HPV Awakening: One Woman’s Battle against Silence and Ignorance

Not long after 25-year-old Tashia Ameneiro became sexually active, her body began feeling out of balance. She lost weight, developed back pain and noticed her period had changed.  So she made an appointment with her gynecologist, who diagnosed a cancer-causing strain of human papilloma virus, or HPV, a sexually transmitted infection.  She was treated and although she does not need to worry about developing cervical cancer, she is furious that she was infected in the first place.

What cultural norm gave Tashia’s boyfriend, who knew he was infected and contagious, the audacity to keep this information from her? Why is ignorance about HPV so pervasive?     How can others be protected from the pain and worry that Tashia experienced?

The answer is HPV Awakening, the fledgling organization that Tashia founded in 2011 to educate others about HPV and to advocate for better public health policies regarding all sexually transmitted diseases (STDs).

In schools, at health fairs, and wherever else she can get a platform, she spreads the word about HPV, a group of sexually transmitted virus strains that grow on the various soft, moist surfaces of the skin such as the tip of the penis, the cervix, and the throat.  HPV is so widespread, Tashia is quick to advise,  that almost every sexually active person will have it at some time. In most cases, it is silent, innocuous and becomes inactive within two years.  But some strains, notably HPV-6 and 11, cause non-cancerous genital warts, which can cause itching, burning, pain and emotional distress but which can be treated with medication and/or surgery. Twelve strains can develop into cancer.

HPV Awakening educates residents at The Lodge homeless shelter

In addition to education, HPV Awakening is focused on advocating for better sex education and better public health policies. Relating an incident where two middle school students were found engaged in fallatio, Tashia noted that syphilis is rampant, yet parents and teachers tend to be uncomfortable talking about sex.  Tashia says, “I’ve been in conferences where people would rather talk to you about suicide than talk to you about STDs. STDs are extremely taboo.”  

And so she pitches the merits of making screening for STDs, including HPV, a routine part of every annual check-up.  If everyone were routinely tested, she argues, the stigma surrounding testing would disappear, asymptomatic but potentially dangerous infections would be diagnosed and treated, and the spread of disease would be curtailed.

Tashia, who works full-time for an HIV/AIDS organization, is a woman on a mission.  Working on HPV Awakening only in her spare time, she put together a board and completed the paperwork to register as a 501 (c) (3) not-for-profit organization. She arranged for the law clinic at Florida International University to prepare bylaws, articles of incorporation, and other required papers.  She recruited her mother, now retired, to do community outreach and consulted with Heather Green, who devised the HIV/AIDS curriculum for the Miami-Dade County schools.  She underwent the training for the school speakers’ bureau, got her materials approved by the school board, and began lecturing in the public schools.

HPV Awakening distributes free condoms in packets adorned with its logo

She also began appearing at health fairs. In addition to local, mainstream fairs, she staffs a table at Exotica, an annual expo of love and sex, and the Anime Festival Orlando, a celebration of Japanese cartoons and animation that attracts many teenagers.  She expanded her lecture arena, appearing at colleges and universities.  She added in-service trainings for organizations like Pridelines and the Alliance, two LGBTQ support organizations. She established a partnership with Planned Parenthood, which provides free condoms and free STD testing.  And she built a social media presence.

In the process, mainstream media interviews came her way:  local public television and CNN Spanish. Largely as a result of her Facebook page emails began arriving from all over the world: India, Philippines, Russia.  Most recently, individuals and couples have begun coming to her privately for information: How can an HPV-positive person protect his partner who is negative? What are the benefits and limitation of the HPV vaccine?[i]  Are there foods that might combat the virus? How effective are male condoms?  What do you think about female condoms? Artificial insemination?

Tashia has accomplished all this in her spare time and with virtually no money.  She does not charge for her counseling or her lectures.  She has successfully negotiated to have fees at the events where she tables reduced or eliminated.  She estimates the work contributed by the FIU law clinic is worth about $5,000.  She distributes condoms that she gets for free from the health department and Planned Parenthood. With no office and no paid staff, her only regular expenses are the HPV labels she affixes to the condom packets she distributes and the organization’s brochures, which she prints herself from her home computer.  Tashia says she plows as much money as she can into the organization and admits she needs to learn how to grow the organization and raise funds.  At present she is working to raise $400 needed to properly register her 501 (c) (3).

HPV Awakening

www.hpvawakening.org

P.O Box 940685

Miami, FL 33194

786-260-2092

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[i] There are two approved vaccines for protection against HPV.  Six-year studies on thousands of people world over, the longest available, show the vaccines to be safe and effective with no signs of weakening at studies’ end. Gardasil and Cervarix both prevent HPV-16 and 18, which cause most but not all cervical cancers.  Gardisil, but not Ceravix, also protects against HPV-6 and -11, which are responsible for 90% of genital warts. For more information about HPV vaccination, see http://www.cdc.gov/std/hpv/stdfact-hpv-vaccine-young-women.htm and http://www.cancer.org/cancer/cancercauses/othercarcinogens/infectiousagents/hpv/humanpapillomavirusandhpvvaccinesfaq/hpv-faq-is-hpv

Girl Power: An Inner City Haven

How does a girl endure gangs roaming her neighborhood? Or addicts frequenting the crack house down the block? Or the drive-by shooting that killed the little boy next door? Or the dysfunction that rages within her own home?   

The answer: By coming to believe that she matters.  That she can chart the course of her own life and make a difference in the lives of others.  That whatever it is she’s going through, there’s a way to get help, a way not to give up, a way not to become a statistic.

