Immigrant Families – A New Report

RefugeeFamily
Photo Credit: http://www.fhcw.org/en/Home

In the last two years, the immigration debate has become louder and arguably less civil. Political platforms and decisions based on fear have dominated the conversation, but behind the conversation are approximately 23 million people. The number includes those lawfully present as well as those who are undocumented. It includes around 12 million children who are legal citizens born in the United States, but whose parents are non-citizens.

How does the current climate affect the health and daily lives of these millions of people?

Kaiser Family Foundation wanted to find out more, and so began work with a research company to interview families in 8 cities in 4 states. They also interviewed pediatricians who work closely with immigrant families in these cities.

Their findings are significant and troubling. Among those findings are these:

  • Fears of deportation and overall uncertainty have increased in the last year. These fears extend to those who are here lawfully.

“I feel unsettled. Even though we already have the green card, if we do not apply for citizenship, I don’t think we can be at ease.” –Korean Parent, Chicago, Illinois

“Uncomfortable and unstable; we feel that in any moment a new rule could be issued leading to expelling us and sending us back.” –Arabic-speaking Parent, Anaheim, California

“There’s no stability. [The President] could write a tweet on Twitter tomorrow and turn things upside down.” –Arabic-speaking Parent, Anaheim, California

  • Children are facing increased fear that their parents will be deported and/or that they will end up having to uproot their lives and go to their parent’s countries.

“My children would come home from school and say that at school they were saying that all parents would be deported…” –Portuguese-speaking Parent, Chicago, Illinois

“All the children, even if they were born here, are fearful. They fear that anytime they’ll come back from school and won’t find their parents there.” –Latino Parent, Chicago, Illinois

“In Brownsville we have about 1,700 homeless children in the schools. Many of those children are homeless because of a parent that was deported or placed in detention.” –Pediatrician, Texas

  • Pediatricians and participants said that bullying and discrimination at work and at school has increased in the past year.

“They get bullied…told things like, ‘now you and your family will have to leave.’….And so, even though those kids don’t actually have to worry about their immigration status, I think obviously a child, they don’t know the details of how the system works.” –Pediatrician, Pennsylvania

“I work in landscaping, and we’re working and they see you working…and they just start yelling stuff at you…” –Latino Parent, Fresno, California

  • Families are making changes in their daily lives and routines base on fear.

 

“I am also concerned because if anything happens to us on the street, if we get assaulted or something, we won’t even be able to call the police because they will see we are immigrants.”      –Latino Parent, Boston, Massachusetts

“…but now around six or seven in the evening you won’t find anyone in [the neighborhood]… due to the fear we all feel about what is going to happen.” –Latino Parent, Chicago, Illinois

  • Increased fear in kids is resulting in behavioral issues, mental health problems, and psychosomatic symptoms.

“The kids who come in with concerns that you can kind of trace back to anxiety are usually the upper elementary age students, like the 3rd, 4th graders, to middle school students… 7th and 8th grade, who have nonspecific complaints like abnormal pain or headaches or decreased appetites… And then, in kids that are in the junior high to high school age range, it’s a little more overt: sadness, decreased appetite, not wanting to engage in usual activities, decreased in-school performance, those sorts of things.” –Pediatrician, Arkansas

  • Across the board, pediatricians are concerned with the long-term consequences of this environment.

“I think that we are going to have a generation of kids, who, especially in our immigrant homes, who are going to have more adverse childhood experiences than they would have. So, I think that we’re just setting up this generation of kids to have higher incidence of chronic disease, higher incidence of poor mental health, higher incidence of addiction…” –Pediatrician, California

“I think a huge worry is that children who have problems that are minor and fixable now… that, if those children go untreated, those could end up being bigger problems in the future that are going to be harder to treat and are really going to impact the child’s quality of life.” –Pediatrician, Pennsylvania


The health and well-being of immigrant and refugee communities is something I care deeply about. Yes, it is my daily work as a public health nurse, but it is more than that. It is something that is deeply embedded into who I am as a person. I have only benefitted from the many in my life who are immigrants and refugees, and it is troubling to me that there is documented fear and anxiety that is affecting the daily lives of those I care about.

