Expanding What ‘Counts’ as International Service-Learning

P1000535 (1)Entering our fourth and final week of this university study abroad in New Zealand program, “Empowering Healthy Communities,” I continue to reflect on how to incorporate service-learning in an international setting, and how to incorporate it in an ethical and meaningful manner. By service-learning with a community health focus I use Serena Seifer’s definition:

“Service-learning is a structured learning experience that combines community service with preparation and reflection. Students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens.”(Seifer SD. 1998. Service-learning: Community-campus partnerships for health professions education. Academic Medicine, 73(3):273-277.)

Within a community health and health professions context, service-learning focuses on student engagement in non-clinically focused service work. Thus, our typical community health nursing clinical rotations are not technically considered service-learning, although the lines can get blurred at times.

In a health systems course I teach for senior nursing students, I have included a service-learning option. Students in my course have concurrently volunteered as emergency youth shelter overnight workers, assisted in food banks, and served as buddies for hospice patients. Through this work they can step out of their ‘learning technical skills’ nursing student roles and begin to make systems-level connections and practice critical thinking skills. It has worked well because I’ve partnered with our wonderful University of Washington Carlson Leadership and Public Service Center. They do all the legwork in establishing and nurturing community partnerships, defining student service-learning placements, and monitoring student progress.

Including service-learning in study abroad university-level programs can make for high impact educational experiences. Studies indicate that inclusion of service-learning in study abroad programs significantly increases students’ sense of connectedness with a wider world community. It also helps students confront their own biases and prejudices, and increases their comfort in working within diverse communities. But those benefits come from well-designed study abroad programs that include pre-departure workshops/readings, embedded critical reflective writing by students with faculty feedback, and debriefing sessions after service-learning activities.

Done poorly, international service-learning can be exploitative and can deepen cultural arrogance and economic disparities. As Sara Grusky points out in her article “International Service-Learning: A Critical Guide from an Impassioned advocate,” most international service-learning study abroad programs from the U.S. are done in poor countries, and can become nothing more than ‘poverty tourism.’ (From the American Behavioral Scientist. 2000. 43: 858-867.)

New Zealand is not a poor country and it continues to rank much higher than the U.S. on many health and wellbeing scales. Yet it suffers from rising socio-economic and health inequities. During our study abroad program we have visited a variety of communities–some have been in higher socio-economic brackets, but most have been within impoverished, multi-ethnic and Maori communities. Before doing any community-based service-learning projects, we’ve first learned about the local and national context, including cultural, political, and socio-economic factors impacting the community. Students learn this through carefully chosen readings, and from talks by community leaders.

My co-leader for this program, Jim Diers, is a social worker and an international consultant on community-led, asset-based development. He has a decade or so experience working with various communities throughout New Zealand. So between his contacts and those of the New Zealand based community-development group, Inspiring Communities, we developed this study abroad program. Jim believes in more upstream thinking, policy-changing work versus direct service. It’s an important point, but I think there is room for both in life and in educating university students for their role as civically-engaged change agents. Students have stated that they are now more interested in knowing about and getting involved with their own ‘home’ communities, and of doing service-learning in the Seattle area.

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Spontaneous musical jam session with young people at the Te Oro music, dance, and art center in Glen Innes in East Auckland. We had spent the day on the Ruapotaka marae (Maori land and meeting house) and were planning to help with stream restoration but it rained too hard–stream flooded, so we did this instead.
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Girls from the Baking Club at the Waitangirua Community Services center challenged our male students to a fitness test. This is their pre-contest strategy huddle. Our guys lost and so they had to do a line dance/song. Everyone was laughing so much our faces hurt afterwards. But this was all initiated by the girls of the community. This is part of the Wesley Community Action program in the greater Wellington area.
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This photo is of a very spontaneous and unexpected service-learning project our students engaged in. We visited a community-primary school center in Epuni, north of Wellington. They have a huge school garden and this arts and crafts center where they bring together community elders with the children to share stories and teach craft skills. Our students were asked to help knit squares for blankets for the children. The students who knew how to knit taught our non-knitter students, who in turn taught other students. Amazing.
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Donning our borrowed gum boots and getting down and dirty weeding, turning compost, and double-digging vegetable beds at the community Fruit and Vegetable Co-op headquarters in the heart of Cannons Creek, Porirua, Note the recycled glass paneled greenhouse (minus the roof)–they are from cast off phone booths.

Here are photographs and brief descriptions of various service-learning activities the students have been involved with during the program. Some of the activities were planned ahead of time and others ‘just happened’ spontaneously. All of them were driven by the community members. They have expanded my notion of what ‘counts’ as international service-learning.

 

 

 

 

 

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Helping bag fruit and vegetables at the Salvation Army in Cannons Creek, Porrirua, north of Wellington. This is part of a fruit and vegetable co-op in one of the more impoverished areas of New Zealand. But as the residents told us that day–the government calls them impoverished… The New Zealand public health unit helps fund this innovative ‘non-charity’ project.

