This Saturday, we had the privilege of hosting Awakin Call with Phuoc Le.

Dr. Phuoc Le is an advocate for equitable healthcare worldwide. He is a physician and co-founder of the HEAL (Health, Equity, Action, and Leadership) Initiative, which trains front-line health professionals to build a community dedicated to serving the underserved. With a name meaning “blessing” or “good fortune” in both Vietnamese and Chinese, Phuoc was born in Vietnam at the end of the war and fled at age 5 with his family by boat -- narrowly escaping death at sea. Now a highly educated and trained physician, Phuoc has worked with Dr. Paul Farmer and Partners in Health to provide healthcare to the world's poor in their homes and communities, including in Africa and post-earthquake Haiti. “For the vast majority of people, it doesn’t turn out the way it did for me,” he says. “As much as I’ve been blessed with, what I expect of myself is to focus on health disparities [as] my life’s work.”

For those interested you can follow Phuoc's work through the HEAL website. We'll post the full transcript of the call eventually, but in the meantime here's a glimpse of some of the stories he shared:

A Patchwork of Early Memories

I was born near the ancient capital of Vietnam in a community of fishermen and fisherwomen. My earliest memories are of playing on the beach. My mother told me I cried every night as a child and the only thing that would relieve me was rubbing my bottom. At 5 at a refugee camp in Hong Kong a single pill cured me. Decades later as a doctor I retroactively diagnosed my years long childhood affliction - it was a simple pinworm infection.

The first time I had a second chance at life was the night my mother made a fateful decision. Our family had aligned with the Southern Vietnam government during the war. So after the communist party took over our future was quite bleak. In 1981 late one night my mother gathered with a few dozen close relatives and extended family and with her two children (I was seven and my sister was 5 at the time), got on a simple fishing vessel probably no bigger than 30 feet and we set off with nothing more than some meager supplies and the clothes on our back. The seas were patrolled back then, and very few refugees had experience sailing. Many were caught or perished. We were on the water for close to a week and we hit a bad storm. It was so strong that one of the waves knocked my mother and I off the boat. She was able to hold onto the side of the boat with one hand. Ironically though I'd grown up on a beach I didn't learn how to swim until I got to landlocked Kansas much later in this story.

Falling into the water I felt like my body was an extension of my mother's body I was clutching her so tightly. If I hadn't been able to hang onto her it would have been the end for me. Fortunately my uncle dove in and rescued us. Several days later we came across a merchant vessel that with some bribery allowed us to board and took us to the nearest port of call -- Hong Kong.

Buses & Jordache Jeans
We were in Hong Kong for about a year. My mom got a job in a factory that was making Jordache jeans -- the emblem is a horse's head and that was what she sewed onto the jeans. That was my first opportunity to go to school, so the first language I learned to read and write in was Cantonese. We took the bus to school and it was such a foreign experience. We hadn't seen buses before in rural Vietnam. After a year we were sponsored by a church group to leave Vietnam and come to the US.

The Opposite of Dorothy in the Wizard of Oz
We landed in Wichita Kansas. Our first time on a plane. We had no idea where Kansas was. Desperation was such that we said yes to any country that would take us. Landing in Kansas for 3 non-English speaking refugees was quite jarring, but for me it was also a wonderful second chance at being able to go to school and live in a non institutionalized setting, being able to taste some freedom, and for my mom who sacrificed everything, it was an opportunity to provide a future for her family.

