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  • Writer's pictureCam Hill

Structural Brokenness

Cam Hill | September, 2021

When they say the system is broken, here's what they mean:

Have you ever had one of those days? The kind of day where everything seems to be going wrong - so much so that part way through the day you begin thinking things like, “of course this would happen to me today…” Those are the days where it feels like it’s you against the world… and the world is winning! Fortunately, those days come to an end and we wake up the next day to a world that has returned to “normal.” And normal is pretty favorable.

Imagine living in a world where the systems around you seem to be working against you. Imagine navigating through life in a world where the “normal” day is a day filled with frustrating circumstances, and things that just can’t seem to go your way. And imagine that all of those things that seem to be going wrong, don’t go wrong because of bad luck, but because the system doesn’t appear to have been built with you in mind.

This is the reality for the countless millions living in poverty in the U.S. We recognize that until you’ve experienced it, or seen it first hand, it’s hard to imagine. We get a fair amount of push-back when we talk about structural racism, or structural injustice. And most of that push-back comes from folks who want to believe that the landscape of our world (in America at least) is built on a foundation of equity, where everyone is given a fair shake in life. And as long as you’re honest, and work hard, you can accomplish anything you set your mind to. I wish that were true. I really do. We are big fans of integrity and hard work. Unfortunately, the vast majority of folks living in poverty need much more than virtue to flourish. They need a system that honors their virtue, by considering their circumstances. Those living in poverty need a system that recognizes the hurdles that stand in their way, and partners with them to help them overcome those barriers.

These convictions don’t come from theoretical arguments. They have been brought to life through the heart-breaking stories of our neighbors. We are regularly given a front row seat to the challenges that our neighbors are facing. Here’s one such story.

Just a few days ago on August 30th, our Program Director called the mother of one of our students, just to check in on them. She hadn’t heard from this family in a few weeks, and she felt a prompt from the Lord to reach out. She said they hadn't been doing well… When asked why, she said that her son hadn't been able to start 7th grade since he didn't have his Tdap vaccine. This was his 10th day missing school… And the school said he would be counted truant soon (kids can go to jail for that sort of thing). She said that she wasn’t made aware of this vaccination requirement until the week before school started and that she had been working to get it taken care of since she found out. The school nurse assured her all she had to do was go to CVS and pay $40 for the shot. First she called her son’s primary care doctor but they weren't offering the vaccine. So she started saving up money to get the shot for him at CVS (she’s been out of permanent work for 2 years). She also put him on the waiting list with the Health Department and was told it could be weeks or months before he could get it.

Quick recap. At the age of 12, her son is just a few days shy of being sent to jail or caught up in the criminal justice system in some capacity BECAUSE OF A TDAP VACCINE REQUIREMENT that they’re trying to get taken care of. She didn’t have money for gas, making transportation incredibly difficult, and she’s contacted 3 locations to try and get this required vaccination. The 2 free options are currently unavailable, and she can’t afford the 3rd. That’s where we’re at. This is more than “one of those days.

Our Program Director called the school, and the nurse reassured her it could be easily taken care of - just $40 at CVS. She was nice.

Grace (our Program Director) called CVS to see if they needed to make an appointment before going and they said the student could not come since he was under the age of 13 and did not have a prescription from his doctor. No problem. They said to try the Minute Clinic because they could give him the vaccination even though he was under the age of 13. Now we’re on to something.

They made an appointment with the Minute Clinic. When they arrived they were told they couldn’t give him the shot. No worries though, they had a sign that explained everything. It said, "MinuteClinic cannot provide vaccines for Medicaid patients if they are 18 years old or younger. Also, due to state and federal law, we cannot accept cash payment for this service. Please visit your primary care provider or Health Department to receive vaccinations.”

Another quick recap. CVS required a prescription to receive the vaccine. The MinuteClinic couldn’t provide the vaccine, and the two options referenced as alternatives were unavailable. And this 12 year old is one day closer to being truant, and getting caught up in “the system” which (statistically speaking) will swallow him up and spit him out a few felonies later, as an adult. But hey, this isn’t anything a little integrity and hard work can’t fix, right?

Our Program Director spoke with the doctor to make sure they couldn't pay over the counter and told her all of the road blocks they had already encountered. The Doctor gave her a number to call and assured her this was somewhere they could go to get the vaccine. No more roadblocks.

As they were leaving another family walked in and the student’s mother said, “they’re going to get the help they need.” The student’s mom wasn’t having a bad day - she was having a normal day, in a system that wasn’t designed with her in mind. Oh, and she was probably right… the other family would likely get the help they needed. The system was built with them in mind.

They called the number they were given, only to be told they couldn’t accept him since he wasn’t already a patient. No surprise there. A normal day, going normally.

They went to Walgreens to see if they could take him (a little friendly pharmacy competition never hurt anyone), but they said they could only see him if he had a prescription from his doctor. (Remember, mom already called his primary care doctor and they weren’t offering the vaccine). They called around and were able to find another primary care doctor who could take him, so they made an appointment for the following morning (12 days out of school at this point).

As they were driving home, the student’s mom thanked her for driving them around town, and said it would've been so hard for her to have paid gas money or bus fare, only to come to the end of the day and still not have accomplished the one goal they set out to accomplish. Let that sink in. When I run around town, and accomplish little, I get frustrated because I wasted time. This mom was just thankful she hadn’t spent all of her vaccine money on gas.

Our Program Director called the school nurse and kindly informed her that this wasn’t an easy fix - and not as simple as “walking in and paying $40.” God forbid someone else gets sent on a wild goose chase. The nurse thanked her.

The following day they went to the doctors office bright and early, to receive a check up and a prescription. The check-up went smoothly, but before they could receive the prescription they had to get blood work done. The only problem was the doctor's office didn’t run blood work. They needed to go across town to get it done. No big deal, they were being given free transportation on this particular day.

They got the blood work done, and went to Walgreens to get the Tdap shot. They were told it would be free at CVS with his insurance, so they packed up and went to CVS, and waited in line. When they were seen, they were told that it would not be free with his insurance. When they asked why, they weren’t given a reason. We paid $63 for the shot. While in line, they found out from the school that this student would not be able to ride the bus to school unless a copy of his immunizations were faxed to the Bus Department. They came to our office and faxed the records, but he wasn’t able to ride the bus the next morning. His mom had to arrange transportation for him (He lives 20 minutes from the School he is zoned for).

Let’s summarize. This student was required to have a Tdap vaccine to go to school. That’s reasonable. The steps needed to receive that vaccine were radically unreasonable, and would have been impossible for this single mom, if it weren’t for their connection to a non-profit that could provide the services, and funds necessary to receive the vaccine. If Grace had not been obedient to the Lord’s prompt to call this mom, her son more than likely would not have received his vaccine, and would have been counted truant and very likely swept up into the Department of Juvenile Justice system, or the Department of Social Services. He’s 12. He’s a pre-teen! They call it a school to prison pipeline for a reason. The system wasn’t designed with him in mind. Consequently, there is a higher statistical likelihood that he will remain in poverty, than not. Integrity and hard work can’t fix that.

There is something fundamentally broken with the structures around us, and the sooner we accept that reality, the sooner we can begin doing something about it. We’ll never roll up our sleeves to fix something if we don’t think it’s broken. I hope this story shines a light on at least one fracture in a foundation that is quickly losing its integrity. It’s not too late to pursue a more just and equitable world, but that work begins when we take an honest look at the state of things, and allow our hearts to lament it’s brokenness. This mom’s version of normal is worth lamenting. It shouldn’t be this way. It doesn’t have to be this way.

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