There's not enough food in Imani Sullivan's life.
At home, Sullivan, 31, often doesn't set a fork for herself at the table so that her sons, ages 3 and 10, can eat.
Naturally diminutive, Sullivan looks frail these days. She has dropped 15 pounds since losing her part-time janitor job during the summer.
Each family meal feels like an obligation she cannot meet, a daily burden multiplied by three.
"It makes me feel like less of a mom not to have food," she says in her mother's North Philadelphia apartment, suddenly overcome by the hardship. Tears form in her eyes. "Every day, I walk into a brick wall. No bricks fall - there's no dust, no crumbling. Just the wall. It never moves."
The hunger in Sullivan's house is distressingly commonplace throughout the area of Philadelphia where she lives: Pennsylvania's First Congressional District.
At a time when more people in America are suffering from hunger, the First Congressional District is one of the hungriest, second only to the Bronx, N.Y., according to the Gallup-Healthways Well-Being Index, an ongoing national poll done in conjunction with the Food Research and Action Center in Washington.
Meanwhile, U.S. Census data released in late September show that the district, with a poverty rate of nearly 29 percent in 2009, is among the 10 poorest in the United States, and poorer than any other district in Pennsylvania.
The district is a bizarrely drawn, serpentine coil along the Delaware River that includes parts of North, West, and South Philadelphia, as well as Chester. Represented by Democrat Bob Brady since 1998, it encompasses the urban opulence of Society Hill and the ground-down, teeming precincts of Kensington. There's also West Oak Lane, Frankford, Fishtown, Northern Liberties, Queen Village, and Overbrook, among others.
Its population is about 650,000, like most House districts. But this one has more troubles than most, helping to make Philadelphia the poorest of America's 10 biggest cities.
The consequences of having such a poor and hungry place in its midst can be catastrophic for a city, whose young people risk being developmentally compromised by a dearth of nutritious food in their first years.
"Too many families here must choose between rent and food," said Renee Turchi, a pediatrician at St. Christopher's Hospital for Children in the First District. "Lack of food hurts brain development in young children. Without enough food for our kids, we are fostering a cycle of failure for the entire city."
The poorest section
St. Christopher's sits just a few blocks north of a tiny rectangle of streets near the intersection of Fifth Street and Lehigh Avenue where 63 percent of the residents live in poverty - the poorest section of the First District, according to research of 2000 census data by David Elesh, a Temple University sociologist.
Here, as well as in much of the district, people live lives of tumultuous hardship, separated from the rest of workaday Philadelphia in a kind of Dickensian quarantine.
In the district, there's no money buffer from bad and crowded housing, poor education, depression, illness, injury, street-corner homicides, the ubiquitous drug trade. And omnipresent hunger.
"Kids here go to school hungry," said Iris Lopez, 54, a 30-year resident of Norris Square, who used to work in a preschool. "But people outside the area don't see, or aren't exposed to it. Even people with jobs have a hard time getting food for their families."
The elderly, too, have been suffering, noticed Patricia Collier, daytime supervisor at a corner store near Cobbs Creek called West Philly Produce."Old people are really short on food, but don't have enough money," Collier said. "They will be 50 cents, maybe a dollar short. I let it go because they really need the food."
Elderly constituents often besiege City Councilwoman Maria Quinones-Sanchez for help. "Things are just getting worse for them with these economic times," she said.
Her district includes the poorer sections of the First District, and she said she was "amazed" at the amount of hunger she had seen. "It is the stuff we all should be outraged about, and we're not."
The irony, Quinones-Sanchez said, is that even as the poor are attacked for taking advantage of government help, many constituents who are eligible for food stamps and other programs don't apply, often because they don't know about them. "The poor are leaving millions of dollars on the table," she said.
Because of tightened federal eligibility, the number of people on welfare has shrunk since 1996. One in 10 of the nearly 43 million Americans living below the poverty line - $22,050 for a family of four - received welfare cash benefits in 2009, according to federal data.
Just applying for food stamps can be "frustrating as hell," said Brady, something he confirmed when he tried to call posing as someone else. He said he had told Gov. Rendell about his experience. Many "look upon people as wanting to beat the system, but they need help."