This is the purpose and success of Girl Power, a haven for girls 11-17 in Miami’s inner city.

“I think the thing we do best is taking girls who feel that their circumstances have predetermined the outcome of their lives. We take an active role in changing their perception of who they are and where they are and helping them understand that they have a bright future,” said Thema Campbell, President and CEO.

With hopelessness expressing itself in lawlessness and Florida’s juvenile justice system the third largest in the nation, Girl Power grew out of the urgent need to quell juvenile crime.  Research had convincingly demonstrated that girls are most vulnerable to delinquency if they have a pattern of truancy, if their performance in grades 6-8 is uneven, if they have relatives who are incarcerated, and/or they have a history of gang membership, poor grades or pregnancy. With risks clearly outlined, Girl Power developed programming to improve school performance, keep girls out of the juvenile justice system, and cut back on school suspensions and truancy.

Community service is an important component of Girl Power programming

Alternative to Suspension was the first program to come on line. With numerous absences and unyielding behavior problems, scores of girls were getting suspended from school.  Barred from class, they were at home getting pregnant, going to the malls and shoplifting, getting arrested.  Clearly, suspension was causing more problems than it was solving. So in 2000, Girl Power created a place where girls could go from 8 a.m. until 3:30 p.m., where the underlying causes of their truancy and behavior problems could be addressed, and where they would work on the academic and life skills needed for success at school.  Today, in partnership with seven inner city middle and high schools, which agree to cut the student’s suspension time in half if she participates successfully in the Alternative program, Girl Power works with 100 girls a year who have been suspended for two or more days. 

The program is built on two evidence based curricula, Reconnecting Youth and Empowering Youth.  Essentially a five-day syllabus, it helps girls understand self-esteem and improve their own self-image. It builds critical thinking skills, and it hones the girls’ abilities to read, understand what they read, write, and listen.  With bullying and fighting pervasive problems, substantial time is also spent on understanding conflict and learning how to be assertive without being aggressive. 

“The girls don’t know how to solve conflicts,” Thema said.  Indeed, 80% of girls suspended from school are suspended for fighting.

“They don’t even know what a conflict is. So you have to walk them through step by step. What is a conflict? How does it get started?  How do you resolve it? How can you come to a resolution so the conflict is over and done with? Because often these girls fight and then go back to school, and if the conflict is not solved with all the parties, it erupts again.”

Accordingly, time is set aside for “girl talk,” i.e., what happened and why they got suspended. While the girls invariably enter Alternative to Suspension believing their punishment was somebody else’s fault, by the time they’re ready to go back to school, they understand the role they played. And they have acquired some skills for redirecting their anger.

Much the same are the results for the Post Arrest Diversion program, which began in 2008 to change the life course of approximately 50 girls a year (38 this year) under age 17 arrested for non-violent crimes like shoplifting.  Like participants in Alternative to Suspension, girls in Post Arrest Diversion are sent to Girl Power, in this instance by the Department of Juvenile Justice. Like the Alternative to Suspension curriculum, the one for Post Arrest Diversion is based largely on Reconnecting Youth and its emphasis on self-esteem and conflict resolution. But this program, which runs eight weeks, is more strict and intensive. Girls can be drug tested.  They get a large dose of sex education: abstinence, pregnancy prevention and safe sexual practices.  The approach is holistic; they learn choice theory augmented by practical, down-to-earth strategies that can help them academically and through life.  There are academics, with an emphasis on literacy and with tutoring as needed.  There are work readiness skills – resume writing, securing money for college and travel, applying academics to the work environment, manners, posture, all the things that make a person ready to get a job and keep a job.  There are health and wellness – nutrition, stress reduction, yoga and therapeutic art.  The program aims to build character and citizenship by helping the girls build their sense of self-worth. And the program satisfies the requirement for community service with opportunities at Girl Power for taking inventory, helping with projects, and assisting staff in other ways.

Younger girls completing Alternative to Suspension and Post Arrest Diversion are encouraged to join the After School program, where creativity is nurtured.  In one project, the girls fashioned African dress.

Family and individual counseling, which is required by the Department of Juvenile Justice for Post Arrest Diversion, is central to both programs. Indeed, it is integral to every program Girl Power offers. Staff knows that most girls who act out, especially those who get into fights, are exhibiting symptoms of a bigger problem being overlooked. Thema estimates that abuse, sexual abuse or neglect is an underlying factor 90% of the time. Accordingly, unless the parents refuse, every girl who walks through Girl Power’s doors has one counseling session to pinpoint problems and determine whether and what kind of counseling is needed. Individual, group and family counseling is then provided at no cost to participants by a partnership with Community Counseling Services of Greater Miami.  

In 2012, the latest year for which statistics are available, 43 girls successfully completed Post Arrest Diversion. In other words, they attended consistently and completed all requirements.  Of these 43, not one was rearrested. 

Results for Alternatives to Suspension are equally impressive.  Cynthia Valdez, who teaches the program and follows up with the participants’ schools, knows of only one girl who was suspended again after completing Alternatives to Suspension. She therefore estimates success at 95%.   Parent and participant surveys reveal that the majority see improved relationships with family, less defiance, better grades.  Thema reports that school personnel frequently ask, “What do you do with this child? She’s a changed girl.”

In addition to Alternatives to Suspension and Post Arrest Diversion, Girl Power offers an after-school education and enrichment program for an estimated 200 middle school girls, mentoring program for older girls, a girls’ choir for 11-17-year-olds, and a fun-filled 7-8 week summer camp for up to 40 girls.  Girls completing Alternatives to Suspension and Post Arrest Diversion are encouraged to stay involved by joining one of the other programs, and many do.  For them, as for all who participate in Girl Power programming, the organizations offers safe harbor amid the turbulent waters of home and neighborhood.

