Since July 18, 2002, every other Thursday night at 6:00, a motor home has pulled up to the curb on the east side of 15th Street just south of F Street, across the street from Smart & Final. The 30-foot coach does not belong to someone looking for a place to sleep. It's driven by employees of Family Health Centers of San Diego. They use it as a mobile hypodermic-needle exchange center. Upon arrival one recent week, the two workers set up a shade canopy on the sidewalk. Beneath it, they place half a dozen folding chairs and a battery-powered lantern. By 7:30, the chairs are full of "clients" waiting their turn to exchange their needles -- used primarily to shoot heroin and methamphetamine -- for clean ones.

Meanwhile, around the corner at the AM/PM gas station and market, co-owner George Zavaro isn't happy about the proceedings. Though he concedes he's had no problems arise directly from the needle-exchange program, he complains, "It is not good for the business. It's a headache. It's completely a headache. I wonder why they don't do it in clinics or somewhere where it is controlled. Instead, we will have scumbags hanging around here. We just got rid of the drug dealers that were here, and now we start with another problem. I can't understand it."

At 9:00, the canopy, chairs, and lantern are packed away again, and the motor home is driven off.

This scene has been brought to the Downtown/ East Village area as part of a pilot program run by Family Health Centers and funded by a $300,000 grant from Alliance Healthcare Foundation, a local organization dedicated to philanthropy in health care. Preceding the program was a task force studying the idea of combating the spread of HIV and hepatitis with clean-needle exchanges. Fran Butler-Cohen, president of Family Health Services, summarizes the task-force process. "Knowledgeable people in health care, drug addiction, and the public-health field came together, and they strongly made the recommendation for a clean-syringe exchange program. And, at that time, councilmember [Byron] Wear stepped to the plate for the downtown community -- and everybody knows that we have a mega problem with IV drug use in that area -- and councilwoman Christine Kehoe also stepped to the plate and said, 'Yes, I have those problems in my communities as well, and I want it in City Heights and in North Park both.' "

The latter two programs haven't come about yet. In North Park they're working on their third proposed site. "The first site they wanted," recalls North Park resident Martin Chevalier, "was on 30th Street [north of El Cajon]. I raised Cain. I contacted KPBS, KUSI, Channel 8, Channel 10, and Debra Enzer of the Union-Tribune, who wrote an article. Then what did they do after that campaign? They moved it a block away."

The short move, to a cul-de-sac on Boundary Street, just north of El Cajon Boulevard, angered Chevalier. Sitting in the living room of the home of Donna Dow, another North Park property owner opposed to the needle-exchange program, he says, "I've had to put in 300 hours trying to defeat this. The fact that they've made me and Donna do all the work we've done... I'm going to put an ax through the heart of this program. I'm going to teach Toni Atkins, if you screw with me once, I can forgive you. You screw with me twice..."

Chevalier and Dow learned of the second proposed North Park site on October 11, only three days before a North Park Community Planning Group meeting at which the idea would be considered. Dow's husband, Joel LaVallee, happened to be doing some work on the Boundary Street apartment building Dow owns when he noticed a flyer, advertising the meeting, posted on the building.

Dow argues that the neighborhood notification was inadequate and complains about the open-forum portion of the planning-group meeting the following Monday. "Pretty much they didn't want to listen to the community at all," she says. "Fran Butler-Cohen and the Family Health Services people spent about 45 minutes showing their video and making their presentation. Then the chairperson [of the planning group] said, 'Now, you people have one minute each to talk.' Afterward, Butler-Cohen says, 'We've got eight votes [on the planning group], and this is in whether you like it or not.' After they told me that, I went around to the neighborhood and notified the people as much as I could and told them to come over to the meeting [the next day]. They did, but, unfortunately, at that meeting it was the same kind of thing. They got the floor for 45 minutes, and we were told anybody who wanted to talk had one minute to speak. The gist of the matter is they passed it through 11-1, with one abstention."

"But all 13 planning-board members live south of University," says Chevalier. "The truth is, nobody wants this. Now, if you were the 13 planning-board members, and you all lived south of University, which is the case, wouldn't your judgment be a little bit biased? If you look on a map at where they live and where they want to put this thing, you'll see that they're putting it as far away from their neighborhoods as possible."

Vicky Granowitz, a social worker and one of the 13 planning-group members, counters, "South of University has had an array of social service programs for as long as I've lived in this community. I moved into my house knowing that around the corner was an emergency shelter for teenage runaways. And not far away from where I live there are also board-and-care facilities, more than one, that handle patients coming out of psychiatric hospitals. I know all that because I was a social worker, and I placed people in board-and-care facilities. So when I bought my house, I knew these places were within walking distance. We also have recovery homes for addicts south of University."

Butler-Cohen refuses to comment on what she calls the "age-old" north/south rift in North Park. "Statistics of the San Diego Police Department and from SANDAG," she explains, "say that the highest number of narcotic arrests occur right in [the El Cajon Boulevard] corridor. So the drug addicts are already there. The people that are I.V. drug users, they already exist in the neighborhood. It is one of the highest concentrations of I.V. drug use and arrests in the city of San Diego, the north end of North Park. There's a map in the final task force report that shows the concentration of arrests in that corridor."

Chevalier has seen the map and finds it laughable. "It's a map of the whole county," he says. "All it has on it is freeways. It shows a concentration of arrests through North Park, but you can't tell if they're along University or El Cajon."

"I went out with our police community-relations officer," Granowitz responds, "and I asked him to show me where the biggest problems with drug use in North Park are. He took me up and down the alleys around 30th Street and El Cajon Boulevard."

After the two community planning meetings, Dow decided to directly contact Alliance Health Care, Councilwoman Toni Atkins, and Family Health Services. "I could see from trying to talk to these people that they weren't going to listen," she says. "They wouldn't even return my phone calls. So I decided I had to get an attorney. And I did it on pretty short notice. Because on October 15 they were telling us that on November 7, that motor home was going to be there on Boundary Street, whether we liked it or not. So I went and got an attorney, and I've spent about $8000. We were right on the point of an injunction when the city attorney, Casey Gwinn, stepped in and decided there was too much controversy surrounding it."

A letter from Gwinn's office written by Deputy City Attorney Lisa Foster to Dow's attorney Leah Zinter states, "Councilmember Atkins directed that the Boundary Street site not be used, and that an alternative North Park site be identified, due to the controversy surrounding the Boundary Street site."

At a January 7 city council meeting, a third North Park site for the needle-exchange program was proposed: the alley behind the southwest corner of 31st and University. The area is much less residential in character than the first two proposed sites. Toni Atkins has said she'd like to see it in operation by the end of January.