Heading to Angeline's

One of the reasons many women cited choosing Tent City 3 over a shelter revolved around having a space for her belongings, a sense of privacy, and while not quite a Virginia Woolf-ian Room of One’s Own, a place to belong throughout the day and night without being kicked out. As a result, shelters were often unappealing specifically because many do not offer privacy or a space to stay during the daytime. Rather, they are most often a sleeping-only safe space, asking the homeless to rise at 6 or 7 in the morning, head off for the day with their belongings, and then return at 7 or 8 at night to line up for a bed for the night. As a result, many are left without daytime spaces.

Angeline's, located in downtown Seattle in a recently renovated building.

There are, however, spaces to serve those intermediary needs. One is Angeline's.

My next round of interviews will be with women who reside or use the day facilities at Angeline’s, a YWCA-run center for homeless women. Here’s a terrific article explaining some of Angeline’s work and the relentless cyclical shuffling one living in poverty encounters on a daily basis. It's old (2002) but I think captures many of the sentiments I heard expressed by TC3 women.

I’ll be curious, more specifically, to learn about how access to health care differs for these women compared to TC3 residents. Angeline’s has public health nurses, health care professionals and resources regularly available.I'm headed there tomorrow for a tour and then will hopefully begin round 2 of interviews shortly thereafter.

Dropping off some resources

I strolled over to TC3 yesterday to drop off the completed Health Care Resource guides. Hopefully, they'll be a somewhat helpful tool for the residents. Here's the finished products if you're curious:

Photo Credit: Kate Reeder

I created both regular sized comprehensive guides and then wallet-sized
resource cards, which were modeled after a similar sized card the
city created to provide a resource of numerous services. The city cards, however,
only included two health care resources for general/primary care so hopefully,
these can fill a few of the needs expressed by residents.

Stigmatized or Less Urgent: Where Do STDs fall?

I'm in the process of gaining approval for the next step in my interviews, in which I'll be interviewing women who live in a shelter to see how resources and referrals compare to those provided to or identified by TC3 residents. I'm interested, in particular, to find out if there is a difference regarding what needs are expressed as unfulfilled. Women at TC3, when asked "How do you think female residents hear about health care services?" most often shared that it was simply through word of mouth. Many female residents share information with others, several longtime residents are considered the camp sages and several women stick entirely to themselves, leaving sans 'health care gossip.'

If, though, word of mouth is the means for awareness raising and resource referring, and no one has an idea about where to get a free pap smear or mammogram, then the chain of communication hits a road block. It would be incredibly interesting to see if a shelter- one which is also receiving funding from the city- has that same communication method and consequential breakdown as well. Or, perhaps, a shelter has a case worker onsite or management employees who keep resource handouts stocked and up-to-date. It should be pretty interesting to find out.

But what I really wanted to write this post about is sexually transmitted infections. No, not about challenges finding free testing and treatment- they're there, you just have to dig a bit. What I really want to talk about is a continuation of a conversation I had with my friend Lauren who works with a policy organization that specifically advocates for homeless people with HIV/AIDS and HIV/AIDS people who become homeless. The question: Are sexually transmitted infections still of such a stigmatized nature that we cannot or do not talk about them in the same way as other diseases, illnesses or health-related needs?

The gut reaction might likely me an resolute 'yes.' No one seems too willing to publicly share their recent bout of herpes or gonorrhea. But then, I had thought that menopause, yeast infections, abortion and mental illness often faced similar stigmas in our society as well. Commercials never actually call a yeast infection by its name, women are shamed for choosing to terminate a pregnancy, we speak of menopause in hushed tones, and mental illness is still looked upon with grave negativity in many circles.

What struck me throughout the interviews with TC3 women is that these otherwise stigmatized actions/changes/illnesses/infections were mentioned repeatedly, openly, honestly, and without any shame (not that there should be any shame attached to any of them). There were a few euphemistic references to having some changes "going on down there," but it was mentioned as part of a litany of health related needs and concerns. They were mentioned without being specifically asked but rather with a probing, "Are your reproductive health care needs met?" or "Are your mental health care needs met?" I never asked any interviewee specifically if she had chosen to have an abortion, if she had any particular mental health needs, if she was undergoing menopause but these bodily changes and challenges were all mentioned and discussed repeatedly.

Just one of the numerous pro-protection advertisments from the past
that places blame squarely on the woman. I'm actually headed to a movie
showing tonight showcasing old sex-ed videos.
 I'll be eager to share, I'm sure.

However, not a single interviewee mentioned any sexually transmitted infection in her listing of current or recent health needs or challenges. I can offer a few hypotheses for why this might be the case, per recent conversations with friends in the reproductive health world: 1) None of the women have an STI/STD; 2) STI/STDs are so common that they don't seem worth mentioning, placing them at the level of a common cold (which was in fact mentioned several times); 3) There are more pressing health care needs that put an STI/STD at the bottom of the list; or 4) STI/STDs still retain such a stigma and are linked with such blame and fault that they just aren't mentioned. (In fact, a quick google search returned the Facebook group, I can proudly say I've never had an STD).

