Infant Mortality and Race

Examining Health Disparities in Charlottesville Past and Present

Words by Lucy Hoak and Spencer Philps. Photo illustrations by Max Patten.

In 2016, a group of researchers at U.Va. published an article in the scientific journal PNAS that explored the implicit racial bias of 222 white medical students and residents at the University.

Twenty-one percent of first-year medical students believed that black patients had stronger immune systems than white patients, and 14 percent of second-year students were of the opinion that black people’s nerve endings were less sensitive than that of whites’. Almost half of first-years and second-years, and one-quarter of resident medical students believed that the skin of a black person is thicker than that of a white person’s.

In that same year, 2016, a black baby born in the city of Charlottesville was nearly 10 times as likely to die in their first year of life than a white baby.

In 2016, Charlottesville’s infant mortality rate for African Americans, or the number of infant deaths before one year of age per every 1,000 live births, was 26.3. This rate was among the highest in the Commonwealth, while the same statistic for white children was just 2.6. This disparity is not at all unique to Charlottesville — nationally, black women have the highest rates of infant mortality out of any racial background.

The context of the systemic social and economic barriers that women of color are subjected to in the United States can explain this racial disparity in pregnancy outcomes, according to a study conducted by Duke University’s Center on Social Equity. Black women experience the effects of both a gender and racial wage gap and are disproportionately exposed to factors that are correlated with poor pregnancy outcomes, such as high levels of poverty and decreased access to healthcare, food and housing.

The city of Charlottesville is no stranger to such racial discrimination and inequities. The City-ordered razing of a prosperous black neighborhood at Vinegar Hill in the 1960s pushed hundreds of African-Americans into public housing. Last year, a New York Times and ProPublica investigation uncovered the rampant racial segregation that exists today in the City’s schools. A recent report presented by the Charlottesville police found that black residents were nearly nine times more likely than whites to be subjected to stop-and-frisk encounters.

However, such an institutional explanation cannot fully explain this phenomenon, for when factors such as levels of education and income are held constant between African Americans and whites, the infant mortality rate gap still exists. What else, then, explains the racial gap in infant mortality rates in this city? Mayor Nikuyah Walker, in an interview published last fall, referred to the city as aesthetically charming, but still a “very ugly-in-the-soul place.” And indeed, the infant mortality crisis in Charlottesville cannot be explained without examining the city’s “ugly soul,” which begins at the University Hospital.

Dr. Michael Swanberg is a nursing researcher and professor at the University who wrote his dissertation, entitled “A Canary in the Coal Mine: Exploring African-American Women’s Lived Experience of Childbirth,” on Charlottesville’s racial disparities in infant mortality.  

Tall and affable, he led us through the labyrinth of hallways in the University Hospital down to the Claude Moore Health Sciences Library, where he wanted to show us primary sources that illustrated the hospital’s gruesome racist past. In the University’s infancy in the early 19th century, a wealth of evidence describes the routine practice of procuring cadavers for the medical school from African American cemeteries in the region, which would often have to be prepared for dissection by the University’s slaves.

“The graves of African Americans were robbed for that,” Swanberg said, “and the owners of enslaved people could sell their bodies — so even in death, the African American people didn’t have ownership of their own bodies.”

Even up until the 1950s and 60s, the hospital remained racially segregated. Black patients stayed in inferior and inadequate rooms with pipes that often leaked from overhead, and an emergency surfeit of patients meant hospital beds and patients would spill over into the hallway.

The legacy of discrimination and segregation prevails among older generations when they remember the old hospital — a legacy inherited by those visiting the hospital today.

Photo from University of Virginia Medical Alumni Newspaper showing pipes dripping onto patients.

“I was born in 1953, so anyone of my age remembers visiting their mother, father, grandmother; this is what it would it would look like,” Swanberg said. “One of the salient characteristics that people talk about — these water pipes, the heating pipes would drip on the patients. Every person that I talked to who’s over the age of 70 — that’s the one memory they take away from this is being in the basement, visiting their family members and having water drip on the patients from the water pipes in the basement.”

This traumatic legacy coupled with the implicit biases revealed in the 2016 PNAS study explains the disconnect that black patients feel in their experiences at the University Hospital, otherwise considered among the best hospitals in the Commonwealth.

The 42 African American women who participated in the focus groups which were the basis for “A Canary in the Coal Mine” often articulated a discomfort with being used as material for medical study, an experience not far removed from the days when African Americans’ graves were robbed for use in lab dissection. African Americans interviewed in the study preferred established doctors over inquisitive medical students.

“Like some people that do have bedside manner — they’re like 40 [years-old],” a participant said in “A Canary in the Coal Mine.” “They’re like way older because they’ve been doing it. And now they just like looking at you like ‘This is my science experiment, let me see what experience I can get out of it.’”

Participants also felt that given space constraints in the birthing room, priority was given to medical students over family members.

