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What do we learn from a year-long intervention on behalf of an unhoused neighbor who lost limbs to Winter Storm Uri? That it takes dozens of interveners to make up for San Antonio’s broken safety net and lack of climate preparation.
Part One: Death By Climate Change
Words by Marisol Cortez / Media by Greg Harman
I’m the one who lives in the neighborhood, so when the news comes I offer to ride down the street. I’m shaking. On my way out it occurs to me to grab a sheet from my bedroom—the prettiest one I have, green leaves on white cloth—which I roll up and wedge between bike seat and bike rack. A sheet is the least we can do.
When I arrive I can’t tell if I see him there on the ground, small and twisted and burned up by the sun, or if it’s the contortions of his cast-off, fawn-colored sleeping bag. In the last few days our small team of helpers has gathered the semblance of a bedroom––a tent, a chair, then a plastic dresser—at his single-person camp beneath the Nogalitos Street off-ramp, just feet from the massive interchange between I-35 South and US Highway 90. Truck traffic roars by night and day, choking the air with exhaust at this southwestern corner of downtown San Antonio.
I’m across the street from his camp, scared to get too close. For a while I just stand there astride my bike, heart thumping, watching some neighbor’s loose, ill-mannered pug sniffing around the camp and pissing on things. It has the audacity to bark at me from across the street as I note a half-full bottle of green antiseptic perched on the dresser. Was that how it happened, my mind scrambles, drinking that stuff for the alcohol content? Isn’t that a thing people do sometimes, if they’re desperate? I’m trying to individuate each visual detail so I can absorb it all into memory and write it down later, taking a picture with my mind so that the pictures can turn into words.
But Albert isn’t there.
I text the small group of folks who have made regular visits to this small camp for the past several months: I don’t see him. But where are the cops the Councilwoman’s office had mentioned? Surely they’d still be hanging around?
I think of the Jesus story, all his friends gathering at the tomb three days after his crucifixion, only to find it empty.
Then the Councilwoman’s staffer texts again: This might be a different Albert. Sorry y’all, for the confusion. We’re up here at the other house, body is still on the ground.
At almost the same moment I see Albert rolling up the street like the resurrection, silhouette bursting into view behind the white hot September sun, maneuvering his chair with his stick arms and the toeless stump of one leg, the other cut off below the knee.
I’ve known for a while, just from staying in one place for long enough, that those who are unhoused, whose best option for whatever reason is sleeping out of doors, are also part of the fabric of a neighborhood. Neighbors. There are a couple I recognize in this neighborhood—a tall white man with longish, floppy white hair and a loping stride, and Albert, always slight and now fragile, who until recently stood regularly at the corner of S. San Marcos and Pendleton, primary exit point for cars leaving the neighborhood. Sometimes his lips would move as he sat on the wall fingering the pages of a Bible, but he didn’t proselytize or solicit or otherwise interact with passersby. We came to recognize each other, catching his eye and nodding if we crossed paths.
A few decades ago, this neighborhood just south of the Union Stock Yards had the dubious distinction of being known as el barrio de la tripa on account of the cattle, meatpacking, and hide-processing industries it bordered. In an essay about Archbishop Patrick Flores, who as a young priest served as pastor at a neighborhood parish, Bishop Emeritus Ricardo Ramirez describes how “the blood and offal generated by the large volume of cattle slaughtered there every day … spilled over into the unpaved streets and formed red puddles. Children played in the streets amidst the stench and the swarming flies. … Numerous calls to the city authorities and letters of complaint regarding these problems produced no results.”
Though the name of the neighborhood doesn’t translate well into English, communities whose histories of racialized exclusion include culinary traditions of eating intestines—menudo, chitlins, tripe stew—will understand the term as vaguely pejorative or at least cynical, referring to the scent and sight of disembowelment, of blood and excrement. La tripa is that part of the animal no one quite wants (but which is still quite tasty when cooked well), relegated to those whose own lives have been made disposable. One hundred years ago, as detailed in recent books by environmental scholars Char Miller and Kenny Walker, the 1921 flood claimed hundreds of lives, a wall of water roaring down the Westside creeks and turning them into graves. Fifty years ago, another sixty after Sinclair wrote The Jungle, Flores and Communities Organized for Public Service had to bring the state Attorney General on a field trip to el barrio de la tripa to finally win regulation of the meatpacking industry there.
