Article

Change

Community

Development

22 June 2023

7 min read

To a house on the hill

Why did a New York lawyer move to a Brazilian slum? Jane Cacouris talks to Luke Simone about his extraordinary story.

Jane Cacouris

Jane Cacouris is a writer and consultant working in international development on environment, poverty and livelihood issues.

an aerial view of a shantytown on a steep hill side in Rio, Sugerloaf Mountain is visible in the distance

Morro da Providencia, Rio de Janeiro.

It was a hot and humid evening in 2015 and Luke had just moved into a tiny house in Morro da Providencia, Rio de Janeiro’s oldest favela, a shantytown located in the heart of the city. His new home was near the top of the hill, sandwiched between two loud and rampant drug dens. He could hear the parties and orgies happening above and below him twenty-four hours a day; his neighbours regularly firing bullets out of the windows. The noise was draining and constant. It was dark outside, and Luke sat frozen in fear, staring at a blank laptop screen by his window facing the street… waiting and praying. He had just been informed that the bandidos (drug traffickers from the main drug gang in the favela) were on their way to pay him a visit. Gossip on the street had spread that he was an undercover police officer. Why else would a white British gringo in his thirties choose to buy a house in one of Rio’s poorest and most dangerous communities?

“After about five minutes I saw a glint out of the corner of my eye… I looked around and a number of drug dealers were arriving on the porch.”

Faced with ten heavily armed gang members, they asked who he was and what he was doing in their community. Luke took a breath and explained that God had called him to Brazil from New York, and that he was choosing to live in Providencia because he loved the neighbourhood, and wanted to serve the community and build something for them; for their children and their young people. The gang listened. Then remarkably they lowered their guns, said “ok then”, and walked away. Luke was stunned.

“I know what happens to people… It was a very violent time. I thought I was going to die and it was terrifying. But God turned it around...”

The relief that he was alive quickly turned into disappointment; a realisation that despite all the sacrifices he had made to be there, he wasn’t wanted by the people he had given up everything to serve.

Armed police patrol the favela.

Armed police stand on steep steps between shantytown dwellings

Five years previously Luke was living in New York working as a finance lawyer with a corporate law firm. He was single, his firm paid for his Manhattan apartment, and he had so much disposable income that he saved half his pay each month. Originally from the UK, he grew up going to a local church in Surrey with his family, but he’d fallen far away from God.

“I was in a favourable position to go off the rails. And I did go off the rails.” he says.

In 2009, the financial crash hit and having spent five years living and working in New York, Luke began to question the premise and direction of his life. Through a family member, he was put in touch with a Christian association working with street children in São Paulo in Brazil, providing living accommodation to homeless children, who were disenfranchised from their families and/or victims of abuse and neglect. The aim was to reintegrate the children where possible with their families. During a weekend visit to São Paulo, within fifteen minutes of being shown around one of the shelters, Luke had a deep conviction that this was where he was meant to be.

“It was not this Damascus Road moment,” he says. “It was a familiar voice. Not someone who was needing to twist my arm or convince me. I felt I was in good hands. Even though change was going to mean going from a six-figure bonus to zero salary…. I was suddenly ready to risk everything knowing I was in these safe hands.”

A few months later Luke moved from New York to Brazil and went on to live and work in one of the shelters for street children for several years. He talks about a particularly bleak time when one of the boys in the shelter took a dislike to him, the relationship becoming so acrimonious that Luke even began fearing for his life. Emotionally and mentally drained, feeling rejected by the children he was trying to care for, he went away for a couple of days to regroup and called his sister. He recalls,

“She said to me, ‘Just come home Luke. Just come home.’”

Her words made him realise that he had life choices the street kids simply didn’t have. He could choose to leave them and “go home” at any moment; home to people who loved and cared for him. The children he was working with were born without options or choices. So, Luke decided to stay, and by making that decision, hoped to model a love and commitment to those who perhaps had never experienced it. A love that doesn’t diminish or disappear, even when we turn our backs.

Luke Simone.

A man sits on a concrete path with one leg splayed out in front.

