KANSAS CITY, Mo. — Twenty-four minutes before the mass shooting at the Kansas City Chiefs Super Bowl victory parade in February left one person dead and at least 24 people injured, Jenipher Cabrera felt a bullet pierce the back of her right thigh.

The 20-year-old and her family were just four blocks from Union Station, in a river of red-shirted Chiefs fans walking toward the massive rally after the parade that warm Valentine’s Day. The bullet — fired by teen boys fighting in the street — thrust Cabrera forward.

She grabbed her mom by the shoulder and signaled in panic to her bleeding leg with her large brown eyes, not saying a word. Cabrera was being treated in an ambulance when she heard reports blasting from the police radio.

“My mom was trying to get on the ambulance,” Cabrera said. “I remember them saying, like, ‘You can’t get on. There might be other victims that we need to pick up.’”

Cabrera’s shooting happened before the one that garnered the big headlines that day and is one of hundreds that kill or injure Kansas City-area residents each year. That endless drumbeat of gun violence — from one-off incidents to mass shootings — has shattered the sense of safety for those who survive. As victims and their families try to move forward, reminders of gun violence are inescapable in the media, in their communities, in their daily lives.

“I look at people differently,” said James Lemons, who was shot in the thigh at the rally. Now when he’s around strangers he can’t help but wonder if they have a gun and if his kids are safe.

The new NFL season opened here with a moment of silence for Lisa Lopez-Galvan, the only person killed at the parade. Kansas City has recorded at least 124 homicides this year. Local police say there have been an additional 476 “bullet-to-skin victims” — people who were shot and survived. And there were at least 50 school shootings nationwide by mid-September.

Collectively it is all taking a toll.

Survivors suffer panic attacks and feel a heightened sense of danger in crowds and deep anxieties about the threat of violence anywhere in Kansas City.

Every shooting survivor responds in their own way to gun violence and even the threat of it, according to LJ Punch, a trauma surgeon by training and founder of the Bullet Related Injury Clinic in St. Louis.

For some, getting shot ensures they will always be on guard, perhaps even armed. Others want nothing to do with guns ever again.

“But what’s the common ground? That people desperately want to be safe,” Punch said.

Cabrera’s search to make meaning out of what happened has led her to work with a frustrated local lawmaker seeking new gun laws — something akin to impossible given Missouri state law, which prohibits nearly any local restrictions on firearms.

Learning of Other Shootings on the Phone

Feb. 14 is a movie in Cabrera’s mind, in slow motion, frame by frame, and the soundtrack is her voice, talking and talking. She sees a group of rowdy teenage boys running around her and her family. Then two pops — fireworks? Another pop. Finally, a fourth.

“I think that’s where the shock kicked in, and I grabbed my mom,” Cabrera remembered. “I didn’t say anything to her. I just, like, looked at her, and I had, like, my eyes were widened, and I kind of signaled with my eyes to look down at my leg.”

Cabrera fell and other fans rushed to her rescue, calling 911, and began cutting off her leggings. Four men instantly pulled off their belts when asked for a tourniquet. She remembers thinking that if she lost consciousness, she could die. So she talked and talked. Or so she thought.

One of her rescuers later said she actually didn’t say a word even when he asked how many fingers he was holding up.

“He told me [that] my eyes were huge, like oranges, and that all I was basically doing was, like, looking up and down four times since he had four fingers up,” Cabrera said.

Cabrera remembers being moved out of the emergency room at University Health to make room for 12 people who came in from the shooting at the rally, including eight with gunshot wounds. She checked social media on her phone — another shooting? Unreal. Finally her parents found her. She spent seven days in the hospital.

Cabrera is grateful to be alive. But she is triggered now when she sees groups of teenage boys cursing and playing, or when she sees red Chiefs shirts. Hearing four pops in a row — a regular occurrence in her northeast Kansas City neighborhood — makes Cabrera’s chest swell and she braces for a panic attack.

“It runs over and over and over and over in my mind,” she said.

‘An Increasing Sense of Threat?’

The U.S. surgeon general declared gun violence a public health crisis in June, but nearly any new regulation on guns is a political nonstarter in Missouri. In fact, a 2021 state law — signed at the Kansas City-area gun store where one of the weapons used in the parade shooting was purchased — would have barred local police from enforcing federal gun laws. The law was struck down by a federal appeals court in August.

Missouri has no age restrictions on gun use and possession, although federal law largely prohibits juveniles from carrying handguns.

Polling of Missouri voters shows support for requiring background checks and instituting age restrictions for gun purchases, but also nearly half were opposed to allowing counties and cities to pass their own gun rules.

Per capita, Kansas City, Missouri, is among the more violent places in the nation. From 2014 to 2023, there were at least 2,175 shootings in this city of 510,000, leaving 1,275 people dead and 1,624 injured. And while murder rates fell in more than 100 cities across the country last year, Kansas City recorded its deadliest year on record.

Shared with permission from The Trace.

Punch, of the Bullet Related Injury Clinic, likened the violence to a disease outbreak that goes unaddressed and spreads. The state’s permissive posture toward guns might supercharge the reality in Kansas City, Punch said, but it didn’t start it.

“So is there something going on? Is there an increasing sense of threat?” Punch asked.

Jason Barton was familiar with that violence growing up in Kansas City. Now settled in Osawatomie, Kansas, he thought long and hard about bringing his own gun for protection when he drove his family to the Super Bowl parade.

Ultimately he decided against it, surmising that if something happened and he pulled out a gun, he would be arrested or shot.

Barton responded quickly to the shooting, which happened right in front of him and his family. His wife found a bullet in her backpack. His stepdaughter’s legs were burned by sparks from a bullet ricochet.

Despite his worst fears coming true, Barton said not bringing his gun that day was the right decision.

“Guns don’t need to be brought into places like that,” he said.

‘A 12-Gauge With Teeth’

Mass shootings can derail survivors’ sense of safety, according to Heather Martin, a survivor of the Columbine High School shooting in 1999 and co-founder of The Rebels Project, which provides peer support to survivors of mass trauma.

“Trying to find a way to feel safe again is very common,” Martin said, “in the years following it.”

James Lemons had always felt trepidation about returning to Kansas City, where he grew up. He even brought his gun with him to the parade but left it in the car at the urging of his wife. His 5-year-old daughter was on his shoulders when a bullet entered the back of his thigh. He shielded her from the ground as he fell. What was he realistically going to do with a gun?

And yet he can’t help but wonder “what if.” He can’t shake the feeling that he failed to protect his family. Waking up from dreams about the parade, “I just start crying,” he said. He knows he hasn’t processed it yet but he doesn’t know how to start. He has focused on his family’s safety.

They got two American bulldogs this summer, making three total in the house now — one for each kid. Lemons described them as “like having a gun without having a gun.”

“I’ve got a 12-gauge with teeth,” Lemons joked, “just a big, softy protector.”

Most nights he sleeps only a few hours at a time before waking up to check on the kids. Usually he’s on the couch. It’s more comfortable for his leg that is still healing, and it helps him avoid the restless kicks of his 5-year-old, who has slept with her parents since the parade.

It also ensures he’ll be the one to intercept an intruder who breaks into the house.

Emily Tavis, who was shot through the leg, found solace at her church and from a sister congregation’s in-house therapist.

But then, the Sunday morning after the Donald Trump rally shooting in July, the preacher’s sermon turned to gun violence — triggering panic inside her.

“And it just, like, overwhelmed me so much, where I just went to the bathroom,” Tavis said, “and I just stayed in the bathroom for the rest of the sermon.” Now even attending church gives her pause.

Tavis recently moved into a new house in Leavenworth, Kansas, that she is renting from a friend. The friend’s husband cautioned that if Tavis was going to be alone she needed a gun for protection. She told him she just can’t deal with guns right now.

“And he’s like, ‘OK, well, take this.’ And he pulls out this giant machete,” Tavis recalled, laughing.

“So I have a machete now.”

A Search for Something Good

Cabrera, the young woman who couldn’t speak after being shot, is now trying to use her voice in the fight against gun violence.

Manny Abarca, a Jackson County, Missouri, legislator, lives down the street. One evening, he came to visit. Cabrera’s parents did most of the talking; she’s shy by nature. But then he turned and asked her directly: What did she want?

“I just want, like, some justice for my case,” she said, “or something good to happen.”

Before the parade, Cabrera was offered a factory job where her sister worked, but she hadn’t started because her leg was still healing. So Abarca offered her an internship, helping him establish a Jackson County Office of Gun Violence Prevention, a plan he introduced in July in response to the parade shootings.

Abarca was in the Chiefs victory parade with his 5-year-old daughter, Camila. They were in Union Station when shots were fired — and they huddled in a downstairs bathroom.

