Volume 4, Issue 1 - Spring 2012
Ruth Margalit, MD
University of Nebraska Medical Center, Omaha, Nebraska, United States
Siena/Francis House, Omaha, Nebraska, United States
Erin Reets, a resident of the Siena/Francis House (SFH) homeless shelter, came in to discuss a medical problem with a doctor at the shelter clinic. Having addressed the medical problem, the doctor sat down and asked Erin to tell his story: How long had he been at the shelter? What was life like before the shelter? As Erin1 recalled, the experience was one of the few times his story was genuinely heard: “This experience of sharing my story—and the recognition that I had a remarkable one to tell—drove me to think through the transformations in my life,” he says. As a result of the experience, Erin and the doctor wondered, “How can we do more of this? How can we allow others at the shelter to share their stories as a way to similarly transform their lives?”
From this encounter at the small shelter medical clinic, the Finding a Voice project was born. Developed in 2008 as a partnership between the SFH and College of Public Health (COPH) Inter-professional Service Learning Academy (IPSLA) at the University of Nebraska Medical Center (UNMC), Finding a Voice (FAV) is a service-learning program that brings homeless guests and health professions students together for mutual learning. Its mission is to celebrate dignity, promote wellness, and create a safe community where all participants can find a voice through creative expression, interaction, and self-reflection. This project strives to enhance awareness about homelessness among health professions students (including medical, nursing, pharmacy, public health, and social work) and the broader Omaha community.
The program is one of several service-learning projects in which over 440 health professions students participate. A Student Leadership Forum was established within the IPSLA to assist students in running their projects, increasing coordination, facilitating funding efforts, and helping students develop leadership skills and share their creativity. With a mission for social justice that extends beyond attending to the physical needs of the poor, the SFH homeless shelter, one of the largest in the country, was a natural partner for the IPSLA, providing a forum for practical professional experience as well as personal development of involved students.
Illness is grounded in the context of life—an individual’s living conditions, experiences, resources, and relationships construct one’s identity, influence one’s interaction with the community, and shapes the perception of one’s future. At the SFH, one of the few shelters in the country where residents are not obligated to be in treatment, we created a community—a space for guests and students to engage and share authentic stories as equals.
The program is based on principles of respect, openness, equity, generosity, community engagement, and collaboration, where shelter guests, former guests, the SFH leadership, and the IPSLA share project “ownership.” The program provides students and shelter guests with reciprocal benefits: students develop professional skills by working to address needs identified by the participants—helping them in the process of overcoming addiction and finding a place in society. The relationships created deepen student awareness of the complexity and challenges of homelessness, helping students to develop a commitment to social justice. More importantly, the program’s emphasis on the value of each individual creates a supportive environment where participants can take positive action.
An important element of the project involves a professional storyteller, who prepares students to engage the community, develop a reflective practice, and learn new communication skills. The storyteller also prepares shelter guests to work with students in the context of service learning. As the program progresses, the students and guests gather once a week in the shelter to participate in a two-hour creative writing workshop. Through creative expression, storytelling, and dynamic interactions, students learn about homelessness and the impact it has on individuals, their families, and friends. They find correlation to their own lives and develop a deeper understanding of self and society. Each quarter culminates with a paired dialogue guided by an interview script. As a vehicle to enhance the conversation, participants share the stories attached to photos they took the previous week to depict their world.
The interview excerpts were recorded, transcribed, and analyzed by graduate level students in the school of communication (fall, 2010). Three major themes surfaced: 1) desire to change, 2) gaining self-worth, and 3) gaining community. Some of these themes were depicted in art. Below, Christopher Leet provides a more intimate view of the experience in his own words, incorporating excerpts of the interviews with other FAV participants:
Desire to change. Change is part of the recovery program, because you have to completely redirect your thinking and behaviors in order to have a chance at staying clean and sober. For me, change came with help from two particular guests who I was living with at SFH: Bobby2 and Jerry.
When I first arrived at the shelter, I met Bobby, a heroin addict who just began his sobriety one month before our encounter. After hearing his life story and the struggles he had been through, I was thoroughly convinced that if Bobby could change, I could change, too. Bobby advised me, “You know, sometimes you just gotta die with, just let the old you die, you understand me. And live with new ideas. You know what I’m sayin’?”