Girl Power, loosely associated with World Literacy Crusade of Florida, employs six full-time and one part-time staff plus one public ally employee.  Budget, which comes principally from public and private grants, is $437,000 exclusive of in-kind contributions, namely counseling provided by Community Counseling Services and art instruction, which is provided by PAMM.

Girl Power

6015 NW 7^th Avenue

Miami, FL 33127

T: 305-756-7374

www.girlpowerrocks.org

Pearl Girlz: Dignity Up; Bullying Down

Joyce Davis, founder and director of Pearl Girlz, LLC, tells about the first time she was the victim of bullying.  She was nine.  It was her first day in a new school, and she was the only black kid in the class.  Just before lunch, when a group of girls were preening before mirrors in the bathroom, one of the girls pulled Joyce’s pony tail. As she said, “Ooh, your hair is so weird,” all the girls started to laugh, and Joyce felt the tears coming.  But somehow, she marshaled the strength to hold them back, and instead of crying said, “Yeah, it does whatever I want it to. I can pull it, I can straighten it, I can curl it.”
      “That’s cool.  Can I play with your hair?” one of the other girls asked.
      “Sure,” Joyce replied.
      “Can I play with yours?”  In that moment, the tension was diffused, and this gaggle of taunting girls turned into a bunch of Barbies fussing with each other’s hair.
      Years later, as a middle school language arts teacher and Master of Arts candidate, Joyce became a serious student of bullying.  She learned that what was once perceived as benign catty behavior was in fact harmful aggression – subtle but very real intent to destroy another girl’s relationship with one or several of her friends.   While boys fight with their fists, girls devastate each other with the roll of an eye, a whispered remark, divulging of secrets, starting of rumors.
      “Girls know how to manipulate the value placed on a relationship in order to truly damage.  To really, really hurt you, I need to damage your relationship with me or with someone else,” Joyce explains.  “One day two girls might be friends. Then someone else comes along and whispers, and all of a sudden, the relationship is damaged. ‘What happened?  You were talking to me yesterday, but you won’t talk to me today.’”
      Throw social media into the mix – the potential for rumors, gossip, and hateful speech to be anonymous and go viral – and the potential for harm escalates exponentially. Who can forget Rebecca Sedwick, the 12-year-old Florida girl who jumped to her death in 2013 after having been mercilessly taunted on Facebook.   
      But just as girls can be mean, they also have the capacity to be loyal and caring, to turn ugly competition into supportive cooperation.  These realizations, together with an appreciation for the importance of self-esteem and socially appropriate behavior, became the seeds of Pearl Girlz.
      Pearl Girlz is an educational organization dedicated to the elimination of girl bullying. Through workshops designed for educators and for middle and high school girls, Pearl Girlz draws back the curtain on how words and body language do harm.  The workshops teach the girls how to silence bullying when they encounter it and how to find their own inner strength and beauty so they will not need to engage in the destructive behavior themselves.
      A series of three workshops for middle and high school girls, titled ”VIR[i] Around the Mean Girls,” begins with a session analyzing the types of aggression girls exhibit.   As Joyce discussed the difference between male and female aggression at a recent session at an inner-city high school in Miami, the girls knew just what she was talking about.
      “ Boys fight and then they’re done. Girls hold a grudge,” volunteered one.
      “ Girls know how to get inside your head, and they seek revenge,” said another.  
      “ Girls will call you names. They’ll curse at you and flirt with your boyfriend,” offered a third.
      “They  won’t invite you to their party, and then they’ll talk about it in front of you."   
      Examples flew across the room:   Girls gossip and spread rumors about you.  They’ll walk past you or roll their eyes at you or shout over you or give you a dirty look so other girls will see you as cast out.
      It quickly became clear that girls instinctively understand that validation comes from feeling secure in important friendships.  By bullying girls separate the victim from her friends. In the process they inflate their own power and diminish the victim’s.
      If bullying is so destructive, the next step is to do away with it.  For that Joyce introduced the Toolbox of Options, a list of 15 effective responses to bullying that the girls would practice at the next session. To protect themselves from bullying, the girls are encouraged to find a safe place – such as someone’s house, church,  the mall --  where they can relax; tell a trusted  adult; stand up for themselves without yelling or hurling insults; seek out friends, family and neighbors who make them feel comfortable and accepted.  To diffuse bullying, they are encouraged to walk away; find something nice to say about the person who is the subject of gossip; tell the perpetrator that what she is doing or saying is beneath both of them.
      At this second session, the participants are presented with typical bullying scenarios and have the opportunity to role play, selecting from the Toolbox of Options the best strategy in each case.  In this session, the girls learn how to be assertive without being aggressive and how to diffuse bullying when they see others perpetrating it.   During these exercises – indeed throughout all three sessions --  the girls are encouraged to be pearls, that is, to demonstrate self-respect, respect for others, and appropriate social behavior. 
      The pearl serves as a metaphor for the girls as they deal with unsavory behavior, Joyce explains   A pearl grows inside an oyster in reaction to irritating or threatening stimuli.  Each time the oyster feels attacked, it encases the irritant in a layer of a substance called nacre.  Layer by layer, as the oyster repels irritants, it builds a beautiful gem. Similarly, the girls build their inner beauty as they learn ways to fend off bullying in dignified ways.
      Bullying emanates from inner hurt, anger, jealousy or feelings of inadequacy. Consequently, making girls feel good about themselves is central to eliminating it, and building a strong sense of self is the focus of the third session in the series. Entitled “Loving the Skin You’re In,” it builds self-esteem by helping the girls to get in touch with their inner beauty – their personality, their character, their talents, ambitions and motivation.  The girls learn 10 characteristics of healthy self-esteem and five strategies for building a strong sense of self. Using a full-length mirror, they verbalize the qualities and characteristics that define their inner beauty.  They write on the mirror: because I’m a great cook, because I’m a caring person, because I help my grandmother.
      Because building a strong sense of self is so critical, this theme pervades all three sessions.   From the outset of the first workshop, participants are encouraged to identify their passions and recognize their uniqueness.  To reinforce the girls’ inner strength, each session ends with a reading of “Still I Rise” and “Phenomenal Woman,” two poems by Maya Angelou.
      “When we read ‘Phenomenal Woman,’ we’re like ‘that’s me,’” Joyce says, “because we’re thinking and acting all through that poem like this is the woman who we’re gonna be in the future. Not the woman who throws champagne glasses across the table. Not the woman who posts naked pictures on the Internet.”  Rather, the woman whose intelligence and self-confidence makes others take notice.  
      Beginning with that day in the girls’ room when Joyce was nine, personal and professional experiences formed the seeds of Pearl Girlz.  But it was 2009 before Joyce gave her first workshop.  Pearl Girlz was incorporated in 2011.  Through this very grassroots organization, Joyce has presented her work at the National Girls Bullying Conference in Las Vegas and has led student workshops in Nevada, Maryland and Florida.  
      No hard data on outcomes yet exists, but workshop participants’ comments make clear that they get the message.  “Don’t let people push you down,” one girl wrote on her evaluation.  “Instead of being a mean girl, be a smart girl.”
      Another wrote, “It helps a lot to learn not to bully someone  and don’t always have revenge.”
      A third wrote, “It helps [to] understand that when people be mean to you, you can find a way to do something without being judicial or using your fist. And how you can help other people out when their being bullied.”
      The Pearl Girlz budget, averaging $20,000 a year, comes solely from workshop tuition, $25 per student per 90-minute session. Joyce operates with no formal office and no staff.  Future plans include establishing Pearl Girlz as a 501 (c) (3) and expanding the reach of her work.  While she looks forward to the day when her workshops will be taking place every day in schools across the country, she still keeps her day job. 

