Can Street Violence Be Fought Like a Virus?
Jeff Deeney
The Nation
June 21, 2012  
http://www.thenation.com/article/168529/can-street-violence-be-fought-virus

It's that time of year again. With summer's arrival,
people flow into the streets of America's poorest urban
neighborhoods. Temperatures rise and tempers get
shorter. Old beefs between corner drug crews start to
simmer again as warm weather brings more addicts to the
neighborhood, sparking territorial disputes over the
swelling black market. Violence can come to the city in
many ways, but it comes, like clockwork, when the
weather warms up.

In the past month alone, Philadelphia has seen an 86
percent spike in homicides, bringing the year's tally to
173. Nearly thirty people were shot in the city over
Memorial Day weekend alone. In Chicago, a rash of summer
gang violence has the city in a state of emergency, as
its homicide total soars 50 percent over last year's.
Some in the press have labeled it "worse than
Afghanistan."

Until the sudden eruption of gun violence in Chicago,
2012 had been a good year for Dr. Gary Slutkin. In 1995
he founded CeaseFire, the Chicago-based public health
program committed to curbing gun violence in the city's
most afflicted neighborhoods. In the past few years, the
infectious disease expert turned urban interventionist
had been seeing the fruit of his labors. A 2008 research
evaluation of CeaseFire showed that the program reduced
shootings in the city's most dangerous neighborhoods by
as much as 40 percent and even completely eradicated
gang-related retaliation homicides in some parts of
town. This February, The Interrupters, an award-winning
documentary about CeaseFire, aired to mass acclaim on
PBS' Frontline. Ameena Matthews, CeaseFire outreach
worker and the movie's charismatic star, did a slew of
high-profile interviews for an admiring press about her
frequently dangerous work. Stephen Colbert called
Matthews an "antibody" against urban violence.

But even more important than awards and accolades was
the publication of a study out of Johns Hopkins in
January, showing that a CeaseFire-based model in
Baltimore-Safe Streets Baltimore-had worked, achieving
similarly dramatic reductions in gun violence as in
Chicago over a three-year period, between 2007 and 2010.
Ceasefire's Baltimore program reduced homicides in
Cherry Hill, one of the city's most violent
neighborhoods, by 54 percent; non-fatal shootings
dropped by 34 percent. Indeed, mounting evidence
suggests that CeaseFire, which has grown from a handful
of employees to a nationally recognized brand name,
looks to be the real deal: a game changer when it comes
to the intractable problem of violent crimes in urban
centers. Efforts are now under way to scale the program
up, exporting it around the globe.

"We're in Baltimore, New York City, Philadelphia, New
Orleans, Kansas City," says Slutkin, speaking from his
office in Chicago and projecting total confidence in his
program's ability to change not just urban America but
the world. "We're in other countries: Trinidad, South
Africa, Kenya, Iraq-and the list is growing.

Some researchers have regarded CeaseFire with doubt. Dr.
Daniel Webster, associate director of Johns Hopkins'
Center for the Prevention of Youth Violence and lead
author of the study of Safe Streets Baltimore, admits he
was a Ceasefire skeptic-until he parsed the data.

"The magnitude of the positive results to me was quite
impressive," Webster says. Controlling for concurrent
law enforcement efforts and other factors that could
skew results, one neighborhood saw a 56 percent drop in
murders after the Safe Streets program began. Another
saw a 53 percent drop. "I assumed that it would take a
long time to see improvements, but the reductions
happened rather abruptly," Websters says. "It suggests
to me that there's pent-up demand for this type of
intervention."

Yet, with gang violence raging across Chicago this
summer as if Ceasefire had never existed, the question
arises: What happened, and does it bring doubt onto
Slutkin's methodology?

