Uzazi Village is Concieved

The Community Visioning was a great success.  Here is the document created after the meeting that summerizes the vision. 

Uzazi Village- A Community Vision of Maternal Infant Health

December 9, 2011 a community meeting was held at the Kansas City, MO Health Department. The purpose of this meeting was to gather a group of community stakeholders to come together to create a vision of what maternal infant health in our community SHOULD look like. Here is snapshot of the vision that was created specific to zip codes within the African-American community of KCMO:

Current Conditions	Goals	Strategies	Action Plans
infant mortality rates above national average FIMR mom profile highest low breastfeeding rates high rates of prematurity high rates of cesareans and inductions high rates of preterm delivery low birth weight delayed or insufficient prenatal care smoking rates increasing high rates of obesity/ social determinants of health put residents of certain zip codes at high risk of poor health indicators	Infant mortality and morbidity rates at or below national average infant deaths not concentrated in the urban core increased rates of initiation, duration, and exclusive lactation among Black urban mothers infants born at term with adequate weights decreased cesareans, and inductions improved access to prenatal care improved maternal health prior to pregnancy work with others to improve life overall in the urban core	culturally appropriate care models midwifery model of care mother friendly care models baby friendly care models collaborative planning and working with all stakeholders home visiting models of care community-based solutions health care delivery models sustainable without government funding woman-centric care models affordable accessible care that preserves dignity and respects those it serve	create a series of “community conversations” to discuss the vision invite others to share in the vision through donations of time, money, or goods identify leadership and create a 501c3 to enact the vision begin to work with existing organizations and community stakeholders to transition the vision to reality make a positive difference in the lives of women and infants and their families in the urban core by improving health outcomes

Uzazi Village- A Culturally Relevant and Respectful Model of Maternal Infant Health for the Urban Core

What is Uzazi Village?

Uzazi is Swahili for birth. Uzazi Village will be a community-based perinatal care model created by community men and women for community women and infants (and their families) who are at higher risk for poor perinatal outcomes. We seek to create a model of care that is affordable, accessible, sustainable, high in quality, is culturally appropriate, and respectful of traditional/ancestral knowing, that promotes a high level of wellbeing and improves overall potential for the individual and the community to live in harmony in order to pursue its full purpose for being.

What does this model of care look like?

Maternal-infant health                   Family health                       Community health

-Peer to peer learning models    -family care/pediatric care       -high risk zip codes

-home visits with 'peridoulas'    -male leadership roles                - on bus lines

-midwifery care                  -assumed male involvement            -vibrant communities

                                       

  -lactation supportive          -same provider throughout             -providers live here

-bartering system for pay     -school nurse expanded role        -linked to other resources

-house calls by midwives   - parish nurse expanded role         -community supported

-same provider throughout   -group centered care              - decreased medicaid reliance

-personal ownership of health    -wellness focused care          - we did it ourselves

-partner with clients, listen       -clients define family            -community gardens

Does this sound like a conversation you would like to join?

This document will be dispersed far and wide throughout our community with a survey attached to invite feedback.  In addition, we will begin next month attending assembled groups to share the vision for the purpose of finding 'our people'.  Those individuals looking for just such a project to work with will hear about us through our "Community Conversations" series.  They will help to write this story.

Another interesting development this week: I invited a national insurance company to join me in crafting an application for a federal grant seeking innovation in healthcare service delivery to Medicaid populations.  They said yes!  We will be submitting a proposal for pregnancy doulas (or what I call 'Peridoulas' ) to follow pregnant medicaid clients from the start of pregnancy to up to a year following pregnancy.  I fully expected this insurance company would read my email and hit the delete button.  Imagine my surprise to get a call the very next day from the Vice President of Research and Innovation out of Long Beach California!  So add to my to do list, crafting a winning grant proposal that is due at the end of January.  Even though I accepted two adjunct teaching positions for the spring semester, I am considering turning down one of them so I can concentrate on grant writing (and book writing, and workshop writing, and article writing...not to mention starting CNM school).  This should teach me to be careful what I ask the universe for...

A Meeting of Minds

Next Friday, December 9th, a very important meeting will take place: 'A Community Visioning'.  This meeting, hosted by yours truly, is an invitation to all 'Community Stakeholders' to come and discuss a plan for creating community-based maternity care; what it would look like, and what it would take to make it happen.  I have been planning this meeting all year long.  I don't want 2012 to come without a plan of action in hand.  All year long now, I have been looking at the vision board in my bedroom next to my bed.  It is the first thing I see when I wake up every morning.  A large poster board covered in sticky notes and timelines foretelling a seemingly impossible dream; an urban prenatal clinic, birth center, and midwifery school.  All quite heady stuff for a former teen welfare mom. How do I galvanize the considerable resources of this community to make it happen?  Well, it will start with this meeting.  I have sent out my clever and attractive EVITE invitations.   I have enlisted a top notch talented facilitator.  I have a state-of-the-art, large meeting room.  I have my mother's cinnamon rolls and fresh fruit for feeding the participants. And I have an agenda.