Pearl Girlz, LLC

500 NE 2^nd Street

Dania Beach, FL 33004

Phone: 219-670-1066

Email: joycel.davis@pearlgirlz.com

www.pearlgirlz.com

 

 

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[i] VIR, pronounced “veer” is an acronym for the three types of female aggression: verbal, indirect, and relational.  Verbal aggression refers to language such as name calling and cursing directly at a target person.  Indirect aggression refers to gossip, spreading rumors, using social media and other ways of harming someone without attacking her directly.  Relational aggression refers to the destruction of important relationships, often the goal of female aggression.

Health Information Project: Making Kids HIP on Health

Here are the just some of facts:

·         One in five high school girls report being physically and/or sexually abused in a dating relationship it

·         One in four teens  has a sexually transmitted infection. An estimated 750,000 American girls become pregnant every year, 82% unintentionally

·         Anorexia is the third most common illness among adolescents; almost half of those afflicted show signs of clinical depression

·         Obesity rates in adults and children have more than doubled since the 1970s

·         Suicide ranks as the third leading cause of death (after accidents and homicide) for 15-24-year-olds

Mental illness, alcohol and drugs, bullying, and more – the issues threatening the health of American adolescents are daunting.  And, whether kids live in the plushest suburb or deepest inner city, whether they  are rich or poor, smart or not, ignorance about matters affecting their health and wellbeing is pervasive.  Yet, because of budget cuts and an overloaded curriculum, health education disappeared from the Miami-Dade County Public Schools in 2008.

Then Risa Berrin founded the Health Information Project (HIP) and put it back.

 A far cry from old-fashioned health ed classes, where teachers read statistics and quoted scare tactics from outdated textbooks, HIP pervades an entire school with a multi-media program that engages everyone in the school community.  Outside, a huge green and white banner shouts, “Be Hip on Health.”   In the hallways, green and white HIP posters advise, “Get your teeth checked every six months,” and “Do not get into a car with someone who is drunk or high.”  In ninth grade classrooms, trained upper-class peer educators, wearing green and white t-shirts bearing the “Be Hip on Health” slogan, weave local news events – like the neighborhood teen recently arrested for drunk driving – into a structured curriculum incorporating interactive discussion, exercises, games,  and multi-media presentations. Classes cover mental health; reproductive health; relationships; alcohol, tobacco and other drugs; nutrition, exercise and obesity; and healthy lifestyle.  The classroom black box welcomes anonymous questions that students were too embarrassed to ask out loud, and incorporates the answers into the curriculum or posts them on social media or in the HIP blog.  On the internet, behip.org provides reputable, reliable local and national information sites as well as health resources in each school’s specific neighborhood.  Social media carry pithy tidbits, links to health-related news items, and encouragement to seek medical care for preventive and acute needs. 

 

Once in a school, the Health Information Project is everywhere, and its impact is apparent. In a testimonial on behip.org Paris Grant, ninth grader at Miami Palmetto High School, wrote,
“I was at a party and my friend was drinking too much and he passed out on the floor. I knew from HIP to take initiative and I took him to the hospital. I ended up saving my friend’s life.”

