The Houses That Help Keep HIV at Bay

At the Belle Reve group home in New Orleans, residents are running for cover. What started as a sunny day in early October quickly turned into monsoon weather, with more than three inches of rain slamming the city within an hour and flooding the streets.
But on the back porch of Belle Reve, an assisted-living facility for low-income and homeless people living with HIV, executive director Vicki Weeks calmly takes a drag off an American Spirit.
“Are you ready?” she asks, stubbing out her cigarette before taking me to meet a few of the residents, some of whom have been there off and on since Hurricane Katrina decimated parts of the city in 2005. “This storm is nothing. At this place, we’ve been through a lot. And damned if I tell you we’re not being tried right now.”
Weeks is referring to the millions of dollars it takes to keep the nonprofit operational — hundreds of thousands of which are in jeopardy by the U.S. Department of Housing and Urban Development. The agency has determined the needs of people living with HIV have changed as the virus has become increasingly manageable and is no longer seen as a death sentence. As a result, the government is planning to shift funds and grants away from group homes like Belle Reve in order to direct more resources to helping HIV-positive people find permanent housing instead.
But for cities with high rates of HIV among homeless or drug addicted populations — New Orleans ranks second in the U.S. for transmission rates — group homes are critical in preventing the virus from spreading. Many of these facilities also treat drug abuse and offer other support services, like counseling, medical oversight and life-skills classes. This wraparound support helps keep the virus in residents at healthy, undetectable levels, making it statistically impossible for them to transmit HIV to others while also boosting their chances of obtaining work and, eventually, living on their own.

Ronnie, a resident of Belle Reve, has been living with HIV for almost six years after contracting the virus from a sexual partner. After years of addiction and homelessness, his time at Belle Reve helped him become sober and undetectable.

There are homeless shelters in New Orleans, of course, but the options for people who are both homeless and HIV positive — especially those who are also in need of drug rehabilitation — are limited. That, despite the fact that facilities housing HIV-positive patients have been shown to improve their health outcomes.
The group-home model helped Phaedra, a 55-year-old woman living with HIV, start to get her life back on track. Phaedra, who asked that her real name not be used to protect her privacy, credits the New Orleans nonprofit Project Lazarus, which provides housing as well as classes, therapy and case management, for her progress. After leaving the home in 2017, Phaedra has been living with her boyfriend and actively searching for work.
“I’m doing my best, and I can say I’m really trying,” she says.
Diagnosed with HIV over 20 years ago, Phaedra has been abusing drugs on and off for decades. “I did everything that could give me HIV, including using IV drugs,” she says now. “I wouldn’t even know whose needle I was using.”
Through proper medical care, her viral load is now at undetectable levels. In that sense, Phaedra is lucky: According to a 2013 report from Human Rights Watch, injection drug users in Louisiana were more likely to develop AIDS within six months of receiving an HIV diagnosis due to a lack of social services.
This dearth of statewide support and services is an obstacle that administrators at Project Lazarus are trying to account for by offering former residents aftercare assistance. So people like Phaedra are paired with specialists who guide them through the job-application process and help them secure permanent housing after they leave — all of which is crucial to keeping them healthy and unable to spread HIV.
This aftercare support is a large departure from the original mission of Project Lazarus and similar facilities caring for those with HIV and AIDS, most of which were established in the late 1980s and ’90s at the height of the AIDS epidemic.
“This used to be a place for people to come and die,” says Nicole Kiernan, an aftercare specialist at Project Lazarus, explaining that the home was formerly used for hospice care for people dying of complications from AIDS. “You didn’t come here to move out at some point, like most people here do now.”
Though medical advancements in treating HIV and AIDS no longer make end-of-life care as critical as before, group homes are sorely needed — at least in New Orleans — as the virus shifts away from primarily affecting gay men. Today, that burden is shared disproportionately with poor communities of color, particularly in the South. Even more to the point, several studies have linked homelessness with a higher risk of contracting HIV, especially for those who are both homeless and young.
“Sometimes we only have one bed available, but have five people who are applying to get it,” Weeks says. And it’s an issue that Kiernan alluded to as well: In an area with over 1,100 homeless people at risk of contracting HIV, there’s just not enough places to shelter them and provide them with life-prolonging medication.
That’s making things worse in Louisiana, where in the past two years HIV diagnoses among drug users has almost doubled, according to the state’s Department of Health quarterly report released last spring. In 2017, nearly 5 percent of those diagnosed were injection drug users. By March of this year, that number increased to just over 9 percent.

              “We’re the ones standing here helping
               these people, and we will continue to do
               so until time runs out for us.”

Complicating an already dire housing situation? Access to funds — or rather, lack thereof.
Group homes that rely on grants from HUD through the program Housing Opportunities for Persons With AIDS (HOPWA) are expecting for the first time in 25 years to see their funding reduced.
“We’ve surveyed the people who get this money and we found that a lot of people who would use these funds actually need them more for permanent housing and not transitional [housing],” a spokesperson for HUD tells NationSwell, referencing that medical trends in HIV care have pushed the department to reevaluate where funds should go. “Even the name of the grants refers to people living with AIDS and, in reality, it’s just not at the prevalence it was. We need to modernize.”
Outside of Louisiana, that trend proves true, according to Kira Radtke Friedrich, services manager for the state’s STD/HIV program that monitors rural HOPWA funding.
“We saw a shift in the late ’90s to early ’00s. People didn’t want to live in group homes anymore,” Friedrich tells NationSwell. “We started hearing from our clients that, ‘I’m independent. I don’t want to live in a group-home setting.’”
But Friedrich admitted that the needs of rural populations are different from the needs of cities, where group facilities for homeless or addicted populations living with HIV are still warranted. “The burden is definitely heavier in New Orleans and Baton Rouge,” she says.
“We’re consistently ranked one of the worst in the nation for HIV and AIDS,” says Belle Reve’s Weeks of Louisiana’s two largest cities. “That’s not going to get any better if we just push these people out. And most of the people in these homes can’t function in permanent housing immediately.
“We’re the ones standing here helping these people, and we will continue to do so until time runs out for us. I just hope we can hang on.”

This is the second installment in NationSwell’s multimedia series “Positive in the South,” which explores the HIV crisis in the Southern U.S., and profiles the people and organizations working to alleviate it.

Looking Back: 4 Times John McCain Embraced Bipartisanship

As a self-proclaimed maverick, Arizona senator and former Republican presidential nominee John McCain embodies a brand of politics rarely seen on Capitol Hill these days. Though reliably conservative, with 30-plus years in the body, McCain has forged long-lasting partnerships and personal friendships with Democrats, even siding with them last year to defeat a hastily drafted attempt to abolish the Affordable Care Act, and co-sponsoring bipartisan legislation to regulate soft money in politics. His devotion to the institution of the Senate is arguably as important a part of his life story as his wartime experience.
For McCain, who was diagnosed with terminal brain cancer last year, the personal and political are inextricably linked, and his inspiring biography the bedrock of his public life and career. So it comes as no surprise that the Arizona senator’s most significant accomplishments are closely tied to his life story, and show a marked compassion for the lives of ordinary Americans. Here are four of McCain’s major legislative accomplishments.


