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Like too many young men in his East Oakland neighborhood, 21-year-old Shaka Perdue spent the earlier part of his youth "living like I was becoming a statistic," as he put it. At 16, he landed in juvenile hall after robbing a pedestrian in broad daylight. Two years later a friend was shot right in front of him in a drive-by. "In Oakland, you run into all the people you have problems with," he explained.
Perdue still hangs out in the neighborhood — but he now wears a stethoscope around his neck. He is one of 90 or so graduates of EMS Corps, a pioneering five-month program spearheaded by the Alameda County Health Care Services Agency that trains young men of color to be qualified emergency medical technicians. "You are the first person to approach the patients," Perdue said of his future as an E.M.T. "The nurses and doctors get them after they're stabilized in the field."
Started in 2012, the corps is a novel effort to recruit, train and mentor a new generation of emergency medical professionals: young men growing up in communities in which concentrated poverty, violence and unemployment are well-documented barriers to health and longevity. Graduates like Perdue have a singular perspective on health disparities — they've lived them.
"The young men who are vilified as noncontributing members of society are not the problem," said Alex Briscoe, the agency's energetic director, who got his start as a dropout prevention counselor at a tough Oakland high school. "They're the solution."
A founding premise of the corps, which has received just over $1 million from the Robert Wood Johnson Foundation, is to create a strong pool of professionals who reflect the neighborhoods they serve. Though participants are trained to save peoples' lives, the corps strives to transform the young men themselves, and influence others who see them, by training them to do meaningful and decently paid work.
"Many of these young men have experienced a significant amount of violence," said Marc Philpart, an associate director of PolicyLink, a national nonprofit research and advocacy group. "Yet they are now exposed to a profession where they become healers."
Jimmy Jordan, another recent graduate, never knew his father and met his mother only once, six months before she died. He had a rocky adolescence, lost his first job, grew alienated from the older woman who was his guardian, and spent a number of years bouncing from sofa to sofa, shelter to shelter, occasionally sleeping in his car. "I used to be outgoing," he said. "But once I hit the homeless part of my life I sort of shut down."
Through a friend, he heard about the EMS Corps, which not only teaches lifesaving care but also provides a kind of life support for its trainees: five weeks of mentoring and "manhood" development — designed to strengthen leadership skills and cultivate a healthy African-American identity — followed by life coaching, individual and group counseling, and tutoring. Graduates continue to have access to counseling and are matched with paramedic mentors on the job. Each of the 50 or so young men accepted each year receives an $800 monthly stipend during training.
For Jordan, 24, the combination of mastering a skill and understanding the social context of his struggles helped him rewrite his life's script. Today, he is a health coach at Highland Hospital in Oakland, a county medical center known for its trauma center. He has an easy bedside manner. "I'm a compassionate person, and I always felt I wanted to share emotions with people," Jordan explained. "But I didn't know how to work through my anger and depression and have it not affect my future.
"The corps has made me proud of myself," he continued. "Being with patients is a maturing, humbling kind of experience. I'm not going to be another homeless teenager not knowing what to do with myself."
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Most young men learn about the program by word of mouth, as Jordan did. Applicants — about 250 a year — must have a high school diploma or G.E.D., a driver's license with no more than two points on it and have no arrests for the past three years. The course meets six days a week and includes a volunteer component in which young trainees serve as educators at health fairs, schools and churches.
"I felt it leave," Mohamed Diouf, 21, said of the sadness, tightness and anger that came from being physically abused as a child. "The EMS Corps teaches you about values. You go from the boy mind to the man mind."
The program is part of a larger national movement to improve opportunities and health outcomes for boys and men of color, including President Obama's "My Brother's Keeper" initiative. In Oakland, homicide is the leading cause of death for young black men ages 15 to 34. It is a population disproportionately affected by inadequate schools, substandard housing, involvement in the criminal justice system and a lack of access to preventive care.
Rather than considering them "throwaway kids," the corps regards its young participants as community assets, said Junious Williams, the chief executive officer of the Oakland-based Urban Strategies Council, a research and advocacy organization. "Even if they decide an E.M.T. career is not for them, they leave the program with an understanding of health careers and confidence for the next stage of life," he said.
