The Other 60 Percent

Coping with asthma leaves schools gasping

Castle Rock mom Heather Clark was so concerned that her 13-year-old daughter, Sami, would have an asthma attack at school and that no one would know what to do, she took to sneaking an inhaler into her daughter’s backpack, just in case. She calls it her “don’t ask, don’t tell” policy.

She didn’t realize that there was no need to treat the inhaler as if it were contraband. In fact, since 2005, Colorado law has given students with asthma the right to carry their inhalers with them and to self-administer their asthma medication, as long as they have a care plan on file with the school.

Last year, the legislature amended that law to remove the requirement for the care plan. But students and their parents are required to sign a contract with the school stating that the student knows how to properly administer the medication.

Douglas County schools, where Sami is a student, have adopted a policy in line with state law.

“I didn’t know that, but I’m excited to know it now,” said Clark, who also had asthma as a child. But she’s pretty sure that stated policy and actual practice don’t always coincide.

“The school doesn’t allow it,” the mom said. “I’ve gotten calls saying she couldn’t have it with her. I’m going to print out a copy of this law and make sure Sami has it in her backpack, along with her inhaler.”

Sami says she’s only had to sneak a puff on her inhaler a couple of times in the past two years, but she likes the security of knowing it’s there.

“At school, if you’re having a problem, you have to go down to the nurse’s office,” the teen said. “Unfortunately, for me that’s a couple of staircases away. That’s kind of scary, to be honest.”

The law is one thing, reality something else

Sami’s situation illustrates a greater problem confronting Colorado students with asthma, their parents and their schools:

The law is one thing. The realities confronting overworked doctors, spread-too-thin school nurses, perplexed school secretaries and anxious parents may be something else altogether.

Asthma facts

  • A CDC study shows 34 million Americans, or 1 in 9, have been diagnosed with asthma at some point in their lifetimes.
  • An estimated 22.9 million Americans – including 427,000 Coloradans – currently suffer from asthma.
  • Asthma prevalence is highest among blacks at 10.2 percent, followed by whites at 7.6 percent, and Hispanics at 6.8 percent.
  • Nearly a third of all children with asthma will miss three or more days of school this year.

“This is a topic that just needs more attention,” said Cindy Liverance, vice president of programs for the American Lung Association in Colorado. “One out of four people in Colorado has asthma. It can be viewed as commonplace. But people can die from asthma. If you don’t access to your medications, or you don’t know how to use them properly, you can end up in the emergency room.”

While Colorado law empowers children to carry asthma medication with them, health educators are now pushing for every school to develop an asthma action plan for every affected student.

That action plan would start with a long conversation between the student, their parents and the school nurse or health care provider. The school should have a list of all medications the child is taking, what the child’s symptoms are, what medications should be used and when, and at what point emergency medical responders should be called.

“Does that happen every time for every child? Sometimes not,” acknowledged Kathy Patrick, assistant director of the Office of Health and Wellness for the Colorado Department of Education and a state school nurse consultant.

“I’m coming from the perspective of a school nurse,” Patrick said. “When you have 4,000 or 5,000 students, how do you get to sit down with a student with asthma and make sure they know how to use their inhaler, make sure they know how to access help when needed?

“Nurses do what they can with the limited time they have available. But the nurse to student ratios, as they are, it’s unfortunate.”

Doctors, too, are often too busy to insure newly diagnosed young asthma patients get the education they need to stay out of trouble. The youngsters need to be made aware of things that will trigger their asthma, what to do if they start having trouble, and, above all, how to properly use their inhaler.

“If the doctor is well-versed in having these conversations, it takes five minutes tops,” said Eliza Lanman, senior director of programs for the American Lung Association in Colorado. “But if they’re not used to doing it, these conversations can take longer, and they just don’t see it as a priority.”

As a result, she said, newly diagnosed children with asthma typically end up in the emergency room an average three times in the first year after their diagnosis, because they don’t know how to minimize an oncoming asthma attack.

Lack of education in proper use can have devastating results

Sami Clark says she didn’t know how to properly use her asthma inhaler for the first two years she had it.

“Because I was never taught,” she said. “I finally learned the right way to use it at asthma camp. I sat down with a nurse there, and it took me two days to learn it.”