I’ve lived here about ten years. I’m not from this neighborhood, but I don’t feel like I’m not from here; my dad’s parents grew up on the Westside, a little farther north along the same creeks that run near our house. We live downstream of where they grew up, just south of where the Alazán and Apache Creeks converge with San Pedro, which then flows into the San Antonio River as it runs downhill to the Gulf of México, where I was born. When I say my grandparents are from the Westside, those whose families share similar roots will understand I mean that they were relegated spatially.
Through my grandfather’s military service, though—if you can call it that; economic conscription might be more accurate—my dad’s side was able to attain a mobility that in just two generations took them from poverty to working class to professional middle class. A lot of what neurodivergence and disability has meant both for me and my partner is that we could not hang onto whatever economic advantage our parents managed to pass down. In some ways I’m demographically out of place in this working poor neighborhood, but at least some of the reason I’ve stayed here is because it was where I could afford to rent and then buy.
If I had more means, I might not stay, I might look for a house farther away from the ugliness of the highway off-ramp that soars through the sky at the end of the block, blocking out that sky—somewhere more shaded and canopied by trees so that you don’t risk sunstroke just walking around. It’s not the neighborhood I dislike but the physical expressions of denial and neglect that have assaulted it, the histories of transportation racism and ecological violence that have made highway planning a destroyer of neighborhoods of color the country over. Nowhere is this clearer than where Interstate Highway 35 crosses San Pedro Creek just outside our neighborhood.
The concrete channel of the creek runs far below street level, its anaerobic shallows strewn with garbage and slick with green algae. Above, the off- and on-ramp to I-35 is so tortuously conceived and carelessly engineered it’s hard to believe there aren’t car crashes here everyday—besides the regularly plowed-down stop and yield signs, that is. That there aren’t testifies to the ways we become intimate with a place, careful with each other, however little master planners have valued our lives. Who threw together this haphazard intersection, when and where, in what boardrooms and official spaces? It feels impossible to know, impossible to research, the abstract origin of the power that so forcibly organizes the spaces we now live and move in.
This, then, is where we’d regularly see Albert: the unconsidered corners and sidewalks and medians of the I-35S off-ramp to Nogalitos Street.
And this is Albert’s story, told with his permission and collected over a period of eight months, May to December 2021, in which I worked alongside a small team of people to locate secure housing and medical care for one unhoused neighbor who lost limbs following Winter Storm Uri.
In the end it would take dogged determination by dozens—an Indigenous-led street medic team; multiple city outreach workers; housing justice activists; ordinary neighbors and writers like myself; three governmental jurisdictions; the psych ward of a local hospital; the state’s protective services department, and ultimately the county temporarily taking over Albert’s power of medical decision-making—to keep him from being returned to the streets to die.
HOW DID YOU FARE IN THE WINTER STORM? WHO IS TO BLAME? WHAT SHOULD BE DONE?
Fill out Deceleration‘s survey before we submit to San Antonio City leaders next month: SURVEY: How Did San Antonio’s Winter Storm-Related Utility Outages Impact You? | ENCUESTA: ¿Cómo le afectaron los cortes de servicios públicos relacionados con la tormenta invernal de San Antonio?
As an intimate portrait of how climate change affects the most vulnerable and intersects with other public health crises like the opioid epidemic, it is, perhaps predictably, a story about the gross inadequacy of existing resources for unhoused people with multiple disabilities. Less predictably, it’s also a story about what is possible when people pushing from the outside team up with those pushing from the inside, collectively refusing to believe there is no solution to a situation like Albert’s. For in a world where industry-driven global warming is only accelerating, such situations will only increase—meaning these unexpected alliances between inside and outside agitators open important space for thinking about what harm reduction as philosophy and practice might look like as a response to climate as well as addiction.
