These women ran an underground abortion network in the 1960s. Here’s what they fear might happen today | CNN



CNN
 — 

The voice on the phone in 1966 was gruff and abrupt: “Do you want the Chevy, the Cadillac or the Rolls Royce?”

A Chevy abortion would cost about $200, cash in hand, the voice explained. A Cadillac was around $500, and the Rolls Royce was $1,000.

“You can’t afford more than the Chevy? Fine,” the voice growled. “Go to this address at this time. Don’t be late and don’t forget the cash.” The voice disappeared.

Dorie Barron told CNN she recalls staring blankly at the phone in her hand, startled by the sudden empty tone. Then it hit her: She had just arranged an illegal abortion with the Chicago Mafia.

The motel Barron was sent to was in an unfamiliar part of Chicago, a scary “middle of nowhere,” she said. She was told to go to a specific room, sit on the bed and wait. Suddenly three men and a woman came in the door.

“I was petrified. They spoke all of three sentences to me the entire time: ‘Where’s the money?’ ‘Lie back and do as I tell you.’ And finally ‘Get in the bathroom,’” when the abortion was over, Barron said. “Then all of a sudden they were gone.”

Bleeding profusely, Barron managed to find a cab to take her home. When the bleeding didn’t stop, her bed-ridden mother made her go to the hospital.

At 24, Barron was taking care of her ailing mother and her 2-year-old daughter when she discovered she was pregnant. Her boyfriend, who had no job and lived with his parents, “freaked,” said Barron, who appears in a recent HBO documentary. The boyfriend suggested she get an abortion. She had never considered that option.

“But what was I to do? My mom was taking care of my daughter from her bed while I worked — they would read and play games until I got home,” Barron said.”How was either of us going to cope with a baby?

“Looking back, I realize I was taking my life in my hands,” said Barron, now an 81-year-old grandmother. “To this day it gives me chills. If I had died, what in God’s green earth would have happened to my mom and daughter?”

Women in the 1960s endured restrictions relatively unknown to women today. The so-called “fairer sex” could not serve on juries and often could not get an Ivy League education. Women earned about half as much as a man doing the same job and were seldom promoted.

Women could not get a credit card unless they were married — and then only if their husband co-signed. The same applied to birth control — only the married need apply. More experienced women shared a workaround with the uninitiated: “Go to Woolworth, buy a cheap wedding-type ring and wear it to your doctor’s appointment. And don’t forget to smile.”

Marital rape wasn’t legally considered rape. And, of course, women had no legal right to terminate a pregnancy until four states — Alaska, Hawaii, New York and Washington — legalized abortion in 1970, three years before Roe v. Wade became the law of the land.

Illinois had no such protection, said Heather Booth, a lifelong feminist activist and political strategist: “Three people discussing having an abortion in Chicago in 1965 was a conspiracy to commit felony murder.”

Despite that danger, a courageous band of young women — most in their 20’s, some in college, some married with children — banded together in Chicago to create an underground abortion network. The group was officially created in 1969 as the “Abortion Counseling Service of Women’s Liberation.”

But after running ads in an underground newspaper: “Pregnant? Don’t want to be? Call Jane,” each member of the group answered the phone as “Jane.”

Despite their youth, members of Jane managed to run an illegal abortion service dedicated to each woman's needs.
From left: Martha Scott, Jeanne Galatzer-Levy, Abby Pariser, Sheila Smith and Madeline Schwenk.

“We were co-conspirators with the women who called us,” said 75-year-old Laura Kaplan, who published a book about the service in 1997 entitled “The Story of Jane: The Legendary Underground Feminist Abortion Service.”

“We’ll protect you; we hope you’ll protect us,” Kaplan said. “We’ll take care of you; we hope you’ll take care of us.”

What started as referrals to legitimate abortion providers changed to personalized service when some members of Jane learned to safely do the abortions themselves. Between the late 1960s and 1973, the year that the Supreme Court decided Roe v. Wade, Jane had arranged or performed over 11,000 abortions.

“Our culture is always searching for heroes,” said Kaplan. “But you don’t have to be a hero to do extraordinary things. Jane was just ordinary people working together — and look what we could accomplish, which is amazing, right?”

Even after several members were caught and arrested, the group continued to provide abortions for women too poor to travel to states where abortion had been legalized.

“I prayed a lot. I didn’t want to go to jail,” said 80-year-old Marie Learner, who allowed the Janes to perform abortions at her apartment.

“Some of us had little children. Some were the sole breadwinners in their home,” Learner said. “It was fearlessness in the face of overwhelming odds.”

Marie Learner opened her home to women undergoing abortions. Her neighbors knew, she said, but did not tell police.

The story of Jane has been immortalized in Kaplan’s book, numerous print articles, a 2022 movie, “Call Jane,” starring Elizabeth Banks and Sigourney Weaver, and a documentary on HBO (which, like CNN, is owned by Warner Bros. Discovery).

Today the historical tale of Jane has taken on a new significance. After the 2022 Supreme Court reversal of Roe v. Wade and the mid-term takeover of the US House of Representatives by Republicans, emboldened conservative lawmakers and judges have acted on their anti-abortion beliefs.

Currently more than a dozen states have banned or imposed severe restrictions on abortion. Georgia has banned abortions after six weeks, even though women are typically unaware they are pregnant at that stage. In mid-April, Florida Governor Ron DeSantis signed a bill that would ban most abortions after six weeks. It won’t go into effect until the state Supreme Court overturns its previous precedent on abortion. Several other states are considering similar legislation. In other states, judicial battles are underway to protect abortion access.

“It’s a horrific situation right now. People will be harmed, some may even die,” said Booth, who helped birth the Jane movement while in college.

“Women without family support, without the information they need, may be isolated and either harm themselves looking to end an unwanted pregnancy or will be harmed because they went to an unscrupulous and illegal provider,” said Booth, now 77.

A key difference between the 60s and today is medication abortion, which 54% of people in the United States used to end a pregnancy in 2022. Available via prescription and through the mail, use of the drugs is two-fold: A person takes a first pill, mifepristone, to block the hormone needed for a pregnancy to continue.  A day or two later, the patient takes a second drug, misoprostol, which causes the uterus to contract, creating the cramping and bleeding of labor.

In early April a Texas judge, US District Judge Matthew Kacsmaryk – a Trump appointee who has been vocal about his anti-abortion stance — suspended the US Food and Drug Administration’s approval of mifepristone despite 23 years of data showing the drug is safe to use, safer even than penicillin or Viagra.

On Friday, the Supreme Court froze the ruling and a subsequent decision by the Fifth US Circuit Court of Appeals at the request of the Justice Department and the drug manufacturer. The action allows access to mifepristone in states where it’s legal until appeals play out over the months to come.

However, 15 states currently restrict access to medication abortion, even by mail.

The actions of anti-abortion activists, who have been accused of “judge shopping” to get the decisions they want, is “an unprecedented attack on democracy meant to undermine the will of the vast majority of Americans who want this pill — mifepristone — to remain legal and available,” Heather Booth told CNN.