“And they have like a crew of students — the room is so crowded and the actual RN is sitting on the sink … It’s entirely too crowded,” a participant said. “I felt that they [the medical students] needed to leave … Like, if they have that many students in there, they can have that many family in there.”

The practices inherent to the pedagogy of medical school created a sense of mistrust by mothers. Swanberg described how the established protocol of having students establish safety by checking the patient’s identity — name, date of birth and number of children — can be at odds with the close relationship the patient hopes to have with their doctor. This practice in turn reinforces the stories from the past, while the medical student only thinks they are creating a safer environment.

“Like when I come in, you should know me by my first name. No matter that you have 3,000 women that you’re seeing. You should know me by my first name,” the participant said. “When you look at my chart, you should have a general idea of what’s going on with me and my pregnancy … I mean you don’t have to know my favorite color, but you should know that this is my first child, you shouldn’t ask me that when you come in the room.”

Swanberg relates these sentiments not only to the disturbing narratives of racism passed down from centuries ago, but also to even more recent narratives such as the destruction of Vinegar Hill.

“The local midwives, once the neighborhood was torn down, that whole social safety net was kind of moved to the hospital,” Swanberg said. “People really thought that medical students were giving the care, that again we kept hearing that narrative that we were being used as science experiments .… I don’t think we’re creating better stories, when we’re talking about health disparities. And if this was your memory, often what the women encountered at the hospital was just re-traumatized.”

Patients’ beds spill into the hallways in photo from 1953 University of Virginia Medical Alumni newsletter.

Despite such deep-rooted oppression, efforts are being made to reduce disparities in infant mortality rates and health disparities generally. Swanberg is hopeful about the projects and endeavors in the future, particularly given the increased public consciousness of past realities.

“The good part of this story a lot of people are working together and we’re trying, but we’re still not anywhere near where we need to be,” Swanberg said. “I think now we’re moving in the right direction, where for a while there we were moving in the wrong direction … a lot of people are working together.”

Yet, Virginians now know that their governor, Ralph Northam, a pediatric neurologist himself, wore blackface in medical school, and still holds office.

The issue of racial disparities in infant mortality caught the attention of local public health departments in 2008 following a district-wide community health assessment which was led by representatives from the University, Charlottesville and Albemarle Schools and Thomas Jefferson Health District. Since then, according to Kathryn Goodman, the public information officer for the Thomas Jefferson Health District which includes five healthcare facilities, a host of measures have been introduced to try to improve rates.

“From that [the results of the 2008 community health assessment], we deemed that we kind of needed to create a coalition that could collaborate and make bigger systems, changes and work together to address the issue, and kind of figure out the root cause of the issue and then work together to create programs and solutions and policies that could improve the birth outcomes,” Goodman said.

This led to the creation of the Improving Pregnancy Outcomes workgroup, a coalition of local stakeholders which strives to achieve goals such as increasing access to timely and adequate prenatal care and intervening on behalf of populations most in need.

Today, Goodman oversees the district’s IPO workgroup, which is in its 10th year and described the types of issues they address.

“There are handful of indicators for birth outcomes, and so we worked on different projects to address everything from reducing the rates of preterm births, low birthweight, infant mortality, of course, and other factors that play into pregnancies,” Goodman said. “So looking at increasing access to early entrance to prenatal care … and looking at enrollment in Plan First, which is a medicaid program that covers family planning services.”

The IPO workgroup puts out a resource guide compiling useful information and services for pregnant mothers in the area. On the guide, one can find resources like free support groups, low-cost or discounted transportation services or maternal education and support programs.

Goodman was optimistic about the progress the group had made and the plans for initiatives in the future, including looking at postpartum support services including maternal mental health.

Dr. Rachel Zaslow, a trained midwife and doula with a doctorate degree in feminist theory, is among those seeking to remedy the infant mortality crisis in Charlottesville. Upon moving to Charlottesville, its deeply ingrained segregation and corresponding health disparities made an impression on her.

“I was immediately struck by how segregated Charlottesville is,” Zaslow said. “There’s people living very different experiences of Charlottesville … you see it evidenced in restaurants and public spaces — and to me that almost always translates to higher parent/infant mortality and health outcomes.”

Zaslow found Charlottesville’s birth outcome disparities to be on par with the nationwide disparities, even when controlling for education and income.

“When you look at a black woman who’s Harvard-educated and eats only at Whole Foods, and her outcomes are just as bad, then we have to say, there’s something else going on. And the answer to that is almost always implicit bias in the case of medical care,” Zaslow said.

In a Cesarean section, Zaslow explained, some degree of pain is perceived as normal. Yet implicit bias means doctors are more likely to dismiss a black patient’s pain level as “normal” and forego additional testing, according to the 216 PNAS study.

“If a black woman has a C-section and says I’m in pain, the doctor is less likely to take her pain seriously than a white woman,” Zaslow said. “And a white woman — they may say, I believe you, let’s just run these labs, and, ‘Oh, we find out they’re internally bleeding, and we’re going to have operate again.’”

