Marti Hottenstein, left, of Warminster, founder of Bucks County's How to Save a Life Foundation, comforts a young woman living on the streets of Philadelphia during a Jan. 20 visit. Hottenstein, who started the foundation after her son died of an overdose in 2006, leads a group of volunteers who twice a month go down to the streets of Kensington to try and get people into substance abuse treatment. [Kim Weimer | Staff Photojournalist]

'What can I do to help you?'

In the underworld of Philadelphia, beneath the elevated subway line along Kensington Avenue, tears were as prevalent as needles. It was a scene that rivaled the aftermath of a storm, its victims caught up in forces that leave many hungry, homeless and hopeless.

The eyes of one woman in her 20s filled as she sobbed in the arms of a familiar woman, Marti Hottenstein, who pledged to get her off the streets and out of the littered encampment, where users piled on makeshift mattresses pumping heroin into their bruised and battered arms.

“I can’t live like this anymore,” said the woman, explaining that she tried to detox on her own Christmas Eve, adding, “It hurt too bad.”

Brushing the girl’s auburn hair away from her hazel eyes, Hottenstein’s intense gaze captured her attention: “Listen, I lost my kid to this; I know it’s bad. I’ll get you treatment today.”

“I’ll go. I’ll go,” the girl said.

But she didn't.

“She’s not ready; she’d be in the car today if she was,” said Hottenstein, who had three other sites to visit that day.

Twice a month, Hottenstein and her group of volunteers from Bucks County’s How to Save a Life Foundation frequent the blighted pockets, passing out clothing, blankets, sprinkle doughnuts, toiletries, sandwiches and sleeping bags. The group’s mission is to get people off the streets and into treatment.

That cold January Saturday afternoon, people emerged from tents and from under layers of coats and blankets to grab items, stuffing them in bags and shopping carts. Many knew Hottenstein by name. Hottenstein, a bold, blonde woman from Warminster, didn't mind pointing or shouting to draw attention. She’s not shy.

Under the Emerald Street Bridge, a group of young people living on the streets detected her raspy voice, as she stepped out of a car. “We have doughnuts. Take one,” she bellowed out, approaching the encampment on foot. As clusters of people living on the streets hugged, smiled and blessed her, she then asked, “What can I do to help you?”

Some stayed beneath their blankets in tents. Dressed in a sequined shirt and copper vest, she knelt down and peered into one, offering food and help to faces who looked barely old enough to drink. On a good day, someone they approach will accept the group’s invitation to get help and climb in a car.

More than two months earlier, Sean Haddock took that leap.

Born and raised in Kensington, the 32-year-old said he had been shooting heroin since he was 12. He met Hottenstein one frigid November day when he spotted her handing out clothes.

Like the sobbing woman under the bridge, Haddock didn’t go right away. He waited a day, connecting with Hottenstein’s group via Facebook. As promised, Hottenstein got him into a treatment center, where he was put on medication-assisted treatment and began his recovery.

“She came right away and picked me up,” said Haddock, adding on this January day he was 55 days sober. “She’s like my adopted mom. She saved my life.” 

Saving lives is the goal of the group of parents, many of whom lost a child to the opioid epidemic or have a family member in recovery. They know it’s not someone else’s job to care.

Every other Saturday, the group sets up camp in The Last Stop, the area’s hub for distributing donations. It's nestled in a hollowed-out brick storefront in a building owned by Eddie Zampitella, also in recovery.

The shelter is a refuge for those barely surviving.

How to Save a Life is one of a few groups that helps a forgotten population stay fed and clothed. That winter day, they arrived in trucks and cars packed with donated goods at 11 a.m., joining a few other volunteers, playing gospel from a portable stereo — music that could be heard from the nearby intersection of Kensington Avenue and Somerset Street.

Within minutes, the volunteers began organizing clothes into piles, passing out hot food, clothing and toiletries. A woman in pink pajama pants rummaged through a pile of jeans handed to her.

"All my stuff got stolen; that happens a lot out here," said the 36-year-old, pushing her leg through the one pair of Hollister pants. Beside her, a small petite woman who said she was "far away from her babies in Baltimore" teared up when she approached the shelter. "I'm just so cold and tired."

Those in need of food and essentials weren't hard to find.

Those willing to accept help for treatment, however, were in short supply that day.

"I don't want to waste someone's time or money," said one man pushing a sleeping bag and clothes in a shopping cart.

As the line started to grow outside The Last Stop, Warrington mother Valerie Fiore, who lost her son to addiction in 2014, stepped outside of the building, handing out pretzels to go with the steamy bowls of chili gripped by weathered hands.

Approaching one familiar face, Fiore offered in a soft-spoken tone: "You can come in and talk to someone here. We could get you help.”

