complicated, just families going through so much turmoil. As case managers, you say, ‘Okay, you know what? As soon as this is over, I’m going to move on.’ But then you start to realize that you enjoy it so much and you’re having such an impact. They become almost like your family. And then it was about, ‘What else can I do to bring broader changes?’ And that’s when I found myself getting involved with, you know, for example, what was happening with the teen homicide in our community. There was no way I could not get involved.”
Adelina attended immigration meetings in the community, representing people who did not have a voice. “When we had these homicides, there was a huge number of children, well, I’ll say young men and young women of color that were being deported. It was just the moms and the dads that were financially supporting them back home. So they would work two jobs while they might be involved with DCF, still financially taking care of their children back home, so what good was that doing anybody, right? And the kids who were deported, they had come to the United States very young, so this was their home, and some of them didn’t even speak the language when they got back home.”
Adelina would share about the mental stress that these situations had on community members during community immigration meetings. She says, “Why can’t we intervene at a time when we can make a difference? So, what is the role of the police department with probation services? You know, there’s no resource out there, so how can we make it better so these kids don’t go back over and over again, end up in jail? Can we intervene at a school? Can we work with the Mayor’s office to find them work? How can we get these moms involved, so they learn better skills to maybe be home or restructure their homes or their lives? Let’s give them opportunities with employment, so they’re not working, you know, 7:00 AM to 3:00 PM and 3:00 PM to 11:00 PM. And the reason they’re doing that is because they can’t afford rent! Why is housing so expensive in some of these neighborhoods where they’re living? How can we get more resources to help some of these families? Do you see the intersectionality of all?”
Adelina and others would also spend ten minutes every Sunday in churches, sharing education about information that was happening in the community. “Are you one of these parents? Do you need help? Upham’s Corner Health Center can [help]. We can help give you some guidance. These are the resources available in your community.”
Adelina and others even went as far as to contact Cabo Verde Airlines. The airlines had an in-flight movie in English that she says few people could understand. Adelina, friends, and organizations, including the embassy, immigration, and the councilor office in Cape Verde, worked to put together a mini commercial about what to expect when moving to the United States. The commercial discussed agencies to contact for help, what to do to get health insurance, and what to do if you have school-age children. Adelina says it was especially important to educate the parents of school-age children on the differences of raising children in the U.S. She says, “You need to be able to be home. There’s no extended family to help you care for your children like we do back home, and you need to be involved with the school – you need to be involved with your community. . .. Back home, some parents. . .one is home, you have grandma, uncle, everybody helping you take care of your children, but here you don’t. You come, you’re in your home, working two jobs, and then your children are there [parentified]. They’re supposed to know how to fix everything. Or how to cook, how to clean, how to take care of the younger siblings. Before you know, they’re influenced by what’s happening at school with their peers, and then DCF comes in, they’re running the street, they’re not going to school, and then they end up in jail being deported. Those are the life stories of some of these kids, or shot, ending up dead. So that community education piece was vital at a time, and still today that needs to happen ongoing. Like now, we’re doing a lot of education around the Covid vaccine and why it’s important. . . People in our community need to hear it from a trusted source. They need to hear it from people like us.”
Adelina shares that there are very few Cape Verdean women who are in the same position that she is in. She feels fortunate and it is evident that she wants to build up the women and families around her. Adelina and some of her colleagues do radio shows in the community. When they choose each topic, they try to incorporate families, and the well-being of families. They include nurturing and love, and the idea that everything starts in the home. That even though it looks different in the United States than it does in Cape Verde, parents can still do it again, or keep having that love in their homes.
“I think that also this year with Black Lives Matter and all that’s happening in the United States, it’s also given us permission to speak a little bit more and be aware of a lot of the inequities that we naturally accept, but we know in the soul of our beings that it’s not okay. And me, looking at myself and looking at all that have done, you know, we’re all impacted. One way or another, very much impacted.”
Favorite part about her job: “To talk with our clients that are not doing well about the care team’s involvement in their care, and their goals, and where they can be if they’re able to just commit a little bit and us also address their social determinants of health. Seeing the impact of everyone’s hands on deck. When you look at a person that’s started right here and six months later, they’re here, you realize how great it was so many people’s hands made a difference. That’s the most amazing thing.”
Adelina also says, “To see some of our young men that were going through a hardship at one point and now they’re dads themselves and I see them and we talk, and we remember that time and focus on, you know, that they survived a certain period of their lives. Or understanding what they were doing at a time. How it was all about survival. They are strong people today because of that. Those are things that make me really, really happy about what I do.”