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This lack of education can also lead to situations such as an incident in January in Monument involving two middle school girls. One of the girls loaned her asthma inhaler to the other girl because she thought her friend was having an asthma attack. When school officials found out, both girls were suspended because school policy prohibits sharing of any prescription drug. The girl who borrowed the inhaler was eventually expelled.

“These two girls are a perfect example of why students need to be educated,” Liverance said. “To think you can just hand an inhaler to a friend is wrong.”

Some Colorado school districts already have asthma policies in place and do a good job of making sure every student with asthma has a care plan on file in the office.

Denver Public Schools, in particular, has partnered with National Jewish Hospital to provide asthma education across the district. Liverance cites Cherry Creek and Aurora as other model districts for asthma care.

But she can’t say how many districts have policies in place, let alone how many actually follow them.

“It’s hard to figure out,” she said. “That’s something we’ve been working on since the bill went into effect last year. It’s in flux. The more districts we talk to, the more interested they are in implementing this.

“But it not only means more work for schools, it also means more work for doctors, more work for parents. It’s understanding that asthma isn’t something you can take lightly.”

Adopting and implementing asthma care policies isn’t something just limited to large districts. Jody Stroh, the school nurse in Creede, is a certified asthma educator. She’s traveled around southern Colorado training her peers in best practices when it comes to managing students with asthma.

“Our goal is to improve asthma literacy among all the school nurses in Colorado,” Stroh said. “But I know that it will probably be a school secretary doing the education about asthma with a child, so we’ve designed a file system with all the different worksheets about what asthma is, what medications you’d use, how to exercise without triggering asthma.”

“A tremendous amount of thought has gone into making sure kids have their medicines available to them immediately,” she said. “We find out who has asthma, who is carrying an inhaler, and those who’ve had any problems in the past year will get a care plan. If you have a child old enough to carry an inhaler, we have a document that we have them sign, and have their parents sign, that says they understand that they’re not to share that inhaler and that they’re must have it labeled.”

after parkland

‘We’re not kidding about this,’ says one teen leader of Memphis march on gun violence

PHOTO: Dylan Peers McCoy
Students in Indianapolis participate in the National School Walkout on March 14. This Saturday, students in the Memphis area will join a related March for Our Lives.

Memphis students were on spring break when this month’s national school walkout against gun violence happened, but 13-year-old Simran Bains is not going to miss her chance to publicly speak her mind.

PHOTO: Simran Bains
Eighth-grader Simran Bains is a student leader at Schilling Farms Middle School in Collierville.

An eighth-grader at Schilling Farms Middle School in Collierville, which is on the outskirts of Memphis, Simran is one of more than a dozen teenagers planning this Saturday’s March for Our Lives in Memphis.

She believes the student drive to protest gun violence following last month’s shooting of 17 people in Parkland, Florida, will not end anytime soon. Saturday’s march is part of a national movement organized by Parkland students to keep the conversation going about gun violence.

“I think this moment is different,” Simran said. “For every school shooting I can remember, it’s the same cycle. People are sad and shocked, but nothing ever changes.”

Students and other supporters will walk to the National Civil Rights Museum from Clayborn Temple, the historic assembling area for civil rights marches of the 1960s.

We spoke with Simran about what this march means to her and what she hopes Memphis learns from it. (This interview has been lightly edited for clarity and length.)

Why are you participating in Saturday’s march?

For me, I’ve always been a little louder than my peers. I’ve always been one to go on a tangent or two. When I heard about the march from a friend, it really stood out to me because it’s being organized by people my age. I have never seen people this young doing stuff like this. It was inspiring. There’s this perception in society that there’s a gun problem in America and that’s how the world will always be. But here, I’m seeing young people, who are the future of America, changing the world, and I wanted to be a part of that.

What message do you hope to send?

I hope people hear that even though we’re young, we’re not kidding about this, and we won’t back down. I want people in Shelby County to care more about this issue and listen to us. I hope people recognize that even if they have a right to protection, no one should have to fear for their life while receiving a public education. This is a serious issue. If we don’t do something, it only gets worse from here.

But I also hope we can broaden the conversation beyond school shootings. We have one of the highest gun homicide rates in the world, one of the highest suicide-by-gun rates in the world. We’re talking about people killing themselves, not just people killing people. Suicide and homicide aren’t often brought into this conversation. I hope that changes in Memphis.

