Hello everyone. My name is Richard Sullivan. My thoughts in this blog are maybe from a different perspective than some others. I am not employed in the field as many of you are. I live in the field. I also do a lot of volunteer, service, outreach, and belong to the same community help committees as you. I attend College, enrolled in the Recovery and Addiction counseling program at CCSF. Also, I am a member of the San Francisco HIV Community Planning Council. My role in HCV elimination is personal to me. I am an HCV survivor. I lived with it for years but have now been cured for over 5 years. I also live with HIV, am a sober alcoholic, in recovery for substance abuse disorder (IV drug use), was formerly homeless for a period of 5 years here in the city, experienced prior incarceration, and have lived experience in the mental health system. My life could not be more different today than from what I just described for you. If I may say, it’s a miracle. But we all know it takes more than miracles. It takes nuts and bolts community effort and wrap around care. The life I live today is the direct result of everything I, we, you, discuss and plan for in our groups, boards, and committees. I have benefitted from all the care and services that I now try to pass on to others. Marginalized populations are my target. Everything I do revolves around trying to find ways to help.
I live in the center of the Tenderloin. My perspective of Public Health has been out here in my neighborhood, my building, and through the lives of people I know that are affected. COVID-19 has shined a bright light on many of the problems facing this community. I was asked to share what I see. I’m not here to complain, or point fingers. I know you are the solution seekers, not blamers. But what I see is glaring, ever increasing, and a definite public health crisis. However the service organizations decide to reestablish care it is imperative that we do so. These issues all dovetail. In one way or the other HCV, HIV, STD all have commonality. The streets right now are rife with unchecked mental illness. Almost never are people here in the Tenderloin practicing social distancing, hand sanitation, masks. It is packed on the sidewalks. Drug use is rampant. There’s no blame here, folks are coping in ways they know, or are available. I am part of a syringe access down on Eddy Street (St. James Infirmary). It is busy every Friday night. Folks are so grateful. (A growing trend I notice is the large amount of smoking apparatus being requested. On many nights, we pass out more speed bubbles and straight shooter crack kits than syringe supplies).
The need for syringe access sites going forward is paramount. As are safe injection sites, sobering stations, street medicine, mobile testing, harm reduction centers, community-based organizations which offer drop in case management, and psychosocial care, mental health crisis services, and homeless outreach. I also cannot overstate the need for Peer Advocacy, Peer Support, and Peer Navigation. Better minds than mine must take this opportunity to find a way to make the COVID hotel situation that the city is now trying into a long term, working part of the solution. As we see, when push comes to shove, there are buildings and sites for this purpose. Sure, there will be bumps, but that’s part of the process. This is an opportunity to have exactly the target populations we seek to help in 4-wall (or tent compound) facilities, with the availability of the needed services for social and medical success on site. Outreach can still get out to other areas, but the benefit of housed clientele would cut out much of the current problem of trying to pin folks down to offer help that is now so much of the battle. Large scale Tenderloin (and other locale) street corner setups for care, consultation, and other services (such as GLIDE sometimes provides) are known people magnets.
In summation: From what I see and hear every day out here in the streets, now is absolutely not the time for reductions in public health, harm reduction, or community-based organizations. I advocate at every opportunity, and strongly encourage others to do so as well. I’m proud of the work people are doing here in the city through their organizations to better serve their clients. But the stakes just got raised. See you in the field.
End Hep C SF are running a series of blogs on how COVID-19 and today’s climate has changed our hepatitis C work in all areas. If you’re like to submit a blog please email info (at) endhepcsf (dot) org.
