In the African-American festival of Kwanzaa, Ujima is a day to celebrate collective work that builds and maintains a community.
That collective spirit inspires Project Ujima, the Children’s Hospital of Wisconsin’s effort to build and maintain a community around young victims of violence.
The Milwaukee hospital launched the violence-prevention initiative 21 years ago, in response to a growing number of youth showing up in its emergency department (ED) with gunshot and knife wounds.
Many were repeat visitors – victims of the city’s “recurrent chronic illness of violence,” says Marlene Melzer-Lange, a pediatric emergency medicine physician at the hospital and a professor at the Medical College of Wisconsin, who help create Project Ujima in 1996. “Children’s Hospital understood from the get-go that this was a public health issue,” she says.
Project Ujima is one of the nation’s oldest hospital-based violence intervention programs. It works every year with about 300 youth victims of assaults who are between the ages of 7 to 18.
The program provides crisis intervention and case management, including home visits, mental health services, youth development in boys and girls groups, a six-week summer day camp, youth leadership and family support. The program expanded a few years ago to provide services to adults.
Before Project Ujima, the hospital had a 12% youth recidivism rate for violent injuries. The rate today is only 1% for youth who are enrolled in the program.
Children who are treated in the ED for violent injuries or assaults are referred to the program. Case workers – “community liaisons” – meet patients and their families at the bedside, provide support and work to prevent retaliation against those responsible for the child’s injury.
“If they meet the community liaison in the hospital and they understand the reason for the program, they are much more likely to let them into their home and their child’s life,” Melzer-Lange says.
After the patient is discharged from the hospital, the community liaison typically arranges a visit within two weeks to the child’s home – or, in some cases, school – to evaluate the child’s and family’s needs and develop a plan for ongoing services. Those services could include health care, counseling, connections to community programs and legal and professional support.
Community liaisons come from the same disadvantaged neighborhoods as do many of the youth enrolled in Project Ujima. “They engage in this work because they care about the people they are serving and believe deeply that they can have a positive impact in the lives of each of them,” says Bridget Clementi, Children’s Hospital of Wisconsin’s community health director.
Patients typically participate in Project Ujima anywhere from a year to 18 months. In addition to curbing repeat ED visits for assaults, the hospital says the project boosts patients’ self-esteem and helps them engage with other children and adults who understand the effects of violence.
“They realize there are people in the hospital and in the community who care about them,” Melzer-Lange says. “Having families understand that they are not alone and there are people who care about their children and their children’s future is probably the teachable moment in most cases.”
Clementi says the program is about “changing the trajectory” for young victims of violence. “No one in this organization believes our role is to just patch kids up and send them back into the neighborhoods in which they live,” she says. “We have an opportunity when an unfortunate event happens to redirect the child’s path.”
One of the ways in which the program redirects traumatized youth is through Camp Ujima, its six-week summer day camp. About 60 kids attend the camp, which aims to help them cope with trauma and help build their resilience.
A special feature of the camp is a “hip-hop” talent show. Therapist Aaron Heffernan uses a microphone, a couple of speakers and his laptop to help campers express their feelings through hip-hop music, poetry and body movements.
“It is a good way to process grief,” Heffernan says. “Violence is the voice of the voiceless. Hip hop is putting a microphone in a kid’s hand and giving them a voice.”
He says the transformation can be powerful. “Kids can rap about their trauma narrative and despite the awful things that should never be visited on any child, the creative process comes to life and in that safe environment they can begin to heal,” he says.
The hospital’s efforts to reduce violence are bolstered through a partnership with the Sojourner Family Peace Center, an advocacy group for victims of domestic violence. With the hospital’s support, Sojourner last year opened a new 72,000 square foot facility in Milwaukee that centralizes services for domestic violence victims and their children. Sojourner, Children's Hospital of Wisconsin and the Milwaukee County district attorney’s office are anchor partners of the center.
Other on-site partners include Aurora Health Care, which offers testing and treatment for sexual assault victims; the Bureau of Milwaukee Child Welfare; the Milwaukee Police Department; Milwaukee Public Schools; Jewish Family Services, which provides mental health services; and Legal Action of Wisconsin.
"We want every part of the building to say ‘you matter as a young person, a survivor, as a family. You matter to us and we will give you dignity and respect,’” says Carmen Pitre, Sojourner Family Peace Center president and CEO.
Hospital community health director Clementi says it is a public health imperative for hospitals and health systems to work with others in the community to address violence. “Programs like Project Ujima are absolutely necessary,” she says. “When a child and family are victimized by violence we can’t turn the other way and expect them to heal on their own.”
She adds: “We know we are making a difference. We can see it in the eyes and hearts of the kids and their families.”
The AHA’s “Hospitals Against Violence” campaign raises awareness about how hospitals and health systems are working to reduce violence in their communities and in their facilities. The campaign’s web page offers examples of innovative examples to tackle the problem, as well as tools and resources that can help hospitals and health systems support their role in reducing violence. Read more AHA News stories on how hospitals are addressing violence in their communities:
Regional One Health's positive alternatives to youth violence
'Wraparound' support stops revolving door of violent injuries
'Cradle to Grave' helps at-risk youth understand gritty reality of gun violence
Keeping teens from being repeat victims of gunshot, knife wounds