CANCER JUSTICE NETWORK - The Latest

OPEN LETTER TO CEOs AND BOARDS OF HOSPITALS: CAN YOU HEAR US?

6/12/2020

From Steve Sunderland, PhD, Director, and Nemat Moussavian, MD, Medical Director, Robert Harris, DD, Cancer Justice Network

Dear Healthcare Leaders:

We want you to change your hospitals into “New Hospitals” of justice. Can you hear the voices of people who are dying because health care for people who are poor and minorities is so poor in our city. You must know the following:

      * Minorities, seniors, people who are poor and with disabilities are dying in greater percentages from the COVID-19 virus than the rest of the population. CAN YOU HEAR US?

      *People who are poor and live in certain city neighborhoods have 35 years less of life expectancy than other city neighborhoods. CAN YOU HEAR US?

      *Seniors are in vulnerable health realities and have limited access to healthcare. CAN YOU HEAR US?

      *People who are poor are more likely to die of cancer than any other population. Inadequate treatment and follow up have gone on without accountability. CAN YOU HEAR US?

      *Infants continue to die at horrible high levels. CAN YOU HEAR US?

There is no program of outreach to work on these healthcare crisises from any hospital. Monies from the Hamilton County Indigent Care Levy have not been targeted to these problems. Politicians have not helped to reduce these health disparities.

What needs to be done by Healthcare Leadership? Create a “New Hospital.”

      1. Each hospital needs an Equity Task Force that reports to the CEO on the programs and progress on these critical health care needs.

      2. Each hospital needs an educational outreach program that partners with churches, community centers, senior centers, and school-based clinics with accountability for the numbers of people educated about critical health needs.

      3. Each hospital needs a Community Based Navigator Program to insure the community that their health needs will be joined to community navigators that will accompany patients to the hospital.

      4. Each hospital needs a free transportation process to assist patients in gaining access to timely treatments.

      5. Each hospital needs training in being friendly, welcoming, and compassionate with patients and insuring that procedures to the hospital are clear, user friendly, and culturally sensitive.

Justice in healthcare can be provided if the above steps are implemented. The City’s high risk population no longer needs to be imprisoned by old notions of hospitals. Now is the time to listen, to review, and to act.

CAN YOU HEAR US?

MUCH TOO SOON?