After the fall of Saigon in 1975, the U.S. broke off all diplomatic relations with Vietnam. Ties were slowly restored over the following decades, and in 1991, the Pentagon opened an office in Hanoi to help look for MIA service members. In 1994, almost 20 years after the last American troops left Vietnam, President Bill Clinton started the process of normalizing relations, lifting a nearly 19-year-long economic embargo against the country. While many conservatives and war veterans decried the move, McCain — who happened to be both conservative and a Vietnam vet — became an unlikely supporter of normalization, leading a 1993 trip to Hanoi with fellow vet and then-Sen. John Kerry.
In 1994, McCain co-sponsored a resolution urging full diplomatic recognition of the country, saying that normalization was the surest way to aid Vietnamese political reforms and protect American security interests in the region. In 1995, the two nations officially restored full diplomatic relations, and Secretary of State Warren Christopher traveled to Hanoi to open a U.S. embassy there.


The Keating Five may not have as large a cultural footprint as, say, Watergate, but it was among the bigger political scandals of the late 1980s. In 1987, a group of five senators, among them McCain, were accused of improperly intervening on behalf of financier Charles H. Keating Jr., chairman of the Lincoln Savings and Loan Association, which was the target of an investigation by federal regulators. Lincoln collapsed in 1989, leading to the loss of $3.4 billion dollars of taxpayer money, calling attention to the substantial political contributions Keating made to each of the senators who had previously shielded him from being investigated.
Though the Senate Ethics Committee ultimately cleared McCain of acting improperly (he was criticized for exercising “poor judgment”), the episode had a lasting impact on McCain, who became a leader in the fight for campaign finance reform. McCain went on to partner with a democratic senator, Russ Feingold, to enact a signature bill, the Bipartisan Campaign Reform Act of 2002 — commonly known as the McCain-Feingold Act — to rein in the vast amounts of money swirling around politics. Though much of the regulatory muscle of the bill was stripped by the Supreme Court’s Citizens United decision in 2010, the legislation still stands as one of McCain’s most important legislative accomplishments.

John McCain 2
John McCain gives an interview after returning from Vietnam in 1973. After enduring nearly six years of torture as a POW, McCain became an outspoken advocate against excessive interrogation methods.


If nothing else, McCain understands the hell that torture visits on a body, having spent nearly six years as a POW in Vietnam. This experience lent him credence as a powerful voice in Congress against the use of so-called “enhanced interrogation techniques” such as waterboarding. After 9/11, his position on torture pitted McCain against the Bush administration, as Bush’s war on terror relied on techniques that many critics, including McCain, considered torture.
In 2005, McCain sponsored the Detainee Treatment Act as an amendment to a defense spending bill, demanding that the CIA adhere to the Army’s interrogation procedures, which explicitly prohibit the inhumane treatment of prisoners, including those at Guantanamo Bay.
This issue is once again front-page news, with President Trump’s recent nomination of Gina Haspel as CIA director. Haspel has been accused of overseeing a secret CIA detention facility in Thailand where detainees were waterboarded, and then subsequently destroying videotaped evidence of such interrogation sessions. McCain urged Congress to reject Haspel’s nomination, stating that “Ms. Haspel’s role in overseeing the use of torture by Americans is disturbing,” and “her refusal to acknowledge torture’s immorality is disqualifying,” though Haspel was eventually confirmed 54-45.


McCain was opposed to 2009’s landmark Affordable Care Act (aka Obamacare), voting no on the original bill, and supporting subsequent motions and amendments to weaken or replace it. But in 2017, just days after the Arizona senator revealed that he had a malignant brain tumor, McCain voted no on a Republican-led effort to repeal the ACA, saying that the Better Care Reconciliation Act (i.e. the “skinny repeal” bill), would have destabilized insurance markets and possibly led to deep Medicaid cuts. (Arizona state officials had estimated that the BCRA would have cost Arizona’s Medicaid program $7.1 billion by the end of 2026.)
McCain’s vote, which stunned many of his colleagues and effectively killed the bill, was less an endorsement of Obamacare than it was a rebuke of the way that the bill was being rushed to passage without proper debate and a CBO score. In his Senate floor speech, McCain called for bipartisan health-reform legislation that was the product of “regular order,” where legislation goes through a transparent committee process and both parties are able to work on it.
McCain also voted no on the subsequent Graham-Cassidy proposal, which would have weakened or eliminated the rule that insurance companies need to cover patients with pre-existing conditions. “We should not be content to pass health care legislation on a party-line basis,” McCain said in a statement on the proposal. “The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.”

Update: Sen. John McCain passed away on August 25, 2018, at his home in Arizona. He is survived by his wife and seven children.

What an Epidemic Among Frogs Can Teach Us About Human Disease

This past year’s deadlier-than-usual flu season cost the U.S. an estimated $15 billion in lost productivity, as millions of infected workers called out sick. And as the Zika outbreak proved in 2016, there is reason to be worried that we aren’t doing enough to prepare for whatever infectious disease comes at us next.
To that end, scientists are turning to an unlikely ally in hopes of learning how to prevent, or quash, the next global health threat: the lowly amphibian.
In the late 1990s a deadly fungal pathogen ravaged millions of amphibians around the world, leading to catastrophic losses among their populations. But researchers recently found that a few species of frogs in Central America, which were thought to be extinct, have rebounded and, in some cases, developed even stronger defenses against the infection.
The study, published last month in the journal Science, looked at how the froggy fungal disease, called chytridiomycosis, went from epidemic levels, when an infectious disease introduces itself quickly and affects large populations, to an endemic, or the point at which the disease becomes commonplace. The fungus is still around and as deadly as ever, suggesting that some frogs have evolved to create resistance to the disease.
“If you’ve ever held a frog or toad, people have that experience of it being a slimy animal. That’s because they have these secretions as a defense mechanism,” says biologist Jamie Voyles, an assistant professor at the University of Nevada, Reno, who led the multiyear study. “Amphibian skin is actually a very complex physiological organ, so in addition to water absorption, there are also these secretions that are helpful to the immune system and are really good at inhibiting pathogens.”
Perhaps the most interesting takeaway from the study, though, can be gleaned by examining what happens to populations — and the disease itself — after an epidemic, which can inform how we to respond to human-spread diseases in the future.
“Historically, we’ve viewed infectious diseases as being able to shift over time, but we haven’t fully clarified how that works,” says Voyles. “Think of the more notorious cases of influenza, or similar kinds of outbreaks, where there is a large panic and high mutation rate, and where we know that the virus is changing all the time from one strain to the next.”
An example of this disconnect between what happens during an outbreak and what happens afterward is the 2015 Ebola pandemic, which sparked widespread media hysteria and killed more than 11,000 people.

2015 Ebola Outbreak
An Ebola outbreak in 2015 left thousands dead. Now researchers are looking to nature to help prevent future outbreaks.

“There is a drop-off in attention paid to host populations after an outbreak,” she says. “We tend to do a lot of hand-waving when an epidemic is going on, but [we don’t much] hear about follow-up in [terms of] understanding the disease after an outbreak.”
By continuing to examine how outbreaks affect wildlife after the fact, we might be in a better position to contain epidemics among humans in the future, says Voyles.
“If we understand the mechanistic underpinnings of how outbreaks happen, then we can apply those lessons to how we respond to other emerging infectious diseases,” she says.
The threat of a devastating global pandemic is increasingly worrisome for public health experts. They point to the lack of preparedness among some nations, even as others, such as the U.S. and China, have established rapid-response teams to swiftly deal with an emergency.
Or as Jimmy Whitworth, a professor at the London School of Hygiene & Tropical Medicine put it, “We’re only as secure in the world as the weakest country.”
And as the worldwide population grows and people pack themselves into ever-denser urban areas, as well as expand to regions previously inhabited only by wildlife, the opportunity for the spread of catastrophic diseases is only increasing.
More worrisome still: As the global stakes rise, funding in the U.S. is being cut.
The Trump administration’s fiscal plan for 2018 slashes millions of dollars from the Centers for Disease Control’s budget, which has led the agency to roll back its efforts in global-disease prevention by 80 percent.
“[Outbreaks and infectious diseases] are not problems that are going away,” Voyles says. “It’s an increasingly connected world, and what that means is that we’re going to be moving more pathogens all around the globe.”
The current situation, much like amphibians themselves, is, in a word, slippery, where preparedness for pandemics is taking a backseat to other economic priorities. Our best hope, then, might just lie with the frogs and what they can teach us about winning the war on global disease.