“This is a further weaponization of the courts to brazenly advance the end goal of banning abortion entirely,” she added.

If women in her day could have had access to medications that could be used safely in their homes, they would not have been forced to risk their lives, said Dorie Barron, thinking back to her own terrifying abortion in a sketchy Chicago motel.

“I’m depressed as hell, watching stupid, indifferent men control and destroy women’s lives all over again,” she said. “I really fear getting an abortion could soon be like 1965.”

Chicago college student Heather Booth had just finished a summer working with civil rights activists in Mississippi when she was asked to help with a different kind of injustice.

Heather Booth, 18, with civil rights heroine Fannie Lou Hamer during

A girl in another dorm was considering suicide because she was pregnant. Booth, who excelled at both organization and chutzpah, found a local doctor and negotiated an abortion for the girl. Word spread quickly.

“There were about 100 women a week calling for help, much more than one person could handle,” Booth said. “I recruited about 12 other people and began training them how to do the counseling.”

Counseling was a key part of the new service. This was a time when people “barely spoke about sex, how women’s bodies functioned or even how people got pregnant,” Booth said. To help each woman understand what was going to happen to them, Booth quizzed the abortion provider about every aspect of the procedure.

“What do you do in advance? Will it be painful? How painful? Can you walk afterwards? Do you need someone to be with you to take you home?” The questions continued: “What amount of bleeding is expected, and can a woman handle it on their own? If there’s a problem is there an urgent number they can call?”

Armed with details few if any physicians provided, the counselors at Jane could fully inform each caller about the abortion experience. The group even published a flyer describing the procedure, long before the groundbreaking 1970 book “Our Bodies, Ourselves” began to educate women about their sexuality and health.

“I don’t particularly like doctors because I always feel dissatisfied with the experience,” said Marie Learner, who spoke to many of the women who underwent an abortion at her home.

“But after their abortion at Jane, women told me, ‘Wow, that was the best experience I’ve ever had with people helping me with a medical issue.’”

Eileen Smith, now 73, was one of those women. “Jane made you feel like you were part of this bigger picture, like we were all in this together,” she said. “They helped me do this illegal thing and then they’re calling to make sure I’m OK? Wow!

“For me, it helped battle the feeling that I was a bad person, that ‘What’s wrong with me? Why did I get pregnant? I should know better’ voice in my head,” said Smith. “It was priceless.”

Like many young women in the 60s, Heather Booth often protested for civil and women's rights.

Many of the women who joined Jane had never experienced an abortion. Some viewed the work as political, a part of the burgeoning feminist movement. Others considered the service as simply humanitarian health care. All saw the work as an opportunity to respect each woman’s choice.

“I was a stay-at-home mom with four kids,” said Martha Scott, who is now in her 80s. “We knew the woman needed to feel as though she was in control of what was happening to her. We were making it happen for her, but it was not about us. It was about her.”

Some volunteers, like Dorie Barron, experienced the Jane difference firsthand when she found herself pregnant a few years after her abortion at the hands of the Mafia.

“It was a 100% total reversal — I had never experienced such kindness,” Barron said. Not only did a Jane hold each woman’s hand and explain every step of the process, “they gave each of us a giant supply of maternity sanitary pads, and a nice big handful of antibiotics,” she said. “And for the next week, I got a phone call every other day to see how I was.”

Barron soon began volunteering for Jane by providing pregnancy testing for women in the back of a church in Chicago’s Hyde Park.

“It wasn’t just abortion,” Barron explained. “We also said, ‘You could consider adoption,’ and gave adoption referrals. And if the woman wanted to continue with her pregnancy, we said, ‘Fine, please by all that is holy make sure you get prenatal care, take your vitamins, and eat as best you can.’ It was women helping women with whatever they needed.”

Most of the women who contacted Jane were unable to support themselves, in unhealthy relationships, or already had children at home, so the service was a way of “helping them get back on track,” said Smith, who, like Barron, had begun working for Jane after her abortion.

“We were telling them ‘This isn’t the end of the world. You can continue to leave your boyfriend or your husband or continue to just take care of those kids you have.’ We were there to help them get through this,” said Smith, who later became a homecare nurse.

From left: Eileen Smith, Diane Stevens and Benita Greenfield were three of the dozens of women who volunteered for Jane.

Diane Stevens says she came to work for Jane after experiencing an abortion in 1968 at the age of 19. She was living in California at the time, which provided “therapeutic abortions” if approved in advance by physicians.

“I’d had a birth control failure, and I was coached by Planned Parenthood on how to do this,” said Stevens, now 74. “I had to see two psychiatrists and one doctor and tell them I was not able to go through with the pregnancy because it would a danger to both my physical and mental health.

“I was admitted to the psychiatric ward, although I didn’t really know that — I thought I was just in a hospital bed. But oh no, ‘I was mentally ill,’ so that’s where they put me,” said Stevens, who later went to nursing school with Smith. “Then they wheeled me off for the abortion. I had general anesthesia, was there for two days, and then I was discharged. Isn’t that crazy?”

Sakinah Ahad Shannon, now 75, was one of the few Black women who volunteered as a counselor at Jane. She joined after accompanying a friend who was charged a mere $50 for her abortion. At that time, Jane’s fee was between $1 and $100, based on what the woman could afford to pay, Shannon said.

“When I walked in, I said, ‘Oh my God, here we go again. It’s a room of White women, archangels who are going to save the world,’” said Shannon, a social worker and member of the Congress of Racial Equality, an interracial group of non-violent activists who pioneered “Freedom Rides” and helped organize the March on Washington in 1963.

What she heard and saw at her friend’s counseling session was so impressive it “changed my life,” Shannon said. She and her family later opened and operated three Chicago abortion clinics for over 25 years, all using the Jane philosophy of communication and respect.

“It was a profoundly amazing experience for me,” she said. “I call the Janes my sisters. The color line didn’t matter. We were all taking the same risk.”

Sakinah Ahad Shannon and her daughters went on to open and run three abortion clinics in Chicago.

It wasn’t long before the women discovered a “doctor” performing abortions for Jane had been lying about his credentials. There was no medical degree — in the HBO documentary, he admitted he had honed his skills by assisting an abortion provider.

The group imploded. A number of members quit in horror and dismay. For the women who stayed, it was an epiphany, said Martha Scott. Like her, several of the Janes had been assisting this fake doctor for years, learning the procedures step by step.

“You’d learn how to insert a speculum, then how to swap out the vagina with an antiseptic, then how to give numbing shots around the cervix and then how to dilate the cervix. You learned and mastered each step before you moved on to the next,” said Laura Kaplan, who chronicled the procedure in her book.

By now, several of the Janes were quite experienced and willing to do the work. Why not perform the abortions themselves?

“Clearly, this was an intense responsibility,” said Judith Acana, a 27-year-old high school teacher who joined Jane in 1970. She started her training by helping “long terms,” women who were four or five months along in the pregnancy.

“Remember, abortion was illegal (in Illinois) so it could take weeks for a woman to find help,” said Arcana, now 80. “Frequently women who wanted an abortion at 8 or 10 weeks wound up being 16 or 18 weeks or more by the time they found Jane.”