What might we do to change this? What might we do to help those whose anxiety is affecting their health and the health of their families? The answer is bigger than any one of us, but some of the things that can help are these:

  • Know the law* and be able to point people to the law. Some of the fear is based on rumor. It is important to squash rumors and to point people to laws.
  • Sensitive locations. Both ICE (Immigration and customs enforcement) and CBP (Customs and Border Patrol) consider hospitals and other health care facilities to be “sensitive locations.” Both agencies have issued memoranda that say that immigration enforcement actions are to be avoided at sensitive locations, including at hospitals and other health care facilities, unless urgent circumstances exist or the officers conducting the actions have prior approval from certain officials within the enforcement agencies.
  • Right to remain silent. While immigration enforcement at health care facilities is limited by the “sensitive locations” guidance, immigration agents may enter a public area of a health care facility without a warrant or the facility’s consent and may question any person present, but those people have the right to remain silent.
  • Reassure your patients. Educate and reassure patients that their health care information is protected by federal and state laws.

An appeal to those of us who are Christians:

Caution and compassion are not incompatible; instead it is reasonable to assume that they work well together.  The state is not the master of the church. If you are part of a faith community, none of this prohibits you and your faith community from reaching out to those who may be affected. They do not prohibit you from reaching out, in love, to refugees and immigrants in your midst. It is a lot easier to wear a sign and yell than it is to make a hot meal and take it to strangers, to check in with sick neighbors, to pray for those who are anxious and fearful. We must be willing to do more than react emotionally. We must be willing to put our loudly voiced news feeds into real action.

“The ability to love refugees well doesn’t require a certain party affiliation. It doesn’t require you to vote a certain way. But it does require us to show up, to step across “enemy” lines, and to choose love over fear.” from Preemptive Love


*See this document for more information.

Note: Communicating Across Boundaries has never been, and never will be, a political blog, but I see this not as a political issue, but as a human health care issue. The brief is much longer and more detailed than this blog post. This post is simply to raise awareness of the issues that result from an environment of fear and anxiety.

The Full Time Job of Healing 


I am on medical leave. For the first time in many, many years I have time. I am not moving. I am not job hunting. I am not on limited vacation time. Instead, my full time job right now is to heal. 

It is one of the hardest jobs I’ve ever done. 

Here’s why: 

  1. Healing takes discipline. It takes discipline to set aside time for physical therapy. It takes discipline to eat properly, discipline to not just veg out and binge on television shows. It takes effort to get up in the morning when you hurt, discipline to put your feet on the ground. I am not disciplined and at heart, I’m pretty lazy. I would far rather have a quick fix then a slow, steady process. But healing has its own agenda and schedule., and it demands discipline. 
  2. Healing takes rest. So much of physical and emotional healing is about resting. And true resting is when both your body and soul are at rest. I find myself trying to rest, but my mind buzzes anxiously with thoughts about what I think I should be doing, how I think I should be reacting. Rest is uncommon in the Northeast. Instead, what is applauded is achievement, academic success, graduating from top schools, busy and successful career paths. Rest is something that we don’t talk about or give permission for, instead opting to glorify busy. But healing demands rest. Our bodies have undergone trauma – whether it be from surgery, from illness, or from an accident. The body’s needs for rest increase. Our bodies also need proper nutrition to augment the rest. 
  3. Healing takes humility. Giving up control is hard. Having to have others help you dress, bathe, cook, drive, clean, even put on your shoes is deeply humbling. Actively watching out for self-pity is also humbling. It’s easy to clothe self-pity into “well I’m just being honest about how I feel..” But at the end of the day, it’s still self-pity. It takes humility to follow the guidelines and restrictions of others, to trust medical personnel. It takes humility to allow strangers into your home to see how you live, and to give you suggestions and ideas of how to live better. It takes humility to accept that healing doesn’t happen on the timeline we request. It takes humility to respond to questions about our bodies, to use assistive devices when we go out the door. 
  4. Healing takes time. Above all, this is true.  Neither physical nor emotional healing comes quickly. Instead it’s a long journey.  Yes, there are things we can do to heal as quickly as possible, but ultimately it still takes time. 