These disparities prompted Zaslow to start the Sister’s Keeper Collective in Charlottesville to educate women in the community as birth sisters, who then serve as advocates for their peers. In the four years since its founding, Sister’s Keeper has trained 65 women as birth sisters.

“Birth sisters work alongside a pregnant person helping them navigate the system, helping them ask questions to get the medical care they want or need, helping them create a birth plan to understand all the options, understand what options they might want, and understand that you can ask for these things,” Zaslow said.

This advocacy for women of color is key, given the implicit biases that may put women of color at risk, if communication is not two-sided and based on trust. In particular, the birth sister will work with the doctor and patient to ensure that the risks and benefits of any possible procedure are out in the open and clearly articulated.

“What we have heard doctors say is, ‘Well, the risk is that you don’t have your baby and the benefit is that you do,’” Zaslow said. “So the doula in that moment would say you can just explain to us a little more what would happen … and are there side effects.”

Ultimately, Sister’s Keeper strives to ensure that health care providers work as a team and allow the mother to make a real choice. The mother’s interests and desires are paramount — no bias is shown against choosing a natural birth, for example. After the birth, the birth sister continues to provide postpartum support.

“We do a 24-hour visit, a one week visit, and then as often as the mom needs postpartum to help her settled into a newborn care routine, to help her with breastfeeding,” Zaslow said. “We do screening for postpartum depression, and we make sure moms are linked into services that will help them to thrive with their new babies.”

Moreover, Sister’s Keeper provides services that aim to bridge the gap between services normally available to white women and women of color. Their new location on the Downtown Mall hosts childbirth education classes, prenatal yoga, babywearing classes, individual meetings with midwives, prenatal counseling and more, all centered on serving women of color.

“One of the things we heard from especially black moms, but women of color in general in Charlottesville, is a sense of disenfranchisement from most of the new mom spaces, so if you go to Bend Yoga on the downtown mall, which is a mommy/baby/prenatal center, it’s all white people in there,” Zaslow said. “Because of the history of segregation in Charlottesville, a black person may not feel comfortable walking into that space, so creating a space here that is a safe space has been an important thing.”

Incidentally, the yoga classes always sell out.

In providing these prenatal services, Sister’s Keeper aims to increase the percentage of African American mothers in Charlottesville who receive prenatal care in the first trimester of their pregnancy — now only 30 percent according to Zaslow.

“The greater piece are these pregnancy crisis centers of Virginia, which are pro-life centers masquerading as health centers,” Zaslow said. “So they’re not real health centers, they don’t have doctors or nurses on staff, they have church volunteers but they offer ultrasounds, free pregnancy testing, and counseling … What we have found is they’re serving over 80 percent of the black population in the first trimester, and what is happening is people think they are getting prenatal care … even though it’s not actual prenatal care, it feels and looks like prenatal care.”

Pregnancy testing is a critical service, as social services such as Medicaid and food stamps require an official verification letter of pregnancy to receive additional benefits. Because such pregnancy centers have been authorized to verify pregnancy, women can come and take what Zaslow calls “a dollar store pregnancy test” to receive social services, decreasing incentive to seek prenatal care at an established health center with medical staff. In response, Sister’s Keeper hopes to provide legitimate prenatal care, attracting women with the same services offered by the pregnancy centers.

“These kinds of things we’re hoping to combat by opening up this center,” Zaslow said.” We’ll be offering free pregnancy testing and verification letters, we’ll be offering the opportunity for people to get prenatal care here with a midwife and then transfer to a doctor if they want to deliver at a hospital.”

Sister’s Keeper also trains women to be advocates for the health of themselves and their babies. Zaslow views this lesson of self-advocacy as instrumental to helping the mother be an advocate throughout her life, thus having the ricochet effect of healing disparities far beyond birth.

“If a mom can be supported to have one, a positive birth experience, but two, the skills that she learns to advocate for herself, to ask questions, will carry forward in this ripple-effect way, through medical care for her children growing, to the school system, learning to ask and advocate for more,” Zaslow said. “You have a right to have more and ask more — this is the toolbox for how you do it.”

Such a ripple effect is crucial because Zaslow says issues of injustice must be attacked at their core, as they are intertwined.

“In the words of Staceyann Chin, all oppression is connected,” Zaslow said. “You can’t separate one from another. They’re all crises in Charlottesville, and they all come down to segregation, a history of explicit and implicit racism and systemic oppression of people of color, both at U.Va. and people in the city.”


Silently Struggling

How students navigate the barriers and doors to mental health access at the University

Words by Molly Wright. Photos and Illustration by Max Patten.

*The names in this story have been changed to protect the sources’ privacy.

A picture-perfect image of a student at the University exists within the minds of other students as someone they constantly have to live up to or strive to become — a student who is double-majoring in rewarding and rigorous subjects, excelling in their classes, leading on-Grounds organizations, having fun every weekend and making it all look easy.