“I just said, ‘Hey, you know, just be calm. Just be quiet. Let’s just find out what’s going on. Something’s happened,’” Abarca said. “And then she said, ‘This is a drill.’ And hey, it tore everything out of me, because I was like, she’s referring to her training” at school.

They emerged shaken but safe, only to learn that Lopez-Galvan had died. Abarca knew the 43-year-old mother and popular Tejano DJ through the area’s tight-knit Hispanic community.

Abarca has taken advantage of this heated time after the Super Bowl parade shootings to work on anti-violence measures, despite knowing the severe limitations posed by state law.

In June, the Jackson County Legislature passed a measure that gives local teeth to a federal domestic violence law that allows judges to remove firearms from offenders.

But Abarca hasn’t been able to get the gun violence office approved, and county officials have refused to take up another measure that would establish age limits for purchasing or possessing firearms, fearing a lawsuit from a combative state attorney general. He hired Cabrera, he said, because she is bilingual and he wants her help as a survivor.

In a sense, the work makes Cabrera feel stronger in her fight to move forward from the shooting. Still, her family’s perception of safety has been shattered, and no one will be attending games or a possible Super Bowl victory parade anytime soon.

“We just never expected something like that to happen,” she said. “And so I think we’re gonna be more cautious now and maybe just watch it through TV.”

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Greenseid’s daughter has Type 1 diabetes, which means she requires daily injections of manufactured insulin to stay alive. The price of a single vial of insulin rose by about 1,200% between 1996 and 2018, and the gold vial was a reminder, Greenseid said, that this lifesaving pharmaceutical shouldn’t be as expensive as precious metal.

“What I heard is that that gold vial remained on his desk at the governor’s office, and he brought it up throughout that summer and fall when he was trying to talk to legislators to get them moving,” Greenseid said.

Ten months later, in April 2020, Walz signed the Alec Smith Insulin Affordability Act. The law was named after the 26-year-old Minnesotan whose 2017 death from rationing insulin became a catalyst for the patient advocates who turned the high cost of insulin in the U.S. into a national political priority.

Now it’s an issue in the presidential campaign. Both former President Donald Trump and Vice President Kamala Harris and her running mate, Walz, have sought to appeal to the nation’s 8.4 million insulin users and their families by touting policies that make insulin cheaper for some patients.

But advocates for diabetes patients fret that neither presidential candidate would go as far as Walz’s Minnesota law, which helps patients even if they are uninsured, despite the law being under legal attack by the drug industry.

The landscape on insulin pricing has already changed significantly in the past five years. One month after Walz signed the Minnesota law, the Trump administration announced a voluntary program for Medicare prescription drug plans to cap copayments for some insulin products at $35. Two years later, President Joe Biden signed a law requiring all Medicare drug plans to cap copayments for insulin at $35 a month.

Now, amid the current presidential campaign, Harris has proposed extending that $35 cap on insulin copayments to Americans with commercial health insurance.

The Trump campaign’s national press secretary, Karoline Leavitt, touted his efforts on prescription drug prices when he was in the White House, including approval of a pathway for prescription drugs to be imported from Canada as well as the voluntary $35 insulin Medicare copayment cap. But she did not offer new insulin-specific initiatives for his possible second stint as president.

“President Trump will finish what he started in his first term,” Leavitt wrote in a statement.

Copayment caps, which have been enacted by 25 states, are popular policies because they provide an immediate financial benefit that many patients see at the pharmacy, according to University of Southern California economist Neeraj Sood. They’re also relatively easy to implement.

But copayment caps don’t address the high list price of insulin itself, so uninsured patients don’t benefit from such rules. About 1 in 12 Americans lacked health insurance last year.

That’s what makes Minnesota’s insulin safety net different. The system has two parts: an emergency program that allows individuals to get a one-time, 30-day supply of insulin for $35, and a continuing need program that provides insulin to eligible patients for a year at no more than $50 for a 90-day supply.

By contrast, list prices for a 30-day supply of insulin can easily top $215, depending on the insulin.

The bill that created Minnesota’s program was bipartisan out of necessity. Republicans controlled the state Senate at the time, while the Minnesota Democratic-Farmer-Labor Party held the House and governor’s office.

Nicole Smith-Holt, whose son the bill was named after, watched in tears as it finally passed the state legislature in 2020.

“I was happy. I was relieved,” Smith-Holt said. “I was sad that it took Alec dying to get to the point where people could walk into the pharmacy and pick up their prescription for an affordable price.”

But because Minnesota’s program requires insulin manufacturers to provide the insulin, it has prompted a backlash from manufacturers. Pharmaceutical industry lobbying group PhRMA filed a lawsuit in 2020 to block the Minnesota law, arguing it violates the “takings clause” of the U.S. Constitution, which says private property can’t be taken for public use “without just compensation.”

That suit is ongoing, yet the state program is up and running and by the end of 2023 it had been used over 1,500 times.

PhRMA spokesperson Reid Porter said his group is committed to helping patients afford medicines. Insulin makers voluntarily dropped list prices last year and now offer patient assistance programs for affording the drugs. And the CEO of insulin maker Eli Lilly first proposed the voluntary Medicare copay cap Trump announced in 2020.

Porter said insulin costs have been driven up by insurance companies and pharmacy benefit managers, also known as PBMs — the middlemen between insurance plans or employers and drug manufacturers — when they pocket the discounts from the list price of drugs that they negotiate with manufacturers.

“Minnesota’s insulin program does not solve this problem and is unconstitutional,” Porter said. “This is not how the system should work, and why it’s critical that policymakers should prioritize reforming the PBM system, a solution that puts patient health over politics.”

In 2021, Sood co-authored a study that found that, despite insulin list prices rising between 2014 and 2018, income received by drugmakers decreased while increasing for intermediaries like PBMs and pharmacies.

In September, the Federal Trade Commission announced a lawsuit against the nation’s three biggest PBMs, alleging they created a system that inflated insulin prices. The companies denied the claims.

Jing Luo, a physician at the University of Pittsburgh, said that regardless of who wins in November he doesn’t expect existing insulin policies like Medicare’s popular copay cap to be rolled back, due in part to the advocacy of people like Smith-Holt and Greenseid.

“They’ve been really effective at tying high insulin prices with really bad, morally repugnant outcomes,” Luo said.

The key in Minnesota was including real stories, Greenseid said.

“We had enough real people who reached out and had conversations and helped to show politicians the extent of the problem,” Greenseid said, “and they listened.”

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Las sillas especiales, los equipos quirúrgicos y la iluminación de la clínica de Missouri —equipo costoso y en perfectas condiciones— todavía podían ser útiles en otros centros de salud administrados por la misma filial, Planned Parenthood Great Plains, en sus otros tres estados.

Gran parte del equipo viajó a Oklahoma, donde la organización estaba en proceso de expansión, según explicó la directora ejecutiva, Emily Wales.

Cuando, unos años más tarde, Oklahoma prohibió el aborto, llegó el momento de reubicar de nuevo esos equipos. Es probable que una parte terminara en Kansas, reflexiona Wales, porque allí la organización había abierto dos nuevas clínicas en poco más de dos años. El acceso al aborto está protegido en la Constitución del estado y la demanda ha aumentado muchísimo.

Las clínicas de Kansas atienden regularmente a pacientes provenientes de Texas, Misuri, Oklahoma, Arkansas e incluso Luisiana, ya que, para muchas personas del sur de Estados Unidos, Kansas es ahora el estado más cercano donde pueden obtener un aborto legal.

Al igual que los equipos que debieron ser trasladados de estado en estado, también las pacientes que necesitan interrumpir un embarazo viajan por todo Estados Unidos para sortear el mosaico de leyes que prohibieron el aborto a partir de la sentencia de la Corte Suprema en el caso Dobbs contra Jackson Women’s Health Organization.

El fallo de la Corte dejó en manos de los estados las políticas sobre el aborto. Desde entonces, 14 estados promulgaron prohibiciones a la práctica que contemplan unas pocas excepciones, mientras que otros han restringido el acceso.

Por el contrario, desde 2020, los estados que no adoptaron prohibiciones han visto un aumento del 11% en los abortos asistidos por médicos, según el Instituto Guttmacher, una organización nacional sin fines de lucro que apoya el derecho al aborto.

Este instituto informa que, en 2023, más de 170,000 personas viajaron fuera de su estado para realizar el procedimiento.

El aumento en el número de abortos no se atribuye únicamente a los desplazamientos de un estado a otro. También influyó la expansión de la telesalud, que ha permitido realizar abortos farmacológicos sin que sea necesario viajar. Esto ha favorecido el aumento de los abortos autogestionados, especialmente aquellos en los que se utiliza el medicamento mifepristona.

Isaac Maddow-Zimet, analista de datos del Instituto Guttmacher, destacó que el aumento en los índices de abortos en los últimos años se explica por personas que viven en estados donde no hay prohibiciones absolutas. Este fenómeno se dio a medida que se expandieron los recursos disponibles y se facilitó el acceso.