And so I have time – and my only job during this time is to heal. 

Years ago, I listened to a recording of a woman who spoke on suffering. It was a powerful talk and I probably listened to it over fifty times in the course of the next few years. One of the many things she said was this: 

Our churches are full of wounded and hurting people who have never taken a season to heal. 

These words are profoundly true – true for the ones who need physical healing, true for the ones who need emotional healing. 

So I will not fight this season, nor will I wish it away. Instead, I gratefully accept my season to heal, and the gift of time. 

Dear Seema: The Politics of Prevention

 

Note: Seema Verma is President Trump’s nominee to lead the Centers for Medicare and Medicaid Services in the United States.

Dear Seema,

I’m a Registered Nurse who works in Boston, Massachusetts. I have witnessed first-hand what it is like for people to go without insurance, to delay preventive health screening only to find out that cancer is a far more expensive problem.

There are not a lot of things that make my proverbial blood boil, but reducing access to preventive healthcare, including maternity benefits, does. It makes me so angry I can’t see straight.

Look, I get it. Health care is expensive. Someone has to pay for it. But everyone bears the burden of an unhealthy society and while the Affordable Care Act (aka Obama Care) was not perfect, it began to put some policies in place that have been needed for a long time.

I come to this not from any political party line. I am a proudly independent voter – in fact, prouder by the day that I don’t buy into that assanine system called “two party.” I also live in Massachusetts where a Republican governor put health care reform as a top priority over 8 years ago and we are slowly reaping the benefits.

 

When, at your confirmation hearing, you mentioned that coverage for maternity benefits should be optional, I shook my head in disbelief.

Optional? Optional? I had to repeat it to myself to believe that you actually said it. The argument goes that if you’re a man or too old to get pregnant, then why should you have to pay for someone to have a baby? The lack of logic and understanding in that idea astounds me! The logical conclusion is that I shouldn’t have to pay for any of the choices that others make. So, by your logic, I shouldn’t have to pay for the business man who has a heart attack and needs bypass surgery. After all, I wasn’t the one who ate and drank too much. It was him.

Maternity benefits are an essential part of a healthy society. Maternity benefits speak to the value of family and children, they provide essential care for a future generation.

As Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women says: “We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs,”  But insurance is not designed to be an  “a la carte approach”. “Women don’t need prostate cancer screening, but they pay for the coverage anyway.”

When as a nation did we allow politics to co-opt our health, to feed us misinformation about insurance and that terror-producing term ‘socialized medicine’? Truth is the term ‘socialized medicine’ is a made up phrase. It was first heard in the early 1900’s but came into wide use when the American Medical Association fought against a national health insurance plan proposed by President Truman. It conjured images of a hammer and sickle approach to health care that would lead us down the slippery slope to communism. That was in 1947 – and it was a public relations coup, for in the six and a half decades since that time we have allowed the term to rule us, to be thrown around willy nilly to produce fear and anger, obnoxious and ignorant voices leading the way.

Here’s what happens when you let politics coopt prevention: 

A breast cancer lump ulcerates and eats away the flesh of a breast; a cervical lesion, easily removed, grows and turns into a completely preventable cancer; a gnawing indigestion and bloated feeling turns into cancer eating away at your colon – fully preventable had screening taken place early in the disease process. You know what else happens when politics coopts prevention? Abortion rates, already far too high, go up. You can’t have it both ways – you can’t want abortion rates to go down and yet reject the notion of maternity care and birth control coverage.

Preventive health is not about being Republican or Democrat or Independent or Green Party or Libertarian. Preventive health is about the health of a society as a whole; it is about being human, living in a broken world where illness and death and “pre-existing” conditions are a reality. Preventive health and being sick is not about politics. When will we in the United States get that?

What you should want to do in your tenure is make the Affordable Care Act better! You should want to expand on it and leave a legacy that puts Obama Care into the water. You should want to make a name for yourself as a person who makes health care great, not just tolerable.

