For many Americans, a trip to the family doctor is as routine as the sun rising or a flower blooming. But for people living in the region around the U.S.-Mexican border, health care is often difficult to access.

Emma Rubin '07, a comparative American studies major, investigated the work of local promotoras de salud, or community health workers, during a semester abroad last fall and for part of this past winter term.

"Health care is a very political issue, especially on the border," she says. "There are a lot of structural problems with the health care system in this country, but the gaps in who receives good health care are particularly apparent on the border—especially for people who struggle with barriers of language, transportation, cost, and legal status."

Promotoras—the focus of Rubin's research project—are individual health educators who work at the grassroots level to provide basic health education and referrals to primary health care facilities for residents of local colonias, communities were poverty is rampant where utilities and other public services are often lacking.

"Emma's project involves looking at how people live in their bodies and understanding what challenges they face to be well in light of the border's social, political, and economic issues," says Assistant Professor of Comparative American Studies Meredith Raimondo. "She's also learning to be an advocate for the promotoras and to help them communicate their message to the rest of the world."

In addition to being health educators, promotoras are community advocates. Promotoras often tackle issues within the colonia infrastructure, such as the lack of clean water or inadequate trash disposal services, which can cause health problems for residents. They also translate for patients during visits to the local clinic and provide in-home, follow-up visits to make sure that people are taking their medicine and following their doctor's instructions.

"I like to think of the promotoras as a bridge between the colonia residents and the health care system," Rubin says. "The promotoras are trying to bring health care to the communities they serve while at the same time making doctors and other health care providers aware of the structural challenges these people face in accessing health care."

Rubin's project was financed in part through the David Love Memorial Fund, which was established in 2002 to recognize the former College administrator's commitment to providing students with opportunities for intellectual transformation. Love was employed by Oberlin College for more than 30 years, during which time he initiated the Oberlin-in-London, Strasbourg, and China study-abroad programs.

"David loved to travel," says Professor of Biology Yolanda Cruz, who is Love's widow. "He felt that traveling was an education in and of itself, and that the very act of travel could broaden a student's academic experiences."

Rubin intends to keep working with the promotoras; in fact, she is heading back to the border this summer to continue her research, which she hopes will translate into a senior honors project in the fall. But Rubin also hopes that she will find a way to support the promotoras and their work over the long term, without trivializing or jeopardizing the bridges they have built between the colonias and local health care providers.

"Emma has a strong, clear plan in terms of her research project, with a carefully articulated methodology that reflects her understanding of the politics that the promotoras negotiate," says Raimondo. "What she is exploring is an ethical way to present and act on her findings. That way, she'll be able to base her actions on what she learns from the promotoras, rather than on some preconceived notion of what she should do. And that's the whole point of an intellectual journey, right?"

Rubin acknowledges that she's still trying to find her path, but emphasizes her commitment to the promotoras and what they represent. "I know that I can never be a promotora," she says. "They have a set of skills and a connection to their communities that I will never have. But I hope that this project will help me figure out a way to advocate for them and help them help even more people."

Rubin's summer research is being funded through a Jerome Davis Research Award, which is designed to defray the cost of field projects in the social sciences. The award can be used for expenses related to travel to and from a research site, as well as for interviewing, supplies, and equipment rental. Competition for the awards is held during the fall and spring semesters.