Reaching Out interprets the life of “Bobby,” a SFH homeless guest, and his desire to change his life and stay sober. The painting progresses from left to right: depicting a hand reaching out through the chaos of murder and darkness. It resembles transformation that occurs in addiction recovery, and the concept of helping others while you are being helped. The piece was created in the basement of the shelter, and has been shown in the Finding a Voice exhibitions throughout Omaha.
A couple months into my recovery, I met Jerry. Jerry was an alcoholic and a drug addict, with an unrevealed talent to paint. I was astonished at Jerry’s artwork, and it was the first thing that motivated me to begin painting again. He helped me realize that the process of doing the art could keep me sober and reinforce my decision to change. And, the process of doing art inspired Jerry to enter into recovery. FAV kept Jerry going, just as it kept me going. Jerry said, “FAV has given me a new outlook—a second wind. When life gets you down, you go into the locker room, and you get that pep talk. So it’s kinda’ like that pep talk. You’re not going to get it [what FAV has done for me] in a single sentence. That’s why I paint. It’s how I interpret life.” Jerry’s painting, Restoration Boulevard, represents his desire to change.
24" by 36"
Restoration Boulevard depicts Jerry with a bottle in his back pocket, looking at a storefront window with a Help Wanted sign. The images in the window represent the future—future promises of a working man. Jerry began this painting when he was using substances and completed it when he became sober.
Lastly, the actual FAV interview process provided me with another dimension of change. For the interviews, I worked with students and guests to facilitate meeting times. It was a daunting task, but it helped me stay busy. It made me feel needed, and it also made the guests feel needed. It gave me a purpose. The interviews allowed me to further open up and learn how to communicate with others. It did the same for students and other residents at the shelter.
Openness & gaining self-worth. Many individuals going through the Miracles Treatment Program (MTP), an optional chemical dependency treatment program through the shelter, have challenges with self-confidence. Wendy shares: “My biggest challenge would be, uh, self-hope. I have a lot of self-hatred, I have a lot of guilt and a lot of shame . . . so those are the . . . the shame, the guilt, ya’ know that I have to learn to let go.” Despite these feelings, guests were willing to share their stories with students. The process of sharing with others about their past self-defeating behaviors has further enhanced their self-confidence and self-validation, just as it did to me.
As students interact with guests through interviews and group activities, they were amazed at how open the guests were about their past experiences. Brandon, a nursing student, explained: “I observed a group of strangers from all walks of life come together and talk about their journeys through life. People shared intimate details about themselves with little hesitation. The group became a safe haven for the thoughts and feelings which poses conflict in each individual.” And Paula shared: “It was a humbling experience. . . . One thing that surprised me was how open the participants were to tell their stories. Each and every one of the participants had an important story to share and this gave them an opportunity to let it be heard.”
Community. Bobby, Jerry, and others associated with FAV helped me open up. They were, and continue to be, my support system. Community often dictates/influences how a person acts, and addicts often lack a positive community. Thus, the strong bonds of friendship formed between individuals in the MTP are invaluable to the process of becoming sober and maintaining sobriety.
When discussing community, Chris S. says, “The main thing I’ve learned is that I can’t do this alone, and I have to have other people help me. And that if I’m gonna’ take, um, all these problems on myself, they’re just gonna’ burn me up.”
Jean also has her views on community when she reveals: “If we don’t learn to work with each other we’ll never make it, ya’ know. . . . I didn’t ever know what a friend was ‘til I got here, and I was willing to let someone in. I had a huge wall, and nobody could get through it, and they broke it down here.”
FAV offers an extra dimension of community within shelter life. Annie, a student, acknowledges this: “I was amazed at the impact this experience had on me; it was absolutely life changing . . . how completely nonjudgmental and accepting the atmosphere of the group was. Each week there was the sense that this was a safe place where you didn’t have to hesitate to open up and share your experiences, thoughts, beliefs, ideas, and emotions . . . this is the definition of finding a voice. A community was created within the group, and everyone contributed to an atmosphere of learning and growth.”
Community sharing a meal
Through FAV, not only did I and other guests find our voice, but the students found their voices as well. Students learn to leave their judgment at the door of SFH, and they recognize and acknowledge their previous stereotypical images of homelessness. Annie shares: “I had never been to a homeless shelter and had a sort of ‘fear of the unknown’ toward this population. This experience took away any fears and biases I possessed and made me more self-aware.”
Stereotypical bird (left)
Acrylic, charcoal, spray paint, feathers on canvas
Acrylic on paper
6' x 4'
Stereotypical Bird and Rebirtha depict transformation. The bird is changing into a person, ridden of all its previous stereotypes. Rebirtha is the middle stage of metamorphosis.