A 2006 graduate of the University of Miami law school, Risa founded HIP in 2009.  She combined two proven models: the sustainable faculty-sponsored club, like debate or yearbook, and peer education, as in woman to woman breast cancer counseling, which demonstrates how much the messenger matters.  She conceptualized a structure wherein a faculty advisor selected by the principal trains a group of eleventh and twelfth graders as peer educators and guides them as they conducted eight ninth-grade classroom sessions. The eight sessions interrupt a core subject (English? History?) of the principal’s choosing and take place when that class otherwise meets.  Curriculum, detailed and scripted including frequently asked questions and their answers, is written by HIP staff.  Revised as soon as important new information is published, each module is carefully based on scientific papers in consultation with academic and clinical experts. New research and current news are readily incorporated.  When, for example, the Rutgers student committed suicide, the issue found its way into discussions on bullying and LGBT tolerance.

Except for HIP’s first year in a school, when the faculty advisor chooses 20-25 juniors to be peer educators, the prospective peer educators are chosen by a student board with input by the faculty sponsor.  Focus groups of ninth graders have shaped the image of peers they are likely to listen to, and interested tenth graders, who submit a written application and undergo an interview, are evaluated accordingly.

“If you’re [promiscuous]  and you’re getting up and talking about elements of reproductive health, that message gets diluted. So they’ve been very stressed out about the kind of people they let in. they’ve thankfully had the opportunity to kind of pick from the best,” said Risa,  who continues to serve as HIP executive director.

Those selected make a two year commitment so that the seniors can mentor the juniors.
Early in the fall, the faculty advisor attends a full-day train-the-trainer session and then conducts a full-day training for the peer educators. The week prior to each classroom lesson, the peer educators attend additional training, which is focused on the module to be taught.  Having studied the curriculum script in advance, the educators are tested on content as well as presentation and public speaking skills.

Max Weinberg teaches a class of ninth graders at Miami Beach Senior High School

At the outset of the ninth graders’ classes each year, the peer educators ask the students a series of anonymous questions: Have you ever been bullied?  Have you ever contemplated suicide?  The peer educators tally up the responses and report them to the students, who invariably are astonished by the numbers.  Typically, the kids respond, “Wow, I thought I was the only one going through that,” and with that response a positive tone for learning is set.  By the end of the course, much learning has taken place.  Misconceptions have been dispelled.  The ninth graders have learned, for example, that people who suffer from depression are not crazy, that undocumented residents will not get deported if they go to a clinic, that you can get pregnant even if you’re 14 and having sex for the first time.  And with new learning comes better behavior: less derogatory language, less bullying, more tolerance, more use of the website as a resource for themselves, their friends and their family.

With pre- and post-tests, outcomes of the program are measured using quantitative and qualitative indicators of behavior, health knowledge, knowledge of resources, and access to care.  Through partnerships with the University of Miami and Florida International University, HIP has acquired surveys that get the right information and accurately measure need and impact.

The 2011 post-intervention survey, the last year for which complete data is available, shows that 81% learned new health information, 84% grew more comfortable discussing health topics,  89% said they prefer having upperclassmen lead the health presentations, and 83% became more confident in their health knowledge and decision-making skills after receiving the HIP program. The majority of students report that HIP is their number one provider of health information.

The upper class educators benefit as well.  Joyce Saturno, peer health educator at Miami Beach Senior High, wrote on the HIP website, “There was this freshman. She was talking about how she had many suicide attempts…like two or three. It made me realize that she seemed so happy but we really don’t know what’s going on.”

 Erika Schumacher, peer health educator, HIP intern and HIP president at Miami Palmetto High  School, spoke for many when she said, “I used to be so scared of public speaking.  I used to get so red and stutter.”

Indeed, Valerie Berrin, director of operations,  reported, “We love seeing how, in the beginning of the year, there is that health educator who is really shy, gets up and in the training is very uncomfortable with teaching. And by the end of the year you see them. . .  in the classroom injecting their personality like it’s something they’ve always done.”

Data sells the project, and the principals jump at the opportunity to acquire it. The late Roseann Sidener, formerly principal at Beach High, listened to Risa’s presentation for only two minutes before stating, “I want it.”  She said the kids are in desperate need.

Shawna Hutchinson, HIP faculty sponsor and ninth grade teacher at North Miami Beach High School agrees. Her testimonial on the HIP website states, “We have no health education in our high school and HIP is our answer to all the issues our students are facing.”

Teachers don’t mind giving up the core class time to HIP either.  Randy  Milliken, assistant principal at North Miami Beach High School, put it this way:  “If you don’t address these health issues now, those kids are not in class. We are actually increasing the amount of school time by educating students about these issues.”

When the HIP program began in 2009,  two schools participated in the program.  By 2012, there were twelve, including one private school, where HIP augments the school’s surviving health ed curriculum.  In 2013, there will be 24. With 600-800 ninth graders in each, nearly 16,000 freshmen and 600 peer educators will have the benefit of this extraordinary program in the fall.

On HIP Day, in April,  all peer educators from across the county meet at FIU to talk about the impact of the HIP program

From the left: RoberT Dollinger, MD, Assistant Dean for Student Affairs; Scarlett Aldana-Bosch, MBA , Assistant Director of Panther Communities; Risa Berrin;  Veronica Alvarez, MD Candidate 2015, HIP Practicum Project Co-Leader celebrating HIP day, April 4, 2013

Risa says that the program is ready to grow.  This coming fall they will test their ability to manage the program beyond the HIP’s own geographical backyard.  While Risa expects to place the program in every Miami-Dade High School, she also sees that the need is similar throughout the country, and the model can work in any high school. 

