San Francisco Department of Public Health

In 1899, there was an outbreak of bubonic plague in San Francisco's Chinatown. During this time, it was discovered that there had been cases of the plague in Hong Kong, China. Chinese people were forbidden from entering the U.S. and fear affected citizens of San Francisco. The San Francisco Health Department closed Chinese businesses and subsequently burned parts of Chinatown. The inhabitants of Chinatown were required to receive vaccinations if they planned on emigrating from the city. A citizen, Wong Wai, sued the department; the ruling was in favor of Wai and requested that the department terminate their behavior. Health officials dissatisfied with the ruling ostracized and isolated Chinatown and all its inhabitants, because of their suspicions of the plague spreading.[3]

The plague scare raised awareness for public health intervention.[4]^: 88 San Francisco's health officials, who consisted of San Francisco Mayor Eugene Schmitz, California Governor George Pardee, and his personal health officials, created a partnership between themselves and the sanitary campaign in Chinatown.[4]^{: 244–249} Through this partnership, health boards all around the state would be notified if the causes of death were suspicious or had suspicion of the plague. This was in efforts to address and better serve the public's interests in health and sanitation during the time of the plague. In addition, any obtained tissues from suspicious causes of death would directly be sent to the Public Health Service Laboratory in San Francisco to help identify and eradicate the infection.[4]^{: 244–249}

In fulfilling the San Francisco Department of Public Health's mission to promote the health of its citizens, it practices a harm reduction model, including needle exchange, which is proven to reduce the spread of viral infections like HIV, hep B and hep C.[7]

Since 2013, SFPDH's has made additional efforts to improve needle disposal through its coordination and funding of several collaborative and community-based programs:

• As of September 12, 2018, there are currently sixteen 24 hour syringe disposal sites located within San Francisco, 7 of which are kiosks and the other 9 being small disposal boxes. In collaboration with the SF AIDS Foundation, SFDPH funds a 10-member clean up team that operates 12 hours a day, 7 days a week to pick up used syringes and needles off the streets, in addition to collaborating with Homeless Youth Alliance, St. James Infirmary, San Francisco Drug User's Union, and Glide Harm Reduction Services in an effort to maximize its proper needle cleanup services.[8]
• Among injection drug users in San Francisco, SFPDH's syringe access and distribution programs like San Francisco Health Information Viability[9] are in charge of providing fresh injection and safer sex materials, referrals for medical treatment, and opportunities for HIV and hepatitis C testing. Reduced HIV and hepatitis C transmission among IDUs and their partners is the program's main objective.

San Francisco Public Works provides maintenance for the streets and groundwork of San Francisco. Through a number of programs, the organization works to fulfill their mission statement of serving those that reside, work, and visit San Francisco:

• Provision of different street cleaning services,[10] specialized by district and by street direction. San Francisco bi-weekly street cleaning schedule is available at San Francisco Public Works website.[11]
• Beginning 2014, SF Public Works placed a number of Pit Stops in various impacted locations around San Francisco. Pit Stops provide access to universal toilets, needle disposal, and dog waste stations. Currently, there are 24 pit stops available in 12 neighborhoods throughout the city. All the pit stops are staffed by paid workers to ensure their cleanliness throughout the day.[12]
• 311 service is available for the residents or the visitors of San Francisco to report illegal dumping on the street or sidewalk, graffiti vandalism, fallen trees, human waste, or potholes on the streets. This service can be accessed via calling 311, mobile app 311, or visiting sf311 online. The city officials respond within 48 hours or devise a plan if a request requires more time.[13]

This branch of SFDPH is part of the Quality Improvement branch that hosts multiple programs and initiatives to promote active-living, healthy eating, and decreasing the spread of STIs, such as HIV. Many of these quality improvement projects are on-going and long-term studies that achieve success through results-based accountability.[14]

• San Francisco Health Department official web site