November 11, 2019
Recent nutrition alumnus Kevin Travia has seen the barriers in health care, both as a patient and provider, and it has driven him to carve out his own niche in the search for solutions.
A congenital condition discovered when he was 10 years old saw Travia in and out of medical offices for treatment, but his father’s eventual job loss meant his family no longer had the security of medical insurance. For a time, Travia had to be careful about participating in activities that other kids his age did every day due to the risk of an accident and the high cost of medical care his family might accrue.
The experience left him with an empathy for those affected by health care inequities, especially in his small-town North Carolina community. It opened his eyes to the obstacles many people face every day in accessing preventative medicine, good nutrition and many other facets of care that contribute to healthy living. In the rural counties of the state, one of the largest barriers to care has been limited access to physicians, specialists, hospitals and other providers.
“When you think about these big problems that we keep seeing in North Carolina, like the number of people who go to the emergency department because they can’t access primary care physicians – these problems can’t really be solved easily with one person,” said Travia. “It takes a team of people to do it. And I think that every person doing their own part to make that happen is really important.”
Travia wanted to be a part of that team. That desire led him to the UNC Gillings School of Global Public Health, where he studied nutrition with the long-term goal of becoming a physician. He saw his chosen field as an opportunity to combine his love of chemistry with his passion for public health. Memories of his grandmother, who often took the train to visit his family in rural North Carolina and spoke about opportunities to utilize the abandoned rail cars she saw along the way, sparked an idea for a health accessibility solution that Travia would soon turn into a budding nonprofit venture called Railcare Health.
Railcare Health began as one shuttle bus that Travia purchased at an online auction. He repurposed the bus for use as a mobile medical space, complete with places for patient triage, examinations and lab work. With the goal of bringing care to communities in need — identified through research at the UNC Sheps Center for Health Services Research — Travia recruited volunteer physicians and medical students to donate their time and put into practice the skills and principles of health care they’d learned in the classroom.
Medical students weren’t the only volunteers involved, however.
“Early on, I made an executive decision that the best strategy was to keep leadership at the college level,” Travia explained. He recruited students from many majors at UNC, all of them unified in their collective passion for bringing accessible care to underserved communities. “I was really trying to harness the passion, drive and time that college kids have and bring that out in a positive way for the community.”
Railcare Health’s shuttle bus has been running since 2018, making scheduled visits almost monthly and ad hoc visits as needed — such as in response to Hurricane Florence. It hasn’t always been easy. The question of how to take and store medical records, how to access wi-fi while traveling, and how to maintain security and HIPAA compliance are just some of the logistical challenges a mobile health facility has to face. There is also the question of patient turnout. Travia noted that the response to scheduled clinic days can range from no turnout at all to a turnout of 30 or more.
“That doesn’t sound like a ton of people,” said Travia, “but 30 patients – it’s a lot for one physician to see.”
Travia has found that the best and most effective strategy for influencing turnout and making an impact in a community goes beyond a flyer or a social media post. It’s all about consistency.
“When the community can trust that you’re going to be there, that means a lot more and it goes a lot farther,” he said. “You’re able to spread your work by word of mouth in a positive way. People get to know who you are and what you represent, and they trust you enough to put their health care in your hands. There’s no marketing strategy we’ve found to be more effective than that.”
The community reception to Railcare Health has made a lasting impact on Travia, and he will bring that experience with him as he pursues medical school in the upcoming year. He has stepped away from the day-to-day operations of the nonprofit, but still acts as the chairman of the board. Railcare currently is working with the Johnston County Public School System to develop a free check-up program for students, and it will continue to hold monthly clinic days across the state.
This summer, Travia began working as a nutrition assistant with the registered dietician at High Point University, and he is learning more about counseling techniques and ways to effectively implement good nutrition in patients’ lives.
“I want to have a strong foundation in clinical medicine,” Travia stated. “I want to be able to see patients and give back to the community in a way similar to what Railcare does – if not with Railcare – and to provide services for those who really need them. I want to provide for people without health insurance, like me when I was younger. That’s my end-all goal.”
Contact the Gillings School of Global Public Health communications team at firstname.lastname@example.org.