All it takes is money.  The administration of HIP, a 501 (c) (3) not for profit organization, is surprisingly lean: a professional staff of three plus two interns.  Office space is donated, and partnerships with FIU and UM add abundant in-kind support.  While participating private schools pay for the program, for public schools it is free.  And each new school adds $10,000 to HIP’s budget. This covers a stipend for the faculty sponsor, building out the website, securing curriculum and training materials, printing health campaign materials, obtaining t-shirts and collecting data.

Health Information Project, Inc.

4601 Ponce de Leon Blvd.
Suite 300
Coral Gables, Florida 33146
Phone: (786) 592-0311
Email: info@behip.org
www.behip.org

 

 

WINGS: The Transformation of Delinquent Girls

Maybe they’ve been beaten, molested, or witnessed severe violence.   Maybe they’ve suffered abandonment or neglect or seen parents go to prison.  One way or another, they are troubled girls, and they’ve gotten entangled with the law:  drugs, shop lifting, major theft, maybe assault or battery.  One-third have committed felonies. On average, they’ve been arrested eight times, convicted four.  Worse, they’re young – as young as 14 – and they’re all either pregnant or already mothers.    So now they’ve been sent to WINGS, the only Florida juvenile detention facility where girls 14-19 can stay with their babies.

The girls will stay here for an average 9-12 months.   They will go to school, learn life skills and have intensive counseling. They will keep their babies with them after they’re born, learn how to nurture and care for them, and in the process they will break the cycle of crime, violence and poverty they grew up in.  When they leave, they will be transformed.  Eighty-nine percent will leave delinquency behind them to become successful, responsible mothers and citizens.  

“Juvenile justice is starting to get that they’re in the business of treatment, not punishment,” says Karen Marcus, LMHC, CAP, Executive Director of WINGS.  “[The courts] recognize that the girls are not adults and that kids don’t just behave this way because they’re bad.”  

They are girls like Monica*, abandoned by her mother at age 5, then again by her grandmother at age 15.  Between the ages of 15 and 18, Monica lived in 20 different foster homes, ran away repeatedly, smoked a lot of weed to dull her pain, let her grades fall from A’s and B’s to D’s and F’s, and got arrested for burglary, grand theft and criminal mischief.

Like Monica, the girls often suffer from substance abuse, eating disorders, underlying mental illness, and gang affiliations.  They are inept at solving problems and have poor values.  Yet most are resilient and can blossom in a properly constructed environment.  Consequently, their detention focuses on understanding the trauma they experienced and providing the therapy and education they need to change.

The WINGS Campus

The WINGS facility, which looks like anything but a jail, occupies a sprawling landscaped campus in Homestead, FL, that can accommodate 20 girls and 12 babies.  The campus houses a fully licensed daycare center for  children up to age 2, school rooms, counseling and treatment rooms, and two dormitories – one for the girls while they’re pregnant and one for those who have already given birth.    They live two to a room, which they decorate themselves.

Two Girls and Their Babies Share a Room

A typical day at WINGS begins at 6:00 a.m., when the girls get up and dressed, do chores, get baby ready for the day and have breakfast.  They’re in school until 12:30 or 1:00.  After lunch, they go outside for recreation, followed by afternoon activities, which might include Healthy Start, trauma group, a field trip offsite.  By 5:00 they’re back in, showering and getting babies ready for the night. Dinner is at 6:00. Quiet time, maybe phone calls to family, follows.  They’re in bed at 9:00.

Rules are strict and demands restrictive.  Buildings are locked (though rooms within buildings are not), and supervising staff must know where the girls are and what they are doing at all times. The girls must ask permission before entering or exiting a room. Items that could be used as weapons – even everyday objects like pencils --  must be checked out and returned to a central location by a predetermined time.  In concert with the basic principles of behavior modification, everything the girls do is rewarded or punished: the way they speak, the way they relate to each other, the way they perform everyday activities.   There is a complex system of rank, each with a set of requirements that must be met in order to move up, and points, which are earned for meeting or exceeding expectation as they go about their tasks.  As the girls rise in rank and accumulate points, privileges mount. 

While demands are severe, support is consistent and unfaltering.  

“The staff never gave up on me,” said eighteen-year-old Jackie[*], one of two girls looking forward to release in January.  “They just kept reinforcing that I needed to change.  They said, ‘you can do good or you won’t.’ But they never left it alone. Having that kind of support and having all the resources – we had so many groups. It’s like they genuinely cared and they just showed us the right way, and it makes you want to change.”

One secret to WINGS success is this transformative combination of strict and demanding expectation together with unwavering, caring support.  The second is each girl’s personal prescription for growth and development. Every girl begins her stay at WINGS with an individualized plan she must complete before she is released. This plan covers medical care and health education, mental health counseling, academic education, and parenting education.

Beyond attending all medical appointments for herself and her baby, her medical plan might include, learning what to expect from her medical appointments and how to voice her concerns, developing the skill to advocate for herself and her baby with healthcare providers, actively participating in planning for her release by identifying the professionals she will see.

Each girl’s educational plan is based upon her academic level, which could be anywhere from 7^th grade to 12^th. Some have not been in school in years. Others require special education.   In general, the goal is to move everyone up one grade level, or, if they’re in high school, to obtain high school credits or a GED. Focus is on gaining competency in basic skills (English, math, science) as well as life skills (goal setting, life planning, budgeting, check writing), critical thinking and problem solving.

