One day the Haight Ashbury Clinic's dove logo and a
link to its
website appeared on
The next day, like the Cheshire Cat, they were gone – at the clinic's
In a July 16 Chronicle op-ed promoting his Care Not Cash
initiative, Supervisor Gavin Newsom wrote: "I have joined with medical
professionals and organizations such as Dr. Pablo Stewart of the Haight
Ashbury Free Clinic ... in support of comprehensive reform of how we
provide care to homeless San Franciscans."
In his July 16 Political Notebook, "Winning Care Not
Cash," Samson Wong echoed the statement: "Newsom has constantly
emphasized the medical community's support [repeatedly citing] ..."Dr.
Pablo Stewart of the Haight Ashbury Free Clinics."
Earlier, Ken Garcia had introduced another Free Clinics
player into the debate, in a July 2 column titled "Homeless measure
makes sense: Care Not Cash plan should make ballot." Garcia quoted Dr.
Frank Staggers, Jr., medical director of the Free Clinic's substance
abuse programs: "We're seeing Third World-type poverty and malnutrition,
and anything that gets these people more food I would support."
In a leap of logic, Garcia then incorrectly connected
Staggers to the proponents of Care Not Cash: "That will explain why ...
compassionate people such as Dr. Pablo Stewart of The Haight Ashbury
Free Clinic ... are solidly behind Newsom's plan."
In an interview, Staggers denied the association: "I am
an apolitical advocate for homeless people without polemic or agenda."
Ken Garcia's column suggests that both Staggers and the
Haight Ashbury Free Clinic medical staff en bloc support CnC. Yet on
July 17, 2002, Majett Whiteside, administrator at the Free Clinic told
me, "CEO Dr. Darryl Inaba states that we have not accepted or adopted an
official policy on the Care Not Cash initiative."
On July 18, I called Inaba and asked him directly, "Does
The Haight Ashbury Clinic or any of its doctors support Care Not Cash?"
"We have written clarifying letters to the editors," he
replied. "To date, none have been published. This has me concerned about
the objectivity of the papers. My biggest concerns are: How does he
[Newsom] assume that the 2,500 people on GA are all addicts? And where
are they are going to go right away? I don't know of 2,500 more slots
for treatment or beds in the city."
"Has the clinic ever come out in support of Care Not
Cash?" I asked.
"No," Inaba answered. "We haven't decided whether we are
for or against it. To be honest, we've never taken any vote. Several
doctors, Dr. Joseph Elson, medical clinic director, and a psychiatrist
here, Dr. Adam Nelson, are strongly opposed. He [Ken Garcia] is quoting
a doctor, and saying it represents the Haight Ashbury Clinic. The doctor
is not authorized to speak on behalf of the Haight Ashbury Clinic."
He continued, "Dr. Stewart supports that initiative. He
has worked here many years as a real advocate for homeless rights and
care. He is frustrated over the lack of resources for [them]. He has
probably been misled that this [Care Not Cash] is going to give them
more care. I have heard him tell people in the newspaper that this is
his own personal opinion, but Gavin and everybody else keeps quoting him
as the Haight Ashbury Clinic."
To counter the mistaken impression that the clinic
supports Newsom's proposal, Inaba sent out a
release on July 18 with the heading: "Haight Ashbury
Free Clinics Take No Official Position on Care Not Cash November Ballot
The statement is worth quoting at some length:
Haight Ashbury Free Clinics, Inc. (HAFCI) today
announced that it has taken no position on the Care Not Cash November
ballot measure that changes the way the city approaches the dispensing
of homeless services.
“It has come to our attention that several of our
employees have taken public stands on this ballot initiative, either
pro or con, and we want the public to know that Haight Ashbury Free
Clinics, as an organization, has not taken an official position on the
measure," says Darryl Inaba, HAFCI's Chief Executive Officer.
"While we support an individual's right to speak out
on matters of public policy, any statements attributed to HAFCI
employees in regard to the Care Not Cash initiative are their own
personal opinions, and not the official policy of our organization,"
"Our clinics provide medical outreach and services to
the homeless and the underserved at no cost to the individual," said
Inaba, "and we will continue to do so no matter how public policy
regarding the homeless is changed in our city."
I asked Staggers, "How do you answer the claim of
Newsom's Care Not Cash folks that the Haight Ashbury Free Clinic is
solidly behind their new proposal? Ken Garcia has written an article
suggesting you support Newsom's Care Not Cash initiative."
Staggers replied, "When he called, I told Ken Garcia,
'It is shameful that I am seeing third-world poverty.' The true context
of my statement was the atrocious state of homeless care I see in San
Francisco, not that I am supporting this or that. People have taken that
third-world poverty quote and said, 'He must be behind Gavin Newsom.' I
don't have a position [on Care Not Cash] that I am willing to state
publicly. I have no comment. My position is as an advocate for the
homeless. They are underserved, and they die quicker."
