Patients wait outside a mobile clinic run by Circle The City near a soup kitchen for homeless individuals in Phoenix on Thursday, May 30, 2024. Located in one of the hottest major cities in America, Circle the City is implementing strategies to safeguard patients from dangerous heat-related illnesses amid soaring temperatures. Nearly half of last year's record 645 heat-related deaths in Maricopa County, including metro Phoenix, involved homeless individuals.


July 1, 2024 Tags:

Alfred Handley reclined in his wheelchair near a bustling Phoenix freeway, bathed in the searing 96-degree morning sun. Nearby, a street medicine team from Circle the City administered vital IV fluids, dangling from a pole, to help him rehydrate. This innovative initiative by the nonprofit aims to safeguard homeless individuals from life-threatening heat-related illnesses in one of America's hottest cities. Last year, nearly half of Maricopa County's record 645 heat-related deaths were among the homeless.

Dr. Liz Frye, vice chair of the Street Medicine Institute, which trains healthcare teams globally, acknowledged Circle the City's unique approach of providing IV treatments directly on the streets. She emphasized the necessity of such measures to prevent fatalities due to extreme weather conditions.

As temperatures continue to rise, healthcare providers across the country, from San Diego to New York, are grappling with better ways to protect homeless populations. In Boston, for instance, the Health Care for the Homeless Program now encounters cases of mild heat exhaustion during summer months, a stark contrast to their usual focus on frostbite and hypothermia in winter.

The Phoenix team tirelessly seeks out homeless individuals in encampments along dry riverbeds, sweltering alleys, and canals. Approximately 15% of those they encounter require immediate hydration through saline drips.

Nurse practitioner Perla Puebla described their daily routines, which include wound care, diabetes medication refills, antibiotics, and managing high blood pressure for homeless patients like Alfred Handley and others in dire need.

Living outdoors in Arizona's blistering heat poses severe challenges, especially for those struggling with mental illness or using sedating drugs like fentanyl or stimulants such as methamphetamine. These conditions exacerbate dehydration risks, which can prove fatal.

In metro Phoenix, where temperatures have soared to 115 degrees this year, the impact on homeless communities is evident. Dr. Aneesh Narang from Banner Medical Center-Phoenix highlighted the increasing incidence of heat-related illnesses among their homeless patients.

Circle the City, founded by Sister Adele O’Sullivan in 2012, has grown to encompass 260 staff members, including medical professionals dedicated to serving 9,000 patients annually. Funding, largely from grants, donations, and insurance payments, supports their efforts in partnership with seven Phoenix hospitals to ensure continued care for homeless patients post-hospitalization.

The organization not only provides immediate medical relief but also aims to transition patients to longer-term housing solutions, with 77% of respite patients avoiding return to the streets or emergency shelters.

Dr. Matt Essary, who operates mobile clinics for Circle the City, discussed innovative approaches such as potential blood analysis tools to detect dehydration-induced electrolyte imbalances. This proactive stance helps identify critical health issues early, including symptoms like severe thirst, dizziness, and dry mouth.

In Phoenix's scorching climate, incidents of surface burns from medical emergencies or accidents are also common, underscoring the urgent need for accessible healthcare services for the homeless.

Rachel Belgrade, a Native American from the Gila River tribe, shared her positive experience with Circle the City as she waited for essential medication and water for herself and her puppy. She emphasized the organization's compassionate approach, contrasting it with the challenges she faces living on the streets.

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