Canaries in the Coal Mine — Part 4

The Depth of the Problem (Part 1)

Baltimore consistently ranks among the top ten cities across the country for homicide, drug overdose, and HIV. We have an extreme 80% drop-out rate among African American boys (with the girls catching up)—some of them dropping out of elementary school. Their lack of education, lack of adult guidance, lack of exposure to positive life trajectories, and lack of critical thinking manifest everywhere you turn. Offshoots of the Bloods, Crips, and Black Guerilla Family gangs from Los Angeles, and the even more vicious 18th Street and Mara Salvatrucha (or MS-13) gangs from Central America, have long since taken root in Baltimore’s decaying ‘hoods.

Local law enforcement and a dedicated contingent of federal agents manage a steady stream of arrests, but this does little to slow drug dealers’ sales or violence. Community residents are sick and tired of the annoying and dangerous drug dealing on their stoops, but few have had the gumption to do anything about it. Some of the bold complainers who have filed police reports have been brutally murdered in their beds the night before they’re due to testify in court, which induces other would-be witnesses to keep quiet. Hospital emergency rooms and City morgues are filled with youths who succumb to stabbings and gunshot wounds—fallout from incessant squabbles over drug corners or girls. The body count is so excessive that local funeral directors have been compelled to organize public protests.

The longstanding neglect of our ghettoes has taken a profound toll on Baltimore’s humanity. There are many a twisted story of unimaginable desperation and sad outcome. Witness the heroic young gang initiate who is ordered to arbitrarily shoot the first person who will disembark the incoming MTA bus. When the first passenger to get off the bus turns out to be the mother of a friend, however, the initiate spins around and shoots his gang “mentor” dead instead. Contemplate the barely pubescent girl whose history of abuse and missing parents (read: incarcerated father and addicted mother) leads her to fall for and become impregnated by a man 10 years her senior. This man has convinced her that sex equates to love, but he will spend most of his adult life behind bars with no opportunity to support or raise the children he has begotten with multiple teen mothers. Consider the elderly man who hosts “happy meals” (a group event with a prostitute) timed around his and his buddies’ receipt of their monthly social security check, who eventually takes Hepatitis C home to what has been a long and contented marriage. Ponder the addict who absconds with her grandmother’s insulin needle to shoot up heroin with her boyfriend, and then secretly returns it only to infect her beloved 80-year-old grandmother with HIV. Look at the young transgender prostitute who deliberately invites HIV infection—a diagnosis that s/he has been told will secure access to free comprehensive health care and, in time as the disease worsens, a HOPWA-funded apartment. Observe the police officer who boldly posts “Training Day” as his favorite movie on Facebook and is later arrested for heroin distribution that has apparently been going on for some time from inside the District Station. Commiserate with the traumatized mother who lost her eldest son, then her middle son, then finally her youngest and last son to the unending cycle of deadly street violence and retaliation.

The View from 1990

In 1990, newly arrived from Boston, I landed my first job at one of Baltimore’s peculiar quasi-government/nonprofit agencies that local government won’t fully fund and private funders feel comfortable ignoring. Our main focus was literacy (or, rather, the widespread lack thereof). Our secondary focus was, by necessity, the poverty and high rate of school drop-outs that seemed to be at the root of what was being fashionably labeled “functional illiteracy.”

As I began to take in my new surroundings, I was shocked by the malaise that seemed to have the city in its grip. Few people expressed alarm when violence took place—even a homicide didn’t always make newspaper headlines. Only a handful of colleagues talked about the failing schools and high rates of illiteracy and unemployment. And no one seemed distressed when the health commissioner himself stated that the city harbored tens of thousands of drug addicts or that the rate of syphilis was the highest in the nation. Even once the HIV epidemic got everybody’s attention, I never heard anyone anticipate that this level of addiction and STDs might just turn Baltimore into a breeding ground for HIV—which is, ultimately, what did happen. And I never heard anyone object out loud to the bizarre surgical excision of condemned row house after row house—caused by a (now defunct) city housing policy that transformed whole blocks into Halloween pumpkin grins with missing teeth.

Accusations of political corruption were rampant. City officials lavished their attention and dollars on tourism and the soon-to-be glamorous Inner Harbor, while blatantly ignoring the massive swaths of impoverishment that crisscrossed the city. Boston, my original hometown, certainly had its share of problems. But nothing even came close to the depth of the social, economic, environmental, and health challenges that faced Baltimore’s citizenry. And yet, there was a silent pall that hung over Baltimore, with massive amounts of quiet suffering happening all across the city.

Despite its status as a major East Coast port, Baltimore is not a wealthy city. By the time I arrived in 1990, an underlay of Jewish philanthropic support coupled with spotty infusions of federal funding were supporting modest anti-poverty work in Baltimore. Unfortunately neither the level of funding nor the approaches taken to combat poverty were enough to reverse Baltimore’s negative trends.

Further, the Association of Baltimore Area Grantmakers (founded in 1983) had begun nurturing professionalism in Baltimore’s small but growing philanthropic sector for several years, but the funders constantly grumbled about the mediocrity of the grant applications they received and the lack of grantees’ documented outcomes. Compared with the mature philanthropic and social service sectors I had left behind in Boston, both the funders and the human service providers of Baltimore struck me as unprofessional, immature, and disorganized as a new resident in 1990.

Just after I started my new job, several things happened that led to a blossoming of the funding and human service sectors. First, in 1991, a new association of nonprofits (Maryland Association of Nonprofit Organizations) began to offer an array of trainings to its members that would, over time, start to professionalize the fiscal, administrative, and service delivery capacity of human service organizations.

Second, three of the nation’s largest private foundations (in terms of assets) began to play defining roles. The Harry and Jeanette Weinberg Foundation began to professionalize its own operations soon after Harry’s death in 1990, and the foundation became keen to have an impact on Baltimore’s impoverished neighborhoods. In 1994, the Annie E. Casey Foundation (originally founded in 1948 with revenue from the Casey family’s messenger service later renamed UPS) moved its headquarters to Baltimore. And in 1998, George Soros’s Open Society Institute headquartered in New York City opened its first U.S. field office to “test the effectiveness of place-based philanthropy strategy on some of the biggest challenges facing Baltimore.”

Third, Baltimore hit the headlines. A series of stark exposés were published in the (then still alive) Baltimore SUN. Progressive talk shows were launched on local public radio stations (Marc Steiner, Tyrone Powers, and Anthony McCarthy). And Baltimore often found itself “front and center” in national news stories about crime and HIV, forcing us to take a closer look at ourselves.  Finally, The Corner: A Year in The Life of an Inner-City Neighborhood authored by David Simon, a former Baltimore SUN journalist, and Ed Burns, a former Baltimore City Police homicide detective, was published in 1997. Then, in 2002, HBO launched The Wire, a 5-season series created by David Simon that would take the whole world by storm!

These news stories, books, and televised docudramas all corroborated just how bad things had become in Baltimore. Collectively, they were a scathing indictment of the city’s political corruption, failing schools, entrenched illicit drug trafficking, and violence. Slowly the public awoke from decades of slothful sleep. We looked in the mirror and what we finally saw shook us awake.

Urban Health
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