For years Albert hung out on the corner of Pendleton in front of the highway, before he disappeared for a time in early 2021. And then, one Sunday afternoon in May, when it was still raining every week, he reappeared, lying on his side along the entrance ramp to I-35N, in a marginally public but highly visible patch of grass that makes it a popular spot for campaign signs. With municipal runoffs just a couple weeks off, he lay completely still in a field of beaming office seekers.
I didn’t recognize the man curled up in the wet grass, partially shielded by an awkwardly propped umbrella, because he was considerably thinner than the man with the Bible I’d seen for so many years on the other side of the highway. That man had been able-bodied, so the wheelchair he lay beside also threw me off. I can’t remember where we were going that day, only that we spotted him as we pulled onto 35 North and immediately pulled off to circle back again, scared he was dead. As I approached to ask if he needed medical attention, I noticed he was an amputee, one white-bandaged leg recently removed just below the knee.
As I would learn after we began to meet with him regularly, Albert lost two limbs after acquiring frostbite during Winter Storm Uri in February 2021—not only the one leg I saw that day, amputated below the knee, but also eventually part of the foot on his other leg. He’d been laid up at Brooke Army Medical Center for months following the storm, and still had unhealed wounds on his arm from a skin graft. In that regard, Albert was one lesser-visible impact of a climate disaster that claimed hundreds of lives during statewide power and water outages that for millions lasted for days on end. Nearly a year after the disaster, the Texas State Department of Health Services has updated the official death toll to 246, although a May 2021 report by BuzzFeed News has used an analysis of excess deaths to estimate that approximately 700 people lost their lives.
Albert waved me off that rainy day in May. But I couldn’t dislodge from my mind the wrongness of seeing a man in such fragile health lying on the side of that obscene highway on-ramp in the rain, and messaged Yanawana Herbolarios to see if anyone from their street medic team could check on him. Having worked with the Herbolarios previously to assist a disabled friend who lost power during Winter Storm Uri, I knew about their powerful, trauma-informed mutual aid work with the unhoused community, and I was grateful to have someone to call other than the cops or EMS. Someone I knew would respond with care and keep following up for as long as it took.
That day the Herbolarios sent Monica, a nurse who’d worked both in Haiti and pediatric emergency medicine. She found Albert vomiting black bile and called EMS; she also filed a report with Adult Protective Services (APS), the first of four we would end up submitting over the next several months.
Later that night, Monica texted me updates—His name is Albert, she wrote—and we exchanged hopes that with the involvement of an APS case worker, the hospital would not simply discharge him back to the streets. But several weeks later, I started seeing Albert in the neighborhood again. Sometimes in the street trying to maneuver his wheelchair, sometimes on his usual corner.
By that time the rains of May had stopped and summer had begun, daytime temperatures rising to the triple digits. Day after day I drove in and out of my neighborhood, and every time I saw him Albert looked thinner and sicker. The urgency of the situation presented itself fully in mid-June during a routine errand. Turning onto the access road, I saw Albert lying in the grassy median beside four lanes of roaring highway, spreadeagled beside his wheelchair beneath the Nogalitos off-ramp. Hazard lights on, I quickly pulled over to see if he needed medical attention, kids waiting for me in the car. As I crouched down beside Albert to introduce myself as a friend of Monica’s, I was alarmed to see his condition: He was emaciated, with open wounds on his arm attracting flies—the result of a skin transplant surgery that had not fully healed, I would later learn—and dried feces caked on his legs. His remaining foot, now partially amputated, was wrapped in a dirty boot.
Again he declined medical assistance, but I called the Herbolarios anyway, and at their recommendation contacted the City’s homelessness outreach hotline to see if I could get him on a list for rapid rehousing. I knew from Monica that he didn’t want to go to Haven for Hope, the City’s sprawling mega-shelter campus. An intended one-stop-shop for wraparound services, many in the unhoused community had come to regard it as unsafe, or else overly exclusionary for its two-tier program (case management and supportive housing for those able to commit to rules on substance use, outdoor sleeping courtyard for everyone else). Monica had also mentioned that Albert didn’t want to be separated from a caregiver friend, though he’d indicated he was open to more permanent housing options.