Many in the district live in intergenerational poverty, a handed-down legacy of choked-off hope, where, advocates say, there are too many guns and not enough fathers.
Some people believe poverty is the fault of the poor, authors of their own bad luck. Others blame a colossal failure of systems and institutions that victimizes the impoverished, block by block, year after year.
Nearly everyone agrees that lives in the First District would be better if there was work.
In the district and nearby areas, 300,000 jobs disappeared between 1950 and 1980, helping to create a lost world of generations of un- or underemployed people, said Walter Licht, an expert on the city's economic and labor history from the University of Pennsylvania.
The current recession, which has cost the country 8.4 million jobs, has only added to the pain, he said.
That the ghostly, shuttered factories remain in the district long after the jobs have departed is by now an ancient irony, barely remarked on.
"People aren't unemployed because they want to be," said Brady, describing his constituents as proudly "hanging in there." He's focused on bringing in federal dollars to help, he said.
What's obvious is that the recession has ensnared people who thought they would never be counted among the poor.
"The district is becoming an equal-opportunity ghetto, where white, Hispanic, and African Americans are living in nearly identical conditions," said Maria Kefalas, a St. Joseph's University sociologist. "The white poor will become increasingly common in the city as the jobs of the white working-class continue to disappear."
In the lives of the poor, hunger is the most dramatic manifestation of doing without.
After losing her job, Sullivan has relied on public assistance and food stamps to support her two children. They receive $400 a month in welfare and $430 in food stamps. That comes to $9,960 a year, about half of $18,310, the federal poverty level for a family of three.
"Hunger is ugly," said Mariana Chilton, a professor at the Drexel University School of Public Health, and a colleague of Turchi's who does hunger research at St. Christopher's.
"And it's ugly primarily because of what it can do to children, and the future of the city."
These days, Chilton and Turchi worry together about the brains of young people.
"Nutrition is vital for brain growth in the first three years of life," Turchi said, and lack of food "can stunt the size and wiring of kids' brains."
Poorly nourished children can have delays in development that affect IQ, Turchi said. While experts say most hungry Americans will not starve to death, people who don't have enough food, and enough of the right food, will not thrive - a condition called food insecurity.
By ninth grade, Chilton said, many students who haven't had enough food during their lives become disengaged, with no sense of the future. They begin taking risks - the boys becoming violent, the girls getting pregnant. Then the cycle starts again.
Even if a child younger than 3 is deprived of proper nutrition for just a week here or there, Chilton said, "it has a detrimental, immediate effect on the brain when it's building connections like crazy."
When a city experiences lack of brain development in generation after generation of its citizens, Chilton said, "you get people whose potential is truncated. Don't think the poor are stupid. But their chances are hurt."
Making matters worse: More people slide into poverty each month, and the number of Americans receiving food stamps has increased 50 percent since the recession began in late 2007.
Last month, the U.S. Census reported that poverty throughout America increased from 13.2 percent to 14.3 percent between 2008 and 2009, while child poverty increased from 19.0 percent to 20.7 percent.
In the First District, however, childhood poverty was at 40 percent in 2009, eighth-worst of America's 435 congressional districts.
Breaking the rules
Chilton is unsettled and worried as she sits writing a grant proposal in her 11th-floor Drexel office with an impressive view of City Hall.
She frequently looks up from the numbers glowing on her Mac as she frets about Sullivan, her sons, and the meals that feel like unmet obligations. Sullivan is one of dozens of women Chilton studies to understand the effects of hunger.
Lately, Sullivan has been depressed, and Chilton is eager to meet with her later in the day.
Chilton, 42, is friends with many of her research participants, which she acknowledges breaks the rules of academia. In her office, she keeps emergency supplies of diapers, clothing, and food for the women, who frequently visit.
Chilton doesn't worry about being different. "I'm hands-on, and I combine research, advocacy, friendship, and love. I admit," she says, "it makes my colleagues uncomfortable."
A tall, blond Harvard University graduate, Chilton was born into a life of wealth, the youngest of six children who grew up mostly on Martha's Vineyard. Her father was an investment banker in Boston and a marketing executive with the DuPont Co. in Wilmington. Her mother was a homemaker and a champion bridge player.