* * *

"Violence is a Disease," the CeaseFire homepage
proclaims. This concept is the basis for the program,
which Slutkin founded based on his theory that violence
is a learned pattern of disordered behavior. When
violence breaks out, the theory goes, it is possible to
prevent it from spreading among peers by blocking
transmission like an infectious disease. Having worked
with the World Health Organization on the Ugandan AIDS
epidemic, as well as spending years in Africa and San
Francisco fighting tuberculosis outbreaks, Slutkin knew
how to build models for fighting infectious diseases. He
designed a violence-prevention model along the same
lines.

Is violence really an infectious disease? It turns out
that it behaves sufficiently like one for the same
principles to apply in combating it.

CeaseFire works through aggressive peer-led street
outreach by ex-offenders with deep ties to the
community, who gather intelligence on gangs in order to
spot potential conflicts. Such conflicts are then
mediated by the program's famed violence "Interrupters."
At its peak, CeaseFire Chicago employed fifty outreach
workers and fifty Interrupters, chosen from pools of
candidates screened by professional and community panels
to ensure they'd left the hustling life. Statisticians
analyze the data gathered by outreach teams alongside
data tracking violence collected by law enforcement,
identifying up-to-the-moment crime hot spots, and
focusing the program's resources on those places where
recent flare-ups of violence have potential to multiply
through retaliation, breaking out and infecting whole
neighborhoods.

Unlike harsh police crackdowns that can create an
adversarial relationship with the community, CeaseFire's
first task is to establish its credibility as an ally in
the fight against violent crime. It does this by
relentlessly canvassing a given neighborhood, building
relationships with corner drug dealers and truant
youths, as well as the families, local leaders and faith
groups who support its work. Outreach team members visit
hospitals to counsel gunshot victims and go to funerals
to stand alongside the friends of murdered street
associates. They get access cops can't get; kids
involved with guns and drugs will talk openly and
honestly with CeaseFire workers because of their shared
history of hustling dope and packing straps. Not seen as
snitches, CeaseFire outreach workers can get privileged
details about grudges between gangs that could flare
into open war. In addition to preventing this kind of
violence, CeaseFire workers continue to engage with the
youths involved to change the cultural norms that make
retaliatory shootings seem like rational responses to
perceived slights and petty disses.

The Interrupters captures how risky this kind of
intensive field work can be; weapons sometimes come out
while CeaseFire is on the scene and outreach workers
have even taken bullets for the program. But the film
also shows how the intensive mentoring provided by
CeaseFire teaches young men and women to find
constructive ways to resolve conflicts rather than
reaching for a gun. The results are astonishing; over
the course of three years CeaseFire entirely eradicated
retaliatory homicides in four Chicago neighborhoods and
nearly halved them in three others. Such results stand
in sharp contrast to law enforcement crackdowns that can
actually spread violence into previously uninfected
communities, as gun-strapped hustlers "fall back,"
fleeing cop-targeted hot spots and moving to less
violent neighborhoods where they aren't immediately
recognized by police.

"We're like the iPod in a world of tapes or vinyl
records," Slutkin says, referring to cities stuck on
older, law enforcement-driven approaches to violence.
"But whereas consumers get to choose an iPod,
neighborhoods don't get to choose whether they want
enforcement and punishment or epidemic control and
behavior change. Usually they still just get crackdowns,
arrests and imprisonments."

Slutkin sees Chicago's recent uptick in violence as
symptomatic of how much the city has come to rely on his
program. Indeed, a similar phenomenon occurred in 2008,
when a temporary pause in CeaseFire's efforts was
accompanied by a spike in violence. He notes that
infectious diseases like tuberculosis and measles
similarly return when public health efforts to control
them are abandoned.

"This is a wave on top of a wave [of violence] that
began last fall when Ceasefire temporarily dropped off
from ninety-nine to fifty-three outreach workers," he
says, noting, "CeaseFire has added outreach workers in
response." He also points to the fact that CeaseFire
workers only cover a third of the city-and in those
areas there have not been spikes in violence.