In many ways I have been waiting 20 years to host this meeting.  I have agonized over the invitation list for months.  I understand that whomever is meant to be there, will be there.  I also understand that this is the first step in taking my dream PUBLIC.  Oh sure, lots of people have heard me talk about my plans to do this or that, but this is the first time in 20 years that I have invited anyone else into that conversation. Its like leaving your five year old at kindergarten for the first time- it finally hits you that someone else will have influence on the way your little one thinks and behaves.  In taking my dream public, there are risks.  On the other hand, alone I can only accomplish so much.  Already, I have been flooded with offers for space for housing the project.  I will be out next week, looking around Troost Ave. for the perfect store front.

I'm picturing it already:
"UZAZI VILLAGE" the sign will read. (Swahili for birth) In small letters beneath it, it will read: "An Afro-centric community dedicated to maternal infant and community health". To start, there will be free pregnancy tests and resource referrals.  Childbirth classes (the good empowering kind), and breastfeeding support groups will be a staple.  Other classes will be added: parenting classes, finance management, employment preparation, etc.  I intend to invite others who are already doing these things to do them at Uzazi Village, not duplicate them. I hope other support groups will spring up; fathering support groups, infant loss support groups, perinatal mood disorder support groups.  Again, there are already folks out there doing these things, I will invite them to do an Afro-centric version at Uzazi Village.  In this way I expand the capacity of organizations who have already perfected this work (whatever it is).  Uzazi Village will be divided into Houses: Umoja (unity) House will be our think tank, leadership, and administrative council (Council of Elders), Kujichacalia (self-determination) House will house job readiness, GED completion programs and such. Ujaama (cooperative economics) House will house a business incubator for nonprofits supporting maternal infant health, and courses on entrepreneurship and nonprofit leadership.  Imani (faith) House will house faith-based initiatives and church volunteer groups and hopefully a parish nurse ministry.  Kuumba (creativity) House will maintain art programs and community gardens.  I will add clinical services as soon as I graduate from midwifery school, unless a practicing midwife or physician wants to offer clinic hours sooner.  The Ida Mae Patterson Perinatal Wellness Clinic will thus, be born. Named for my grandmother, Ida Mae, who had 24 babies, but only saw nine live to adulthood, this clinic is the crux of the vision. Clients of the Ida Mae clinic can expect home visitors known as pregnancy doulas to visit them at home and do assessments and education. Hierarchies will be flattened as care providers retrieve their clients from the vibrant and active community room (no waiting rooms) and walk them back to their serene and tastefully appointed,  mutual exchange suite (no exam rooms)  I hope the place is filled with students wanting to learn: nursing students, midwifery students, medical residents (DO, OB, family practice)  etc.  As it evolves from an education center to clinical services, I will also add birthing rooms: The Nia (purpose) House. I chose this name because of Morningstar's quote in her book of the Cherokee birth blessing, "May you live long enough to know why you were born."  I want every child born at Nia House to know their purpose, to know why they were born, to be an integral part of the community that has welcomed them.   I hope there will be tutoring, a community garden, a daycare...  I hope it expands to take up the entire block... the entire city... the entire world...  I want Uzazi Village to be a sustainable, replicable model of community-based wellness care that supports maternal infant health that radiates forth to positively impact family health, that glows outward to support community health.

Now join me in my vision.  What do you see...?

Winter Update

Much has happened since my last post.  I have left my job as a nursing instructor.  I am enrolled in a nurse-midwife program, and working on my IBLCE credential (lactation consultant).  I have attended the MANA (Midwives Alliance of North America) conference in Niagra Falls and gave my two presentations.  I have attended the local March of Dimes conference on Prematurity.  I'm just back from the Holy Land for a meeting about a nine day pilgrimage in Mexico in January.  Some committments are ending, while new ones begin.  Plans are underway for the clinic/birth center it has become my destiny to create.
What has become clear is that I must press on, despite any obstacles.  The work is greater than myself and I am only a conduit of God's will and desire.  This work has nothing to do with my own resources of lack of them.   While in Niagra Falls at MANA, I was priviledged to spend a lot of time with the midwives of color, these were amazing women from all over the United States, Canada, Mexico, and the Caribbean.   Spending time with these midwives and birth workers reminded me that I am not alone in what I am attempting to do, nor am I the first to attempt it.

