July 22, 2011 — University of Virginia nursing professor Arlene Keeling and doctoral student Pamela DeGuzman could hardly contain their excitement as they perused the contents of a box of diaries and other items belonging to Nancy Milio, a pioneer in nurse-managed health centers.
The archive, which the School of Nursing's Center for Nursing Historical Inquiry acquired at the end of June, contains Milio's detailed diaries, papers, photographs, an audio-taped interview, poems and published and unpublished papers, plus secondary sources, including yellowed newspaper and magazine clippings, all related to the Mom and Tots Center that Milio founded in 1966 on Kercheval Street in an impoverished area of inner-city Detroit.
Keeling, the center's director, said, "This is a small but rich collection."
DeGuzman learned of the material while researching a paper for Keeling's class on historical methods in nursing history. For her paper, "Addressing Disparities in Access to Care: Lessons from the Kercheval Street Clinic in the 1960s," she contacted Milio, now professor emeritus of nursing and professor emeritus of health policy and administration at the University of North Carolina at Chapel Hill.
During the ensuing interview, DeGuzman learned Milio had saved what Keeling refers to as a "treasure trove" of material related to the center and public health nursing in the 1960s.
When Keeling learned what DeGuzman had found, she persuaded Milio to donate the collection to the University's nursing history center, one of only two in the country.
Once cataloged, "The archive is going to be a widely used collection for students and faculty," Keeling said.
Milio's storefront "Mom and Tots Center" is an early example of a successful nurse-managed health center, DeGuzman said. "What she did was so pertinent now with health care reform and the current disparities. It's an important example of how nurses can help," she said. "Nurse practitioners often go where doctors do not want to go."
Milio involved the community in all levels of participation and care. The mission of the center encompassed health care and community issues, including family planning, prenatal care, some day care and sex education for teenagers. It was a place where people gathered to talk about issues concerning the community.
"What she did was so novel," DeGuzman said. "She deliberately went out and recruited people from the neighborhood. It was an experiment in community health care. She was ahead of her time.
"Poor moms, single moms – she understood how to get access to care: Bring it to the neighborhoods."
"She really listened to the neighborhood people about what they needed," Keeling said. "Kids even cleaned up the street in front of the center's storefront location and distributed flyers.
"This is such a great model. We need to look back and consider how we can do this now."
Contributing to Milio's success was her ability to raise funds to keep the center viable.
"She was persistent in getting funding. Nurses traditionally do not feel comfortable in that role," said DeGuzman, who earned an MBA from U.Va.'s Darden School of Business after getting her bachelor's in nursing. She worked in health care administration for 10 years before returning for her doctorate in nursing.
"We need to get comfortable with the money conversation if we are going to be successful," she said.
Milio's center became the hub for various neighborhood activities. In one diary entry, Keeling came across a flyer for an event: Self Identity of Being Black.
Milio's 1970 book, "9226 Kercheval: The Storefront that Did Not Burn," told the story of how the center survived the 1967 Detroit riots while buildings all around it burned or were destroyed. The neighborhood considered it a vital part of their community and were directly invested in its success.
Milio kept an almost minute-by-minute chronology of the riot in one of the diaries. It listed calls from various community members reporting the burning of each building around the center. Community members had marked the Mom and Tots Center's window with a "B," signifying "soul brother."
"The MSC is OK and it stands out like a sore thumb," Milio wrote. (Although it was called the Mom and Tots Center, Milio still referred to it in her shorthand as the "maternity satellite center," a name she had originally given it before she began to involve the community.)
"The community did this," DeGuzman said, referring to the center's survival.
The archive is a "view into race relations at the time and a microcosm of the tension in the country at the time," Keeling said.
As a historical archive, "this is more important than we thought," she said.
– by Jane Ford