* * *

Philadelphia's own rise in summer violence was
precipitated by a freak mid-winter spike in murders that
left thirty-four dead in January, just as its fledgling
CeaseFire program was emerging from the pilot phase.
Philadelphia is ranked sixth in homicides nationwide
among cities with a population greater than 500,000, and
five months later its violence trend hasn't snapped;
there were 173 murders as of mid-June, compared to 140
this same time in 2011.

Looking at Philadelphia CeaseFire, it's hard not to feel
like Slutkin's rhetoric about Ipods and vinyl records
and global game changers is getting ahead of itself.
Strictly grassroots and thinly funded, the program
comprises a street outreach team (and paid staff) of
only four people, led by Executive Director Marla Davis
Bellamy. Working out of a small office space on Temple
University's campus, the program uses volunteer
undergraduate criminal justice majors for extra manpower
to help locate social services for its clients.

An attorney with experience in public health, Davis
Bellamy holds dual appointment at Temple University's
law and medical schools and has an advanced degree in
government administration from the University of
Pennsylvania. Her outreach team brings the typical mix
of CeaseFire street wisdom and deep neighborhood
intelligence to the table. More than that, team members
are hungry for results, relentlessly canvassing the
neighborhoods where they work, while Davis Bellamy
pushes hard to make political inroads with the city's
top brass.

The program was piloted in the North Central
Philadelphia's 22nd Police District, a desperately poor
and persistently violent stretch of land, pocked with
crack cocaine corners and dense with urban blight. Davis
Bellamy is quick to point out that, of the rash of
murders back in January, "only one of those was in the
area we've been working in." Like Slutkin's conclusion
about Chicago's recent violence, Davis Bellamy believes
there are similar indications that the program is
already making a difference, with Philadelphia's most
violent police district appearing to have largely bucked
the recent trend.

But Philly's violence hot spots remain numerous, spread
across a vast territory encompassing multiple
neighborhoods and ethnic groups. How do a team of four
and a single director get their arms around this?

"By being persistent, man," says Terry Starks, tall and
stocky in a bright orange CeaseFire outreach worker
sweatshirt that matches his henna-dyed Muslim's beard.
"People in the neighborhood have been disappointed
before [by social programs]. At the scene of a shooting
they'll ask us, `Is this the only time I'm gonna see
your face?' That's why we're out there every day, we
call our clients every day, we're constantly checking on
them."

Starks, a onetime gunshot victim who spent much of the
last fifteen years bouncing in and out of jail on a host
of drug and other charges, including attempted murder
(ultimately withdrawn), agrees with Dr. Webster's
assertion that there's a pent-up demand for this type of
intervention. In Philly, he says, the CeaseFire team is
welcomed in places where cops are not and has easily
made connections, despite a pervasive Stop Snitching
street code in North Philly-long derided by police and
politicians as a cancer on the city-where sharing any
information about a person's drug operations or criminal
involvement is nearly certain to result in violent
retaliation. Witness intimidation has plagued city
courts, hindering the District Attorney's ability to get
convictions against violent criminals. Threats against
those who would cooperate with authorities are scrawled
in graffiti all over the city's hottest drug corners.

This makes the trust forged by CeaseFire workers
critically important. "When we roll up on the corner,
dudes are like, `What's up oldhead?'?" says Starks.
"Because they know who we are, they want to check out
what we're doing, they'll take our pamphlets and hear
our message." He points to a time a young man refused to
take a pamphlet "because there were people on the corner
watching us talk." But as they left, Starks turned
around to see the man cautiously take the literature
from another corner kid. "People want to learn about
this."

The youngest of CeaseFire's Philly four outreach workers
is 23-year-old Nortavin Rogers, who goes by his street
name, "Black," even around the office. While CeaseFire's
Chicago work has been largely facilitated by the
predictable patterns of retaliation that occur between
known gang affiliates, Black points out that Philly's
violence problems aren't driven by gangs. "Some dudes
try to bring that [gang] stuff over from Jersey, but
they find out real quick that ain't nobody in Philly
give a shit what color you wearing," he says. Instead,
violence is driven by fractious networks of ragtag
corner drug crews and pill-popping, PCP-smoking stick-up
cliques.