I hope to resume teaching in January.  Here are a few projects I am working on for next year:

• finding an adjunct teaching position
• writing a workshop that I will start presenting next May nationally
• writing a book that I hope to publish next year
• sit for the lactation consultant exam in July
• submit an article for a peer-reviewed journal
• take the nurse educator certification exam next Spring or Summer
• begin preceptor courses  for nurse-midwife program
• begin apprenticeship with a local homebirth CPM
• work with a design student on architectural sketches for clinic
• vie for a seat on the state nursing board
• feasibility study for clinic
• host community visioning sessions
• create 501c3 for clinic
• complete training and fundraising for pilgrimage
• complete 9 day pilgrimage in Mexico
• investigate MPH program (just dreaming here)
• increase business training to include ACLS and LPN-IV course
• write for some grants
• find some partnerships to complete the Mama Love Project

All well-wishes much appreciated.

Autumn Update

I have just returned from the Autumnal Equinox gathering at the Holy Land in central Missouri.  It was a small but mighty gathering of women.  We shared our usual drumming and fire circles, walks, and herb gatherings, and meal making and sharing.  Sr. Morningstar led us in many healing rituals and conversations. I slept under the September stars in the tipee on both nights, grateful to have it all to myself, and for the peaceful star filled nights.  I fell asleep each night to the hoot owl calling from the woods and woke in the morning to whipor-wills and woodpeckers.  It was three days of bliss. 
For several months now, I have been making plans for the birth center, and becoming acclimated to midwifery school.  I am taking a pharmacology class this Fall but begin my core midwifery courses in the Spring.  I am also planning to return to Mexico in January to complete the nine day San Miguel Walk with Sr. Morningstar and 8 other women from our spiritual community.  It is a nine day pilgrimage over the Sierra Madres of central Mexico, walking about 8 hours per day.  I am also preparing to speak at MANA (Midwives Alliance of North America) this Fall in Niagra Falls Canada.  I'll be speaking on maternal infant health after a disaster (based on my three trips to Haiti) and cultural competency in maternal infant health.  I continue to teach full time, and will soon begin speaking nationally on active learning teaching strategies.  Next year I look forward to becoming certified in nursing education through the National League of Nursing (NLN), publishing my first article in a peer reviewed journal and sitting for my lactation consultant credential.  I am also working on next year's CIMS (Coalition to improve maternity services) conference, and locating a building in which to house my future birth center. It has been a busy Fall.  Next year will be busier.
I am learning to trust my own intuitive knowing, when to seek the advice of others, and when to press on in my own wisdom.  My lessons are many, the trials are difficult, but I am confident of my path.  I press on.

The Mama Love Project

A couple of months ago, I was contemplating the problem of infant mortality in my community. This is a topic often discussed in the Women's, Children's and Infant's Health Committee (WICH) of the Kansas City Health Commission. WICH is also the Community Action Team (CAT) of our local Fetal Infant Mortality Review Board (FIMR). The CAT receives reports from Case Review Team (CRT), the other half of FIMR (of which I am also a member). The CRT reviews cases of infants that have died in the most high risk zip codes of our city to determine if their deaths were preventable. The CRT then makes recommendations to the CAT for systems, policy, or protocal change that will have an impact on the number of infant deaths. The CAT is charged with disseminating and if possible, implementing these changes.

If all of this is confusing to you, I was a WICH member for months before I realized it was also the CAT. The bottom line is, both the WICH and the CAT are actively involved in the issue of infant mortality. Nowhere is this issue more pronounced than in the African-American community in our urban core. Nationwide, Black infant die at rates twice that of Caucasian infants. Here locally, it's almost three times higher. I've discussed this topic before on this blog. I've attended conferences devoted to this topic. I've presented at conferences on this topic. I spent a year and a half researching this topic for my master's research project.

It occurred to me recently that as bad as this problem is, it is an essentially invisible social phenomenon. I thought, what if we put a face on Black infant mortality. As a natural born storyteller, I understand the impact of the personal narrative. I use storytelling as a teaching strategy with my nursing students. I thought, why not let the women tell their own stories of perinatal infant loss. What could be more powerful than that?

The Mama Love Project is born out of a need to put a face and a voice and a human presence on an important social and health issue. Months of work on the FIMR, pouring over the death records of deceased infants and analyzing events that led up to their deaths, has convinced me that most of these deaths were preventable.