A Prescription for the Doctor-Patient Language Barrier

Even if you’re a native English speaker who’s lived their whole life in the U.S., the healthcare system can be a nightmare.
Labyrinthine call systems are only the start. You’ve also got to find a doctor you trust; figure out the care you need; decipher what your insurance will cover; learn how and when to take (or refill) prescriptions; and remember to make follow-up appointments. If you’re a parent, you’ll need to repeat the exhausting process for each of your children. And if you’re employed full-time, you’ve also got to find the time to juggle your healthcare before, after or in between work hours.
Now imagine navigating that same confusing terrain without being able to speak fluent English.
For the millions of Americans who don’t, ConsejoSano (translation: “healthy advice”) is here to help. The Southern California-based telehealth startup offers the only health platform tailored to address the needs of multicultural, non-English-speaking patients.  
Most of the clients ConsejoSano works with are health plans, employers, government programs and at-risk providers who are united by a common cause: Motivating the people most likely to fall through the cracks of the U.S. healthcare system learn how to master it — in their own language. Through a suite of technological solutions, including multi-channel messaging and data analytics, along with a cadre of bilingual employees, ConsejoSano helps the marginalized and underserved access the care they need now and improve their overall health literacy.
The company’s initial focus was on helping Hispanic patients. Services are free, around-the-clock and help tackle issues related to costs, language barriers and immigration status.
“In the U.S., nearly 60 million people speak Spanish; 20 million of those only speak Spanish. Another third can only manage basic communication in English, like ordering food at a restaurant,” explains Abner Mason, ConsejoSano’s founder and CEO. “Ask them to explain — in English — that they have a piercing pain in their lower back, and they don’t have the tools. Or if a doctor wants to explain to them, also in English, why their 12-month-old baby needs vaccinations, they won’t get the full understanding.”
Although Hispanics make up over 17 percent of America’s population, “Spanish-speaking doctors represent only 4 percent of our physicians,” notes Amon Anderson, director of Acumen, an investor in ConsejoSano. “In four short years, ConsejoSano has quickly expanded its reach across Southern California … escalating thousands of cases to healthcare providers and ensuring Hispanic patients receive the care they need.”

ConsejoSano healthcare
ConsejoSano founder Abner Mason says it’s his mission to never leave any patient behind.

Today, ConsejoSano also provides services to speakers of Arabic, Farsi, Mandarin, Cantonese, Armenian and Tagalog, among other languages. Currently, the company counts about 300,000 users and hopes to see that number climb to 1 million by the end of 2018.
But ConsejoSano does far more than translating a generic automated call into a different language.
For starters, initial communications from ConsejoSano to patients are likely to happen via text.
“One thing all cultures have in common across the board is text messaging,” says Mason. “Many communities have loved ones and friends in other countries, so they’ve become accustomed to using WhatsApp or other platforms. It’s just how people communicate now.”
The next step: calling a patient and talking to them in their own language, with an emphasis on their cultural background. (ConsejoSano’s multilingual employees follow a script that has been reviewed and approved by the company’s medical director.)
“Say you’re going to convince a mom that her baby needs vaccinations,” says Mason. “If you use the same message in Spanish to communicate with a mom in San Diego as you do with a mom in Miami, you won’t get the same results. One culture comes from Mexico, the other may be someone who comes from Puerto Rico or Cuba. They don’t have the same traditions or culture.”
Patient content is consciously tailored too.
“Often people design materials for English speakers, then translate it into other languages. But because they’re not starting with culture, just hitting Google Translate, the signal it can send to the patient is, ‘Who I am doesn’t really matter. This message isn’t really for me,’” says Mason.
Dr. Alfredo Ratniewski is executive chief medical officer for Borrego Health, a ConsejoSano client whose 23 locations serve Medicaid patients in California’s San Diego, Riverside and San Bernardino counties. He’s seen firsthand how ConsejoSano campaigns have coaxed parents to bring their children in for wellness checkups, encouraged women to have annual mammograms and convinced older adults to agree to colonoscopies so they can be screened for colon cancer.
“That cultural approach makes all the difference in the world,” says Ratniewski.
Before launching ConsejoSano, Mason founded the Workplace Wellness Council of Mexico, which is now the leading corporate wellness company in that country. He also served as a member of the Presidential Advisory Council on HIV/AIDS and was the founder and executive director of the AIDS Responsibility Project.
What causes people to ignore their healthcare is a puzzle he tries to solve every day. And every day, the answer is different.
“If an Arabic woman needs to come in for a pap smear, you need to build a trusted communication channel not just with her, but for [her] family,” Mason says by way of example. “If someone needs a prostate exam, the reasons why need to be explained and in a way that also deals appropriately with their culture.”
Our current political climate can make that tricky. Many people don’t trust “the system.”  They worry loved ones may be taken away by ICE. In other words, says Mason, “they don’t feel equal.”
Because of that, “we’ve got to get the culture right, the language right, the mode of communication right — and all that has to be built on a foundation of trust,” Mason says. “We get responses all the time, from patients who say, ‘This is the first time someone’s treated me like a first-class citizen.’”

One Couple’s Long, Bumpy Road From Opioid Addiction to Sober Living

It’s just before 7 p.m. in Huntington, W.V., and the street lights have turned on for the night. The east side of the city is illuminated by a deep orange that cascades over the roads and trickles onto the large lawns of two-story homes that line these streets.
Justin Ponton sits with his girlfriend, Jami Bamberger, on the stoop of Newness of Life, the recovery home Ponton runs. Both finish cigarettes (they smoke Newports) as they talk about the homemade cooking — much of it deep fried — they missed by not attending church that Sunday.
Ponton sports skinny jeans, a tight-fitted “Kanye West for President 2020” shirt and black sneakers that are impeccably clean. His arms are tattooed into sleeves of crosses, roman numerals and cartoonish lettering. His bombastic, urban style is very much out of place. Ponton knows — and doesn’t care.
“From where I stand, the skinny jeans make me stand out,” he says.
In front of the couple, a group of five men wearing baseball caps and baggy pants slip out of the shadows and walk side by side in the street. Ponton raises his hand and gives a wave.  
They acknowledge him with nods, but continue walking.
“Probably have a meeting or something they need to get to,” Bamberger says as the men walk into Recovery Point, a drug addiction and alcoholism recovery center, at the end of the street.
Bamberger should know. At the time, she was the coordinator for another Recovery Point location about 35 miles away in Charleston, W.V. It follows the same schedule, though that facility is all women.
“Everybody — news outlets, politicians — keep coming to Huntington and talking about how bad it is here. It kills me that Huntington has been reduced to a city that has this dark side to it,” says Ponton. “Dead-ass, we have a problem, but there is so much recovery in Huntington. And nobody ever talks about that.”
In August 2016, Huntington was thrown into the international spotlight when 26 people overdosed on heroin within a five-hour timespan. Since then, a barrage of news outlets have trekked to Huntington — a small city in a rural state that’s experienced the demise of its main industry — to tell the story of how it became the poster child for the nation’s opioid epidemic, nicknaming it the “Overdose Capital of America.”
Residents and public officials resent that moniker. When asked to speak with NationSwell, both the mayor’s office and Huntington Police Department declined to be interviewed, with one member of the mayor’s administrative staff saying that, “even good press is bad press at this point.”
But with a number of options for recovery that are giving thousands of addicts a second chance at life, including peer-mentor models like the ones that Ponton and Bamberger operate, locals have come up with a different moniker for their city: The Recovery Capital.