Study Abroad: The Evidence

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Signpost near the Waiheke Island(New Zealand) ferry landing. Photo credit: Josephine Ensign/2015

Until recently, the effects of study abroad experience on college students were mainly anecdotal in nature—more in the form of personal testimonials from students about what they gained through the experience: “Such a blast! Best bar scene ever and their drinking age is 18–how cool is that?!” and “Did you bungy jump yet off the Kawarau Bridge in Queenstown?” to the more serious “It opened my eyes to the way Americans are perceived in other countries.” But parents, university administrators, and funding agencies increasingly want hard evidence on the cost-benefits of study abroad experiences.

The number of U.S. students studying abroad has more than doubled in the past decade. During the 2013/14 academic year (latest stats available), 289,408 students studied abroad for at least a month for academic credit. (Source: Opening Doors, an initiative of the Institute of International Education.) The Institute of International Education recently launched the Generation Study Abroad campaign to double the number of U.S. university students who study abroad by the end of the decade. The campaign also aims to increase the diversity in race/ethnicity, academic disciplines, destinations (the UK and European countries are the vast favorites), and gender. Racial/ethnic minority students, first-generation college students, and STEM majors are underrepresented in study abroad programs. In addition, 65% of study abroad students from the U.S. are female. Are young women more adventuresome somehow?

Here are some intriguing findings from recent studies on the benefits of study abroad programs. Controlling for prior GPA, credit-taking, and SAT scores, a student who studies abroad has a 10% greater chance of graduating in four years than a student who does not. Why would that be, I wonder? It does run counter to what many parents–and even some academic advisors–worry about with study abroad, that it will complicate a student’s credit requirements and therefore delay their graduation. In my own case with a ‘junior year’ study abroad experience, the summer semester’s worth of credit allowed me to graduate a year early. Perhaps through study abroad experiences, students see the value in completing their undergraduate degrees as quickly as possible and getting on with the rest of their lives.

Study abroad experience has been shown to increase students’ self-reported cultural sensitivity, self-confidence/adaptability in dealing with complex, unfamiliar living/working/studying conditions, and knowledge of world geography. The American Association of Colleges and Universities identify intercultural understanding as an essential learning outcome for contemporary university liberal arts education. Employers and graduate school admissions committees place value on prior international study abroad and other international experiences (such as volunteering). For health professions students, study abroad experiences would seem to be ideal for helping to increase cultural knowledge/humility, as well as perspective (and humility!) on the failings of our U.S. healthcare system.

Before our study abroad program started this summer, I asked our current group of twenty-two university students who are here in New Zealand studying community health, to write down at least four personal goals they have for themselves. While a month is not a lot of time for a study abroad experience, it can be impactful, plus I have found it is more accessible to a broader demographic of students who otherwise might not get to have a study abroad experience.

We have an amazing and quite diverse group, many of whom are in (or going into) health professions education, including nursing, social work, medical anthropology, global health, pre-med, and pre-physical therapy. Here (paraphrased to protect identities) are some of what they wrote/shared with me in terms of their goals for this study abroad experience: “To find my place as a global citizen.” “To be able to problem-solve bravely and maturely.” “To learn new ways to manage my stress.” “To let the fire in my heart truly burn for global health.” “To get the chance to slow down and really reflect on where I have been and where I want to be in the future.” “To be able to practice cultural humility and greater global awareness.” “To push my boundaries and push myself outside my comfort zone; deal with difficulties in a mature manner.” And finally, from one of our many ‘first time out of the U.S.’ students, “I hope to have culture shock and awkward moments where my ‘Americanism’ shows.”

If our students accomplish even a few of these personal goals during our study abroad program, I will consider it a grand success.

Resources:

Prepare to Come About: Reflections on Study Abroad Experience

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Auckland Sky Tower. Photo: Josephine Ensign/2015

Was I ever that young? This question came back to me earlier this week as our group of twenty-two university students from the U.S. gathered in Auckland to start our month-long study abroad program. For many of them, this is their first trip outside our home country; their first time staying in an international youth hostel; their first time handling the confusion of foreign coins; their first time having spotty to no wi-fi access; their first time being a pedestrian along busy urban streets where cars drive on the ‘wrong’ side of the road.

I remember my own travels outside my passport zone—outside my comfort zone. I try to remember lessons I learned through my travels, lessons that can perhaps inform my teaching here.

My junior year study abroad program was with SEA Semester, out of Woods Hole National Oceanographic Institute on Cape Cod, Massachusetts. I had just turned nineteen. Sea Semester is a twelve-week intensive course on sailing, oceanography, and all things sea-related. (Not to be confused with the very different but similarly titled Semester at Sea—which is more of a giant cruise ship/party boat traveling to different port cities around the world.)

We sailed on the Westward, a 125’ Topsail Schooner research vessel, to Nova Scotia and Newfoundland. We took nautical science, marine science, and an English literature course on the lore of the sea (including reading Moby Dick). I loved night watch duty on the bowsprit, and was mesmerized by the glittering spray from the phosphorescent algae. I would lean out over the bowsprit and feel myself diving into that flowing luminescence. It was a kind of cleansing, simultaneously a deep relaxation and exhilaration with the white noise of the whooshing bow waves, the cold spray on my face, the briny sea-smell, and the shimmering lights. Obviously, from a nautical safety perspective, I was worthless on bow watch at night.