It’s urgent, I told the intake worker after a long hold. I’m really worried he won’t survive this heat. I paced up and down the unshaded streets as the intake worker took down my information. I’d tried to place the call from beneath the highway in case they needed to talk with Albert directly, but the rush of vehicles behind us was so loud I could barely hear.
Not unsympathetic, the intake worker said there wasn’t an emergency housing waitlist per se, only an outreach team that could check on Albert and take him to a shelter or hospital if necessary. If he declined either of those options, though, there wasn’t really anything else they could do. For good measure I also called and texted Albert’s APS caseworker, but I never got a response.
Monica had given me another number, though, for a social worker employed as a homeless outreach specialist with the City’s Department of Human Services (DHS). She’d found him unusually helpful, she said. So I texted Daniel Groven, and he texted back. The following week I typed up notes on interactions with Albert to date, cc’ing Yanawana Herbolarios’s founder and operations director Maria C. Turvin, and the three of us agreed to meet in the neighborhood to put our heads together on how to help Albert.
Thus began a months-long, intensive push from both outside and inside the system—between Groven as a city outreach worker; Turvin as head of a radical street medic collective; District 5 Councilwoman Teri Castillo’s office as city leaders with roots in housing justice work; and myself as Albert’s neighbor and writer of notes, emails and, finally, this story—at getting Albert off the streets and saving his life.
I’m uncomfortable reading that back: it sounds dramatic and missionary. But it really was a life-or-death situation. Now 54, Albert had been on the streets for 15 years when he became gravely disabled by Uri, with no remaining family members who could take him in. Neither were any of the city’s emergency shelters medically equipped to accept him. His only companion was another unhoused friend, a functional heroin user who brought Albert food and, yeah, street opioids to manage the pain and trauma of being a double amputee living outside amid extreme cold and heat.
Statistics on how accelerating extreme weather events have affected unhoused folks are hard to come by, in no small part because many cities do not track the numbers of people who die on the streets (let alone suffer grave disability or hospitalizable injury). With little systematic data collection, the best indicators of climate change impacts may need to be extrapolated from very localized situations. For instance, Arizona’s Maricopa County reported that heat was “the primary or secondary cause of death” for 146 people living unhoused in 2020 during Phoenix’s hottest summer on record. Similarly, the June 2021 heatwave in the Pacific Northwest killed at least 91 people in Washington State; while not all counties tracked how many of these were unhoused, those that did reported that a substantial number of the deaths under investigation were of unhoused or inadequately housed people.
Closer to home, the toll of extreme heat and cold on the unhoused community is equally hard to quantify. Eric Samuels, President/CEO of the Texas Homeless Network, has tallied eight deaths among people experiencing homelessness on account of Uri, but stresses that this is likely an undercount. “I’m sure others died due to the storm that we haven’t learned about and will probably never learn about,” he wrote to Deceleration. “And there were without a doubt many more that were hospitalized or rendered disabled as a result of exposure,” though neither THN nor the South Alamo Regional Alliance for the Homeless (SARAH) knows of any agency that tracked this data. This points to a broader gap in the recordkeeping: Although San Antonio-area agencies track the total number of homeless deaths by year, no one “specifically tracks the cause of death for people experiencing homelessness,” according to SARAH’s Executive Director Katie Vela.
In the absence of data, all we have is the anecdotal. Though early counts excluded San Antonio from those cities reporting deaths of unhoused people following Uri, Turvin and her medic team suspect that one client who disappeared during the freeze–“none of us have seen [them] since”–actually died. Over her six years working with the unhoused community, she has also noted an awareness of the unprecedented nature of Uri. “We always had folks that were like, ‘Oh, it’s cold, it’s cold, but we’ll survive, we’ll make it,’” said Turvin.