Instead, I’m shaking my head and saying: “What in the name of Sam Hill is she thinking?” 

C’mon Seema! Be a Woman. Stand up for what is right. 

 

Get a Life

“Oh, for God’s sake…get a life, will you?”–William Shatner

 

Connor left nearly a month ago to return to the University of British Columbia. As he and Lowell pulled away from the house I felt the bottle of grief shaken within me lose its scarcely screwed on lid. Before I knew it I was drenched, inside and out, with sadness. I came into the house, sat in my chair, gently held my coffee cup and cried.

In my sad spot I remembered that this is our Adelaide’s last year of high school too and a fresh wave of grief dragged me under. It felt like my heart would break.

I wondered at the strangeness of parenting. We wrap our lives and our hearts around these miniature people. We tend, nurture, guide, direct. We attend concerts and games, plays and competitions. We give up our rights to complete thoughts, finished sentences, sleeping in on Saturdays, uninterrupted conversations, Sunday afternoon naps, free time, long showers, the late show. We trade it all in for diapers, runny noses, giggles, knock knock jokes, princesses, pirate ships, play dough, lego towers, swing pushing, nail painting, homework helping, eye rolling, door slamming, curfew pushing kids! And if we get a minute we’d admit that it was a fair trade. For the most part we’ve loved it—!

In that sad moment in my chair I wanted those days back again. I wanted another turn at it all. I wanted to hold fiercely on to the childhood of my children. They said it would go fast and for the longest time I thought they were mocking me…but now I realized with horror at how right they had been. It was over with my kids before it had really begun in me.

As I sat sipping my coffee, which now oddly tasted like nostalgia and sorrow, I thought to myself, “Robynn, You need to get a life”! I suppose it was a mild rebuke from my more sensible self to my emoting sobbing self. Even as I thought it another thought quickly jumped up in defense of me. Wait a minute…I do have a life!

I do. I have purpose. I’m a spiritual director in training. My brain is being stretched and stimulated by the program I’m enrolled in. I have a broad worldview. I’ve had the humbling privilege of travel and crossing cultures in varying places around the globe. I’m a part of an Environmental Missions effort. I’m passionate about climate change and its effects on the world. I care deeply about the oppressed and long for justice. I have deep friendships with interesting people who expand my world in significant ways. My thoughts are often outside of my inside domestic duties. I read books, I engage in conversation, I watch the occasional documentary, I listen to intellectually stimulating podcasts.

Honestly I think that’s one of the best gifts I’ve given my children. They’ve seen my heart for others. They know I have a wide circle. They’ve heard me rant about racial injustice, about welcoming the immigrant, about caring for the poor. They’ve seen my eyes fill with tears with concern for friends that are hurting. They know I have dreams and goals and longings outside of our home.

I attended an international boarding school in the Himalayan foothills of Pakistan. Multiple times a year we’d have to say goodbye to our parents. It was devastatingly difficult. But I’m convinced it was made marginally easier because we knew my parents had purpose. We knew they loved each other well. Their marriage was solid. We knew they’d be ok without us.

Kids need to know that their parents are going to be all right when they’re not around. It’s too much pressure for a child to believe that his mother’s or his father’s emotional well-being is connected to him. He needs to know they have a life without him.

There are ways we interpret our obsession with our kids that sound noble and self-sacrificing. But I wonder if we scraped those notions back down to the frame if we’d find something more self-serving than we originally thought? Does it give us a sense of importance? Are we tethering our identity solely to our role as caregiver?

I’m not saying that being a parent is not an important vital job. By all means it is! But the goal is to work yourself out of a job. We want to raise adults that are independent, that no longer need us for their daily cares. We want to train up people that know what it means to contribute in valuable ways to the world around them. They will not know about that unless we show them. It will be important to your health and the health of your progeny that you have some other meaningful thing to give yourself to.

