Monday, February 28, 2011

Beyond The Story, Part Three: The Challenge Before Us: Why is our area the one of greatest health need and the fewest resources?

Read the posts below for the first two posts of this three post essay, from my lecture last fall at OU Norman, that goes deeper into our experience, history, and current actions here...

3. The Challenge of Collaboration and Hope: or, Why Is Our Area The Place of Greatest Health Needs, lowest life expectancy, and the fewest resources located within it?
Collaborations, especially when people into voluntary association with one another, are based on covenant, or promises, and not on contracts, which are set quid pro quo type agreements that guide much of the rest of our lives, such as jobs and sometimes where we live. To paraphrase another theologian, Martin Buber of the Jewish tradition, we are the promise making, promise breaking, promise renewing people. This means what we do isn’t easy, especially now. The kinds of collaborations that happened in the days of homogeneity and stability in the Turley area, the days of growth, those that some of us are tempted to recall with nostalgia, occurred under the best of social circumstances and with a culture that reinforced them. What we do now and attempt now together in this world of social fragmentation has echoes only in the faroff days of the early Builders generation, the frontier, when the community was first forming; but in fact, it is much harder even than that in many ways because there is not an empty canvas and because we must wrestle with the legacies, especially ethnically, of all that has happened since then, and without the kinds of commonalities that shaped the founders and their world, a world before television, when the most common communication mode for our community was only face to face, for all intents and purposes, since there was no local newspaper or mass media, it leaned heavily toward being an oral culture. And in oral cultures, where individuals are dependent upon one another for knowledge, collaboration is a necessity for survival. Contrast that, these 100 years later, with our electronic web culture, with virtually everyone having their own mass media carrying around with them, and you see why collaboration is itself so against the grain of postmodern life.

And yet, as mentioned, in the world of social fragmentation such as in our zipcodes, collaborating with others is also a necessity if another kind of world is going to be possible. The redeeming aspect, the gift we have been given, is that in such a world of abandonment and isolation, a little collaboration goes a very long way. Our initiative with A Third Place is a testament to that. When just a few people collaborate to plant a small wildflower bed along the bike path where strangers to our area ride through our area without riding just a block or two off the path into our area because we have no sidewalks, then such a small act of welcoming, or reminding the stranger that there is a community of people here, such a very small act really stands out in ways that would be lost if the same thing were done in other areas. So it is when just a few become the defacto city waste management and go pick up the littered furniture along the streets where they have been illegally dumped, when they are seen picking up trash along the street because it is their street and not because they have community service hours. Or when we throw free communities parties, offer free community meals, collect food from those who others think can only be given it, plant gardens at schools, organize public forums, keep an open place where people can come with their questions or offerings of help. Small acts of justice, of random kindness and beauty, done with great love, and hope, and faithfulness, done with one or two or more people, all of these change the world. At a time when so many people feel they have so little to give back, where they choose to give of themselves can make a big difference, and places such as ours are ripe for their investments.

Just know there will be setbacks and reactions to every transformation; and every collaboration carries with it the possibility, probability, of being hurt so that the doorway to cynicism and retreat back into the status quo of the fragmented world is always open and beckoning. Our challenge is to respond by living more fully in the “as if” world where each setback allows us to see the horizon clearer and more partners possible.

So, just as we are getting close to owning that new house of hope, the old abandoned church building, as a site of transformation itself, after all these years it was hit with extensive vandalism. It was a gut punch, but we’d been there before and it dawns on us that we now will need to rely on many others than we thought we would at first, just to do clean up and get the building back into the rundown shape it was in. We know the collaborators are there though. We set our sights higher. Just as when we were beginning to transform an empty vacant lot into a native plant nature trails area. This site is situated strategically by our gardenkitchenpark site, and in a bridge location between groups within our area, alongside where people walk quite a distance to school and stores. Just when we were about to unveil it, a new person mowing grassy areas nearby mowed it all down; but we know being native plants they will return in beauty, and this time we know we will be better prepared with better collaboration, and signs ahead of time, so it will be a new, easily maintained, site of beauty where before people would have only seen what was there as weeds, and waste. What a metaphor for our whole area. Just as when we decided to surprise our community on Easter Sunday morning with a row of flowers along Peoria Ave. in big pots, so that in the morning they would drive by and see these gifts of hope, but during the night, someone went along and dumped the flowers and dirt on the ground and took the pots, and so the residents were greeted with little piles of discarded dirt and trampled flowers; we learned from that we have a deep culture of kicking things to the curb in our area so people just think automatically they are there for the taking, and not for the giving (at least in our better days we give them such a benefit of the doubt); besides nothing like that, nothing like us, had ever happened in the area before. Out of that, came the Let Turley Bloom initiative where we would create such areas more securely by planting in the ground itself rather than in pots. And of course there are many more even smaller ways that changing the culture takes perseverance.