5/4/2020

The numbers of U.S. dead is above 67,000 people. Many are seniors, too many are minorities, people with disabilities, and the poor. Is it too soon to be open for “normal” life? What can it mean to be “open” and “normal” at this time? The Cancer Justice Network has been thinking about the great needs of our friends that we have not seen at the church dinners for the homeless, or the health and senior centers, and at the health fairs. For a brief moment last week, there were many national news stories about the unequal results of the virus in these populations. The country “woke up” to the reality that there are large numbers of the general population that are dying in greater and greater numbers due to the standard reasons: lack of access to health care; no firm relationship with a primary care provider; no outreach to the poorest communities that have experienced the greatest mortality; reduction of food on a regular basis; the loss of even low incomes; and, the failure of the culture to make health care for all a priority.
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> The Cancer Justice Network believes it is not too soon to consider a major reorganization of the systems of healthcare in Cincinnati. Going back to more and more mortality or a deepening of the health crisis for people of high risk, is unacceptable to those of us who are hoping for changes that both improve the specific health of those in greatest need and a recognition of the health needs of the entire community. This pandemic has shown that the health care system is fragile for everyone: people of all income levels have had to face hospitals with inadequate equipment to protect the physicians and other health care workers as well as dangerous occupational roles for transit, grocery, and emergency response staff. It is clear that no one is safe and no one is insured good health care and, most sadly, no one is in charge of raising the standards for community health care improvement. The governor has made courageous choices to close most of the state but his choices now seem under attack as thousands of citizens are forced to be out of work, encouraged to remain at home, and frightened about the necessity to suspend social relationships during this time. Our mayor and health commissioner have also followed up with similar warnings that are aimed at frightening the population into a major change in all social contacts. Overhanging all of these orders is the threat of long term unemployment, no healthcare from employers, reductions in pension incomes, and the increasing possibility of both limited employment and dangerous participation in local society.
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> Now is the time for ideas to be shared about a rethinking of healthcare in Cincinnati. First, a commitment needs to be made from the hospitals to set up health outposts in those neighborhoods of greatest mortality. Hospitals should be provided with protective equipment as they establish centers for testing for the virus as well as expanding their exams to other chronic diseases. The UC Medical, Pharmacy, and Nursing Schools need to be rethought as an ongoing assistant to these efforts, with medical, pharmacy, and nursing students joining teams of physicians to provide in-neighborhood exams and treatment. Eradicating the virus’s present invasion will need to be followed up for the rest of the year with more exams, given more often, and with greater success in welcoming the highest risk populations. The Cancer Justice Network needs to expand its staff of Navigators to accompany these teams of healthcare personnel, taking appropriate precautions to insure Navigator safety from the virus. Moreover, a Center for Community Navigation, with the capability of telemedicine, will need to be established and broadcast on a weekly basis to the community. This Center will update the community on what is happening in neighborhoods as well as provide Navigator-in-training classes that can be taken on-line. Navigators, both in person and on line, will need to work within the communities to encourage exams and retesting as well as participation in the follow-up for treatment and contacts with infected citizens. An army of trained Navigators, expanded to every high risk neighborhood, connected to different hospitals and health centers, visiting via television and in-person and face to face meetings at dinners and health fairs, will make a substantial impact on stopping the virus’s spread and, importantly, the slowing the killing of vast numbers of high risk citizens.
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> Yesterday, my wife and I visited a Hamilton County park. Dozens of families were out to enjoy the warm weather and the beautiful surroundings. Yet, no one had a mask on and no one reminded the population that lives were at stake. I wondered just what it will take for our community to accept that they are “Navigators” of public health and that their citizenship, if they want to raise the possibility of living, will require a different kind of action. The first stage of the virus coming to Ohio has been shocking; now, with gentleness for the difficulty involved in protecting the community, with recognition of the anger at the leaderless figures in our society that are watching as the local and regional economy is disappearing, and, with compassion for those families that have had a death or have had to postpone healthcare, a new path must be discussed and, with agreement about Covid justice for all, taken as soon as possible.

COVID JUSTICE NETWORK?

4/27/2020

The Cancer Justice Network has been on hold since the advent of the Covid 19 pandemic. Our regular work of visiting people with a high risk for chronic disease at North Church, Over the Rhine Senior Center, Christ Church Cathedral, Booth Retirement Community, St. Vincent de Paul, the Bobbie Sterne Health Center, Crossroad Health Center has stopped. Navigation has been defined as being in the community, working face to face with people who are low income, homeless, minorities, people with disabilities, and seniors. The requirements of the State of Ohio to stay home, to avoid meetings of 10 people, and to close congregant meeting places, has removed the essential trust building ingredient of the relationships with our “friends.” Added to this radical change, is the total focus of the hospitals and health centers on testing and treating the Covid virus. Navigating people to cancer exams, dental visits, and vision exams is no longer possible according to these rules.

The Covid virus has revealed that people with the highest risk, the poor, people with other underlying diseases, seniors, people with disabilities, and people of color, have had the greatest mortality. This medical condition comes as no surprise to the Cancer Justice Network. Our work to build relationships in the Cincinnati community has been in those neighborhoods and with people who are experiencing a 20 year life expectancy difference BEFORE the virus descended on these communities. We have met with people and navigated many to their first exam for cancer, their first meeting with a dentist, and their first change of glasses in decades. The spread of the virus has added an additional layer of mortality to an already dire situation. We find that the rules of social distancing have isolated us from our meetings and removed people we serve from being brought to hospitals and health centers for timely exams and treatments. Reduced to supporting people over the phone, we have tried to have navigation continue for people needing dialysis or for emergencies. But navigation by Navigators that accompany people to and from medical exams has effectively been stopped and is likely to remain in this condition for the foreseeable future. The Cancer Justice Network must now consider whether the future holds the possibility of Covid Justice.

