Through my AmeriCorps service term, I’ve served as a Health Educator for San Francisco’s most vulnerable populations. I’ve been part of the Department of Public Health’s Whole Person Integrated Care program, which includes low-barrier initiatives like Street Medicine and Shelter Health. These programs are based out of the Maria X Martinez Health Resource Center, which provides urgent and primary care for people experiencing homelessness. 

The Shelter Health program was founded in 2014 by nurse manager Kathleen Shuton to provide on-site medical services in shelters. The program initially placed registered nurses at two of San Francisco’s largest shelters: Next Door and MSC South. 

Before this initiative, there were no on-site medical personnel in shelters. At the time, every medical concern, no matter how minor, required a 911 call, even for issues like scraped knees or common colds. Because of this, Next Door and MSC South had the highest volume of 911 calls in the city. After placing nurses at the sites, 911 calls from both sites dropped by around 50%. The program has since expanded to offer medical and behavioral health support throughout the city’s shelter system.

Currently, Shelter Health clinics offer a wide variety of drop-in services, including wound care, infectious disease testing (COVID, TB, HIV, Hep C, STIs), chronic disease management, medication management, immunizations, and support with Medication Assisted Treatment (MAT) for patients with substance use disorders. The clinics also help clients connect with long-term primary care and prepare for life beyond shelter.

Over the past year, I’ve supported care coordination across more than 20 congregate and non-congregate shelters and drop-in centers. My responsibilities have included assisting patients in scheduling appointments, supporting nurses during wound care, collecting vitals, documenting infectious disease testing, and providing accessible education and resources on STIs. But what’s stayed with me most are the people I’ve met: their stories, strength, and resilience.

One client, Deb, came to San Francisco fleeing human trafficking. She survived years of domestic abuse, her body scarred by repeated scalding burns. After escaping from her abuser, she was trafficked for 3 years until she came to San Francisco, where I met her in the DPH Shelter Health clinic at A Woman’s Place Drop-In Center. Deb expressed concern about providing her personal information, including her name and date of birth which is what we usually ask of clients as we check them in. 

One of our regulars, Amy, is a lively woman who tells us colorful stories of her life in Miami, Boulder, and exploring Hawaii. She always comes into the clinic bright and early, turning her whole body to face each of us, one at a time, to ask us how we are. On Mondays, she asks each of us about our weekends, listening intently. Amy is so present when you speak to her, and she remembers specific details we mentioned weeks or even months prior. Through everything, she’s kept a positive mindset and always has a pep in her step, even with the greatest weight sitting on her shoulders. From Amy, I learned to look at life through rose colored glasses and that every day can be a special occasion if you allow it to be. 

Jules is a transgender woman who left home after her family told her she was no longer welcome. She had nowhere to go and sought solace in San Francisco due to the resources and community. Jules was initially introverted, but opened up over time. She enjoys giving herself and her friends at the navigation center manicures and pedicures. Jules reminds me how healing can start with small, affirming connections.

Another regular, JT, is a hardworking chef who moved to San Francisco from the Deep South in search of a more accepting environment. Despite her records clearly indicating that she is a transgender woman, previous providers often misgendered her and repeatedly used her dead name, even after she corrected them. Now living in San Francisco, JT works long nights preparing French cuisine for hundreds of diners. She’s incredibly proactive about her health, always aware of her upcoming appointments and consistently staying on top of her weekly injections without needing reminders from our team. Their weekly clinic visits come with updates about work and their favorite dishes to cook.

Em once owned a business in Oakland but lost housing during the pandemic and struggled with substance use. They moved to San Francisco for shelter and are now 5 months clean with the support of the nurses at the navigation center. Since then, they’re rebuilding their life and plan to return to Oakland soon to restart their business.

At the Transitional Aged Youth (TAY) Navigation Center, I’ve worked with 18- to 25-year-olds transitioning from systems like foster care. Folks staying in this shelter are constantly in job interviews, applying to schools, and staying on top of their health. They come in regularly, unprompted, for sexually transmitted infection (STI) testing and routine bloodwork. Many of the youth at TAY are curious about healthcare, asking us why we do certain tests or wanting an explanation of what causes a certain condition. 

A lot of our team’s work is outreach: going to patients’ beds or knocking on their room doors to follow up on how their wounds are healing and encourage them to come to the clinic for even just a blood pressure check. With our population, consistent outreach is critical to building trust between the patient and the care team. Many of our clients have bad experiences in healthcare environments or are wary of the medical system, so outreach, patience, and compassion are key to rebuilding that trust. 

This year has shown me that healthcare is about far more than treatments or test results; it’s about meeting people where they are, earning their trust, and recognizing their humanity. Working in Shelter Health has challenged me to grow not only as a future clinician but also as an advocate and listener. I’ve seen firsthand how compassion, accessibility, and persistence can change lives. As I move forward in my healthcare journey, I carry with me the stories of Deb, Amy, Jules, JT, Em, and so many others, each one a reminder that healing begins with connection and that everyone deserves care rooted in dignity and respect.

*The names of clients have been changed for privacy and patient confidentiality.