PHOENIX — When temperatures reach triple digits across metro Phoenix, homeless recycler Victor Schaeffer shrinks into a dwindling patch of shade behind a convenience store and douses himself with water. Just off work at a national fast-food outlet, homeless mother Kimberly Mariano, meanwhile, pays $4 for an all-day pass and rides the air-conditioned light rail train back and forth across the city to cool off. Street sleeper Carol Molina waits for the sprinkler system in a nearby apartment block to sputter to life so that she can grab a vital drink of water during a week when the temperature peaked at 115 degrees. “We're always filling cups up with water with the sprinklers to keep cool and stuff,” said Molina, grateful for the brief respite. “Thank God for the blessings we've got.” The trio are among about 1,000 homeless sleeping out on the sun-scorched streets of metro Phoenix, scrabbling to stay alive in recent days in sweltering heatwave conditions that each year prove fatal to those without shelter. From 2006 — when Maricopa County began keeping heat records — through last year, a total of 691 people were killed by the heat in the metro Phoenix area. Over a fifth — 151 of them — were homeless people. As temperatures recently showed a potentially fatal pattern this month with a six-day spate of highs above 110 degrees, with lows barely dipping to the mid 80s, the National Weather Service issued an excessive heat warning flagging the elevated risk of heat illness for those outdoors, ranging from mild to fatal “depending upon the amount of exposure and the health of an individual.” Symptoms of heat exhaustion include nausea, headaches, and confusion, which can swiftly lead to deadly heat stroke as the body loses the ability to regulate its temperature.

With their belongings and dog, an unidentified homeless couple take refuge from the sun behind a strip mall in Phoenix. Tim Gaynor

The dangers of heat injury were uppermost in the minds of homeless people like Schaeffer, who roamed the sun-baked sidewalks of the city with a shopping cart, foraging for cans and bottles to recycle. “I keep myself wet constantly when I'm in the sun. I have to, because I've had heat exhaustion every summer for the last six summers,” he said. “Two times I was really bad, throwing up, I couldn't quench my thirst, it didn't matter how much I drank, didn't matter … I had cramps… It's almost to the point where you're so bad you can't get yourself to the hospital,” he added. For mother-of-three Mariano, meanwhile, riding the chilly light rail as it carved through the burning asphalt of the Phoenix valley gave her a few hours' respite before a night sleeping out in a park with her partner Nicholas. “It's very important to stay cool, I can get sick very fast. I don't want to end up in the hospital because I'm working and I do have my kids to worry about,” she said of the couple's children, who are in the care of child protective services. The light rail is “very well air-conditioned, it's cold. There's nothing to complain about unless there's people there to harass you,” she added. An Arizona Department of Economic Security survey carried out on one night last year found there were 1,044 people on the streets and 4,865 staying in shelters in Maricopa County, an area contiguous with metro Phoenix. As well as the dangers of heat exhaustion and heat stroke, risks from extreme heat range from severe sunburn and feet scorched by hot asphalt, to a perilous exacerbation of underlying conditions such as high blood pressure, heart disease, diabetes and even psychiatric disorders, medics said. “It's a very big concern because homeless people are already at risk. People are already dealing with issues and in many of them, their systems are already weakened, whether it's because of a chronic illness, or because of their drug or alcohol history,“ said Vicki Copeland, the medical director of Healthcare for the Homeless at the Maricopa County Department of Public Health, noting that too frequently their distress went unnoticed. “If you're homeless, who's looking for you? Who's checking on you? Who's making sure that you're okay? Who notices that you're acting a little stranger than normal? Well, those people they're always sweaty and smelly, right? Who's going to notice that there's actually something wrong with them, that there's actually something different?” she said.

Homeless recycler Victor Schaeffer rests behind a 7/11 convenience store in Phoenix, as temperatures soar. Tim Gaynor

Awareness of the grave risks faced by those trapped in relentless high temperatures was stamped into national consciousness during a blistering desert heatwave that engulfed Phoenix in July 2005, killing more than 30 people in a two-week period, most of them homeless, their bodies found in dirt lots, vehicles and between buildings, according to news reports. The spate of heat deaths, which also included elderly people, some without adequate cooling in their homes, highlighted a need for more emergency shelter beds, heat refuges and water stations throughout the sun-blasted metroplex to provide life-saving hydration and a respite for the most vulnerable. “The silver lining to that is that it got everybody's attention,” Lindsey Roberts, the spokeswoman for Central Arizona Shelter Services, or CASS, which provides emergency shelter and a one-stop shop for homeless services in Phoenix, said of the deadly heatwave. “It made everybody realize ‘we need to do something about this … we don't have the winters that the rest of the country has, but we have this really deadly summer and what can we as a community do to make sure that these individuals are safe?’” As part of that community response to that fatal July, a county-wide Regional Heat Relief Network has brought together municipalities and government entities, homeless service providers, faith-based groups, local businesses and community volunteers to ensure that dozens of water and heat refuge stations are available during summer months across the city for the homeless and other vulnerable people. As part of a portfolio of services, CASS provides emergency accommodation for 600 men, women and children each night at shelters in the city. At its human services campus west of downtown Phoenix, it also offers vital shade, water and meals for 1,100 people who use it each day, and support services to clients ranging from medical and dental care to help finding jobs and housing. The nonprofit sector has also stepped up to respond to the needs of the homeless in the summer, among them the Phoenix Rescue Mission, a faith-based group that dispatches a “Hope Coach” outreach team providing food, water, clothing, toiletries and other essentials to people living on the streets as part of its “Code Red 2015” heat relief drive, which they believe has already saved at least one life this year. “Just last week we came across a woman who was passed out in the street in the sun and we called the paramedics,” chaplain Clifford Danley said as he drove around west Phoenix handing out aid to street sleepers, some in out-of-the-way spots behind strip malls, convenience stores and alleyways. “They said 'in reality, you saved her life, because we're not sure anyone would have discovered her in the particular little place she was laying down,” he added.

Carol Molina, left, and Sheila Perez chat with a volunteer from the Phoenix Rescue Mission as they take shelter. Tim Gaynor