Intended for healthcare professionals

Student Life

Street life

BMJ 2004; 328 doi: (Published 01 May 2004) Cite this as: BMJ 2004;328:0405210
  1. Eve Ekman, outreach worker, journalist, and photographer1
  1. 1San Francisco

Eve Ekman gives an insight into the poverty, addiction, and desperation that affects many women trapped by drugs and prostitution

Using only her right hand, Alice rifled through the make up bag with fascination. She knelt over opening each lipstick and eye shadow and arranges them at her knees in the doorway of her dark room.

My bag overflows with hygiene and medical supplies for the women in these hotels. However, only the small make-up bag I bring is truly coveted. It often serves as the conversation piece with the women, giving us an opportunity to chat and be girly together.

Alice's left hand looked cartoonish in size--like Minnie Mouse's white gloved paw. But there was nothing funny about the massive swelling from an abscess just above the knuckle of her little finger, which left her arm puffy up to the elbow. Flushed from fever caused by the wound's infection, she finally chose a deep crimson colour and began to retreat back in to the warm darkness of her room. I softly urged her to get it checked out a hospital before the infection spread. “I will not go to any of those places, they abuse you. I've been taken advantage of in all those places; you may not believe me, but it is true.” Sensing my concern she added, “I'll just wait it out; I've had these for years; it will go away. Always does.”

The southwest corner of 16th Street and Mission has always been the worst part of San Francisco. Growing up, I was forbidden to go there; and my defiant excursions found the area fascinating but frightening; it seethes with addiction, desperation, and commerce. People traverse the same two blocks ferrying money or drugs or other people with agitated determination to get the next hit. For …

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