“I definitely think there is an unspoken level of success,” said third year College student Sarah Nolan. “I feel like you’ve made it [as a University student] when you are involved in at least two organizations and you’re on the executive board for at least one of those. You’re on the Dean’s List the whole year. You probably have a job or some way to get money and you also have a great job or internship lined up.”

This desire to be perfectly well-rounded usually leaves students feeling overwhelmed, stressed and confused as to why they’re not keeping up with their peers, when their peers may very well be struggling as well.

Illustration by Max Patten.

“U.Va. is a highly-ranked institution, and students get here because they’ve been extremely successful for all of their academic careers and especially in high school, having been involved in lots of things,” said Nicole Ruzek, the Director of Counseling and Psychological Services at the University. “So what we tend to see is a lot of students coming in and striving still to be the best and to get into all the different clubs and majors that they want to be in and not always being successful like they were in high school. That can create some identity confusion and just kind of a re-evaluation of you know, ‘Who am I?’ ‘What do I really want?’ and ‘What’s important to me?’”

Ruzek said that while this “process of self-reflection” often goes well, in other cases these questions lead students to a lower sense of self-efficacy and self-esteem that can then trigger mental illness. The effects of mental illness and the nastier side of the University’s culture of competition and perfection is something that Alex* has seen more than once as a first year Resident Advisor at the University.  

“Around exams, one girl did not get into a leadership position for First Year Council, and she was threatening to throw herself in front of a bus,” Alex said. “Her friends found me, and we ran over there. She was sitting on the side of the street, and I ended up talking to her for 30 minutes with those girls.”

What Alex saw from this girl, they said, was the need to be perfect and the desire to fit the “U.Va. mold” that they have recognized many more times in other first-years who were also struggling.

“It’s usually about fitting in at U.Va, not feeling like they belong,” Alex said. “I don’t know how to correct that at U.Va, but I do think that there’s a lot that can be done about changing what we perceive as success and perfection. I try to tell people that you can be successful in so many different ways.”

The pressures of success ride on the backs of University students almost every day because, as Ruzek mentioned earlier, many students have already been successful for most of their lives. The idea of not being the best or even failing once in a while seems detrimental.

“There is an atmosphere at U.Va that discourages acknowledging [anxiety, depression and stress],” said an anonymous student survey respondent conducted by abcd magazine over Google form to which 29 students responded. “At U.Va, it seems as though every student is expected to have it all together all the time — make the best grades, be the most social, and be the most involved. In reality, no one has it all together, but no one ever dares express that. U.Va students hide behind a facade of perfection. I don’t think it’s only students’ faults though, I think the University in general doesn’t want to admit any kind of fault, or instance where we aren’t the best. They don’t want to compromise U.Va.’s reputation.”

So what do students do when they feel they can no longer handle being under constant stress or sense that their struggles might be the beginnings of a mental illness like anxiety or depression? The University offers free therapy sessions for students with Counseling and Psychological Services at the Elson Student Health Center, yet gaining access to the mental health resources at CAPS has proved difficult for many students.

Each year, CAPS sees approximately 2,000 students and has around 13,000 in-house appointments, but these numbers do not account for the amount of brief screening phone calls CAPs makes, which Ruzek cited as the way most students enter their services.

“Most of the students, they do an initial phone call, and it’s a script that we follow,” Ruzek said. “We know it’s not that fun for students to do because it’s you know very scripted, but it’s the best way for us to kind of look at everyone and see what level of functioning they’re at — get a sense of if they’re eating, if they’re sleeping, are they going to classes, are they using substances, are they having any thoughts of self-harm — that kind of thing.”

During the phone call, CAPS employees determine if the specific student fits into one of four categories, according to Ruzek. The first category is for students during an emergency or crisis, and CAPS will ask them to come into the center right away. A student may not be immediately in crisis, but is still not functioning well, and as CAPS’ second category, they are asked to do an “urgent intake.” For an ugent intake, although the student might not be seen by CAPS the day they call or even the day after, they will not have to wait more than five to seven days to be seen by CAPS.

A student who has a “standard issue” for CAPS falls into their third category. This might be a relationship breakup or “having some anxiety maybe having a few depressive symptoms but they’re still going to class and doing O.K.,” Ruzek said. The wait time for an appointment at CAPS for students like these during the middle of the semester can be up to three weeks before they are seen.

About 2,000 students use CAPS each year. Photo by Max Patten.

The last category that CAPS assesses is a student who either does not want to wait for an appointment at CAPS. Some students already know they have a mental health issue that they had been treated for at home by a psychologist or therapist and would like a similar kind of treatment. Others may complete a mental health screening and realize they want a therapist faster than CAPS can provide. For these students, CAPS tries to give them referrals for other psychologists or psychiatrists in the community.