The Argument for Abstinence

Ponton’s recovery home is well known in Huntington for its underdog  approach to recovery. Newness of Life doesn’t turn anyone away; most of its male residents don’t have any money, and many don’t have stable employment. They are exactly how Ponton was when he was in rehab years earlier.  
Today, community leaders embrace the 33-year-old former addict. But when he was just 10 years old, Ponton was slinging drugs and living on the streets of a Washington, D.C., suburb.
“There’s something about Justin,” says Kim Miller, a close friend of Ponton’s and director of corporate development for Prestera Center, a rehab clinic. “People just gravitate toward him, and they trust him.”
In and out of prison and rehabs for over a decade, Ponton found himself in Huntington at a faith-based recovery center where he turned his life around.
“I was actually kicked out for selling drugs within the rehab,” he says. “But I came back, got clean and started working for the program. And that’s when I wanted to go out and go on my own.”
Newness of Life is an abstinence-only halfway house that operates out of two houses located next door to each other on the eastern side of Huntington — not far from Marshall University and the local hospital. Setting it apart from the numerous other two-story dwellings in the neighborhood: The vending machine dispensing Monster Energy, a heavily caffeinated drink, sitting on the front porch.
Residents are required to stick to a regimen. Morning chores and attendance at 12-step Alcoholics Anonymous meetings and a weekly house get-together are mandatory. No one is allowed visitors, and everyone must have a job.
“I came to Newness and didn’t have anything, didn’t know how to take care of myself or my family,” says Matthew Thompson, a former resident at Newness of Life. “Yeah, it was tough, but with Justin’s help, I was able to get back on track.”
And being tough is exactly what Ponton wants.
“We don’t want you getting too comfortable,” Ponton says. “The point is to become a productive member of society, pay for your child’s bills and get a real home.”
Most importantly, it’s mandatory that every individual living at Newness remain sober — even medically-assisted treatment (MAT) like methadone or Suboxone, which prevents users from suffering withdrawal symptoms like nausea or severe cramping, is not allowed.
MAT is considered the gold standard for recovery treatment. The Centers for Disease Control, The National Institute of Health and dozens of other medical leaders support the use of MAT, and multiple studies have found MAT has reduced opioid deaths from relapsed users by more than half.
“The importance of offering a variety of medication assisted treatment modalities is really that we’re keeping people alive,” says Miller.
But many former addicts reject it.
“You’re just swapping methadone or whatever you’re given for the original drug,” says Ponton. “But not to throw shade on [MAT]… We like to say that not one solution is for everyone.”
In warmer months, Ponton may see only a dozen guys at a time taking shelter at Newness. But once the cold sets in, Ponton usually has a full house, with almost 35 men staying at the facility.
Typically, inpatient rehabilitation centers can cost up to $6,000 a month for residents. Ponton charges just $100 a week for people to stay at Newness of Life, but most of the time, people can’t even afford that. As a result, Newness operates primarily in the red, as Ponton’s mantra is “never turn anyone away, even if they can’t pay.” The houses are in desperate need of maintenance, and shoestring budgets aren’t enough to keep the electricity from being turned off on occasion.
“Somehow, he figures it out. Every single month, the guy has no cash, and he is still able to get those guys heat and water and a roof,” says Ryan Navy, a close friend and executive pastor of New Heights Church, which provides religious counseling for many of the guys at Newness of Life.  
“Everyone in the church knows about Newness and Justin, and they’re right alongside them every Sunday,” he says. “They’re willing to help, which kinda shows you what this community has been doing since the news has come out on the problems here — how we’ve tried to address it.”

How Heroin Took Hold

Huntington’s decline is no different than other towns in the Appalachian region of America. Once filled with miners and coal workers, the city found itself struggling in the early 2000s as the clean energy and technology industries decreased the country’s reliance on fossil fuels and highly-educated Millennials flocked to urban centers along both coasts.
It’s easy to blame the economic downturn for why people started using drugs. But that’s leaving a key point out of the narrative: How the drugs found their way into Huntington in the first place.
Workers’ compensation claims over the past two decades have fueled an increased use of opiates nationally, and West Virginia has been flooded with pain killers at a higher rate than other states, according to an investigation done by the Gazette Mail. Since Huntington is a former city of industry, a significant number of its residents incurred injuries on-the-job. Initially prescribed drugs for legitimate pain management — surgery, injury rehabilitation — many later turned to a cheaper alternative, heroin, as states began cracking down on unnecessary  prescriptions.
“You had this situation where you had large numbers of people abusing prescription opioids and then we took measures to reduce the availability of those pills,” says Robin Pollini, associate director of the West Virginia University Injury Control Research Center in Morgantown, which studies opioid use in the region. “At the same time, heroin traffickers were looking to these places and saying, ‘Hey, we’ve saturated the urban markets, let’s start going into these smaller markets.’ And what they had was a population that was looking for a cheaper, more available opioid for the pills they were using.”
Bamberger, Ponton’s girlfriend, was one such person. At 21, she was prescribed Oxycontin after undergoing surgery for a sports injury.
“[Prescription] drugs did save my life, at first. They did. Honestly,” she says. “I had knee surgery, but from there — and that’s how it started — it only took about five months, and I was already using a needle.”
Originally from Tennessee, Bamberger excelled in staying clean at Liberty’s Place, a rehab in Richmond, Ky. That success led her to the Charleston, W.V., Recovery Point location, which houses close to 100 women fighting for their sobriety without MAT.
The opportunity to work at a rehab center was something Bamberger, 24, always wanted to do. Before falling into addiction, she was attending school to be a drug counselor.
A tour of Recovery Point Charleston reveals that the women live a militaristic lifestyle. Beds are perfectly made, and there’s a limit on personal items. Residents are confined to the building, strictly monitored and have a schedule that includes daily chores, classes and “trudging” — a practice that requires the women to walk miles each day.
Bamberger explains the practice as, “If we could walk for our drugs, we’re going to walk for our recovery.”
Success is rewarded with a paid gig as a peer mentor, a position that pays minimum wage. Recovery Point claims that more than 60 percent of its former residents remain clean. That number is controversial, however, as critics argue that the organization cherry picks data from its alumni events.
“This program, when you come in, they start you from the bottom and you work your way up. You’re taught responsibility, you get jobs, you have to wake up, you have to you know, do a chore here, you go to classes, you learn a lot more,” says Hailey Miller, 24, who is one of Bamberger’s close friends and a resident at Recovery Point.