What is intriguing about Luke’s story is not the desire to “re-purpose” his life. So many of us feel at times in our lives that we are drifting without purpose or meaning but when we look for more purpose, it tends to be either seeking fulfilment in our work - towards more wealth or influence or social legacy - or through our relationships. What is intriguing is that Luke chose to follow God’s purpose, rather than his own.

Luke’s story is one of sacrificing comfort, wealth and status to simply do life alongside the people that society in general has given up on, and, at times, in return getting hostility and death threats from the very people he is walking with. The story is a little reminiscent of the gospel story of Jesus Christ. Although, of course, Luke will be the first to say that he’s certainly not Jesus - “unqualified”, “unprepared” and “broken” are words he uses to describe himself – but perhaps this self-awareness of his own flaws has given him the ability to rely entirely on God rather than himself, in a place where he simply has to.

Missionaries, like Luke, are perceived by many to be the outworking of a colonial interpretation of the “Great Commission.” This refers to a number of passages in the gospel of Matthew where Jesus tells his apostles to “make disciples of all nations.” People assume this means going to far flung places and preaching about Jesus. But when I asked Luke about his work in Providencia, for him, mission is far more integral and encompassing than “straight evangelism.”

As theologian Christopher Wright points out, Jesus was concerned with responding to the needs of people - both materially and spiritually - in the power of the Holy Spirit. The two go together and are integrated. The Book of Acts and letters of the apostle Paul in the Bible show a commitment of the followers of Jesus to preach the good news and bring others to faith, but also to live with compassion as a loving community seeking to address the social and material needs of those around them. In fact, Paul’s first of many missionary journeys was to provide famine relief to prevent starvation of the people in Judea.

So where is Luke now thirteen years after he first left New York? He still lives in Providencia and together with his team of volunteers and a local church in Rio, he has built and runs a community house, Casa Cruzeiro (House of the Cross) and adjoining educational annex at the highest point of the favela.

Casa Cruzeiro.

A group of buildings jostle together at the summit of a hill in a city.

On entering Casa Cruzeiro during my visit to Rio a few months ago, I was struck by the sense of peace. The community around the house is far from calm. It’s poverty at its crudest and, as Luke will say, at times depicting humanity at its darkest. Murder, rape, incest, drugs, extortion, prostitution, abuse, neglect… the list goes on. Life at the margins doesn’t get more marginalised than this. Casa Cruzeiro is a light in the darkness, a stillness in the chaos. It operates an open-door policy where anyone is welcome, drug traffickers included (as long as they behave), for a meal, to hang out, to talk, even to stay if someone needs a roof over their head. About 200 children, adolescents and adults pass through their doors each week, and some of the activities include an afterschool programme, adult literacy support, a communal vegetable garden, career counselling, guitar lessons, bible studies and prayer groups. Material and spiritual needs met seamlessly and uncomplicatedly together as part of a whole.

A Providencia family.

A mother sits with a toddler standing in front of her. The father appears from the side lying on his back reaching an arm out.

A family play in a Rio favela.

If you could rewind the clock by thirteen years, and make a different choice, would you? I ask Luke. He pauses, and says no, but is clear that it hasn’t always felt like an easy choice. He’s often pondered over the comfort and wealth that he left behind. But at the moment he has no plans to leave.

And what has he learnt about God over these years in Brazil?

When he relies on God he feels a deep sense of peace, and a conviction of God’s love in a way he hadn’t known before.

“When God called me to Brazil, he was saying, ‘You need to know me again. I want to reintroduce myself to you. This is who I am. And this is how much I love you.”

Jesus said to His father, “Let thy Kingdom come, on Earth as it is in Heaven.” And as I walk around the safe, clean space of Casa Cruzeiro… chat with Iam over lunch, who became a Christian five years ago when reading a passage of scripture with Luke… hear about Monique, who with the team’s help, has been accepted onto a youth apprenticeship programme… look out from the roof top past the carefully nurtured community vegetable garden to the dark winding alleys and mish mash of favela shacks sprawling down the hill and into the city beyond….and watch Luke’s eyes lighten as he tells me about the young people that he and his team look after and walk through life with…

I realise this is what Jesus meant.

Article

Care

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.