As a precedent, CAPS also tells students that it can only offer up to eight sessions because of the high demand for appointments and there only being 18 counselors working for the 2,000 students they see each year.  This is a higher ratio of counselors to students than the one to 1000 ratio the International Association of Counseling Services recommends. However, the brevity of sessions, along with a lack of available appointments, has made many students upset with their services.

“I have a friend and she went to CAPS five or six times and she really liked the person that she worked with — she felt like it was helping,” Lanier* said. “Then they told her, ‘O.K, we can’t really help you anymore.” They tried to find her someplace else to go and they actually did find her someplace, but like she doesn’t have a car, she has to take three buses to get there and she just doesn’t click with the person. She just feels like she wasted all that time getting to know the other person at CAPS, so it’s just problematic.”

Even in times of crisis, the resources at CAPS have fallen short for students.

“I remember one time this girl was really struggling, and we were on the phone with her parents because she was going to spend the night in the E.R.” Alex* said. “A person from CAPS wasn’t available so the police escorted her to the E.R., and she was trying to make an appointment for CAPS just after, but they were like, ‘We won’t be able to see you for a week because we’re overpacked.’ I feel like they’re understaffed.”

Other students voiced their concerns and complaints about a disconnect between the brief screening phone call and the follow up in-person appointment that can happen weeks later.

“I wasn’t seen in an actual session, but I did the process of being screened to be seen twice,” said an anonymous student who voluntarily answered a survey posted on Facebook by the reporter. “Both times, it took two weeks to schedule a phone call for them to see what type of service would be best. Then it was two further weeks until they could get me in. The first time I did the process I convinced myself I was fine and just overreacting in the two weeks between me scheduling the call and actually doing it so I canceled it. The second time I did the same but after having the diagnosing call. I definitely needed help both times and the waiting periods created such a barrier to seeking help.”

Other students reported that they have benefited from seeking help and using the resources at CAPS.

“I gained a lot of skills and new ways to manage my anxiety,” said one anonymous student respondent. “My therapist was very intentional and seemed very proud to see my improvement. I greatly appreciated my sessions at CAPS.”

CAPS also has more than 12 group therapy classes in an effort to expand the number of students that can be seen by their services. Some of these offerings include a mindfulness meditation hour each week, a “Hoos Stress Less” group and groups for those needing support with substance abuse or eating disorders. However, students like Emma* have commented that the dynamic is different in group therapy compared to individual sessions.

“I’m going in for group therapy this semester, but it’s very odd just because they recommend that you do it for eight sessions and you’re not allowed to talk with the people that you see in group outside of group,” Emma said. “They don’t want you to develop extremely close relationships with anyone and then for that to effect the group dynamic — for them to feel like they’re getting more support from another peer. It’s just very odd — the fact that you can’t discuss everything that’s said in group because it involves other people’s lives and issues is just very strange because I was personally seeking out one-on-one treatment with a professional at the same time. Though it’s understandable that their  resources are very much strained — it’s not necessarily therapy in the same way that we think of therapy.”

CAPS is attempting to expand, but the details of expansion may not be clear for the next two years. Photo by Max Patten.

According to Ruzek, CAPS is currently trying to expand its resources for students with the construction of a new student health and wellness center on Brandon Avenue in the next two years, and do not have a budget yet. They hope to hire more therapists, but do not know how many, and have more wellness focused offerings, even a contemplative space with relaxation and mindfulness resources. Ruzek said she would like CAPS to focus more on helping promote students’ well-beings at the University so that fewer students would reach the breaking point of needing urgent care at CAPS.

“I think what we would all like to do is more prevention-type work and more wellness focused work, so instead of waiting until someone’s developed anxiety or depression,” Ruzek said. “We have a group called Enhance that’s based more on positive psychology and really helping people to build on their resilience. We’d like to be doing more of that kind of work to keep people healthy versus just addressing them when they’re not healthy.”

Student groups such as the University’s chapter of the National Mental Health Alliance, a national grassroots mental health organization, the website group and Peer Health Educators also provide resources and safe spaces for those struggling with mental health to find a community and share their stories.

“As of right now we are mainly just doing activities, trying to get people together so they can share their story, talk about this and find a group where they can feel comfortable sharing and having a dialogue,” said Wendy Wang, second-year College student and president of National Alliance on Mental Illnesses.

Wang also mentioned how NAMI is planning a panel on the topic of minority students and mental health stigma and said that she personally hopes to have a resources panel for first-years and exchange students next fall with representatives from CAPS, Madison House and the Maxine Platzer Lynn Women’s Center.

“NAMI is trying to fill a lot of gaps,” said Grace Leffler, second-year College student and NAMI member. “We’re trying to re-group and really look at how we can be advocates for mental health. We’re going to try to pair with IfYoureReadingThis and potentially other mental health-based groups to bring more awareness and also strengthen the ties between these different advocacy groups. If we’re all on the same page and aware of what everyone else is doing then we can better focus on our side of the court.”

