Street Without Hope

On Madison Street, crowds of crack-addicted homeless are plaguing police and downtown businesses. But no one seems to be doing much about it.

Few homeless drug addicts can get off the streets by themselves. Most need to be led to the doors of programs. And once they're in, they often need enormous support. Unlike addicts from more secure settings, for many homeless addicts entering a program means leaving the only friends and social network they have--on the street.

Candy's route off of Buckeye led from Michael to Kay Jarrell, a county outreach nurse who makes regular visits to the mission.

In an outdoors twist on house calls, Kay Jarrell, 48, and social worker John Gallagher bring health care to sick homeless people living away from the walk-in or hobble-in services available at the county's downtown Health Care for the Homeless clinic. Driving a county van, Jarrell and Gallagher, 29, reach people in places rarely seen by government officials other than police or fire emergency crews. They met Candy on one of their outings to the mission.

Some of their patients come through referrals from programs and shelters around Phoenix. Yet many come straight from wherever Jarrell and Gallagher find them. Their regular patients are as far-flung as Sunnyslope and the homeless encampments in the river bottom, south of downtown. They make the rounds of numerous camps along the canal that flows past the salvage yards and rendering plant west of 35th Avenue south of Lower Buckeye Road.

They manage to earn the trust of outcasts who customarily avoid vehicles bearing goverment seals. Their success stems partly from the fact that they don't play the public-health heavies.

"The regular cant about substance abuse," says Jarrell, "is abstinance is the only way. There's no in between. You just quit."

But she and Gallagher approach the problem in a way that the drug-addiction field labels as "harm reduction"--reducing the harm caused by drug use. The "just say no" crowd might say they're simply coddling homeless dope fiends. But Jarrell says she's more interested in providing basic health care to people who need it.

"People get terrible abscesses all the time by shooting up with dirty needles," says Jarrell. "I give them scrub brushes and antibiotic ointments and Band-Aids, and I tell them not to wait until it turns into the size of a grapefruit.

"What we've found in doing stuff like that is after weeks and months, they begin thinking about doing something different. John and I don't have to remind them about the problems of substance abuse. But we let them know that if they want to change that, we're available."

That's how Jarrell first came to know Candy.
"We really didn't know her as well as some of the other girls," Jarrell recalls. "Maybe all we'd ever done for her, for months, was give her condoms, a blanket or some ointment or Tylenol. But Michael had been talking to me about her, saying that she wanted to get off the street."

When Candy and Jarrell talked initially, Candy asked about getting into Another Chance, a federally funded drug treatment program that the city initiated to target downtown substance abusers.

But Candy would have had to lie about where she was staying to be eligible for the program. The larger glitch, as Jarrell saw it, was the program's outpatient format.

Jarrell's sense was that Candy needed to be taken off the streets and insulated from the life she'd led. "I thought she needed a program with much more structure--one that removed her from the people she ran with. I also thought she needed one that would keep her working and give her a family setting."

Jarrell got lucky and found a spot for her in the Salvation Army's A.R.C. program, one of the more highly regarded residential treatment programs. It's a six-month term that involves extensive work in classes, counseling and job training.

The Salvation Army declined to discuss the specifics of the program Candy is in. But former and current patients say its boot-camp discipline provides what many homeless people lack on the street.

It gets people up and fed in the morning, takes them to work at the Army's distribution center on South Central Avenue, and closely monitors their daily progress. The 13 women in A.R.C. eat and sleep in the family setting of a group home in central Phoenix.

Candy says softly that the program is forcing her to look at her past with a clarity and honesty that scares her.

"Yesterday, they asked me to write a letter to my mother but never mail it, because I don't know where to mail it at. It's hard to write to somebody. It's hard to think about that right now."

She begins to cry, pauses to dab her eyes with the back of a hand, then continues: "I guess I'd just tell her that I miss her a lot. And that I'm sorry. I hurt my mother. I hurt my whole family. Otherwise my life probably would have been different.

"I have four kids. I have two kids in Alabama that I don't have any contact with. And I have two kids here. I have a daughter on crack cocaine. She's probably messing with it because that's what she saw her mother do. I have a son that just got out of prison a year ago.

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