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By Anne Blythe
Viviana Martinez-Bianchi was 11 years old in 1976 when a military coup disrupted life in her native Argentina, cutting off the free flow of information to a country and a young, curious girl hungering for knowledge.
Her parents, a vascular surgeon and a biochemist, inspired their eldest child to not let the new dictatorship dictate the direction of her life. They encouraged her to reach high toward her ambitions and let her passion for justice and compassion for others guide her beyond the limits of her country’s borders.
Those early foundations from her youth have led Martinez-Bianchi to where she is today, serving as a needed conduit for the flow of crucial details about the coronavirus pandemic to and from North Carolina’s Latino and Hispanic residents.
A family physician at Duke Health who speaks Spanish, Portuguese and English, Martinez-Bianchi has been a needed and powerful voice for communities of color among the hardest hit by COVID-19.
With her colleague Gabriela Maradiaga Panayotti, a Duke pediatrician, Martinez-Bianchi formed Latin-19 early on during the pandemic to elevate the needs of a people whose access to quality health care has not been equal for years.
That advocacy and her willingness to speak out and up to people in power landed her a place at the side of Mandy Cohen, secretary of the state Department of Health and Human Services, to help shape the pandemic response for the more marginalized communities of color.
“It is wonderful to be joined by such amazing women leaders that we have in our state,” Cohen said during a recent briefing with reporters with Martinez-Bianchi alongside her.
Takes the bull by the horns
In North Carolina, Latinos make up nearly 10 percent of the population but represent 43 percent of the lab-confirmed COVID-19 cases for which race and ethnicity are known. Many work in construction, meat processing plants, grocery stores and other jobs deemed essential though they often fail to come with the pay and benefits that reflect how crucial such services are.
Martinez-Bianchi has highlighted the need to bring in trusted testing sites to Hispanic communities, where fears of questions about immigration status and fears of deportation are barriers to health care.
This month, the state has been staging free testing sites in communities of color and making sure it is free in certain ZIP codes. It also publishes key information in Spanish on the DHHS dashboard.
“Viviana has really taken the bull by the horns,” said Maradiaga Panayotti, her colleague, friend and co-founder of Latin-19. “She is just like this firecracker.”
Martinez-Bianchi has an innate ability to zero in on a problem, figure out how it will play out, and then develop an action plan that is difficult for others to turn down, her colleague added. She knows how to seek out and bring together the people who can go beyond simple recognition of the problem.
“She brings that valuable piece of next steps,” Maradiaga Panayotti said. “She’s on it. She’s looking for funding, she’s figuring out how to get it done.”
Then she digs in to do the work. “She must have 40 hours in her day,” Maradiaga Panayotti marveled.
At a recent briefing with the media in which Martinez-Bianchi addressed listeners in English and Spanish, a question arose about Latinos being turned away from some health care facilities because they don’t have health insurance or are being asked about their residency status.
“We really are trying to understand the magnitude of this situation,” Martinez-Bianchi responded. “We have identified it as an issue of self-advocacy in one way, but also the importance of really figuring out where these cases are happening and how can we inform our hospital organizations, our people working in triage to really not turn people back.”
A father-daughter moment shapes a life
Martinez-Bianchi came to the United States nearly three decades ago after getting her medical degree in 1990 from National University of Rosario Faculty of Medicine in central Argentina.
She grew up in Parana, a provincial capital city with many similarities to Raleigh, where she lives now with her husband and college-aged son.
Her interest in health care was heightened in 1978 when she, at just 14 years old, absorbed her father’s interest in a landmark declaration hammered out at an International Conference on Primary Health Care held in what is now Almaty, Kazakhstan.
More than four decades later, the accomplished physician recalls how her dad, a vascular surgeon, was reading about the conference, sharing details from the newspapers about the ambitious commitment to health as a human right. The Alma-Ata Declaration goes far beyond working to cure and treat disease. It highlights the impact that social and economic well-being have on overall health.
The declaration called for better allocation of the world’s assets, recommending a laying down of the armaments used to tear warring countries apart and shifting those resources toward the elimination of persisting public health disparities by 2000.
“That was a very big deal,” Martinez-Bianchi said recently. “I remember him telling me how important that was.”
What he left to her and future generations was figuring out how to work globally to achieve that goal and the best career path for doing that.