Expansion is a common theme among the mental health resources at the University. The website, founded by first-year graduate student of Medicine Alexandra Pental, plans to not only develop its presence at the University more but also expand to other universities such as the University of Florida and Northwestern University. These plans are being enacted by the current president of, fourth-year College Student Alexander Hyldmar.  

Pentel started during her years as an undergraduate student to provide students with letters from their peers about mental health, stigmas, substance abuse or anything else people would like to write. She said the idea behind the website came from the need to have a support system of friends who were comfortable sharing their struggles and stories together. Pentel also stressed her excitement over having faculty members write letters as well to break down the barriers between students and the administration.

“I think it’s really great that Dean Groves and President Ryan wrote letters,” Pentel said. “Dean Groves’ was a lot more personal than I expected, being like, ‘hey I’ve struggled with this, I went here too, just know you’re not alone and just because I’m Dean Groves doesn’t mean that I’m immune to that.’”

While the student team behind cannot provide professional help, they have been trained and started a peer counseling group for students who may not be comfortable enough to talk to CAPS yet or just want to talk to a friend, according to Hyldmar. Pentel also said CAPS refers students to their website, and then helps students get connected with resources at CAPS.

“We want to create less of mental health resource nodes around U.Va and more like a net that can hopefully catch everyone,” Pentel said.

The word has spread around Grounds about as Hyldmar says they are seeing more and more submissions for letters from people the team does not know. The group also provides its subscribers with a mental health newsletter every so often and has a list of resources at the University and in the Charlottesville community on their website. Pentel said they have had conversations with Dean Groves about expanding the conversation surrounding mental health at first year orientation, seeing as discussions and modules about sexual abuse and drug and alcohol abuse are already included in the first year education process.

“Our first aim is to have a newsletter, like an email that’s sent out to all first-years or all undergrads,” Hyldmar said. “Then next step is maybe integrating a mental health module at orientation.”

“We want to let first-years know that U.Va cares about this and just let them know what’s there,” Pentel said. “I think a lot of times the only thing people know about is CAPS but there’s a lot in Charlottesville specifically for U.Va students.”

The hope from organizations like NAMI and is that those struggling at U.Va will not feel like they are struggling alone — that students will know about the vast array of sources available to them and see that many students at the University struggle with stress, anxiety and depression. In the Google form survey conducted by abcd magazine, 100 percent of its responders said that they thought anxiety, stress and depression were problems at the University.

“Honestly before like three years ago when I arrived at the University, mental health was not spoken about,” Hyldmar said. “I just remember that so clearly and over time, not only, but just like everything — other students, other organizations have created this community where people are more comfortable. I think we want to reach this level where everyone, not only a certain group of students, but everyone can be comfortable talking about it.”

*Names have been changed for anonymity

If you or anyone else you know is struggling with anxiety, depression or any other mental health concerns please call CAPS at 434-924-5556, the UVA HelpLine at 434-295-TALK, or dial 911 for emergency situations.

For more resources see: IfYoureReadingThis.orgStudent Health Links, NAMI

Catching the Shadow

The ‘Kitty’ Foster Memorial

Words by Kasey Roper. Photos by Riley Walsh.

“At this place, on the site of Catherine Foster’s home, this ‘Shadow Catcher’ links the visible with the unseen even as it pulls the eyes to the sky; it creates a shadowy, grid-like outline of the house that once stood at this location,” reads a plaque directly outside the Shadow Catcher Memorial honoring the household of Foster, a free black woman who bought the property in 1833.

The metal structure is between Nau Hall and Olson Student Health, almost directly behind what is now New Cabell Hall and Old Cabell Hall. There are cylindrical metal poles holding up the “roof” of the memorial — a collection of thin, flat metal beams that criss-cross over the ground above what used to be the home of Catherine “Kitty” Foster and her family. These structures cast a shadow in the shape of the house, reminding us of its presence.

However, the history of the Foster Site was largely unknown prior to 1993. It was only when construction workers beginning to expand a parking lot where Nau Hall stands discovered evidence of burials — coffins and remains — that the history of the land was evaluated. The remains were left undisturbed, but the historic investigation began.

“That was the beginning of the consciousness of the Foster family,” said Brian Hogg, senior historic preservation planner in the Office of the Architect.

A task force spearheaded by the Department of Anthropology and the Carter G. Woodson Institute for Afro- American and African Studies was formed to do initial archeological and historical research into the site. The team determined that the University had an obligation to further investigate the site for historical and local significance. Rivanna Archeological Services, a local firm run by two alumni of the University, was brought in to complete a formal archaeological survey, which was estimated to cost somewhere between $50,000 and $150,000 in the task force’s original notes. These records can be found in the Special Collections Library at Peabody Hall.

What initial archaeological and historical research discovered — buttons, thimbles, dolls, cobblestones, bowls and more — revealed the life of a free black seamstress and her family.  

