Nancy speaks about community health nursing. Full interview available on Audio page.
Mary E. Gibson, PhD, RN & Pamela A. Kulbok, DNSc, RN, APHN-BC, FAAN
Milio narrated a poem, “Health is wholeness, unfolding” as both prologue and epilogue to her story of 9226 Kercheval. This poem set the stage for her story and focused attention on the meaning of health in the broadest of contexts. Health as wholeness unfolding transcends time and place and has meaning for public health nursing and population health.
As prologue …
Health is wholeness unfolding:
It is sharing, significantly, increasingly,
in the varieties of human experience…
It is growing in awareness…
And it is feeling good about it all, coming into Self-hood…
As epilogue …
Health is wholeness unfolding:
It is the pink skin covering a wound.
It is a book in the hand of a ghetto-dweller,
and soul music on the lips of the suburbanite.
It is the preschooler’s first whoop in day care.
It is knowing,
not only I and You
Health is wholeness, unfolding.
And it is present
Only when we continue to seek
in ourselves, in our institutions,
together with others,
A sharing which is significant,
in the possibilities of man,
A growing awareness of self,
And a feeling of self-worth,
Which is the result.
The World Health Organization’s definition - originally endorsed in 1946 – states that, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1 This broad definition of health has not been amended since its public declaration in 1948. Public health advocates are very familiar with this definition – yet health is not yet conceptualized in this way in the wider population. In 1968, when Nancy Milio’s dream of “health” for this underserved and vulnerable population was partially realized in the formation of the Mom’s and Tot’s Center, the community surrounding Kercheval was becoming healthier.
Milio’s work demonstrates the development and fulfillment of the potential of the Kercheval community, i.e., a group of individuals, who shared a sense of place and acted intentionally for a common purpose. The Mom’s and Tot’s Center succeeded in engaging those involved and their concurrent commitment to the health of their community. Thus, the community itself was enhanced – hundreds of mothers and children benefitted from the services and the population of the neighborhood trended towards healthier behaviors. Just as Johnnie, Mary Louise, Felicia and Mrs. Watkins all found a place in the center, found their own “WHOLENESS UNFOLDING”, so too the broader community became engaged in the work of the center. Various local agencies invited Mom’s and Tot’s staff to present to their groups, providing an extended scope for the idea of health in a damaged, and vulnerable community.
The “pink wound healing,” reflected in the poem, could refer to the racism that was part of the every-day lives of Kercheval’s residents. While it would be naïve to consider that the Mom’s and Tot’s Center eliminated the longstanding effects of racism, poverty and lack of opportunity in the community, we do know that the advancement of some of the residents undoubtedly empowered them. This represents a reach towards “whole-ness unfolding,” and thus movement closer to the WHO definition of health. This is a process that does not happen overnight. The Center involved black power brokers of Detroit in its inception, its development and its continued success. As difficult as it was to engage those militant groups, their buy-in facilitated the ownership of the center by the black community at large.
Many would say that Nancy Milio took the hard road leading to wholeness; however, the ownership of the Center by local residents made Mom’s and Tot’s a model public health initiative that others may use as a classic example of community partnership. By sharing selflessly with others the possibilities of the collective, within the community and outside of it, Milio created opportunities for growing self-awareness and feelings of self-worth in the Kercheval community. This resulted in the WE that protected 9226 Kercheval, the storefront that did not burn during the 1967 Detroit race riots.
1. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.