Trademark: Calm demeanor.
Adelina’s Goals for the Future: Adelina is on track to graduate as a social worker this August! She will concentrate on trauma and geriatric counseling.
Free advice from Adelina for people starting out in a community health center: “If you want to learn about vulnerable populations, you have a desire to help. . .have a sense that you are meeting this person, their life’s journey right here. So they may seem broken, but you don’t know where they started, right? So the person you have in front of you might be their strongest version of themselves. And what influence can you have, how you help them move from here to their next journey? Because you’re only here for a tiny little bit. So how can you make your experience memorable? How can you give them your best so when they leave, they remember how they were when they were with you?. . .People lose hope when the world around them loses hope in them. . . You’re here now. . .how can you and I work together get to the next step? It’s possible.”
Elise Henricks – Former UCHC medical director and current physician
Time at Upham’s: 22 years
Job description: Elise currently practices as a family medicine physician, caring for children and adults. She also performs gynecology procedures. When I spoke with Elise for this interview, she said, “I just looked at my schedule today, and I have 11 patients scheduled, but I think seven of the appointments are from three families. I thought that was really cool. I have three sets of moms and kids coming in today. That doesn’t always happen, but that is the epitome of family medicine.”
Elise also worked as the medical director at Upham’s from 2013-2019. There is not enough room to list everything in that job description. Needless to say, she was the boss and still is a boss.
How she got started in community health: Elise attended a residency program at a CHC in Lawrence, MA. She learned about this residency program through the director at a recruitment fair for family practice residents. Elise and the director connected because they had both been a part of the Jesuit Volunteer Corps. She decided to go to Lawrence, and this is where she first really learned about CHCs. Elise loved the sense of community ownership at the health center. When she began looking for jobs, she only looked for jobs at CHCs and at community-oriented hospitals. “I just decided that my heart is in the community.”
“I wanted to do work that wasn’t just helping that one person with their blood pressure, but because I helped that person with their blood pressure, maybe they could take care of their grandkid, who would then graduate from high school, who could then maybe go to college. . . There would be a lot more chance of having generational impact by working at a community health center.” Elise also says that she wanted to have an impact on justice issues.
Favorite part about her job: “I think what I love most about it is in the longitudinal nature of it,” Elise reflects. “I’ve known my patients for 20 years. They are my family. I mean that authentically. Some people might say, ‘That’s weird,’ or ‘that’s bad,’ or ‘that’s crossing the patient/professional boundary.” But Elise remembers when her own mother passed away that her patients were there for her. “They were so lovely. They wanted to give me a hug. . .I really felt cared for. . . It’s not something you can always get in a job you have one or two years. You really need that long-term sense of connection.” Elise loves having deep connections with her patients and having shared experiences. She adds, “I can honestly say in twenty-plus years, I have never been bored.”
Trademark: Elise often wears beautiful clothing that she has made herself! She is a talented seamstress, quilter, and knitter. She calls herself “a pan-enthusiast of the needle arts.”
Elise’s Goals for the Future: “I feel like I’m at the point in my career where one of my most important roles is mentoring.” Elise not only wants to share medical knowledge she has gained but also “about being a woman in the workplace, about having a family, being in a partnership. How to get some equilibrium between work and home, and self-care. Trying to figure out how to be a resilient person in this healthcare life takes a while. I love training and working with new staff. Because of my previous role as medical director, I have worked with dozens of new staff. I love seeing people grow and change and progress. And hopefully stick around in community health in some way, shape, or form.”
Free advice from Elise for people starting out in a community health center:
#1 “Engage in self-care. The work will always be there. But if you don’t take care of yourself, you won’t be there to do the work.”
#2 “Never underestimate the impact of the work that you do. I think you can get really discouraged by the huge mountains that we have to climb and the social inequities that are so deeply ingrained in what we do, but. . . I’ve seen incredible success. . .The work that you do matters. . .I believe it.”
Aldous, Claire, and Adelina Alves. Interview. Personal, March 12, 2021.
Aldous, Claire, and Maria Barbosa. Interview. Personal, March 11, 2021.
Aldous, Claire, and Elise Henricks. Interview. Personal, March 12, 2021.
Aldous, Claire, and Dilza Pires. Interview. Personal, March 12, 2021.
Liu, Jennifer. “Read the Full Text of Amanda Gorman’s Inaugural Poem ‘The Hill We Climb’.” CNBC. CNBC, January 20, 2021. https://www.cnbc.com/2021/01/20/amanda-gormans-inaugural-poem-the-hill-we-climb-full-text.html.