A Boy Among the Lightning Bugs
I've never been back to Wichita since leaving it. We were living in public housing projects alongside other immigrant families. To us the quarters seemed quite nice. Being in an area where I felt safe, I felt like I had an opportunity to learn and I was really grateful for that, and for just having the chance to be a kid again, running in the park with the lightning bugs. To me life was really good. I'm sure it wasn't so for my mom who didn't speak the language and had never gone to school in Vietnam and couldn't read or write in any language. She was offered some night classes but felt like she didn't have the aptitude. So she networked and started finding manual labor jobs that she felt like she could handle. Then we moved to Garden City -- home to a large beef processing factory and she was able to find a job there and I remember her telling me, even if it's hard manual labor it's better than being stuck with the violence of war in Vietnam. She was grateful for it but she missed opportunities because she didn't go back to school. Three and a half decades later my mother still doesn't speak English and doesn't read or write and has been maintaining jobs as a manual laborer or a restaurant worker in Vietnamese restaurants.

The Repercussions of Poverty
Growing up in a class that was very poor that led to many repercussions, including the violence of gang membership, the daily grind of living in poverty in the ghettos, and many folks that were like me ended up on the other side of violence which is ironic because they came here trying to escape violence and find opportunity, but that opportunity wasn't readily apparent to them.

Between Two Worlds
We moved from Kansas to Sacramento -- a one way ticket on Amtrak. My tenth birthday was on that train. Our culture at home was wholly Vietnamese -- we lived by values and rules that were common in the rural country side of Vietnam. What that meant was that discipline was carried out with the whip or with the back of a metal fly swatter. And constant reminders of how blessed I was. My name, Phuoc, actually means 'blessed' or 'good fortune'. At school any cultural diversity was shunned. I remember one time a Caucasian boy called me a derogatory term for Asian and I was so upset, all this anger boiled up inside me at this racial slur. It tipped me over the edge. I was 11 at the time. His name was Eugene and I said, "Eugene meet me after school out in the yard." And we met each other and were wrestling and throwing random punches. Fortunately we were quickly seen by our music teacher and figuratively pulled up my the ears and taken to the principal's office. I felt so proud for sticking up for myself. But when I came home with a black eye and pride in myself for standing up against discrimination, my mother said, "Phuoc why did you do such a stupid thing? What you really should do is just put your head down. You're lucky to be here. America has already given you so much." My intense pride was deflated. And that's representative of many of the feelings of immigrants who have left arduous circumstances or violence. Their sense of gratitude is paramount and leaves no room to stand up for equality or justice.

The Road to Medicine
As I was growing up, my mother would tell me to become a doctor, lawyer or engineer. My mother had learned those were the most prestigious professions when we became part of the Vietnamese community in Sacramento -- so even though she didn't know what it really meant to be in any of those positions that's what she wanted for me.

For college I went as far away from home as I could in New Hampshire. A couple of classes really were transformative. I was studying Chinese because it was fascinating and biochemistry since I was interested in science and how life worked and in my junior year I decided that I was going to go and do some volunteer work. I was blessed to have the opportunity to work in a very rural part of Costa Rica in a clinic. I lived with a physician who was deployed from Cuba. He would hold clinic every day and I would help out with taking blood pressure and taking height and weight of kids. And I remember seeing this one child who came from a nearby village -- two or three months old and he came in with his mom who looked no older than 17 or 16 and she walked two or three rivers -- rivers with fast rapids, treacherous. Rivers I'd fished in, so I understood what it took for her to get to the clinic. The child was covered in sores and his nails hadn't been cut. I took a nail clipper over to cut his nails and I remember very clearly that one of the nails fell off as soon as I touched it. This child who was living just a few hours away, a child born into these sorts of circumstances really didn't stand a chance. And that's how I started thinking about the invisible structural forces that influence people's lives. I felt powerless at the time. I offered them nail clippers and a mosquito net, the physician gave him an antibiotic for his sores. But these were bandaid measures. What it would take for this child to reach his full potential was much more complex. Poverty is just one of the components, one of the structural forces that alter people's lives. My journey into medicine started in that village in Costa Rica.