 “Esto refleja, en muchos sentidos, que el acceso al aborto tampoco era perfecto antes del fallo Dobbs”, afirmó Maddow-Zimet. “Había muchos obstáculos para recibir la atención, y uno de los mayores obstáculos era su costo”.

El año pasado, el número estimado de abortos realizados en el país superó el millón, la cifra más alta en una década, según el instituto.

De todos modos, los opositores al aborto celebraron una reducción significativa del procedimiento en los 14 estados que tienen  prohibiciones casi totales.

“Es alentador que los estados pro-vida continúen mostrando descensos masivos en la práctica del aborto, con una caída de más de 200.000 procedimientos desde el fallo Dobbs”, escribió en un comunicado Kelsey Pritchard, vocera de Susan B. Anthony Pro-Life America.

Las organizaciones que trabajan en los estados donde el aborto sigue siendo legal perciben casi de inmediato las repercusiones de cada nueva prohibición. Por ejemplo, una filial de Planned Parenthood que tiene una clínica en el sur de Illinois, informó que hubo un aumento de aproximadamente el 10% en el volumen de llamadas en mayo, durante las dos semanas posteriores a la promulgación de la prohibición del aborto a las seis semanas en Florida.

Midwest Access Coalition, un fondo con sede en Illinois que proporciona asistencia financiera y otro tipo de colaboración a personas que necesitan practicarse un aborto, experimentó una situación similar el día en que se anunció el fallo Dobbs, en junio de 2022.

“Nuestra línea telefónica estaba desbordada”, afirmó Alison Dreith, directora de alianzas estratégicas de esa organización.

Las personas que llamaban no sabían qué significaba exactamente el fallo de la Corte Suprema ni tampoco cómo afectaba sus posibilidades de interrumpir el embarazo, explicó Dreith. Ni siquiera entendían si se iban a mantener las citas que ya tenían programadas.

Midwest Access Coalition ayuda a las personas a viajar para acceder a abortos en 12 estados del Medio Oeste, cuatro de los cuales ahora tienen prohibiciones totales que contemplan muy pocas excepciones.

En 2021, Midwest Access Coalition ayudó a unas 800 personas. El año siguiente, el número subió a 1.620 y en 2023 llegó a 1.795. Parte de ese aumento puede atribuirse al crecimiento natural de la organización, que existe solo desde hace alrededor de una década, argumentó Dreith. Pero también es un testimonio de la calidad de su trabajo.

Esta entidad cubre cualquier medio de transporte que sea necesario para llevar a las pacientes hasta las clínicas. Esto incluye una colaboración con otra organización sin fines de lucro en Illinois, que cuenta con pilotos voluntarios dispuestos a transportar a las pacientes en vuelos privados a través de las fronteras estatales para que puedan tener un aborto.

“También reservamos y pagamos habitaciones de hotel”, dijo Dreith. “Y damos dinero en efectivo para los gastos de alimentación y para cuidado infantil”, agregó.

La National Network of Abortion Funds, una coalición de grupos que ofrecen asistencia logística y financiera a las personas que quieren tener un aborto, informó que las donaciones aumentaron después del fallo Dobbs.

Los miembros de esta red registraron un aumento del 39% en las solicitudes de ayuda en 2023, el año posterior al fallo. En ese período pudieron ayudar económicamente a 102.855 pacientes, que residían tanto en el propio estado como en otros lugares. Sin embargo, desde entonces se ha producido un “asombroso descenso” de las donaciones.

El aumento en la conciencia sobre las opciones para abortar, impulsado por la catarata de noticias sobre el tema desde la decisión en el caso Dobbs, puede haber contribuido al aumento general en los abortos, opinó Maddow-Zimet.

Ambas partes esperan la próxima ronda de resoluciones políticas sobre el aborto, que los votantes decidirán en noviembre. Las iniciativas electorales en por lo menos una decena de estados podrían consagrar el derecho al aborto, ampliando el acceso, incluso en dos estados que hoy tienen prohibiciones integrales.

“Se perderán vidas con la eliminación de las leyes que protegen anualmente a más de 52.000 niños no nacidos”, escribió Pritchard, de Susan B. Anthony Pro-Life America, citando un análisis en la página web del grupo.

Mientras tanto, Wales dijo que sus clínicas en Kansas no tienen suficientes turnos para atender a todas las personas que se acercan para solicitar un aborto.

En los primeros días tras el fallo sobre Dobbs, recordó Wales, sólo el 20% de las personas que llamaron a la clínica pudieron hacer una cita.

La organización ha ampliado y renovado sus instalaciones en todo el estado, incluidas las de Wichita, Overland Park y Kansas City, Kansas. La clínica más reciente se inauguró en agosto en Pittsburg, a sólo 30 millas de Oklahoma.

Pero incluso considerando toda la capacidad que han agregado, Wales sostiene que su organización sólo podrá responder a la demanda de la mitad de las personas que solicitan ayuda.

“Hemos hecho todo lo que pudimos para aumentar nuestra capacidad de atención”, explicó Wales. “Pero aun así resulta insuficiente porque no ha sido posible reemplazar los recursos de muchos estados que prestaban atención a sus comunidades y han dejado de hacerlo”, concluyó.

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It’s the second new clinic the regional affiliate has opened in Kansas in a little over two years, to accommodate the growing number of patients coming from Texas, Missouri, Oklahoma, Arkansas and even Louisiana.

For many people in the South, Kansas is now the nearest place to get a legal abortion.

Fourteen states have enacted abortion bans with few exceptions since the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision in 2022 left policies on abortion to the states. Many more have limited access.

And yet, the estimated number of abortions in the United States last year rose to over 1 million, the highest number in a decade, according to the Guttmacher Institute, a national nonprofit that supports abortion rights. That’s due in part to the efforts of groups such as Planned Parenthood Great Plains to fill the void left in the states with bans.

Over 170,000 people traveled out of their own state to receive abortion care in 2023, according to Guttmacher. That’s a big jump after Dobbs even though the share of out-of-state patients has been rising since at least 2011.

Not all of the increase in abortions comes from interstate travel, of course. Telehealth has made medication abortions easier to obtain without traveling. The number of self-managed abortions, including those involving the medication mifepristone, has risen.

And Guttmacher data scientist Isaac Maddow-Zimet said the majority of the overall abortion increase in recent years came from those in states without total bans. The increased attention on the issue since Dobbs and efforts to expand access for people in the states with bans bolstered access for people locally as well.

“That speaks, in a lot of ways, to the way in which abortion access really wasn’t perfect pre-Dobbs,” Maddow-Zimet said. “There were a lot of obstacles to getting care.”

Abortion opponents, meanwhile, hailed an estimated drop in the procedure in the 14 states with near-total bans.

“It’s encouraging that pro-life states continue to show massive declines in their in-state abortion totals, with a drop of over 200,000 abortions since Dobbs,” Kelsey Pritchard, a spokeswoman for Susan B. Anthony Pro-Life America, wrote in a statement.

Organizations in states where abortion remains legal feel the ripples of every new ban almost instantly.

One Planned Parenthood affiliate with a clinic in southern Illinois, for example, reported a roughly 10 percent increase in call volume in the two weeks following the enactment of Florida’s six-week abortion ban in May. Both sides now await the next round of policy decisions on abortion, which voters will make in November. Ballot initiatives in 10 states could enshrine abortion rights.

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Recovery chairs, surgical equipment, and lighting from the Missouri clinic — all expensive and perfectly good — could still be useful to other health centers run by the same affiliate, Planned Parenthood Great Plains, in its three other states. Much of it went to Oklahoma, where the organization was expanding, CEO Emily Wales said.

When Oklahoma banned abortion a few years later, it was time for that equipment to move again. Some likely ended up in Kansas, Wales said, where her group has opened two new clinics within just over two years because abortion access there is protected in the state constitution — and demand is soaring.

Her Kansas clinics regularly see patients from Texas, Missouri, Oklahoma, Arkansas, and even Louisiana, as Kansas is now the nearest place to get a legal abortion for many people in the southern U.S.

Like the shuffling of equipment, America’s abortion patients are traveling around the nation to navigate the patchwork of laws created by the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, which left policies on abortion to the states.

Since that ruling, 14 states have enacted bans with few exceptions, while other states have limited access. But states that do not have an abortion ban in place have seen an 11% increase in clinician-provided abortions since 2020, according to the Guttmacher Institute, a national nonprofit that supports abortion rights. Over 170,000 people traveled out of their own state to receive abortion care in 2023, according to the institute.

Not all of the increase in abortions comes from interstate travel. Telehealth has made medication abortions easier to obtain without traveling. The number of self-managed abortions, including those done with the medication mifepristone, has risen.

And Guttmacher data scientist Isaac Maddow-Zimet said the majority of the overall abortion increase in recent years came from in-state residents in places without total bans, as resources expanded to improve access.

