Dusk to Dawn teaches youth that better decisions can save lives

Omaha’s University of Nebraska Medical Center hopes it can change how at-risk youth think about violence by showing them what happens to gunshot victims inside the emergency department.

The medical center last April teamed up with Nebraska Medicine to launch “Dusk to Dawn,” a program designed for 12- to 18-year-old youths from the city’s most violence-prone neighborhoods.

The program brings from 12 to 15 young people every month to the hospital for a two-and-a-half hour class that provides a graphic look at the consequences of gun violence.

“We want to shift their way of thinking and teach them decision making skills that will allow them to avoid risky situations and stay out of trouble,” says trauma surgeon and program director Charity Evans, M.D.

The program starts in the trauma bay where participants hear the story of Roberto Gonzalez, who died of a gunshot wound in 2015.

A girl had messaged Gonzalez on Facebook, offering to sell him marijuana. He agreed to meet her, but instead of encountering the girl, he was met by three men. One shot him in the chest.

Doctors intubated Gonzalez and opened his ribs with a heavy metal instrument. But he died 11 minutes after arriving at the hospital, at 20 years old.

“We don’t want these kids to end up like Roberto,” says trauma nurse Ashley Emmel, who coordinates Dusk to Dawn and was part of Gonzalez’s emergency care team. “We want them understand that there are choices they can make.”

In the trauma bay, one of the Dusk to Dawn participants lays on a gurney. Evans indicates where a bullet struck Gonzalez and killed him.

Evans believes his tragic story has an impact. “We are able to capture their attention,” she says. “For many of these kids we are able to turn on the light and that gives me hope.”

And she says Gonzalez’s mother is a strong advocate for the program – and a classroom presenter. “She says maybe this is what his life was for – to save others,” Evans says.

After the Dusk to Dawn participants see how real things get in the trauma center, they move into the classroom to talk about emotions, values and decision-making. About 70 kids so far have participated in the program. 

Dusk to Dawn sends the message that “trauma and violence isn’t what you may see on TV, where survivors can miraculously survive gunshot wounds,” Evans says.

The program is built on an evidence based anti-gang curriculum and was created in partnership with its community partners, including the Omaha Police Department, the Boys & Girls Club of the Midlands and the anti-violence group You Turn Omaha.

The program’s name came from a high school student who had seen the devastation caused by gun violence in her neighborhood. The idea meshed with the program’s goal of moving from darkness to light in stopping gun violence in the community.

Dusk to Dawn is patterned after a similar program created at Temple University Hospital in Philadelphia called Cradle to Grave.

The Robert Wood Johnson Foundation last month awarded a three-year grant of $315,000 to Dusk to Dawn to help expand its referral network and build it from a once-a-month-course into an eight-week program. Evans says expanding the curriculum will allow presenters to spend more time with youth discussing risk factors that might lead to decisions that could put their lives at risk.

She says the grant also will allow the hospital to offer the program at the city’s youth detention center, juvenile probation office and jail.

Acknowledging the important role families play, Evans says work has begun to start a parent's group in which families will be given shared lesson plans and recommendations for supporting their child in the program.

Evans says Dusk to Dawn reflects the hospital’s commitment to do more than simply treat victims of violence, but also to prevent the violence before it occurs.

“We are laying the groundwork to taking a different approach as a hospital system,” she says. “Violence is a health issue. If we are simply sewing up their wounds and sending them on their way, then we are missing an important opportunity.”

The AHA's "Hospitals Against Violence" initiative provides information on national, state and local efforts to help hospitals and health systems end violence in their communities. Check out the resouirces available to help you combat violence in your community.