Rivanna Archeological Services’ work led to the Foster Site being added to the Virginia Landmarks Register for archeology as well as the National Register for Historic Places.

Foster started her business working as a seamstress and launderer for students and faculty of the University, which was a job previously done mostly by enslaved laborers behind the Pavilions. In the 19th century, laundry was not as simple as it is today — rather than tossing clothes into a machine and coming back to toss them into another machine an hour later, washing clothes was a very labor-intensive, all-day task. Workers sorted clothes, carried buckets of water, built fires to boil the water, stirred and washed each large load of laundry, scrubbed each individual piece of clothing, rinsed the clothes, rung out extra water from them by hand, hung them to dry and occasionally mended tears and sewed buttons onto the fabric.

The entire design of the original Foster Site — originally known as the Venable Lane Site — was directed toward these laundering practices. There is evidence of a large cobbled work area near the house to prevent the ground from becoming muddy while working with large amounts of water.

Foster was an important presence just south of the University during its formative years. Not only was she an entrepreneur, but she was a free land-owning black woman as well. During the 1830’s, it was rare for African American women to own property, even in upper Southern states like Virginia. Foster purchased 2 ⅛ acres of land in 1833. Three generations of Fosters — all headed by women — lived on and improved the land, even renting it out to tenants, until 1906, when it was sold to white land developers.

In the early 20th century, the University purchased land around the Lawn in an attempt to hide the black community.

“Up to the 1890s, it is a neighborhood that is mixed in terms of who lives there,” said Kirt von Daacke, co-chair of both the President’s Commission on Slavery and the University and the President’s Commission on the University in the Age of Segregation. “It’s not all free, it’s not all enslaved, not all black, not all white.”

As the Jim Crow Era of segregation solidified, the neighborhood became predominantly black.

This community was vital to the functioning of the University because enslaved and minimally-paid laborers alike built and maintained Grounds. This was not by accident. The opening of the University in 1825, von Daacke said, attracted a diverse group of workers who settled just south of the Lawn in what is referred to as “Canada.”

The term Canada appears in census reports from the 1850s as well as in notes from Board of Visitors’ meetings during the same time frame. The exact origin and meaning of the nickname Canada is unknown. Some theorize that it pays homage to the country that housed runaway slaves prior to the Emancipation Proclamation.

Others argue that it is a degrading term meant to emphasize the different, foreign nature of these “other” people who supported the University.

“Canada is a kind of a derisive reference to free people who [the University faculty and students] think really should be enslaved,” von Daacke said.

The Fosters lived in Canada — they’re listed as residents of it in census records — and thus had deep ties to the community and the people living there. The 12 remains found during construction were initially thought to be part of a Foster family graveyard, but as more remains were found — 32 in all — researchers realized that it was more likely a community graveyard.

Canada remained a community that housed those who supported the functioning of the University. However, just as a shadow changes its composition throughout the course of a day, the community’s composition shifted from one of a largely mixed neighborhood to a predominantly black neighborhood over the course of the nineteenth century.

This was difficult because Canada was not University-owned property, so the University really had no control over the interactions students had with the community.

The University saw the community as a “pest hole,” according to von Daacke, and sought to limit University students’ involvement with it.

When choosing between three separate designs for the South Lawn — only one of which closed off the Lawn — the Board of Visitors decided on the one that closed off the Lawn. The result of that decision is Old Cabell Hall, which New Cabell Hall was eventually built around. These buildings would have blocked sight of and access to Canada from the University as well.

The relationship between residents of Canada and the University is complicated because of racism, white supremacy and mutual dependence. The University needed residents to function, just as the residents need the University for work. Students also relied on Canada for products and activities they were prohibited from doing on Grounds.

For example, Canada was where students went to drink alcohol, gamble and interact with their enslaved servants, who were not allowed to live on Grounds. They also went to Canada to practice shooting their firearms.

Additionally, residents of Canada were employed by the University for various tasks, including cobbling, cooking, cleaning and more.

Von Daacke explained how this tension between the residents of Canada and the University — both free and enslaved — transferred to working at the University.

“To take those jobs is to require that [the residents of Canada] interact with — on a daily basis — hundreds of white would-be masters and young U.Va. students who are in the middle of identity formation as the master class, who feel very comfortable treating every person of color they meet as an enslaved person and using violence to dominate them,” von Daacke said.

Interactions with the University, therefore, did not come without risks for the residents of Canada.

The Shadow Catcher Memorial represents the story of a woman who stood in the face of racism and white supremacy, took advantage of several economic opportunities and succeeded in creating an established, private home for herself and her family for generations.

“The [memorial was built as] recognition that this is really kind of an amazing story,” Hogg said. “She’s a free black woman in the 1830s in Charlottesville. She had enough money to purchase that property when many of the people around her were renting, and she and her family managed to own the property for 75 years.”

He concluded by calling Foster “an entrepreneurial spirit.”

