Odds, Ends, and Observations

Out for a Walk - Reality sets in

A few days ago I accompanied Robin and Sarah on a "route" to hand deliver hot meals to people in the program. These people get one hot meal a day - 365 days a year. The route was 10 stops in the Tenderloin district, considered one of the lower income and impoverished districts of San Francisco. It is actually the surrounding blocks around Open Hand, and after being given the safety run down, I was told that this would be quite the experience -they were right.

To begin, the streets of the Tenderloin have at least 3 homeless or very close to homeless people per street.  I am accustomed to seeing homeless people from my days in Jersey City and taking the train into NYC, but never to this extent. After asking around it seems like there is a need for shelters and organizations that aid the homeless. That said, it was difficult to walk into nightly hotels to deliver a meal and pass by so many people who could use one as well. Although I had been warned that the living conditions would be adequate at best, I was taken aback when one lady opened the door and the room was simply an old lazy boy chair, a small coffee table, and a dresser. The phenomenon that I was completely unaware of is called - SROs (Single Room Occupancies). At best it's a room with a bed, private bathroom, and a TV to escape reality or pass the time. At worst it's a bug infested room, with no bed, and a bathroom shared by the entire hall. One place had carpets torn and full of stains, a stagnant smell of cigarette smoke, and an electrical box with exposed wires awaiting a potential life threatening tragedy. 

The deliveries are met with a polite smile and thank you. Some talk of how much the meal means to them, others are too shy or embarrassed to open the door enough to see their face. After giving a warm meal of beef stew with rice and steamed broccoli to a Spanish woman in her late 50s, I was left wondering what circumstances had led her to this path? My personal pursuit to understand wanted to ask 20 different questions or somehow express my solidarity and concern, but in the 15 seconds it takes to hand a meal over I could only muster a touch of the hand and a "I hope you have a good day" in Spanish. On the walk to the next stop I kept thinking about what I would like to ask her, like was she aware of the different organizations that could help her, but in the middle of my thinking it was already time to ring the next door bell.

It does appear though that something is finally being done. The city of San Francisco is now slowly buying the privately owned SRO hotels and is giving up to 50 year leases to non-profits and church groups to set up SROs that have social programs. We went into one, and it had signs for free TB tests, $10 Flu shots, an eating healthy seminar, as well as a birthday board. These places at least show concern for the person and attempt to address pertinent health issues. In my opinion it is certainly a step in the right direction. 

Volunteers

One of the great things about Open Hand is the amazing amounts of volunteers that allow the organization to run as smooth, efficient, and effective as possible. I have met people, like John from the slide show, who have been volunteering here for 20 years! This seasoned veteran is a fixture on the assembly line and brings an open mind and friendly smile to all who come to volunteer or utilize the services of Open Hand. Many of the volunteers have been there over 10 years and all comment on how much a difference the place makes in the community.  Also, many of the volunteers are a wealth of knowledge regarding HIV in San Francisco. Whether its discussing their personal stories, such as of losing a partner or why they volunteer, or how the perceptions have changed over the last 10 to 20 years, I gain invaluable information simply talking or being around them. I thank them for their candidness, honesty, and interest in my project. 

Interview Completed

I am very satisfied and excited about the interviews. My first completed interview was not only inspiring, but it provides a very realistic and insightful perspective on what living with HIV is like in San Francisco. As I have been told several times, San Francisco is the best place in the world to live if you are HIV +, yet there are still hardships that are endured that can be avoided. For instance, the manner in which this man was told by his doctors of his status had lasting effects - no preparation, no counseling, just an "oh by the way..." and then a silent exit out of the room. Also, something that really stayed with me after the interview was the discussion on how faith is involved in this person's life and the changing issues over the last 10 years in San Francisco. This gentleman is a prime example of how non-profits can really help a person through  battling not only a "terminal virus" (as he put it) but also the shock and depression that follows testing positive. Furthermore, the depth of the responses attest that HIV is still a vital issue in the United States.  With the advent and accessibility of Antiretroviral medication, those with the virus can live typically healthy and longer lives. As a result, the mindset of people in this region, and the government of the US, has relegated HIV to the back burner. It is thought of now as a chronic and treatable disease and not as threatening to society, which is reflected in the gov't's budget cuts for NGOs and NPOs that provide HIV care (specifically, lowering the amount of money provided by the Ryan White Care Act). These issues and more are voiced in the interview, and intriguingly by someone who is both HIV + and works for Open Hand.