“Shoot, even when we were out right before Winter Storm Uri, they were like, ‘Aw, we’ve been through cold before.’ It wasn’t until a few nights in that they were like, ‘All right, nevermind—we haven’t been through cold like this.’”
After Uri, in fact, the City’s Homeless Services Administrator would email Turvin and other outreach workers to collect data for the first time on the number of clients who had sustained frostbite injuries that year.
As for the heat, Turvin as a street medic has tended to treat more heat injuries in housed people (during protests, for example) than in the unhoused, simply because the latter are more accustomed to surviving San Antonio’s brutal summers. “But they are very aware of those things out on the street,” she said, “because they’re out on the street! Like the whole frog in the pot of boiling water? That’s our houseless folks out there.” And yet, she continued, “I have had a few folks cry over the summer to me, and early fall, telling me that they’re getting older and it seems to be getting hotter or it seems to be getting colder, and they don’t know how much longer they can do this.” In that way, she says, she is starting to see climate disruption register on a very intimate, lived level with those living unhoused, “even if they don’t know the terminology for it.”
Despite regularly alerting residents to the public health challenges of climate change, the City’s Climate Action and Adaptation Plan does not propose anything specific for protecting the unhoused from increasing extreme heat and cold, though an action dashboard suggests that an expansion of mobile health clinics, “with a focus on underserved areas of the community,” is “underway.”
Similarly, in their final report on Uri, the City’s Disaster Preparedness Committee affirmed what many volunteer first responders had already seen on the ground: Both City and CPS failed “to adequately respond, provide timely information, and quickly mobilize resources in a time of need” compared to community-led mutual aid efforts, which “organized food and water distributions, delivered hot meals and blankets to senior living communities, and provided direct cash assistance to families through mutual aid funds. In many cases, community-based groups were the first to identify and respond to emergency situations involving our elderly, homebound, homeless, and digitally disconnected residents.”
This is, however, the sole reference to San Antonio’s unhoused community in the City’s planning for future climate disasters. In fact, the updated Hazard Mitigation Plan from November 2021—intended “to evaluate successful mitigation actions and explore opportunities to avoid future disaster loss”—not only fails to address the unique challenges of extreme weather for people experiencing homelessness, it includes the “homeless population” as one of the “hazards not [otherwise] listed” posing “a wide-scale threat to your neighborhood,” as written in by five percent of 174 residents surveyed (just shy of “Invasive Plants and Pests” at six percent).
One Sunday in August, I would notice Albert’s wheelchair standing empty at his camp. After another day passed without seeing him in it, I flagged down his companion Jake (not his real name) to see if he knew where Albert was. As it turned out, he’d been hospitalized. Heat got him, Jake said.
Hearing that, our small team called every area hospital, finally tracking Albert down to an acute care unit at the Medical Center. “That’s the one that can’t turn anyone away,” Turvin explained, “so even though it’s further from downtown, sometimes that’s where the houseless folks do end up.”
Once more, we were hopeful we might coordinate with the hospital social workers and APS—Groven had filed another report—to come up with some other option for accessing the long-term rehab and nursing care Albert needed. But once more we found ourselves running into a catch-22 at every turn, in which the institutions and agencies tasked with caring for the most vulnerable claimed they could do nothing if Albert declined help. And Albert declined help, we had come to suspect, because he relied on street opioids to manage his pain and trauma. In this way, the public health challenges of accelerating climate change intersected with the ongoing, but also intensifying, public health crisis of the opioid epidemic.
Meanwhile, a man in our neighborhood was literally dropping limbs before our eyes as he wasted away.
Next week, come back for our second installment of “‘His Name is Albert’: Lessons from a Polar Vortex.” In “Mutual Aid Gets the Goods, Or: The Murphy Method,” we enter into the headspinning labyrinth of barriers and exclusions that make San Antonio’s landscape of homelessness services uniquely inaccessible to the city’s most vulnerable residents—and learn in the process what it takes to collectively pierce the escape velocity of this bureaucratic paradox.
Greg Harman contributed reporting to this installment.