Near Newfoundland we sailed through huge displays of Northern Lights and followed the migratory paths of blue whales. I was at the helm the day our marine biology professor from Newfoundland spotted a 70’ blue whale off our port bow. “Prepare to come about! Follow that whale!” the Captain yelled. As I turned the ship’s wheel, I felt like yelling back, “Call me Ishmael!”

We spent time in small fishing villages, the houses perched on stilts on the rocky shores of Newfoundland’s deep fjords. The Newfies’ accents were so thick it was like deciphering a foreign language. We traded bottles of rum for cod and moose meat. We hiked up a mountain on the West Coast of Newfoundland to see the MOHO, the mohorovicic discontinuity, the boundary where the Earth’s crust and mantle meet—something only a geologist could get excited about, as it just looked like a thin band of grey mud to us.

Similar to what we are having students do on our New Zealand study abroad program, we were tasked with designing, conducting, and presenting results on a scholarly research project. I remember a fellow student, a psychology major, who designed a questionnaire for all of us to complete, through which he attempted to link personality traits with a propensity to develop sea-sickness. He was so incapacitated by sea-sickness throughout our voyage that we had to help him complete his project. I was fascinated by the inner ear stones–otoliths–of bony fish and spent hours collecting fish from different ocean depths, and dissecting them on our ship’s table at night after dinner.

Did I find my true name through this experience? Did I find my place in the wider world?

The experience deepened my awareness of environmental health and the health of our environment–something we are incorporating into our New Zealand study abroad program. The somewhat limited interactions we had with Newfies, and the more extensive interactions with the land and sea of Newfoundland, have given me a deeper appreciation of people living in more isolated areas of the world. The experience gave me a deeper understanding of books like Annie Proulx’s Shipping News and Wayne Johnston’s The Colony of Unrequited Dreams. The experience gave me a respect for the power of study abroad programs to broaden young people’s horizons.

International Service-Learning: Take Two

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Franz Joseph Glacier, South Island New Zealand. Photo credit: Josephine Ensign/2014

As a teacher, I believe in striving to learn from my mistakes. I also believe in the power of international travel and of service-learning. Done well, they can become life-changing, enriching experiences for students. Done poorly, they feed into the Ugly American tourist syndrome.

What follows is part of my self-reflection on a study abroad program in New Zealand that I helped lead in (our) winter of 2014. My essay, titled “Fossicking the Ten Essentials,” was published June 2015 in Traveler’s Tales/Tales-toGo. I’m about to embark as a leader on a ‘take two’ service-learning study abroad program in New Zealand and hope to have learned from my mistakes. I plan to publish a series of blog posts about our progress (while, of course, protecting student identities).

Fossicking the Ten Essentials

Fossicking: An Australian and New Zealand term for “rummaging” and “prospecting,” and specifically for “picking over the abandoned workings” (of gold, precious stones, and fossils.)

The Ten Essentials: A term coined in the 1930s by The Mountaineers Club in Seattle for a list of necessary equipment to take on hikes. Updated in 2003 to the functional systems approach used as the headings in this essay.

~ ~ ~1. Navigation

Using Google Earth instead of a compass or celestial navigation, my current location is 43.4 degrees South and 170.18 degrees East. High noon. Franz Joseph Glacier, at the foot of snow-capped Aoraki/ Mt. Cook, South Island, New Zealand. I’m sitting at the bottom of a huge rock and ice slide at the terminal face of the glacier where its melt waters run into the Waiho River.

The sun is out and there’s no breeze in this deep canyon dug by the glacier. It’s January 2014, high summer here in the land of the Southern Cross, so it’s warm enough to take off my jacket. There seem to be no bugs—no biting flies—no mosquitoes—and no birds to be seen or heard. Feathery waterfalls are cascading down thousands of feet from the sheer cliffs surrounding the canyon. The smell is elemental, metallic. All surfaces my body touches are gritty, covered with the fine glacial flour that turns the river waters to milk, that turns my skin to alabaster, that crunches lightly between my teeth, tasting of bitter iron.

The rocks at my feet are newly fractured, jagged, split open quartz crystals of dazzling white and pale green. I pick one up and gaze into it like a crystal ball, considering its history—considering my history—and considering how it is we came to meet here at the foot of an ancient glacier. Then I become aware of the sound of rocks skittering down from the top of the pile behind me. I will myself to stay, but I turn so I can keep an eye on the rocks. I’m aware of the folly, knowing I could never run fast enough to escape being buried when the rock and ice pile finally gives way. I’m on the supposedly safe side of the yellow rope barrier put up by now absent park rangers. As the sun heats the valley and the rocks begin to fall more steadily, I decide to walk back out of the canyon.

I retreat from the rock pile because I’m leading a group of fourteen young women, college students from Seattle on a study abroad program. I’m responsible for their health and safety for the three months we’re touring New Zealand. I lead them away from the glacier, back into the primeval temperate rainforest of towering tree ferns and vines. The steady din of cicadas and the occasional tremulant trills of bellbirds and tui envelop us.