The women's stories will be filmed and the footage will be made available to agencies working to decrease health disparities in infant mortality and to create public health announcements. What I need now is the women. I'll be setting up a Facebook page titled, The Mama Love Project. I am actively seeking women willing to share their stories. These women must be African-American, reside in Kansas City's urban core (preferably in our high risk zip codes) who have experienced perinatal loss from greater than 20 weeks gestation until 28 days postpartum.

If you or someone you know would like to participate in the Mama Love Project, please contact me at laborpayne@yahoo.com. Perhaps your story can help prevent future deaths, and bring needed attention to a serious problem that remains under the radar screen.

The She Wolf Lodge

Photos: me giving counsel, a morning fire circle session, a mother and child, young maidens in a hammock, Sr. Morningstar being smudged during opening ceremonies

Sacred images from the Holy Land (Morningstar Community) where I went this weekend for the Summer Solstice Celebration of the She Wolf Council. I live for these: the drum circles, the smudging, the storytelling around the fire circle, the sessions led by Sr. Morningstar, the fabulous vegetarian and vegan feasts (no meat is allowed on the Holy Land). A pure weekend of women who have left their lives to come together for sharing growth, enlightenment, and transcendance. I'm excited to be moving into my crohn years (defined as one year without bleeding), when I can take my place among the other queen mothers and elders and begin to participate in leadership. In the meantime, I look forward to how much I learn about myself each time I attend. The lesson this time was observing my comfort in my own skin and being still in my own knowing. These are blessed discoveries that prepare me for the work ahead. I'll go back again for the Fall Solstice and continue my work on becoming me.

At one point, Sr. Morningstar asked us to describe our perfect day. Here is mine:

I wake up early, as usual, around 5am. I sit in my garden and have my morning cup of tea and quiet time. After my morning routine, I leave my house and walk around the corner to the clinic. I like to be the first one there to open it up. There is an early morning meeting and I bring fresh flowers from my garden to brighten up the meeting room. As the morning progresses, the clinic staff starts to arrive, the meeting begins and ends, and clients begin to arrive. I oversee the workings of the clinic and the staff, and leave midmorning for more meetings. On this my perfect day, all things go my way. Every idea, every initiative is met with a 'yes!' After a successful round of meetings, I meet my beloved for lunch. We meet at one of my favorite restaurants tucked away on a high hill overlooking downtown on the West Side. After a lovely meal and time to connect with my spouse, I head back to the clinic and oversee its finish for the day. There are patients to see, reports to file, emails and calls to return. My administrative assistant has been dispatched to the airport to pick up a group of international students and researchers. They will be staying in the guest house and working in our clinic for a few weeks. When the last patient has been seen, I rush back around the corner to the house to make sure everything is ready for the arrival of the guests. Dinner has been prepared and the house is full of home-cooked smells. I sit down to dinner with my family and enjoy a good meal. Afterwards, I sit and think and reflect on what a wonderful day it has been. I remember, that it is my perfect day.

Now your turn. What would your perfect day look like?

The Checklist

In the two weeks since I have returned from Haiti, I have been involved in several activites, most of which I will attempt to summerize here:

• I queried my story about Dr. Delson to a journal but they turned it down, however they did give me ideas of what type of journal might be interested in the story.





• I started teaching my summer classes, one for LPNs and one for RNs and will be teaching through July.





• As a part of my committe work, I will be working on the two following projects- 1) collecting and cataloging the stories of African-American women who have lost babies due to preterm delivery or low birth weight,and 2) interviewing the three urban KC hospitals that do deliveries in order to celebrate what they do right and encourage improvements.





• My two proposals were accepted by the MANA conference, so now to get started fleshing out the following: Lessons from Haiti: maternal infant care during a disaster from the midwifery model, and Brick by Brick: dismantaling racism in maternal infant care.





• I continue planning for the CIMS Forum 2012- currently identifying potential speakers.





• My business is expanding to a third state, and I am writing the training manual for new trainers.





• I am lobbying for a mayoral appointment to the county hospital board from our newly elected mayor.





• I am researching and writing an educational module on preconception care. If all goes well, I'll be traveling around the country presenting it to home visiting nurses and community workers, along with other content.





• I am doing my preliminary planning for my profit prenatal clinic and my nonprofit maternity care think tank.





• fielding offers to work in my (so far imaginary) clinic





• preparing for a Board of Nursing visit at my college where I teach





• planning for trip to Canada in November and Mexico in January, and trying to find a way to go to Tazania in December





• looking forward to a trip to The Holy Land (Morningstar Community) at the end of the month for rest and rejuvination





• kids leave home but keep coming back, now what?

• Still waiting and mentally preparing to hear if I am accepted into the midwifery program





• gardening daily now and loving it!