Get to Huntington

Some states — including those outside the Appalachian region — have started to look at ways proactively to combat opiate addiction. For example, Washington, Colorado and Vermont have discussed legislation that would allow safe injection facilities where users could receive sterile injections while under supervision.
Those programs have come under fire for a host of reasons, including the assumption that they lead to endorsement of drug usage. But safe injection sites are known to be effective in curbing opioid use and overdose. In one study, their use lowered the number overdoses in addition to reducing the spread of HIV and Hepatitis C.
The research, though promising, is so controversial in America that even doctors have conducted studies in complete secrecy without federal approval.
For now, recovery homes and rehabs are the primary go-tos for people seeking help in Huntington. That’s primarily because the city has become very well-versed in triage, but not in prevention or identifying those who are currently in need of help.
“When you’re in the midst of what has been labeled an epidemic, you kind of get in emergency response mode,” says Prestera’s Miller. “What we’re doing is putting out fires a lot. We’re helping the people that we know are coming in seeking our services, and we’re throwing everything at them.”
The work doesn’t stop once someone is clean. Relapse is imminent for many; up to 60 percent of those in recovery will abuse drugs again, according to the National Institute of Drug Abuse, part of the National Institute of Health.
Miller says that there’s no “best solution” to solve for addiction or eliminate the chance of relapse, including MAT. In multiple instances nationwide, addicts placed into abstinence-only recovery programs by drug courts wound up dead because they started using again.
This is why Ponton doesn’t claim Newness of Life residents achieve success, only a chance at it. And it’s why he keeps fighting for others.
On the Sunday morning that NationSwell is with Ponton, he receives a call from an old friend who is using drugs again. The guy is high and called Justin in a moment of weakness, wanting to get help and come back into the program. It’s a phone call Ponton gets often — sometimes daily — he says.
“Alright,” Ponton tells the friend. “Get to Huntington.”
The friend arrived, as promised, but used again the very next day.

A Winter Gift

This past November, Ponton’s heating systems at Newness of Life were shot, and the guys were at risk of having to spend the entire winter with no heat — a scary prospect considering Huntington’s winters are brutal.
“I don’t know where we’re gonna get the money to fix this,” Ponton says under his breath as he analyzes a spreadsheet that reveals in angry red ink the thousands of dollars he’s behind on his bills.
Two days later, Ponton and Navy, the pastor, meet in the back of Lafayette’s, a cigar and wine shop located in downtown Huntington. Navy had news that could only be announced over a Romeo y Julieta cigar: An anonymous donation had been made to Newness in the form of a new heating system.
Less than a week later, the guys at Newness of Life were living in a warm place again.  They may still be battling addiction, but at least they wouldn’t be spending the winter in the cold.
Correction: A previous version of this video incorrectly stated that Ponton and Bamberger opened a new recovery facility in January 2018.
Homepage photo by Joseph Darius Jaafari for NationSwell.

Fighting Drugs With Drugs in West Virginia

Justin Ponton hit the gas pedal and sped his Dodge Charger up a hill to the parking lot of Hurricane City Park, in rural West Virginia. It was November 2017, and he had just found out that a friend was using drugs. Again. Ponton feared what he’d find when he reached the man.
Ponton, 33, only had a few minutes to get there. He has been through this before. As the owner and operator of a sober-living facility in nearby Huntington, he knows all too well how easy it can be to accidentally overdose and die.
Ponton found his friend sitting in the passenger seat of a parked van — just high, not overdosing. Which was lucky considering Ponton didn’t have any naloxone, the overdose-reversing drug that he often carries with him for occasions like this. Had his pal actually overdosed, Ponton would’ve had to wait for the paramedics to arrive.
America’s heroin and opioid crisis killed more than 60,000 people in 2016, according to estimates from the Centers for Disease Control. That’s twice the number of fatal shootings for the same year. Put another way, drug overdoses today kill more people each year than the HIV epidemic did at its peak in the mid-1990s.
States have scrambled to find ways to get users clean and halt the spread of heroin and, increasingly, the synthetic opioid fentanyl — a drug that can be up to 100 times more powerful than heroin. Prescription painkillers also remain problematic, especially in rural states.
But now another drug is working to reverse those statistics.
Breathing can slow down or stop completely when someone is overdosing. It’s in that moment when naloxone — more formally referred to by its brand name Narcan — binds to opioid receptors in the brain and reverses or blocks the effects of other opioids. The drug works in seconds to restore normal breathing.
Naloxone is relatively inexpensive. But as the demand for it has increased, so too has its price.
“This is absolutely an epidemic,” says Robin Pollini, associate director of the West Virginia University Injury Control Research Center, which studies opioid abuse. Her state has the dubious distinction of having the highest rate of overdose deaths — 52 per 100,000 people, compared to 19.8 per 100,000 people nationwide. “Have we seen the worst of the drug problem? I don’t think any of us can say, because I don’t think we have a real handle on what’s going on out on the street or in people’s homes.”
Opioid abuse crosses state lines, of course, but recent coverage of the epidemic has put a spotlight on West Virginia — and Huntington in particular. In 2016, the city of just 49,000 made national headlines after 26 people overdosed in one five-hour span. The event launched a federal investigation by the CDC and a media firestorm that was quick to label Huntington as “America’s overdose capital.”
READ MORE: Born Into Rehab: Giving Life to West Virginia’s Tiniest Opioid Victims
As director of outreach of WVU’s Injury Control Research Center, Herb Linn became curious about the effectiveness of take-home naloxone kits. During the heroin scourge of the 1990s, the kits, which typically contain two doses of naloxone, were distributed to drug users in major cities where heroin was prevalent, including New York, Los Angeles and Baltimore. Recipients administered the naloxone themselves when someone nearby overdosed.
Getting an opioid antidote in the hands of drug users in big cities — where you can pinpoint at-risk communities in dense areas and then focus on treatment and prevention — is easier than it would be in the rural environs outside of Huntington. “I became very intrigued about whether this kind of program could translate to a rural population … and whether it would be effective with abusers of opioid pain medicines.”
That’s a legitimate concern, says Pollini, who argues that it’s not enough to simply take a program that worked in a densely populated city and apply it to a remote town of 1,000 people.
“In rural areas, you don’t see [drug users] out in the open as much. There’s not a street scene like you might see in Baltimore or Philly,” she says. “And they’re not accustomed to outreach from harm reduction programs.”
And then there is the stigma of drug dependency, especially in small towns where it can seem like everyone knows your business. For addicts and their families, the fear of public shaming may deter requests for the life-saving kit.
In 2013, Linn published a brief on the effectiveness of naloxone when it’s made widely available in a community. He shared it with public officials in the state, and two years later, the legislature passed a law allowing physicians to prescribe naloxone to anyone who might have to use it — from drug users and their families to first responders answering an emergency call.
“What that did was open up the door to folks who were allowed under that legislation to start programs,” he says. For Linn, that helped local communities start distribution programs from late 2015 through 2016 and led to a collaboration with the state to distribute over 8,250 kits in 2017.
Among those receiving kits were emergency workers in Huntington. They began a pilot program that deploys a quick-response team whenever there’s an overdose. Not only do first responders administer naloxone to revive someone, but they also stay on the case by working to get the victim into a treatment program or a drug court.
Experts say the city has seen a dramatic turnaround in the number of people dying from overdoses.
“We have educated the community about what an overdose looks like,” says Kim Miller, director of corporate development for Prestera, a rehab clinic, and a clinical expert in opioid addiction. “In Huntington, we have allowed access to [naloxone], so that more people are carrying it than ever before. If you’re at a restaurant and someone overdoses in the restroom, for example, and you carrying naloxone, you could save their life.”
That belief has Ponton constantly scrambling to stock up on more of the kits. Currently, he relies on donations to keep a steady supply on hand at his sober-living home.
After the close call with his friend that night in November, Ponton asked the city’s fire chief, Jan Rader, for a kit she had on her.
“I hope we figure out a way to get more of these out there,” he said, before giving her a hug and heading back to his car.
Less than two weeks later, he used that same kit to revive someone else from yet another overdose.
Additional reporting by Kayle Hope.