The Beauty of Lunch

Lunch. For 8 years in grammar school I had it at 12 noon sharp. We would file in, sit down, eat and laugh.  In high school, I had it at 12:25pm, and the discussions centered on sports, class work, and how people were going to get home. In college, lunch become a matter of convenience -whenever or where ever best fit the schedule. However, lunch time now has taken on a new meaning. It is a time to learn, listen, and attempt the process of understanding.

For starters, the lunch room at Project Open Hand and its atmosphere is a prime example of what one of my mentors would call "a beautiful thing". But how should it be classified or described? Everyone, including staff, volunteers from all different origins (developmentally disabled, retirees, college students, and people who are HIV positive), and administrators, comes together in the same room to break bread and discuss whatever topics that come to mind; what is the mayor doing? did you catch the Raiders game? how is so and so?. Furthermore, all the food choices are the exact same as those provided as meals for the "clients". Is this a small window into Marxist communism where class is not an issue and just the good of the whole prevails? Is this what politicos call an egalitarian society where everyone comes to the table with the same respect, rights, and dignity? Perhaps, it's the best example of the Christian moral doctrine that stresses how each of us is made in God's own image and therefore are united, equal, and together in solidarity. 

My lunch conversations are where a great deal of my understanding about how HIV, both past and present, has impacted the lives of those in this city. For instance, a simple question "how did you guys hear about this place?" led me into a world I had never really attempted to place myself into. All three men at the table had lost a partner to AIDS, and all three men recounted the pain and sorrow of watching a loved one pass with an inability to help. They spoke of a time where HIV was still horribly misunderstood and long term treatment was not an option. One recalled the plight of his partner and simply stated, "I wouldn't wish that on my worst enemy". They then recounted how being a caregiver consumed their lives as their partners worsened. One was lucky enough to stumble onto a simple support group for AIDS Caregivers run by a Jesuit who had left the society. He spoke of the group as a life line that granted him a peace of mind and de-stressed his daily routine. This conversation lasted less than 10 minutes, but it put on display the impact this disease has had on this community and the toll it has taken on the psyche of homosexual men in San Francisco.

Open Hand, Open Hearts

A Perfect Fit

After volunteering two full days at Open Hand, I completely understand why they came so highly recommended as a great place for me to consider. I understood that their mission was to provide nutritious meals for people who have HIV, critically ill, or elderly, but, after spending three hours cutting fresh peppers of all colors, picking rosemary, and then cutting Oyster mushrooms for a sauce to top roasted chicken breast, I soon realized that this place was serious about providing quality, wholesome, and healthy meals.

The wholesome mentality is reinforced in everything they do. They compost everything possible, which brings tens of thousands of dollars back into the organization, and they save energy with two donated solar panels on the roof. But let me get back to the food! Some items that caught me off guard were Wolfgang puck soups, flavored yogurts, raw frozen chicken, yams, tomatoes, and 4 different types of milk! The absolute majority of the food contains no high fructose corn syrup and is full (and i mean full) of grains, oats, and heart healthy choices.  Oh and talking about choices, they provide: Regular, bland (low sodium), Vegetarian (yes Tofu is a choice), diabetic, mechanically softened and Low Fat/No Diary (mostly for people battling Cancer). 

All this is done by amazing management and organization. Teams of volunteers come in to work one of two shirts. The morning cuts and preps all the food and the afternoon works the assembly line to pump out over 1400 sealed, deliverable meals. I should mention I am much better scooping peas then Brussel sprouts and also that I still can't manage to keep my 1940s style ice cream vendor hat tightly on.

