Pursuing Justice in Public Health

I went to Vanderbilt specifically to study the social determinants of health, specifically those related to outcomes of Black birthing folks.

Two days ago, Paul Farmer died unexpectedly in Rwanda, at age 62. A physician and a medical anthropologist, he has done so much to advance global health in the far reaches of the world, from Haiti to Rwanda and more. His works makes so clear the strong connections between science and justice.

Akaninyene Ruffin is a Family Nurse Practitioner in Nashville, TN. Prior to her nursing training she attended Vanderbilt University studying Medicine, Health and Society and African American and Diaspora Studies. She spiritually identifies as one who believes like Jacob in wrestling with God until you receive all of your blessings. Her faith informs her idea that the pursuit of justice is righteousness in its purest form. This belief has inspired her work to address and eliminate health disparities among some of our most vulnerable populations. Her next goal is to augment her practice by becoming a certified nurse midwife in efforts to create more spaces for Black birthing people and families to access reproductive justice.

What was your journey into healthcare?

Can you describe your journey into healthcare? What inspired you to become a nurse? Any mentors or motivators along the way?

I had a very winding path into healthcare. To be honest for most of my teenage years, I wanted to be a journalist because of how much I love stories and storytelling. However, as I entered high school, my family became the primary caregiver for my paternal grandmother, and helping with her care allowed me to tap into the nurturer inside of me. I realized how much I enjoyed taking care of people.

Then, my junior year of high school, I caught mono and had several complications that left me needing a lot of medical care. In the months that followed I had excellent providers and some that left a lot to be desired. But by the end of that journey, I knew that I wanted to be one of the good ones, and I totally pivoted from wanting to go into journalism into healthcare.

I went to Vanderbilt specifically to study the social determinants of health and became very interested in building interventions for racialized health disparities–specifically those related to outcomes of Black birthing folks. It was that interest that inspired me to become a family nurse practitioner, and I am hoping to return to school in the next couple of months to become a nurse midwife.

How is justice connected to your work?

Outside of your nursing studies, you were extensively involved in activism and social justice in college, working to make your campus a more supportive and inclusive environment for students of color. For example, you became the lead facilitator for Hidden Dores, an organization whose aim is to make students of color and their voices more visible on campus. How do you bring your heart for social justice into your current work?

Public health is a social justice issue. What good is the fight for liberation, if everyone has died? So yes, fight for curriculums that illuminate historical and present oppressions, fight for the abolition of prisons, fight for climate change, fight for housing, and also we have to have folks that are fighting to make sure that Black folks aren’t dying of things like diabetes and heart disease. Keeping folks alive, especially those that white supremacist capitalism seeks to discard and destroy feels like resistance and revolution. To me it is all interconnected. My collegiate work was centered on having spaces where I felt like my Blackness and Africanness could be celebrated, and now my work is centered on making sure that I get to be Black for a really long time. Because it would be unjust for my life to be shortened simply because I lived in a country that never valued my wellbeing. So, I see providing healthcare to vulnerable populations as valuing their wellbeing in a world that does not always do that.

It’s my faith background that says that we should have access to a life more abundant, and I seek to help as many of my patients navigate towards that…not just as something that is attainable in whatever comes after this life, but as something we can know in the land of the living.

How do you fit faith and science together?

As a healthcare professional and person of faith, how would you describe your relationship with faith and science? Where does faith fit into your scientific worldview?

The more I know about science, the more amazed I am about the Creator and all that has been created. I think my faith is strong enough to admit all the things we do not know and be excited about all of the discoveries that science and scientific research make possible. To me science can reveal things that my spiritual practice has not been explicit about, and my faith fills in the blanks for somethings that science has not yet revealed. They work synergistically in a way that allows me to marvel at this world and at the Maker of Heaven and Earth.

I grew up hearing that faith without works is dead, that our love for others should move us to compassion to take care of the vulnerable, believing that when we take care of the least of these we care for a representation of Divinity here on earth. So it’s the stories of Jesus healing and feeding without care for where people came from, if they had money for their copay, if they had preexisting conditions, or if they had “unhealthy coping mechanisms.” That inspires me to provide care without judgment and with a spirit of fierce love. It’s my belief, that humans are a part of something so much bigger than what we can see, that spurs me to pursue wellness on this side of life. I’ve spent the majority of my career working for a free clinic and taking care of uninsured patients that struggled to access basic services.

My faith is following after the practices of Jesus, Yeshua ben Yosef, a carpenter without much education known to hangout with drunks, a man living under colonialism and imperialistic rule, whose parents had been refugees who struggled to find housing and accommodations at his birth, a man who was imprisoned and executed at the hands of the state. Because that’s the man whose teachings I follow, it’s an honor and a calling to take care of the folks who reflect life experiences like his. Those who are homeless, who have been incarcerated, immigrants and refugees, those without much education. It’s my faith that says its an obligation to take excellent care of these people with evidence-based, scientifically grounded medicine.

What role can scientists and healthcare workers have in the Church?

What role do you think scientists and healthcare workers in congregations can have in bringing science to the Church, especially to combat misinformation during these pandemic times? Have you found ways to do this in your own church or faith community?

Even before the pandemic, I saw healthcare workers in church spaces as an incredible resource for their community. It’s awesome to be able to teach folks in my community about their bodies, answer questions they have about their specific illnesses, and help them formulate conversation points so they can best advocate for their wellness with their personal healthcare team. This became even more important when the pandemic arose, and folks did not necessarily know who they could trust or where to get standard information.

Scientists and healthcare workers have an incredible responsibility to debunk misinformation especially in these times. So much research is not written in a way that lay people can understand, and those of us with background and specific training should work to stand in the gap for those of us in our community. For me, specifically during this pandemic that has meant looking like holding space for all the fears around the vaccine, and being honest about the medical experimentation that Black communities like mine have faced historically while also explaining the ways vaccines can help keep us safe.

This article was supported by a 2020 Diversity grant from the National Association of Science Writers (NASW).

Feb 24, 2022
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