Born Into Rehab: Giving Life to West Virginia’s Tiniest Opioid Victims

In the rear of the Cabell Huntington Hospital maternity ward is a medium-sized, unlit room. Occasionally, its darkness is pierced with a scream that nurses can only describe as a kind of cat call.
The patients inside suffer from seizures and are hyper-sensitive to bright light. Sometimes, their bodies cramp, stiffening like a board. Other times, they’re fidgety. And the thumb sucking… it’s never ending — unusual, even for newborns.
These babies are the youngest victims of America’s heroin problem. Exposed to opiates while still in the womb, they suffer from Neonatal Abstinence Syndrome, or NAS.
In the U.S., the number of babies born with NAS increased by more than 300 percent between 1999 and 2013, according to a report released in 2016 by the Centers for Disease Control. In Huntington, W.V., the problem is exponentially worse. CDC findings reveal nearly 33 cases of NAS per 1,000 hospital births — the highest in the nation. But anecdotally, Cabell Hospital nurses report witnessing more than 100 per 1,000 babies, nearly 16 times the national average.
To be clear, these babies are not born addicted to opiates. Rather, their brains were exposed to opioids in utero, damaging how they’re formed and similar to how alcohol affects brain development in children born with Fetal Alcohol Syndrome.
It’s well documented how FAS impairs childhood development. In sharp contrast, medical professionals have been able to recognize the symptoms and diagnose NAS for decades, but they continue to be perplexed by what happens to these newborns as they age. Many doctors and nurses say they simply don’t know.
“We have so many babies that are being born prenatally exposed to illegal drugs. That’s been a well-documented problem in our community and in our region,” says Robert Hansen, director of addiction services at Marshall University in Huntington. “The question becomes what’s happening to these babies after they withdraw from those drugs, and what’s going to happen with their moms? What’s going to happen to the children as they grow and develop and enter the school system?”
Where Huntington sees a crisis, it also sees a solution. As community leaders do their best to mitigate the opioid epidemic that has gripped their city, members of the medical community and local university are partnering together to care for these newborns by launching the first-of-its-kind childcare program to study the long-term effects of NAS. The hope is that their findings will be used to inform future educational initiatives.


The reason why Huntington has such a high number of babies born with NAS is largely due to its location. The city straddles three state lines — Kentucky, West Virginia and Ohio — and has one of the only large hospitals in the region. Mothers are more likely to give birth there than anywhere else in the area.
Two years ago, the CDC released a report revealing that women aged 15 to 44 were filling opiate prescriptions at a higher rate than normal. Because of the opioid epidemic in this part of Appalachia, Cabell Huntington Hospital is overrun with drug-exposed babies.
There’s just not enough beds, says Sara Murray, nurse manager in the Neonatal Intensive Therapeutic Unit at Cabell Huntington Hospital. Her unit only has 15 beds, but during the first week of November 2017, nurses were caring for 19 babies with another expected at any moment.
Newborns with NAS remain in the hospital longer — up to 100 days, compared to three to four days with other babies — making overflow inevitable. The extended hospitalization got Murray thinking.
“They were staying for long periods of time, and we just felt like there was something that must be missing in caring for them, thus causing them to stay so long,” Murray says.
In response, Murray and two coworkers, Rhonda Edmunds and Rebecca Crowder, opened Lily’s Place, a NAS clinic that would serve as overflow for the hospital.
Lily’s Place is only the second facility in the U.S. that exclusively cares for NAS babies. It’s modeled after a program in Kent, Wash., that, according to Edmunds, “needed to also be in Huntington.” Since opening in 2014, the facility has cared for more than 300 babies. First Lady Melania Trump and other influential politicians have said that the unique program should be a model for the entire nation.
The care provided to newborns at Lily’s Place mirrors what they’d receive at the hospital. To ease withdrawal symptoms, nurses rely on methadone, an opioid that satisfies the physical cravings of opiate dependency, but doesn’t provide the high that heroin or prescription painkillers do.
Though methadone has been controversial for adults in recovery —  many view it as a substitute for another drug — treating newborns with methadone is widely accepted within neonatal units.
“Any parent will tell you in here that withdrawal is very painful,” says Sarah Murray, who runs the Neonatal Intensive Therapeutic Unit at Cabell County Hospital. “We don’t want the babies to suffer that pain, so we get them through the acute withdrawal.”
By the time each infant goes home from Lily’s Place, it’s been weaned off all opioids, including methadone.
Despite its success in providing overflow for the hospital and counseling and caregiving services to parents of babies with NAS, Lily’s Place faces tremendous difficulties. Funding is a continual problem. The majority of women who give birth to opioid-exposed babies are on Medicaid. With national healthcare on unstable ground, public and private donors could be needed in the future to finance the cost of treating a newborn with NAS, which carries a price tag of more than $60,000, according to the National Institute of Drug Abuse.
Because of health insurance and Medicaid complexities, Lily’s Place can only accept babies born to West Virginia residents; those born to mothers from out of state cannot be transferred from Cabell Huntington Hospital to Lily’s Place. For now, the hospital’s maternity ward continues to be overrun.
The clinic has tried to solve this by offering other states guidance on how to open up similar programs, but there have been no successful takers, as of yet.


The long-term effects of opioids on the babies that leave Lily’s Place or the hospital is anyone’s guess.
“There needs to be a lot more research done about what the children need. That start[s] out with neonatal abstinence syndrome, and really, across the country, there hasn’t been enough research to answer that, so it’s very variable,” Marshall University’s Hansen says. “Some children who start out with NAS may not need much support and services. Others will need different [things]. We just don’t know yet.”
In January 2017, Hansen reached out to Suzi Brodof, owner of a shuttered daycare facility, to discuss what to do about Huntington’s newfound fame as America’s heroin capital.
More specifically, he wanted to talk about babies with NAS.
“I went to a meeting and there were about 30 other people from all different organizations in the community. We all wanted to help because we were concerned about what was going to happen to all these babies that are being born to moms who are addicted,” Brodof says. “Everyone went around and said what they could offer. When it got to me, I said that I have a building that was built to be a childcare center, and if we want to still use it in some way for children, I’m willing to contribute that to the cause.”
Brodof had contemplated turning her building into an office complex, but stopped due to the fact that everything inside was miniaturized.
“We didn’t want to just convert it to some other use if we could use it for something for children,” she says.
Educators estimate that 500 students with NAS will be entering the school system in Huntington alone, but didn’t provide proof of that number. “The concern is that the teachers are not prepared,” Brodof says. “They don’t know what to expect or how to handle them.”
That’s where Brodof’s new childcare facility, River Valley Cares, steps in. The childcare center, which opens this year, is studying NAS children in a controlled environment in conjunction with researchers from Marshall University. One nursery room, for example, has a two-way mirror that researchers can use to observe child interactions without intruding.
The hope is that the program will provide the first-of-its-kind research on how toddlers with NAS interact with other students and how they work in learning environments.
If successful — and it will likely take years to conduct the research — River Valley Cares will be able to give teachers, parents and educators the tools needed to figure out how to manage children with NAS.


Ryan Navy, a 26-year-old pastor, adopted a baby boy with NAS after a parishioner in his church, New Heights, relapsed on heroin.
“She was clean for, I think, two years. She was doing well,” Navy tells NationSwell. “Three or four weeks before this baby was supposed to be born, she relapses and started shooting up heroin again.”
This story isn’t uncommon in Huntington. But neither are the examples of city residents demonstrating their belief that it takes a village to raise a child — especially when those children are afflicted with NAS. In many instances, mothers can’t manage a newborn while going through opioid withdrawal themselves and the baby ends up in foster care.
Navy’s New Heights congregation is well known for fostering NAS children. The church has about 18 foster families, Navy says, and a fellow pastor has adopted “two or three kids.”
“I can’t even keep track anymore,” Navy says with a laugh.
The good that results from this village mentality extends far beyond Huntington’s newborns. When Brodof went to that first meeting with Hansen, she immediately recognized the benefit of the community banding together.
“Until we all came together last January, none of us really were interacting,” she says. “We were all doing good things for children and families, but we realized once we all came to the table that we would be able to be much stronger if we worked together.”
Additional reporting by Kayle Hope
Correction: A previous version of this article stated that bright light causes babies with neonatal abstinence syndrome to have seizures. A previous version of the video stated a factual error regarding medical information. NationSwell apologizes for the errors.