There could surely be additional reasons, or thoughts about why one woman didn't share something compared to another. And my data set isn't nearly large enough to run any kind of quantitative, causal analysis but it's surely something to think about. And in a positive light, to be glad that those health care changes or challenges that were mentioned aren't facing a stigma that keeps someone from talking about them to a grad school interviewer without any medical training.

A study to be cited for years to come...

And yet another timely article in the Times, reporting on a study that finds when low-income have access to health insurance, they have better health. Indeed, it does seem obvious, and certainly echoed in the thoughts of the women at TC3. However, what's different about this particular study is its random selection of those on and off Medicaid, significantly minimzing other variables.

Here's just a tiny excerpt:

Women with insurance were 60 percent more likely to have mammograms, and those with insurance were 20 percent more likely to have their cholesterol checked. They were 70 percent more likely to have a particular clinic or office for medical care and 55 percent more likely to have a doctor whom they usually saw.

Vancouver

It seemed like I would be remiss to be in Seattle and not visit Vancouver, the city people glow about. So, last weekend, we took the Cascades Amtrak up to Vancouver. Here's a few photos from the 48 hours spent exploring:

Yup, Vancouver had a one-room Jimi Hendrix shrine. It was well worth the five minutes we spent inside.

This is me making John lift up the house on stilts.

We strolled through Chinatown and found the usual assortment of bins full of spices, fish, and mushrooms. However, I've never before seen a bin full of lizard skins on sticks. They were not expensive either.

Vancouver likes to knit things for their bike racks. I think we should probably do something similar for the ones at school- it gets cold in Cambridge in the winter.

There were fantastic sculptures all around, many added to the city for the 2010 Olympics.  I especially liked this one- there was a circle of red squatting men, all identical to this one. The artist is Wang Shugang.

Stanley Park has a collection of beautiful totem poles that were created in the late 1980s.

And what trip to Vancouver would be complete without people watching- there were tour buses full of high schoolers decked out for the prom. The dresses were definitely a bit more elaborate than what I'm accustomed to.

Just part of Vancouver's beautiful skyline.

Ok, this is Rory. We hung out with him on Whidbey Island a few weekends ago but I thought he deserved to be included in a blog photo posting.

A Success!

Just a quickie but today was a good one. I think I've finally finding some services to share with people over at TC3!

I have now located free vision care (eye exams and glasses), free dental care, including dentures, and free prenatal care. It may have taken calling at least 20 different so-called 'low-income dental clinics' but free dentures exists. The resource manual is coming along quite nicely and I should be able to bring it over to TC3 within the next week.

More coming soon detailing the next step of the project!

18 Interviews Down

Hi Blog Readers,
This is an entry of disparate thoughts:

1. First of all, many thanks to everyone who's shared their encouragement and interest in my project. Your praise for the blog and support for the challenges that this summer's work proposes has been enormously appreciated. And if you have ideas, thoughts, etc. please don't hesitate to leave me a comment note.

2. I've now completed 18 interviews with women at TC3. Each story has been so very different and yet, the frustrations with the limits and failures of health care provisions continue to resonate. In addition to the often-mentioned vision and dental care barriers, mental health care needs continue to arise. Not only is there limited access for diagnoses and support but the costs of filling prescriptions often seem to feel insurmountable. I'm going to move into the next stage of the project shortly so stay tuned for details!

3.  For each of these 18 interviews, I've sat at the Tully's coffee shop directly across the street. The staff have been fantastic and most patrons seem to have no idea what's going on- it's just me scribbling furiously to catch every word the woman sitting across from me says. However, earlier this week, there was an older man sitting, drinking his coffee and working on a crossword puzzle, who kept giving me the dirtiest looks. I don't know what it was about- I was sitting with a woman who looked more 'homeless' than some of the others I've interviewed. I do believe the majority of these women would 'pass' and those of us with sustainable incomes would never guess them to be tent city residents. I just smiled back at him, despite his continued glares. Eventually he got up and left, not without shooting me one last glare. I hope my interviewee didn't notice.

Today, though, after completing one particular interview, the interviewee and I chatted a bit about what it's like for her to live in a tent city. She had already shared how she believes her interactions with medical care providers to be different because of her housing and lack of insurance coverage. She then stated that when she had stayed at a Tent City 4 location previously, she had been part of a panel of residents who spoke with community members at a new tent city location. She stated that a woman in the audience of this panel stood up and asked the tent city residents if they would be using the park a few blocks away. One panelist responded, "Well, yes, it's a public park and people in the tent city do like parks."

The audience member then probed further and said, "Well, what are we supposed to do with our children?" My interviewee shared that she had been holding the mic at this point, and had no idea what to say, so she responded, "I'm not really sure what you mean."

The woman, rather than catching onto the idea that her question might have been offensive, just repeated it verbatim. "What are we supposed to do with our children?"

Dumbfounded that someone would speak with such presumption and prejudice, the panelists were all silent. Finally, one non-tent city resident who was also speaking on the panel, vouching for the community's credibility, shared, "Well, some tent city residents have children and have raised children so I assume they'd be happy to meet your kids."

The woman I was interviewing shared this story with grace and with sadness. But not with any hint of anger or frustration or anger. In fact, she admitted that before she ended up in a tent city, she had dismissed homeless people, and probably would have shared some concerns similar to this particular accuser.