Depending on her history and diagnosis, each girl has specific therapy goals governing anger and other mood management, behavior management, control of anxiety and depression.  Placed in groups according to diagnosis, the girls work to process their history and address such issues as substance abuse or sexual trauma.  Each girl’s plan includes a family component incorporating, if appropriate, baby’s father. 

Group therapy takes place daily. Among other tasks, the girls write the story of their personal past, present and future.  In the process they explore how the trauma they experienced influenced the decisions they make now and the kinds of changes they want to make based on their new understanding. While group therapy takes place daily, individual and family therapy (and/or therapy with baby’s daddy) take place at least once a month, more often if needed.

Parenting education plans take on a more uniform shape. Healthy Start, through the University of Miami, provides a formal curriculum of prenatal care, childbirth and development, breast feeding, basic infant care, infant safety, and the like.  Equally, if not more, important is the role of the infant mental health specialist, who teaches the art of nurturing, which is difficult for all teenage mothers and especially so for this population.

Like most teens, the WINGS girls tend to be egocentric, impulsive, and lacking in sensitivity.  To compound these problems, most have had poor parental role models, little nurturing, and poor nutrition.  The infant mental health specialist helps the girls break this pattern.  While they are pregnant – when they are feeling frightened and vulnerable and are therefore receptive – she helps them see how their own childhood experiences harmed them and how changing the pattern will make life better for both them and their babies. They talk about the importance of eye contact and verbal communication with baby.  The girls learn about child development, appropriate expectation and constructive discipline. What does discipline mean?  Why don’t we hit our children? Why do we talk to our children?  What expectations are appropriate at different ages?

While they are pregnant, the girls must write three baby songs, and read and sing to baby.  Because research shows that teen moms tend to put their babies down and walk away, WINGS moms don’t wheel their babies in a stroller. They carry their babies in a sling or carrier to underscore the importance of holding baby and paying attention to her.  They develop patience by learning that crying is normal (not a reflection of their poor parenting) and how to interpret baby’s cries.   When the girls hold their babies and peer into their eyes, their attachment and communication are palpable.

Mama and baby

The transformation that takes place is best seen through the eyes of the girls completing the program.  Jackie spent eleven months at WINGS following an ugly period on the street and involvement with drugs.  She is sweet, poised and soft-spoken – a far cry from the girl who, by her own acknowledgment, arrived angry and combative.   Initially she resisted the help offered to her and had her time extended twice for bad behavior.  “I had the idea,” she said, “that this would be just like my two previous programs. That I could just do whatever I felt like it and go home, that I wouldn’t have to work on anything too deep, that I could get away with just talking about surface things.  I didn’t expect that I would actually change.”   But she ultimately gave in and focused on herself and her baby.

”I had a hard time with that,” she acknowledges.  “I wasn’t ready to think about everything in my past, but with nothing but time and a therapist who wasn’t going to let me clam up or talk about the weather, I ended up working on issues that, if I hadn’t realized I had, would have slowly led me to my grave.”

While at WINGS, Jackie completed her GED and has been accepted to a community college, where her four-month-old baby will receive free childcare. Jackie plans to become a paralegal and one day a lawyer.

Monica, now out of the program for 2 years, is mature and insightful about her past.  She has nearly completed her AA degree. Her two year old daughter is thriving, and Monica is in a healthy, committed relationship.

Graduation -- A Triuimphant Moment

WINGS,  a 501 (c) (3) not for profit organization, is an affiliate of the not-for-profit AMIKids, Inc., which specializes in rehabilitating troubled youth. WINGS operates with a staff of 31, including two teachers supplied by the Miami-Dade County Public Schools, a pediatrician and two nurses, a mental health staff of 7 (4 full-time), childcare center staff, and direct care staff, who supervise and coach the girls day and night.

Budget is just under $1 million, most of which goes to staff salaries.  Overhead consumes 15-20%.   Under contract with the Florida Department of Juvenile Justice, WINGS receives most of its funding from the State and the Miami-Dade County Public Schools. Because the babies are not in State custody, this funding does not cover the babies’ costs.  The childcare center receives some funding from the Teenage Parent Program (TAPP), which provides childcare financial assistance to students enrolled in Miami-Dade County Public Schools. But, says director Marcus, “There’s no way you could run your childcare on this allocation.”  To supplement government funds, WINGS relies on private foundation grants and tax-deductible donations. One hundred percent of these funds go directly to supporting program.

AMIKids WINGS South Florida

11000 SW 220 St
Miami, Florida 33170
Office: 305-256-6275
Fax: 305-256-6278
www.wingssfl.org

 

 

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[*] Not her real name

MUJER: A Refuge from Abuse in Rural South Florida

For Susan Rubio Rivera, who grew up in rural South Miami-Dade County, founded MUJER and has served as  executive director since its inception, sexual abuse and domestic violence are personal. From the age of five, she watched as her alcoholic father brutally beat her mother.  Week after week the ritual persisted until Susan’s mother, beaten bloody and wearing only her underwear, took Susan and her sisters and fled to her parents’ home. There, her grandfather ruled with an iron fist and a strong sense of entitlement.   Susan and her sisters became his servants by day and his victims by night as he molested them one by one.

Years later, having formed a support group of Hispanic women from diverse backgrounds, Susan discovered that although the members represented a variety of cultures (Mexican, Mexican American, Cuban, Ecuadorian Costa Rican, and more), many shared one common ordeal: abuse.  Yet the nearest services for victims were 30 miles away, in Miami.  In that support group Susan’s dream of rescuing women from brutality and helping them build a safe, secure life was born.  Since 1997, MUJER – Women United in Justice Education and Reform – has been a haven from domestic violence and sexual abuse for the Hispanic women and children of South Dade.