I also want the march to remind us that we can’t become desensitized to gun violence. Whenever we read that someone was shot, we don’t always think how somebody just lost one of their own. That person will have to go home to empty bedrooms.

What specifically would you like to see happen in Tennessee?

I’m personally not one to advocate for the total removal of guns. I think that’s sometimes an assumption of people who are against protests like March for Our Lives. They assume we want to take all guns away. That’s not necessarily true. But I want a written exam to purchase a gun, like in Japan. I also want a longer wait time when you purchase a gun. I don’t think you should be able to walk into a gun shop and walk out the same day with a weapon. School shootings, or gun violence in general, can often be a spur-of-the-moment decision. What if the person had to wait a few days, weeks or months before they actually got that gun? Would they still feel the same way they did when they first went to buy the gun?

Have you or your family or your friends ever been personally touched by gun violence?

My family has never been a gun family. My parents are immigrants from India, and it’s just never been a thing for us. Going to school where I do, there’s a lot of political viewpoints. Some people are really pro owning guns, some are really against. And it’s an interesting place to talk about this. But also, I’ve gotten to know people from different backgrounds. I know people in Memphis and areas surrounding it who have lost someone to guns. I’ve known people who have lost loved ones to guns in homicides or gang violence.

Starting young

These 11-year-old Brooklyn students are asking New York City to do something about segregated schools

PHOTO: Christina Veiga
Matilda and Eliza Seki, left, and their friends Noa and Benji Weiss, right, collected signatures at a district 15 meeting to discuss middle school integration efforts.

While they learned about the history of segregation, a group of Brooklyn 11-year-olds took a good look around their classrooms and realized their schools weren’t so different from the photos in their textbooks.

So Matilda and Eliza Seki paired up with their friends Noa and Benji Weiss — two sets of twins — and decided to do something about it. They launched a petition on calling on the city to integrate its schools.

“We learned about separate and equal in the civil rights movement, and that it was not equal,” Eliza said, referring to the “separate but equal” legal doctrine once used to justify segregation. “And since there are schools with people of only one race, and it’s all separated, it cannot be equal.”

Matilda and Eliza are in the sixth grade at M.S. 839, and Noa and Benji are fifth-graders at P.S. 10. They already have a bit of experience in activism, having joined the Women’s March in D.C., and helping to lead environmental clubs at their school. They hold sophisticated views for kids their age, and are aware of the hurdles ingrained in addressing school segregation.

Describing how housing patterns can tie into school quality, Benji began his thoughts by saying: “Let’s say you’re from a different culture or race and you don’t have as much money as other people do — because we still live in a racist country — and you’re in an area where the housing is cheaper but you don’t have as good schools.”

Across New York City, adults have debated how to spur integration in the country’s largest school system — and one of the most segregated. According to one recent analysis, the city’s most selective high schools enroll 84 percent white and Asian students, even though those groups make up only 30 percent of the city’s student enrollment.

But student-organized groups have also been at the forefront of a grassroots movement for more diverse schools. The work of budding advocates Matilda, Eliza, Noa and Benji caught the attention of some those groups, and they’ve now joined the ranks of Teens Take Charge and IntegrateNYC as some of the youngest members. The changes they’d like to see go beyond admissions policies, but also include a push for additional resources for underserved schools, hiring more teachers of color and curricula that reflects all students and cultures.

“We decided it was an important issue and we wanted to help fix it,” Noa said.

Matilda added: “Our schools should look like our city.”

Their schools are in District 15, where 81 percent of white students are concentrated in just three of the district’s most selective middle schools, according to an analysis by parents. The city has launched a series of public workshops to craft a new admissions model to integrate middle schools there, but these kids already have their own ideas for how to do that.

Benji, who is heading to middle school next year, said it would be “pretty good” if schools stopped picking students based on criteria such as class grades and attendance. Such “screening” contributes to segregation because of a number of factors — from which elementary schools students attend, to their parents’ ability to navigate the complicated admissions process.  

“It’s… important to learn about different peoples’ backgrounds, and religions, and cultures,” he said. “And also to make sure that all kids, no matter their race, religion or where they live can get the same, good education.”