So much in the human service community has been upset for every agency that it is hard to imagine the return of critical services to the population in greatest need. Without face to face meetings, how can navigation to essential and life saving services be offered? Without group settings for offering food on a regular basis, how can the nutrition needs of the people who are poor or homeless be met? Without access to hospitals and health centers for tests for cancer, how can true prevention be available to a population that is the cancer center of Ohio? Without rebuilding relationships with individuals and communities that regularly meet, how can people who suspect that they might have the virus be navigated to physicians, health centers and hospitals? Covid justice means answering these questions while also recognizing that pubic health safety is the highest priority. Covid justice means thinking anew about how to visit communities that have been invaded by the virus in ways that suggest access to medical assessment and treatment. Covid justice means training staff in nursing homes, senior centers, and homeless shelters in the signs of Covid 19 and encouraging action for people in need. The near future cries out for Covid Justice. As I write this note, close to 50,000 people have died in the US. And, there is no plan for Covid Justice for all. We applaud the Homeless Coalition, the United Way, and the Greater Cincinnati Foundation for providing the first funding for homeless individuals and families that were in shelters and exposed to the virus. We applaud the Congress and the president for signing relief bills to provide limited resources. We are grateful that our transportation resources, Cincinnati Area Senior Services and OKI, are available for connecting some people. Our funding from the Congregation of St. Joseph continues to assist us in thinking through our local next steps. Yet, the increasing need for more resources for those in greatest peril, remains. What is Covid Justice now?

CREATIVE RESPONSES TO GRIEF: THE TUBMAN PROJECT #3

4/27/2020

“Even in the worst of times, such habits sustain, protect and in the most unlikely way, lift us up. I cannot think of a more compelling reason to foster the creative habit.”—Twyla Tharp and M. Reiter(2006). The Creative Habit: Learn it and use it for life. Simon & Schuster.

In the 1970s and 1980s I was a grief consultant to many Native American and Canadian nations. The nations were struggling with suicide, alcoholism, early child death, and extreme poverty. Many visits were heart breaking as I was introduced to personal, spiritual, and environmental examples of death. One of my guides on the Ojibwa Reservation in northern Wisconsin was a young member of the Red Cliff band, Walt Bressette. Walt was a gifted story teller, a well prepared environmentalist, and a keeper of the fire at the very start of the Iraqi war. “Keepers of the fire” were honored members of the community as they kept a fire going through all weather conditions. As the fire was tended, Walt, his friends, and I would have many conversations about what the war would mean for his nation and for the country in general. Walt was not ignorant of the impact of war on many of his fellow tribespeople and he worried that this war would be another damaging experience for too many Native Americans.

From time to time, Walt would tell a story about how his nation overcame wars, addictions, and poverty. At that time, his stories were about fishing rites and rights, a battle between Wisconsin fishermen who didn’t want to observe the treaty and state law that permitted Ojibwa fishermen to have a first day of the fishing season to themselves. Ojibwa fishermen were threatened with rifles and pistols if they argued with the Wisconsin anglers. One year, Walt and I went to a gathering of the Ojibwa nations in Thunder Bay, Ontario. Bands of Ojibwa were invited to come and discuss the state of “nation,” the problems and opportunities of that year. I was invited to be the opening speaker at the convocation on the first night. The meeting was held in a large hotel with an immense ballroom. I arrived early and planned to address the people at around 7-7:30pm. My host, a leader of the conference asked me if I would mind going on and sharing after “gifts” were presented to the elders. This kind of sharing was their tradition and acknowledged that these elders have travelled long distances to come and share at the meeting. I agreed. At about 7:30 the host invited all the elders to the stage to receive their gifts. About 30 elders of different ages came to sit on the stage. The host invited each to come forward to receive his gift and to introduce himself. It was a beautiful ceremony, taking 2-3 hours. After the last gift was given, the host addressed me and apologized for the long introductions and informed the group that I would be the opening speaker first thing in the morning.

Next morning I arrived at 9 at the conference hall and found no one there. About 11:30am the host arrived and said that the conference would resume after lunch, about 1:30. “Great,” I said, as I pulled together my many handouts. At 1:30 the host rose to speak to the conference and said that they were in for a special treat. Their major philosopher had just arrived at the conference and, after living for a year in the forests of Canada, she was eager to share her knowledge. He also indicated that my talk would follow her presentation. Rising up from the audience was a woman of indeterminate age, dressed in an old and weathered dress, mostly brown. Her eyes sparkled as she held the microphone and began to share her ideas, thoughts she called, “The Four Circles of Life.” As I listened to her, I began to realize that I was hearing one of the best talks of my life. Furiously, I began to take notes on each of her “Circles,” detailing all that she was saying in as fast a scribble as I could but I couldn’t keep up with her rapid speech and the many examples. I thought I was able to copy down at least the first three but she ended her talk before I could complete the fourth “Circle.” She finished to great applause and sat down next to me. And smiled.

