Believe Magazine_Summer 2024_Tackling Gun Violence

Believe

TACKLING GUN VIOLENCE

Building Connections to Save Lives

Caring for Our Community

Heart Research Award Highlights Tradition of Excellence

Every story is different, but they are good kids, most of whom have done nothing wrong.

― Jawanna Hardy

TACKLING GUN VIOLENCE

Building Connections to Save Lives

The 10-year-old recovering from surgery to repair a gunshot wound refused to speak to anyone in our Pediatric Intensive Care Unit. His mother also had been shot and was at a different hospital. Yvonne Doerre, LICSW, longtime Children’s National social worker and part of our Youth Violence Intervention Program, called in her colleague, Jawanna Hardy. Hardy, an experienced educator and community activist, scanned local social media accounts. She made a few phone calls, then walked into the patient’s room. “I said his brother’s name and asked if he wanted to FaceTime him,” she says. “He smiled so big his whole face lit up.”

As the hospital’s first Violence

Intervention specialist, Hardy supports patients who experience violence, starting with when they’re in the Emergency Department (E.D.) and for months afterward. Her superpowers? Connections to community resources, bravery and street smarts. Most of all, she has an abundance of compassion. While the 10-year-old patient was in the hospital, Hardy brought snacks for his siblings to their home. “They were struggling with food insecurity even before the shooting,” Hardy says. “It’s very hard to go through life on an empty stomach.”

The team followed up with family care and support for several months. They connected siblings to communitybased therapy resources and provided

The Youth Violence Intervention Program team gathers after an appreciation dinner to recognize the commitment and hard work of patients and families

Violence is a chronic disease that runs much deeper than a single injury. I wanted to do more to break the cycle and address its root causes.

― Dr. Katie Donnelly

campus

logistical and emotional support to the boy’s single mother. They also mentored the oldest brother, 19, to steer him away from thoughts of retaliation. “I witnessed the brother’s attitude shift to focus on his little brother’s care and his family’s healing,” Hardy says. “It was beautiful to see.”

Critical Community Care

Hardy grew up in Capitol Heights, Maryland, in Prince George’s County. At 12, she started a lowcost home day care to help moms in her neighborhood. “I hate to see people struggle,” she says.

As a teen, she and her mother

Dire Challenges for Kids

Black middle and high school students are 14 times more likely to die from gun violence than their white peers, according to the CDC.

made sandwiches for the homeless even when they didn’t have enough food themselves. At 19, she joined the United States Air Force for six years. When she came home, she was dismayed by the impact of gun violence on her neighborhood. She founded a nonprofit to support families and advocate for positive change. The Youth Violence Intervention Program team at Children’s National recruited Hardy in 2022 to add a critical community component to care.

The window in the team’s small workroom looks out onto the ambulance bay outside our E.D. Hardy often meets children with gunshot wounds there as hospital staff carry them in on stretchers. Items stuffed in the pocket of a kid’s jacket retrieved from the ambulance might give her clues about where they go to school. “Obviously keeping children alive is our top priority,” she says. “Then we quickly switch to community support for these kids.”

Exactly who are they? “They are bright. They are leaders, full of personality,” she says. “Every story is different, but they are good kids, most of whom have done nothing wrong.”

A recent caseload included 10 children, ages 8 to 15, considered

In 2023, more than 3 of 5 youth survivors of gun violence enrolled in Medicaid did not receive mental health services within six months following their injury (Pediatrics). Firearms are the leading cause of death for children and adolescents in the United States, according to the Centers for Disease Control and Prevention (CDC).

Jawanna Hardy greets patients and families at the main

It’s a big deal having Miss Hardy on our team and representing Children’s National in the community. She builds tremendous credibility and creates a bridge to care.

― Yvonne Doerre

to be at highest risk for experiencing repeat gun-related violence. One is a 15-year-old who was shot nine times in a case of mistaken identity after he moved into a new neighborhood. Another, 14, is paralyzed from the waist down after being shot. Hardy says he hasn’t wanted to leave home or return to school. She recently paid for transportation so he could get a haircut and visit a friend.

