Nursing Forum Explores What Nancy Milio’s Detroit Mom and Tots Clinic Did So Well

If the Civil War had Abraham Lincoln, said Dorrie Fontaine, dean of the University of Virginia School of Nursing, then Detroit’s inner-city Kercheval neighborhood had a champion of similar spirit in nurse Nancy Milio.

Fontaine gathered Tuesday with nearly 200 students, faculty, alumni and other public health professionals in McLeod Hall’s Fenwick Auditorium to hear Milio recount the challenges she faced in her work as a public health nurse in the 1960s, and to understand their modern relevance as nursing professionals continue to struggle to provide health care to the underserved, vulnerable and impoverished.

“Addressing Disparities in Access to Care: Lessons From the Kercheval Street Clinic in the 1960s,” a panel discussion, was co-sponsored by the School of Nursing, the Darden School of Business, U.Va.’s Women’s Center and the Nursing School’s Bjoring Center for Nursing Historical Inquiry.

In June 2011, Milio, professor emerita of nursing at the University of North Carolina, Chapel Hill, donated her papers, journals, photographs and other memorabilia to the Bjoring Center, one of two such nursing history centers in the U.S. Her talk yesterday was part of the University’s celebration of the Rev. Dr. Martin Luther King Jr.

Milio joined the visiting nurses’ association in Detroit in the late 1960s. She not only dreamed up the novel idea of the Mom and Tots Clinic – a place that became a national model for community-based care, and is the subject of Milio’s seminal nursing text, “9226 Kercheval: The Storefront that Did Not Burn” – but also secured its funding, battled against its detractors, hired community members as its staff and rallied for the women and children she served, all while pouring her no-nonsense attitude and big heart into its success.

Milio’s clinic became an integral part of the Kercheval neighborhood’s fabric, a place that offered local women and children access to prenatal care, vaccinations, transportation, hot meals, day care and information on contraception and family planning.

The allegiance the mostly African-American population felt for the clinic was never more obvious than in June 1967, when the clinic was purposefully spared – marked with a “B” on the outside window, for “soul brother” – during the Detroit race riots that killed three dozen, injured thousands and ignited nearly 1,300 fires throughout the city. The Chicago Tribune dubbed the four-day period the “Detroit Holocaust.”

Many of the health care needs Milio’s clinic addressed still exist today, the co-panelists noted. Nursing School associate dean and professor Linda Bullock, who studies interventions for rural women, often the victims of domestic violence, noted that President Obama’s Affordable Care Act has earmarked some $1.4 billion for home visiting programs that offer much of what Milio’s Moms and Tots Clinic convened in a single place: care and information for poor mothers and children.

Without voices to urge its support, however, Milio said those monies would be lost.

“We’re not going to see that money if we keep quiet,” said Milio, her diminutive frame straightening. “If you don’t speak up, keep your eyes on the budget, write letters to the editor and let your senators and representatives know, those funds will be cut.”

Milio also underscored the impact her early work as a nurse has had on her lifelong career as a champion of those without a voice.

“Many of these children grew up, did good things,” she said. “Many of the moms grew up, did good things, and some of them fell on hard times. I can tell you this: they changed my life.”

Others on the panel – including assistant nursing professors Pam DeGuzman and Cathy Campbell, Bullock and professor Arlene Keeling, the director of the Bjoring Center – saluted Milio as one who has affected dramatic change in the field of nursing.

“Nancy’s journey illustrates the community-to-community drive for healthy environments for children, health care for women, who are the rocks holding the family together,” Campbell said. “To reach these communities, we can’t live 8-to-5, Monday to Friday; it has to be after hours, on the weekends, meeting with church groups. Nancy’s work reminds us: We have to go where the people are.”

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Christine Phelan Kueter

School of Nursing