I told her how impressed I was with her talk and I indicated that I had missed the last part. “Oh, she said, “let me see what you have written.” Happily, I handed her my notes which detailed the first three Circles. “I’d like to finish my notes with your fourth points,” I said. “Well,” she said, “the fourth Circle is really important. But, I think I have to destroy your notes. You’ll remember the important parts.” She proceeded to rip the pages of my note book into a dozen pieces. I don’t remember what happened next.

She was teaching me a vital lesson about how wisdom is gained, used, and appreciated. Her knowledge, freely given, was a creative invitation to reflect on my life and the life of her nation. What was to happen as a result of her gift, what I was supposed to learn, what I was able to put into practice, was all an open question. I realized that her “Fourth Circle” was for me to fill in, for me to embrace, and for me to honor. I left that conference deeply appreciative of the gifts that continue to inspire my creativity.

TUBMAN PROJECT #2: MIEP GIES

4/27/2020

“I’ve often been down in the dumps, but never desperate. I look upon our life in hiding as an interesting adventure, full of danger and romance, and every privation as an amusing addition to my diary. I’ve made up my mind to live a different life from other girls, and not to become an ordinary housewife later on. What I’m experiencing here is a good beginning to an interesting life, and that’s the reason—the only reason—why I have to laugh at the humorous side of the most dangerous moments.”

      Anne Frank in Anne Frank’s Diary: The graphic adaptation(2018). Adapted by A. Folman and Illustrated by D. Polanski. Pantheon Books. Page 129.

  Anne Frank’s story has intrigued me for the past forty years. Her sparkling personality has moved me in deep ways to think about hope, possibility, and courage. These qualities shine through in her diary and her short stories. In 1980, I had the chance to work with the Dutch foundation named for her and with the director of the international exhibit, Cor Suijk. Cor, a former Dutch diplomat, educator, and friend of Anne’s father, Otto, had created a traveling exhibit to tell Anne’s story and the history of the rise of Hitler as a warning about the dangers of intolerance. I had worked to bring the exhibit to Cincinnati and, in the process, Cor and I developed a friendship. We spent many amazing hours talking about the Frank family, the Netherlands during the war, Cor’s family as too frightened or prejudiced against Jews to take more than one person for hiding, Cor’s experience in the Dutch resistance, and Cor’s good friend, Miep Geis.

  The more I learned about Anne and her family’s survival, the greater my interest in how Anne survived and why she chose to write her journal. Cor had many answers and they all circled back to Miep and her husband, Jan. One day, Cor asked if I would Iike to visit with Miep and Jan and ask them these questions directly. I traveled to Amsterdam and, with Cor, went to a small apartment in the center of the city. I remember two rooms in the apartment: one, a small living room with a large table on which was a large plate of Dutch chocolates and an adjoining room, smaller, that was filled with boxes of letters from school children and their teachers from around the world. Cor was a very close friend of Miep and Jan and he arranged for us to have an afternoon of discussion. For the next 4-5 hours we talked and finished the plate of chocolates. We laughed a lot, cried some, and discussed so many aspects of their lives as members of the Dutch resistance durning World War 2, especially what it was like to bring food to the Franks and four or five other families in Amsterdam that were in hiding. Miep and Jan described getting up before dawn each day and visiting friendly farmers on their bicycles and then separating and going to deliver the food to the different hiding places. Slowly, our discussion returned to Anne and the day of her capture. Miep, with tears in her eyes, said that she had to close up her apartment every August just to meditate on what had happened that day. ”They just burst in; they knew where to go. And, they took everyone in the Attic except they didn’t take me, “ she said with quiet fury. “Take me, too,” she insisted, “I do not want to leave my friends.” Her request was ignored. “You are not a Jew but an Austrian,” she was told as the Nazis left the house. Dazed, Miep went back into the house and found the pages of Anne’s diary on the floor and rescued them.

