In Litchfield Park, where Camelback Road narrows to one lane, a gate near the side of the road surrounds a stretch of land with no buildings in sight — just dirt, silence and the White Tank Mountains in the distance.

But it is somewhere special. White Tanks Cemetery is the final resting place for hundreds of Maricopa County residents, some of who died while living on the streets.

One of them was Diana.

The woman only known by her first name at the Andre House of Hospitality had trouble taking care of herself. Ash Uss remembers staff bribing Diana with a sandwich to get her to shower.

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"She was so chronically ill," said Uss, advocacy and partnerships coordinator for the Andre House, a day center for people experiencing homelessness.

When the news spread of Diana's death, Uss said she rushed outside and cried before finding Diana dead near the gates of the Human Services Campus.

"We were sitting near her and outside with her. It was about four hours where she was just lying dead on the cement under a sheet," said Uss on waiting for the Medical Examiner's Office to arrive and remove her body from the street.

"And then the Office comes and examines her and takes her away. And you never see that person again. That's trauma. That's traumatic."

Not afraid of death

Tears fall down 24-year-old Willy Bean's face as he talks about his grandfather, who was homeless when he died on a Phoenix street.

"The one that died right in front of that gate, my grandpa," Bean said, pointing his finger west while sitting inside Andre House. "Do you know that gate in front of CASS, where all the cars park at, every Sunday morning? Right there by the Cadillac? That's where he died."

Bean and his grandfather were homeless together.

Before living in Phoenix, Bean was raised in the South. He said he started experiencing homelessness when going in and out of jail.

"I was the last one that spoke to him before he passed away," Bean said, crying. "And he'd be my backbone."

Jay Minich, director of finance and administration for Andre House said at least six individuals living on the streets have died this summer.

"Most of us don't know what it is like to deal with survival conditions," he said.

The Maricopa Association of Governments found 6,298 individuals in the county were homeless on the night of January 22 in its 2018 Point-In-Time Homeless Count.

The count found 2,619 were unsheltered, a 27 percent increase from 2017. The Maricopa Association of Governments defines unsheltered as an individual living anywhere not designed for living, such as on the street, in a car or an abandoned building.

Uss remembers another guest called "D" who collected heart-shaped rocks and gave them to people.

"That's how I know her as, but to most people, they only know her as a homeless person or no one, because she just died on the street," Uss told The Republic.

Teraunce Mendez Gonzalez, 24, and his mother became homeless due to financial problems.

He said people look at him like he's a criminal.

"They have to see it from our point of view. Not all of us are bad people, not all of us wanted to be out here in the streets," he said.

Even though Bean and Gonzalez have seen other individuals die, they are not afraid of death.

"I don't want to die on these streets," Gonzalez said. "I'm not afraid of death. I just don't want to die homeless."

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Leading causes of deaths

According to a 2017 report by the Maricopa County Department of Public Health, 26 percent of heat-associated deaths occurred among homeless individuals. The department estimated 94 homeless individuals died due to the heat between 2016-2017.

However, heat is not the only significant contributor to death on the streets.

Chief Medical Examiner Jeffrey Johnston said those experiencing homelessness are more likely than other county residents to die by accident or homicide and less likely to die by natural causes or suicide.

The county health department will soon begin to study the causes surrounding deaths of the homeless population.

"Maricopa County Department of Public Health is interested in the causes of death for our homeless population specifically because this is a group that often experiences many barriers to accessing preventative health and treatment services," spokeswoman Jeanene Fowler said.

According to Fowler, national research has shown illnesses like HIV/AIDS, pneumonia and other infectious diseases were major causes of deaths. However, a study conducted in Boston showed when outreach services improved, acute infectious diseases were replaced with chronic diseases like heart disease as major causes of death.

"MCDPH and community partners are interested to see if that shift has been similarly experienced in MC. This could have implications for the types of services offered to homeless individuals in our community," Fowler said.

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What happens after death?

When someone is found dead anywhere except a health-care facility, investigators from the Maricopa County Medical Examiner's Office come to the scene.

The office works to confirm the person's identity, determine the cause of death and assign a manner of death.

However, the medical examiner does not investigate every death involving someone who experienced homelessness, according to Johnston.

The office will investigate if the death was unexpected or involved in suspicious circumstances, accidental injuries, overdose, heat-related or if the body is unidentifiable.

Johnston said deaths of those experiencing homelessness are usually reported to the office by law enforcement or medical professionals.

Medical Examiner's Office staff will interview family, friends, health-care providers and law enforcement to determine whether the person was homeless. To help identify the deceased, the office works with law enforcement, dental and health-care providers and family.

After it's investigation, the medical examiner tries to locate the next of kin. If a family member is not found within a reasonable time frame, the deceased is sent to a funeral home.

The funeral homes take turns, serving on a rotation arranged by the Maricopa County Public Fiduciary's Office, according to Johnston.

If a funeral home still can't find the deceased's family, the business will publish an obituary to seek the public's help with finding family.

If family is still not located, or is found and can't pay for burial or cremation, the funeral home seeks burial assistance from the county.

The Public Fiduciary's Office reviews applications before deciding if it can help with assistance. According to Maricopa County spokeswoman Erika Flores, the county pays up to $350 for a standard burial at White Tanks Cemetery or cremation.

According to Flores, cremations are done when the office is able to find the deceased's family. The family must approve cremation instead of burial.

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White Tanks Cemetery

Chaplain Tom Chapman's words are muffled as a plane flies above the dirt-covered cemetery near Luke Air Force Base.

"God grant us serenity," he said as six Maricopa County inmates, members of the burial detail, lower a coffin adorned with a dirt cross and a rose into the ground.

Between the fiscal years of 2015-2017, there have been 820 burials at White Tanks Cemetery.

If it is determined that someone is a veteran, the Public Fiduciary will refer the burial to the National Cemetery. The office referred 157 veteran burials from 2015-2017. Also, the office cremated 321 of the deceased during that time frame.

The burials are closed to the public due to safety concerns involving open graves and heavy equipment. Flores said the practice is common throughout the state for county burials.

The public is able to visit gravesites at White Tanks to pay their respects by placing flowers and other mementos, according to Flores.

Round metal plates stick up from the ground marking the grave sites. The plates give only the name and birth date of the deceased.

Chapman became a volunteer chaplain for White Tanks about 15 years ago.

He said one reason he volunteers is for "the grace."

"Any one of us could be in that situation," he said. "Why would we not want to honor those who do not have someone?"

Gonzalez, who is Muslim, said he wonders if he dies while still experiencing homelessness, will there be someone to bury him in the ways of his faith.

The eight chaplains at White Tanks are of various religious backgrounds, according to Chapman.

"It doesn't matter what denomination you are," he said.

Chaplains only receive the names and date of births of the deceased.

When interviewing potential chaplains, Chapman said he makes sure they understand the burials must be simple and should not contain a sermon but only prayers or blessings.

Chapman said being a chaplain doesn't get hard for him because he has received many blessings over the years.

"Be grateful that you're a part of it," he said. "Thank God that you can reach out in compassion and love in this situation."

About 200 people gather at White Tanks each Thanksgiving eve for a memorial service hosted by Andre House.

The organization has held the service for at least 15 years. Attendees pray, light candles and remember those who have died in the past year.

"There's just a somberness to it," Minich said. "There would otherwise be no one there to remember these folks."

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