“That speaks, in a lot of ways, to the way in which abortion access really wasn’t perfect pre-Dobbs,” Maddow-Zimet said. “There were a lot of obstacles to getting care, and one of the biggest ones was cost.”

Last year, the estimated number of abortions provided in the U.S. rose to over 1 million, the highest number in a decade, according to the institute.

Still, abortion opponents hailed an estimated drop in the procedure in the 14 states with near-total bans.

“It’s encouraging that pro-life states continue to show massive declines in their in-state abortion totals, with a drop of over 200,000 abortions since Dobbs,” Kelsey Pritchard, a spokesperson for Susan B. Anthony Pro-Life America, wrote in a statement.

Organizations in states where abortion remains legal feel the ripples of every new ban almost instantly. One Planned Parenthood affiliate with a clinic in southern Illinois, for example, reported a roughly 10% increase in call volume in the two weeks following the enactment of Florida’s six-week abortion ban in May. And an Illinois-based abortion fund, Midwest Access Coalition, experienced a similar pattern the day the Dobbs decision was announced in June 2022.

“Our hotline was insane,” said Alison Dreith, the coalition’s director of strategic partnerships.

People didn’t know what the decision meant for their ability to access abortions, Dreith said, including whether already scheduled appointments would still happen. The coalition helps people travel for abortions throughout 12 Midwestern states, four of which now have total bans with few exceptions.

After serving 800 people in 2021, the Midwest Access Coalition went on to help 1,620 in 2022 and 1,795 in 2023. Some of that increase can be attributed to the natural growth of the organization, which is only about a decade old, Dreith said, but it’s also a testament to its work. It pays for any mode of transportation that will get clients to a clinic, including partnering with another Illinois nonprofit with volunteer pilots who fly patients across state lines on private flights to get abortions.

“We also book and pay for hotel rooms,” Dreith said. “We give cash for food, and for child care.”

The National Network of Abortion Funds, a coalition of groups that offer logistical and financial assistance to people seeking abortions, said donations increased after the Dobbs decision, and its members reported a 39% increase in requests for help in the following year. They financially supported 102,855 people that year, including both in-state and out-of-state patients, but have also seen a “staggering drop off” in donations since then.

Increased awareness about the options for abortion care, spurred on by an increase in news stories about abortion since the Dobbs decision, may have fueled the rise in abortions overall, Maddow-Zimet said.

Both sides now await the next round of policy decisions on abortion, which voters will make in November. Ballot initiatives in at least 10 states could enshrine abortion rights, expanding access to abortions, including in two states with comprehensive bans.

“Lives will be lost with the elimination of laws that protect more than 52,000 unborn children annually,” wrote Pritchard of Susan B. Anthony Pro-Life America, citing an analysis on the group’s website.

In the meantime, Wales said her clinics in Kansas don’t have enough appointments to accommodate everyone who reaches out about scheduling an abortion. In the early days after the Dobbs decision, Wales estimated, only 20% of people who called the clinic were able to schedule an abortion appointment.

The organization has expanded and renovated its facilities across the state, including in Wichita, Overland Park, and Kansas City, Kansas. Its newest clinic opened in August in Pittsburg, just 30 miles from Oklahoma. But even with all that extra capacity, Wales said her group still expects to be able to schedule only just over 50% of people who inquire.

“We’ve done what we can to increase appointments,” Wales said. “But it hasn’t replaced what were many states providing care to their local communities.”

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Six months after Gabriella Magers-Darger’s legs were burned by sparks from a ricocheted bullet at the Kansas City Chiefs Super Bowl parade in February, the 14-year-old is ready to leave the past behind.

She is dreading the pitfalls of being a high school freshman, even as she looks forward to being back with friends and at color guard, dance, and volleyball. She might even join the wrestling team to get some respect at school.

But the past remains ever present.

At a July Fourth gathering, a family friend brought noise-canceling headphones in case the fireworks became too much. Earlier in the summer Gabriella had a hard time viewing a relative’s gun collection, the handguns in particular. And she hyperventilated when she saw a family friend’s finger after it was sliced by accident — the sight of blood reminds her of seeing a fatally wounded Lisa Lopez-Galvan minutes after she was shot outside Union Station, the only person killed that day.

Her mom, Bridget Barton, said Gabriella has had a chip on her shoulder since the parade.

“She’s lost some softness to her, some gentleness to her,” Barton said.

Children are particularly vulnerable to the stresses of gun violence, and 10 of 24 people injured by bullets at the Feb. 14 parade were under 18 years old. Countless more children like Gabriella experienced the trauma firsthand. They’ve endured fear, anger, sleep problems, and hypersensitivity to crowds and noises.

A 15-year-old girl who was shot through the jaw and shoulder effectively dropped out of school for a time and daily panic attacks kept her from summer school, too. An 11-year-old boy shot in the side described feeling angry at school for reasons he couldn’t explain. A 5-year-old girl who was on her father’s shoulders when he was hit by gunfire panics each time her dad feels sick, fearing he has been shot again.

“She’s not the same kid. I mean, she’s definitely not,” said Erika Nelson, mother of the 15-year-old, Mireya, who has scars on her jaw and face. “You never know when she’s going to snap. You never know. You might say something or someone might bring up something that reminds her of that day.”

Guns overtook motor vehicle accidents as the leading cause of death for children in 2020, but a far higher number of kids are hit by gunfire and survive. Research suggests that kids sustain nonfatal firearm injuries anywhere from two to four times more often than they are killed by guns.

Scientists say the long-term effects of gun violence on kids are little researched and poorly understood. But the harm is pervasive. Harvard and Massachusetts General Hospital researchers found that during the first year after a firearm injury, child survivors experienced a 117% increase in pain disorders, a 68% increase in psychiatric disorders, and a 144% increase in substance use disorders. The mental health effects spill over — to mothers, fathers, siblings.

For many affected by the shooting in Kansas City, Missouri, the triggers began right away.

‘I Get Mad Easily’

Just 10 days after Samuel Arellano was shot at the parade, he attended another big sporting event.

Samuel was invited to attend a University of Kansas men’s basketball game at Allen Fieldhouse in Lawrence. During a break in the game, with a video camera pointed at Samuel and his parents, former KU star Jalen Wilson appeared on the scoreboard and addressed him directly.

“I heard about your story,” Wilson, who now plays in the NBA, said on the big screen. “I’m so very thankful that you are here today and it is a blessing that we can have you to give you the love and support you truly deserve.”

Wilson asked the 16,000 fans in attendance to stand and give Samuel a round of applause. As the crowd clapped and an announcer bellowed about him being a “brave young man,” Samuel looked at his parents, then down at his feet, smiling shyly.

But minutes later when the game resumed, Samuel started to cry and had to leave the auditorium with his mom, Abigail.

“When it got pretty loud, that’s when he started breaking up again,” his dad, Antonio, said. “So she had to step out with him for a minute. So any loud places, if it’s too loud, it’s affecting him.”

Samuel, who turned 11 in March, was shot in the ribs on his right side. The scar on his back is barely noticeable now, but lingering effects from the parade shooting are obvious. He is seeing a therapist — as is his father, though Abigail has had a tough time finding a Spanish-speaking one and still hasn’t had an appointment.

Samuel had trouble sleeping in the first weeks after the shooting and often crawled in bed with his mom and dad. He used to get good grades, but that became more difficult, Abigail said. His personality has changed, which sometimes has shown up at school.

“I get mad easily,” Samuel said. “I [have] never been like this before but like, if they tell me to sit down, I get mad. I don’t know why.”

Traumatized children often have difficulty expressing emotions and may be given to outbursts of anger, according to Michelle Johnson-Motoyama, a professor of social work at Ohio State University.

“I’m sure for that child there is a sense of tremendous injustice about what happened,” Johnson-Motoyama said.

Especially right after the shooting, Samuel had panic attacks, Antonio said, and he’d break out in a sweat. Therapists told them that was normal. But the parents also kept him off his phone for a while, as there was so much about the shooting on the news and online.

Abigail, who works at a car dealership with Antonio, is anxious about seeing her son change, his suffering and sadness. She is also concerned for her three daughters, a 16-year-old and 13-year-old twins. Her father, Victor Salas, who was with Samuel at the parade, was also reeling in its aftermath.

“I’m crying and crying and crying about what happened,” Salas said in Spanish four days after the parade. “Because it was chaos. It doesn’t mean that families don’t love their family, but everyone took off to save their own lives. I saved my grandchildren’s lives, but what happens to the rest of the people? We’re not prepared.”

On the good side, Samuel felt very supported by the community in Kansas City, Kansas. Many people from his school stopped by in the first few days to visit, including friends and even a former bus driver, who was in tears. He has a “room full of candy,” Abigail said, mostly Skittles, his favorite.

