July 2014 • By Martha Ross

As a 7-year-old girl in El Salvador, Beatriz sold peanuts on the street with her mother to help feed their family.

When she became a mother herself, she didn’t want her children to have to worry about whether they would eat, go to school or have a chance for a better life. So she made the agonizing choice to leave her children and travel thousands of miles away, at one point crossing deserts and mountains on foot while trying to evade gangs and police. Her destination: the United States.

Beatriz looked to America as a place where she could earn enough money to improve her children’s quality of life. But in leaving, she didn’t know when she would see them again.

“When I left, my daughter said, ‘Mommy, please don’t leave,’” she recalled. “As I left, I turned around, and I saw both of my children waving good-bye.… That was four years ago.” She hasn’t seen her children since.

The brutal hardships Beatriz endured to find a better life for her family in America reads as though it comes from a distant time or place – a 19th-century immigrant’s sojourn or that of a refugee from a war-torn African nation – instead of from a woman we might see every day in a modern American community. But Beatriz was telling her story in 2009 to Rosa Maria Sternberg, an assistant adjunct professor in the Department of Family Health Care Nursing at UC San Francisco School of Nursing.

The Dean's Blog | David Vlahov

With startling regularity, stories continue to appear in publication after publication in which the authors fret about how to respond to the growing demand for health care, particularly primary care, and the accompanying shortage of doctors. Typically, the writers call for more medical schools, more money for medical students to lower debt, and incentives for medical students to go into primary care.

As we have noted many times before – and in many settings – such measures are important, but they will not be enough and they will not get solutions in place as quickly as is necessary. Meanwhile, there is a more immediate, research-based solution right in front of us – if only state legislatures would listen objectively to the evidence.

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