DIGNITY BY DESIGN | Nina Ragunanthan

On August 30, 2022, there was a gas leak at Sunset Village apartments just outside Cleveland, Mississippi in the rural Mississippi Delta that left a 31-year-old mother and her 5-year-old daughter dead. Like many events affecting the poor in Mississippi, it did not garner much attention.

Families were displaced for months afterwards. Residents were evacuated into nearby motels while emergency repairs commenced. However, residents were still expected to pay their rent for their uninhabitable apartments while living in motels. Some families lived with five or more children within one motel room. 

Several families who lived in those apartments came to see my husband and me for medical care afterwards, concerned about carbon monoxide poisoning and their newfound homelessness. My husband—a pediatrician and I—an OB/GYN, tended to our patients dealing with the after-effects.

Many noted that this event, the one that finally brought attention to the condition of the apartments, was just one issue among many. They described conditions of mold growing on the walls for years, constant water leaks, broken appliances and falling ceiling tiles. After the deaths, lawyers from the University of Mississippi’s Low-Income Housing Clinic filed lawsuits asserting the apartment complex violated numerous federal housing regulations. 

When one of my patients described her apartment to me, I said “Wow, it sounds like it’s not fit for humans to live there.”

She said, “Doc, if you like dogs, you wouldn’t even put your dog there.”

Her words have reverberated in my mind ever since.

Every day when I provide care to my patients, I want them to feel something that is so far removed from that despair. I want them to feel dignity. I want them to feel they are worthy of excellence. 

A physical space is a part of creating dignity. Delta Health Center, where I practiced at that time, is the oldest rural federally qualified health center in the United States. It is located in the small town of Mound Bayou, Mississippi, a town founded by ex-slaves after the Civil War. It has a rich legacy of not only providing healthcare, but of reaching beyond the walls of the clinic to address the needs of the community.

Fortunately, the clinic building is new and modern. It is brightened by many large windows. The facilities are kept clean and well maintained. And yet, as a function of the rural location, it is also a place where the internet fails several times per month, meaning it is not always possible to look up a patient’s medical record or send an electronic prescription. Sometimes the water is cut off, meaning that in between patients, I have had to wash my hands with bottled water instead of being able to use the tap. Even electricity is periodically lost. Working without those amenities seems hard to imagine here in the United States, but it’s just another day in the Mississippi Delta. 

After turning over my patient’s words again and again in my mind, we decided to find a piece of art for the clinic. Paul Farmer, the founder of Partners In Health and my role model for health as a vehicle for social justice, served as the inspiration. Farmer insisted on having fish ponds at his clinics and hospitals, even in rural Rwanda and Haiti. It is impractical, and yet fish ponds and fountains are common in the lobbies and courtyards of affluent hospitals. They provide a calming beauty. Having one in the midst of poverty signifies to the patient, You matter. You, too, are worthy of beauty.

We chose a photograph by artist Mikael Owunna, a masterful Nigerian-Swedish American photographer and engineer, as well as a personal friend. The image is of a regal Black woman who sits in darkness gazing downward, with her arms folded and legs gently crossed. Her body and natural hair are glowing with fluorescent paints of blue, illuminated only by the camera flash. The title is Mgbakwocha (Grand Lady of the Mysteries). 

We placed it on the wall in the waiting room shared by the offices of obstetrics/gynecology and pediatrics. It is next to the door patients enter to get their vital signs assessed for the OB/GYN practice, so it not easily missed.

Below it, we placed the artist’s caption: “At the beginning of the universe, all was one in the blackness of space. Eke-Nnechukwu, the feminine polarity of the Igbo primordial androgynous deity, manifests Herself as Mgbakwocha. She is the Grand Lady of the Mysteries of creation…and is the birth source of life, which emerges from the blackness of Her womb.”

Owunna has written the following about his work: “I sought to transfigure Black bodies from sites of state violence into cosmic vessels drawn from African cosmological traditions…I leveraged my training as an engineer to build a camera flash that only transmits ultraviolet light, hand-painted the bodies of nude Black models with fluorescent paints that only glow under ultraviolet light, and photographed them in total darkness. For the fraction of a second that the shutter snapped, a transfiguration happened: their bodies were illuminated as the starry universe itself.”

Yes, this is what I want for my patients. For them to see themselves as the starry universe itself.

After putting up the photograph, patients and staff alike commented on its beauty. Many simply paused and said “wow.” 

That wonder, that pause to view something beautiful and powerful, is what gives rise to something else: hope. Hope is necessary, but it is hard to come by for some in a place like the Mississippi Delta.

Every day my patients receive messages telling them they are insignificant, from crumbling apartment complexes to failing schools to politicians that divert welfare funds and deny Medicaid expansion. That message is built into the very fabric of society. It breeds despair and cynicism. Paul Farmer has said: “Those are the two biggest dead ends we’ve got: despair and cynicism.”

Gazing upon beauty and seeing the divine universe reflected in human form, and more specifically in Black, female form, is a measure against that. A small measure of hope, of opportunity. Because we are all worthy of beauty.

Nina Ragunanthan is an obstetrician/gynecologist and assistant professor at University of Pittsburgh Medical Center Magee-Womens Hospital in Pittsburgh, PA. From 2021-205, she practiced as a solo-coverage OB/GYN in the Mississippi Delta, an experience that continues to shape her clinical and academic work.

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