“Is he alive?”
The man was splayed on the sidewalk near the intersection of Massachusetts Avenue and Melnea Cass Boulevard, just before 10 a.m. under a searing August sun.
The query came from Frank Mitchell, who was making the rounds with his crew of outreach workers from Whittier Street Health Center. They walk the area a couple of times a week, wading into a sea of humanity that congregates there.
“Yes, we checked,” replied Angela Melo, a high acuity case manager for Whittier.
The incident ― more routine than anomaly ― is a reminder that while Mayor Michelle Wu of Boston may have taken down the tents and found housing for people living on the street around Mass. and Cass, more than 100 people continue to do just that in the area, a number that swells on weekends.
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Progress, it seems, depends on your perspective.
By many accounts, it was much worse last year. Several hundred people occupied encampments stretching from Atkinson Street to Newmarket Square, an area that can feel like an industrial no-man’s-land at the confluence of the South End, Roxbury, and Dorchester. Wintertime was particularly perilous, with people building fires to keep warm.
But the violence endemic to the area remains, as does the open-air drug market with people shooting up in public, leaving the ground littered with bright-orange syringe caps. A humanitarian crisis continues to unfold with people huddled under patio-size umbrellas, sleeping on blankets, and using wheelchairs as seating.
“This has been going on for years,” observed Mitchell, a Whittier program coordinator. “What is the endgame?”
A twin scourge of opioid addiction and homelessness has drawn people to Mass. and Cass., where those battling addiction can seek methadone treatment or a bed at city-run shelters. Conditions began to deteriorate after the sudden closure of the city’s Long Island recovery campus in the fall of 2014, when the Walsh administration declared the bridge to the island unsafe.
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The pandemic deepened the despair, and tents began going up in droves in spring 2021, with upwards of 200 appearing in a matter of months. Encampments have been a fixture in other major cities — from San Francisco to Philadelphia — but not in Boston.
The tents flourished because no one was in charge at City Hall. Mayor Marty Walsh had left to become US labor secretary in March, and Kim Janey had taken the reins as acting mayor while also locked in a tight mayoral race.
Suffolk County Sheriff Steve Tompkins tried to fill the void, as he watched the tents pop up outside the South Bay House of Correction on the corner of Bradston and Atkinson streets. He proposed converting empty space at his detention center into a drug treatment facility with dorm-style accommodations featuring common areas with sofas and TVs.
Tompkins got support from Governor Charlie Baker, Attorney General Maura Healey, and then-Suffolk District Attorney Rachael Rollins. It was one of several proposed solutions, but public health leaders balked at the idea because it would involve police arresting people on outstanding warrants and forcing them into treatment. Instead, doctors and advocates favored an approach centered around housing and health care.
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And since Wu was elected in November, that is the approach she has taken.
Tompkins — who endorsed Wu in the primary and considers her an ally — said the area feels safer than a year ago, thanks to stepped up law enforcement patrols and private security hired by the Newmarket Business Association. Tompkins, who is seeking reelection as sheriff, said he’s hopeful that one day there won’t be people living on the streets, but it will take time.
“She’s rolled up her sleeves,” Tompkins said of Wu’s efforts. “They’re going to put some muscle to this and try to make it happen.”
Business owners are less sanguine.
“What is the plan?” asked an exasperated John Fish, chief executive of Suffolk Construction, whose Roxbury headquarters is a few blocks away from Mass. and Cass.
Fish, who is an early riser, called me recently after seeing a trio of prostitutes in front of his building at 4:30 a.m. He has told me similar stories of seeing U-Haul trucks turned into makeshift hotel rooms.
“I can’t believe ... this is allowed to go on,” said Fish. “I have 400 employees at Suffolk. What do I say to them?”
According to Boston police, arrests in the Mass. and Cass area are up significantly year over year. There have been no homicides, but violent crime is up slightly, while property crime is down by 15 percent. Earlier this month, police working with the Suffolk district attorney’s office conducted an undercover operation that resulted in the arrests of a dozen men charged with soliciting sex.
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Tania Del Rio, who is coordinating the city’s response team on Mass. and Cass, understands why frustration is high in the business community. The city estimates the area continues to draw about 100 to 250 people a day, even though some have housing.
“My heart is with the businesses,” said Del Rio, who took on the role in June from Dr. Monica Bharel. “It’s not easy to go through what they’ve gone through and are still going through.”
As for a plan, Del Rio said the city remains focused on finding and creating housing for those living on the streets, as well as providing them with drug treatment and other services. Since January, 326 people have been placed into housing. Of those, 45 have found permanent homes, while 173 continue to live in six transitional housing sites set up for people from Mass. and Cass.
“This is a tough disease, so everybody is going to have a different path to their recovery, but obviously the city’s vision is for as many people to enter that pathway into recovery as possible,” said Del Rio.
That’s why you’ll find outreach workers on Mass. and Cass., hoping a chance encounter will spur someone to turn around their lives. In December, I walked the streets with a four-person team from Whittier Street Health Center on a bitterly cold day. Earlier this month, I was out with them on one of the hottest days of the year.
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“Ice water!” bellowed Whittier worker Lamar Booth.
“Agua!” shouted senior medical case manager Diana Sencion.
Within minutes, two cases of bottled water were gone. They ducked into a nearby convenience store to buy two more.
The Whittier team focuses on preventing the spread of HIV. It hands out condoms and offers rapid testing for HIV. But team members also give out other essentials, such as bleach kits, masks, and hand sanitizer. And if anyone decides they want detox treatment, they are ready to get them help.
These outreach workers come to Mass. and Cass often enough to differentiate between newcomers and regulars.
Sencion gave me an update on one of them, Elena Soto, who has been living on the streets on and off for five years. Sencion caught up with Soto in December, and when she felt how cold she was, Sencion took her own gloves off and gave them to Soto. The moment just before was captured by Globe photographer Craig Walker in a memorable front-page image, and readers responded by sending Sencion more gloves and other clothing to hand out.
Sencion said she saw Soto in May during a medical check-up. She has housing and is getting healthy.
“Elena is doing amazing,” said Sencion.
Last time it took us more than two hours to make the rounds on Mass. and Cass. This time, we were done in a little more than an hour.
It can be difficult work to see so many destitute people, but not for Melo, the high acuity case manager.
“It is a gift,” she said. “It makes me feel like I am doing something good. ... Let’s hope it gets better.”
Shirley Leung is a Business columnist. She can be reached at shirley.leung@globe.com.