The miscarriage could happen quickly, but it rarely did, she said. It usually took anywhere from one to two days.

“Women who had no one to help them would come back when contractions started,” Arcana said. “One of my strongest memories is of a teenage girl who had an appointment to have her miscarriage on my living room floor.”

The group also paid two Janes to live in an apartment and be on call 24/7 to assist women who had no one to help them miscarry at home, said Arcana, a lifelong educator, author and poet. “But many women took care of it on their own, in very amazing and impressive and powerful ways,” she said.

Judith Arcana learned how to do abortions herself and wrote about the Jane experience in poems, stories, essays and books.

Any woman who had concerns or questions while miscarrying alone could always call Jane for advice any time of the day or night.

“People would call in a panic: ‘The bleeding won’t stop,’” Smith recalled. “I would tell them, ‘Get some ice, put it on your stomach, elevate your legs, relax.’ And they would say ‘Oh my gosh, thank you!’ because they were so scared.”

For women who were in their first trimester, Jane offered traditional D&C abortions — the same dilation and curettage used by hospitals then and today, said Scott, who performed many of the abortions for Jane. Later the group used vacuum aspiration, which was over in a mere five to 10 minutes.

“Vacuum aspiration was much easier to do, and I think it’s less difficult for the woman,” Scott said. “Abortion is exactly like any other medical procedure. It’s the decision that’s an issue — the doing is very straightforward. This was something a competent, trained person could do.”

It was May 3, 1972. Judith Arcana was the driver that day, responsible for relocating women waiting at what was called “the front” to a separate apartment or house where the abortions were done, known as “the place.”

On this day, a Wednesday, the “place” was a South Shore high-rise apartment. Arcana was escorting a woman who had completed her abortion when they were stopped by police at the elevator.

“They asked us, ‘Which apartment did you come out of?’ And the poor woman burst into tears and blurted out the apartment number,” Arcana said. “They took me downstairs, put cuffs on me and hooked me to a steel hook inside of the police van.”

Inside the apartment on the 11th floor, Martha Scott said she was setting up the bedroom for the next abortion when she heard a knock at the door, followed by screaming: “You can’t come in!”

“I shut the bedroom door and locked it,” Scott said, then hid the instruments and sat on the bed to wait. It wasn’t long until a cop kicked the door in and made her join the other women in the living room.

“We tell this joke about how the cops came in, saw all these women and said, ‘Where’s the abortionist?’ You know, assuming that it would be a man,” Scott said.

By day’s end, seven members of Jane were behind bars: Martha Scott, Diane Stevens, Judy Arcana, Jeanne Galatzer-Levy, Abby Pariser, Sheila Smith and Madeleine Schwenk. Suddenly what had been an underground effort for years was front page headlines.

“Had we not gotten arrested, I think no one would ever have known about Jane other than the women we served,” Scott said.

Top: Sheila Smith and Martha Scott.
Bottom: Diane Stevens and Judith Arcana.

An emergency meeting of Jane was called. The turnout was massive — even women who had not been active in months showed up, anxious to know the extent of the police probe, according to the women with whom CNN spoke.

Despite widespread fear and worry, the group immediately began making alternate plans for women scheduled for abortions at Jane in the next few days to weeks. The group even paid for transportation to other cities where abortion had already been legalized, they said.

News reports over the next few days gave further details of the bust: There was no widespread investigation by the police. It was a single incident, triggered by a call from a sister-in-law who was upset with her relative’s decision to have an abortion, they said.

“It wasn’t long after I was arrested that I came back and worked for quite a few months,” said Scott, one of the few fully trained to do abortions.

“I like to think I was a good soldier,” Scott said. “I like to think what did made a difference not only to a whole bunch of people, but also to ourselves. It gave us a sense of empowerment that comes when you do something that is hard to do and also right.”

As paranoia eased, women began to come back to work at Jane, determined to carry on.

“After the bust, we had a meeting and were told ‘Everybody needs to start assisting and learn how to do abortions.’ I was like, ‘Whoa, whoa, whoa!’” said Eileen Smith, who had not been arrested. “But you felt like you really didn’t have much of a choice. We had to keep the service running.”

Laura Kaplan volunteered for the Janes, later immortalizing the group in her book,

The preliminary hearing for the arrested seven was in August. Several of the women in the apartment waiting for abortions the day of the arrest suddenly developed amnesia and refused to testify. According to Kaplan’s book, one of the women later said, “The cops tried to push me around, but f**k them. I wasn’t going to tell on you.”

It didn’t matter. Each Jane was charged with 11 counts of abortion and conspiracy to commit abortion, with a possible sentence of up to 110 years in prison.

As they waited for trial, the lawyer for the seven, Jo-Anne Wolfson, adopted delaying tactics, Kaplan said. A case representing a Texas woman, cited as “Jane Roe” to protect her privacy, was being considered by the US Supreme Court. If the Court ruled in Roe’s favor, the case against the Jane’s might be thrown out.

That’s exactly what happened. On March 9, 1973, three months after the Supreme Court had legalized abortion in the US, the case against the seven women was dropped and their arrest records were expunged.

Later that spring, a majority of Janes, burned out by the intensity of the work over the last few years, voted to close shop. An end of Jane party was held on May 20. According to Kaplan’s book, the invitation read:

“You are cordially invited to attend The First, Last and Only Curette Caper; the Grand Finale of the Abortion Counseling Service. RSVP: Call Jane.”

Today, most of the surviving members of Jane are in their 70s and 80s, shocked but somehow not surprised by the actions of abortion opponents.

“This is a country of ill-educated politicos who know nothing about women’s bodies, nor do they care,” said Dorie Barron. “It will take generations to even begin to undo the devastating harm to women’s rights.”

In the meantime, women should research all available options, keep that information confidential, seek support from groups working for abortion rights, and “share your education with as many women as you can,” Barron added.

As more and more reproductive freedoms have been rolled back over the past year, many of the Janes are angry and fearful for the future.

Abortion rights demonstrators walk across the Brooklyn Bridge in New York nearly two weeks after the leak of a draft Supreme Court opinion that would overturn Roe v. Wade.

“This is about the most intimate decision of our lives — when, whether and with whom we have a child. Everyone should have the ability to make decisions about our own lives, bodies, and futures without political interference,” said Heather Booth, who has spent her life after leaving Jane fighting for civil and women’s rights.

“We need to organize, raise our voices and our votes, and overturn this attack on our freedom and our lives. I have seen that when we take action and organize we can change the world.”

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One month later, people living near a toxic train derailment wonder if their lives will ever be back on track | CNN


East Palestine, Ohio
CNN
 — 

This had been a quiet little town of about 4,700 people nestled in the rolling hills of Northeast Ohio. A sign posted on State Road 14 welcomes visitors to East Palestine, “the place to be.”

But for the past month, ever since a freight train derailed and caught fire, the town has been bustling with responders and reporters. Residents say they’re grateful for the help, but the attention and uncertainty have begun to strain the town’s hospitality.

