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Public health must recognize responsibility

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City officials must know that the criminal justice system is no substitute for improved services for the unhoused. (Mike Koozmin/2013 S.F. Examiner)

Though it is always scary when a friend is ill or injured, hearing that they are recovering is an immense relief. I am particularly proud when it is our own Department of Public Health that is thanked. During Nurses Week, it is common to receive notes of appreciation from former patients. While a good nurse always expects the unexpected, the following letter underscores the peculiarities of being a patient in a public hospital:

“Whenever I’ve had to visit the ER at San Francisco General Hospital, their nurses and doctors have always been extremely caring. That was particularly welcome during my last unexpected visit. There wasn’t much they could do for me medically except provide me with acceptance and support, which is exactly what they provided. The nurses and doctors treated me with tenderness and understanding — not necessarily something I expected coming in as an arrested protester in handcuffs and chained to the gurney.” — Shannon Bolt

Bolt, a San Francisco small business owner, had been brought to the hospital after being arrested during direct action in support of the demands of the “Frisco 5” hunger strikers — that Mayor Ed Lee hold his appointee, Police Chief Greg Suhr, accountable for the police shootings of minorities. This was not the first time nonviolent demonstrators had been brought to SFGH after police violence.

In 1988, union leader Dolores Huerta was beaten by police and brought to SFGH. Her injuries were so severe that her spleen had to be removed. The United Farm Workers were joined by AIDS activists in front of the Saint Francis Hotel. Despite the demands that he be fired, then-Police Chief Frank Jordan went on to be mayor of San Francisco. United Farm Workers co-founder Cesar Chavez came to SFGH from the Central Valley, where he had been fasting in support of the grape boycott and against pesticide use that poisoned farm workers.

On April 7, 2016, Luis Gongora was shot by police six times before he arrived at SFGH. Unfortunately, his injuries were too severe, and he died within hours of arrival. Gongora had been living in a tent less than a mile from the hospital — only a few blocks from the tent city along Division Street that had been declared a “public health nuisance.” Gongora had been homeless since 2012, when he was evicted from his Mission Street apartment. Despite conflicting accounts from eyewitnesses and a shortage of shelter beds, Gongora’s unhoused neighbors were “evicted” from their tents within days of his death during a rainstorm.

Department of Public Health workers are proud of their work. Though many workers can no longer afford to live in San Francisco, they are still proud to be city employees who provide the full spectrum of care from San Francisco’s only World Health Organization-certified Baby Friendly and Level One trauma hospital; to one of the few remaining public rehabilitation hospitals at Laguna Honda; to the neighborhood-based clinics and world-class HIV and tuberculosis care.

Criminalizing poverty in a city with ever-widening income inequality will inevitably fill the jails and emergency rooms. Many DPH workers are puzzled by The City’s priorities. It is embarrassing that a city with so many billionaires cannot provide shelter for all of its residents. Unauthorized camping is only one symptom of the disease.

Prior to calls to remove Chief Suhr, Bolt worked hard to help provide portable toilets, tents and food for the unhoused. It is both ironic and sad that she was injured and arrested when she is part of the “upstream” public health solution.

In the meantime, SFGH has been so full that the emergency room was forced to turn away all but the most critically ill or injured more than 62 percent of the time in March. The hospital’s nurses are calling for improved staffing in order to provide quality safe patient care for all. Turning away mentally ill individuals from The City’s only psychiatric emergency room is genuinely a public health emergency.

Nurses cannot solve homelessness any more than the police can. Activists such as Bolt and Huerta should not be brutalized in advocating for a more just society. City officials must know that the criminal justice system is no substitute for improved services for the unhoused. Moving along tent encampments is the real public health nuisance.

Primary prevention can save lives. Criminalizing poverty makes as much sense as sending someone to jail for having AIDS. Public health can do better.

Sasha Cuttler, R.N., Ph.D., is a nurse at San Francisco General Hospital and on the steering committee of the Service Employees International Union Nurse Alliance of California.

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  • Luis Ricardo Mercado Mendoza

    Most homeless are crazy! You usually see them walking around with shit in their pants and yelling at themselves