Along with a master's degree in epidemiology from the University of Oklahoma, Chilton has a doctorate in anthropology from Penn. She has worked with the Southern Cheyenne of Oklahoma, fighting to keep an American Indian hospital from shutting down.
"I have always been moved by people who are suffering," she says. "It's random and unfair that I was born into wealth and others into poverty."
Considered to be the area's leading expert on hunger, Chilton, who lives in Havertown, says she notices people shake their heads when "the white, suburban lady treks into North Philly."
Chilton says she has been berated by some African American observers: " 'You're a white academic advancing your career on the backs of black people,' I'm sometimes told."
"Some don't trust me because I look like the oppressor. OK, but I can't help that. I've stopped explaining myself."
She says pain comes with the job. "This work has almost destroyed me," Chilton concedes. "I've gotten traumatized by dealing with all the women's on-the-edge life crises."
She turns to Buddhism to find inner peace. It works sometimes, Chilton acknowledges.
A national figure, Chilton has testified at congressional hearings about hunger in the lives of women like Sullivan.
Recently, the producers of Sesame Street asked Chilton to help them figure out how Elmo and other characters could talk about hunger in America.
"How sick is this?" she asks. "Hunger is so normal, we're talking about Big Bird going to a food pantry."
It was hunger and its attendant ravages that got Sullivan and Chilton together in 2008. Sullivan, the daughter of an unwed mother who seemed to be at work all the time, is one of several women Chilton met through her Drexel research.
The two women bonded initially through Sullivan's need and Chilton's need to help. When they speak of each other, it's always in loving terms.
Chilton on Sullivan: "Imani is sparkling and truly embraces life, and she's filled with power and magic. And other times, she's very, very down."
Sullivan on Chilton: "Mariana is an angel I can call at midnight to tell my problems to. She helped my self-esteem, made me feel like I was worth something. And nobody ever did that."
After giving cameras to Sullivan and 39 other women, Chilton created Witnesses to Hunger, a research and advocacy program that includes a display of photos of life in poor neighborhoods. The goal was to make hunger less invisible.
One of Sullivan's pictures was snapped at a county assistance office, where Sullivan had gone to iron out a dispute about benefits. Her 3-year-old, Asem, who hadn't eaten breakfast that day, was holding out his hands to the case manager for a graham cracker she had in a box on her desk. For some reason, the woman had refused, and Sullivan, angry and hurt, captured the boy's fingers wriggling in the air, stretching for the food.
That photo and those of the other women were displayed in a U.S. Senate office building, as well as in venues around the country - including last summer in Chilton's old haunts on Martha's Vineyard.
Chilton invited Sullivan to accompany the exhibition, and Sullivan relished her role as a kind of instructor among the well-to-do vacationing crowds. "Talking about my life is easy," she says. "Living it is hard."
The precious days on the Vineyard "were a fairy-tale adventure I never wanted to end," she remembers. "There's no trash on the island, nothing floating in the water. I was barefoot on sand in a whole other world."
Forced to retreat from the salt air and sense of purpose, however, Sullivan had to return to a soul-stifling block of shabby rowhouses in North Philadelphia.
"I'm this new person on Martha's Vineyard, talking, being heard," Sullivan says. "But when I get back home, I'm the same old person. It was torture. Sometimes, I think it would have been better not to go away at all."
Sadly aware that opening Sullivan's world also wounded her, Chilton has tried endlessly to help.
In her Center City office, Chilton's BlackBerry sounds as she completes her grant work. The ringtone plays the Louis Armstrong classic "What a Wonderful World."
It's a text from Sullivan saying she may not make their meeting. This is unlike her, Chilton thinks. Something is wrong.
A bad year overall
A green shamrock mobile hung in a corner of a cramped and crumbling Juniata Park apartment bearing the words, "Luck of the Irish."
The shamrock wasn't working. The Scotts - Melissa, Joe, and their five children - were to be evicted in six weeks, a result of their landlord's losing the two-story rowhouse to foreclosure. They didn't know where they would land.
Joe, 27, is a carpenter idled by the recession. His wife, Melissa, the same age, had been a cashier once, a receptionist at a tax-preparation place another time.
But those jobs evaporated. Currently, the family takes in $22,356 annually from food stamps, welfare, and Supplemental Security Income for Joseph Jr., 8, who suffers from asthma, seizures, and searing eczema.
