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Kendra Outler, MD, MPH

Founder, Uzima Health & Wellness

THERE ARE NO CHILDREN HERE

October 2020

Relisha Rudd went missing in March 1, 2014 from a D.C. homeless shelter. When I saw her face across the screen, the loss of innocence and a lost childhood was staring back at me. The report says that she also went by the name Lil’ mama. I saved the article and followed the news about her and her D.C native family. Examining the pieces of her short life, it was a clear case of child exploitation. Her fate in life is sealed by societal factors beyond her control. Sunday, March 1, 2020, the Baltimore times ran a brief story reminding people about her disappearance; By March 20, 2020, Washington, D.C went on a mandatory “stay at home” order due to the coronavirus pandemic. Solving the disappearance of Relisha and the robbing of childhoods will have to wait.

 

Solving the disappearance of Relisha and the robbing of childhoods will have to wait.

Examining this short tragic life is worth the time because we are reminded that children are born into circumstances beyond their control. In February 2020, Los Angeles County Schools superintendent, Mr. Austin Beutner, said there were more than thirty thousand homeless kids. CBS News interviewed a family with two children who lived in a motel for over two years. The parents were working-class but had experienced joblessness and now homelessness. Like Relisha their faces and mannerism reflected a loss of childhood as they explained why they lived in a hotel. “We have no money” is what the little girl said. I think she is eight years old. Relisha was eight when she was escorted into a hotel never to be seen again. A homeless expert in the documentary explained that for children the process of living in hotels and being exposed to violence and criminal activity around them is abusive. Even if the parents did not intend for this to happen the structural abuse is real. Structural violence creates the house for the abuse. A homeless expert in the documentary explained that for children the process of living in hotels and being exposed to violence and criminal activity around them is abusive. Even if the parents did not intend for this to happen the structural abuse is real. Structural violence creates the house for the abuse.

The failure of the news reports as we talk about Covid-19 and children is the obvious omission of the societal ills that exist for some families. Reducing the debate about whether our schools are safe from a virus does not allow for a wider conversation about the value of the schoolhouse nor education. People like Relisha’s mom and homeless families in Los Angeles are victims of structural abuse. Structural abuse is the process by which an individual is dealt with unfairly by a system of harm in ways that the person cannot protect themselves against, they cannot seek justice for, cannot reverse nor change. The children are the subject of the abuse. The parents after limited educational opportunities, limited income, gentrification, loss of jobs are victims of structural violence; the actions committed by larger society, i.e. racism, classism.

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The children are the subject of the abuse. The parents after limited educational opportunities, limited income, gentrification, loss of jobs are victims of structural violence; the actions committed by a larger society, i.e. racism, classism.

New York City according to a New York Times report in November 19, 2020 stated that there are 114 thousand homeless children. The article shared a familiar running theme: a tale of children with stolen childhoods being dragged around the city that never sleeps trying to get an education by single Moms; Moms who are trying to survive against all odds. The article noted that the number of homeless students increased by seventy percent over the past ten years. Four months later, after this we would see Governor Cuomo with eyes fixed front, hair coiffed, cameras flashing, equipped with chart and numbers, get out front and discuss the public health crisis of New York due to Covid 19. The New York hospitals are being overrun; people are dying. He was on a mission to flatten the curve, he was New York’s hero. The homeless problem did not go away with the onset of the first wave of the virus. New York City, like much of the nation, closed the schools and sent the kids home. Home to where? Imagine, if Governor Cuomo stomped on the daily news about the problem of homeless youth before the virus infiltrated the poorest areas of New York. These children in the shadows are even more vulnerable due to the loss of school, economy and the overburdened healthcare system. Without school they are cut off from social services, behavioral health services and help with common medical conditions like asthma not to mention homework. Additionally, children with special needs and learning disabilities are cut off from school-based rehabilitation services.

As the nation responds to Covid-19, “There are no children here” seems to be the overriding principle at work. However, I have to ask the question. What about the children? Will there be an outcry for them? Because the next public health crisis is looming. It is the premature deaths (physically, mentally, and emotionally) of a generation of children affected by our handling of the Covid 19 pandemic. When a child dies right now due to a lack of medication, delay in health care or abuse there is no ticker counting the death and its juxtaposition to the coronavirus. It is a preventable death; it matters if we want to make sound health care policy.

The first black surgeon general, Jocelyn Elders said, “You can’t educate a child who isn’t healthy, and you can’t keep a child healthy who isn’t educated. Dr. Jocelyn Elders is an American pediatrician. She was the first board-certified pediatric endocrinologist in the state of Arkansas before President Clinton appointed her to lead the public health system for the nation. The American Academy of Pediatrics has issued the following statement: the AAP strongly advocates that all policy considerations for the coming school year should start with the goal of having students physically present in school.

American Academy of Pediatrics has issued the following statement: the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.

The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020. Lengthy-time away from school and associated interruption of supportive services often result in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality.

Wherever you fall on this debate, the future of a nation is always in the preparation of its youth. With the stroke of a pen we were able to move ships off the coast of New York and Los Angeles. We call the ships The Comfort. We have created outdoor restaurants because fine dining is quintessential to a civilized nation. The gyms are open and outdoor yoga is en vogue. However, as the school year emergences our nation debates the question of whether to leave our schools empty. Our pediatricians have spoken, and our teachers are waiting.

D.C General Hospital

The hospital conceived in 1806 to be dedicated to the care of the poor of the city was called by many D.C General. From its beginning it was fraught with controversy and rejection. After a bitter objection by the nation’s elite, it was finally settled on the banks of the Anacostia River in 1840 where it was called Gallinger Municipal Hospital. Throughout its existence it was described as the “city’s poorhouse.”

After its controversial closure in 2001 by Mayor Anthony Williams, D.C. General became a homeless shelter providing refuge for D.C.’s transient families. Relisha’s Mom, a third-generation D.C. local ended up there. In 2014, Relisha Rudd’s disappeared with a janitor who worked there who ultimately killed himself and his wife. Relisha is still unaccounted for. This was bad press for the Mayor, the city and the final link in the chain for this facility.

In 2018, Mayor Muriel Browser made good on her promise to Washingtonians looking for a new D.C. The following was her announcement on closing day:

“We embarked four years ago on closing D.C. General,” said Bowser. “We all believed it was too big, too rundown, too isolated to serve families who need emergency shelter. We have worked over the course of the last four years to create short term family housing in all eight wards of the city.”

“The last family has moved out of the facility,” she said. “It’s no longer being used as a family homeless shelter.”

…There are no children here.

 

 

 

 

 

 

 

 

 

Dr Outler, thank you for reminding us that the impact of school closures reverberates beyond academic instruction.

It is paramount that we prioritize and compensate for the essential social, behavioral health and developmental services schools provide to our children and their families in the midst of proposed digital instruction.

 

Tahira G. Adelekan, MD, FAAP
Developmental-Behavioral Pediatrician
Dayton Children’s Hospital

 

Assistant Professor of Pediatrics
WSU Boonshoft School of Medicine

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