The $600,000 yearly tab for the program, which guarantees a job to all graduates who pass the National EMS Certification Exam, comes from a county sales tax for emergency health care.
Rachel Unruh, associate director of the National Skills Coalition, a Washington, D.C.-based work force development group, said the corps incorporates many of the current best practices in what is known as "sectoral-focused employment training" — programs that tailor job training to the needs of local employers. Many programs focus on high schools: last year, for instance, the New York Alliance for Careers in Healthcare launched a program with a grant from the Heckscher Foundation for Children that is training 30 high school seniors and unemployed young adults to be certified as pharmacy technicians, "an occupation anticipated to have strong growth in New York City," said Shawna J. Trager, the executive director.
The EMS Corps began as a modest urban health initiative at Camp Wilmont Sweeney, a minimum-security residential program for adolescent males in San Leandro, Calif., run by the Alameda County probation department. The program didn't jell until the life coaching, mentoring and manhood development elements were added, said Michael Gibson, the EMS Corps director, who, himself, grew up in East Oakland, and whose parents both struggled with addiction. Gibson spent his youth in and out of juvenile hall for drug offenses. At 16, he was sentenced to eight and a half years in the California Youth Authority (now the California Division of Juvenile Justice).
He managed to break the cycle of self-destruction with the help of mentors from an African-American male transition program. "They pointed out what I was doing — the fake sense of manhood," he said. "They saw something in me that I didn't see."
He wound up with a full scholarship to Morehouse College. Now the EMS Corps members Gibson mentors mirror his younger self. "They have issues with low self-esteem, a negative attitude, and a lack of confidence due to trauma and family environments," he said. "They are young men ready for a second chance."
Much of the hands-on training for the Corps is provided by Bay Area EMT, a coed emergency medical worker program for 18- to 24-year-olds co-founded by two Oakland firefighters.
To date, about 75 percent of the graduates are working as E.M.T.s or in related positions. Some drop out for personal reasons and some are unprepared for the academic work. Dale Feldhauser, the chief operating officer of Paramedics Plus/California, which handles about 88 percent of the county's 911 calls with 62 ambulances, has hired five graduates and is expecting to hire three more. They are doing well on the job, he said, adding that he's only had to let go of one part-timer with an "attendance issue."
A challenge for the program is that there are now more graduates than jobs, so the health services department is scrambling to identify other opportunities, such as working with hospital health coaching programs or assisting at a local detox center.
More serious is a cautionary tale from Washington, D.C. A cadet program designed to train young firefighters fresh out of high school is currently under scrutiny after a 77-year-old man died of a heart attack across the street from a firehouse, where a rookie cadet at the station's watch desk was unclear how to respond, according to a Washington Post investigation. This program has a history of problems: in an earlier incarnation, a 19-year-old cadet was arrested and booked on a first-degree murder charge, one of a number of criminal incidents.
The corps goes to great lengths to avoid similar problems, screening its candidates carefully, said Dr. Jocelyn Freeman Garrick, deputy medical director for the Alameda County EMS Agency. The mentoring and coaching are essential, she added. "We can train all day, but if the young man's attitude, hope and vision is not re-directed, the same learned negative behaviors will continue," she said.
Teetering between his old life and his future one, Shaka Perdue asked himself a hard question: "Are you going to be the person who inspires the next generation to be good?"
Were it not for the corps — and "the support of 20 other guys who came from where you came from," he says that he would probably be earning minimum wage somewhere. Today, walking through his neighborhood, he often runs into the "O.G.s," or "older gangsters," who now treat him with respect. They don't resent his stable income or aspirations for a better life, he said. Instead they say: "I want you to talk to my son."
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Patricia Leigh Brown, a former staff reporter for The New York Times, writes regularly for The Times and The Center for Investigative Reporting from San Francisco. She was awarded a Loeb Fellowship at the Harvard Graduate School of Design and has taught at UC Berkeley and Yale.
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