The Community Will Tell You What They Need If You Just Listen

July 1, 2024. By Palak Patel.

2023-24 Schweitzer Fellow Palak Patel

I stand behind a white folding table in the lobby of City with Dwellings, a community center for people experiencing homelessness. The sign taped to my table reads “Are you Sun-Safe?” A cartoon sun wearing oversized sunglasses grins out from the laminated plastic, underscoring my point. I wave, invitingly, to a couple shuffling past. In response, they shuffle faster, fanning their faces with their hands. Either it’s hot outside or they’re shooing me away. A fly lands on my bucket of sunscreen samples, his long legs dipping between tubes of SPF30 and SPF50. So far, he’s the only one interested.

I’ll be honest; the cold reception at City with Dwellings left me indignant. I was offering free sun-protective gear in exchange for participation in an educational workshop – and no one wanted to talk to me? Did they know they were denying themselves free samples and the opportunity to learn about skin cancer? I felt like I’d been picked last for the softball team.

Eventually, Mr. Hart took pity on me. He set his backpack down on my booth and opened one of my brochures, “5 Myths about Skin Cancer.” Interesting stuff, he announced, louder than necessary. A few eyes flicked in my direction; the couple began their slow shuffle back towards my booth. Did you say free samples?

When I first set up my booth in the lobby of City with Dwellings, I imagined – at least subconsciously – that I was coming in to do the community a favor. I was taking time out of my day (the very busy days of a fourth-year medical student and Schweitzer Fellow) to improve the health of transient people. The realization that they’d rather play Bingo, sip quietly on coffee, or ignore me altogether made me feel that they didn’t value my time, or my service.

When I shared my feelings with Mr. Hart, he grinned ruefully and pointed out the selfishness of my logic. What about the value of our time, Ms. Patel? City with Dwellings was open for two hours every day. Clients had two hours to apply for jobs using the free computers, research housing options, and maybe, if time allowed, enjoy a cup of coffee. It was easy to see how a workshop on sun-protection might not top their priority list.

Too often, underserved communities end up being overserved services, products, and interventions that weigh them down rather than lift them up. Volunteers overestimate the importance of their own cause and time and undervalue the time and perspective of the community they want to serve. This sort of thinking alienates the community and keeps them from utilizing health resources. Lucky for me, Mr. Hart took the time to teach me a lesson in humility.

The more I listened to the community and valued their time and opinion as equal to my own, the more effective my service became. Mr. Brooks took one look at the white UV-resistant shirts I had bought and told me to return them. Black shirts would look cleaner for much longer than white shirts, meaning people were likely to wear them more. Ms. Tina put her backpack on my shoulders, and I nearly crumpled under the weight. “Less is more,” she said, weighing my overfull bags of sunscreen samples in her palm, “remember we have to carry around whatever you give us.” Ms. Jacobs yawned halfway through one of my workshops. “No one wants to spend 30 minutes being lectured at; can you make this more interactive?”

It’s been six months since I first came to City with Dwellings, and I cringe whenever I think about that stiff girl handing out heavy bags of sunscreen samples in her white coat. I no longer believe I’m at City with Dwellings to perform “community service.” Instead, I’ve come to think of my work as community collaboration. I teach the clients what I know about sun-safety, and they teach me how this knowledge can be applied to the practicalities of their lived experience. I believe that if more health care providers involved community members in the work of building healthy communities, their work would be much more beneficial to the people they are trying to serve.

A couple shuffles through the front doors and waves to me, their forearms covered by the sleeves of a UV-resistant shirt. I grin and set up for an interactive game of “Spot that Melanoma.” This game, like the rest of my intervention, is shaped by the needs and learning style of the community I am trying to serve – and is all the more impactful for it.

Palak V. Patel

2023-24 Schweitzer Fellow

Wake Forest School of Medicine, Class of 2024