Getting Real About Golden Years

Getting old isn’t for the faint of heart. Healthcare is expensive. Extra services are needed. There’s pressure on your adult children to take care of you. (And from their perspective, they’ve got to deal with the mental anguish of watching you try to cope!)
Yes, it’s joyous to lead a long, healthy life, but the operative word is “healthy.” If you’re lingering, not living, I don’t see an upside.
Making it to 100 — or beyond — only makes sense, to me, if you have a high quality of life. If you’re confined to a wheelchair, if someone has to clean you, bathe you and dress you, and if you’re not even aware of your surroundings, living to such a ripe old age doesn’t feel like much of a victory. To enjoy longevity, it’s crucial that we can still give back to others, feel well enough to participate in activities, and enjoy our family and friends.
When my father was 69, he had a stroke. A medevac helicopter rushed him to the hospital, where doctors told us there was a possibility that he’d recover. As a family, we decided to put in a feeding tube.
Had I understood the magnitude of my father’s stroke and been given more clear medical information, I would have made a different decision.
My father lived 14 more years, but he was confined to a wheelchair and had minimal speech capabilities. He suffered. Despite my parents’ long-term health insurance policy, his illness also ate away at their financial resources.
Three years ago, my father finally passed.

Afterward, I thought my mother would have a chance to be healthier and happier, as she was no longer a primary caregiver. Unfortunately, that didn’t happen. Last year, she fell and broke her hip. At the same time her physical health declined, so did her mental health. Now she, too, requires 24-7 care.
Today, my mother resides in a senior living facility. It’s clean and safe. She’s treated with kindness. A nurse visits her once a week and calls me with any problems. But since my mother’s finances were drained from my father’s illness and her long-term insurance doesn’t cover much, I support her. At first, I was optimistic that Medicare would help, but at the end of the day, when someone needs around-the-clock care, the cost is too considerable.
I’m not complaining; many others are in a similar situation. As people live longer, they need to be cared for. That’s the concern with an aging population, and it’s one that should be addressed more seriously.
I think the healthcare crisis we’re in is substantial. It’s a tragedy to see people lose their Medicare while drug prices rise, and to hear about terrible nursing home situations in the news. The longer people live, the more needs they have, and the greater the burden on our entire system.
I doubt that I’m alone in these thoughts. There’s a movement in our country toward hospice services. People want compassionate solutions, not 911 drama. As we have the opportunity to live longer, it will become critical for people in the medical field to come clean with families so that appropriate choices can be made. Hopefully, those decisions will be guided by love.
On the other hand, exactly when the “best” years are in your life depends on you, your career and your interests. Each individual’s journey is different. There’s no prescription for success or happiness.
If I were to live to 100 and still had a good quality of life, I’d continue to engage in enriching, cultural activities. I’d spend my days going to the theater, watching old movies and reading fiction. I’d surround myself with interesting stories, and would hopefully be reading them to my great-grandchildren.
Although I officially retired as president of the Brooklyn Academy of Music in 2015, I recently completed a two-year senior fellowship at The Andrew W. Mellon Foundation. Now, I’m serving as a senior advisor to the Onassis Foundation’s cultural centers in New York and Athens, Greece.
I love what I do, but it’s hard to know if I’ll still be working at the age of 100. Younger people will call the shots at that point, but hopefully I’ll be interesting enough to stick around and contribute to their shining moments.
If so, I’d try to illuminate and educate younger generations without always saying, “In my day…” I’d try not to hold on to the same level of professional intensity I had in my 40s, 50s and 60s.
In return, I’ll hopefully be seen as a visionary in my day — someone who worked hard, did well and added more vitality to the field.
As humans, we can’t go backward. We have to move forward. If it’s intimidating to think about that in big chunks, then we can break it down day by day. To me, that means if I can wake up and feel good, continue to work and be with the people I care about, then I’m lucky.

Karen Brooks Hopkins served as President of the Brooklyn Academy of Music from 1999 until her retirement in 2015 and was an employee of the institution since 1979. She has worked with the Cultural Institutions Group, the Mayor’s Cultural Affairs Advisory Commission and as the Brooklyn Regent for the New York State Education Department. In 2013, Crain’s named her one of the “50 Most Powerful Women in New York.” Karen currently serves on the boards of the Jerome L. Greene and Alexander Onassis Foundations, as Senior Fellow in Residence at the Andrew W. Mellon Foundation and Fellow of the National Center for Arts Research at Southern Methodist University.
This post is paid for by AARP.

Long Live Good Nutrition, Healthcare and Biology

Recently, I was looking through a book that listed the “most amazing places” to visit around the world. I remember thinking, “Will I really get to see all 35 in the time I have, or will I need to pick and choose?”
It’s scary to think that our time here on earth is limited. Many people, including myself, have a massive list of things they’d like to do or accomplish. If I could have five careers, for example, I would. Although I’m a health and fitness coach and social worker, I’d also love to support my community in other ways. Rehabbing abused animals and working in prison advocacy immediately come to mind.
When I consider the possibility of living to be 100, I can’t help but think, “Why not?” It sounds awesome — just think of how much more time we’ll have! But to enjoy it, we’ll need to take care of ourselves.
People in my family live long, healthy, happy lives. My great-uncle, one of the original Tuskegee Airmen, lived to be 95. We used to spend an afternoon each week together. Mentally, he was very sharp until his last few months. His sister-in-law, my great aunt, lived to 99. She went skydiving for her 85th and 90th birthdays.
Today, the oldest person I’m closest to is my father, who just turned 84. He’s very active, both physically and mentally. He does callisthenic exercises every morning, walks the family dog, and mows the lawn and cleans the gutters on his own. A former judge, he’s still an avid reader and thinker, and actively works to keep his mind sharp. My mom’s only 71, but she’s on the treadmill every day.

Because I was adopted as a baby and don’t know much of my biological history, I’m unsure what I can reasonably expect in regard to my own longevity. But I deeply believe that it will depend on a lifestyle that places value on physical and emotional health.
If people are going to live to 100, healthcare will have to improve. Not only should it become more accessible and affordable (that’s a given), but people should be rewarded for paying attention to preventative care, such as annual exams.
I’d love to see a broader range of medical treatments in everyone’s health plan. Along with prescribing drugs to control symptoms, an emphasis should be put on using nutrition to help people manage issues like high blood pressure. In an ideal world, doctors would receive nutrition counseling to help them discuss it with their patients.
We’ll also need more acceptance and education about mental health issues. They impact large swaths of our society, and yet we continue to behave as if that’s not the case. As a result, more and more people go without getting the support that could help them build meaningful, fulfilling lives.
Staying active is a key part of being physically and emotionally healthy. I fully intend to remain active throughout the course of my life. I currently run triathlons, and I am planning to start yoga soon. Ideally, I’ll still be doing triathlons when I’m 80 — or 100 — but I’ve had three surgeries already on my knee, so I need to be open as to how things play out. If I can’t do a triathlon, then I’ll walk every day — and I’ll be the best walker I can be. Aging isn’t about what you can’t do. It’s about keeping up with your own parameters.
I think gym memberships should be part of healthcare plans. People need to find a way to move their bodies that make them feel good. In the decade I’ve spent in the social work field, I’ve routinely found that older adults who maintain active lifestyles are able to rehabilitate and return home from the hospital far faster than those who don’t.
My understanding is that women generally live longer than men, so I do have some fears about outliving my husband if I were to live to 100. I don’t intend to have children, so I hope I won’t be alone. I have 14 nieces and nephews that I’m close to, who range from newborn to 30 years old. Some I babysit. Others train with me for triathlons. “Will you be on the hook for me when I’m older?” I tease them. (“Is that why you’re spending so much time with us?” one of my nephews asked the other day.)
The answer, of course, is no. At the present time, my vision for living to 100 involves living independently in the Shenandoah Valley, on the acres of farmland I own. I hope to be homesteading and growing my own fruits and vegetables. Whether working or volunteering, I want to still be helping others. And maybe visiting all 35 of those “most amazing places” in the world.