I suppose there’s no real easy way to say this….but moms and dads –you have got to get a life! I don’t care what age your kids are now, begin, even today to imagine a little life outside of your children. Start researching ideas of what you might want to do. Pray it through. Take up a hobby that energizes you. Are there distance education classes you could enroll in even now? Are there places you could meaningfully volunteer? Are there courses offered in your community that might spark your imagination? Do you have dormant dreams that you used to think about? What would it look like to fan some of those back into flame? The little people won’t be little for long. Start now and get a life!

 

 

This is my Body–A Repost

I’ve been thinking about the aging process and how it plays out in my body. And then I remembered this piece I wrote three years ago. I think it relates. It seems like we need to do the work of coming to grips with our limited capacities, our weariness, our weakness. This is (still) my body, breaking and broken. 

Though they may be out there, I have never met a woman who is not consumed with food, and body image.There are those who are clinically diagnosed with eating disorders but all of us are to some degree disordered in our relationship to food and to our bodies. It started, of course, in the garden with Eve and the fruit. It was food and it spoke to her. Granted the fruit didn’t actually talk, but her soul’s enemy spoke to her and the message was mixed in with the food. Temptation with a spiritual marinade, a dipping sauce, a glaze.  Ever since then we’ve battled burgers and burritos; biscuits and beans. Our fight with food has been handed down to us through a long line of mothers.

I am no exception. I’ve wrestled food since I hit puberty. It’s a love-hate relationship. I love to eat. I hate how food gathers and stays on my body. I love the taste and smells of food; the texture, the flavours. I hate the pull and power of food. My history with food includes unseemly weight gain with entering and reentering cultures, with culture shock and stress.

Lately my body has been out of whack. My metabolism is on strike. My ability to burn calories seems to be deterred by fatigue and hormonal changes. I’ve never loved exercising. I love people. I’ll go for a walk if a friend will go with me. But a walk just for a walk’s sake seems like a waste of time. I don’t enjoy it. Now I can hardly eat anything and the weight still seems to creep on. It’s depressing. It’s disheartening.

Last week I was praying again for grace in this…. I don’t want to obsess about it. I don’t want to become consumed with myself, with food, with my body or with my feelings about my body. I was trying to release all that again up to Jesus who understands about bodies. He chose to be bodied, to take on flesh, to become a person. He came for our souls and for our bodies. He healed the lame, gave sight to the blind and hearing to the deaf. Jesus healed diseased bodies, broken bodies, bleeding bodies. He touched bodies that no one else would touch. He associated with bodies that others avoided.

As I was praying for my body and my emotions about it…these words came to mind. “This is your body.” It seemed a divine pronouncement over me, over my agonies, over my physical frame. I repeated it slowly, out loud, “This is my body. This is my body.” I felt somehow it was a remedy for my conflicted distorted soul stuck in this conflicted distorted body. This is my body. I’ve been chewing this over and over. It keeps coming to mind. As the negative thoughts come, this thought has dropped like a sweet warm blanket to cover the ugliness of my beliefs. This is my body.

At the last meal that Jesus shared with his friends he tried again to explain to them that he was about to be executed, that he would die, that he would come back to life. It was a mystery to them. They couldn’t understand it. Using what was right in front of him (the food!), Jesus, picked up the bread, and he broke off a chunk. This was a metaphor they could figure out. It was the language of survival and comfort. It was memory and mystery. It was bread. “This is my body,” he said, “Broken for you. Take it. Eat it.”

Jesus wasn’t just giving them a cute expression, a fun phrase, or a clever speech. When Jesus says, “This is my body, broken for you,” it’s significant. His broken body—his sacrifice—has the capacity to redeem me. All of me. My body. My relationship with food. All of it. His body restores my body. He offers us his broken body for our consumption. We are invited to, “take and eat”. We consume Jesus and we are satisfied. That alone means something for my food issues and my body issues and my brokenness.

In that moment at that last meal when Jesus proclaimed, “This is my body, broken for you,” it makes me wonder if in some sense Jesus himself had to come to grips with his own body and its impending brokenness. He was about to endure the profound breaking of his own body. He leans into it and he accepts it. That has implications for me accepting my own body and my own brokenness.

