Activists: Official Suppression of Peer Advocacy Worsens TB, Flu

Advent of the LA-tuberculosis situation problematizes the lack of training in good habits of hygiene amongst the homeless. Programs in WASH (water sanitation and hygiene) have been proven to reduce the incidence of disease in programs on a global level, but in the developed nations many vulnerable populations lack the kind of outreach and training that prevent disease in WHO programs around the world.

Homeless emergency shelter operators came under fire at the Santa Barbara Board of for failure to respond to well established internationally recognized disease control imperatives. In 2012, homelessness organizers were criticized on the basis that people were quartered on grounds of a local Episcopal Church without access to sanitation of any kind: no water and not even portable sanitation units.Subsequent peer advocacy training in Cough Hygiene were initially well received, but later led to bitter factionalization as warming center shelter operators, spurred by religious missionaries, rejected such measures as criticism contrary to staff morale.

TEACH Cough Hygiene Initiative project coordinator Geof Bard spoke to the county noard about the problems exacerbated by Freedom Warming Center's "foot dragging and obfuscation" with regard to infectious disease, citing the outbreak of tuberculosis in Los Angeles hot on the heels of an unusually active national influenza season.

Speaking to the bipartisan panel, he pointed out how [Community Development Block Grant] funding of the warming centers could lead to increased costs when otherwise-healthy homeless people are crammed one hundred to a room and end up with higher incidence of disease. "Everything I am advocating [is based on guidelines] from the Center for Disease Control" and the County Health Department.

With the SBCDPH Director Takahashi Wada, M.D., M.P.H. in the audience, he pointed out tension between the Department and the warming center staff, underscoring that their resistance to implementing any kind of infection control plan places them at odds with established health authority. Elsewhere, it had been noted that a Public Health employee had complained of an epidemic of "deafness" amongs homeless careeer specialists. Mr. Bard pointed out that lack of appropriate response led to more preventable "influenza, and now tuberculosis", as reported widely with regard to the LA TB situation currently under investigation by the CDC.

In an earlier email, he had called for additional disease control protocols to include contact tracing information for homeless persons. Under current warming center policy, names, or nicknames, are taken only occasionally and sporadically, and no cellphone, address or email addresses are written down. Thus, if it were determined that one of the warming center guests or staff had been disseminating bacterial, viral or other type of infection, there would be no way to implement the standard contact tracing by which health professionals alert possible victims and direct them to diagnostic and therapeutic resources.

In separate communications, TEACH had advocated for confidential contact trace methods based upon STF testing, advocating for information that will allow shelter operators to contact persons who may have been exposed to infections.