In the years preceding the discovery that would fuel nightmares -- that the aging, harmless-appearing Dr. Kermit Gosnell had been running more of a slaughterhouse than a women's health clinic from his office on the corner of 38th Street and Lancaster Avenue in Philadelphia -- I was working with a family homelessness program that put mostly single mothers with children into permanent housing in the same community.
Chronic individual street homelessness is often driven by severe mental health disorders like schizophrenia, frequently co-occurring with a substance use problem, but family homelessness is more likely a purely economic problem. A single mom with little income can't absorb much budget shock; one prolonged illness, one lost job or one disruption in TANF money can quickly land mom in a homeless shelter with her children or uncomfortably doubled up with family members. Once out of the housing market, she begins the monumental task of saving the first, last and security deposit that the private housing market demands. Subsidies are few and far between and can take longer to materialize than they're worth.
In getting to what family homelessness has to with Kermit Gosnell and his baby butcher shop; let me share with you on woman's story.
Abortion among the often Biblically-literalist and very conservative black churches of Philadelphia is heresy. "Don't kill your miracle!"
When I met Ashley she was 19 and homeless, living in ad hoc arrangements on sofas around North Philadelphia along with her mother and her new born child. Her mother, a long time crack addict recently out of jail after a botched armed robbery attempt, was looking for help finding a place to live. While Ashley's mom was doing time, Ashley had lived with her grandmother, who was also an addict. After Ashley's mom was released, staying clean and struggling to find work and a place to live, Ashley decided to join her on the streets. Her grandmother's condition had been deteriorating, her household sinking into chaos as she strung together late night binges, strange men coming and going. Better to tough it out with her mom, Ashley figured, who for the first time was looking like the more stable and reliable parent.
Ashley's boyfriend was still in the picture as well. He didn't provide much help, but he did no harm. Like most kids who come up on the streets in North Philly, his skill set revolved around low level drug hustles. There the drug economy provides most of the jobs for unskilled, uneducated kids. When he wasn't hustling, he would dip his toe into what remained of the city's industrial economy, working part time minimum wage factory and warehouse jobs. He didn't seem like bad news to me. Mostly he just looked like a kid who was lost and confused and had no idea how he was going to make it in the world. When he and Ashley had their first baby, he found a new role as a child care provider, freeing up time for Ashley to start community college classes, which she excitedly did. She planned to train in health services and maybe some day go to nursing school.
My agency decided that the wisest thing to do would to be to split this family unit into two, providing Ashley's mom a place of her own where she could focus on her recovery from addiction. Ashley moved, with her boyfriend and her baby, into a studio apartment in North Philly and we figured out a razor tight budget where government programs covered the bases: WIC money fed the baby, SNAP put food on the shelves and TANF paid the subsidized rent. It was possibly the first stable housing experience Ashley ever had in her life. Sure, she was living off the dole, but she was also working hard to break a three-generation cycle of poverty.