FAJARDO, PUERTO RICO — It is 10:15 a.m. A 5-gallon dispenser filled with ice water rocks to and fro inside a truck belonging to Intercambios Puerto Rico, a nongovernmental organization that advocates for the social integration of people who use narcotics, do not have housing or earn a living as sex workers.
“May I have some water? I’m parched,” a man says, approaching the dispenser. This request is uttered again and again by those who visit Intercambios Puerto Rico meeting points each week.
While a heat wave brings record-breaking temperatures to the region, responsibility for the well-being of thousands of people who live on the street has landed on the shoulders of nonprofit organizations, which bring temporary relief to a community bereft of basic services.
People without housing face bleak living conditions, and more intense exposure to the effects of climate change, especially the heat. In June, the National Oceanic and Atmospheric Administration reported heat indexes of up to 125 degrees Fahrenheit (nearly 52 degrees Celsius) and a new daily temperature record of 95 degrees Fahrenheit (35 degrees Celsius) in Puerto Rico. For those who spend their days outdoors without reliable sources of cold water or ways to cool off, this environment can become hellish.
“The other day, I had, like, a heart failure. My hands stiffened up,” says Juan A. Santiago, a 61-year-old man who spends his days on the street. “It felt like I was having a heart attack,” he says, sipping water from a paper cup.
Rising heat indexes require organizations like Intercambios Puerto Rico to prioritize needs such as providing cooling shelter, water, hats and clothes to people whose needs go far beyond these provisions.
“The first things they ask us for are cold water or juice and fresh clothes because they’re in the street, in the sun and sweating,” says Jomeini Rodríguez, who works at PITIRRE, a clinical care program for people who use narcotics. The program is based in the north of Puerto Rico, where it also provides care to people without housing. “It’s possible for [participants] to be more irritated due to the heat, obviously, because they’re in the sun and it’s unpleasant.”
Every two years, the United States Department of Housing and Urban Development requests a local point-in-time count and housing inventory count. In 2022, a total of 2,215 people without housing were reported in Puerto Rico. Over half were unhoused for the first time, and the majority were experiencing it due to narcotics use, familial problems or economic problems, according to data from Portal Informativo del Ciudadano, which is run by the government of Puerto Rico.
The impact of the high temperatures goes beyond mood. There are consequences for people who use narcotics and suffer from dizziness and nausea. Sweating affects sores and wounds, not only aggravating their condition but also delaying admission to temporary housing. The pain is twofold: the physical pain and that of continuing without stable housing.
J.D.L., 63, asks to be identified only by his initials because he doesn’t want his comments to affect his search for government-funded housing. He appreciates the services provided by community programs like El Gancho, a branch of Intercambios Puerto Rico that replaces syringes and provides snacks and time for conversation. “I spend my time looking around,” he says about how he seeks shelter from the heat.
The big challenge: day cooling centers
In four of the 78 municipalities of Puerto Rico, the government offers shelters to people without housing, “where they can go during the day to receive food, to shower, and to wash and/or change clothing, among other services.” But elsewhere, it does not provide day cooling centers so people who live on the street can keep cool, as happens in other areas of the U.S., where public libraries with air conditioners and parks lessen the impact of the heat and allow people to cool off, get water and use bathroom facilities. “I wash myself at a faucet over there,” J.D.L. says, pointing to an empty street.
Although cooling shelters are scarce in Puerto Rico, the government and NGOs offer other housing types for people like J.D.L., but they have barriers. Global Press Journal interviewed service providers who say intake rates are low for people experiencing narcotics addiction and those presenting with sores.
“The state doesn’t have a way, doesn’t want, or can’t address the situation, so the nonprofit entities have to join the fray to seek out options for dealing with these very complex issues,” says Alex Serrano, the community relations director of Iniciativa Comunitaria, an organization that arranges services for people experiencing social exclusion. “Policies continue to be discriminatory against people who consume narcotics.”
The key aid of the third sector
Belinda Hill, the executive director of Solo Por Hoy, an organization that helps people find housing, says there are shelters for those who do not have stable housing, but she also acknowledges that finding a place to live and keeping oneself safe from the heat has its challenges. The housing available does not always meet the requirements of the people unhoused. Financial problems limit access to affordable housing. The digital divide can be a hindrance because some government assistance requests must be made online.
“For 52% of people who are homeless, it is their first time, and that indicates it is not necessarily a drug problem; it is a financial, family crisis or accessible housing problem,” Hill says. “I had never seen a mother and child sleeping in a car before. That is what’s being seen now.”
The Multisectoral Council in Support of the Homeless Population, a multisectoral alliance created by law in 2007 and overseen by the Anti-Addiction and Mental Health Services Administration, is intended to “promote easy access to existing services.” Even though it was created more than 15 years ago, it is still working to establish systems-based agreements involving municipal governments to guarantee direct services.
“The efforts of the third sector are vital for providing care to people without housing,” says Carlos Rodríguez Mateo, the council’s president. Although lack of funding kept the council inactive for five years, it has begun work to get its mission on track, he adds. In recent months, it reached two agreements to construct housing in the south and east of Puerto Rico. “Discrimination against the homeless population still exists, and it is something we have to work on,” Rodríguez Mateo says.
Both Frederick Cortés, the coordinator of El Gancho, and María Heredia, the coordinator of Punto Fijo, an Iniciativa Comunitaria program, think the best way to help is to minimize stigma and approach the issue from a public health perspective, something that has not been accomplished in Puerto Rico. “Even though we want to provide all services in the street, it’s impossible to do so because, very often, they need medication. They very often need 24/7 care,” Heredia says.
“They don’t take good care of you in the hospitals,” says Édgar Ramos Torres, a 50-year-old man who intermittently lives on the street. “They forget about us. They ignore us.”
To Rodríguez, the PITIRRE facilitator, there is a need to create specialized wound care shelters. “With this heat wave, it’s extremely difficult to find a shelter where their hygiene needs can be properly taken care of, and their sores can be kept clean,” he says of the 500 people to whom they provide care. “I believe the best thing has to be a shelter for treating wounds and where people can tend to their personal hygiene as well.”
The government offers addiction treatment programs to people who use narcotics, but since they are temporary, when a person finishes the program, in most cases, the only option is to return to the streets.
Social worker Jessica Contreras says it is vital to guarantee not only the right to housing but also free will. “You might not believe this, but for many, securing a home is not the priority,” says Contreras, who is assisting J.D.L. in his search for a roof to keep him out of the heat.
“I’m waiting,” J.D.L. says beneath the scorching August sun. “All I have left to do is bring in a paper.” That month tied for the hottest in the history of the Luis Muñoz Marín weather station in San Juan. He still has no place to live. On Oct. 15, Puerto Rico broke another daily record for the highest temperature at that station. That makes 24 times so far this year.