One of my favorite parts of the day is the conversations that take place while doing work that could otherwise seem tedious. On my first day I was stationed next to a lovely elderly lady with a quaint proper British accent who quickly commented on my 'better than average' skills with the knife.  I later confessed that I had an advantage - growing up in a household with a grandfather who was a butcher in Argentina and a mother with favorite hobby of gourmet cooking. I asked about her pleasant accent and found out she was born and raised right outside of Capetown. She was delighted to find that my project has me visiting South Africa. Beautiful and scenic were the words she used to describe Capetown and the surrounding farming country. My next question led to a discovery that gave me a better understanding of the organization. She was going on her 18th year volunteering at Open-Hand! As I went around the room asking the volunteers - 18, 16, 8, 5 - it became clear that this is more than a 4 story factory or a place to volunteer when you have the time, this was a family where volunteers become close friends and most importantly believe in both the organization and the cause. Man or woman, old or young, heterosexual or homosexual, everyone has the same thing in mind and the the numbers also depict this concept. A self proclaimed "rookie" can see and learn that the most important thing about cutting bacon, mushrooms, and peppers is preparing the meals with an open heart; after all, the slogan of Open Hand is "Meals with Love". 

Coming Soon - Working in the Grocery Store and Going on Home/Site Deliveries

National FACEAIDS Conference

The Perfect Plunge

There is something about being in a room full of students who have come from 25 different universities across the country to discuss the AIDS pandemic in Africa. Whether it is the passion and drive that is reflected in the discussions or the common belief that access to preventable and treatable diseases is a basic human right, the energy in the room depicts a piece of a movement that fosters a human quality much needed in the light of so much tragedy,  inequality, and oppression - this quality is simply hope. 

In small group discussions, the beauty of FACE AIDS comes alive. Big state schools (such as Michigan) and little Jesuit school (like Fairfield and Gonzaga), large established chapters (like Texas) and brand new budding chapters (like University of Wyoming).  It is a testament to the drive and beauty of activism and solidarity. Also, fundraising $850,000 for the Partners in Health Clinics in Rwanda demonstrates the merits and influence of such activism and unity.

I got the chance to ask Dr. Farmer (who by the end of the evening shook my hand and for better or worse jokingly called me a character) one of the questions I will be using when interviewing managers/directors of HIV organizations in the different regions. The question asks people to comment on what is needed most in this fight against HIV. Jim Kim, the former WHO director and co founder of PIH, stated at the first national FACEAIDS conference that political will is the key to large scale change. This was then echoed by Stephen Lewis, Kofi Annan’s special envoy on AIDS in Africa, at the 2nd National FACE AIDS Conference. The Dali Lama, in a documentary that featured Dr Farmer, placed the strongest emphasis on human compassion, and lastly, many say the biggest gains will be made through enhancing infrastructure of clinics.

Farmer thanked me for my question and answered the way I knew he would. To paraphrase, one is not more important than the other. The pandemic is a multifaceted problem that must be resolved through several avenues. For instance, he used the example of food. He discussed how much nutrition plays a role in resource poor areas and how many people debate and comment on whether his clinics should and could sustain paying for food (which he said accounted for 20% of the Rwandan clinic budget). In his matter of fact style the sentences that followed embodied his most basic belief and approach to successful healthcare. It is the whole picture one must understand,  band aids don’t work to cover a severed limb, and barriers remain unless broken down or maneuvered around. What good is putting someone on ARV’s if they are starving to death? Food is part of the equation of a healthy life.

The successes of PIH in Rwanda has created a stir among those in public health, and yet the secret is not hiding under a rock in Kigali. PIH has created a model that is well funded through the donors (heavily in part by the Clinton Foundation) and that has a government that is willing to seriously take on a crisis and do everything it can to make PIH a success. There is a reason people in southwest Rwanda are living a little better than 5 years ago. There is a reason PIH is revolutionizing health care in resource poor areas. There is a reason PIH has been asked to scale up there efforts to the national level, and there is a reason for hope in Rwanda.