The money falls well short of the federal poverty level of $33,270 for a family of seven.
Their problems with hunger were detected by Drexel researchers working for Chilton at St. Christopher's.
For the Scotts, it was a bad year overall. Beyond the pending eviction, someone had ripped off the family's two Chihuahuas, along with all their Christmas presents, which Melissa Scott had hidden in the car that no longer ran. The bikes that the children shared also had been stolen, and the gas and electricity had been turned off and just recently restored.
More immediately, it was nearing the end of the month, and Scott was running out of food stamps. By the third week of the month, many families living in poverty are desperate and scrambling, praying for a loaves-and-fishes-type miracle with the two remaining packages of Ramen Noodles that, if they're lucky, are still in the cupboard.
For Scott, the math was simple: On the 21st of the month, the family had $47 in food stamps left. That was for 10 days, 30 meals, for seven people - an impossible 210 servings if they all ate, which the parents did not.
"I go days eating nothing," said Scott, passing a hand over her tiny torso. "My husband eats once a day."
Before cooking, she erected a baby gate between the living room and the kitchen to keep 18-month-old Aiden from crawling into danger.
It was a good night - hamburger had been on sale at the Cousin's market. As Scott made sloppy joes, the kids could hear the endlessly orbiting ice-cream truck outside, its insipid jingle provoking ire in Karen McElroy, Joe's mother, who was helping watch the kids.
"Who's got money for ice cream?" asked McElroy, at 44 already a grandmother of 15. She herself lives in poverty and has been addicted to pain medication since a former lover beat her knees crooked with a baseball bat.
The smell of cooking and the sounds of the truck churned up the kids, now hungry beyond reason, their senses overloaded in a 6 p.m. crescendo of need.
"Hurry up, Mom!" Seamus, 3, ordered as he and his fussing siblings scrambled over the gate like invaders assailing a fort, surrounding their mother in a scuffling clamor.
Earlier, Scott had written the name of each child on a Styrofoam cup, then filled the cups halfway with fruit punch. "Please don't drink before you eat," she admonished. "There's no more."
Scott placed them on the counter where daylight-brave roaches had been crawling earlier.
She ladled the meat onto hamburger rolls, serving dinner on paper plates. No potatoes, no vegetables, no sides. The children devoured the dripping sandwiches in moments, then returned to the television. Scott ate nothing.
"Tonight," McElroy said with dread, "these kids will be screaming for snacks."
Scott nodded somberly, asking, "Where will that food come from?"
'Depressed and angry'
Sherita Parks went shopping in a corner store in Frankford the other day with her too-thin daughter, Joe-anna, 2.
Nearly windowless, the bricked-in place looked even more like a siege-proof bunker within, with thick-Plexiglas partitions separating customer and proprietor.
Not dirty but not clean, the two-aisle store featured canned goods, sugary juices, and a box on the floor of hard, scrawny potatoes and bruised, oozing onions.
The point of the shopping trip was to purchase a single item: "Hey, Papi, could I get a quarter pound of American cheese?" Parks, 33, asked the man behind the partition.
Parks handed the proprietor $1.25 through an opening in the barricade.
"I only wanted to spend a dollar today, so this is a lot," Parks said. "But she'll eat a slice of cheese for a meal."
Parks tries the food pantries, but these days they're strapped themselves and can't offer enough groceries to make a difference during each long, hungry month. Besides, she said, she doesn't like dealing with the "drunks and homeless" who show up in the various places she visits.
On the walk home, Joe-anna, who weighs 20 pounds but should be 26 or more, dawdled on the dirty sidewalks of Torresdale Avenue until Parks pulled her into the tidy, small house owned by Joe-anna's father, Parks' boyfriend.
Parks regarded her daughter with anxiety. "She doesn't have enough food, and it affects her brain. She can only say 'Mommy' and 'Daddy.' She can't even tell me when she's hungry," said Parks, an unemployed nurse's aide and former part-time model who devours Patricia Cornwell mysteries.
"There's just not enough food in the house, and now she has developmental delay.
"It makes me depressed and angry."