Town halls and news conferences have taken over the school auditoriums and municipal buildings and shut down its main street. A clinic opened to address worrisome health questions and symptoms, and government workers have been going door-to-door to survey residents about health impacts.

Gov. Mike DeWine has traveled to East Palestine four times since the derailment and US Environmental Protection Agency Administrator Michael Regan three times, each with entourages of aides and press wranglers. Some business owners near the downtown area are so tired of answering questions, they posted signs asking reporters to stay out.

The streets are busy with utility trucks for environmental clean-up companies TetraTech, Arcadis and AEComm. Plastic hoses snake into Leslie Run and Sulphur Run, two creeks that run through town that were contaminated by the accident. Large pieces of equipment that look like showerheads churn and bubble the water in these streams, hoping to speed the breakdown of chemicals in them.

Still, the floral, fruity odor of the chemical butyl acrylate still wafts up from the streams.

Many residents say they are angry.

Donna Reidy, 62, lives about a mile and a half away from the site in a white house on a hill that overlooks Leslie Run, one of the area waterways contaminated by the spill. On Thursday, she answered questions for a government health study that’s being conducted by the Agency for Toxic Substances and Disease Registry, a division of the US Centers for Disease Control and Prevention.

Reidy said that neither she or her husband – who has lung problems and requires supplemental oxygen – experienced any new or worsening physical symptoms since the derailment. However, her daughter, who also lives in East Palestine, had, she told investigators.

Reidy said her daughter had to gone to the hospital after vomiting and developing a rash. Donna said the stress of trying to protect her husband and worry for her daughter had worsened some anxiety she already struggled with, and she’s afraid of health problems that could arise later on.

“I’ve already had cancer, I don’t want to get it again,” she told Dr. Dallas Shi, an officer in the CDC’s Epidemic Intelligence Service, as they stood in the front yard outside her home.

For the study, called an assessment of chemical exposure, or ACE, Shi is working with a mapping specialist Ian Dunn, a geospatial health scientist and CDC contractor, to interview residents in some of the areas believed to be most impacted by the contamination.

After Reidy answered pages of required questions, Shi and Dunn ask her if there was anything else she wanted them to know.

“Yeah,” she said. “This stuff sucks.”

“We got roots here,” she told them. Five generations of her family lived in East Palestine. Her husband’s father saved money during World War II and sent it home to his wife so they could buy the home they live in today. Her children and grandchildren have gone to the local schools.

“They just ruined everything,” Reidy says, speaking of Norfolk Southern.

“My kids are moving, my grandkids are moving away. They just ruined everything,” she said as she started to cry.

“I’m so sorry,” Shi said, “Can I give you a hug?”

Shi, who was dressed in her dark blue public health service uniform and black work boots, put her arms around Reidy. “I can’t imagine,” she said.

“I’m so mad at them because they’re so cheap and all they cared about was money for themselves,” Reidy went on, speaking through tears. “They should have huge fines against them.”

Then Reidy apologized for getting upset.

On Thursday night, some area residents came to the local high school auditorium for a town hall meeting – their first chance to confront Norfolk Southern since the spill – and expressed similar anger and frustration.

The company was ordered to appear at the town hall by the EPA after declining to participate in earlier events.

“One thing I would like to say … is that we are sorry. We’re very sorry. We feel horrible about it,” said Darrell Wilson, who was representing the company.

The room erupted with shouts of “Buy us out!”

“Do the right thing,” one man shouted. “Tell Alan to buy us out,” referring to Norfolk Southern CEO Alan Shaw.

Several people said they believed staying in their homes was making them ill, but they couldn’t afford to go anywhere else. They want the railroad to buy their homes, which they feel have lost value since the spill.

“Get us out!” some yelled.

“We are going to do the right thing,” Wilson said, responding to the shouts.

Wilson said the company had leased office space in town and “and we signed a long lease. So we’re gonna be here for a long time,” he said..

But when asked whether there had been talk of the company relocating residents, he said there had not.

Some said they had experienced health problems since returning to their homes after the derailment. Others said they had lost their jobs or stopped going to work at jobs they felt were too close to the site. They are worried about their children or grandchildren potentially being exposed to toxins and having health problems down the road.

Some people say they continue to experience symptoms such as headaches, vomiting, dizziness and persistent coughs, and they feel puzzled by ongoing tests of the town’s air and water that have not detected chemicals at levels that are known to pose health risks.

“Why are people getting sick if there are no toxins?” East Palestine resident Jamie Cozza asked the panel answering questions at Thursday’s town hall.

“We do have a team here that is trying to collect health information so that we have a better understanding of the potential exposures and health effects,” said Capt. Jill Shugart, who is an associate director of emergency management at CDC’s Agency for Toxic Substances and Disease Registry, or ATSDR.

The agency is conducting a total of three Assessment of Chemical Exposure, or ACE, investigations – one for Ohio residents, one for people in Pennsylvania, and another for first responders to the accident scene.

Shugart said it would take about three weeks to collect enough information to get an understanding of the full picture, then the agency has to work with Pennsylvania and Ohio to present their findings to residents.

Data from some surveys are starting to come available. On Friday, the Ohio Department of Health released preliminary data from its ACE survey, and out of 168 completed, 74% of people said they experienced headaches, 64% reported anxiety, 61% reported coughing, 58% listed fatigue, and 52% said they had irritation, pain or burning of their skin. The health department is still collecting surveys through its health assessment clinic, which will be open again next week.

Many at the town hall said they felt that the evacuation order had been lifted too soon – less than a week after the derailment – and may have put them in harm’s way, before any potential dangers were fully assessed.

On Thursday, the EPA capitulated to demands from residents and said it would require Norfolk Southern to test for dioxins, cancer-causing chemicals that form during combustion. The EPA had previously declined to require testing for dioxins, saying that these chemicals are already present in the environment, so it’s hard to interpret what their levels mean. The EPA said it would require the railroad company to study background levels of dioxins in comparable areas in order to give some context to the test results.

Authorities have focused much of their concern on a 2-mile radius around the spill, but residents that live farther away, including some farmers in nearby Pennsylvania, say they’ve been impacted, too.

Dave Anderson raises grass fed beef 4 miles downwind of East Palestine, in nearby Darlington Township, Pennsylvania. After the derailment, fire and controlled burn of toxic chemicals, the thick black smoke drifted over his Echo Valley Farm.

“As far as the smoke, you could probably see 100 yards,” Anderson told CNN’s Miguel Marquez.

Anderson said his eyes, throat and mouth burned.

The cloud from the spill settled on his pastures and ponds. Anderson said now he’s not sure whether the grassfed cattle he’s raised for years are safe for human consumption.

So far, there’s been no testing of his water, soil or air on his farm.

Pennsylvania’s Department of Environment Protection, or DEP, just visited Anderson’s farm for the first time this week, nearly four weeks after the event.

In a written statement provided to CNN, the Pennsylvania Department of Agriculture said it launched a hotline encouraging those impacted to reach out if they have concerns about livestock or crops.