An autographed football from Kansas City Chiefs quarterback Patrick Mahomes arrived on his birthday. It made him cry, his father said, which happens pretty often.

“There are good and bad days, days that are more normal and easier, and then there are days where the family has to be a little bit more aware and supportive,” Abigail said in Spanish. “He’s always been outgoing and talkative like his mom, but that has changed since the parade.”

Fourth of July a Weeklong Trigger

The Fourth of July was particularly harrowing for many of the young survivors and their families. Should they buy fireworks? Will they want to celebrate? And why do all the firecrackers going off in the neighborhood sound like gunshots?

Fourteen-year-old Gabriella needed help from her stepfather, Jason Barton, to light her fireworks this year, something she is ordinarily enthusiastic about doing herself. At the parade, like many people, the Barton family initially mistook the sound of gunfire for fireworks.

And Erika Nelson, a single mom in Belton, Missouri, feared even bringing up the holiday with Mireya, who has always loved Independence Day. Eventually Mireya said she didn’t want any big fireworks this year and wanted only her mom to set theirs off.

“Just any little trigger — I mean, it could be a light crackle — and she just clenched,” Erika Nelson said.

Patty Davis, a program manager for trauma-informed care at Children’s Mercy hospital in Kansas City, said even her clients who were at the parade but were not injured still flinch at the sounds of sirens or other loud noises. It’s a powerful response to gun violence, she said.

“So not just an accidental trauma,” she said, “but a trauma that was perpetrated for violent purposes, which can cause an increased level of anxiety for persons around that to wonder if it’s going to happen again. And how safe are they?”

Reliving Getting Shot

Random sounds, bright lights, and crowds can catch the kids and their parents off guard. In June, Mireya Nelson was waiting for her older sister after a dance recital, hoping to see a boy she knew give a flower to a girl everyone said he had a crush on. Her mom wanted to go, but Mireya shushed her.

“Then all of a sudden, there was a loud boom,” Erika said. “She dropped low to the ground. And then she jumped back up. She goes, ‘Oh my God, I was getting shot again!’”

Mireya said it so loudly people were staring, so it was Erika’s turn to shush her and try to soothe her.

“I was like, ‘Mireya, it’s OK. You’re all right. They dropped a table. They’re just moving stuff out. It was an accident,’” Erika said.

It took a few minutes for the shock to wear off and Mireya later giggled about it, but Erika is always on watch.

Her daughter’s early sadness — she watched movies for hours, crying throughout — has since changed to a cheekiness. Half a year later, Mireya will joke about the shooting, which tears her mother up. But maybe that is part of the healing process, Erika says.

Before the Fourth of July, Mireya went to Worlds of Fun, a large amusement park, and had a good time. She felt OK because there were security guards everywhere. She also enjoyed a visit to the local FBI office with a friend who was with her the day of the shooting. But when someone suggested a trip to the ballet, Mireya squashed it quickly — it’s near Union Station, the site of the shooting. She doesn’t want to go downtown anymore.

Erika said the doctor appointments and financial strains have been a lot to juggle and that her biggest frustration as a parent is that she’s not able to fix things for her daughter.

“They have to go their own way, their own process of healing. I can’t shake her, like, ‘Get back to yourself,’” Erika said. “It could take months, years. Who knows? It could be the rest of her life. But I hope that she can overcome a little bit of it.”

Goose Bumps in the Sweltering Heat

James Lemons noticed a change in his 5-year-old daughter, Kensley, who was on his shoulders when he was shot at the parade. Before the shooting Kensley was outgoing and engaged, James said, but now she is withdrawn, like she has closed off her bubble and disconnected from people.

Large crowds and police officers remind Kensley of the parade. Both were present at a high school graduation the family attended this summer, prompting Kensley to ask repeatedly to leave. James took her to an empty football field, where, he said, she broke out in goose bumps and complained of being cold despite the sweltering heat.

Bedtime is a particular problem for the Lemons family. Kensley has been sleeping with her parents. Another child, 10-year-old Jaxson, has had bad dreams. One night, he dreamt that the shooter was coming near his dad and he tripped him, said Brandie Lemons, Jaxson’s stepmom.

Younger children like Kensley exposed to gun violence are more likely to develop post-traumatic stress disorder than older children, according to Ohio State’s Johnson-Motoyama.

Davis, of Children’s Mercy in Kansas City, said children whose brains are not fully developed can have a hard time sleeping and understanding that they are safe in their homes at night.

James got the family a new puppy — an American bulldog that already weighs 32 pounds — to help them feel protected.

“I looked up the pedigree,” he said, “They’re real protective. They’re real loving.”

Searching for an Outlet to Let Off Steam

Gabriella took up boxing after the shooting. Her mother, Bridget, said it restored some of her confidence and control that dimmed after the parade.

“I like beating people up — not in a mean way, I swear,” Gabriella said in April as she molded a mouthguard to her teeth before leaving for training.

She has since stopped boxing, however, so the money can instead go toward a trip to Puerto Rico with her Spanish class. They’re paying $153 a month for 21 months to cover the trip. Boxing classes were $60 a month.

Bridget thought boxing was a good outlet for leftover anger, but by the end of July Gabriella wasn’t sure if she still had the drive to fight back that way.

“The past is the past but we’re still gonna all, like, go through stuff. Does that make sense?” Gabriella asked.

“You’re mostly OK but you still have triggers. Is that what you mean?” her mother asked.

“Yeah,” she replied.

After the shooting, Mireya Nelson tried online classes, which didn’t work well. The first few days of summer school, Mireya had a panic attack every day in the car and her mother took her home.

Mireya wants to return to high school this fall, and Erika is wary.

“You know, if I do go back to school, there’s a chance at school of being shot, because most schools nowadays get shot up,” Erika recalled her daughter saying. “And I’m like, ‘Well, we can’t think like that. You never know what’s gonna happen.’”

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Enfrenta los desafíos de ser una estudiante de primer año de secundaria, aunque también está emocionada de reencontrarse con sus amigos y volver a bailar y a jugar voleibol. Incluso podría unirse al equipo de lucha libre para ganarse el respeto en la escuela.

Pero el pasado sigue presente.

En una reunión del 4 de julio, un amigo de la familia llevó auriculares que amortiguan el ruido, por si los fuegos artificiales eran demasiado para ella. A principios del verano, Gabriella tuvo dificultades para ver la colección de armas de un pariente, especialmente las pistolas. Y comenzó a hiperventilar cuando vio la herida en el dedo de un amigo de la familia que se había cortado accidentalmente: la vista de la sangre le recordó a Lisa Lopez-Galván, quien murió por una herida de bala afuera de Union Station, la única fatalidad ese día.

Su madre, Bridget Barton, dijo que Gabriella ha tenido una actitud más dura desde el desfile. “Ha perdido algo de suavidad, algo de dulzura”, observó.

Los niños son particularmente vulnerables al estrés de la violencia con armas de fuego, y 10 de las 24 que sufrieron heridas de bala en el desfile del 14 de febrero tenían menos de 18 años. Muchos más niños como Gabriella experimentaron el trauma de primera mano. Enfrentan miedo, ira, problemas de sueño e hipersensibilidad a las multitudes y los ruidos.

Una adolescente de 15 años que recibió disparos en la mandíbula y el hombro prácticamente dejó la escuela por un tiempo, y los ataques de pánico diarios también le impidieron asistir a la escuela de verano.

Un niño de 11 años que recibió un disparo describió sentirse enojado en la escuela por razones que no podía explicar. Una niña de 5 años que estaba sobre los hombros de su padre cuando le dispararon entra en pánico cada vez que su papá se siente enfermo, temiendo que le hayan disparado de nuevo.

“No es la misma niña. Quiero decir, definitivamente no lo es”, dijo Erika Nelson, madre de Mireya, de 15 años, quien tiene cicatrices en la mandíbula y la cara. “Nunca sabes cuándo va a estallar. Nunca sabes. Podrías decir algo o alguien podría mencionar algo que le recuerde ese día”.

En 2020, las armas superaron a los accidentes automovilísticos como la principal causa de muerte de niños, pero un número mucho mayor sufren heridas de balas y sobreviven. La investigación sugiere que los niños sufren lesiones por armas de fuego no fatales entre dos y cuatro veces más a menudo de lo que son asesinados con armas.

Científicos dicen que los efectos a largo plazo de la violencia armada en los niños se investigan poco y son mal comprendidos. Pero el daño es generalizado. Investigadores de Harvard y del Hospital General de Massachusetts encontraron que durante el primer año después de una lesión por arma de fuego, los sobrevivientes infantiles experimentaron un aumento del 117% en trastornos del dolor, del 68% en afecciones psiquiátricas y del 144% en adicciones. Los efectos en la salud mental se extienden a madres, padres y hermanos.

Para muchos afectados por el tiroteo en Kansas City, Missouri, los desencadenantes comenzaron de inmediato.