This holy truth, with its layers and layers of implication and revelation, has been slowly seeping into my soul this week. This IS my body. It’s the body I’ve been given. It’s no surprise to my Creator that my metabolism is malfunctioning. He’s not shocked by my disdain for exercise. He’s not horrified by longings for a piece of cake or a handful of snack mix. He actually loves me completely. From the freckles on my arms to the hair that’s coming in grey and wiry; from my ingrown toenails to my one short thumb; from the ski-sloped nose to my varicose veins…all of it designed and delighted in by my Potter, my Maker.

And it’s broken. Broken because of the Fall. Broken in childbirth for my children. Broken in India for the sake of my calling. Broken in aging. Broken in natural deterioration. Broken here for my holy now. Broken for Jesus.

We follow in his example. We mimic our model. We saw him lay down his body for the sake of his friends and so we lay down our lives for the sake of ours. It’s our way of participating in the redemption of others. We give ourselves up. We give ourselves over. And we experience that brokenness for the sake of others. Our bodies become a type of sacrifice, living and holy.

Part of the mystery includes offering to Jesus our brokenness. Our Catholic brothers and sisters understand this. When they write about suffering some of the first words out of their mouth are almost always that we get to give our suffering as an offering to Jesus. There’s certainly no sense that Jesus takes and eats us. He doesn’t consume us or use us up.  But we do get to offer up our broken bodies to him, our broken and stale bread, our broken and moldy connection to food.

That is a spiritual reality made present and tangible in our physicality. Hurting, aching, bearing, enduring, suffering. All in our bodies. St Paul wrote that he was glad to suffer, for his friends, in his body…somehow he knew he was participating in the sufferings of Christ that continue for Jesus’ body, the church. Paul understood that suffering bears fruit. He was “willing to endure anything” –and as preposterous as it sounds–he even considered it a privilege, a divine opportunity, if it would result in the rescue of another or in glory going to God.

This is my body, a holy temple filled with his Holy Spirit presence. Broken it may be. Damaged. Wounded. Lumpy. Chicken pock-marked. But there is a mystery at work in my members. And I give myself up to be consumed by others. I get to participate in that redemption-rescue mission work, where bread is broken and wine is poured.

And so, dear brothers and sisters, I plead with you to give your bodies to God because of all he has done for you. Let them be a living and holy sacrifice—the kind he will find acceptable. This is truly the way to worship him.  Don’t copy the behavior and customs of this world, but let God transform you into a new person by changing the way you think. Then you will learn to know God’s will for you, which is good and pleasing and perfect. (Rom 12:1-2)

(Col 1:24, 2 Tim 2:10, Phil 1:29)

The Urban Disadvantage – State of the World’s Mothers 2015

state of the worlds mothers 2Every year around Mother’s Day a report is released from Save the Children called the “State of the World’s Mothers.” And every year, I write about it.

Because it is so important to me. If I could spend all day every day with moms and babies, I would. There are so many reasons for this – but partly its because I have five of my own and I learned so much from those younger days. I know what helped and I definitely know what didn’t help. Healthy moms and babies are critical to a healthy world.

In the last 60 plus years, the number of city dwellers in the world has increased by over 20%, so that half the world’s population now lives in the city. While this creates incredible advantages for many of us, there are many others who live in extreme poverty where disease is prevalent, nutrition poor, and violence high. The World Health Organization (WHO)estimates that nearly a billion people live in urban slums, shantytowns, on sidewalks, under bridges, or along the railroad tracks.” One of the worst places in the world for a mom and a baby to be is in a city slum. 

state of the worlds mothersThis year’s report is on mothers in urban settings and is appropriately called “The Urban Disadvantage.” Here are some summary findings, taken directly from the report:

“Every day, 17,000 children die before reaching their fifth birthday. Increasingly, these preventable deaths are occurring in city slums, where overcrowding and poor sanitation exist alongside skyscrapers and shopping malls. Lifesaving health care may be only a stone’s throw away, but the poorest mothers and children often cannot get the care they need.”