Also this week, Pennsylvania opened a community resource center in Darlington to help people who want to get their soil or wells tested. The center is also conducting medical exams for residents with health concerns. Adam Ortiz, regional administrator for EPA’s region 3 office, which includes Pennsylvania, said the center has seen about 100 people a day since it opened.

The crash occurred just feet from the Pennsylvania border. The winds typically blow east, toward Pennsylvania. The state is going house to house, testing soil and water in areas closest to the derailment. Anderson said officials are still trying to figure out if they should extend that testing to other areas.

Samuel Wenger and his wife Joyce had their fourth child, Jackson Hayes, a week ago. Wenger said the state’s response has been too slow and lacking in information to know whether Darlington is still a safe place to raise a family.

They only recently were able to get their well tested, and they were told it would take another three weeks to get the results of that testing. They said it was agonizing to bring their newborn son back to their house when they don’t have answers about contamination.

“I feel like I possibly regret the decision every day but here we live paycheck to paycheck, we live within our means, and we don’t have the financial luxury to pack up and move,” Samuel said. “It’s scary.”

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Ohio, Pennsylvania offer health services following train derailment, but some residents feel skeptical | CNN


Darlington Township, Pennsylvania
CNN
 — 

The municipal building in tiny Darlington Township, Pennsylvania, was buzzing with activity on Wednesday afternoon as a stream of locals arrived seeking information on health screenings, chemical exposures and well testing.

Darlington, home to about 1,800 people, sits just over the border from East Palestine, Ohio, the site of a catastrophic train derailment and controlled burn of toxic chemicals that sent black smoke billowing over the area for days in early February. Residents here say the wind blew acrid smoke into their homes and coated their cars with a fine ash. State and federal officials gave East Palestine residents the all-clear to return to their homes days later.

But residents in both places are now wondering whether their water is safe to drink and their air safe to breathe. The characteristic floral, fruity odor of butyl acrylate still permeates some homes and wafts up from some of the impacted streams that run through the town. Some say they’re experiencing symptoms – cough, headaches, rashes, watering eyes and dripping noses – that might be related to a chemical exposure.

Government-run community resource centers and health clinics have opened in East Palestine and Darlington to answer residents’ questions and connect them to any care they might need. More than 140 people have come to the clinic in East Palestine since it first opened on February 21, according to the Ohio Department of Health. The Darlington center opened February 28, and more than 200 people visited in its first two days, according to the Pennsylvania Department of Health.

Still, some residents are skeptical of the clinics, and the response overall. While many residents who live near the derailment site are following the testing for chemicals in the air and water, what they really want to know is whether they’ve had chemicals from the accident in their bodies, and whether those chemicals have impacted their health.

They’re swapping information online, and seeking out blood tests they hope will identify potential problems. Some are seeking out medical care so there’s a record of their symptoms.

On the advice of a lawyer, Ron Book and his wife came to the East Palestine Health Assessment Clinic on Wednesday afternoon to have their illnesses documented. Book says since the derailment, his nose has been running constantly. He has a sore throat, and he feels stuffy.

“It’s like I have a cold, but I don’t have a cold,” he said.

Book said he saw a doctor who took his vitals and advised him to keep up with the regular blood work that he needs for his ongoing treatment for prostate cancer. He was inside for about 45 minutes, and said the experience was helpful, and about what he expected.

“They can’t heal you,” Book says, “because nobody knows about this chemical.”

At the Darlington center, tables were staffed with experts to answer questions about the chemicals involved in the train derailment, free well and air testing for residents, and potential impacts to area farms.

There were pamphlets on how to manage stress following a disaster and mental health counselors, as well as Zuko, a 3-year-old Great Dane therapy dog.

Residents are also invited to take a nine-page questionnaire to contribute data to a newly launched Assessment of Chemical Exposure, or ACE, study, which is being conducted by the federal Agency for Toxic Substances and Disease Registry. Health investigators can use their data to inform a study into the health effects associated with the chemical exposures after the derailment.

People could see a doctor, or get referrals for a primary care physician.

“I think approximately 40% of people sought some sort of clinical evaluation,” said Nate Wardle, who is the special response project manager for the Pennsylvania Department of Health.

Wardle said when they opened the clinic, they weren’t sure what to expect – whether residents would be angry that it took more than three weeks to get them these services. So far, he said, people have been grateful and eager to get the help.

Jim Denes, who is 71, came to the health clinic in Darlington Township on Wednesday. He said he lives less than 2 miles from the accident site. On Friday of last week, Denes said he felt awful.

“I was just miserable. I was trying to cough up stuff, I couldn’t,” Denes said. “My eyes were all runny and watery.”

He said he took a Covid-19 test, but it was negative.

Denes said he’s extremely tired and had to drag himself to the clinic, but he’s glad he did. The doctor he saw diagnosed him with bronchitis and prescribed an antibiotic. The clinic was a lot closer than his regular doctor in Ellwood City, and he was able to walk in and be seen without a wait.

Denes said the doctor told him he couldn’t say whether it was related to the chemicals that were spilled or not.

Some residents said they have no interest in going to government-run health clinics.

“I honestly, at this point, don’t know who’s working with who and I really just don’t trust anything that has to do with the government right now,” said Giovanni Irizarry, whose family lives within a mile of the train derailment site.

In the evening hours of February 3, his wife Ashley Irizarry was driving to work when she noticed she could see thick black smoke hanging in the air, even though it was dark. Eventually, she saw the raging fire along the railroad tracks.

That night, Ashley had a red rash on her cheeks, her eyes were burning and red and a metallic chemical smell had burned her nose and throat. On Saturday, Giovanni said, his lips burned like he’d had scalding hot soup. Giovanni’s mother, who was living with them, developed a cough so severe she couldn’t catch her breath. The Irizarrys evacuated on Sunday to Boardman, Ohio, about 15 miles away.

They returned home on Saturday, February 11, in anticipation of school restarting on Monday.

As soon as they got close to town, Giovanni said, “I immediately felt my lips like start that burning sensation.”

He and his mom started coughing. His wife and kids developed debilitating and unrelenting headaches. After the kids came home from school on Monday, both started vomiting.

Ashley says she has taken the family to their primary care doctor, an urgent care and the hospital.

“It was not getting better,” she said.

Medical records reviewed by CNN show Ashley was prescribed a steroid and given a chest X-ray due to “toxic effects of gas exposure.” Her son was also diagnosed with chemical exposure.

When the doctors looked into her nose and throat they told her ” ‘Your mucous membranes are all pale. Like they were burned,’ but they didn’t know what to do at this time,” Ashley said in an interview with CNN on Wednesday.

On public Facebook groups, residents are sharing names of providers who will order blood testing for chemical exposures, which isn’t something either of the government-run clinics is doing currently. Some have even tried to do their own research to try to identify the medical codes needed to order tests for specific chemicals in the blood from large labs.

Instead of going to the government health clinic, on Wednesday, Ashley went to see their chiropractor, Richard Tsai, who has been ordering certain blood tests for existing patients who think they have having health problems connected to chemical exposures from the derailment.