Before students end involvement, they usually realize that Finding a Voice is applicable to all participants, and that each student gained more than what they were able to give—a reflection of true service-learning. Becky, a student, shares: “When this process started, I thought that I was going to be the one to help ‘those’ people, but through this, I was the one who was helped.”
And, their learning experience will certainly stay with them as they progress into the health professional world. Hannah, a nursing student, assures this: “This experience has seriously changed my life. It changes the way I think about my patients. By examining such a vulnerable population it helped me to remember why I want to be a nurse, the impact that I can make simply by being me, showing up, and treating others with respect.”
I was first introduced to the Finding a Voice project in the fall of 2009, while I was living at the Siena/Francis House homeless shelter. I had attended a FAV meeting that involved students from the University of Nebraska Medical Center and SFH homeless guests. At this point in my life, I had hit rock bottom; I was a homeless alcoholic and an addict in treatment. I remember leaving the meeting full of hope. This hopefulness is hard for me to put into words as I had felt hopeless for so long. Over the course of the program, I found my voice, through art and engaging with students. Now, I have the privilege of giving back what was freely given to me. I work with new students and current guests in order to empower them and to help them find their voices. My friend Jade Guiterez, who was also an artist, tragically took his own life in the summer of 2004. He was an addict who struggled in life and had never been given the opportunity to find recovery. I dedicate this paper to honor him and all who struggle out there. You can find your voice. Find hope and transformation.
This was the first painting Christopher Leet created after leaving the shelter.
The Finding a Voice team: Ruth Margalit, director of Finding a Voice and the Service Learning Academy, COPH, UNMC; Mike Saklar, Siena/Francis House CEO, project codirector; Rita Paskowitz, professional storyteller, project facilitator; Lisa Zulawski, VISTA AmeriCorps, photographer; Jamie Odden, VISTA AmeriCorps, project coordinator; Christopher Leet, AmeriCorps; Shakira Davis, AmeriCorps, writing assistant; Kyle McAndrews, AmeriCorps, assistant coordinator; Nancy Farris, nursing faculty, CON, UNMC; Laura Hansen, MPH student, COPH, UNMC, project graduate assistant.
RUTH MARGALIT, MD (Ruti) is a family physician and associate professor in the department of Health Promotion Social and Behavioral Science, University of Nebraska Medical Center (UNMC). She is the founding director of the Inter-Professional Service Learning Academy at UNMC, College of Public Health, with clinical appointments at both UNMC and Creighton Medical Center, departments of Family Medicine. Ruti was born in Detroit, Michigan, and has lived most of her life in Israel, receiving her medical doctorate from the Hebrew University, Hadassah School of Medicine in Jerusalem, Israel, where she trained in pediatrics and family medicine. Her medical practice abroad included participation in a primary care project in rural Ghana, Africa associated with the World Health Organization. Ruti also completed Fellowship training in Baltimore, at the Johns Hopkins Bloomberg School of Public Health. She has been living in Omaha with her husband and 3 girls since 2003.
CHRISTOPHER LEET is a former guest at the Siena/Francis Homeless Shelter in Omaha, Nebraska. Over one year ago, he graduated from its drug/alcohol treatment program. Art played an important role in Chris’ drug rehabilitation process. Now, he runs an “Artist in Recovery” program under the Finding a Voice project at the shelter, where he inspires current homeless guests to pursue all forms of art in order to promote their well-being. Chris was born in Omaha, Nebraska in 1973 and was raised in Houston, Texas. He lives in Omaha, pursuing degrees in History and Chemical Dependency Counseling at Metropolitan Community College. He consistently exhibits his art in the public. Today, he celebrates over 32 months of sobriety.
About the artist of Restoration Boulevard
Jeremiah Neal is a former homeless guest at Siena/Francis House in Omaha, Nebraska. While battling with addiction and other personal struggles on the streets, Neal was encouraged by Siena Francis staff to embrace his artistic talent. He hadn’t picked up a paintbrush in over 25 years. Art helped him define his future and find his voice. Today, Neal is sober and works to empower other homeless guests to find their voice and start new journeys. He has painted over 100 pieces of art and has sold several of his works. Neal grew up in Muskegon Heights, Michigan. He recently moved from Omaha to Atlanta, Georgia to be closer to his family.