Marianna Johnson has spent her career as a social worker and a certified health and fitness coach supporting people improve their quality of life.  She was raised in Northern Virginia and spent time living internationally with her Foreign Service family. She’s been an athlete throughout her life and is training for her first half Ironman race.
This post is paid for by AARP.

Teen Caregivers

A 62-year-old recovering from a broken neck and a 17-year-old who wore the reddest dress in the world to prom are an unlikely pair. But they’re mentor and mentee, and now friends, as part of a program that aims to solve two troubling challenges: the “silver tsunami” of millions living longer and needing care, and the challenges of at-risk urban youth trying to find meaningful careers that offer the chance for advancement into the middle class.
Olga Cruz lives in The New Jewish Home, a nursing home in New York City’s Upper West Side. She fights feelings of isolation and depression with the help of Wenetta Celestine, who shares stories about life during weekly visits. Celestine, like 225 other high school students from the Bronx and Manhattan, spends six to eight hours a week training to work in geriatric care.
Cruz helps her understand what it is like to grow old and what elders in a long-term care facility need.  
“She’s wonderful and loving; I want to hug and squeeze her like a grandma,” Celestine says of Cruz. “If I can’t tell my mom something, I can tell her.”

Many of the teens who are part of the Geriatric Career Development program develop mutually supportive relationships with residents.

With 10,000 Baby Boomers turning 65 every day, and the population of elderly people expected to more than double by 2050, well-trained caregivers are already scarce. And they’re becoming even harder to find, with growth slowing in the primary pool of such workers: women ages 25 to 64.
Back in 2006, The New Jewish Home had trouble hiring certified nursing assistants (CNAs) for residents in its facilities in Manhattan and Westchester County, N.Y. Meanwhile, the graduation rates of many high schools in the Bronx and Manhattan was 40 to 60 percent; few students went on to college.
With the help of private, city and federal grants and a curriculum from nearby Columbia University Teachers College, the Geriatric Career Development (GCD) program introduced 20 students to eldercare.
As part of a summer certification course, Tania Hueston (left) and Jaileen Morales (right) performed clinical tasks at a local hospital. The teens do similar work all year long at The New Jewish Home.

GCD isn’t just about finding people to take vital signs, empty bedpans and bathe the elderly. Its larger aim is to provide struggling teens with the skills and jobs that make it possible for them to earn money, pursue higher education and escape from poverty (almost three quarters live below the poverty line; many reside in violent neighborhoods).
Without this program, Celestine says, “I wouldn’t be working to be a CNA, and I’d probably not know CPR. I learned that there’s always an open door, no matter where you go.”
Eleven years in, it’s found success. Ninety-nine percent of GCD’s 517 graduates have finished high school and 28 currently work at The New Jewish Home. Of this year’s 62 graduates, all are going on to attend college.
In return, the Home gets more than simply a larger hiring pool. Students spend 8,000 hours a year with its elders.
“It makes the residents feel less lonely, and they feel a sense of satisfaction, especially those who do not have family around,” says John Cruz, director of the program. “It makes them feel young again, alive again.”
GCD participants Hinelsey Quezada (left) and Jose Moncada (right) study for their Certified Nursing Assistant certification exam.

Research shows that both young people and the elderly gain when participating in programs like GCD. A recent Stanford University report called for “intergenerational engagement,” citing particular benefits for underprivileged youth.
Today, similar programs exist in Maryland, through the High School Health Education Foundation, and via the Pathways in Technology Early College High School (P-TECH) model, where students can enroll in a six-year-long program that includes job training, a no-cost associate degree and employment that’s all but guaranteed.
Demand for the GCD program is high — each year about 200 students (mostly African American or Latino) apply for 100 spots. Most start as sophomores and spend the next three years learning how to care for elderly patients. Students can earn $11 an hour during a nine-week-long internship at the Home when they are seniors.
Participants receive tutoring help and assistance on how to study for the SAT and how to write resumes and cover letters, among other topics. They also receive counseling on college selection and are taken on campus visits.
About 80 percent continue their medical education by receiving nursing assistant certification via Lehman College (The New Jewish Home covers the cost for each student’s certification course), and some become certified phlebotomists, EKG technicians, medical coders or patient care technicians.
Kayla Rivas, 17, and Joanne Langer, 91, chose each other because they both like to sing.
Joanne Langer, 91, and Kayla Rivas, 17, at The New Jewish Home in New York City.

“It was like love at first sight,” Rivas says. Langer explains that they enjoy “anything except rock and roll,” before she croons her rendition of Irving Berlin’s “What’ll I Do?”
“I feel like she’s like a grandma for me. I always come to her for advice and comfort. When I told her about wanting to go to college she always motivates me, and gives me hugs and kisses,” Rivas says.
Other pairs share similar sentiments. Jaileen Morales, 18, says that without Mizue Fujimoto, 67, she’d likely be struggling more and planning to stay local after high school, instead of going to the State University of New York in Old Westbury, where she plans to study biology.
Just as important, Fujimoto helps Morales, who was raised by her grandmother, have a better relationship with the elderly.
The New Jewish Home has extended its program to people ages 18 to 24, who have dropped out of school or are not currently working. After three months’ of training, participants become certified home health aides, a position that does not require a high school diploma and pays a median hourly wage of $10.87.
Half of all home aides live in households that receive welfare or food stamps and other public benefits. Because of this, the program encourages graduates to earn more credentials.
Certified nursing assistants fare slightly better, earning a national median of $11.68 per hour, compared to $12.81 for patient care technicians and $16.92 for medical coders. While some of these jobs may not boost a worker into the middle class, they can further his or her healthcare career path or provide useful income during college.
Some GCD students are aiming higher. In all, 40 percent of GCD graduates became or are studying to become doctors, nurses, physical or occupational therapists, administrators or other healthcare professionals.
Rivas wants to be a physician’s assistant, a position that has a median salary of more than $90,000. And Morales hopes to become a plastic surgeon.
What started out as a desire to fill entry-level jobs has turned into a program that’s creating a chance to fulfill big dreams. Celestine, Cruz’s mentee, says that without GCD, she wouldn’t be heading off to SUNY Cobleskill in the fall.
“I like to keep to myself, so I’d stay home and get a job,” Celestine says. “I learned that there’s always an open door, no matter where you go. When I see kids on the street, I feel like saying, ‘If you all just knew what GCD could do for you, even if you’ve not finished high school. This is like a change.’”
Correction: A previous version of this article stated that 530 GCD students have finished high school and 75 of this year’s class is going to college. NationSwell apologizes for these errors.