  • The world, especially the developing world, is becoming urbanized at a breathtaking pace. Virtually all future population growth in developing countries is expected to happen in cities, resulting in a greater share of child deaths taking place in urban areas.
  • In developing countries, the urban poor are often as bad as, or worse off than, the average rural family, and for many rural families, moving to the city may result in more – rather than less – hardship
  • Few countries have invested sufficiently in the infrastructure and systems, including water and sanitation, which are critical to addressing the basic health needs of the urban poor. More countries need to adopt universal health care as a national policy to help address the unmet needs of the urban poor.
  • While great progress has been made in reducing urban under-5 mortality around the world, inequality is worsening in too many cities.
  • The poorest children in almost every city face alarmingly high risks of death.
  • High child death rates in slums are rooted in disadvantage, deprivation and discrimination.
  • Malnutrition is the underlying cause of 45 percent of deaths of children under 5, leading to over 3 million deaths each year, 800,000 of which occur among newborn babies.
  • Among capital cities in high-income countries, Washington, DC has the highest infant death risk and great inequality. Save the Children examined infant mortality rates in 25 capital cities of wealthy countries and found that Washington, DC had the highest infant mortality rate at 6.6 deaths per 1,000 live births in 2013. While this rate is an all-time low for the District of Columbia, it is still 3 times the rates found in Tokyo and Stockholm.

Here’s the good news: We know what works! This is huge. Save the Children looked at six cities that, despite significant population growth, have made strides in saving children. Again, from the report:

The cities are: Addis Ababa (Ethiopia), Cairo (Egypt), Manila (Philippines), Kampala (Uganda), Guatemala City (Guatemala) and Phnom Penh (Cambodia). These cities have achieved success through a variety of strategies to extend access to high impact services, strengthen health systems, lower costs, increase health awareness and make care more accessible to the poorest urban residents.  1) Better care for mothers and babies before, during and after childbirth; 2) Increased use of modern contraception to prevent or postpone pregnancy; and 3) Effective strategies to provide free or subsidized quality health services for the poor. 

The yearly report always ends with recommendations, and this year is no exception. As a public health nurse, I am always encouraged and discouraged about this report. On the one hand, the statistics are depressing and overwhelming. On the same hand, its all well for a group like Save the Children to talk about what needs to be done, but it is completely different convincing country, state, and city governments that money needs to be given to these efforts.

So where’s the good news? The good news is in places like Heartline Ministries in Haiti. I’ve never been there, but feel like I know two of the midwives who work with Heartline – Beth and Tara – through our email and online interaction. They are two of my “sheros.” Heartline’s mission statement is “Intentionally walking alongside the impoverished men, women, and children of Haiti during their life journeys, meeting critical physical, emotional, financial, educational, and most importantly spiritual needs.” Their maternity center exists to provide prenatal, labor and delivery, and postpartum care to women in Port-au-Prince, Haiti. If you want to know where your money is going to, and want to make a difference, I highly recommend this group. Connect with them on Facebook here.

And the other place I’ve written about before. Shikarpur Christian Hospital has met the needs of moms and babies for years with little recognition and a lot of perseverance. Pakistani and Western staff work hard to give great care to moms and babies in Shikarpur and surrounding areas.

In my public health heart, I know that for real and lasting change to happen, policies are needed at the highest levels. I know that some things are completely impossible without the support of local government. I know in my soul that for real and lasting change, hearts have to change. But while some may say these places are bandaids on a gushing wound, I would say that until we live in a perfect world, thank God for the people who are willing to put on bandaids.

Photo Credit – https://www.pinterest.com/pin/13370130120653125/

Face Transplants, Domestic Violence, & Identity

In September of last year I wrote a post about meeting the mother of Carmen Tarleton in Thetford, Vermont. I relayed how while in line for a barbecue on a holiday weekend we began talking and she shared with me the story of her daughter. Her daughter was a victim of a vicious domestic violence attack. Her ex-husband assaulted her one night and after beating her senseless, sprayed industrial strength lye all over her body.

