City, State Turn to FP for Leadership During Pandemic

“I was like, ‘OK, I am totally willing to help out with this full time,’ but I never stopped teaching,” said Parajón, who developed a community health and engagement course with funding from the CDC and the AMA that gave students tools to address social determinants of health and social justice issues. “During the whole pandemic, I have been able to work with medical students, public health students, undergraduates and residents to actually help with the pandemic. There have been staffing issues during the whole pandemic. Involving students and residents really helps amplify the workforce. Not only that, it gave them an amazing experience.”

Parajón led a team of service providers, volunteers, shelter staff and students to develop testing, quarantine and isolation protocols to help prevent the spread of COVID-19 in the largest homeless shelter in the state. The team also secured hotel accommodations for those who had tested positive and supported medical staff who cared for those patients. These testing and isolation protocols are now being used in other places, she said.

Her efforts included training shelter staff to do contact tracing.

“They became better at it than our own contact tracers because they had trust of the community of people experiencing homelessness,” she said. “They knew what people needed and what they wanted in order to stay in quarantine and isolation. When you give people the opportunity to work to their top skill level, they tend to want to serve their communities.”

Her work with the city’s homeless population didn’t go unnoticed. In December 2020, the state called with an even bigger COVID-related task.

“They asked, ‘We know we can get vaccines out quickly, but we also want to make sure we are reaching people who have been disproportionately affected by the pandemic. Would you be willing to take a challenging job with less pay and more responsibility?’” she said. “I had been in the trenches for nine months taking care of people experiencing homelessness who are at way higher risk of COVID. The vaccine was like a beacon of hope for all of us working in health care and being able to be a part of a team serving the state to make sure the most vulnerable people also get vaccinated was an amazing opportunity.”

Parajón is currently serving as deputy secretary of health in the New Mexico Department of Health, where she has oversight of the state’s labs, public health and epidemiology divisions. Her tasks also include working with a team to develop and implement a vaccine equity plan, expansion of a community health worker network to support vaccine equity efforts and managing more than $100 million of CDC funds for health and vaccine equity.

As of Jan. 17, more than three-fourths of New Mexico adults had completed the COVID vaccination series, and 90% had at least one dose. For children ages 12-17, 58% had completed the series, and 68% had at least one dose.

Although she is technically on leave as executive director for community health and associate professor in the UNM Department of Family and Community Medicine, Parajón is once again involving students in her work, including projects related to rapid testing in vulnerable populations, increasing vaccine uptake for children and the development of a student-run clinic for people experiencing homelessness.

In 2020, she was recognized at UNM with both exemplary teacher and community service awards, and in 2021 the AAFP honored her with its annual Public Health Award.  

“Most of my background in family medicine has been in the area of community health and asking, ‘How do we partner well with communities and really work alongside communities to address not just health issues but all the social determinants of health?” she said.

Parajón completed her medical, public health and residency training at the University of New Mexico. After working with her father, Tsunie Chanchien, M.D., at his internal medicine practice in College Park, Md., for two years, she moved to Nicaragua, the home country of her husband, David Parajón, M.D., as medical missionaries with American Baptist Churches International Ministries.

“They ask communities what they want and then they provide the missionaries that can help support the local people,” she said. “Your mission is really to train local people in whatever skills you have and then leave. The job is to work yourself out of the job.”

The job was supposed to last five years. They stayed for 18.

Ultimately, the Parajóns started a sustainable nonprofit, AMOS Health and Hope, that compliments Nicaragua’s existing health system by reaching extremely remote areas that had previously been underserved. The organization has 25 community health workers in 25 remote communities, serving roughly 74,600 people.

“I saw babies die of things that I never saw babies die from in the States, like diarrhea and pneumonia,” she said. “I saw people dying of completely preventable diseases, but I also saw how community health workers can make a huge difference. We trained community health workers in very simple protocols, how to recognize danger signs, how to know when to refer a patient, how to treat the simplest of things. These people aren’t medical professionals initially, but they are once you train them.”

Parajón said her training as a student and resident at New Mexico helped her build partnerships in Nicaragua, and her experience in Nicaragua helped prepare her for COVID-19.

“I worked with tons of community partners in Nicaragua,” said Parajón, who returned to UNM as faculty in the fall of 2018. “I really learned how to partner with multiple sectors and saw the power of public health linked with primary health care. Nicaragua does that really well, as well as many other Latin American countries. In the United States, you’ll see a primary care clinic and a public health clinic in the same building, but they’ll literally draw a line between medical work and public health work.”

Parajón’s role with the state is unclear beyond 2022, and that’s OK with her.

“I’m just taking it a year at a time,” she said. “I know I’m staying for this year, and I’m still teaching at UNM. It doesn’t matter to me where I am. I am principle-driven. How do we link public health to primary care? How do we reach the most people who have been most affected by any illness, which is primarily populations that live in high socially vulnerable index areas, and address racism and racial and ethnic inequities?”

Parajón’s work with the city and state has thrust her into high-profile roles, something counter to advice she received from her father growing up. The family immigrated from Taiwan in the 1960s before she was born.

“I realized at a really young age that things weren’t really equitable,” she said. “My dad actually told me, ‘Stay invisible. Asian people get discriminated against all the time.’ That’s how we grew up. I think that that really affected my thinking because I was always like, ‘Oh, yeah, don’t make waves. Don’t do anything different.”

Parajón, however, has found her voice as an educator and advocate.

“Working in this field, you can’t stay quiet,” she said. “You have to keep on pushing for the people whose voices you represent, people who are disproportionately affected. I had to fight a lot against that ‘invisible Asian’ motif in order to do my job. You can’t be invisible.”