Latina Physician Collaborates with Promotoras in Sustainable Infection Control Efforts

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In a modest house in Los Angeles, California, a young girl buried her nose in a book.

She focused on the book’s colorful graphics of doctors helping sick patients. Closing her eyes, she pictured herself in this role.

Her mother’s words echoed in her mind, “Education is the key to opening doors in life.”

The young girl wasn’t sure how, but she decided she was going to go to medical school, and she was going to become a doctor.

Decades later, the young girl — now a grown woman – has a successful career in medicine.

Dr. Marlene Martin is an associate professor of clinical medicine at the University of California, San Francisco (UCSF) and a hospitalist at San Francisco General Hospital (SFGH).

In these roles, Marlene combines her passion for clinical care of marginalized patients, education of medical students, advocacy for a diverse workforce, and systems improvement in hospital-based addiction care.

She is also poised to act against emergencies, and to build capacity for daily needs, such as infection control.

Inspired by her Mexican immigrant background, Marlene is keenly focused on tackling health inequities and social justice issues in the Latino community.

So, when the COVID-19 pandemic hit San Francisco and disproportionately impacted Latinos, Marlene felt a call to action.

“At the very beginning of the pandemic, almost everyone who was coming into the hospital with COVID-19 was Latino and Spanish-speaking,” Marlene said. “Many Latinos couldn’t safely quarantine at home or isolate because they had to work. They didn’t have a financial safety net, and many were essential workers. These challenges that particularly impacted the Latino community made me feel like I needed to do more to prevent the spread of COVID-19.”

COVID-19 Infection Control in the Community

Eager to help vulnerable Latinos, Marlene volunteered to administer COVID-19 tests.

Soon, an opportunity to get even more involved in COVID-19 infection control arose through the UCSF Latinx Center of Excellence.

This opportunity involved collaborating with other Latino-focused community organizations to help bring COVID-19 infection control education and resources to the Latino community, as well as perform case investigation and contact tracing.

Serving as physician lead for this project, Marlene and collaborators developed a program that heavily involved community health workers – called promotoras de salud in the Latino community – who “did an amazing job” providing culturally and language-informed care to Latinos.

   Community COVID-19 events

In addition, the program provided wrap-around services, in which patients could get care for other issues like mental health and food resources.

“When people expressed that they were having symptoms of depression, we could link them to one of the community-based organizations providing mental health resources,” Marlene said.

The wrap-around services proved to be especially important in COVID-19 infection control.

“When patients expressed that they couldn’t afford to isolate because they had bills to pay, there were resources to give people two weeks of pay so they could afford to stay home from work,” Marlene said. “Food insecurity was another issue. Community-based organizations would deliver food to these patients so they could continue to quarantine. These services were lovely to see and were vital to infection control.”

The program proved sustainable, continuing today with community organization and Department of Public Health leadership with Marlene now serving as technical support.

County leaders were also so impressed with the success of the program that they started a community health worker and promotora training academy, since these healthcare workers proved vital in mitigating the spread of COVID-19.

Marlene and her team

They are also developing similar projects to tackle other infectious diseases and conditions affecting the Latino community, such as diabetes and alcohol use disorder.

With her credentials and strong interest in addiction medicine, Marlene is excited focus on a new program for alcohol use disorder.

“The community really mobilized to make the COVID-19 program possible,” Marlene said. “Leaders are taking note that if we can do it for COVID-19, we can do it for other diseases and issues affecting our community.”

In honor of their hard work mitigating the spread of COVID-19 in San Francisco, California Senate District 11 honored Marlene and the promotora team with a 2021 COVID-19 Heroes Award.

Marlene was humbled by the award but insisted that the community health workers and promotoras deserve the most recognition.

She also pointed out that as a hospitalist and educator, infection control is part of her daily regimen.

Infection Control Practices – An Everyday Necessity

Marlene cited masks, gowns, gloves, eye protection, and hand washing as some of the most effective ways of preventing disease transmission in the clinical setting.

“We live by these infection control practices, and they will continue to be important,” Marlene said.

Marlene also enjoys teaching the next generation of physicians the importance of infection control.

“The medical students and residents definitely learn infection control practices before interacting with patients – especially the basics,” Marlene said.

Marlene’s commitment to infection control is also apparent in her work in addiction medicine.

She and the Addiction Care Team at UCSF help prevent infections that can result from sharing needles and other substance use supplies, such as skin and soft tissue infections, HIV, and hepatitis C, through harm reduction efforts in partnership with the San Francisco AIDS Foundation.

Much of her infection prevention efforts in addiction medicine have revolved around education.

“In terms of addiction care, we meet patients where they are. Many are motivated to improve their health outcomes. Some are interested in stopping or reducing their substance use. For those whose goal is not to stop altogether, harm reduction helps reduce the risk of overdose, death, and infections and increases engagement in addiction care over time. If someone might continue using substances, we discuss the importance of using sterile needles, having naloxone, and other supplies and practices that reduces the harms of substance use,” Marlene said.

Sustainable Change for the Future

As a first-generation college student, Marlene is supportive of other “first-gen” students who want to pursue medicine, especially those who might come from immigrant backgrounds, like herself.

She emphasized that help is out there if you ask for it. She received a lot of guidance from others in her journey to becoming a physician.

Marlene couldn’t picture herself in any other career.

“I think medicine is a beautiful combination of our stories, science, public health, and interprofessional teamwork. It’s so much fun,” Marlene said.

At the heart of medicine is effective infection control, which Marlene continues to practice every day in the hospital and community.

Because of heroic collaborative efforts, the Latino community in San Francisco will continue to get more life-saving resources.

What Can You Do to Promote Infection Control in Your Healthcare Setting?

Help keep yourself, your colleagues, and your patients safe from infectious disease threats, such as COVID-19, by building on your infection control knowledge! To show your dedication, sign this pledge to complete an infection control training or activity through CDC’s Project Firstline!

PLEDGE TO TAKE THE TRAINING!

You can also access more information about infection prevention and control in healthcare by visiting resources from CDC Project Firstline.

Salud America! at UT Health San Antonio is working with the National Hispanic Medical Association to bring Project Firstline infection control educational content to healthcare workers, so they are equipped with the knowledge they need to protect themselves, their facilities, and their patients (Latinos and all communities) from infectious disease threats in healthcare settings.

You can read these articles:

Learn More about Project Firstline!

 Editor’s Note: This article is part of a collaboration between Salud America!, the National Hispanic Medical Association, and the CDC’s Project Firstline. To find resources training materials, and other tools to bolster knowledge and practice of infection control, visit Project Firstline and view Salud America!’s infection control content.

By The Numbers By The Numbers

100

percent

of healthcare workers should focus on infection control

This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.

The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.

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