  We were quiet for a while. Finally, I asked her about Anne’s energy, her desire to write her diary. Miep, now subdued by her memories, replied that Anne was so different, so amazing: “She was so energetic, so alive, so unwilling to be depressed and so interested in hearing the latest news.” Cor interjected a comment: “Yes, dear friend, she was all those things because of you, because of your friendship, because of your courage, because of your showing her that you and Jan would not be defeated by the Nazis.” Miep smiled and said nothing. Then she continued to describe Anne as the only one in the Attic that wasn’t afraid, depressed, or resigned to her fate. “Anne was different, almost crazy, alway alive,” Miep recalled with a smile and a loving look.

  Later on we looked at some of the letters from children and teachers that filled dozens of cartons in the next room. “I answer every one,” Jan said, “and it is important to share Anne’s story.” Anne, Miep, Jan, and Cor’s stories continue to illuminate the darkness of their time and now as well. I can feel the warmth of their friendship, almost taste their chocolates, and know that their strength can be a hand forward in these times of confusion and despair. May their memory continue to burn brightly.

NAVIGATING THE CANCER JUSTICE NETWORK: NAVIGATORS AS PPE

4/27/2020

NAVIGATING THE CANCER JUSTICE NETWORK: NAVIGATORS AS PPE

The shortage of essential equipment to fight the virus is astounding. Each state has been shown to have little of the basic resources needed to provide minimum but life-saving conditions. Now, the statistics about mortality are revealing that minorities, the disabled, the aged, and minorities are suffering and dying in the greatest percentages. What is becoming clearer to the nation is the central truth of healthcare in the US: healthcare for many people doesn’t exist, especially if you are in the known sectors of society that are high risk. For the past five years, the Cancer Justice Network has created the first Community Navigator Program to both model a just health care process and to actually provide navigation to health exams, dentistry and vision exams. We have worked in the areas that now are designated neighborhoods of lowest mortality. Thanks to the Cincinnati Health Department, we know which parts of our City have a 20 year life expectancy difference. And, this horrifying reality existed before the virus!

The model of health care that the Cancer Justice Network has implemented is based on the research of Harold Freeman, MD pioneered in 1985 at Harlem Hospital in New York City. Freeman, a cancer surgeon, found that bringing people into the hospital for exams in the earliest stage of their cancer, dramatically increased their life expectancy because their received timely cancer care. Hospital staff, called, “Navigators,” went into the community and built trust with people who rarely felt their health needs were respected. In just 5 years, Freeman’s Navigators changed the face of cancer care. Freeman became the first African American president of the American Cancer Society, joined the administration of George H.W. Bush, and led a research team looking at health inequities in the nation. Further research on the Navigation Model brought similar results and, the American College of Surgeons, now requires some form of a Navigation Program for the accreditation of every major cancer program.

The Cincinnati healthcare community has known about Freeman’s research and has resisted starting this program even though cancer deaths for high risk populations in Cincinnati make the City the cancer capital of Ohio. The Cancer Justice Network has failed to convince hospitals in Cincinnati that navigation can make a critical difference to so many people in need in our neighborhoods. Even a visit by Dr. Freeman to Cincinnati four years ago to explain his model and the latest research did not convince even one hospital to attempt a program based on Navigation. Now, with the virus having descended on our communities, the need for a rethinking of healthcare for seniors, people with low incomes, people who are homeless, minorities, people who are disabled, is of critical importance. The prior model of health care has proved inadequate for the entire population but the worst outcomes are in the population with highest risk because they have been rejected for years by our healthcare institutions. What will emerge post-virus for our entire city and for the population in greatest need? Navigators, spread throughout the city, based at every health center, school based clinic, library, and community center, tied to a transportation system that provides rapid and low costs, and linked to Navigators at each hospital, would make a dramatic difference in building a just healthcare system. Navigators are as important as any form of PPE: Navigators are the process that provides “air” to people who are suffocating with their illnesses; Navigators are the “hands” that reach out to everyone who needs to be guided to a new health system; Navigators are the “hearts” that touch everyone’s fears and hopes; and, Navigators are the “guides” that provide the transportation information that can guide people to whatever “health” comes to mean in our new day.