Joe-anna has failure to thrive, meaning she has low weight for her age, caused in part by not getting enough food. Drexel University's Grow Clinic tries to treat the condition, which is underdiagnosed and still being studied by doctors. The clinic, at St. Christopher's, was founded by Chilton.
"Failure to thrive has impacted Joe-anna's language development," said Hans Kersten, the quiet, lanky pediatrician who heads the clinic. "And food insecurity is an important factor in her failure to thrive. We feel she's not getting enough calories."
Parks said her boyfriend, who works in a warehouse, made just a few dollars too many to qualify for food stamps. But, she added, he still can afford to give her only $100 a month to buy food.
"When families don't have a lot of money," Kersten said, "they end up buying things that are cheaper, like juice. We feel Joe-anna drinks way too much juice. And kids filled with juice are just not going to be hungry."
Parks, a victim of sexual abuse and poverty so severe that she lived years in North Philadelphia without heat or hot water, said she eats inexpensive food that is high in calories but short on nutrition - prepared noodles, hot dogs, white bread.
The same diet of cheap foods packed with carbohydrates can make a parent overweight while stunting her child's growth with a dearth of nutrients, Chilton said.
Kersten said Parks' state of mind could also spur failure to thrive. "I absolutely worry about the mother's depression," Kersten said. "That impacts her ability to provide structure in the home, which affects regular mealtimes."
Parks frets about Joe-anna all the time. "Will she die?" she asked. The doctors won't let that happen, they've told her.
"Still, without food, I feel despair," Parks said.
Just then, Joe-anna made some sounds that Parks interpreted as hunger. She boiled a hot dog, cut it in half, and served it with Cheerios on the side. Dinner.
"I try to live right," Parks said. "I'm not popping out different babies with different baby daddies. I'm with a good man. Joe-anna is our only child.
"People say our house is nice. So what? We need grains, lean meats, salads.
"We need food."
A dark impulse
Imani Sullivan turns up in Chilton's office for their meeting after all, later in the afternoon. As Chilton expected, there's a problem. Sullivan is quiet for a moment, then confesses to a dark impulse, one that she has been struggling with in recent weeks: She no longer wants to live.
Immediately, Chilton gets Sullivan in touch with Drexel psychologists, who hospitalize her for 10 days.
The doctors speak with Sullivan, assess her anguish. They decide to hospitalize her for 10 days.
After she is released Sullivan returns to North Philadelphia. To help her one day, Chilton looks after Sullivan's boys for a day, bringing them home to feed them and to play with her three kids.
Months later, Chilton arrives midmorning and presents her with blue comforters for the boys. From her days with the Cheyenne, Chilton learned that blankets were sacred gifts. She thinks Sullivan could use a touch of the divine today.
"Thank you," Sullivan says tightly, her pain pushing to the surface.
It isn't a good morning. Asem, 3, has just eaten cereal and is watching a SpongeBob SquarePants cartoon. But he turns to Sullivan and says, "Mommy, I'm still hungry."
Sullivan panics. De-Mire, 10, has not awakened yet.
"What do I do for food when he wakes up?" Sullivan wonders, looking at Chilton, who has often brought groceries to the house to try to ease Sullivan's burden. "It's hard to talk about because it's hard not to feed my kids, hard to say no."
"When you're unhappy, your kids know it," Chilton says, rubbing Sullivan's back.
"I'm back to not loving myself, and I'm so scared," Sullivan says.
Her tears frighten Asem, who is now staring at his mother. "Mommy? Mommy?" he repeats. That stops Sullivan cold.
"Mommy's OK," Sullivan declares with surprising strength, as though shocked back from the abyss. Suicide, she is realizing after the counseling, won't help her children.
Then she faces Chilton, saying, "I was going to take myself out and force my mother to take care of my kids.
"But my conclusion now is that that would be abandoning them. And I can't do that. I'm just tired of the no food. Tired of the gunfire in the neighborhood. Tired.
"But if it wasn't for the kids, I wouldn't be living. And that's the God's honest truth."
Chilton hugs Sullivan tightly. Sullivan, composed now, walks toward the kitchen to make sure there is enough milk for De-Mire.
Stopping suddenly, she turns and looks directly into Chilton's eyes: "You were proud of me before," Sullivan says to her.
"I'm still proud of you," Chilton says. Sullivan nods.
But she does not smile.