As Natalie Ferraiolo reflects on her 2014-2015 GloCal Health Fellowship, she recalls, “A big, tough looking guy with tattoos all over his body clutching a teddy bear like there was no tomorrow.”
This ironic visual is the result of a needs assessment and subsequent research project Ferraiolo and her mentors conducted at the UC San Diego Health Frontiers in Tijuana (HFiT) clinic. The community needed tattoo removal so a clinical trial studying tattoo removal became the research project, examining the psycho/social health factors associated with having tattoos in this particular community, explained Ferraiolo.
“We learned that people in Tijuana experience discrimination for their tattoos, with much more stigma than in the US,” said Ferraiolo. Law enforcement would often beat people for having tattoos, or take their possessions without cause. Employers sometimes made employees strip to prove they did not have tattoos. In short, tattoos – both gang related and not – created serious barriers for individuals.
“Laser tattoo removal can be painful, so we had a collection of teddy bears to comfort participants,” said Ferraiolo.
When Ferraiolo received her GloCal Health Fellowship for the tattoo removal project, she was already familiar with border populations and global health. Her interest in global health developed throughout medical school at UC San Diego (UCSD), volunteering at clinics in Tijuana and throughout Baja, Mexico. These experiences gave her the opportunity to learn about the health issues that border populations face. "It was really exciting to see how people working together from both sides of the border can make a big difference," said Ferraiolo.
One of these clinics was HFiT. HFiT works in Tijuana’s Zona Centro, an area where drug use, homelessness and sex work are pervasive. Ferraiolo learned a lot as a medical student caring for this population; above all, the experience opened her eyes to a neglected segment of society. “Once I saw that, there was really no turning back,” said Ferraiolo.
With the support of her mentors at the HFiT clinic – Drs. Victoria Ojeda (UCSD) and José Luis Burgos (UCSD) – Ferraiolo applied for and received a GloCal Health Fellowship, a move that propelled her career.
"I can't describe how much I grew in that year and how much I learned from [my mentors]," said Ferraiolo. “They had a wealth of experience and knowledge to share with me and they really cared about my growth both as a physician and a researcher."
During her year in Tijuana as a GloCal Fellow, Ferraiolo soaked up her mentors’ experience and knowledge as much as she could. "I learned so many things I wouldn't have been able to otherwise – how to do a needs assessment, how to perform research, and how to write a research paper start to finish," said Ferraiolo. “It was an experience I wouldn't have been able to get anywhere else and it will inform the rest of my career."
Of all the things she learned that year, Ferraiolo says humility rises to the top. The education she received from her mentors and colleagues about the community in Tijuana and its unique needs stands out as an important lesson.
"Humility is super important in global public health,” said Ferraiolo. “Each place you go has its own set of challenges and you can't necessarily translate what you did in one place to another place.” Learning to approach communities without preconceptions allows us to listen a lot better and learn from the community about what they really need, explained Ferraiolo.
Ferraiolo is now applying what she learned as a GloCal Fellow to her residency at Scripps Mercy Hospital in Chula Vista, CA. As a resident, she is focusing on the importance of mental health in caring for the underserved. She is currently working with community members on a project examining the connection between adverse childhood experiences (ACEs) and well-being at a local high school.
Ferraiolo is also interested in integrative medicine. “I believe we should take a more holistic approach to patients and be open to other ways of healing,” she said. She hopes to combine these interests with her interests in mental health during her upcoming integrative medicine fellowship.
In the meantime, she is still publishing papers with Drs. Ojeda and Burgos and continues to volunteer at the HFiT clinic as a resident. “I truly hope to continue to be involved for the rest of my career,” said Ferraiolo.