In this impoverished community of laborers from Mexico and other Latin American countries, fifty-six percent earn less than $3,000 a year, and many have no more than a fifth grade education.  Abuse -- physical and sexual  -- is rampant. Yet the pervasive culture dictates acceptance, silence and a blind eye.

“Our culture said if you’re married you have to stay in this relationship,“ said Susan, whose father and grandfather were farm workers. According to cultural dictates, a woman could live with her parents or her husband, but never on her own. If she married an abusive man, too bad.  

Moreover, she added, “Whatever happened at home stayed at home. Society accepted, Nobody was going to interfere even if they knew. Even if [a woman] had been screaming and yelling, nobody would have interfered because it wasn’t OK to interfere.”

With MUJER, Susan set out to establish a new norm, and with a $20,000 grant from the Governor’s office on domestic violence, MUJER began to educate the community.  They went into the middle and high schools and talked about healthy relationships and dating violence.  They reached out to the adults as well.  They developed a series for couples on building  successful relationships,  communication, sexuality and intimacy – subjects that were unheard of in these communities. For parents, discussion focused on the laws governing physical and sexual abuse  and how to discipline children effectively without beating them.   

To entice attendance, they held the sessions close to where the participants lived – in backyards, community centers and church parking lots.  They provided childcare, served dinner, and offered a $100 stipend to anyone who attended all 10 classes.  At the end, they celebrated completion with a ceremony and certificates.  For some who attended, this was the first certificate of any kind they had ever received, and it was a very big deal.  Both courses drew 90% attendance, and they were transformative.

Toward the end of the couples’ classes, one of the participants called to say she and her husband were celebrating their anniversary and asked for help making a certificate for him.  Meantime, her husband bought flowers to present to his wife in class.  Susan reported that this macho Mexican man stood before the class and told his wife, “There are only 11 roses in this bouquet because you are the 12^th rose.”

With additional grant money, MUJER expanded their program to offer victim advocacy and individual counseling.  Within half a dozen years, MUJER had developed a family violence prevention network – 10 core organizations which work together to provide comprehensive services including law enforcement,  daycare,  after school programs, emergency assistance, housing and more.  More than a loose affiliation of community organizations, this is a formal working collaborative that meets regularly and partners on grants.  In addition, MUJER works with at least 25 other organizations on an unofficial collaboration. For example, the South Dade Skill Center, an arm of the Miami-Dade County School Board, provides academic and vocational training. WeCare offers assistance paying utility bills. Carrfour Supportive Housing provides emergency shelter   

Today, MUJER’s clinical department offers individual and group counseling.  A team coordinator together with the client identifies all the services the client and her children need. The coordinator then connects the family to appropriate resources and meets regularly with the team to discuss progress and needs.  Needs vary among families and might include a church pastor, school counselor, or other agency.  For example, Legal Aid can help a survivor of domestic violence secure a restraining order and can provide the legal services associated with divorce, child custody and property rights.  If the client is a  battered immigrant, she is  referred to VIDA for help getting permanent residency for herself and her children.  A victim’s advocate helps the client understand her rights, supports her as she traverses the judicial system, helps to keep her safe from her perpetuator and meets a variety of other needs.   Physical and spiritual wellness rounds out the program. 

Ana Obregon, herself a product of the migrant worker community and a survivor of domestic violence, currently works as MUJER’s care coordinator and director of community education.  While she praises the comprehensive care MUJER provides its clients, she says its most valuable services are the self esteem and sense of empowerment it brings to its clients.  These qualities emerge, she says, during the process of listening to the women, accepting them for who they are without judging them, validating their experience, and offering them encouragement and support as they work through their issues.  Self-worth is further reinforced when they see that their advocate is available to them around the clock, taking them to court and answering their calls at any hour of the day or night.

“We don’t just take a victim and try to help them by taking them by the hand. We show them. We empower them,” she said.

Susan illustrates this empowerment with the story of a mother whose son was molesting his sister. Susan told the mother that the law required reporting the behavior to the police and offered the mother the opportunity to make the call.  If the mother made the call herself, it would be better for the children.  If Susan made the call, the boy would be arrested and the girl would be taken into foster care.   Difficult though it was, the mother took Susan’s advice. Although the son was picked up by the police, he was placed in a special program where he received treatment. The daughter also received therapy and was permitted to remain at home with her mom.

Empowerment is further enhanced when the clients are encouraged to give back to the community. Several, for example, worked with Catalyst Miami on a Penny Wise campaign to preserve vital community services. They addressed the County Commission, told their stories, and explained why MUJER deserved continued funding.

In the 15 years that MUJER has been operating, the people of South Dade have grown less accepting of abuse.  In 2011, MUJER embraced 908 new clients.  While the organization does get referrals from other agencies, 68% walked in on their own.

MUJER’s  full-time staff  includes six direct service providers, two victims’ advocates and one intern. In addition, four therapists work 30 hours a week on contract.  Clients receive services for free. 

Annual budget is about $800,000, but the collaborative relationships described above effectively stretch those dollars three fold. Funding comes principally from grants.  In addition, Legal Aid and VIDA rent space in MUJER’s Naranja offices, providing some income to MUJER and one-stop shopping for clients.  Still other income comes from providing domestic violence workshops to the Children’s Home Society and therapy to TRICARE, which provides healthcare services to the military.  Additional revenue raising initiatives are planned for the future.

MUJER

27112 S. Dixie Highway
Naranja, FL  33032.
P.O. Box 900685
Homestead, Florida
305-247-1388
www.mujerfla.org