Martha Ryan's clients are society's most vulnerable women.
They are pregnant and they are homeless. Virtually all were born into poverty, and many are battling addiction or are victims of domestic violence.
And yet these women achieve extraordinary results. Over 90 percent of their high-risk pregnancies result in healthy drug-free babies, "exceeding the national average for all births, including low-risk pregnancies."
Just as important, Ryan's organization the Homeless Prenatal Program (HPP) has helped thousands of at-risk women land jobs and find permanent housing.
What's special about Martha Ryan's approach? It's modeled after the refugee work she did long ago in East Africa. In those camps, she would train female refugees to be healthcare providers in their communities. Not only did these newly-educated women gain jobs and greater status, but when administering care to fellow refugees there was no cultural divide that often hinders outside aid workers.
Ryan employs the same strategy at HPP, where over half of the group's 80 staff are former clients who were once homeless and in need of support.
"HPP has linked me to affordable housing; helped me gain employment and job skills. It also helped me feel more confident in delivering my child and caring for a newborn. They gave me access to diapers, clothing and gave me community. In my future, I plan to continue my education, employment and one day own my own home." #25hpp
"I really hadn't planned to do the work I'm doing here in America," she said in an interview at HPP's office in San Francisco. "I had planned on going back to the developing world and setting up child health programs there. But I was getting my Masters in Public Health at Berkeley, and I was volunteering in a shelter, and I saw women who were homeless and pregnant. I saw the developing world right here in America."
Ryan argues that pregnancy is a special window of opportunity for at-risk women.
"In the 25 years that I've been doing this work, I've never met a woman who really wanted to hurt her unborn child," she says. "All women who are pregnant and continuing with their pregnancy want to have a healthy baby." This desire motivates women to seek out support and get access to information or resources they lacked.
The Huffington Post recently asked Ryan to share some life lessons -- about parenting, regrets, relationships, and her life's work.
Have you had any recent realizations about living a more fulfilling life?
I feel really privileged to be doing the work that I'm doing, and I feel very fulfilled by the work. So recently I would not say that I'm thinking about a more fulfilled life. I could use a slower life because the pace is pretty darned fast around here.
You grew up in a family of 13 kids.
It was fabulous. It was chaotic. I'm number three, so I grew up taking care of my younger siblings. When I was six-years-old, I got my first charge. I was responsible to make sure that she was cared for and if she was hungry, she got something to eat.
I have a friend who told me recently that she loved playing at our house because we never played with dolls, we always played with babies.
So it was a lot of fun. We had friends -- the friends were my siblings. And they continue to be my friends, my oldest friends in life.
What lessons did you take away from your parents? Did they play a big role in you dedicating your life to service?
My parents were terrific role models -- as busy as they were, they were always giving back and helping out other people, people who were less fortunate than we were. And there were times when we were not very fortunate and we needed a helping hand.
And then I've always been a volunteer. I volunteered at St. Anthony's Medical Clinic here in San Francisco while I was working full-time as an ICU nurse. I would wonder on those weeks when I only had two days off why I was giving up half of one day to go work again in a clinic. But it never failed that when I left St. Anthony's, I was inches off the ground. They truly cared for people that nobody else wanted to look at or touch or have anything to do with. They provided them with exquisite care, and it just made me feel good to be part of that environment.
"[I keep my family healthy by] always working toward being closer, never surrendering to problems, whatever they may be at the time. HPP helped us by first and foremost giving us hope at a time when we didn't have any. Secondly, by placing us into The Pregnancy Assistance and Temporary (PAATH) Program. HPP used The PAATH Program to take us off the streets and house us until we found family shelter placement 3 months later. [In the future I dream for my family] successes that give us our individual satisfaction. Working on projects that leave an impact on the world and leave a legacy for future generations of The Carus Family." #25hpp
Is there anything your parents got wrong that others can learn from?
You know parents, we all get things wrong. Maybe they made assumptions, about me in particular. I was not the greatest student in the world, and I didn't do well in school, so there was a sense that I wouldn't do anything in life.
I think that now my mother's quite surprised at what I have done with my life, and she's very proud of what I do.
It is a lesson that I use here at the agency: you never give up on anybody. Even when people go through rough times or don't seem to be living up to their potential, there is always that possibility that they'll be able to reach their fullest capacity in terms of growth and development.
HPP clients often share anecdotes about you showing kindness when they were being difficult. Here's one example:
"Consider Bridchette Johnson, who in 1994 was addicted to crack, sleeping on public benches, and four months pregnant. Desperate to have a drug-free baby, Johnson followed a friend's recommendation and went to Homeless Prenatal. From the moment she walked in, Johnson remembers, she was treated with respect. 'As crazy as I was, as loud as I was, [Martha] would just look at me and give me a hug,' says Johnson. 'They felt like I was worth something, so that made me feel like I was worth something.'"
Not everyone would respond the way you do. What makes you different?