A new day is on the horizon for healthcare in Cincinnati. It is 35 years since Freeman’s model was started. We can launch a new approach in Cincinnati, an alternative to what has existed if we understand and act with boldness and compassion. Navigation is a part of PPE, perhaps the critical element. New rules, new approaches and new obstacles will confront our communities. Navigators, health and community workers, stand ready to create a just system for Cincinnati.

December 22, 2019

12/22/2019

Ten months Matthew came into our world. He looked very small having arrived three month early. Thanks to the caring of many people, parents, friends, doctors, nurses, and colleagues he is, today, a fat little guy with big smiles. He is also crawling. Nothing normal about this reality: compassion was woven together by so many people as they saw in this little person a chance for life.

Also, this year Mary got her first glasses in forty years, thanks to our Navigators and the friends at St. Vincent de Paul. The smile on Mary’s face stretches across all of Over the Rhine. Cliff, a spry 75 year old, is also grateful for having his teeth cleaned and appreciative of the dentists at the Cincinnati Health Clinic for such good care. He a glad citizen of the West End. Barbara, overcoming her fear, trusting a Navigator, had her first breast exam in 30 years. No cancer was found and a great sigh of relief was heard throughout Northside.

All of these wonderful events were kind of a birth. We witnessed the new experience of peace in people who had little hope that medical care would be available. Trusting Navigators, they were transported to a new experience: respectful healthcare. Throughout the city of Cincinnati we meet people who smile at us with a kind of delight as they now know that we are just a part of their beginning a solid relationship with a physician, a nurse, a physical therapist, a dentist, and a community health care worker. Like Matthew, they have been invited into a community of compassionate action. They all have friends that are linked to them as guides to present and future health problems and concerns. Navigators have formed partnerships, a kind of hug, that supports and cherishes the whole person. We are all growing in this community of love, grateful for the support of so many “grand folk” like OKI, Congregation of St. Joseph, Over the Rhine Senior Center, North Church-CAIN, First United Church of Christ, Christ Church Cathedral, Booth Retirement Community, St. Paul’s Village, the Cincinnati Health Department, St. Vincent de Paul, and Crossroad Health Center.

Matthew, Mary, Cliff, and Barbara have reminded us about how fragile life is and how important it is to take action for health when we can. Very sadly, we attended the annual event that remembers the homeless people that have died this year. Organized by the The Homeless Coalition, we stood in a circle in Washington Park and read over 100 names of people who died this year. One was a child of two. How many died because they couldn’t reach out to a Navigator, or that they didn’t know warning signs of ill health, or that they just had no one to help them on their efforts to stay alive? This year we want to increase our efforts to reach seniors who have had little or no health care, and touch base with people with disabilities that might want to see a dentist, and with people who are poor and need an eye exam and glasses. We know that with greater effort, we can reach even more of our friends who are lost and confused about how to navigate our health care system. We want to celebrate life for more and more people, helping them find their first “steps” to kind health care.

If you can, please send a check to Cancer Justice Network, 4129 Georgia Avenue, Cincinnati, OH 45223. We can expand the circle of hope with your continued help. Thank you.

April 29th, 2019

4/29/2019

Dear Friends:

Partnerships have been key to the development of the Cancer Justice Network. Our partners have allowed us to attend weekly dinners, weekly health meetings, and weekly meetings at senior centers. Over time, this trust in our work has led to an increase in citizens taking advantage of meeting with our Navigators for discussions of cancer in specific and health in general. Through these partnerships we have expanded our discussions to include both cancer prevention and dental health as doorways to a person considering that their healthcare can be taken seriously and, by implication, their lives can be improved. Thanks to the partnerships, we are now the largest cancer prevention organization in the community. People have realized that prevention has meant going, often with us, to exams to see if they have cancer or some other life threatening disease. Having predictable, safe, and accessible transportation provided by our partnership with Cincinnati Area Senior Services(CASS) has raised the possibility that people with low or no incomes can be navigated to health care. Having access to the Cincinnati Health Network and the Cincinnati Health Department’s Health Centers have opened up a visible road map for cancer care and dental exams.

