Life on L.A.'s Skid Row – the only area of its kind in the country – is worse than ever before. Just ask Andy Bales, CEO of the Union Rescue Mission. About two years ago, he contracted three different kinds of deadly bacteria – E. coli, strep and staph. Now doctors say he'll never walk again, and he may have to get his leg amputated. He spends much of his time in a wheelchair.
"Conditions on Skid Row are worse than they have ever been in the 11 years I’ve been here," Bales says. "And I would venture to say that they are the worst and the most violent and the most lawless they have ever been."
Bales has a long history of health problems. He has Type I diabetes and received a kidney transplant — from his wife — in 2013. Five weeks after the transplant, he took part in a triathlon, a decision that he now admits wasn't his best. A blister from the race turned into the wound that, in his opinion, made him vulnerable to all manner of bacteria festering on Skid Row, despite the fact that he wore a special boot to protect himself.
He guesses he became infected while on a "water walk," where he and members of his staff walk the streets handing out water bottles. A few days later, on a flight to Raleigh, North Carolina, his foot began to ache, and he started to feel feverish.
The infection spread horrifyingly fast.
"If I showed you the pictures, you’d be sick," Bales says. "My foot looked like [something out of] The Walking Dead. I went in [to the hospital] and showed them the foot and said, 'Please cut this off.'"
He had to be hooked up to an IV drip of antibiotics for six weeks just to kill the bacteria. Still, his foot refused to heal. He contracted something called Charcot Foot, which is usually contracted by lepers and diabetics; it rendered his foot and ankle useless. Only when the doctors removed a bone from his foot did his condition stabilize.
But Bales will never again walk normally (he can walk, slowly, with the use of a special boot), and he'll probably always wake up in pain, which he's been managing with medication.
The shockingly unsanitary conditions found on Skid Row are rarely seen outside the Third World. In 2013, public health officials discovered a strain of tuberculosis believed unique to the area. And while all this makes just walking down the street dangerous, for diabetics and other people with compromised immune systems, it can be deadly.
"There are many other vulnerable people like me, diabetics, that are on these streets," Bales says. "I found one young lady, her thumb was black, and she was gonna lose her thumb. It took me an hour to convince her to come in here to our clinic and then go to the hospital. So what I experienced, a lot of the vulnerable people on the sidewalk are experiencing because of the conditions that are out there right now."
According to the latest count, there are more than 41,000 homeless men and women in Los Angeles, a 16 percent increase from two years ago. But those official numbers don't quite seem to capture the magnitude of the epidemic, apparent under many bridges and freeway overpasses. Even in neighborhoods like Silver Lake and Venice, there are dozens, in some cases hundreds, of homeless encampments.
"Venice has become a second Skid Row," Bales says. "If you got to Third and Rose, you will think you’re on Skid Row. There are more than 100 people in tents on the sidewalk."
But nothing compares to the sheer density of people in downtown's downtrodden sector: Anywhere from 2,000 to 11,000 people (Bales estimates 4,000, twice as many as there were when he first started working at the Mission 11 years ago) are living on the streets and in shelters in a roughly 40-block radius, an area that is nevertheless gentrifying even as conditions worsen.
"Now, there’s kids in the tents on Skid Row, for the first time in years," Bales says. He adds that the streets are more dangerous than ever before — so dangerous, in fact, that the Rescue Mission's staff are afraid to walk to lunch.
Homelessness is something that most big cities in America are currently struggling with. But while New York Mayor Bill de Blasio is tackling the problem head on, calling it an epidemic and spending $22 million on a new mental-health initiative, L.A. Mayor Eric Garcetti's response has been rather tepid.
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Garcetti did, in July, declare "war" on homelessness, but he's done little in the way of spending any real money. Last year, he pledged to end veteran homelessness by the end of 2015, but his office has admitted that they'll miss even that goal. The problem, meanwhile, seems to be getting worse. An estimated 13,000 people become homeless in L.A. County every month.
Bales still goes out on water walks – he rolls along in his wheelchair. It's difficult. Sidewalks are often blocked by encampments. The things he sees are still as shocking as ever:
"We saw a guy the other day, he was probably 6-foot-3 and 90 pounds. He was so weak he couldn’t pull up his own pants. He was just standing there shaking. He was one of several people we saw that were that thin and that sick. And they had days, if not hours, to live in that condition.
"It isn’t right to have precious human beings living and dying in this filth, on the streets of Skid Row. To have precious people living in these conditions and dying — it's an embarrassment."