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TASTE OF PROVIDENCE - Swim Program Gives Youths Power Over Asthma

Posted on: Thursday, 2 June 2005, 18:00 CDT

* Editor's note: Students in an advanced feature writing class at Brown University were assigned to write a feature story about a street that conveys a sense of place. The project, now in its seventh year, presents aspects of city life from the perspective of college journalism students.

* * *

PROVIDENCE - Wilfredo Baez, 12, stands near the edge of the swimming pool in his swim shorts. The large towel thrown over his shoulders, the wave of his black hair and his confident expression give him the look of Rocky Balboa, in seventh-grade form.

Like the other kids splashing around in the swimming pool, and one of 40,000 children affected in Rhode Island, Wilfredo has asthma -- but he knows how to handle it.

Most Wednesday and Friday afternoons, Wilfredo walks from his home just around the corner to the Southside Boys & Girls Club on Louisa Street to take swimming lessons with the Asthma Swim Program, which helps urban youngsters learn about their asthma and how to control it.

Asthma Swim is part of Project HEALTH, a program run by students at Brown, Harvard, Columbia and George Washington universities. Developed by 10 Harvard undergraduates in 1996, Project HEALTH works to help empower children of low-income families through health awareness.

"Asthma Swim was our first community-based program," said Rebecca Onie, who founded Project HEALTH as a sophomore at Harvard. "The idea was to develop a program that would provide physical activity through swimming, after-school homework help, and teach kids how to manage their asthma effectively."

Brown students volunteer to help combat the growing number of asthma cases among inner-city youth and minorities -- numbers that have been steadily rising.

"The incidence of asthma has increased by about 40 percent per decade each decade over the last three decades," said Dr. Robert Klein, director of the Asthma and Allergy Center at Hasbro Children's Hospital. These national statistics result primarily from incidence among urban youngsters and minority youngsters, he said.

According to a report by the American Lung Association in February, minorities -- particularly African Americans and Hispanics -- have a disproportionately high incidence of respiratory ailments.

"About 5,000 Americans die from asthma each year and there is a preponderance of these being minority people," Klein said. "A lot of people don't realize it's that high."

A recent study in the American Journal of Respiratory and Clinical Care said that Puerto Ricans have the highest incidence of asthma out of any ethnic group.

Though environmental factors associated with living in urban areas contribute, the study also found that Puerto Rican Americans, Dominican Americans and African Americans respond less effectively to asthma medications, Klein said.

"When you have all the risk factors coming together in one place - - an urban center -- where you have higher numbers of ethnic groups who respond badly to asthma -- you end up with an incidence of asthma that is much higher," Klein said.

Klein is mentor to the Asthma Swim Program. He says it is important to educate minority children living in urban areas about their asthma and how they can take care of themselves.

"These are things that get relegated to the last four minutes of a doctor's visit," Onie said. "Here we can spend four hours a week communicating these same messages."

After four years with the Asthma Swim Program, Wilfredo knows a lot about his breathing. He knows that cold weather, dry air, cigarette smoke, dust, mold and getting too upset or excited could trigger an attack. He knows the difference between his two types of medication: a controller that he takes every day to better stabilize his asthma and an albuterol inhaler, or quick release medication, that he uses when he starts to feel an attack coming on.

Asthma Swim has also taught him to recognize the symptoms of an attack as it is starting. He knows that when his chest tightens, when he starts coughing, wheezing, getting watery eyes, or feeling nauseated, this means the muscles in his bronchial tubes are swelling up, that his body is overproducing mucus and the air passages to his lungs are becoming smaller and smaller. He knows -- he has learned in the Asthma Swim classroom -- that this means he is having an attack.

The Asthma Swim classroom in the basement of the club is painted bright blue and covered in hand-drawn posters. One lists "Things You Can Do Even Though You Have Asthma," another lists "Pool Rules." There are also lists of the kids' favorite foods and birthdays.

When the children arrive at the Boys & Girls Club, they each puff into plastic peak flow meters to measure their lung capacity. Then they change into swimsuits, grab their inhalers and run to the pool.

From a distance, the large pool filled with kids and volunteers looks chaotic -- bodies splashing around in all directions: some doing handstands, others doing somersaults; some learning how to float, to do the breaststroke, the sidestroke, the backstroke; others standing at the edge of the pool with their bodies tightly curled over, learning how to dive; and others still, jumping on the backs of volunteers or playing games with them.

"A lot of our kids don't even know how to do the doggie paddle and then they are swimming laps by the end of it," said Onie. "For kids to be able to feel that there is a safe way for them to engage in physical activity is really important."

The yellow tiled walls of the basement poolroom sweat from the thick air.

