Anthony Dingman remembers the morning he woke up with his face paralyzed. Diagnosed with HIV in 1986, Dingman is of the generation of gay men who have perforce become experts on their disease and speak of the symptoms of AIDS with the kind of medical expertise one normally hears from medical professionals. But that morning, he was at a loss to understand what had happened, and made an appointment to see his doctor at Howard Brown Health Center ( HBHC ) . On the examining table, he was surprised when his physician, Dr. Catherine Creticos, asked, "Do you mind if I look in your ear?"
As Dingman recalled, "I thought well, that's kind of a funny question, but said, 'Sure, you can look in my ear.' And she looked and said, 'Okay, here you go, you've got shingles in your ear.' She knew right away what the problem was.'" People with HIV/AIDS are especially susceptible to shingles, and it takes a specialized physician to look for the right symptoms. In describing the care he gets at HBHC, Dingman stressed that the center is the best place for people like him.
On the issue of HBHC's mismanagement of funds, however, he is clear about his unhappiness at the current situation. "I think the board needs to hire people with a proven track record of integrity and performance," he said.
Dingman is among the many who heartily praise the services HBHC provides. Their sense of its critical importance has led to Howard Brown's fundraising success in the past few weeks. They have so far triggered the $100,000 challenge and, according to CEO Jamal Edwards, met almost 60 percent of their goal. Yet, within the community, the recent crisis has raised multiple issues. Its support is combined with an ambivalence about HBHC and questions about its future.
Owen Daniel-McCarter is the project attorney for Transformative Justice Law Project ( TJLP ) of Illinois. TJLP provides free legal services to incarcerated or formerly incarcerated transgender and gender-non-conforming people. "All of our clients get services from Broadway Youth Center or the clinic itself when not incarcerated," Daniel-McCarter said. Having been a client of HBHC himself, Daniel-McCarter had special praise for its recently implemented standard of care for transgender clients, which includes a "client empowerment inform and consent model where you are informed of what could happen to you when you take hormones; it has really moved away from this model of pathologizing trans people."
He said that poor transgender clients who end up in Cook County experience transphobia, compounded by their unequal economic access to care. While praising HBHC for its work, he was also critical of its mismanagement: "It's incredibly alarming, not only personally but for our entire community."
Ursula OrElse, a professional dominatrix and sex worker, is a member of Chicago's chapter of Sex Workers' Outreach Project ( SWOP ) . SWOP holds its meetings at HBHC's community center and that fact speaks volumes to OrElse, whose fellow sex workers are often stigmatized by the mainstream medical community. She felt that HBHC's goals of harm reduction and its sliding scale make it a "mainstay" of the community. She was especially concerned about the potential loss of funding to various safe sex and STD outreach projects designed for vulnerable populations.
While recent events highlight HBHC's importance to the community, they also point to several arenas for change. Among these is the ongoing issue of race in a city whose historic and ongoing segregation is apparent in what many see as the unequal portioning of resource on the north side. Daniel-McCarter's clients are largely poor and of color and he points out that "another problem with HBHC is the accessibility of the space. Getting to Howard Brown has been problematic for many of the people I work with." The group Gender JUST, whose members are largely youth of color from the South and West sides, recently released a statement on the issue. [ Disclosure: This reporter is also a member of GJ. ]
Talking with Windy City Times, Sam Finkelstein of GJ pointed out that almost all its members benefited from HBHC because they either got their healthcare there or used the services of Broadway Youth Center; several also get their hormone therapies there. But he also felt that its crisis might prompt the creation of multiple health centers in different parts of the city. He noted that Project VIDA and VIDA/SIDA on the South and West sides have faced similar crises in recent years, but those did not incite the same rush to support as with HBHC. Finkelstein attributed this partly to the fact that people see HBHC as a one-stop center, but also to unequal health care resources for people of color in a community where the default community is seen as white and living on the North Side.
Evette Cardona is a longtime community member, a co-founder of Amigas Latinas and a senior program officer at the Polk Bros. Foundation. She said that her initial response to the news of mismanagement of funds at HBHC was shock and that she was "doubly shocked when it was found to be true." She added that she was also saddened "because gay organizations have the additional burden of proving themselves; the scrutiny is double. When something happens to one of us, it [ makes it seem like ] it can happen to all of us. It makes it hard for the next gay organization to pass muster."
With regard to the calls for transparency, Cardona said that "the layers of bureaucracy" that organizations the size of HBHC are required to go through "challenge the concept." According to her, "We need to change the skills sets of the boards so that they understand how to navigate bureaucracy." Like many others, she was clear that the mismanagement needed to be separated from the work of the medical personnel and staff "on the ground." Like Finkelstein, she saw this as an opportunity for wider community dialogue on how best to bring about changes and to continue providing services to the community: "This is a huge wake-up call." Unlike some, however, Cardona did not see the need to oust the entire board but felt that those responsible for the crisis ought to step down.
It is clear that HBHC serves the multiple needs of various and vulnerable populations, providing them the kind of culturally competent care they cannot find elsewhere. In their defense of the institution, HBHC staff and officials often say that without it, people will die. But those words also demonstrate the fact that whatever policies caused the current crisis were put in place by a board that put the lives of those very people at risk. In the coming months, HBHC's position in the community may well be strengthened by the amount of financial support it receives but it will also be closely scrutinized. Yet, it is possible that this crisis marks a new approach to thinking about the health care needs of a community marked by differences in economic access as much as by race and ethnicity. Daniel-McCarter points out that HBHC's strengths in working with trans people, for instance, could be actively taken to places like Cook County and that "ultimately what needs to happen is that we need to have a shift in medicine where the status quo is not transphobic, racist, classist, homophobic medicine. How can we have an anti-oppression framework for medical care?"