Our latest setback from collaboration itself, which we are using to help us to see wider and collaborate even more, comes from the presumed pending closure of our community health clinic which OU has operated with us as one of our first joint ventures. This past summer all of the similar clinics on the northside were closed; ours was the only one left open but our contract was redone for just one more year. We had gradually been reduced from up to three days a week at one point down to just one morning a week. Funders hit by the recession…Difficulties in getting people who aren’t used to preventive care as part of something one does or can do to take advantage of the clinic…turnover of staff…mutual lack of communication about needs…perhaps a concern about a duplication of services of primary care with other institutions? Only in areas of scarcity does it seem duplication of services is an issue; not in places of more wealth and insurance. For Still you come back to the facts on the ground that we have the lowest life expectancy; our residents, because they have been without health care, were sicker and so in more need of referrals and that costs more, and they did not have health insurance as they were unemployed. So there are higher costs and little income to care for them. Of course they are going to keep going to the emergency rooms for their urgent care and being admitted there and so the costs for someone is going to be even higher.

Our response could be, drawing from the history of institutions and our area, see, we shouldn’t have trusted in the first place; we are now losing something again, and literally nurse our wounds and grow our grudges. Instead, we choose the collaborative response and say how can we turn this weakness into a strength?

First, I am not 100 percent given up on the idea that some form of direct care providing can’t continue, given that other clinics in the other parts of Tulsa where there are more people and more insurance streams are still operating full days (maybe a bit of resource shifting is possible, in order to see and show that the patient you are caring for in community health is not just an individual, but is the community itself); and there are some developments through other institutions nearby which might over time open up some traditional care opportunities in our zipcode; we are hopeful….But beyond all this our attention is being drawn to how we can take a loss and make it a tremendous gain, how we can actually help form a new response to health care that will get to the root causes of what lands people even in primary care clinics in the first place; a new network of lay health leaders who live in the neighborhoods of need themselves, who can connect their communities with institutions of health, being two-way teachers, to providers about neighborhoods, and to residents about health literacy, self-care and monitoring, and when they do get to see doctors and providers how to be better patients and get the most out of those encounters. For we know that just getting persons and physicians together doesn’t magically make health happen. We are working on grants, and looking at somewhat similar models elsewhere, and hope that our area, even at a time of losing a modern-era medical clinic, can create a gift not only for our area but for others of a way of growing healthy lives and neighborhoods that is both post-modern, truly communal, and draws on the wisdom of the frontier…

.This vision had its roots in a collaborative brainstorming Sunday afternoon at A Third Place Center with various members of the OU community when we were looking at being a site for a competition known as the X Prize for Revolutionizing Health Care; we said then that if we didn’t win the prize, or as the case turned out, weren’t even eligible for it, that the ideas were too wonderful, too “disruptively innovative” that they would have a life beyond…And so they are again with these plans…And we know again that if the grants don’t come, that they will continue to find a way in our new place to become seeds of what can be created out of the heart of hope, the heart of collaboration, for the heart of the real issues that have kept us apart, kept us struggling, kept us sick.

I close with the full quote from theologian of hope Moltmann, who witnessed the destruction of whole communities in firebombing and other acts of horror throughout Europe during World War Two. He writes: “The ideology of “there is never enough for everyone” makes people lonely. It isolates them and robs them of relationships. The opposite of poverty isn’t property. The opposite of both poverty and property is community. For in community we become rich: rich in friends, in neighbours, in colleagues, in comrades, in brothers and sisters. Together, as a community, we can help ourselves in most of our difficulties. For after all, there are enough people and enough ideas, capabilities and energies to be had. They are only lying fallow, or are stunted and suppressed. So let us discover our wealth; let us discover our solidarity; let us build up communities; let us take our lives into our own hands and at long last out of the hands of the people who want to dominate and exploit us. (Jurgen Moltmann, The Source of Life: The Holy Spirit and The Theology of Life, Fortress Press: Minneapolis, 1997; English translation, SCM Press, Ltd: London, p. 109-110.

Our hands, from many places, many colors, that do many kinds of work; Our hope, Our health, Our Community.

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