How a trip across the border inspired a doctor to fight for health care equality.

Disparities of patient treatment are real. It's time all doctors join efforts to help change that.

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Northwestern Mutual

When Dr. Paula Aristizabal first started working in pediatric oncology, she was a little uneasy.

"I was scared because I didn’t know what to expect," Aristizabal explains. Even though cancer specialists have to assume they'll be treating people with a lower than average survival rate, knowing that all her patients would be children made it somewhat more daunting.

Fortunately, however, that was far from the experience Aristizabal ended up having.


Aristizabal. Photo via Northwestern Mutual.

"I learned pediatric cancer is highly curable, so it was very rewarding because I would be able to make a difference in [my patients'] lives," Aristizabal says.

Little did she know treating cancer in children wouldn't be the only way she'd make a positive impact on health care.

After completing her pediatric oncology training, which is the study of childhood cancer, in her home country of Colombia and her fellowship at the University of California San Diego School of Medicine, Aristizabal joined the medical staff at Rady Children’s Hospital in San Diego, California. She, soon after began collaborating with St. Jude's Children's Research Hospital on a project to improve pediatric cancer care in the U.S- Mexican border region.

On an initial visit to a city hospital in Mexico, she learned they didn't have anything like a pediatric oncology ward.

"I thought, 'Oh, goodness, it’s so different from the U.S.,'" Aristizabal shares. "I saw the disparity right there."

Since 2008, she's improved care in several Mexican hospitals, including two in Tijuana and La Paz.

Image via iStock.

But that was just the beginning.

It became Aristizabal's mission to address the racial and ethnic disparity occurring in hospitals in the United States as well.

When she began to notice disparities in how the treatment worked for Hispanic patients where she practiced in San Diego, she decided to do some research to better understand barriers to response to treatment.

Aristizabal learned that while it's likely there are biological differences that can contribute to disparities in the survival rate of Hispanic children with cancer, she also found a disparity in access to health care due to language and cultural barriers.

Thanks to funding assistance from Alex's Lemonade Stand Foundation and Northwestern Mutual, whose Childhood Cancer Program has generated more than $15 million for research and family support nationwide, Aristizabal was able to conduct her own research on that disparity. This was an important research focus for Northwestern Mutual in their mission to ensure that all kids have a chance to grow up.

[rebelmouse-image 19530659 dam="1" original_size="640x426" caption="Photo via Selmaemiliano/Flickr." expand=1]Photo via Selmaemiliano/Flickr.

She took an in-depth look at her own specialty in particular. She learned a large percentage of parents of kids with cancer have a low level of health literacy, meaning they have trouble navigating America's complex health care system due to their cultural background. For example, Hispanic families are less likely to participate in clinical trials, which, in pediatric cancer, often offer the best chance of survival.

Image via iStock.

Since her first language is Spanish, Aristizabal knew she could do her part to help close that cultural and linguistic gap.

At the Peckam Center for Cancer and Blood Disorders at Rady Children's Hospital, where she practices pediatric oncology, 50% of the children who receive treatment  are Hispanic. At her clinic, 95% of her patients are Hispanic, and 65% of their parents speak Spanish as their first language. Aristizabal knew her cultural background was key to providing them the best care possible.

"Since I’m Hispanic, and I know the culture and speak Spanish, I try to provide cultural concordant care and language concordant care," Aristizabal says.

Research shows that when individuals receive care from someone in their own language and culture, the treatment results are much better.

Image via iStock.

When a doctor can fully communicate with patients, they can be sure they're getting all the necessary details about a medical condition. In turn, patients feel more at ease knowing their doctor fully understands their condition and can clearly communicate a treatment plan. All this adds up to better results.

But Aristizabal can only do so much as one doctor. That's why she's inviting others to contribute to lessen this country-wide disparity.

"We need to prepare because the Hispanic population in the U.S. will comprise more than 30% of all Americans by 2050. There’s something we can really do in our own institutions."

Image via iStock.

One simple step is to access a free bilingual treatment journal from the ALSF website to help families track their care plan.  The journal is funded by Northwestern Mutual as another way to address disparities.  

If pediatric cancer centers don't have bilingual doctors on staff, they can improve access to interpreter services. Another strategy is that their doctors pursue cultural awareness training. Institutions can also offer medical Spanish lessons to their staff or any other language that might help their patients.

It requires a bit of effort, but it will make a world of difference.  

Just imagine a scared child who doesn't speak English in a hospital. A doctor who can speak their language could be the only thing that puts them at ease.

"It’s so rewarding when you learn about other cultures," Aristizabal says. "It facilitates the care that you provide because when you learn about another culture, you’re able to better understand where [patients] are coming from."

And any doctor knows that's more than half the battle.

Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company, Milwaukee, Wisconsin, and its subsidiaries. Learn more at northwesternmutual.com

Images courtesy of Letters of Love
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When Grace Berbig was 7 years old, her mom was diagnosed with leukemia, a cancer of the body’s blood-forming tissues. Being so young, Grace didn’t know what cancer was or why her mother was suddenly living in the hospital. But she did know this: that while her mom was in the hospital, she would always be assured that her family was thinking of her, supporting her and loving her every step of her journey.

Nearly every day, Grace and her two younger sisters would hand-make cards and fill them with drawings and messages of love, which their mother would hang all over the walls of her hospital room. These cherished letters brought immeasurable peace and joy to their mom during her sickness. Sadly, when Grace was just 10 years old, her mother lost her battle with cancer.“

Image courtesy of Letters of Love

Losing my mom put the world in a completely different perspective for me,” Grace says. “I realized that you never know when someone could leave you, so you have to love the people you love with your whole heart, every day.”