Martinez-Bianchi had the fight to find the path that best fit her mission. In her native Argentina, she went on a hunger strike and marched to the chancellor’s office to protest admission standards that were limiting access to medical education to a privileged few.
With the matriculation of so few, the health care force could not grow to the numbers needed to help the underserved.
“I entered medical school post-dictatorship and what was very interesting to me during that process is that I was learning the law — I had a really excellent education — but at the same time there was a mistreatment of women that was really marked,” Martinez-Bianchi said in a transcript published at MedPageToday in 2017 titled “From Hopeless to Healer: Finding Acceptance as a Doctor, Value as a Woman.”
Finding family medicine
Martinez-Bianchi had been a foreign exchange student in the United States and returned during summer breaks to learn more about medicine in this country.
Her adopted family was in Mount Prospect, Ill., about 20 miles from downtown Chicago, and helped her land a rotation in an emergency department in Arlington Heights, also northwest of the city.
Though she enjoyed the variety of cases and people she encountered in the fast-paced environment, she hungered for a chance to follow up with patients to find out how they were doing.
A mentoring physician asked if she had ever thought about going into family medicine, a field she was not entirely familiar with at the time.
“I fell in love with the idea of taking care of people through their lifetime and being there for them, and being able to do both advocacy and caring for babies, and caring for moms, and delivering their babies, and doing all of that what family medicine entails,” Martinez-Bianchi recalled later.
“I thought family medicine would be doctors that do everything but also have a foot in the community,” Martinez-Bianchi said in a recent telephone interview. “I love having one foot in the community.”
Those who know her and marvel at how she seems to have endless energy to care for people inside and out of the hospital might say she has planted both feet firmly in whatever community she is in at the time.
She uses her language skills, her understanding of different cultures, her medical skills and her deep well of tenderness and mercy to do what she can to knock down barriers to health care that still exist two decades after the goals aspired to in the Alma-Ata Declaration.
She did it in the Chicago area, where she was a resident in training.
She continued the tradition in Iowa, where she made it through 11 winters before telling her husband Greg Bianchi, a urologist she met while doing research, that she needed to move south.
Active inside and outside the hospital
Now, here in North Carolina, where she took on a new role this summer as director of health equity for the Department of Family Medicine and Community Health at Duke Health, she is active inside and outside the medical complex in ways large and small.
It was happening long before the pandemic.
In 2017, her sister, who followed Martinez-Bianchi and their mom to the United States, taped a speech she gave on behalf of health professionals marching in their white coats at the North Carolina capital.
The event was organized by the state NAACP, when the Rev. William J. Barber II, the architect of the Moral Monday protest movement, was at the helm of the organization and actively criticizing laws and policies of the Republican-led General Assembly.
Martinez-Bianchi advocated for the expansion of Medicaid in North Carolina, a policy change that before the pandemic would have made the program accessible to some 550,000 low-income adults who would not otherwise qualify for the federal assistance. That number is likely larger, expansion advocates say, as people lose jobs and health insurance because of the prevalence of COVID-19, yet Republicans steering the General Assembly have not softened their stance against enacting the policy.
“We march for our patients whose voices are not being heard,” Martinez-Bianchi told the gathered crowd on a cold Saturday in February three years ago. “We march with you because we know the issues you are fighting for are essential to your health and the health of every community: a living wage, affordable housing, a healthy environment, LGBT rights, criminal justice reform, acceptance of immigrants, and strong public education.
“We know that your ZIP code will affect your health more than your genetic code. We march to improve that.”
Listening and understanding a culture
As willing as Martinez-Bianchi is to speak to a crowd, it’s not unusual for her to take a quiet moment with someone in need.
While recounting one of those moments recently, Martinez-Bianchi had to pause to tamp down the emotion bubbling to the surface, choking her voice.
President Donald Trump had just been elected and the political rhetoric about building a wall along the country’s southern border as well as the sharp uptick in immigration arrests and deportations had sown fear in many Latino families.
There was a 14-year-old boy who had been examined numerous times by residents on her service, but they could not figure out why he had frequent bouts of nausea and vomiting.
“I asked about his parents,” Martinez-Bianchi recalled.
The resident did not know whether they had the proper paperwork to be in this country, so she sat down with the boy’s mother to find out more.
They did not, Martinez-Bianchi said, recalling how the source of the boy’s trouble began to emerge through that conversation. He was worried about his parents being deported and what would happen to him in their absence.