Yet the memorial also represents the enduring Canada community, a place of interracial coexistence as well as a crucial part of understanding the University’s relationship with the larger Charlottesville area. This is where the University’s interest was peaked when initial investigations into the site were ongoing. Not only were the Foster Site and the Canada community important to the development of the University, but they were also important to the complex tale of slavery, racism, freedom and the tightrope walked in between.

If the memorial is a literal shadow, how can we catch it?

Upon first glance, the site does not declare its significance loudly, as the Berlin Wall outside Alderman Library does. Second-year nursing student Rosie Ix passed by the Shadow Catcher on her way to class in McLeod Hall.

“I didn’t realize this was a memorial,” Ix said. “I guess I’m always walking through here just trying to get somewhere.”

Lack of awareness about the site raises questions about the University’s efforts to make its history known — especially its history tied to racism and slavery. Von Daacke explained that the University has increased its efforts to make its history with racism and slavery transparent. The Shadow Catcher Memorial, he suggests, is not well known because of the design of the South Lawn.

Jefferson Park Avenue divides Nau and Gibson Hall from Central Grounds, and students typically use a bridge to travel between the two areas. The memorial is located on the Nau and Gibson side, away from the bridge, so students are not typically positioned to walk past the Shadow Catcher Memorial. Conversely, the Berlin Wall Memorial is in Central Grounds, where many students, faculty, locals and visitors alike have more opportunities to walk past it.

Matilda Olbin, a third-year exchange student from Sweden studying Sociology, is not an expert on the memorial, but is generally interested in history. She thinks memorials allow history to be interpreted and not just lectured or rehearsed.

“It’s more solid, I guess you can make your own idea about it,” Olbin said. “If someone tells you about it, it’s gonna be their story.”

To Olbin, it is more inviting to experience history in the present. That is what the Shadow Catcher is trying to evoke — a visual perceived differently by each passerby in each moment.

Even in the early stages of the creation of the Foster Site, the Charlottesville community was actively involved in the conversation of what to do and how. Meetings were held to receive feedback from the community, and press releases were given to update the community on archeological findings and decisions, such as the decision to halt construction for the parking lot until further research could be done.

The University is still engaged with the Charlottesville community and thinks critically about its relationship to the area. For example, President Jim Ryan created a Community Working Commission last October made up of local residents to identify key issues within the area and help address them together.

The top issue listed in a report released in January is affordable housing in Charlottesville and Albemarle County. This is relevant to the University because if it does not provide enough housing, then it pushes people off Grounds and drives prices up for everyone.  

The other top issue, non-living wages for University employees, has a direct link to the early years of the University and the Jim Crow Era, when it had no obligation to pay high wages.

“They [did] not feel compelled to, nor [did] they have to, pay a living wage,” von Daacke asserts. “This is a legacy we’re still talking about in Charlottesville today where [there is] steep income inequality.”

The Shadow Catcher is a reminder of the University’s deep historical connection to the local community, as well as to institutions of racism and white supremacy.

Other memorials in Charlottesville also directly connect to these institutions, evoking controversy over the glorification of pro-slavery figures. Most notably, the removal of the Robert E. Lee statue in Emancipation Park has been debated since 2016 when city councilor Wes Bellamy proposed a commission to discuss the statue and local African-American high school students petitioned City Council, asking for the statue’s removal because they felt it was offensive. The debate reached a violent head when the Unite the Right Rally came to Charlottesville on Aug. 11, 2017 partly to protest the statue’s removal.

On Grounds, the statue of Thomas Jefferson on the West Lawn was vandalized with the words “Racist+Rapist” criticizing Jefferson’s slave-owning practices the night before the 275th anniversary of his birth. Both memorials have sparked charged discussions and confrontations about how to best represent Charlottesville’s history of racism.

But the Shadow Catcher memorial represents a different kind of narrative coming out of the same history — one of resilience.

“It’s an amazing success story when you look at Catherine Foster,” von Daacke said, because she succeeded despite being surrounded by “pro-slavery ideologues.”  

This shadow the memorial casts is our history. As time passes and things change, so does the placement of the shadow around the Foster House. The position of the sun changes our perception, as well as the prominence, of the history present there. Yet we are also attached to it directly — we cannot separate it from ourselves nor our present.

There are certainly times, however, when we cannot see the shadow, when we are not aware of our past or how it affects us.

“I pass here every day almost, but I’ve never stopped except for now,” Olbin explained.

There are other times when our past and present line up nearly exactly. This overlap of time and space is physically represented by the Shadow Catcher.

“Every once in a while, the light is such that … the shadow cast is the exact footprint of the house,” Hogg said.

In these moments, the sun is in the exact position to cast a shadow on the still-present, though hidden, foundation of the Foster House. In some moments, we understand clearly the effects of our history on the present.

“The Shadow Catcher is meant to evoke the presence of the house, but also reflect transience because the house is gone and all that’s left is a shadow,” Hogg said.