When we’ve returned to the forest path, I tell the students I’ll meet them back at the van in a few minutes. I duck down a deserted, quiet side path for a few moments of peace—away from the students’ raw enthusiasm, raucous singing, and selfie-picture-taking in front of every scenic view—including the rock pile of the retreating glacier. As I’ve driven them around the South Island in a mini-van, some have taken to yelling out the van windows “Hey cows!” or “Hey sheep!” to scare the herds and then laugh hysterically. Those are the Biology majors, a fact I find ironic. I was a Biology major thirty-odd years ago. Was I ever that young?

On this study abroad program I’m ostensibly teaching community and environmental health, but what I really want to teach is the value of travel as critical self-discovery. Not the navel-gazing, bathetic sort of self-discovery, but rather the sort that leads to greater knowledge of and tolerance for uncomfortable aspects of ourselves and of people we view as “different” from us. I want to expose the students to the deep satisfaction of getting past being picture-taking tourists, instead, becoming travelers, perhaps even pilgrims walking towards the far horizon to arrive home.

It isn’t working out well. So far, halfway into our trip, it’s more like a case study of how not to lead a study abroad program. We’re traveling around so much it feels like we’re never here, in New Zealand. Staying in ten different cities and villages in as many weeks, passing through and ticking off the have-done-have-been-there bragging list of photo-ops, skydiving, and bungee jumping: I feel more like an adventure tour guide (and an emergency room nurse) than a teacher. It’s not helping that we’re staying in youth hostels full of international backpacking nomads who proudly proclaim they have “done Franz Joseph,” they have “done Milford Sound,” they have “done Rotorua,” as if these are all colonial conquests—places and natives and experiences to be possessed and bragged about. But I signed onto this program late and had little hand in its design, so I’m trying to make the best of it.

As we drive and tour and wander, I ask myself: Do we discover more about ourselves through movement or through rootedness to one place over time?

If, as Lucy R. Lippard contends in her book The Lure of the Land, “space” is passing through coordinates and “place” is pausing to make meaning of the space, does it follow that space is to tourism as place is to travel? And if so, what is essential for the work of transforming space into place, tourism into true travel, into pilgrimage?

The Exquisite Corpse Hits the Hospital

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“Imprint of the Intangible” Mixed media, 2000, Heather Hawley. University of Washington Medical Center.

The exquisite corpse is a French surrealist parlor game named after one of their first nonsensical collaborative sentences, “The exquisite corpse will drink new wine.”  There are written and arts-based (including drawing, collage, sculpture, theater, and dance) versions of the exquisite corpse. They all emphasize elements of unpredictability, collaboration, and tapping into unseen/subconscious sources of creativity. And just plain fun.

This summer I adapted the written version of the exquisite corpse for use in the hospital-based narrative medicine/health humanities course I am teaching. I first had students divide themselves into groups of 4-5 people, each person with a clean piece of paper. Then, I asked them to write one sentence across the top of the paper and base the sentence on one concrete observation about their classroom. I gave them 30 seconds to write the sentence and then asked them to pass their papers to their right. They had another 30 seconds to write a second sentence in response to the first. Before passing the paper again, they were asked to fold down the paper in order to hide the first sentence. We repeated this exercise a total of five times. At the end, they could unfold their papers, read, and share with the class what the group had come up with based on their initial sentence. Much laughter ensued. Then, I had each student write a short reflection on what the experience was like for them.

I learned this classroom version of the exquisite corpse at the 2015 Chuckanut Writers Conference from two writers/creative writing teachers, Brenda Miller and Lee Gulyas, who both teach at Western Washington University in Bellingham. Miller and Gulyas have a recent collaborative essay, “Come Closer,” published in Sweet: A Literary Confection (vol. 7, issue 3, 2015) and an intriguing interview by Carmella Guiol with them about this essay and their collaborative process (July 16, 2015). In their workshop, we were all writers of various sorts, and the prose/poetry pieces our groups came up with were quite funny, creative, and profound.

As were the pieces that my students produced, although they mostly were much more matter-of-fact and not as fanciful as I expected them to be. These were nurses after all–nurses tasked daily with life and death decisions. Flights of fancy and parlor games are typically frowned upon among health care providers. But, since teaching is in itself a creative endeavor, I try to take calculated risks in the classroom and try new things. For this one I’d give myself a B+ for effort.

Feedback from the students (from their written reflections) ranged from, “this felt like a drinking game” (note: no alcohol was consumed in the auditorium as far as I know), through “I don’t understand why we did this exercise,” to perhaps more insightful, critical thinking responses including these:

“Even though we are talking about the same topic we said or have different points of view about our classroom. How we described it is different person-to-person. This is common in workplaces, like when we have to write up patient care plans, we hardly agree on them.”

“I enjoyed the spontaneity of doing this exercise. So much of our class work and assignments has been related to following directions exactly and making sure we are doing everything right.”

“I’m thinking this would be a good tool if I was leading a patient support group or leading a class. Patients with chronic illness get told all the time about what it the right thing to do and this could be used to let them tell their stories a different way.”