"In Philadelphia [violence] is a moving target because
of these cliques or crews that split, regroup and split
again," says Dr. Slutkin. "But this [fragmentation of
gang culture] is the new normal, it's happening in many
cities." Figuring out how to adapt is one of the
challenges CeaseFire faces. "Cities also will differ in
characteristics of violence; the distribution, forms,
structures," he continues. ".. It just means that
calculating [through street-level data collection] how
to deploy our workers is critical."

From city to city, another hurdle to overcome is
politics. Many mayors and local politicians pay lip
service to the need for innovative, evidence-based
social programs, but when it comes to funding,
implementation and long-term investment, political
calculations can trump programs that actually work.
Particularly in an atmosphere of severe austerity-
Republican Governor Tom Corbett is working to eliminate
welfare funds for single adult recipients, a safety net
program for the poorest in the state that has existed
since the New Deal-public funding for social programming
is seen as a fiercely competitive zero sum game. Nobody
wants their piece of the pie jeopardized to pay for new
programs run by unfamiliar players, no matter how
promising. And in at least one city (which Slutkin did
not wish to name), rather than pay to import replication
efforts, officials have tried to create knock-off
CeaseFire programs by reworking pre-existing (and
ineffectual) violence prevention programs run by
insiders.

Slutkin stresses science over politics. "CeaseFire is a
very specific and replicable system," he says. "Like a
vaccination campaign, you need the right ingredients,
the right dose, given at the right time by trained
professionals. Many agencies may say, `We're already
doing that,' or, `We can do it ourselves,' but they soon
learn that there is more to it-and are grateful for the
new training."

There is a palpable sense of anxiety at Philadelphia
CeaseFire over funding. The program is paid for only
through June 30, at which point it could conceivably
fold without an infusion of cash. Recently, Davis
Bellamy says, they've been trying to tap into federal
funds, and are preparing a grant that would fund a new
operation in the city's 25th police district-a notorious
neighborhood and the nexus of Philly's heroin trade-
should their efforts in the 22nd District wind down.

Both Slutkin and Davis Bellamy say they have met with
Mayor Michael Nutter and feel like he's behind them. And
contrary to the kinds of tensions one might expect
between police and ex-offenders working at the same
crime scenes, the police department welcomes any help it
can get in wrestling down the murder numbers. Davis
Bellamy stresses that Philadelphia Police Commissioner
Charles Ramsey has been a strong ally, as has Captain
Branville Bard of the 22nd District. Still when asked by
The Nation about providing the funding necessary to make
CeaseFire a permanent addition to Philadelphia's roster
of public health programming, and expanding it into more
gun violence-plagued neighborhoods, Mayor Nutter's
office declined to respond.

Part of Slutkin's intent in medicalizing violence was to
shield CeaseFire from funding pressures by making
prevention part of every city's budget. If violence is a
behavioral disorder that spreads like an epidemic rather
than a criminal act rooted in immorality, his argument
goes, then there should be a dedicated funding stream to
control outbreaks, as is done with tuberculosis, and
treat it the way we do other behavioral health disorders
like drug addiction.

Even with the funding odds against them, the Philly team
is clearly ready to do more than survive. Confronted
with the possibility that they could soon lose their
paychecks, Davis Bellamy pep-talks her outreach staff.
"Remember guys," she tells them, "the Chicago program
started with four people too."

___________________________________________

Portside aims to provide material of interest to people
on the left that will help them to interpret the world
and to change it.

Submit via email: [log in to unmask]

Submit via the Web: http://portside.org/submittous3

Frequently asked questions: http://portside.org/faq

Sub/Unsub: http://portside.org/subscribe-and-unsubscribe

Search Portside archives: http://portside.org/archive

Contribute to Portside: https://portside.org/donate