“Me enojo fácilmente”

A solo 10 días que Samuel Arellano fuera baleado en el desfile, fue a otro gran evento deportivo.

Samuel fue invitado a un partido de baloncesto masculino de la Universidad de Kansas en el Allen Fieldhouse en Lawrence. Durante un descanso del partido, con una cámara de video apuntando a Samuel y a sus padres, Jalen Wilson, ex estrella de KU, apareció en la pantalla y se dirigió a él directamente.

“Escuché tu historia”, dijo Wilson, que ahora juega en la NBA, desde la pantalla gigante. “Estoy muy agradecido de que estés aquí hoy, y es una bendición que podamos tenerte para brindarte el amor y apoyo que realmente mereces”.

Wilson pidió a los 16,000 fans presentes que se pusieran de pie y aplaudieran a Samuel. Mientras la multitud aplaudía y un locutor exclamaba que era un “joven valiente”, Samuel miró a sus padres, luego al suelo, sonriendo tímidamente.

Pero minutos después, cuando el partido se reanudó, Samuel comenzó a llorar y tuvo que salir del auditorio con su madre, Abigail.

“Cuando se puso bastante ruidoso, fue cuando comenzó a desmoronarse de nuevo”, dijo su padre, Antonio. “Así que ella tuvo que salir con él por un momento. Así que cualquier lugar ruidoso, si es demasiado fuerte, lo afecta”.

Samuel, que cumplió 11 años en marzo, fue baleado a la altura de las costillas en su lado derecho. Ahora, la cicatriz en su espalda es apenas perceptible, pero los efectos persistentes del tiroteo son evidentes. Está viendo a un terapeuta, al igual que su padre, aunque a Abigail le ha resultado difícil encontrar uno que hable español y aún no ha tenido una cita.

En las primeras semanas luego del tiroteo, Samuel tuvo problemas para dormir y a menudo se metía en la cama con su madre y su padre. Solía tener buenas notas, pero eso se volvió más difícil, dijo Abigail. Su personalidad ha cambiado, algo que a veces se ha manifestado en la escuela.

“Me enojo fácilmente”, dijo Samuel. “Nunca he sido así antes, pero si me dicen que me siente, me enojo. No sé por qué”.

Los niños traumatizados a menudo tienen dificultades para expresar emociones y pueden tener arrebatos de ira, según Michelle Johnson-Motoyama, profesora de trabajo social en la Universidad Estatal de Ohio.

“Estoy segura que para ese niño hay una sensación de tremenda injusticia por lo que sucedió”, dijo Johnson-Motoyama.

Especialmente justo después del tiroteo, Samuel tenía ataques de pánico y comenzaba a sudar, contó Antonio. Los terapeutas les dijeron que eso era normal. Pero los padres también lo mantuvieron alejado de su teléfono por un tiempo: había demasiado sobre el tiroteo en las noticias y en internet.

Abigail, que trabaja en un concesionaria de automóviles con Antonio, está ansiosa por ver a su hijo cambiar, por su sufrimiento y tristeza. También está preocupada por sus tres hijas, una de 16 años y gemelas de 13. Su padre, Victor Salas, que estaba con Samuel en el desfile, también estaba devastado después de los hechos.

“Estoy llorando y llorando y llorando por lo que pasó”, dijo Salas en español cuatro días después del desfile. “Porque fue un caos. Eso no significa que las familias no amen a su familia, pero todos huyeron para salvar sus propias vidas. Salvé la vida de mis nietos, pero ¿qué pasa con el resto de la gente? No estamos preparados”.

En el lado positivo, Samuel se sintió muy apoyado por la comunidad en Kansas City, Kansas. Muchas personas de su escuela se acercaron en los primeros días para visitarlo, amigos e incluso un ex conductor de autobús, que estaba llorando. Tiene una “habitación llena de dulces”, dijo Abigail, en su mayoría Skittles, su favorito.

En su cumpleaños, recibió una pelota de fútbol americano autografiada por Patrick Mahomes, mariscal de campo de los Kansas City Chiefs. Lo hizo llorar, algo que ocurre con bastante frecuencia, dijo su padre.

“Hay días buenos y malos, días más normales y fáciles, y luego hay días en los que la familia tiene que estar un poco más atenta y apoyarlo”, dijo Abigail en español. “Siempre ha sido extrovertido y hablador como su madre, pero eso ha cambiado desde el desfile”.

El 4 de julio, disparador de una semana

El 4 de julio fue particularmente angustiante para muchos de los jóvenes sobrevivientes y para sus familias. ¿Deberían comprar fuegos artificiales? ¿Querrían celebrar? ¿Por qué todos los petardos que explotan en el vecindario suenan como disparos?

Este año, Gabriella, de 14 años, necesitó la ayuda de su padrastro, Jason Barton, para encender sus fuegos artificiales, algo que normalmente hace con entusiasmo. En el desfile, como muchas personas, la familia Barton primero confundió el sonido de los disparos con fuegos artificiales.

Y Erika Nelson, madre soltera de Belton, Missouri, temía incluso mencionar la celebración a Mireya, quien siempre ha amado el Día de la Independencia. Eventualmente, Mireya dijo que no quería fuegos artificiales grandes este año y que solo quería que su madre los encendiera.

“Cualquier pequeño desencadenante, quiero decir, podría ser un ligero chasquido, y ella se tensaba”, dijo Erika Nelson.

Patty Davis, gerente de programas para el cuidado informado sobre el trauma en el hospital Children’s Mercy en Kansas City, dijo que incluso clientes suyos que estuvieron en el desfile pero no resultaron heridos todavía se estremecen ante los sonidos de sirenas u otros ruidos fuertes. Es una respuesta poderosa a la violencia armada en general, no solo al desfile.

“No es una respuesta exagerada”, dijo Davis. “De hecho, es muy natural para los jóvenes, y no tan jóvenes, que han experimentado algo similar o han presenciado violencia con armas de fuego”.

“No se trata de un trauma accidental, sino de un trauma perpetrado con fines violentos, que puede provocar un mayor nivel de ansiedad en las personas que lo viven, que se preguntan si volverá a suceder. ¿Y qué tan seguras están?”, agregó.

Reviviendo el instante

Los ruidos extraños, las luces brillantes y las multitudes pueden tomar desprevenidos a los niños y a sus padres.

En junio, Mireya Nelson estaba esperando a su hermana mayor después de un recital, con la esperanza de ver a un muchacho. Su madre quería ir, pero Mireya la hizo callar. “De repente, se escuchó un estruendo muy fuerte”, dijo Erika. “Se agachó y luego se levantó de un salto. Dijo: ‘¡Dios mío, me estaban disparando otra vez!’”. Mireya lo dijo tan fuerte que la gente se quedó mirando, así que fue el turno de Erika de hacerla callar y tratar de calmarla. “Le dije: ‘Mireya, está bien. Estás bien. Se les cayó una mesa. Solo están sacando cosas. Fue un accidente’”, explicó Erika.

Pasaron unos minutos hasta que el shock se disipó y más tarde Mireya se rió de la situación, pero Erika siempre está atenta.

La tristeza inicial de su hija (que veía películas durante horas y lloraba todo el tiempo) se ha transformado en descaro. Medio año después, Mireya bromea sobre el tiroteo, lo que destroza a su madre. Pero tal vez eso sea parte del proceso de sanación, dijo Erika.

Antes del 4 de julio, Mireya fue a Worlds of Fun, un gran parque de diversiones, y la pasó bien. Se sintió bien porque había guardias de seguridad por todas partes. También disfrutó de una visita a la oficina local del FBI con una amiga que estaba con ella el día del tiroteo.

Pero cuando alguien le sugirió ir al ballet, Mireya lo descartó rápidamente: está cerca de Union Station, el lugar del tiroteo. Ya no quiere ir al centro. Erika dijo que ha habido muchas citas médicas y dificultades económicas, y que su mayor frustración como madre es no poder arreglar las cosas para su hija.

“Tienen que seguir su propio camino, su propio proceso de curación. No puedo sacudirla, como diciéndole: ‘Vuelve a ser tú misma’”, dijo Erika. “Podría llevar meses, años. ¿Quién sabe? Podría ser el resto de su vida. Pero espero que pueda superarlo un poco”.

Piel de gallina en medio del calor sofocante

James Lemons notó un cambio en su hija de 5 años, Kensley, que estaba sobre sus hombros cuando le dispararon en el desfile.

Antes del tiroteo, Kensley era extrovertida y comprometida, dijo James, pero ahora está retraída, como si estuviera dentro de una burbuja y se hubiera desconectado de la gente.

A Kensley, las grandes multitudes y los policías le recuerdan al desfile. Ambos estuvieron presentes en una graduación de secundaria a la que asistió la familia este verano, y Kensley solo quería irse. James la llevó a un campo de fútbol vacío, donde, dijo, se le puso la piel de gallina y se quejó de tener frío a pesar del calor sofocante.

