We’ll keep Lyon-Martin open

April 18, 2011

In late January, Lyon-Martin Health Services, a one-of-its-kind community clinic serving women and transgender people in San Francisco, announced that it may have to close its doors due to financial distress.

The community rallied to the clinic's aid, raising $200,000 in just the first six days of fundraising. As of early April, the community had raised $360,000, giving the clinic time to catch its breath, and begin the process of setting itself on a path toward financial stability.

Jackson Bowman is one of the activists in the community coalition that took a lead in both raising money to keep the clinic open and working toward transparency and space for community input in how the clinic will be run. He talked to Christine Darosa.

DO YOU have a background in community activism or organizing?

THE FIRST experience that I had doing organizing was union organizing. I used to work for Whole Foods market in Wisconsin, and we organized a union at our store. We were the only Whole Foods market to ever successfully organize. We were squashed very quickly, but it was my first experience doing anything that looked like grassroots organizing.

I think that a lot of union organizing campaigns don't always look like grassroots organizing, because they are usually performed pretty heavily by union organizers and are paid for by a union, but the union local we were working with was extremely underfunded, extremely understaffed and inexperienced, so we were really leading the union local in terms of what we wanted to see.

We organized ourselves, and then we said, "Well, we really should be represented by somebody," so we approached them, instead of the other way around. I was really young, and I learned about what it meant to organize a group people around an idea from other people who did organizing. And I learned a lot.

Supporters collect donations to help keep Lyon-Martin Health Services open
Supporters collect donations to help keep Lyon-Martin Health Services open

I think it took me a long time to learn that organizing without winning is still good. I really felt at the time, "Why did we just waste our time doing this if we were going to lose anyway?" It's something that I've learned over the years.

I've also had a job running a CDC DEBI--Diffusion of Effective Behavioral Interventions--which is an intervention that the CDC has proven is evidence-based, and that they ship out to cities to say, "You should do HIV prevention with this pre-packaged strategy."

The strategy was pretty flawed, in the way that it interacted with our community wasn't effective, so we did a lot of reorganizing of the way the intervention was written. The part of the reorganization that I was part of was to bring together front-line staff with other youth-serving agencies to pool resources and staff time in order to impact HIV transmission for LGBT young people.

Through that effort, we created a network of providers that were meeting all the essential baseline needs of young people: housing, food, clothing, mental health, health care, social support and HIV testing were all covered by our agencies.

Some of it was events-based, like parties, but a lot of it was actually weekly programming where we helped young people build networks within their communities to support each other and themselves. We did a lot of organizing around accessibility to free space, especially with San Francisco Parks and Recreation, because they are very rapidly reducing people's ability to access free space.

I didn't realize that when I was upset about Lyon-Martin closing, and wanted to do something, and get other people upset, that that was organizing. This is important because I don't think that people who do organizing necessarily define themselves as organizers. I mean, if someone doesn't define themselves as an organizer that doesn't mean they can't organize. It's not a trade, it's a skill that anybody can do.

WHAT GOT you involved in the fight to save Lyon-Martin?

INITIALLY, IT was that my partner works for Lyon-Martin, so I'd seen it coming for a while, and already had been building up toward being pissed, with it affecting my life and my family.

If my partner loses her job, then what does that mean for our household? That was my initial motivator, but at the same time, I and a lot of people recognized that it's an important resource for our community, and that really became more of the driving force in keeping in open.

I say it over and over again: it's an unduplicated resource, you can't get this anyplace else, it could almost never be started again. These kinds of wins that we had in the '50s and '60s, that we almost lost in the '70s and '80s--we can't just stand back and just let them go away.

Lyon-Martin was started as a project of a nurse practitioner who was looking around at her community and saying, "Why are lesbians ending up in the emergency room for things that they should be able to go to the doctor for?"

It started out in somebody's apartment. We could never start a community clinic out of an apartment today. There were some people at the beginning of the clinic's crisis who said we should just scrap it and start over. There's already been so much foundation laid, and such a rich history, and the way that Lyon-Martin does its care for its patients is so unique, we could never duplicate it. It would be something different, and that's not to say it would be worse, but it would just be different, and if we like it the way it is, we have to fight to keep it this way.

CAN YOU describe where Save Lyon-Martin came from, and its relationship to the clinic?

THE GENESIS of Save Lyon-Martin was extremely organic. On the morning that the announcement that the clinic was going to close happened, there was a call put out to social networks that alerted people that it was happening, and that grew and grew and grew, and more and more people wanted to get involved.

Honestly, by 10 p.m. that same night, Save Lyon-Martin was born. It wasn't purposefully created as a reaction to the clinic, it was just, "This thing is happening, I don't want this thing to happen, let's organize ourselves. Who's interested in organizing around this? Give us your e-mail addresses."

And from those e-mail addresses, that was what became Save Lyon-Martin. We are a group of people who have decided to continue to work together to keep Lyon-Martin open. We're just a group of people who are concerned. That's all it really is.

There is a favorable, familiar relationship between front-line staff at the clinic and the community, and there is also a formal relationship, a collaborative relationship, between executive staff at the clinic and the community, which is good because normally the community never gets to talk to somebody like an executive director or a board chair or a CFO.

