Maria Gomez, two decades ago, watched scores of refugees pour into the District, fleeing a bloody civil war in El Salvador. A nurse with the city’s Department of Health, Gomez knew D.C. wasn’t equipped to handle the influx, many of whom were women seeking to earn money to send to their families back home.

“Around that time, the city was suffering from a very severe infant mortality rate,” she said. “There also was a very high rate of teen pregnancy. And it was the beginning of the AIDS epidemic. You took the three major public health problems, and you added immigrant women without health insurance, without being able to communicate, and with very, very severe post-traumatic stress — that was just a lot for the city to take on.”