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Long Story Short: Sacrificing health care for daily survival

Oklahoma Watch, May 15, 2024

Shay Swindall lives in a tent, under a busy Oklahoma City overpass, in a sprawling homeless encampment. When she needed a new albuterol inhaler recently, she tried to ration the last few puffs she had left.

Her health had been fairly good before last winter, though, even at age 64, health care was not something she prioritized. There were times she was taken to emergency rooms for problems that could have been managed at health clinics, she said. But finding a ride to providers can be a real challenge.

Last winter, she became desperately sick with double pneumonia and a supervirus. She lay in her tent for at least three days, wet and freezing, burning with fever.

This was no cold, no simple virus that a few days’ rest would cure.

“It was so bad,” she said. “I was so, so sick. So sick.”

Falling in and out of consciousness, she needed help badly but she was too ill to go find it. Finally, someone noticed her condition and called for help.

“I don’t remember getting on the gurney and I don’t remember getting in the ambulance,” she said.

She does remember fighting off the techs who were trying to insert a device down her trachea. She had no idea what was happening to her.

“It was horrible,” she said, tears spilling down her cheeks.

Swindall’s experience isn’t unusual for people experiencing homelessness, data shows. The stories are individual; some involve COVID-19, HIV, uncontrolled diabetes or high blood pressure. Some people succumb to the ravages of winter with severe frostbite, leaving them without their fingers or toes. Some get too hot under Oklahoma’s blazing summer sun and die.

Without reliable and consistent health care and transportation to appointments, every day is a struggle for people like Swindall. Despite hundreds of health clinics and centers that offer free, or nearly-free services, when people experiencing homelessness get sick, they often suffer until they have no other option than going to an emergency room.

When they are dying, services are even more difficult to obtain.

“When you’re in survival mode, your healthcare is not important to you, because first you’re wanting to make sure you have something to eat, and you have to secure yourself a place to sleep that night,” said Tim Chandler, a licensed practical nurse who heads the Community Health and Wellness Street Medicine program of Mental Health Association of Oklahoma.

A trip to a free clinic means a missed meal at a charity. Being away from camp too long can mean returning to find belongings stolen. A cough or stuffy nose, painful back or headache take a backseat to sustenance and safety.

In 2023, in Tulsa and Oklahoma Counties alone, more than 2,500 Oklahomans lived unsheltered or in homeless shelters, according to that year’s Point in Time counts.

Statewide, a few street outreach teams such as the Street Medicine program, as well as onsite clinics at shelters cater, to the basic health needs of those Oklahomans.

The Homeless Alliance offers onsite clinics through their partnership with Healing Hands, a program of Community Health Charities. They offer transportation to Healing Hands on off days.

City Care’s Mobile Outreach and Engagement program, known as MOE, offers daily rides along a route of nonprofit agencies. Other groups offer similar services.

Still, access to transportation can be a constant obstacle for people experiencing homelessness if they proactively seek healthcare.

“For the most part, when somebody takes suddenly ill in the day shelter or the winter shelter, or is seriously injured, (their option is) EMSA and the closest emergency room,” said Dan Straughan in an email to Oklahoma Watch.


Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.

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