In thinking over how this went–my first attempt at doing the exquisite corpse exercise with a group of hospital-based nurses–I’ve realized I probably need to fine tune it for this setting and for these ‘parlor game’ players. Next time I would keep everything the same with the exception of the initial sentence writing prompt. Instead of having them write about their classroom, I’d ask them to write a sentence about a recent frustration at work–and that it can be a minor and seemingly frivolous frustration (in oder to keep it from getting too deeply emotional for this collaborative writing exercise). My aim would be to have it more directly pertinent to their work as nurses, while maintaining the fun, spontaneity, and collaborative nature of the exercise. As physician-educator and innovator in the health humanities Alan Bleakley says, “health humanities creates a serious play space.”

The Art of Nursing

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“Array” 1999, cut and fabricated aluminum, by Irene Pijoan. Harborview Medical Center. Photo credit: Josephine Ensign /2015.

Entering week seven of a nine week narrative medicine/health humanities course I’m teaching to a group of nurses at Harborview Medical Center. This is my third summer teaching this course, but my first time teaching it in a hospital setting. This is also the first time I have taught it to a class of experienced and currently working RNs.

I’ve always focused on introducing students to the practice of narrative medicine, of learning to apply Dr. Rita Charon’s close reading drill, and of expanding that to include my ‘closer close reading drill‘ to various forms of literature. This year I kept those elements, but have added art to the course.

It helps that we are surrounded by amazing artwork throughout the Harborview Medical Center complex. Even in (and outside of) the otherwise functional-looking Research and Training Building where our classroom is located, there are the art installations shown in these photographs. “Array”depicts cerebellar neurons, tied to a Harborview research emphasis of neurology and also “metaphorically mimics the scientific process itself”–according to the placard beside this piece. At the building’s entrance is “Integument” representing the leadership of Harborview in the treatment of burns and trauma. And, according to the placard, “The integument motif also metaphorically references the cutting through the outermost surface of the building, implying that it too functions as an extended body.”

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“Integument” 1999, cut and fabricated aluminum, by Irene Pijoan. Harborview Medical Center. Photo credit: Josephine Ensign/2015.

As part of their small group presentations on topics such as death/dying, disability, and racism in health care, I have students include a piece of Harborview art that speaks to them about some aspect of their topic for their class presentation. I also had my colleague, poet, psychotherapist, and educator Suzanne Edison lead the class in an exploration of ekphrastic poetry.

While the students have been open to the inclusion of art in this health humanities course, there is one in-class art activity I added this year that seems to have engaged them the most. It was a blind contour drawing activity that I learned from Drs. Catherine Belling and Martha Stoddard Holmes in a workshop at the Health Humanities: The Next Decade conference this past May at the University of Colorado Center for Bioethics and Humanities. As Belling and Holmes pointed out, this activity includes art (the doing/drawing) and humanities (refection/writing).

Here’s how it works: 1) have students pair up and sit face-to-face, 2) each student has a blank piece of paper and a pen/pencil, 3) each student looks at their partner’s face for two minutes, while drawing their face on their paper–without looking down at the paper, 4) after drawing (and laughing) and then showing their portraits to their partner, each student writes for 4-5 minutes–reflecting on what the experience was like for them, and exploring whether they were more more uncomfortable being observed or doing the observing–and why.

This in-class activity led to much laughter, but also to a rich class discussion of the experience and its connections to their work as nurses. The best kind of classroom learning activity: fun, engaging, profound.

Community Resilience: Prepare for the Really Big One

DSC00963This week’s New Yorker article by Kathryn Schulz, “The Really Big One”, about my beloved Pacific Northwest’s vulnerability to a devastating mega-earthquake and tsunami, has stirred a lot of debate and fear here in my hometown of Seattle. There’s been a run on the buying of ready-made disaster preparedness kits. Companies doing seismic retrofitting of houses are now booked out almost a year. As the article states, scientists report that we are overdue for a large or mega earthquake (9,0) and tsunami (100-ft) that will kill at least 13,000 people, injure 27,000, displace 1 million people, and destroy two-thirds of all hospitals. Everything west of Interstate 5 will be destroyed.

Currently, despite having the technology to install a sophisticated early-warning earthquake system, we don’t have one and we will have to rely on the “cacophony of barking dogs” to provide us with a 30-90 second warning before the ‘real quake’ hits. (Dogs can hear the high-frequency compression waves that precede an earthquake. Yet another reason to love dogs.)

It is clear that our government entities, businesses, hospitals, schools, fire departments, need to do much more to prepare for this disaster. As individuals we can support legislation to require better community-wide disaster preparedness (and support ways to actually fund these measures). As individuals we can heed the public health disaster preparedness advice and keep adequate disaster kits in our homes, school, and worksites. In a previous blog post titled “Be Very Afraid” (November 22, 2014) I wrote: “Or be at least a little bit afraid: not so afraid that you become paralyzed with fear and not so little afraid that you don’t do practical things to better prepare yourself (and your family) in case of disaster/emergency. Aim for being ‘just right’ afraid.” And I recorded the items I collected to make our family’s disaster/emergency preparedness kit–along with the realization that disaster preparedness is not an equal opportunity affair.