I wrote these words:

“I learned what living hell on earth was” said the mom, shaking her head.Her voice trailed off  “But I also learned what Heaven was. Seeing her walk through the door when she came home from the hospital? That was Heaven.” I looked at her and had nothing to say. All I could think was how little I understand of the resilience of the human spirit – that spirit that reflects the image of God.

Into this unimaginable story of living through abuse, living through the healing and scars of burns that cover your entire body, living through the moment by moment nightmare that is survival, comes a will and a strength that can’t be stopped. Blind, disfigured in a way that makes people recoil, but facing this with courage and resilience. This is the wild grace and spirit of God. from In a Few Short Moments

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On Valentine’s day this past year, Carmen Tarleton received a new face. She underwent a transplant surgery that was 15 hours long and is now one of the few people worldwide who have had face transplants. It was, and continues to be, an enormous risk — but Carmen was taking on this face for good reason. The residual effects of the attack included scars that caused much pain, inability to blink, and inability to express emotions because of the scar tissue.  A face transplant is not only a physical procedure, but one that is deeply personal and psychological.  For better or worse, our faces are uniquely ‘us’. We have had them since we were in the womb. To take on the face of another, even though in Carmen’s case this is a gift, is to think about the heart of where our identity lies.

I felt many emotions as I read the follow-up of Carmen’s ongoing journey. Emotions about strength, about love, about resilience. But perhaps the most significant is what I felt, indeed feel, about identity. Because Carmen has not ceased being who she is with a new face, she still has the same personality, the same wit, the same disposition. The core of her, the part that matters, is still unique to her.

And this is the part that her abuser couldn’t touch. He wanted to “steal, kill, and destroy” – but she lived. She defied what he wanted, what he tried to do.

October is Domestic Violence month. Unfortunately it has to vie with the pink of breast cancer to make the headlines, so it often ends up on the back page when it should scream from the front page of every journal, every paper, every magazine.

My heart hurts when I read the statistics on this issue. One in Three women, yes 1 out of 3, one-third, have experienced some form of domestic violence from someone they are intimate with. Behind every statistic is a real person, a real story. This is control and manipulation masquerading as ‘love’ – the worst kind of betrayal. The profound impact of these statistics shows in many ways beyond bruises or scars – headaches, difficulty sleeping, chronic pain, and emotional pain to name a few. But the biggest impact is on the sense of self — for abusers never honor the word ‘no’, the word ‘stop’, the words ‘you’re hurting me.’.

Domestic Violence crosses all class, religious, and cultural boundaries. Make no mistake, you could on any given Sunday be sitting in church next to a friend who is being abused. And this can be the hardest – because what good, believing woman wants to accuse her man of abuse? And so she cries soundlessly late into the night, praying for strength to confront her abuser or to leave the relationship.

Yet Carmen’s case shows that the abuser doesn’t have to win, doesn’t get to win.

The heart of where our identity lies is deep within our skin. Others may curse the outside, hurt it, betray it, but ultimately we don’t have to let them win. We may dress the outside, paint it, primp it, and dye it, but our identity is our core. You can paint mean all you want — it’s still mean. You can primp insecure – it’s still insecure. All of us have to face our true identity and it goes way beyond the surface.

Beyond Carmen’s new face lies a strength and a will that make her a true hero. She’s learned to live with stares in grocery stores, with disfigurement that to most of us feels unthinkable, with constant pain and daily therapy. But she no longer lives with an abuser, she no longer has the daily trauma of someone trying to rob her of self.

Face Transplants. Domestic violence. Abuse. All this would try to take away Imago Dei, would rob the victim of who she is created to be. But the strength of this image lives; lives in a true identity through strength,resilience, and love. It’s the wild grace of God. 

Survivors

  • Telling you that you can never do anything right
  • Showing jealousy of your friends and time spent away
  • Keeping you or discouraging you from seeing friends or family members
  • Embarrassing or shaming you with put-downs
  • Controlling every penny spent in the household
  • Taking your money or refusing to give you money for expenses
  • Looking at you or acting in ways that scare you
  • Controlling who you see, where you go, or what you do
  • Preventing you from making your own decisions
  • Destroying your property or threatening to hurt or kill your pets