Committed to serving the underserved

Graduate student Supraja Saravanakumar did a public health internship in Kenya last summer with support from a Dr. Elizabeth Woldemussie Fellowship. Her work there built on many years of volunteer service in health education.

UCLA International Institute, March 4, 2024 — Supraja Saravanakumar, a community health and preventive medicine M.P.H. student at the UCLA Fielding School of Public Health, is committed to serving underserved populations both locally and globally.

During her undergraduate years as a neurobiology student at UC Davis, she volunteered extensively for the Willow Clinic in Sacramento, which provides free medical services to the unhoused population in the city. She also worked at the UC Davis Student Health and Counseling Services, spearheading harm reduction initiatives for alcohol and marijuana, which ignited her interest in public health. She has continued to volunteer in Los Angeles at the Mobile Clinic Project at UCLA and the LA chapter of the nonprofit organization Peace over Violence.

While working as a research associate at City of Hope after she completed her undergraduate studies, she encountered a serious car accident that plunged her into the thankless task of navigating hospital bills and insurance companies.

“I had thought that recovering from a traumatic head injury would be painful,” she said. “But the stress of figuring out insurance was worse because there was no guidebook for doing that. When I saw the
medical bill, I thought, ‘There goes my entire life.’”

As a result of that experience, Saravanakumar aims to build a support system to guide people, especially from disadvantaged populations, in navigating the complex U.S. healthcare system.

The untimely loss of her beloved grandmother just before she began her M.P.H. program gave her an additional interest: a passion for maternal and child health. Her grandmother, who had largely raised her, “was my happy place. She paved the way intergenerationally for her daughters and granddaughters,” she related.

“I grew up hearing stories about insufficient access to healthcare facilities in her hometown Nallampalayam, in Tamil Nadu, India, and how that had resulted in her losing a child.” Saravanakumar recounted the societal pressures surrounding gender preferences, which increased female infant mortality rates, all of which now fuel her commitment to addressing disparities in women’s health.

Adding global experience to her education

Since a 400-hour public health internship is an academic requirement of her M.P.H. program, Saravanakumar took the opportunity to broaden her reach. “I’ve always wanted to work globally, but finances have been my biggest hindrance,” she related.

With the support of a Dr. Elizabeth Woldemussie Fellowship from the African Studies Center, Saravanakumar spent five weeks working on-site in Kenya with the Kisii Konya Oroiboro Project (KIKOP), and another five weeks working for the organization remotely. “If the center had not provided me with funding, I would not have been able to pursue this opportunity,” she said. “I am extremely grateful.”

Among the aims of KIKOP, a community-based nonprofit managed by two Kenyan public health professionals, is improving maternal and child health in the county of Kisii. (KIKOP works closely with Curamericas Global, a U.S.-based nonprofit that helps provide lifesaving healthcare services and health education to underserved communities in countries worldwide.)

As of 2017, the reported maternal mortality ratio in Kenya was over 25 times greater than that in developed countries, related Saravanakumar. Following KIKOP’s program, both maternal and infant mortality decreased by about 80% in Kisii county over three years.

“KIKOP uses a bottom-up, community-based, impact-oriented approach. Community health volunteers bring maternal and child health education to the mothers directly in their homes through ‘care group lessons,’” said Saravanakumar.

“Each mother then passes these lessons to her neighbors, so there is a mother-to-mother training cascade that generates behavioral change at the household level.”

KIKOP has developed 12 modules for care group lessons that are delivered once every two weeks. These lessons address such subjects as danger signs in pregnancy; prenatal care; exclusive breastfeeding; child immunization recommendations; and how to manage malaria, pneumonia and other illnesses in newborns. Volunteers also do routine home visits with pregnant women and mothers of children under the age of two, during which they check vitals and provide health education and support.

“I have a huge respect for these mothers — they called us mpenda watoto, which means lover of children, and that humbled me,” she said. “They sent us home with sugarcane from their community gardens, which are also a KIKOP project, invited us over for ugali (a traditional Kenyan dish), taught us a local dance and even gave us our very own Kisii names — mine was Moraa. The community reminded me a lot of my grandparents’ community in India. It was familiar, yet foreign.”

As part of the internship, Saravanakumar wrote a report on the impact of the maternal and child health program on established healthcare indicators based on knowledge, practice and coverage surveys.

“The statistics show a significant increase in the number of mothers who have chosen to go to a health facility to give birth as opposed to at home, and an improvement in health indicators,” she reflected.

Saravanakumar also developed care group lessons on menstrual hygiene management and sexual and gender-based violence (SGBV). She noted that female genital mutilation (FGM), despite being outlawed in Kenya, remains a widespread practice due both to its perception as a local tradition and community pressure.

“One of KIKOP’s surveys asked women if FGM practices should be eradicated. Although 99% of the mothers said ‘yes,’ 75% of them still went through with it,” she related.

“When it comes to SGBV, we realized that beyond interventions that empower women, we need to target husbands and male village elders to shift community-wide attitudes,” she said.

Saravanakumar loved her experience with KIKOP and drew a major lesson from the internship: “It is important to transcend the pressure to comply with the limitations of the current healthcare system and its policies and meet people where they are at — be it in Kenya or the U.S.

“This means bringing resources and services into people’s homes first, slowly building trust between patients and healthcare providers and then encouraging them to visit health facilities and hospitals. This is a more sustainable approach than top-down approaches, especially for reaching underserved populations.”

Saravanakumar with participants in the KIKOP maternal and child health program.
(Photo provided by Saravanakumar.)

Looking ahead

The young graduate student will complete her M.P.H in June and is eager to pursue a career path promoting health equity. “My roots are anchored in communities with deep histories of inequity — I am a woman of color, a child of immigrants and a first-generation graduate in the U.S. This means that I hold a conviction [that it's important] to improve the livelihood of people with stories like mine.”

In fact, Saravanakumar is a finalist in the Health Equity Challenge organized by the UCLA Center for Health Policy Research. She is creating a program to reduce the prevalence of postpartum depression by encouraging conversation and dismantling stigma within South Asian communities in Los Angeles.

“It all circles down to giving back to women. The women in my life have taught me that it is not about being unafraid of what is to come. It is about being afraid, but being brave at the exact same time, and doing it anyway.”

Published: Friday, March 1, 2024