La hora de dormir es un problema particular para la familia Lemons. Kensley ha estado durmiendo con sus padres. Otro hijo, Jaxson, de 10 años, ha tenido pesadillas. Una noche, soñó que el tirador se acercaba a su padre y lo hacía tropezar, dijo Brandie Lemons, la madrastra de Jaxson.

Los niños más pequeños como Kensley expuestos a la violencia con armas de fuego tienen más probabilidades de desarrollar un trastorno de estrés postraumático que los niños mayores, según Johnson-Motoyama, de la Universidad Estatal de Ohio.

Davis, del Children’s Mercy en Kansas City, dijo que los niños cuyos cerebros no están completamente desarrollados pueden tener dificultades para dormir y comprender que están seguros en sus hogares por la noche.

James le compró a la familia un nuevo cachorro, un bulldog americano que ya pesa 32 libras, para ayudarlos a sentirse protegidos. “Busqué el pedigrí”, dijo, “Son muy protectores. Muy cariñosos”.

En busca de una salida

Para desahogarse después del tiroteo, Gabriella comenzó a boxear. Su madre, Bridget, dijo que le devolvió algo de la confianza y el control que había bajado después del desfile. “Me gusta golpear a la gente, no de una manera mala, lo juro”, dijo Gabriella en abril mientras moldeaba un protector bucal a sus dientes antes de irse a entrenar.

Sin embargo, desde entonces ha dejado de boxear, por lo que el dinero puede destinarse a un viaje a Puerto Rico con su clase de español. Están pagando $153 al mes durante 21 meses para cubrir el viaje. Las clases de boxeo costaban $60 al mes.

Bridget pensaba que el boxeo era una buena salida para la ira que le quedaba, pero a finales de julio Gabriella no estaba segura de si todavía tenía el impulso para contraatacar de esa manera. “El pasado es el pasado, pero todos vamos a pasar por cosas. ¿Tiene sentido?”, preguntó Gabriella.

“Estás bien en general, pero todavía tienes desencadenantes. ¿Es eso lo que quieres decir?”, preguntó su madre. “Sí”, respondió.

Después del tiroteo, Mireya Nelson probó las clases en línea, que no funcionaron bien. Los primeros días de la escuela de verano, Mireya tenía un ataque de pánico todos los días en el auto y su madre la llevaba de vuelta a casa.

Mireya quiere regresar a la escuela secundaria este otoño, y Erika es cautelosa. “Sabes, si vuelvo a la escuela, existe la posibilidad de que me disparen, porque en la mayoría de las escuelas hoy en día hay tiroteos”, recordó Erika que dijo su hija. “Y yo digo: ‘Bueno, no podemos pensar así. Nunca se sabe lo que va a pasar’”.

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Michigan was one of the first states to protect abortion access at the ballot box after the Supreme Court overturned federal abortion protections in Dobbs v. Jackson Women’s Health Organization in 2022. But the amount of time some abortion restrictions in the state have remained on the books serves as a caution to other states holding similar votes. Election results may not be as clear-cut as you might think.

This year, voters in as many as 12 more states, including Missouri, could weigh in on abortion. Here, as in most of those states, a likely ballot measure would add abortion protections to the state constitution.

Abortions in Missouri have been banned in nearly every circumstance since the Dobbs ruling. But the procedure was largely halted here years earlier by a series of laws designed to make abortions scarce. These laws are sometimes called “targeted regulation of abortion providers,” or TRAP, laws.

By 2021, the last full year before Dobbs opened the door for Missouri’s ban, the state recorded only 150 abortions, down from 5,772 in 2011.

Even if Missouri voters enshrine abortion protections in the state constitution this year, state regulations such as a 72-hour waiting period and minimum dimensions for procedure rooms and hallways in clinics that provide abortions would remain on the books.

Such laws likely wouldn’t be overturned legislatively under a Republican-controlled legislature and governor’s office. But they will surely face legal challenges, which could take a while.

The lawsuit that led to Tuesday’s ruling in Michigan, for example, was filed 15 months after voters added abortion protections to the state’s constitution.

The delay had a purpose, according to Elisabeth Smith, state policy and advocacy director at the Center for Reproductive Rights, which filed the lawsuit: It afforded the Democratic-led legislature time to act. It’s often more effective to change laws through the legislature than through litigation because the courts can only strike down a law, not replace one.

Michigan did pass an abortion rights package that was signed into law by the state’s Democratic governor, Gretchen Whitmer, in December. But the package left some regulations intact, including the mandatory waiting period, mandatory counseling and a ban on abortions by non-doctor clinicians, such as nurse practitioners and midwives.

Abortion opponents such as Katie Daniel, state policy director for Susan B. Anthony Pro-Life America, are critical of the Michigan lawsuit and such policy unwinding efforts.

“The litigation proves these amendments go farther than they will ever admit in a 30-second commercial,” Daniel said.

Of the seven states that have voted on abortion since Dobbs, Ohio may be the most politically similar to Missouri.

Last year, Ohio Attorney General Dave Yost, an antiabortion Republican, said passing an amendment to protect abortion rights would upend at least 10 state laws limiting abortions.

Voters passed the measure with nearly 57 percent of the vote, but most of those state laws — including a 24-hour waiting period and a 20-week abortion ban — continue to govern Ohio health providers.

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Those were reactions from some of the 20 gunshot victims from the Kansas City Chiefs Super Bowl parade shootings who were awarded $1.2 million from the #KCStrong fund on Thursday, with individuals receiving payments ranging from $22,000 to $100,000.

Chris Rosson, president and CEO of the United Way of Greater Kansas City, said the payouts will help these survivors even while recognizing that gun violence like the Feb. 14 shootings happens in Kansas City every day, typically in low-income communities that are already under-resourced.

“When launching the fund, it was important for us to support first and foremost direct victims of the violence of that day, but also to drive critical financial resources to violence prevention and response organizations, to mental health supports, into first responders,” he said.

The shootings at the end of the rally near Union Station left 24 people injured and one dead. Lisa Lopez-Galvan, 43, a mother of two and a popular Tejano DJ, was killed. 

Since the shootings, some victims and their families have incurred thousands of dollars in medical bills for emergency room treatment, ambulance rides, ongoing medical care for bullet wounds, or mental health counseling. Some are still struggling to return to work and are relying on a confusing patchwork of assistance from GoFundMe accounts and a group of local churches.

Erika Nelson, whose 15-year-old daughter, Mireya, was shot in the chin and shoulder at the parade, said that the money from the United Way is a blessing but that her daughter still struggles with the physical and emotional wounds of the violence.

“I don’t care how much money it is. It could be a million dollars. It could be a billion dollars. It’s never going to change what my daughter goes through every day,” Nelson said.

The #KCStrong fund was launched by the United Way on Feb. 15, fueled by a first donation of $200,000 made by the Chiefs, the NFL, and the Hunt family, which owns the team. The Kauffman Foundation and an anonymous person were listed as the top donors with $250,000 each.

The funds are unrestricted, so they can be used for medical bills, college funds for the children injured during the victory celebration, or anything else families need. Rosson said the group believed the victims and the people closest to them should decide how best to spend the money.

“Giving unrestricted funding directly to those verified gunshot victims allows them to make the decisions that are right for them and their family and their path forward,” he said.

Kera Mashek, communications director of the local United Way, said the money falls under the umbrella of needs-based assistance and won’t be taxed.

United Way worked with the Jackson County, Missouri, Prosecutor’s Office to verify victims. Only 20 of the 24 victims were compensated because two did not apply and a third turned down the donation, United Way officials said. A fourth, unnamed victim was denied funds because he is connected to the criminal case, according to Jackson County Prosecutor Jean Peters Baker.

None of the victims were named in the June 27 announcement.

Emily Tavis said she felt “beyond blessed and overwhelmed with appreciation” to receive the assistance. Tavis; her partner, Jacob Gooch Sr.; and stepson, Jacob Gooch Jr., were all shot at the parade.

“It’s a huge relief that bills are going to get caught up and paid and then some,” Tavis said. She had already started paying off credit card bills with her portion of the payout.

Antonio Arellano, whose 11-year-old son, Samuel, was shot in the side, said the money was a “really big help” for the family. 

He said Samuel is hoping for a vacation to Florida and season tickets to see the Chiefs play football. But being in large crowds is still difficult for Samuel, so Arellano said they’ll try attending one game first to see how it goes.

James Lemons, who recently had the bullet lodged in his leg removed, said he appreciated the aid and feels blessed, but also feels as if the money is already gone. He wants to pay back the assistance the family received in the aftermath of the shooting, including money he borrowed to help them relocate after their landlord sold their rental home soon after the parade.

So far, three adults and three minors have been charged in the shootings, along with three men who face federal charges of trafficking illegal guns or lying to FBI agents. 

