Rebuilding the Foundation by Addressing Basic Needs

The effect on victims of violence is something that seems like an obvious association that does not need much explanation. Our class has had several classes where this was the focus, and even when it is not the immediate focus, class discussions are almost always related to how violence affects the victim and their communities. There are effects on victims, their families, friends, their support systems in their communities and churches feel the effects of violence. The cost of violence, both on the part of victims and their perpetrators, has an effect on our society  The following are statistics from 2000 [Cortso et al., 2012] that outline the effects violence has on individuals an their communities:

  • 2.5 million injuries were due to interpersonal and self-directed violence resulting in total lifetime costs > $70 billion.
  • $5.6 billion were spent on medical for violence related injuries
  • $64.7 billion were lost in work and household productivity

These statistics demonstrate the cost to society when it comes to the effects of violence. When people are abused, they can have lasting consequences that can affect their ability to work and be a functioning part of the larger society. Victims sometimes (but not always) seek medical care after a violent injury, which in turn contributes to added cost to society in medical bills. These statistics demonstrate the economics related to violence, and as our class has further explored, there are even more costs to society when it comes to an individual’s mental health and overall wellness. These emotional and psychological costs, affect each layer of an individual’s support structure, which has a ripple effect on the environment around them.

            Prevention is the key, like many issues, to solving violence in our communities. One thing we must consider, when thinking about solutions to violence is what might prevent communities from seeing that violence is an immediate problem. Often, communities with long standing histories become desensitized to violence. More importantly, people living in these communities have real, basic problems such as how to put food on the table for their children, the need for employment, and sometimes it’s a matter of how to put a roof over their head or where they will sleep that night. In nursing school, we have had many class discussion based on Maslow’s Theory of Hierarchical needs. The basic principle behind Maslow’s hierarchy of needs is that you cannot address people’s needs of security, belongingness, and self-worth without addressing their BASIC physiological needs first (food, shelter, water, air, clothing and sleep).


I bring up this theory I have so often studied and applied to case studies in my nursing classes for a reason. The Grady Nia Project was introduced to our class this past week as a success story in a local approach to addressing the basic needs of women who are victims of domestic violence and have considered or attempted suicide. The program begins with a thorough evaluation that addresses key issues such as a client’s current living situation, employment, sleep patterns, current medications, and nutrition/diet. By examining these key physiological areas closely, the program aims to first address these issues, or helps the client address them throughout the program, so they can then begin to focus on the goal of the program.

Nis is a kwanza term that means “purpose.” The purpose of program is to reduce risk of suicide of the women enrolled in the program. The program offers individual and group therapy to women and helps women to identify their strengths and weaknesses with regard to their developed coping mechanisms. Additionally, it provides help and resources to women to address substance abuse problems, as well as psychosocial illnesses including bipolar disorder or depression. Most importantly, when all of this is addressed and working pieces are moving together, the Nia Project helps women realize their self worth and helps them to understand they deserve love and respect…that they matter to their community.

The Nia Project gave me the tools to build the foundation that I now stand on today. And for that, I am Grateful.” Participant of the Nia Project, interviewed 2007.

Grady is often discussed in the context of the low-income population it serves and is more often than not, depicted as a drain on GA tax-paying dollars. As a future healthcare provider, I know that much of what I have learned while in school has come from my experiences at Grady. Grady cares for people with limited to no resources, and it continues to generate amazing programs such as the Nia Project. Grady may not have the fanciest technology, and may not be a moneymaking hospital, but that’s not what the heart of Grady is to bright eyed student like myself. Grady is a once in a lifetime opportunity to learn in a setting similar to underdeveloped countries in a major urban city, that has the capacity to show how a program, or even one person can affect change by meeting the basic physical needs of a victim or patient. This is not something you can teach in books, you have to see his or her story sitting in front of you, look into their eyes. Only then can you understand that there is a chance to take a desperate situation and inspire it into something good, if you take the time and walk with them step by step in the process to realizing their own self worth.


Corso, S.P., Mercy, J. Thomas, S.R., Finkelstein, E.A. (2007). Medical Costs and Productivity Losses Due to Interpersonal and Self-Directed Violence in the United States. American Journal of Preventative Medicine. 32(6) 474-482.

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