Service Learning on the U.S./Mexico Border: A Qualitative Evaluation

BY dr. abby lohr

The Border Health Service Learning Institute (BHSLI) is an annual, team based, weeklong course through the Mel and Enid Zuckerman College of Public Health at the University of Arizona. Five to seven academic instructors with diverse expertise (e.g., epidemiology, health promotion, environmental science), co-teach BHSLI with ten graduate students. Through BHSLI, students learned to use an assets-based approach, think critically, and planned to advocate for im/migrant rights and health equity. Service learning courses may be one way to ensure that public health students are prepared to successfully collaborate and partner with communities impacted by health inequities.

In 2008, Dr. Cecilia Rosales and Jill Guernsey de Zapien leveraged (1) funding from Community Campus Partnerships for Health (CCPH), (2) support from the Arizona Area Health Education Center Program, and (3) the anti-im/migrant political climate in Arizona to develop BHSLI. They employed service learning, or experiential education benefiting all involved, to ensure reciprocity between students, instructors, and community partners.

BHSLI rotates locations across the Arizona/Sonora border from Douglas/Agua Prieta to Yuma, Somerton San Luis/San Luis Rio Colorado to Nogales/Nogales. Prior to course start, students complete readings (e.g., The Devil’s Highway by Luis Alberto Urrea). During the in-person portion of BHSLI, students visit county health departments, healthcare facilities, small businesses, and migrant advocacy organizations on both sides of the border as well as a US Customs and Border Patrol station. Students listen, learn, and interact with public health professionals and individuals with lived experience around the synergy between migration, public health, and economic development through an advocacy lens. Students then reflect by writing daily journal entries in response to prompts that encourage critical thinking.

To better understand how students’ perceptions of the border and personal and professional goals change during the course, we analyzed 71 student journals from the 2008-2017 courses. We learned that students interpreted their BHSLI experience through the lens of their personal background. Some students were new to the border and described evolving perceptions from a deficits-based to an assets-based approach. One student wrote:

This course helped to completely shift my perspective on border towns and rural communities...this course showed me the myriad strengths that exist in these areas...being able to see the border and interact with the organizations and communities living there added depth and nuance to my understanding of border health issues. (2017- Douglas, Arizona/Agua Prieta, Sonora)

Students connected with others through listening (especially over meals), sharing with their fellow students and instructors, and reading (feeling connected to the fictional characters in the pre-course readings). For example, one student wrote:

One important thing I learned is that each story has multiple sides. As a person who advocates for public health and the improvement of health as a population, I have to always keep in mind that learning to listen and understand the opinions of others different from mine is part of moving forward. Learning to compromise and not impose my own ideas but instead understanding the context of other people’s beliefs and ways of life are key to creating policies and cooperation among communities. (2016 – Douglas, Arizona/Agua Prieta, Sonora)

BHSLI students reported an increased interest in the border and a desire to continue working in the region. Some students wrote about challenging their own assumptions about the border and a newfound sense of their positionality and privilege. Other students highlighted how social justice work can be integrated into their current and future career plans with statements like:

This experience has served as a strong reminder to never lose sight of the underlying motivations of social justice that brought me into the field of public health and that have driven my studies and career choices...I realized that I don’t need to change careers or my academic path to work for social justice. I only need to keep my passion at the forefront and let it guide all my endeavors. (2013 – Yuma, Somerton, San Luis, Arizona/San Luis Rio Colorado, Sonora)

We encourage schools of public health to use service learning to prepare students to establish mutually beneficial partnerships with communities impacted by health inequities. Additionally, because service learning courses may require extra costs, we recommend seeking support from funding sources like CCPH to enhance financial sustainability.