I think that we are trying to be thoughtful about how close our relationships are with people who are in executive positions, because we are not an arm or an appendage of the executive leadership of the clinic. In terms of the decisions about who's hired and fired, what the budget is going to look like, and what the business plan is going to look like, we want to have influence over those things, but at the same time, we want to be protective of our ability to organize free of responsibility to those ends.

The relationship with the executive staff has been productive. I think we would have been able to do much less for the clinic without the cooperation of the executive leadership, so I wouldn't say that if you're out there trying to organize something, you should definitely not work with the executive leadership of whoever you're trying to work with because it won't be a fruitful relationship.

You have to play it by ear, but you also have to maintain autonomy as a group of people who don't work for them. Don't allow a grassroots process to be dictated by their model.

EVERYONE HAS marveled (and keeps marveling) at the overwhelming community response to the news of Lyon-Martin's closing. For example, $200,000 was raised from the grassroots in six days. Did you expect that kind of overwhelming response?

I EXPECTED the physical response--I expected people to show up, and the line to be down the block. That's what I wanted. I just didn't expect that people would give as much money.

I gave more than I could afford to, and I guess other people did too. So if everyone gave as much as they could give, and then a little more, that's how we got to this place. Right at the beginning there was a palpable energy around people being excited that other people were excited.

I've never seen anything like it either, but I'd just chalk that up to not having a lot of experience--I've never been part of a campaign like this, so whatever was going to happen was going to be amazing.

But I also think that some of the same people who were saying "I never expected this, I can't believe this happened, unbelievable" were also people that originally wanted to let it go--they were unengaged in terms of what people's needs and thoughts were about this kind of health care, about health care in general, about queers, about trans people, about all of these things. They weren't understanding the situation that people are really in.

WE'RE NOW two months and $360,000 in donations further along now, the board has lifted the threat of imminent closure, and it seems like the clinic and Save Lyon-Martin are now passing out of crisis mode. What are the tasks ahead?

THAT'S EXACTLY what's happening: transitioning from crisis fundraising and planning, crisis organizing, crisis messaging. Our plan at this point is two main things: community members are stepping up to apply to become members of the executive board of the clinic, in order to make sure the voices of community members, staff and patients are represented at the executive level of the clinic, and that there is a renewed passion for leadership and sustainability from board.

The other goal is to establish criteria and membership for a Community Advisory Board that we envision as being an integral part of board strategy. It would be made up of community members, patients and organizers, but isn't held to federal guidelines that govern clinic boards or the Lyon-Martin bottom line, and is able to give the perspective of being outside of those structures.

I feel like us being outside those structures and being able to advise leadership has been successful so far. Any board at Lyon-Martin, to move more successfully, needs to continue to have outside perspective.

Save Lyon-Martin is also developing tools and strategies for sustained fundraising in our community. The clinic and board will be doing fundraising and development, but it will be good for the community to continue this because it engages people in their health care.

I've gotten some feedback from organizers who were active in ActUp at the height of the HIV crisis, comparing the reaction of the community then to the reaction to Lyon-Martin now. They've said, "Thank God people are reacting this way, not just to save the clinic, but also to reengage themselves in health care as queer people."

Not all queers, but many, are resigned to the idea that Human Rights Campaign and groups like that will "do it for us." Queer people who aren't middle class, who are immigrants, who are women, trans, young, old--people who aren't in that middle area--are all being left behind, in terms of the direction queer politics are going.

Continuing to engage people in sustaining the clinic financially keeps people engaged in our health care at the grassroots. We have to look at it like a political movement. And we have to get away from the pigeonholing of queer politics. People need to be doing activism around health care in general, not just queer health care.

This is true for a lot of issues. It's not just queers that shouldn't be homeless--no one should be homeless. Everyone deserves health care, food, shelter, safety. These issues are important for everyone, not just queer people. Even ending the war. We need to get out of the mentality that "if it's not a queer issue, why would I worry about it?"

THERE IS clearly a necessity to make common cause across different communities and different issues. Do you think there is opportunity to do that right now?

WHEN WE think about how we got to that height of resistance in the 1960s, and then you look back at the '40s and '50s and see how craptastic everything was for everybody, then you see that you really have to be pushed to a point of breaking.

So, I think that there is opportunity on the horizon, because things are going to get really messed up--the economy sucks, the states are broke, social programming and social services are being just stopped in their tracks, people are having to do more with less all the time, people can't get jobs, people's health care is getting cut, people are hungry and homeless all over the U.S.

It's almost like the Depression. It's going to get bad. And I think it's bad in a different way--socially speaking, we're moving more toward tolerance, more toward acceptance of queer people and trans people and all these things. So I don' t know if it's going to be necessarily a fight around civil rights, but I think that capitalism unchecked is very damaging, and I think that we're seeing the effects of that.

Everyone's being damaged by it. I think that the opportunity that's being presented is to say, "We need to resist being put into a place of lifelong debt and poverty, and barely getting by for the rest of our lives."

We're like teeny batteries for this giant resource-consuming machine. And I think people will have to resist it because people will die from it. People will die from poverty, lack of health care, lack of education, incarceration and all of the things that happen when capitalism is unchecked. I think that when people really feel that their lives are on the line, they will resist.

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