Tsai’s practice, Blackhawk Chiropractic, is right next door to the Darlington Township community resource center and clinic that was opened by the Pennsylvania Department of Health and other state agencies this week.

The tests Tsai orders are general and standard in medical care – a test called a complete blood count, which measures levels of red cells, white cells, and clotting factors in the blood; and a test called a basic metabolic panel, which measures blood sugar, electrolytes, and kidney function. If his patients ask for it, he also orders a more specialized test that measure exposure to the chemical benzene. In the past two days, he estimates about 15 patients have asked him for blood testing.

Tsai, who lives in East Palestine, says he’s been frustrated by the government’s response.

“We shouldn’t be having to do this,” Tsai said, in an interview with CNN on Wednesday.

“Why are people having to figure this out on Facebook? These people need to know where to go and what’s available.”

Dr. Bruce Vanderhoff, director of the Ohio Department of Health, pushed back against the idea that the government wasn’t giving people enough information. He said that during the course of the medical assessment at the health clinic, the clinic physician might make recommendations for further testing, but that would be done by the person’s regular doctor.

If people don’t have a doctor that they see regularly, Vanderhoff said they are trying to help residents find one.

Vanderhoff said it would be important for the primary care providers to continue to monitor changes in a patient’s overall health.

“Because when we look at the chemicals involved, especially the primary chemical vinyl chloride, there is simply not a blood test that we can do or a urine test that we can do that would say ‘Aha! You had an exposure,’ ” Vanderhoff said. “That would be great, but that’s just not the case.”

Tsai, who lives in East Palestine, said that he’s legally able to order medical tests, so he does, within limits. “Why wouldn’t you do that?” he said.

Dr. Erin Haynes, the chairperson of the department of epidemiology and environmental health at the University of Kentucky, says she thinks it’s sound for residents to seek out common blood tests.

In an email to CNN, Haynes said in addition to a complete blood count and basic metabolic panel she would add a liver function test, since vinyl chloride, one chemical that was on the train, can damage the liver.

But Haynes says trying to test for specific chemicals may be a step too far.

“Testing for chemical exposure at this point is a difficult,” says Haynes, who has helped impacted communities investigate environmental exposures. “The high levels are now gone, and we aren’t exactly sure what to measure in blood or urine since we don’t know what chemicals formed during the fire. There are suspects, but not clear answers yet.”

Haynes said it would be ideal to collect blood and urine samples now, but store them for later testing, but this would be difficult for a local clinic to do.

Overall, Haynes says the government’s response to chemical spills like this one leaves something to be desired.

“The community is in dire need of an organized and coordinated health monitoring study that includes exposure assessment,” said Haynes, who hopes to bring such a study to the area soon.

Down the road, she says, there’s still a lot to learn about the health impacts of environmental exposures to toxins.

“We also need more research on what these chemicals do and methods for rapid testing,” Haynes said. “Communities with railroad must know what is moving through their community, when and how much. They also must receive training on how to safely respond when a disaster occurs.”

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After a train derailment, Ohio residents are living the plot of a movie they helped make | CNN



CNN
 — 

When Ben Ratner’s family signed up in 2021 to be extras in the movie “White Noise,” they thought it would be a fun distraction from their day-to-day life in blue-collar East Palestine, Ohio.

Ratner, 37, is in a traffic jam scene, sitting in a line of cars trying to evacuate after a freight train collided with a tanker truck, triggering an explosion that fills the air with dangerous toxins. In another scene, his father wears a trench coat and hat while people walk across an overpass to get out of town. Directors told the group they wanted them to look “forlorn and downtrodden” as they escape the environmental disaster.

The 2022 movie was shot around Ohio and is based on a novel by Don DeLillo. The book was published in 1985, shortly after a chemical disaster in Bhopal, India, that killed nearly 4,000 people. The book and film follow the fictional Gladney family – a couple and their four kids – as they flee an “airborne toxic event” and then return home and try to resume their normal lives.

Ratner tried to rewatch the movie a few days ago and found that he couldn’t finish it.

“All of a sudden, it hit too close to home,” he said.

Ratner and his family – his wife, Lindsay, and their kids, Lilly, Izzy, Simon and Brodie – are living the fiction they helped bring to the screen.

Officials ordered them to evacuate their home last week, a day after a Norfolk Southern train carrying 20 cars of hazardous materials slid off the rails and caught fire, threatening to explode. The National Transportation Safety Board is still investigating the cause of the incident.

“The first half of the movie is all almost exactly what’s going on here,” Ratner said Wednesday, four days into their evacuation.

In a way, the movie has provided a point of grim humor about the situation facing the residents of East Palestine – the joke no one wanted to make.

“Everybody’s been talking about that,” Ratner said of his friends and neighbors who are keeping in close touch through the crisis. “I actually made a meme where I superimposed my face on the poster and sent it to my friends.”

In the 2022 film

Scholars who study DeLillo’s work say they are not surprised by the collision of life and art. His work is often described as prescient, said Jesse Kavadlo, an English professor at Maryville University in St. Louis and president of the Don DeLillo Society.

“The terrible spill now is, of course, a coincidence. But it plays in our minds like life imitating art, which was imitating life, and on and on, because, as DeLillo suggests in ‘White Noise’ as well, we have unfortunately become too acquainted with the mediated language and enactment of disaster,” Kavadlo said.

The night of February 3, Ratner was watching his daughter’s basketball game at the local high school when the crash happened. He didn’t hear it over the noise of the game, but when they walked out of the building, he could see the massive blaze. He shot a few seconds of video on his cell phone.

His family returned to their house, which sits less than a mile from the crash site. Throughout the night, he said, they heard sirens but got little information. “We weren’t sure exactly what the danger was.”

While his family slept, he stayed up, nervously watching the fire and the news.

The next morning, activity around the site had picked up. “There was a lot of commotion, helicopters and people hightailing it out of town, and it was it was a little intense,” he said.

His wife and kids headed to stay with his wife’s parents, who live about 2 miles from the crash site. Ratner went to work running the coffee shop he and his wife own, LiB’s Market, in nearby Salem.

By that afternoon, an official alert warned that people needed to move even farther, beyond a 2-mile radius. Roughly half of the town’s 4,800 residents had to evacuate.

A friend offered to let them stay in their pool house. They later moved to another friend’s house next to their café.

School was canceled for the week. They got their dog out of the house, but they had to leave the pet turtle behind.

For now, they’re keeping their distance. But even after they go back, they have to decide whether they’ll stay.

East Palestine is in an economically depressed area, Ratner said, but it had been on a rebound. He and his wife had been considering opening another café there, but now they’re worried that plan is in jeopardy.

“That’s where we’ve been raising our kids, finishing college, buying a business, and that’s been our place,” he said. “In the future, are we going to have to sell the house? Is it worth any money at this point?”

Five of the tankers on the train that overturned last week were carrying liquid vinyl chloride, which is extremely combustible. Last Sunday, they became unstable and threatened to explode. First responders and emergency workers had to vent the tankers, spill the vinyl chloride into a trench, and then burn it off before it turned the train into a bomb. Authorities feared that an explosion could send shrapnel up to a mile away.