My mother sacrificed everything for her children. We were raised in a difficult environment but she was raising us the way she was raised, and the way her mother was raised. It was what she knew. When I was a high school senior she told me she was going to Vietnam for a month and that I'd have to look after my siblings, I had a one-year-old half sister and five-year-old half brother at the time. She said, "There's food in the fridge that I cooked, and here's money so you can give $5 a day to my friend who will watch the kids during the day." It was natural for her to leave the oldest sibling in charge of the little ones. That's how she grew up. But for me it was a pivotal experience. I wrote about it in my college application and found people were really interested in that. I got a full ride to school to a college I could never have dreamed of going to. I had all kinds of opportunities to work and volunteer abroad. The neglect, isolation and abuse of my childhood has a flip side. It made me who I am and led me to this work.

The work of HEAL
Heal stands for Health, Equity, Action and Leadership. The key word is the Equity piece and it's been a constant struggle for us. Many of the global health practices and institutions come directly from the roots of conquest and imperialism. We wanted a bilateral exchange of knowledge and skills. And we wanted the opportunities given to the global north to be given to our colleagues in the global south.

So the fellowship is set up in a really different way, It's a 1 for 1 model. Say you're a recent graduate of Internal medicine and we place you for two years in Navajo Nation that shares many problems in the health care infrastructure as our partners in low and middle income countries like Mexico, India, Nepal. So we would recruit and at the same time also give an opportunity for someone from Navajo Nation to be placed with us. It's truly inter-professional and allows people to lead from where they are, whether they are a doctor a nurse or a community health worker.

We measure our impact in the career paths chosen by our graduates and the vast majority more than 90% have committed themselves to careers that serve the underserved. The great majority that are from those low income countries decide to stay in those places and take up leadership positions and now have a community of practice from all over the world to lean on.

The Language Dilemma
One of the edges we're navigating is around how to expand and be more inclusive. Something we are sitting in all the time, is the tension of language being exclusive, and how English is often the language that creates that circle of inclusion/exclusion. We had a person who wanted to join HEAL but English was his fifth language (French was his third). He didn't have enough English for the program to benefit him, so we had to turn him away. He studied English intensively for a whole year and reapplied. And now he's thriving in HEAL. But not everyone can follow that path.

On the Potential of Truly Integrated Medicine

I spent a year learning traditional Chinese Medicine that was one of my years abroad in college and I gained an incredible amount of appreciation for the cumulative wisdom of 1000s of years. The other night I was talking about the story of Artemisinin -- a drug that has saved literally millions of children and adults from malaria. A drug that has been used in Chinese medicine and other traditions for thousands of years. I'm not saying that the only good thing that comes out of traditional medicine is when we find a biochemical reason based on western science to exploit that medicine, but I'm saying that traditional knowledge from 1000s of years of observation is certainly valuable and we need to embrace and integrate that. When I did some public health work during college living in rural Tibet, the hospitals there were truly integrated. You'd see a doctor practicing traditional Tibetan medicine, they'd take your pulse examine your urine, and at the same time say I want you to get an ultrasound, or I think we need an X-ray. They didn't see the tools as mutually exclusive. When there are true efforts of integration bringing the best of both worlds that's where we can offer the patients the most value. That's just one story -- within the HEAL initiative because we're not focused on clinical medicine per se we are really looking at the other elements that can improve access and systems. But many of our partner institutions employ traditional healers and medicine men and have the option of giving patients consults from traditional practitioners. So these things are practiced hand in hand.

Reconnecting to Origin Stories
I wholeheartedly believe that the vast majority of people who go into medicine start that journey for service hearted reasons. But once they get in the grueling minimum 7-years-process to become a board certified physician, it pounds that altruism out of people. It buries those true reasons and origins. We try and resurface those reasons through our work. And we've had fellows who have come to us and said, "HEAL has allowed me to live up to the original reasons I became a doctor in the first place."

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Pointing to the power of small acts, human relationships, trust and of connecting to our local communities and showing up to whatever degree and in whatever ways we are able to in our different contexts Phuoc's call was an inspiration from start to finish, and a compelling reminder of the tremendous potential we each have to be a healing force in the world.