“It’s hard to explain how everyday life is so hard for these kids,” Hardy says. “There’s a lot of fear after the trigger is pulled. It’s easy for them to fall behind in school. They are cautious about things as simple as going to the playground. Our team helps reintroduce them to the world. Sometimes it’s as simple as just showing up.”

Support for Families

Jawanna Hardy helps families get their lives back together after gun violence. Most mornings start with organizing rides to school for kids too scared to walk through their neighborhoods. On a typical day, she might also:

• Prepare a parent to visit their child in the hospital for the first time after a gunshot wound.

• Create a safety plan for a child to avoid future violence.

• Provide guidance for medical follow-ups, including transportation to appointments.

• Refer families to organizations that assist with food and housing insecurity.

• Make check-in visits and calls to a child’s home, school or church.

• Help a teenager apply for a summer job.

• Visit a public defender’s office to help a child speak up.

• Connect kids and parents to mental healthcare providers.

• Meditate at night with a child who is alone in the hospital.

• Visit a patient in our adolescent psychiatry unit.

In 2023, 106 juveniles were registered as gunshot wound victims in Washington, D.C.; 16 incidents were fatal (Metropolitan Police Department).

Jawanna Hardy and Yvonne Doerre discuss a young patient’s situation

Inspired to Make a Change

Children’s National created the Youth Violence Intervention Program in 2022 to build connections with patients and prevent future violence through follow-up support for them and their families.

Hardy and social workers Doerre and Amy Anderson, LICSW, work under the leadership of Katie Donnelly, MD, MPH, the program’s medical director who is an emergency medicine physician. The team cares for children who are survivors of community violence, including gunshot wounds, stabbings or assaults. The program has cared for about 250 youth to date.

Dr. Donnelly and Monika Goyal, MD, MSCE, associate division chief of Emergency Medicine and Trauma Services, lead our efforts to support survivors of violence with a focus on prevention. Dr. Goyal leads the Safer through Advocacy, Firearm Education and Research (SAFER) group. It works on a local and national level to reduce firearm injuries and deaths among children.

We spoke with them about their goals and the impact of this work.

The interview is edited for brevity.

WHAT INSPIRED YOU TO LAUNCH THE YOUTH VIOLENCE INTERVENTION PROGRAM AND SAFER?

Dr. Donnelly

Injury is a part of life, and it is something I can never fully protect any child from. But for me, the toughest cases are those caused by violence, particularly gun violence. We are seeing more kids come in with their second or third injury. Violence is a chronic disease

Dr. Katie Donnelly offers words of encouragement to kids at a Youth Violence Intervention Program dinner

Drs. Katie Donnelly and Monika Goyal

that runs much deeper than a single injury. I wanted to do more to break the cycle and address its root causes, such as disconnection from school, unaddressed emotional trauma and poverty. I researched other hospital-based violence intervention programs and learned about the D.C. Office of Victim Services and Justice Grants. We established the program with funding from that entity.

Dr. Goyal

As we started to hear more about gun violence impacting youth, I felt like I needed to do something. Every time I care for a child in our trauma bay who suffered a gunshot wound, it just takes a piece of me. I co-founded SAFER in 2016 to make our communities safer for children so they can live healthy and fulfilling lives. It began with four physicians and has grown into a multidisciplinary team of more than 40 Children’s National experts who volunteer their time in addition to their regular duties.

WHAT KEEPS YOU GOING WHEN CHALLENGES FEEL INSURMOUNTABLE?

Dr. Donnelly

I try to focus on the kids’ successes. Last year we had several teens in the program enroll in D.C.’s Mayor Marion S. Barry Summer Youth Employment Program. They were so proud to show off the debit cards they received to process their earnings. I also think about the kids that our team has helped get back into school who are doing well. These successes are things you can’t always measure with graphs or reports. But I hold them close to my heart, and they are all inspiring.