But that didn’t happen. The controlled burn worked and the evacuation order for East Palestine residents was officially lifted Wednesday after real-time air and water monitoring did not find any contaminant levels above screening limits.

“All of the readings we’ve been recording in the community have been at normal concentrations, normal backgrounds, which you find in almost any community,” James Justice, a representative of the US Environmental Protection Agency, said at a briefing Wednesday.

Support team members prepared to assess remaining hazards in East Palestine, Ohio, on February 7.

Although authorities have assured the residents that any immediate danger has passed, some residents have yet to return home. Ratner said they’re worried about longer-term risks that environmental officials are only beginning to assess.

Real-time air readings, which use handheld instruments to broadly screen for classes of contaminants like volatile organic compounds, showed that the air quality near the site was within normal limits.

The decision to lift the evacuation order was based on analysis of air monitoring data, according to Charles Rodriguez, community involvement coordinator for the EPA’s Region 5 office.

Up to this point, officials have been looking for large immediate threats: explosions or chemical levels that could make someone acutely ill.

“Under this phase, it’s been the emergency response,” Kurt Kohler of the Ohio EPA’s Office of Emergency Response said Wednesday. “As you see the emergency services go back home, off-site, Ohio EPA is going to remain involved through our other divisions that oversee the long-term cleanup of these kinds of spills.”

The cleanup and monitoring of the site, he said, could take years.

Although the explosion risk is past, Ratner said, people who live in East Palestine want to know about the chemical threats that might linger.

Fish and frogs have died in local streams. People have reported dead chickens and shared photos of dead dogs and foxes on social media. They say they smell chemical odors around town.

When asked at Wednesday’s briefing about exactly what spilled, representatives from Norfolk Southern listed butyl acrylate, vinyl chloride and a small amount of non-hazardous lube oil.

“Butyl acrylate is a lot of what we’re gathering information on,” said Scott Deutsch, a regional manager of hazardous materials at Norfolk Southern.

Butyl acrylate is a clear, colorless liquid with a strong, fruity odor that’s used to make plastics and paint. It’s possible to inhale it, ingest it or absorb it through the skin. It irritates the eyes, skin and lungs and may cause shortness of breath, according to the National Institute of Occupational Safety and Health. Repeated exposure can lead to lung damage.

Vinyl chloride, which is used to make PVC pipes, can cause dizziness, sleepiness and headaches. It has also been linked to an increased risk of cancer in the liver, brain, lungs and blood.

Although butyl acrylate easily mixes with water and will move quickly through the environment, it isn’t especially toxic to humans, said Richard Peltier, an associate professor of environmental health sciences at the University of Massachusetts at Amherst.

“Vinyl chloride, however, has a specific and important risk in that is contains a bunch of chlorine molecules, which can form some really awful combustion byproducts,” Peltier said. “These are often very toxic and often very persistent in the environment.”

Portions of a Norfolk Southern freight train that derailed February 3 were still on fire the next day.

A spokesperson for Norfolk Southern acknowledged but did not respond to CNN’s request for more information on how much of these chemicals spilled into the soil and water.

The Ohio EPA says it’s not sure yet, either.

“Initially, with most environmental spills, it is difficult to determine the exact amount of material that has been released into the air, water, and soil. The assessment phase that will occur after the emergency is over will help to determine that information,” James Lee, media relations manager for the Ohio EPA, wrote in an email to CNN.

Lee said that after his agency has assessed the site, it will work on a remediation plan.

Vinyl chloride is unstable and boils and evaporates at room temperature, giving it a very short lifespan in the environment, said Dana Barr, a professor of environmental health at Emory University’s Rollins School of Public Health.

“If you had a very small amount of vinyl chloride that was present in an area, it would evaporate within minutes to hours at the longest,” she said.

“But the problem they’re facing here is that it’s not just a small amount, and so if they can’t contain what gets into the water or what gets into the soil, they may have this continuous off-gassing of vinyl chloride that has gotten into these areas,” Barr said.

“I probably would be more concerned about the chemicals in the air over the course of the next month.”

State officials said they would continue to monitor the site for exactly that reason. They are also continuing to try to dig and remove contaminated soil.

“Right now, we have a system set up. As the data comes, it is distributed to a network of people to look at both on an immediate-phase – ‘Hey, is there anything really alarming to look at’ – and those smaller numbers that really matter to long-term health,” Kohler said at Wednesday’s briefing.

He said the local health department would test residents’ wells to make sure their drinking water is safe. Officials are also offering to test the air in residents’ homes before they come back.

Norfolk Southern is funding a phone line for residents to speak to a toxicologist with the Center for Toxicology and Environmental Health, an environmental consulting firm.

No one is quite sure whether to trust the help, though, since it’s coming mostly from the company behind the spill. Some residents have already filed a class-action lawsuit against Norfolk Southern.

“We’re definitely signing up for the air testing of the home before we get in there,” Ratner said.

The first trains to pass since the accident started rolling through again midweek, Ratner said. The roar of the trains, a sound he used to tune out, is now jarring.

Even the sounds of loud trucks are “off-putting,” he said.

Don Cheadle, left, and Adam Driver star in

Ratner said it was fun to be part of a disaster movie – a stylized, darkly comedic Netflix streamer starring Adam Driver, Greta Gerwig and Don Cheadle.

In real life, the situation has been gutting.

“Those are great actors, but it was hard to see it as a put-on,” Ratner said.

He shares the sentiments of Lenny Glavan, a local tattoo artist, who wrote a letter to Norfolk Southern CEO Alan Shaw on Tuesday to express the town’s anger and frustration over the accident.

“You just ripped from us our small-town motto ‘A place you want to be,’ ” Glavan wrote.

“It may not be beach-front property, it may not even have the highest paying jobs, or much else to offer, but in my experiences in life, the place I and most people want to be is when you need a helping hand, a shoulder to cry on, a friend to pray with, or a place to call home East Palestine has always been that place to want to be,” he said in his note, which was publicly posted on Facebook.

“With the events in which have occurred, the railroad that gave this small town life has now taken the life, the heartbeat, the unity and that security that families or individuals long for in this wild world away … possibly indefinitely.”

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Pediatricians are giving out free gun locks to approach the gun violence epidemic as a public health crisis | CNN



CNN
 — 

In a triage waiting room of St. Louis Children’s Hospital in Missouri, a clear basket filled with gun locks sits near the walkway, just noticeable enough to those passing by.

The hospital staff calls it the “No Questions Asked” basket, to encourage gun safety without having to confront gun owners about what can be a sensitive and divisive topic. It holds an assortment of cable gun locks free of charge, available to those who need them, alongside pamphlets explaining how to properly and safely store firearms.

The initiative, aimed at reducing the stigma of addressing gun safety, is part of a growing effort by medical professionals who are treating the country’s gun violence epidemic as a public health crisis.