But something I have learned from my colleagues in New Zealand who work on post-Christchurch earthquake recovery efforts, is that an equally important part of disaster preparedness at the community level is promoting community resilience and wellbeing. More closely-knit communities–regardless of economic resources–tend to weather disasters better than others. Several of the Christchurch-area Maori marae (communal, sacred land/communities) organized to take in and provide food and shelter for foreign students and visitors affected by the earthquakes before any official government-sponsored program was able to do that. This isn’t to gloss over the very real socio-economic and racial disparities highlighted by ‘natural’ and man-made disasters. The lessons on this from Hurricane Katrina in New Orleans stand as reminders.

I was somewhat skeptical when I first encountered these bright, up-with-people banners (shown in the photo above) I saw in the midst of the still fresh earthquake devastation in the downtown core of Christchurch in 2014. But as I focused more on their messages, I realized they were all about building individual and community resilience. They are part of the All Right? Campaign, a Healthy Christchurch initiative of the Canterbury District Health Board and the Mental Health Foundation of New Zealand. They based their campaign on the work of the UK-based social, economic, and environmental justice think tank, The New Economic Foundation, which developed the evidence-based Five Ways to Wellbeing (with a Kiwi slant below). Now these are some excellent ways to prepare for the Big One.

  1. Connect… With the people around you. With whanau, friends, colleagues and neighbours. At home, work, school, or in your local marae, church or community. Think of these connections/relationships as the cornerstones of your life and invest time in developing them. Building these connections will support and enrich you every day.
  2. Be active… Exercising can make you feel good! Step outside. Go for a walk or run. Cycle. Play a game. Garden. Have a boogie or do some kapahaka. The most important thing is to find a physical activity you enjoy that suits your mobility and fitness. Do it with friends or whanau and you’ll be ticking two boxes… connect and be active!
  3. Take notice… Be curious. Catch sight of the beautiful. Remark on the unusual. Notice the changing seasons. Savour the moment, whether you are walking to work, eating lunch or talking to friends. Be aware of the world around you and what you are feeling. Reflecting on your experiences will help you appreciate what matters to you.
  4. Keep learning… Try something new. Rediscover an old interest. Sign up for that course. Take on a different responsibility at work. Fix a bike. Learn Te Reo or how to play an instrument or cook your favourite food. Set a challenge you enjoy achieving. Learning new things will make you more confident as well as being fun.
  5. Give … Do something nice for a friend, or a stranger. Thank someone. Smile. Volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness, as linked to the wider community can be incredibly rewarding and creates connections with the people around you. Aroha ki te tangata, a Maori saying meaning respect for/goodwill towards others.

Dorothy Day and Nursing

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From Creative Commons

Dorothy Day is known for her work in social justice, and especially for her co-founding and longtime work with the Catholic Worker Movement. Earlier in my career I worked with the Richmond, Virginia-based Freedom House, modeled after Day’s houses of hospitality. Freedom House, like Day’s original house of hospitality in the Lower East Side of NYC, included a shelter, soup kitchen, laundry and clothing services, counseling and friendship. The staff members of Freedom House lived in voluntary poverty as a mark of solidarity, and as a way to become un-insulated from the realities of poverty and homelessness.

I also knew that Dorothy Day had been a journalist and had been involved with the women’s suffrage movement. She picketed the White House in 1917 as part of the Silent Sentinels’ nonviolent civil disobedience, and was arrested and jailed for her part in the peaceful protest.

But, I had no idea that Dorothy Day was also a nurse. I discovered that fact recently when I read her autobiography, The Long Loneliness (Harper and Row, 1952). In 1918, as WWI and the influenza pandemic raged on, Dorothy wrote to a friend: ‘I hate being Utopian and trying to escape from reality . (,,,) What good am I doing my fellow men? They are sick and there are not enough nurses to care for them. It’s the poor that are suffering. I’ve got to do something.”

So she went to work as a nurse–or a nurse-in-training– at the Kings County Hospital in Brooklyn. She writes of this time: “From the beginning I enjoyed the work. (…) My experience there reassured me as to the care one received from the city. It was a care given to citizens, not to paupers. And it was all free.”

In her autobiography, she describes specific patients and hospital wards that were particuarly memorable to her. Two female patients dying near each other in a ward, one a woman of fifty and the other a girl of twenty-two. Of the younger patient she writes, “There was the smell of death around her, I kept thinking, and there was no one to bring her flowers to deaden it.” She moved to a fracture ward. ‘This ward broke me, the work was so hard. (…) One afternoon when I had been cleaning up filth all day, and the perverse patient had again thrown her bedpan out on the floor dirtying my shoes and stockings, I left the ward in tears and sat in the washroom weeping uncontrollably at the ugliness and misery of life.” Day claims that she had a sympathetic nursing supervisor who took her off the difficult ward, “… transferring me to medical where there were fifty patients with influenza.” (I’m not so sure I’d call her supervisor sympathetic.)

We forget how devastating the 1918 flu pandemic was: “This was the time of the ‘flu’ epidemic and the wards were filled and the halls too. Many of the nurses became ill and we were very short-handed. Every night before going off duty there were bodies to be wrapped in sheets and wheeled away to the morgue. When we came on duty in the morning, the night nurse was performing the same grim task.(…) It was hard not to be careless at this time when every day ten or twelve new patients were carried in or walked staggeringly only to fall unconscious as soon as their clothes were taken from them.”