“His whole world was completely unsafe,” Martinez-Bianchi said.
It wasn’t that thought, though, that caused the rush of emotion in her. What got to her was when she recounted how she talked with the boy and his mother about developing a plan for where he would go and be safe if the family was torn apart by an Immigration Customs Enforcement arrest.
The boy turned to his mother and the doctor and asked: “Can I come here?”
Martinez-Bianchi said the boy’s comfort with being at the medical facility and feeling cared for there was not just because of her. “The people who had been seeing him made him feel safe,” she said proudly.
Having that kind of cultural understanding to be able to pull back the curtain on a world that’s foreign to some, to really pinpoint the source of a problem, is an important part of medicine. Martinez-Bianchi does it well, her colleagues say.
A school mom and a healer
Once while taking her son to school, Martinez-Bianchi recalled being pulled aside by the school secretary because she spoke Spanish.
A woman was parked at the curb unable to get the young girl in the back seat to get out of the car and join her classmates inside the building.
Martinez-Bianchi talked to the woman at the steering wheel in Spanish, telling her that she did not work at the school, that she was just a mom who dropped her son off that morning. Could she help, she asked.
Martinez-Bianchi found out the girl had been distraught since her father left, curling herself up into a ball of grief, pain or depression each day before school.
Upon further probing, Martinez-Bianchi found out the girl’s father had been deported, but told the woman with whom she was speaking she would not translate that for the school staff there.
The doctor offered to walk with the girl into school and listen to her and hear her if she wanted to share her feelings. The driver, whom Bianchi-Martinez had assumed was the girl’s mom, said she would get fired if she continued to arrive late to work, that this was happening every morning.
In a blog post recounting this story, Martinez-Bianchi said she told the girl: “Let’s help mom get to work.”
The woman adds “I have been trying to find them, I have talked even with the Mexican embassy, and nobody can help me. No one knows where they are. I can’t deal with this. I love her, but she wants to run away to her family.”
“But.. you…” I start. “All of them were deported” the woman adds. “I was their neighbor, I took her in. They asked me to keep her and give her a better life. She is the only American citizen in the family. They were all deported. But all she wants is to see them. Every day is the same. She wants to run home to them”…
‘This is my home’
Though Martinez-Bianchi’s mother and sister have joined her in this country, her brother remains in Argentina where he is a vascular surgeon. Their father died at age 52.
Martinez-Bianchi likes to travel and attends many conferences around the world — including one of those full-circle life trips to Kazakhstan in 2018 to acknowledge the failed dream of Alma-Ata and set new goals in the Declaration of Astana — but she does not envision a move back to Argentina.
“I often feel like I’m more needed here than there,” she said. “This is my home. I’m like a potted plant. This is where my roots are now.”
Her husband retired at 50 because of multiple sclerosis and now spends a lot of time doing woodworking. They have a son who will be starting college soon in this country.
“They keep me sane,” Martinez-Bianchi said during an interview in a week when she had been putting in long hours as a doctor, a community advocate and a pandemic policy-shaper.
When asked how she unwinds, perhaps plan a trip with her family to get away from it all, she responded:
“I’m the nerd who goes to meetings on a vacation. My husband asked me one time whether we were going to have a real vacation ever. We always would go somewhere where there was a conference or a meeting. We were two workaholics when we met.”
They made time for sailing, dancing and dining out at their favorite restaurants. There are quieter moments, too. She enjoys grilling vegetables and fish and being surrounded by family and friends.
Martinez-Bianchi knows how to have fun, too, said Maradiaga Panayotti.
“She’s a hoot,” her friend said, recalling a night of dancing at a fundraiser the first time they met. “The thing I will say about Viviana is she’s just so authentic. You can be with her and you know it’s real.”
That authenticity plays a major role in her commitment to opening wide global access to health care, a seed planted so many years ago discussing the news of the world with her father.
The pandemic, she said, has highlighted disparities that no longer can go unnoticed as the state and world try to get beyond COVID-19.
“We’re seeing all these things,” Martinez-Bianchi said. “Now we have to say, ‘How do we go forward in a different way?’”
Correction: We have updated this story to reflect the correct name of Martinez-Bianchi’s employer, which is the Department of Family Medicine and Community Health at Duke Health.