The warm water, the humidity and the exercise in general help strengthen the children's lungs, said Carrie Goldschmidt, the program coordinator who is a senior at Brown.

"One of the main exercises you do is breath-control exercises as a swimmer," said Goldschmidt, who was a competitive swimmer through high school. By swimming regularly, the kids practice rhythmic breathing and are able to strengthen their lung muscles, which helps them better control their asthma.

Goldschmidt is one of 22 volunteers involved in the program. Brown students also volunteer with two other programs run by Project HEALTH in the Providence area: Girls FitNut, an after-school program at Roger Williams Middle School for girls at risk of obesity and type 2 diabetes, and the Family Help Desk at Hasbro Children's Hospital, which gives families information on housing, food, childcare, job training and public benefits.

"If we had all the money in the world, would we hire someone other than students?" said Onie. "I would say no. The best people are undergraduates because they are the best translators. They can take complicated information and translate into a game of asthma Jeopardy."

Goldschmidt began volunteering with Asthma Swim as a freshman and the experience has motivated her to want to go to medical school and work with children.

"The whole program had an influence on me," Goldschmidt said. "It felt right helping kids out and teaching them about this stuff."

The children are from Providence, which along with Woonsocket, Central Falls and Pawtucket, has the highest number of asthma cases in Rhode Island.

"You have twice the chance of getting admitted [to the hospital] for asthma if you come from these urban areas," Klein said.

The children participating in Asthma Swim and Girls FitNut come from the South side, one of the poorest urban areas in the state, said Lori Leibowitz, Project HEALTH site director for Providence.

"The South Side community is primarily black and Latino and low- income," Leibowitz said. "It is also an area that doesn't have a lot of services. There are not a lot of after-school programs going on in that neighborhood."

Since the program began about six years ago, it has served around 130 children.

Most of the 26 children now involved with Asthma Swim come from Mary Fogarty School, about a block and a half away from the Southside Boys & Girls Club. They range in age from 8 to 13.

"They are almost all at or below the poverty line," Leibowitz said.

The link between poverty and poor health is what motivated Onie to create Project HEALTH. "We could run the same program and it would help suburban kids, but I think the connection between poverty and health is so critically essential," she said.

Onie, now a lawyer in Chicago, is still a member of the organization's board. "The reason why our programs work is because of this relationship between undergraduates, the physician partners and the community organizations where we run our programs," she said. "Bringing together these three groups that otherwise wouldn't be working together -- that's the passion of the program."

After their swim lesson, the kids play a game of blob tag. They link hands to form a chain of bodies. By the end of the game, the chain of kids and volunteers snakes its way all the way around the pool.

"I think there is a certain magic that occurs between middle school-aged kids and college-aged young people," said Lisa Schorr, executive director of Project HEALTH. "Middle school kids tend to look at young adults of that age as an automatic role model."

A buzzer means it is time for the kids to get out of the pool and they run to the locker room to change back into their clothes and return to the classroom for a lesson on healthy eating.

"These kids are doing exercise and being active and that's what we want them to do. There is a real connectivity between asthma and obesity," Klein said. "We want very much for them to be active. This Asthma Swim program gets kids going. It gets their metabolism up. They learn to eat better."

According to a study released in March by Case School of Medicine in Cleveland, obesity nearly doubles the risk of asthma, particularly in African American males ages 8 to 11.

"Often, kids with asthma don't get enough exercise or don't get any exercise at all. We are talking about pretty serious and scary asthma here. If it's not controlled correctly, it is dangerous for them to exercise and so parents stop them from exercising," Schorr said. "But if they don't exercise, their heart and lungs get weak and they can become overweight. So then you have different health problems developing."

During today's lesson, the kids are learning about healthy foods. A table is filled with random objects: a yo-yo is the size of one serving of bread; a ping-pong ball is a serving of peanut butter; a deck of cards is a serving of meat.

Wilfredo sits around one of the two tables filled with children who are eager to get their hands on the healthy snack of the day -- a homemade salad. They mix spinach leaves, hot peppers, apple, garlic, basil, cheese and sauce. Some of the grumble that they want some "real food" but within minutes, the salad is devoured.

After that, the children gather their backpacks and leave. Wilfredo stays behind to ask for help on a math worksheet. Michael Kingsley, a senior at Brown, sits next to Wilfredo at one of the long fold-out tables.

"The diameter is the whole thing across?" Wilfredo asks. Kingsley nods, explaining how to go about the problem Wilfredo is stuck on. The program helps him with more than his asthma.

The seventh grader and his Brown mentor work for about 10 minutes. Then Wilfredo picks up his worksheet and walks back around the corner to his home.

Source: Providence Journal

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