Of burnout and emotional numbing in her work a a nurse, Day writes this: “Nursing was like newspaper work. It was impossible to suffer long over the tragedies which took place every day. One was too close to them to have perspective. They happened too continuously. They weighed on you, gave you a still and subdued feeling, but the very fact that you were continually busy left you no time to brood.” She writes of finding solace and peace outside in the hospital grounds: “I just sat for a brief rest and watched the sparrows and starlings looking for crumbs from the apron pockets of the old women. ”

Dorothy Day worked as a nurse at the hospital for a year, until after the influenza epidemic was over. “Then a longing to write, to be pursuing the career of a journalist which I had chosen for myself, swept over me so that even though I loved the work in the hospital, I felt it was a second choice, and not my vocation. My work was to write and there was no time for that where I was.” She concludes this chapter of her life by writing, “…I had been a good and sympathetic nurse. I knew that I loved the work, and that if I had not had the irresistible urge to write, I would have clung to the profession of nursing as the most noble work (…).”

Nurse Dorothy Day, along with suffragist/activist/radical hospitality Dorothy Day: an inspiration.

In Boom or Bust: Standing in Solidarity

Version 2Seattle is a boom or bust town. Boom times: The timber/logging industry of its early days. The jumping off point for people drawn to the Klondike Gold Rush in the Yukon. The Boeing surge during WWII. And, since the 1990s and accelerating over the past four or so years, the technology boom with Microsoft and now Amazon leading the way. The bust times in between, including the Boeing Bust of the early 1970s, spurring the famous billboard near the Sea-Tac airport reading, “Will the last person leaving Seattle turn out the lights.”

Since its early days Seattle has been a socially progressive place. King County, which includes the City of Seattle, was formed by the Oregon Territorial legislature in 1852. From the beginning, the King County Commissioners were responsible for such things as constructing and maintaining public buildings, collecting taxes, and supporting ‘indigents, paupers, ill, insane, and homeless people living in the county.’ Today, while there is a robust safety net in our community, it is not strong enough. Homelessness in the Seattle area is increasing, with tent cities sprouting up wherever they can, including along the original Skid Road (Yesler Way) in the shadows of Harborview Medical Center as shown in this photo taken late last fall.

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Homeless encampment near Harborview in downtown Seattle. Photo credit: Josephine Ensign/2014.

As the bumperstickers at the beginning of this post proclaim: Healthcare is a human right; housing is health care. They were produced by the National Health Care for the Homeless Council, of which I am a member. The Council recently issued this timely and hopefully provocative-in-a-good way justice statement entitled Standing in Solidarity: In Support of the Movement for Social Justice. It reads:

“The National Health Care for the Homeless Council recognizes that the significant health disparities associated with homelessness are part of a much larger pattern of injustice in the United States. Poverty and structural racism too often are perpetuated and upheld by poor public policies and narrow social opinion, leaving millions of men, women, children, and youth unable to achieve their potential for well-being and success. We stand in solidarity with the growing social movements and supportive jurisdictions that seek to correct underlying social and economic inequities. We understand that our work as health care providers is part of a much larger struggle to attain human and civil rights, to include the rights to housing and health care.

Numerous recent events involving police violence and community responses have reawakened the national consciousness around the failures of our public systems. Rather than focusing on sensationalized moments and ignoring the daily traumatic violence experienced by those living in poverty, we ask that media outlets instead continue to highlight the root causes of these incidents—social disinvestment, racism, and the ongoing, profound inequities in opportunities, as evidenced by the following:

Public policies created current conditions, but the policy-making process can also promote a robust and inclusive society. We call for measures to establish for everyone in our country the rights to health care, housing, and livable incomes. We also call for those in the Health Care for the Homeless community—and others allied with this cause—to continue our work toward public policies that achieve social justice.”

Gone South

Cabin at Camp Hanover, Mechanicsville, VA
Cabin at Camp Hanover in Virginia

For many years now I have sought ways to reconcile with my Southern roots. My white Southern roots. I find it painful to re-read my journals and stumble across blatantly and unselfconsciously racist entries. But I am done with white guilt, as I see that only perpetuates white privilege narcissism. In the words of poet, psychotherapist, and anti-oppression trainer Leticia Nieto, “refuse to re-use recycled guilt.” (From Beyond Inclusion, Beyond Empowerment, Cuetzpalin Publishing, 2014, p 55.)

I am reminded of a powerful quote from one of my favorite authors, William Maxwell (Time Will Darken It, Harper and Row, 1948): ” The present with its unsolved personal relationships and complex problems seldom intrudes upon the past, but when it does, the objects under glass, the framed handwriting of dead men, the rotting silk and corroded metal all are quickened, for a tiny fraction of time and to an almost imperceptible degree, by life.”

And I am reminded of an essay I wrote entitled ‘Gone South’ (Silk Road: A Literary Crossroads, 6.1, 2011, pp8-40), in which I addressed the intrusion of the past that is part of what it means to be Southern. Here are a few excerpts from that piece that I find relevant to our very un-post-racial reality. Of note, I grew up on land that had been taken from the Pamunkey Indians (of Pocahontas fame), which just this week received federal recognition (see The Washington Post article by Joe Heim “A renowned Virginia Indian tribe finally wins federal recognition,” 7-2-15).

