WE haven't decided if we are supporting it yet...

by Carol Harvey

"The baby grunted again, ...`If you're going to turn into a pig, my dear,' said  Alice, seriously, `I'll have nothing more to do with you...

`Did you say pig, or fig?' said the Cheshire Cat.
 

`I said pig,' replied Alice; `and I wish you wouldn't keep appearing and vanishing so suddenly:  you make one quite giddy.'

One day, The Haight-Ashbury Clinic's Dove logo and a link to its site appeared on Care Not Cash.org.   Like the Cheshire cat, at the Clinic's request, the next day it was gone.  

In his promotional Chronicle op ed in the July 16th Chronicle for his Care Not Cash initiative, 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," Samsun Wong echoed the statement, "Newsom has constantly emphasized the medical community's support (repeatedly citing)..."Dr. Pablo Stewart of the Haight Ashbury Free Clinics."

In his Chronicle article, on July 2, "Homeless measure makes sense/Care Not Cash plan should make ballot," Ken 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."

Garcia incorrectly connected Staggers to proponents of Care Not Cash following this quote: "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, Dr. Staggers denied the association telling me, "I am an apolitical advocate for homeless people without polemic or agenda."

Do such disinformative maneuvers undermine Care Not Cash's credibility? Do Newsom's suddenly vanishing claims of support from the medical community amount to --- in terms of Alice in Wonderland --- a baby, a pig, or a fig (ment) of his political imagination?

Ken Garcia's article suggests that both Dr. Staggers and the Haight Ashbury Free Clinic medical staff en bloc, support Newsom's CNC plan.  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, 2002, Dr. Inaba, CEO of the Haight Ashbury Clinic, answered my phone query; "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 Dr. Inaba.
 

"No," he 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."

"Dr. Stewart supports that initiative," Dr. Inaba continued.  "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 this mistaken impression that the Haight Ashbury Clinic is supporting Newsom's proposal, Dr. Inaba sent out a press release on July 18 with the headline: "Haight Ashbury Free Clinics Take No Official Position on Care Not Cash November Ballot Measure."

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," said Darryl Inaba, HAFCI's Cheif 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," added Dr. Inaba. 

"HAFCI has been providing primary health care to the uninsured and medically underserved for 35 years...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."

In an interview, I asked Dr. 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 this article with your quotes suggesting you support Newsom's Care Not Cash initiative."

Dr. 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 pairing and placement of Dr. Staggers' quote immediately before Dr. Pablo Stewart's, a single Haight Ashbury Clinic M.D. who supports vouchers, was particularly innovative in its attempt to suggest a political position by association.

It shifted the focus toward Care Not Cash and away from Dr. Stagger's life's work in promoting adequate health and social services for homeless people.

Dr. Staggers said, "I'm an addiction, hypertension, and published stress specialist.  I've been in this business since the '80s 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, Dr. Staggers drew upon his many years' experience working as a medical provider to homeless people.  He emphasized four main points about the illness, suffering and premature deaths caused by homelessness:

1.  "We all know that homelessness wreaks havoc on physical and mental health," Staggers said.  "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,"Staggers continued."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."

3.  "Dr. Staggers," I asked, "Newsome 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?"

Dr. Staggers' answered, "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," Staggers concluded.  "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 ouside then 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 --- it's Third World quality --- they said, 'People need to know that'."

And, in fact, disinformation like Newsom's, picked up and repeated by Garcia and Wong, will only undermine Care Not Cash's credibility. It may be that public refusal of the medical community to support both such disinformative tactics and Care Not Cash will reveal this proposal as nothing more than a fraudulent visit to Wonderland and the birth of a baby, a pig, or a fig(ment) of Newsom's political imagination.