Twice a week, they come here to a place so many of us try to avoid. They park their white van, get out on foot, and spend the morning among people living on the streets by Massachusetts Avenue and Melnea Cass Boulevard.
The team of outreach workers from Whittier Street Health Center have been out here for years, but as the encampments have grown so has their mission to make sure people are healthy, have something to eat, and get a chance to turn around their lives.
And sometimes these workers anticipate what people need even before they do.
One recent gray morning, the temperature barely above freezing, senior medical case manager Diana Sencion had just begun her rounds checking in on the unhoused living around Mass. and Cass. She was wearing bubblegum pink knit gloves. Soon, they were on someone else’s hands.
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Sencion saw Elena Soto, who’s been living on the streets here on and off for five years. The two women embraced, as Sencion whispered a short prayer in Spanish: Dios mio ayudala y dale mucha fuerza. God help her and give her strength.
When Sencion felt Soto’s skin, she knew what to do. She had to part with her North Face gloves, the warmest she owned.
“I knew she was cold. I was cold,” said Sencion. “You have to care about people to do this work.”
On any given day, along with Boston police officers in their squad cars presiding over Mass. and Cass, a stream of outreach workers and nurses from the city and various nonprofits such as Boston Health Care for the Homeless, Eliot Community Human Services, and Victory Programs fans out among the unhoused.
To so many people battling mental illness or a drug problem, these workers are a lifeline.
Whittier, which sits about 2 miles away in Roxbury, dispatches a team of four to Mass. and Cass. Officially, their focus is on preventing HIV, which is on the rise among homeless drug users, easily spread through sharing needles and unprotected sex. So they carry condoms and bleach kits to clean needles, and will test whoever wants a screening for HIV. But sometimes people are just hungry or cold. So they carry granola bars too.
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It’s emotional, exhausting work, to see so many people living in squalor, especially in a city as rich as Boston.
“When I first started coming to Mass. and Cass, I just started to cry,” said Sencion.
She and her colleagues know what’s at stake. People shouldn’t be living in tents. Boston’s streets shouldn’t be open-air drug markets. And every bleach kit or granola bar is an opportunity to start a conversation that could help a struggling person make a decision to get to someplace better than this.
“There is a lot of pain out here,” observed Frank Mitchell, the Whittier program coordinator, as he stood among tents pitched on Atkinson Street. “You never know when someone has a moment of clarity.”
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On a frigid morning just before Christmas, one man wrapped in a blue-and-green flannel blanket came shuffling toward Cornelius Sewell along Newmarket Square.
“How are you doing, man?” asked Sewell as he gave him a flier with information on HIV testing and counseling. “If you need help, man . . . make that phone call . . . You are not alone . . . I am positive too. If I can do this, you can do this.”
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Sewell has been HIV-positive since 2006 after sharing needles with someone he did not know had the virus. Today Sewell is healthy, his viral loads are undetectable. You would not know he is positive unless he told you.
HIV “has no face,” Sewell said. “You have to take care of yourself. You can’t be doing drugs.”
Sewell, who has been a community health worker for Whittier since 2018, encouraged the man in the blanket to seek stable shelter, noting that the city plans to clear the area by Jan. 12 and provide housing for everyone.
“I know [Mayor] Michelle Wu has three sites,” he said. “Two of them are hotels!”
Other days, Whittier’s outreach team visits Nubian Square, Codman Square, South Bay, and the Ashmont neighborhood. But those don’t compare to the destitution at Mass. and Cass, where violent crime and overdoses are all too common.
Sewell saw an overdose just a couple of months ago, right here on Atkinson Street.
“She was purple,” he said. Then several nurses and outreach workers came running to her side. “They brought that girl back to life.”
In his tote bag, Sewell carries Narcan nasal spray, which can reverse the effect of an opioid drug overdose. Has he had to use it?
“By the grace of God, no,” said Sewell.
* * *
As I made my way toward Atkinson Street, where the main encampment is, Whittier community health worker Lamar Booth reminded me to be careful. Hide my notebook. Take no pictures. Never go inside the tents.
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“We are in the war zone,” he explained.
Booth has been working the Mass. and Cass area for five years, and says things have gotten much worse since the tents proliferated last summer. Syringes, feces, and trash litter the pavement. The city has cleared tents from two streets, but dozens remain on Atkinson and in Newmarket Square.
Booth weaved in and out of clusters of homeless people, bellowing “Bleach kits! Masks!”
He has some takers. If people seem disinterested, Booth will ask, “Are you hungry?” He’s got granola bars.
Last week Booth met someone who wanted an HIV test and then became interested in also getting treatment for his substance use. The next day Booth was ready to take him to Whittier, but had trouble reconnecting with him at Mass. and Cass. So Booth and the team piled into their van and picked him up at the Back Bay MBTA Station. It would take several more days, between dealing with health insurance and finding the right facility, but the man got into a detox program.
“When you got someone who wants it, you don’t want to lose it,” said Booth.
That’s also because the moments when people want to make a change are few and far between. People battling substance disorders have to be ready for recovery.
“If they’re not ready to come in, we can’t force them to come in,” Booth said. “That would never work.”
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The pull of street life is real. For too many, the encampments have become their only home. Christmas wreaths adorn some tents; others are fortified with wooden pallets and tarps. One is powered by a loud generator.
“If that is your only community, it becomes a challenge to leave that,” said Whittier Street CEO Frederica Williams, “especially if you are abandoned by your family and society.”
Williams knows one conversation is unlikely to change lives. That’s why her team keeps coming back. Some cases they’ve been tracking for years.
“It is really meeting people individually and knowing their stories and meeting people where they are,” she added.
* * *
Just last week Sencion saw Soto — a 29-year-old mother of six — wandering Mass. and Cass. But the two did not have much interaction.
“She disappears on me a lot,” said Sencion. “She gives me attitude.”
As a medical case manager, Sencion tracks about 75 clients. She checks to make sure they are taking their medications, getting health care services, and have enough to eat. If need be, she will bring them to Whittier for lab work.
Sencion first met Soto in 2017. She got to know her well enough that she threw Soto a baby shower in 2019 when Soto was staying with her mother in Mattapan. Sencion thought Soto had quit drugs, but later a social worker told her that Soto had been using heroin during her pregnancy.
“That kind of broke my heart,” said Sencion. “Here I was thinking she was doing OK.”
On the day I met Soto, she was grateful for Sencion and outreach workers like her.
“They are good people,” Soto said.
Walking along Mass. and Cass, it is hard to imagine that in two weeks the encampments will be gone. More power to Wu if she can pull it off. Tents or no tents, the Whittier team plans to be back in the area as long as there are people who need help.
“We’re out here in the fire,” said Mitchell, the program coordinator. “We are here everyday to pull someone out of it.”
Shirley Leung is a Business columnist. She can be reached at shirley.leung@globe.com.