I was born and raised on 600 acres in coastal Virginia that was the first racially integrated children’s summer camp in the South. In 1957 my Presbyterian minister father was recruited from his North Carolina church to open and run Camp Hanover. He presided over each solemn opening and closing campfire deep in the nighttime woods, reciting the poem, “Kneel always when you light a fire, kneel reverently and grateful be for God’s unfailing charity.” As he lit the fire, a circle of restless faces gathered around. The faces of the white children glowed in the firelight, while those of the black children stayed hidden.

Our land near Cold Harbor had witnessed the bloodiest battles in the Civil War. Two battles that were two years apart; soldiers on both sides in the last battle unearthed decomposing bodies from the previous battle as they dug trenches. The grounds of Camp were strewn with their bullets, musket balls, and deep earthworks. From an earlier time, the Pamunkey Indians had scattered white quartz arrowheads. My mother collected arrowheads and bullets along the road. She taught me to search for them. (…)

One late summer day in 1970 I was riding in our VW bug, my mother driving on back roads from the Richmond airport. I was ten, sitting in the backseat reading a book, vaguely registering the Virginia countryside and farms we were passing, when she slammed on the brakes.

“Damn!”

I never heard my mother curse, so I looked up quickly.

“What?” I asked.

“Keep your head down and stay quiet,” she said, adding more softly as she turned off the engine, “It’ll be OK.”

I could see her leaning forward, both hands tightly clutching the top of the steering wheel. I slumped down in the seat while quickly peering out the side window to see what had stopped us, to see what would be OK—to see what she didn’t want me to see. I figured it was a bad car accident.

It was approaching dusk, the witching hour for the waning sun. The field next to us glowed golden, with large rectangular hay bales strewn about the field of wheat stalk stubble. Hovering over the field, suspended in the thick damp evening air were shining motes of hay bits, effervescent like Fourth-of-July sparklers. With our car engine turned off, the sound of cicadas and crickets became a curtain of white noise, as mesmerizing as the floating hay.

“Evening, ma’am. Don’t mean no trouble. Gotta stop you here awhile. There’s a meeting passing through, that’s all.”

The man’s voice, polite, official sounding, with crisp words stuck in a slow southern drawl, echoed through our open window. I looked between the seats and saw a spotless white-gloved hand cupped over the doorsill. Behind that was blazing white with a thin, trickling, blood red cross. Above the cross was a white mask and pale thin lips moving within an elliptical cutout area. From the words spoken and the weight of the voice, I expected to see the blue uniform of a policeman. When I first saw the white mask, I had to remind myself it wasn’t Halloween.

As the man moved away, I looked out the front windshield to see where he was going. Up ahead, perhaps fifty feet away, was a swarm of ghostly pointed-hat masked figures swirling around a huge bonfire. It took a moment for me to see that inside the bonfire was a ten-foot dark wooden cross.

“What’s that and why are they wearing those weird costumes?” I asked.

“Shhhhh—I’ll tell you later. Stay down and stay quiet!”

Absorbing the fear in my mother’s voice, I sank deeper in the seat, but moved over in the middle so I could see out the front windshield at the fire and the figures. Several of the white-clad men reached into the fire with long wooden sticks and withdrew flaming torches. Then en masse, with fluid amoeboid movement, the group came toward us, sucking in lone figures as it streamed forward. I heard deep-voiced chanting, words indecipherable as a foreign language. They grew louder, surrounding our car, lighting the inside with their glowing whiteness and lit torches, gently rocking the car as they brushed past it, moving across the road, and thinning to double file down a dirt path. The comforting familiar smell of wood smoke followed them.

I didn’t hear my mother start the car. We were speeding away, screeching around bends in the road. Reflected in the rearview mirror, I saw my mother’s face set hard as stone, etched with the fierce anger I seldom saw. I was more afraid of her anger than I’d been of the men we’d seen. I stayed quiet, bracing myself for the rough ride. When we got home she disappeared into her bedroom, talking quietly with my father—so quietly I couldn’t make out what they were saying, even with my ear pressed against the rough stucco wall between our bedrooms.

At the dinner table that night, my father told me we’d been in the middle of a Klu Klux Klan meeting. “They’re racist white men who wear those costumes to look like ghosts of Confederate soldiers to scare black people—and to scare white people who don’t agree with them— like it scared your mother.”

As I slowly chewed a mouthful of food, I considered this information. The ghostly man who had stopped us seemed polite, a Southern gentleman. Being in the midst of the KKK meeting had been exotic, dreamlike, seductive—almost beautiful. I knew that what I had seen—the way I had seen it—was not something to discuss. I swallowed the dissonance between my mother’s reaction and my own experience of the encounter.

The dissonance remains.

The landscape of my childhood is a landscape of half-buried violence, covered with violets, punctuated by deep, abandoned wells. The roads leading back to it are as twisted as the country roads I grew up on. Within the accretive layers of nostalgia, lie the sludge of orange dust tasting of blood. I fear—and yearn for—the complexity, the offbeat rhythm of the South that formed me.