I see relationships as really important in life, and it's through relationships that we move through life.
I also get a lot back. So often the clients that we serve here, they feel like they're just not worthy. But when you give some warmth to people who are down and out, just the slightest smallest little thing to show a person that you care about them or that they're worthy -- that's the beginning point of helping somebody heal and move in the right direction. So if I give a hug to somebody, I get a hug back.
The vast majority of the families that we serve, basically the common denominator of their lives is that they have been raised in poverty and without the same opportunities that the rest of us have had when it comes to schools, where we live, opportunities for jobs and for advancement in life.
For me to be able to give them just a little bit, to help them feel like they deserve what they haven't had -- I tell you, there's nothing stopping people from going forward once they get on that road.
The success rates of your program are extremely high. What's unique about your approach?
We invest in the community we serve. We have a staff of 80 and more than half come from the community we serve. There's this trusting relationship that is here when families walk in the door, and they start to work on the issues that they have.
When families come in this building -- which is a beautiful building, 26,800 square feet, lots of light, lots of space, clean -- it's for them. When they walk in, they get a sense of hopefulness. They get a sense that if they put one foot in front of the other, it's going to be better for them.
We have a policy here: we don't judge. If more than half your staff had been homeless at one point in time, had sat in that office applying for aid, being judged -- they know how it feels. There but for the grace of God, we could be in that position.
We don't know how someone came to the place where they are today. A lot of people over the years have assumed that families are homeless because they're drug addicts. But so many families are homeless because of violence in the home; they flee to get away from a violent provider. There are many, many issues that cause a family to become homeless.
So we don't judge. We believe that they, given the opportunity, can turn their lives around. And we value them, and we respect them. And when you combine all those things together, people feel good about themselves.
I've had parents tell me that I was the first person that ever believed in them. And for them, if I believe in you, then you're going to begin to believe in yourself. And if you believe in yourself, you'll move forward. If you don't, it's really hard.
"Being accepted into the Community Health Worker Program set me in a totally different direction in my life. I took the program very seriously and took advantage of going to school, being able to learn new skills; interacting with clients learning resources and referrals for our community. I took that and was able to apply for a permanent position here at Homeless Prenatal after doing an internship. Here I am as a New Beginnings Case Manager working with pregnant women who use substances within their pregnancy. I started to facilitate groups- doing a newborn group and a toddler group; constantly learning and growing. I appreciate HPP for always listening to our ideas and taking them seriously. Thank God for Martha for listening to me on having the idea for fathers being included and now we have a whole Fatherhood Program here at HPP. I recently celebrated 5 years and the Community Health Worker program will always be a foundation for where I am today and where I see myself in the future." #25hpp
Any great regrets about your life?
I think one of the most important things my mother ever said to me once was never regret anything.
So when I think of regret -- maybe my regret would be that I am not the best at confrontation. It's not that I want to confront people, but I think that it has held me back from helping people move forward in their own position here in the agency.
If somebody has issues that could use some development, but it might be hard to talk about them, I would skirt around it as opposed to being upfront and a little bit more transparent, if you will.
You say that pregnancy is a unique window of opportunity for at-risk women.
It is a special time. In the 25 years that I've been doing this work, I never met a woman who really wanted to hurt her unborn child. All women who are pregnant and continuing with their pregnancy want to have a healthy baby. Nobody wants to have a baby that will be unhealthy. But so many of the clients that we serve today, many of them don't know how to do it or they don't have the resources to be healthier. They don't have the access to nutrition or to the information.
There are people who are judgmental. They see a poor woman or a woman who doesn't have housing, a homeless woman, and they say, "Why? She shouldn't [have a baby]." But she should. I believe in family planning too. It's important for us to provide access to family planning, to prenatal services, to healthcare services. Healthcare is a right; it's not a privilege.
You've said you don't want the Homeless Prenatal Program to get too big. But the problems you're dealing with are widespread and profound. How does your model spread if not through your organization getting bigger?
I would love to see other people model our program in different cities around the country.
Even recently I have been thinking -- we do a lot of things, and we do a lot of things quite well. But do we have to continue to do things just because we do them well? Do we have to continue to add things on?
I think it's more important to drill down and to do what you do well, do it even better and share that with others. Recently there was an opportunity to apply for some more funding to do another project, but I said no. It's just too fragmented. You don't want to have fragmented services. You want to be able to really provide appropriate services that really work well for people.
So I say I don't want to get bigger. We have gotten a lot bigger than I thought we would ever become. Now I'm thinking, if you get too big, you become too thin. And then I think the important thing is at my age, after 25 years, as I think about exiting and leaving, my job is to make sure that this agency stays and continues.
I'm too old to go around and do it myself. I say that sort of tongue-in-cheek, but I am. I'm happy to share anything. I'm happy to help anybody do what we do. But I'm not going to go out there and do it.
(You can make a tax-deductible donation to the Homeless Prenatal Project here.)