More than 80 people were trampled in the melee after the shootings, Baker said, adding that they are also among the many victims of the attack. They will not, however, receive money from the fund.

Campaigns like #KCStrong that emerge in the wake of mass shootings must balance distributing the money broadly enough to include people directly affected without dissipating the available resources, according to Jeff Dion of the Mass Violence Survivors Fund. The nonprofit organization has helped communities across the country distribute such funds.

The OneOrlando Fund, which emerged after the Pulse nightclub shooting in 2016, for example, made a range of payments, including $350,000 to the families of each of the 49 people killed, but also $25,000 each to 182 people who were at the nightclub but weren’t physically injured. That fund raised $29.5 million compared with the $2 million raised in Kansas City.

The $31.4 million fund that emerged in Las Vegas in 2017 after a mass shooting at a concert with 22,000 attendees did not include payments to people who were not injured. As many as 1 million people attended the Super Bowl parade in February.

“When you’re dealing with actual dollars, you have to find a way to be able to serve the most people with the most amount of money,” Baker said. “So I think that was probably some of the decisions that had to be reached in this case, which is difficult, hard, but also necessary.”

The community groups, which each received $59,410, are: AdHoc Group Against Crime; Boys & Girls Clubs of Greater Kansas City; Center for Conflict Resolution; Guadalupe Centers; Kansas City Metropolitan Crime Commission; KC Common Good; KC Mothers in Charge; Lyrik’s Institution; Newhouse Domestic Violence Shelter; Rose Brooks Center; Transition Zone; The Battle Within; Uncornered; and University Health.

Other efforts have directed money to survivors of the Super Bowl parade shooting as well. GoFundMe accounts have raised $667,785. A faith-based group called “The Church Loves Kansas City” raised $184,500 and so far has spent more than $50,000 in funeral expenses, medical procedures, counseling, and living expenses, said Gary Kendall, one of the leaders.

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Chris Rosson, presidente y CEO de United Way of Greater Kansas City, dijo que los pagos ayudarán a estos sobrevivientes, reconociendo al mismo tiempo que la violencia con armas de fuego, como el tiroteo del 14 de febrero, ocurre todos los días en Kansas City, en general en comunidades de bajos ingresos que ya están desprovistas de recursos.

“Al lanzar el fondo, era importante para nosotros apoyar en primer lugar a las víctimas directas de la violencia de ese día, pero también proporcionar recursos financieros críticos a las organizaciones de prevención y respuesta a la violencia, de apoyo de salud mental y a los que proporcionan primeros auxilios”, dijo.

El tiroteo cerca de Union Station, hacia el final de desfile, dejó 24 personas heridas y una muerta: Lisa López-Galván, de 43 años, madre de dos hijos y popular DJ de música tejana.

Desde el tiroteo, algunas víctimas y sus familias han recibido facturas médicas por miles de dólares, por tratamientos en salas de emergencia, viajes en ambulancia, atención médica continua por las heridas de bala o consejería de salud mental.

Algunas todavía están luchando por volver al trabajo y dependen de una confusa red de asistencia de cuentas de GoFundMe y un grupo de iglesias locales.

Erika Nelson, cuya hija de 15 años, Mireya, recibió disparos en la barbilla y el hombro, dijo que el dinero de United Way es una bendición, pero que su hija todavía lucha con las heridas físicas y emocionales de la violencia.

“No me importa cuánto dinero sea. Podría ser un millón de dólares. Podrían ser mil millones. Nunca va a cambiar lo que mi hija vive todos los días”, dijo Nelson. El fondo #KCStrong fue lanzado por United Way el 15 de febrero, impulsado por una primera donación de $200,000 hecha por los Chiefs, la NFL y la familia Hunt, dueña del equipo. La Kauffman Foundation y una persona anónima fueron listados como los principales donantes, con $250,000 cada uno.

Los fondos no tienen restricciones, por lo que pueden usarse para facturas médicas, fondos universitarios para los niños heridos durante el desfile por la victoria de los Chiefs, o cualquier otra cosa que las familias necesiten.

Rosson dijo que el grupo creía que las víctimas y las personas más cercanas a ellas deberían decidir cómo gastar mejor el dinero. “Dar fondos sin restricciones directamente a esas víctimas de disparos verificadas les permite tomar las decisiones que son adecuadas para ellos y su familia, y el camino que seguirán”, dijo.

Kera Mashek, directora de comunicaciones del United Way local, dijo que el dinero cae bajo el paraguas de asistencia basada en necesidades y no estará sujeto a impuestos.

United Way trabajó con la Oficina del Fiscal del condado de Jackson, Missouri, para verificar a las víctimas. Veinte de las 24 víctimas recibieron compensaciones porque dos no aplicaron y un tercero rechazó la donación, dijeron funcionarios de United Way. A una cuarta víctima, no identificada, se le negaron los fondos porque está conectada al caso criminal, según Jean Peters Baker, fiscal del condado de Jackson.

No se nombró a ninguna de las víctimas en el anuncio del 27 de junio.

Emily Tavis dijo que se sentía “más que bendecida y abrumada por el agradecimiento” al recibir la asistencia. Tavis, su pareja, Jacob Gooch Sr., y su hijastro Jacob Gooch Jr. recibieron disparos en el desfile.

“Es un gran alivio poner las facturas al día”, dijo Tavis. Ella ya había comenzado a pagar cuentas de tarjetas de crédito con su parte del pago.

Antonio Arellano, cuyo hijo de 11 años, Samuel, recibió un disparo en el costado, dijo que el dinero fue una “gran ayuda” para la familia. Dijo que Samuel espera unas vacaciones en Florida y boletos de temporada para ver jugar a los Chiefs. Pero estar en grandes multitudes aún es difícil para Samuel, por lo que Arellano dijo que intentarán ir a un juego primero para ver cómo va.

James Lemons, a quien recientemente le extrajeron la bala alojada en su pierna, dijo que agradecía la ayuda y que se siente bendecido, pero también siente que el dinero ya se ha ido. Quiere devolver la ayuda que la familia recibió tras el tiroteo, incluido el dinero que pidió prestado para ayudarlos a mudarse luego que el dueño de la casa que alquilaban la vendiera poco después del desfile.

Hasta ahora, tres adultos y tres menores han sido acusados por el tiroteo, junto con tres hombres que enfrentan cargos federales de tráfico de armas o de mentir a agentes del FBI.

Más de 80 personas fueron pisoteadas en el caos generado tras los tiroteos, dijo Baker, agregando que también están entre las muchas víctimas del ataque. Sin embargo, no recibirán dinero del fondo.

Las campañas como #KCStrong que surgen tras tiroteos masivos deben equilibrar la distribución del dinero de manera lo suficientemente amplia como para incluir a las personas directamente afectadas sin disipar los recursos disponibles, según Jeff Dion del Mass Violence Survivors Fund. Esta organización sin fines de lucro ha ayudado a comunidades de todo el país a distribuir este tipo de fondos.

Por ejemplo, OneOrlando Fund, que surgió tras el tiroteo en el club nocturno Pulse en 2016, hizo una gama de pagos, incluyendo $350,000 a las familias de cada una de las 49 personas asesinadas, pero también $25,000 a cada una de las 182 personas que estaban en la discoteca pero no resultaron físicamente heridas.

Ese fondo recaudó $29.5 millones en comparación con los $2 millones recaudados en Kansas City.

El fondo de $31.4 millones que se recolectó en Las Vegas en 2017 tras el tiroteo masivo en un concierto con 22,000 asistentes no incluyó pagos a personas que no habían sido heridas.

Cerca de un millón de personas fueron al desfile del Super Bowl en febrero. “Cuando estás manejando dólares reales, tienes que encontrar una manera de poder servir al mayor número de personas con la mayor cantidad de dinero”, dijo Baker.

“Así que creo que esas fueron probablemente algunas de las decisiones que tuvieron que tomarse en este caso, lo cual es difícil, duro, pero también necesario”.

Los grupos comunitarios que recibieron cada uno $59,410, son: AdHoc Group Against Crime; Boys & Girls Clubs of Greater Kansas City; Center for Conflict Resolution; Guadalupe Centers; Kansas City Metropolitan Crime Commission; KC Common Good; KC Mothers in Charge; Lyrik’s Institution; Newhouse Domestic Violence Shelter; Rose Brooks Center; Transition Zone; The Battle Within; Uncornered, y University Health.

Otros esfuerzos también han destinado dinero a los sobrevivientes del tiroteo del desfile del Super Bowl. Las cuentas de GoFundMe han recaudado $667,785. Un grupo basado en la fe, llamado “The Church Loves Kansas City”, recaudó $184,500 y hasta ahora ha destinado más de $50,000 a gastos funerarios, procedimientos médicos, asesoramiento y gastos domésticos, dijo Gary Kendall, uno de sus líderes.

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