Dr. Goyal

Gun violence has a ripple effect. Even if a child has not personally experienced gun violence, it may still touch their lives. They may have family members, neighbors or friends who are victims. Their neighborhoods may have experienced gun violence, so it impacts a child’s ability to feel safe. It is devastating. Our work through SAFER keeps me going. We are doing this by sharing evidencebased interventions, advocating for policies that protect kids, and educating families about safe firearm storage and use, among other efforts.

WHAT DO THESE EFFORTS MEAN TO YOU?

Dr. Donnelly

The work we do gets us a seat at the table to impact larger change, and that is gratifying. Children’s National has become the expert on pediatric firearm injuries in the D.C. region, and we work with local governments on gun violence prevention legislation. I also appreciate opportunities to share our knowledge with the community. I recently spoke at a Teach for America conference about how young teachers can talk about gun violence and safety in their classrooms.

Dr. Goyal

There have been so many feelings of helplessness, and we know we can’t make a difference in every child’s or family’s life. But we are committed to tackling this crisis and trying to prevent tragedies from happening again. It is humbling to be part of this work.

HOW CAN PHILANTHROPY SUPPORT THESE PROGRAMS?

Dr. Donnelly

External support is essential to sustaining the Youth Violence Intervention Program. We are thankful for the government funding to keep this work going, but D.C. has faced budget cuts, so it’s not always guaranteed. Also, most of the critical psychosocial support we provide is not reimbursed by insurance. This includes things like food and housing resources and transportation costs for kids to get to school or medical appointments safely. Philanthropic support would ensure that we can continue this work and expand the program. We need more Violence Intervention specialists and a trauma-focused mental healthcare provider so our patients don’t have to wait for services. There is much more we can do to ensure that families have what they need to thrive.

Dr. Goyal

I agree, there are so many opportunities for growth. We were grateful to receive a generous gift from the Honorable Ann Brown (former commissioner of the U.S. Consumer Product Safety Commission) to support some of our prevention efforts. These include expanding screenings in the E.D., developing trainings to help youth de-escalate conflict and advancing research to increase awareness of gun safety. Additional support would allow us to scale and grow our programs so we can make an even bigger impact.

Repairing Wounds, Addressing Trauma

Children with gunshot wounds arrive, sometimes daily, at Children’s National. Trauma surgeon Mikael Petrosyan, MD, MBA, often meets them in the operating room. “The first thing I see is innocence,” he says. “If the child is awake, I see despair in their eyes. Wounds may shatter a kid’s body, but it also shatters their life.”

Surgeons and hospital staff can repair physical damage but not always. The youngest child Dr. Petrosyan operated on was a 6-year-old boy who did not survive. The patients are mostly boys, occasionally girls. Elementary school students. Middle school kids. A freshman in high school with big dreams.

“Injuries related to gun violence cast a grim shadow that lingers over a child’s psychological and emotional life. That shadow extends to their families and perhaps their entire community,” Dr. Petrosyan says. The emotional burden also extends to the orchestra of hospital staff and first responders working to save lives.

All of this is why Dr. Petrosyan believes it’s vital to support community outreach efforts, such as the Youth Violence Intervention Program. “As a surgeon, I do my best to repair the physical damage. But Jawanna Hardy’s job — earning

Trauma surgeon Dr. Mikael Petrosyan in the operating room at Children’s National

the trust of these kids and working to help them repair the psychological damage and break the cycle of violence — is a lot harder and critically important.

“Philanthropy makes a difference. The return on investment is the well-being of children in our community. Each of them is important.”

Operating on a young child with gunshot wounds is the most heart-wrenching and challenging aspect of my job. It takes a heavy toll. These injuries are preventable.

― Dr. Mikael Petrosyan

The Youth Violence Intervention Program team celebrates a young patient

The trauma unit team cares for a patient