“It takes standing at the bedside of one child who has been shot to realize that we all have to do more and as the leading cause of death for children in this country, pediatricians need to be front and center of the solution, of all the solutions,” said Dr. Annie Andrews, a professor of pediatrics at the Medical University of South Carolina and an expert on gun violence prevention.

Over the course of two years, thousands of gun locks have been taken from the basket, according to Dr. Lindsay Clukies, a pediatric emergency medicine physician at the hospital.

In the coming weeks, baskets filled with free gun locks will be available at more than 17 locations operated by BJC HealthCare, an organization serving metro St. Louis, mid-Missouri and Southern Illinois, Clukies said. It’s a low-cost and effective way to easily distribute firearm safety devices.

“We’ve had employees as well as patients take our locks, also their families and even a grandmother who took one for her grandson. It’s for anyone who needs them,” Clukies told CNN. In recent years, a rising number of pediatricians across the country have been engaging with the topic of gun safety in medical settings by focusing on safety and prevention, already a natural aspect of their work.

During patient visits, it’s increasingly common for pediatricians to ask the patient’s parents if there are guns at home, and if so, how they are stored. Some hospitals then offer free gun locks, often sourced from donations or police departments and paired with safe storage education.

Some pediatricians, who bear witness to the effects of gun violence on children in their workplace every day, told CNN they see it as their obligation as medical professionals to be part of the solution to the epidemic.

In 2022, 1,672 children and teenagers under 17 were killed by gun violence and 4,476 were injured, according to the Gun Violence Archive, a nonprofit organization tracking injuries and deaths by gunfire since 2014.

“We have just as an important voice in this conversation as anyone else because we’re the ones who have invested our entire careers to protecting children and ensuring that children can grow up to be the safest healthiest version of themselves,” said Andrews.

“It is only natural that we see these things that we understand that they’re preventable, and we want to get involved in finding the solutions,” she added.

So far in 2023, high-profile incidents of children accessing firearms have heeded calls for stronger, more consistent laws nationwide, requiring adults to safely secure their guns out of the reach of children and others unauthorized to use them. They have also highlighted a lack of public education on the responsibility of gun owners to store their guns unloaded, locked and away from ammunition, CNN previously reported.

In early January, a 6-year-old boy was taken into police custody after he took a gun purchased by his mother from his home, brought it to school and shot his teacher at Richneck Elementary School in Newport News, Virginia, police said. Just over a week later, a man was arrested in Beech Grove, Indiana, after video was shown on live TV of a toddler, reportedly the man’s son, waving and pulling the trigger of a handgun, CNN previously reported.

Hundreds of children in the US every year gain access to firearms and unintentionally shoot themselves or someone else, according to research by Everytown for Gun Safety, a leading non-profit organization focusing on gun violence prevention. In 2022, there were 301 unintentional shootings by children, resulting in 133 deaths and 180 injuries nationally, Everytown data showed.

Firearm injuries are now the leading cause of death among people younger than 24 in the United States, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics released an updated policy statement in October 2022, stating firearms are now the leading cause of death in children under the age of 24 in the US.

The Academy’s statement urged a “multipronged approach with layers of protection focused on harm reduction, which has been successful in decreasing motor vehicle-related injuries, is essential to decrease firearm injuries and deaths in children and youth.”

The Academy has free educational modules for pediatricians to guide them on how to have what can be challenging or uncomfortable conversations about firearms with families, according to Dr. Lois Kaye Lee, a pediatrician and the chair of the Academy’s Council on Injury, Violence and Poison Prevention.

“This shouldn’t be considered as something extra; it should be considered as part of the work that we do every day around injury prevention, be it around firearms, child passenger safety and suicide prevention,” Lee said.

Dr. Georges Benjamin, executive director of the American Public Health Association, told CNN the public health approach to addressing gun violence removes the politics from the issue and “puts it into a scientific evidence-based framework.”

“Physicians have a unique opportunity to engage their patients, the parents of kids or the parents themselves as individuals to make their homes safer,” Benjamin said. “We already do this for toxins under our kitchen cabinets, razor blades and outlets in the wall.”

In the emergency department at St. Louis Children’s Hospital, all patients are screened for access to firearms and offered free gun locks, as well as safe storage education, Clukies said. Gun locks can also be mailed to families, free of cost, through the hospital’s website.

“Every patient that comes into our emergency department, whether it’s for a fever or a cold or a broken arm, is asked about access to firearms,” said Clukies, adding 5,000 locks have been given out since the initiatives were started in 2021.

In a collaborative effort between trauma nurses, physicians, social workers, violence intervention experts and family partners, the hospital created a “nonjudgmental” script for doctors to follow as they ask patients about access to firearms, Clukies said.

During the screening process, pediatricians will ask parents or caretakers questions such as: Do you have access to a firearm where your child lives or plays? How is it stored? Is it stored unloaded or loaded?

“When I first started doing this, I would say, ‘Are there any guns in the home? Yes, or no?’ But I have found and learned from other experts that if you just say, ‘If there are any guns in the home, do you mind telling me how they’re secured?’ it takes away the judgment,” said Andrews, a pediatrician whose hospital, the Medical University of South Carolina, also offers free gun locks to patients.

An assortment of cable gun locks offered free of charge by the Medical University of South Carolina.

Families are asked about firearms in the “social history” phase of a patient visit, during which pediatricians will ask who lives in the home, what grade the child is in, what activities they engage in and where the child goes to school, according to Andrews. When parents indicate their firearms are not safely stored, like on the top of a shelf or in a nightstand drawer, Andrews said those are important opportunities for intervention and education about storage devices such as keypad lockboxes, fingerprint biometric safes and other types of lock systems.

It’s also important for pediatricians to understand the parents’ or caretakers’ motivation for owning a firearm to “inform the conversation about where they’re willing to meet you as far as storage goes,” she added.

Andrews and Clukies said they were pleasantly surprised by the willingness of families to discuss firearm safety, most of whom recognize it is an effort to protect their children.

“I expected more pushback than we received, which is attributed to us really focusing on how we properly word these questions,” Clukies said. “I think it’s because we turn it into a neutral conversation, and we focus on safety and prevention.”

Andrews added it is uncommon for medical schools or residencies to discuss gun violence prevention, which she says is due to the “politics around the issue.”

“Thankfully, that has evolved, and more and more pediatricians are realizing that we have to be an integral part of the solution to this problem,” Andrews said.

At the St. Louis Children’s Hospital, pediatricians followed up with patients who received a free gun lock in a research study roughly two months after they launched the initiative in the fall of 2021 to see if their storage practices changed.

The study found two-thirds of families reported using the gun lock provided to them by the hospital and there was a “statistically significant decrease” in those who didn’t store their firearms safely, as well as an increase in those who stored their firearms unloaded, according to Clukies.

But there is still much more work to be done in the medical community to fight the gun violence epidemic and scientific research on the issue is “woefully underfunded,” Andrews contended.

According to the American Public Health Association’s Benjamin, a multidisciplinary approach by policymakers, law enforcement and the medical community is essential to fostering a safer environment for children.

“Injury prevention is a core part of every physician’s job,” Benjamin said. “It’s clearly in our lane.”

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