Oh my GAWD it's freakin hot, even for the South! The only other time I've had to deal with this kind of heat was when I spent time in Death Valley, California!
It's so hot that when I stepped off the porch and into the direct sun yesterday, the temperature had weight to it and you could feel the heat pressing on you; and I mean pressing on you, like it had some physical presence against your body.
Folks on the street are staggering around, looking for respite in damned near any place they can find it, and many of us who normally try to spend time on the streets helping others are finding any excuse we can not to go out in it. This is a rare change because most of the time, folks are out in every kind of weather, but I'm telling you, this heat is beyond ridiculous.
I submitted a piece to the homelessness resource center recently that should come out there soon and I'll share it here, because it deals with outreach in the heat and may help some of you in your efforts.
Beating the Heat on the Street
As an outreach worker and a formerly homeless person in recovery, I know firsthand the impact hot summer days can have on those of us who must survive almost continual immersion in the natural elements. Much has been written on the clinical symptoms of hyperthermia and the signs and symptoms of exposure to extraordinarily hot summer days are important to know and recognize.
Heat-related illness occurs when a person’s body is unable to compensate for the increase in temperature and properly cool off. Cooling occurs normally by sweating and evaporation but in some situations an individual’s perspiring is simply not enough to get the job of cooling the body done. When this occurs, a person's internal temperature can quickly rise into the danger zone and if left unchecked, the high body temperature may damage the brain or other vital organ and could result in death. Joseph Rampulla explains that “heat waves account for more deaths than all other natural disasters combined in the USA (2004). He reminds us that the poor, elderly, children and those individuals who isolate themselves are both at very high risk and are “disproportionately affected” by extreme heat.
The Center for Disease Control (CDC) states that “Extreme heat is marked by temperatures that stay 10° or more above the average high for a region over a period of weeks” and provides the following information to recognize heat related emergencies:
• Heat cramps are painful spasms of the leg or stomach muscles that may be accompanied by heavy sweating. They do not require medical attention, but the person should stop all activity, sit quietly in a cool place, and drink water, juice, or a sports drink.
• Heat exhaustion is marked by extreme fatigue, heavy sweating, thirst, headache, dizziness, fast and shallow breathing, nausea and vomiting, pale and moist skin, and a fast, weak pulse. If untreated, the symptoms may progress to heat stroke.12,14 Cooling measures may include rest in an air conditioned environment; light weight clothing; cool, nonalcoholic beverages; and a cool shower or bath.
• Heat stroke is a life-threatening hyperthermic condition caused by breakdown of the body’s thermoregulation. The skin no longer sweats and becomes red, dry, and very hot. Body temperature is above 103°F and can rise rapidly to 106° F in as little as 15 minutes.14 Chest pain, shortness or shallowness of breath, and abdominal pain may be present along with confusion, anxiety, a rapid pulse, and throbbing headache. Until emergency medical care arrives, caregivers should start to cool the person rapidly with whatever methods are available: remove extra layers of clothing, fan, wrap in a wet sheet, sponge with any cool liquids, or spray with cool water from a garden hose.
While the medical aspects of over-exposure to heat are certainly important to understand, they are not the only issues individuals face when the mercury rises. Sweltering days may cause significant difficulties in the daily routine of individuals while increasing overall risk factors to those who must endure them. My own anecdotal street experience in dealing with the heat on the street has found that when the weather turns oven-hot for days at a time, cities get even hotter, thanks to heat-absorbing properties of asphalt and concrete, creating the “urban heat phenomenon” (Rampulla, 2004).
People experiencing homelessness are already under significant stress from difficult living conditions and adding unbearable heat for long periods can reduce coping mechanisms; tempers may increase as patience and tolerance can shorten. Several other troublesome issues arise; insomnia increases among many people experiencing homelessness due to intolerable sleeping conditions; the heat increases the risk of food spoilage and resultant illnesses for those without access to refrigeration; and hot temperatures also causes some to take increased risks in order to beat the blazing heat by swimming in dangerous and/or polluted waters, trespassing to access cool areas, drinking alcohol more heavily than normal, using drugs to escape the misery, etc. Alcohol and coffee are diuretics which can quickly deplete the body of available fluids, while certain drugs, especially amphetamines or cocaine, create hyperthermic responses in the body under normal conditions; using speed, crack or cocaine during heat waves can spell disaster for the individual.
I approach outreach differently during very hot days. If one is available, I try to use a large air conditioned van and fill several coolers with ice and bottled water. I make my rounds around the city and offer “cool seats” inside the van when I encounter people on the street. I have a small dvd player and a selection of comedies that folks can watch as they take 30 minutes to sit in a cool environment and rehydrate themselves. I also provide free “shuttle service” to the local libraries and day shelters so folks don’t have to walk to “cooling centers” in the heat. I try to regularly visit those people I know to have serious and/or chronic health issues that make them more susceptible to the heat. Finally, I purchase extra daily bus passes and hand them out so individuals can escape the heat by riding air conditioned public transportation.
Summertime brings with it additional dangers and problems for those on the streets, but it also brings new opportunities for outreach and engagement as well. A kind face, a cool seat, a short ride, a bottle of iced water, and a bus pass will be remembered by those you’ve helped for a long time to come, and you may just save a life in the process.
CDC. (2007). Emergency Preparedness & Response. (2007). Centers for Disease Control
and Prevention. http://www.bt.cdc.gov/disasters/extremeheat/heat-guide.asp
Rampulla J. (2004). Hyperthermia & Heat Stoke: Heat-Related Conditions, In The Health
Care of Homeless Persons: A Manual of Communicable Diseases and Common Problems in
Shelters and on the Streets, Boston Health Care for the Homeless Program.
http://www.bhchp.org/BHCHP%20manual/pdf_files/ Part2_PDF/Hyperthermia.pdf
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