Grace’s father was instrumental in helping in the healing process of his daughters. “I distinctly remember my dad constantly reminding my two little sisters, Bella and Sophie, and I that happiness is a choice, and it was now our job to turn this heartbreaking event in our life into something positive.”

When she got to high school, Grace became involved in the Leukemia & Lymphoma Society and a handful of other organizations. But she never felt like she was doing enough.

“I wanted to create an opportunity for people to help beyond donating money, and one that anyone could be a part of, no matter their financial status.”

In October 2018, Grace started Letters of Love, a club at her high school in Long Lake, Minnesota, to emotionally support children battling cancer and other serious illnesses through letter-writing and craft-making.


Image courtesy of Letters of Love

Much to her surprise, more than 100 students showed up for the first club meeting. From then on, Letters of Love grew so fast that during her senior year in high school, Grace had to start a GoFundMe to help cover the cost of card-making materials.

Speaking about her nonprofit today, Grace says, “I can’t find enough words to explain how blessed I feel to have this organization. Beyond the amount of kids and families we are able to support, it allows me to feel so much closer and more connected to my mom.”

Since its inception, Letters of Love has grown to more than 25 clubs with more than 1,000 members providing emotional support to more than 60,000 patients in children’s hospitals around the world. And in the process it has become a full-time job for Grace.

“I do everything from training volunteers and club ambassadors, paying bills, designing merchandise, preparing financial predictions and overviews, applying for grants, to going through each and every card ensuring they are appropriate to send out to hospitals.”

Image courtesy of Letters of Love

In addition to running Letters of Love, Grace and her small team must also contend with the emotions inherent in their line of work.

“There have been many, many tears cried,” she says. “Working to support children who are battling cancer and other serious and sometimes chronic illnesses can absolutely be extremely difficult mentally. I feel so blessed to be an organization that focuses solely on bringing joy to these children, though. We do everything we can to simply put a smile on their face, and ensure they know that they are so loved, so strong, and so supported by people all around the world.”

Image courtesy of Letters of Love

Letters of Love has been particularly instrumental in offering emotional support to children who have been unable to see friends and family due to COVID-19. A video campaign in the summer of 2021 even saw members of the NFL’s Minnesota Vikings and the NHL’s Minnesota Wild offer short videos of hope and encouragement to affected children.

Grace is currently taking a gap year before she starts college so she can focus on growing Letters of Love as well as to work on various related projects, including the publication of a children’s book.

“The goal of the book is to teach children the immense impact that small acts of kindness can have, how to treat their peers who may be diagnosed with disabilities or illness, and how they are never too young to change the world,” she says.

Since she was 10, Grace has kept memories of her mother close to her, as a source of love and inspiration in her life and in the work she does with Letters of Love.

Image courtesy of Grace Berbig

“When I lost my mom, I felt like a section of my heart went with her, so ever since, I have been filling that piece with love and compassion towards others. Her smile and joy were infectious, and I try to mirror that in myself and touch people’s hearts as she did.”

For more information visit Letters of Love.

Please donate to Grace’s GoFundMe and help Letters of Love to expand, publish a children’s book and continue to reach more children in hospitals around the world.

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Images courtesy of AFutureSuperhero and Friends and Balance Dance Project
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The man inside the costume is Yuri Williams, founder of AFutureSuperhero And Friends, a Los Angeles nonprofit that uplifts and inspires marginalized people with small acts of kindness.

Yuri’s organization is one of four inaugural grant winners from the Upworthy Kindness Fund, a joint initiative between Upworthy and GoFundMe that celebrates kindness and everyday actions inspired by the best of humanity. This year, the Upworthy Kindness Fund is giving $100,000 to grassroots changemakers across the world.

To apply, campaign organizers simply tell Upworthy how their kindness project is making a difference. Between now and the end of 2021, each accepted individual or organization will receive $500 towards an existing GoFundMe and a shout-out on Upworthy.

Meet the first four winners:

1: Balance Dance Project: This studio aims to bring accessible dance to all in the Sacramento, CA area. Lead fundraiser Miranda Macias says many dancers spend hours a day at Balance practicing contemporary, lyrical, hip-hop, and ballet. Balance started a GoFundMe to raise money to cover tuition for dancers from low-income communities, buy dance team uniforms, and update its facility. The $500 contribution from the Kindness Fund nudged Balance closer to its $5,000 goal.

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James started a GoFundMe to crowdfund supplies for his students’ team ahead of the First Lego League, a school-against-school matchup that includes robotics competitions. The team, James explained, needed help to cover half the cost of the pricey $4,000 robotics kit. Thanks to help from the Upworthy Kindness Fund and the generosity of the Citizens of the World Middle School community, the team exceeded its initial fundraising goal.

Citizens of the World Mar Vista Robotics Team video update youtu.be

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AFutureSuperhero started a GoFundMe in July to cover the cost of gifts as well as travel expenses like hotels and rental cars. To help the nonprofit reach its $15,000 goal, the Upworthy Kindness Fund contributed $500 towards this good cause.

Think you qualify for the fund? Tell us how you’re bringing kindness to your community. Grants will be awarded on a rolling basis from now through the end of 2021. For questions and more information, please check out our FAQ's and the Kindness Toolkit for resources on how to start your own kindness fundraiser.

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