Garcia's placement of Staggers' statement immediately
before Dr. Pablo Stewart's, the single Haight Ashbury Clinic M.D. who
supports vouchers, shifted the focus away from Stagger's lifelong work
promoting adequate health and social services for homeless people and
toward Care Not Cash, suggesting a political position by association.
Staggers continued, "I'm an addiction, hypertension, and
published stress specialist. I've been in this business since the 1980s
and with the clinic since 1990. Before I came here, I was with clinics
in Alameda County, and I direct a Hayward methadone program. I have
designed homeless shelters and programs. I trained at Highland Hospital
in Oakland. I was surprised because I thought it [allowing himself to be
interviewed] was a way to get my feeling out there. He [Garcia] didn't
do it that way. He said my words exactly. But it's just the way they're
situated. I can't speak for Pablo Stewart.
"It [Garcia's quote] makes it look like, 'Dr. Staggers
is saying he supports anything, so he must support this,' and I was say,
'No!' My emphasis has always been making sure the homeless have decent
adequate services. Homeless people don't have enough psychiatric,
medical, or social services. [What services there are] need more
funding, just basic things like bathrooms, showers."
In our lengthy interview, Staggers drew upon his many
years' experience as a medical provider to homeless people. He
emphasized four points about the illness, suffering, and premature
deaths caused by homelessness:
1. "We all know that homelessness wreaks havoc on
physical and mental health. Homeless people live a shorter amount of
time. One study by Drs. Goldman and Sacks around 1990 first showed
that homelessness itself is a risk factor for premature death.
Subsequent studies indicate if you are homeless, you have more chance
of getting killed, you are at risk for AIDS or TB, for mental
breakdown. Homeless people die prematurely. I always emphasize it is
hard in San Francisco to find services for my homeless patients. We
don't have enough services, and the services we have are at risk of
getting budget cuts."
2. "It depends on the city, but a huge number of
homeless people have addiction problems. Homelessness and addiction is
a significant thing. Statistical studies [reveal that] the number of
homeless people who have mental illness, mental illness and
alcoholism, and mental illness, alcohol and drug addiction is huge.
The overlap between addiction types and homelessness is also huge."
(I asked, "Newsom and his Care Not Cash camp are tarring
the homeless with the addiction brush. People say that drug addiction
leads to homelessness. People say homelessness creates drug addiction.
What is the truth?")
3. "The truth is it can go either way. It's a two-way
street. I can't count the number of folks who had decent jobs, were
good all-American citizens, then got on drugs, and now they're
homeless. We see that all the time.
"However, I have also seen the opposite. For example,
most of the women patients I've got are routinely and repeatedly raped
within a few days of being homeless because it is very hard to protect
yourself. Many of my women have all these survival skills. They
reverse their sleep patterns because if they stop moving at night,
they'll get raped. They come in to me and they say, 'Doc, I can't
sleep during the night. I have to keep moving at night in order to
stay alive.' I support [the general public] being educated on how
stressful homelessness is because that is not understood. You can tell
people I have women who are repeatedly raped. Then they have
post-traumatic stress disorder. This can lead to the use of substances
in order to anesthetize the stress. People don't know that.
"A lot of people are one paycheck away from being
homeless. I see patients who are normal folks who become homeless.
They get raped, mugged, beat up. They totally become stressed out, and
then they start taking drugs as the result of the stress of the
homelessness. I see it all the time – homelessness leads to stress,
which leads to drug abuse. I'm glad you asked that question because it
is such an important issue that people don't understand. If you are
going to write about it, I would be very grateful if you could get
this information out there. Homelessness is a major physical and
psychiatric stressor which can lead to substance abuse and addiction."
4. "Some take the position that there are plenty of
shelter beds. You can't just count beds. You must ask, 'What is the
quality and safety of the shelter?' A lot of homeless tell me, and I
have visited those shelters myself and observed, that they are
horrible and unsafe, especially for women. You are actually safer
staying outside than sleeping in shelters."
In the end, Staggers waxed optimistic. "Most of the
feedback I've got is positive. I have gotten a lot of calls from folks
who took my statement in the Chronicle the right way. They said they
were glad to see somebody talking about not enough services for the
homeless. Everybody said that the statement that we have horrible
poverty – its third world-quality – they said, 'People need to know
And, in fact, disinformation like Garcia’s will only
undermine Care Not Cash's credibility. It may be that the sudden
disappearance of support from the medical community will make this
proposal nothing more than a visit to Wonderland and the birth of a
baby, a pig, or a fig(ment) of Newsom’s political imagination.
Carol Harvey (firstname.lastname@example.org)
is an artist and journalist. She has a BA and MA in Language,
Literature, and History from the University of Michigan in Ann Arbor,
and extensive teaching experience. An earlier version of this article
appeared in the
San Francisco Sentinel.