Our partners have connected with us to provide a next level of health care access. Adding to regular dinner meetings a health emphasis has made for new connections for people wanting to take action on their health needs. We are grateful to Churches Active in Northside(CAIN), First United Church of Christ, St. Paul’s Village,Christ Church Cathedral, Booth Retirement Community, and Over the Rhine Senior Center allowing and encouraging us to share health information at their dinners and breakfasts. Similarly, we appreciate having access to outstanding health centers, especially Crossroad, the Cincinnati Health Network, and the Cincinnati Health Department’s Health Centers. These locations have also allowed us to expand and focus on dental health and we are especially happy with our partnership with UC Blue Ash’s Dental Hygiene Program. St. Vincent de Paul’s efforts to improve health via the UC Open School Program has also invited us to weekly participation. And, the Public Library of Hamilton County has seen it desirable to offer our program at their downtown branch.

Changing the culture of health for our population requires a different attitude from health providers and we are happy about our partnership with the nursing schools of UC and Xavier and with the medical, dental hygiene, pharmacy, and physical rehabilitation students of UC.

Finally, we are in partnership with Ohio, Kentucky, and Indiana Regional Planning(OKI) and with the Congregation of St. Joseph. Both organizations have been strong partners in encouraging innovative and sound programs for opening up the health and transportation systems of our community. Their financial and psychological support has been critical in any of our success.

Having a compassionate partnership network has made for a city-wide road map for improving health for our most neediest citizens. Each partner has brought a level of trust and openness to new ideas that has fueled our work. We have learned a lot from each partner and we are happy to strengthen our learning and support networks.

-Steve

April 02nd, 2019

4/2/2019

Dear Friends:

One of the main characters in August Wilson’s play, “Two Trains Running,” is a person called “Hambone.” He repeats the same line for two acts: “I want my ham!” Hambone has been wronged 9 years earlier by a shopkeeper. Hambone was promised a ham if he painted a fence to the satisfaction of the owner. He didn’t. All Hambone wants is justice and that is all he is focused on, day after day. Hambone also represents the many people in Pittsburgh in the ‘60s that were poor, unemployed or marginally working in a declining neighborhood. Wilson gives voice in a simple and straightforward way to those in the neighborhood, largely African American, who keep finding the “rules” changing and with little chance for justice at any level.

This character reminds me of too many of the people we see at the senior centers, Over the Rhine, Booth, and St. Paul’s Village, and at the dinners for people who are poor at CAIN’’s North Church, Christ Church, and St. Vincent de Paul. Rarely, are their voices heard above a murmur and even more scarce is their complaints about the lack of justice in the health care system. What we do as Navigators in seek to change the relationship by being present for discussions even if there is a fear of talking. Being present means offering a guidebook to going into the system even though there are scary stories of what happens when a person who is poor and sick crosses over into the hospitals. Providing resources, including accompaniment, seems critical if the past obstacles and present barriers are to be overcome. Grudgingly, we find a few people who, in one way of another, say: “I want real healthcare!” Together, we walk to the transportation that is provided by Cincinnati Area Senior Services(CASS) and we enter a world with more rules that are puzzling than can even be imagined.

This week we met with many people wanting to change the system and join our Commission on Cincinnati’s Health Inequities. So many people has stories about people being lost on the way to health care, or rules that prohibited people being able to buy their drugs or see a dentist. We also met with people, Kate Bennett, who are veterans of the systems, who understand the subtlest of meanings in the “rules.” Slowly, thanks to more understanding we are seeing the paths to healthcare for our “neighborhood” more clearly. Hambone never gets his ham from his former employer. Instead, a new friend, named “Sterling,” places a ham in his coffin. This is not justice. But it is an act of compassion. We are doing better and not enough. Let us all chant: “I want my healthcare justice.”

Steve

Check out our first research publication!

1/26/2018

From Patient Navigation to Cancer Justice: Toward a Culture-Centered, Community-Owned Intervention Addressing Disparities in Cancer Prevention

Cancer Justice Network

We are uniting agencies and people that serve the poor and minorities in Cincinnati, Ohio to create a Cancer Justice Network. For more information, email :steve.c.sunderland@icloud.com
CALL 513.404.3882

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