But she didn’t press when the man walked away. That’s not what they do.

“We give them food and clothes, ask them about their situation and ask if they want to make changes in their life, and if they say ‘yes,’ I get Marti right away,” Fiore said. “I shake their hands, hug them and treat them as God’s children.”

Fiore rarely ventures to the encampments under the bridge.

“Breaks my heart,” said Fiore, who finds it too hard to stomach the clusters of youth on mattresses lining the littered streets.

Help in addiction isn’t easy without a connection, she said. And connections can’t happen without trust.

She works to establish that trust with those gathered at The Last Stop, reaching out to those who carry most of what they own in a backpack. While bags of clothes are offered to many, few want extra materials to haul around.

One green-eyed blonde inched her way up to the line at the shelter, asking for shoes when the group returned in February.

“I’m a size 6½,” said the woman in her 30s, wearing boots that were soaked and thinning from wear. “My feet are so cold they are frost-bitten.”

The woman, a Bucks County native who called herself Jasmine, was tired and hurting, she said. Police roused her from sleep that day at 2 a.m. in a Center City underground train station, a warmer and safer place to sleep than under the bridges, where too often her clothing and belongings get swiped.

But the suffering on the streets — the sleep deprivation, constant hunger and shooting pains in her feet — pale in comparison to the agony of withdrawal, she said.

“The withdrawal is horrible; feels like my insides are breaking apart,” said Jasmine, adding that she uses to feel normal, and no longer feels high.

After more than 18 months living on the streets, her past life, she said, seems almost imaginary. She exists in a world that couldn’t be further from the future she envisioned, she said.

“I have three degrees," she said. "Two years ago, I was making $30 an hour. I had a career and a house — I lost everything."

 Approaching Jasmine with a bowl of this visit's offering, shepherd's pie, Lisa LaTerza asked, “Hungry, honey?”

 Jasmine accepted, offering a “thank you” and they exchanged pieces of their story. LaTerza, of Upper Southampton, didn’t have to hear that Jasmine had a master’s degree to see that she was smart.

“There’s help out there; you are so worth it,” said LaTerza, who was happy to hear that Jasmine talks daily with her mother.

LaTerza knows that the disease can grab a hold of anyone, despite intelligence and success. Thanks to help offered by Hottenstein’s group, LaTerza's son Matt Freda got the treatment he needed — in the short window of time he was open to it, she said.

“I was planning his funeral, but miracles do happen,” LaTerza told Jasmine. “This is not your destiny.”

LaTerza knows the window of opportunity to get someone help and into treatment isn’t always open. That day, though, Jasmine wasn’t reaching for help. She needed boots and something warm to wear. She was handed a cream sweater. Before leaving, LaTerza said, “I’ll pray for you.”

Prayer is the glue that bonds this group of parents together, and helps them cope with the challenges of addiction that plagued themselves or their children in the past.

As part of the Kensington ritual, Mike Foley, a minister, gathers Hottenstein and the group in a huddle to kick off that day's outreach effort. Volunteers locked arms in a circle as the Hatboro father of three gave the day’s blessing, and then like a coach prepping players before a big game, added: “Let us make a difference. Let’s do this.”

Grateful for his own recovery from a drug addiction, Foley reached out to Hottenstein’s group in 2012 to donate $1,000.

“It was enough to help one person get into a treatment center for seven days,” he said.

When he heard Hottenstein made trips to Kensington, he offered his time, his orange Jeep and his prayers.

“It’s a beautiful thing to touch someone’s life with a sandwich and a bag of chips,” said Foley. “Some people won’t want to do it; they might see dirty individuals, but they are not; they are loving angels that we should care for. I have been given the ability to pray and cry with them and say, ‘You can do it. You are loved no matter what.'”

Foley, grateful to God for his recovery, said he is there to reach out, give hope and show others hope.

Hope was something volunteer Kathy Waters was losing the night she first connected with Hottenstein about three years ago.

At the time, her son Anthony agreed to get help from his heroin addiction — a step that Waters feared would never happen. Yet she sat crying hysterically in her car outside the emergency room at a Philadelphia hospital because doctors turned him away. Most of the treatment centers she called didn’t have beds and the ones that did wouldn’t take her insurance. She jumped on Facebook, pleading for someone in her virtual community to help her before the pain of her son’s withdrawal pushed him back into using.

Hottenstein’s name came up.

“That was on a Friday, and by Sunday, my son was in treatment; and after seven days when they wanted to release him, Marti got on the phone and hassled them and he got 20 more days,” Waters said. “She’s a miracle, and since the day she helped my son, I haven’t left her side.”

Shortly after she arrived in Kensington, Hottenstein skipped down Somerset Street as a man she has been trying to help trailed behind her, pushing a shopping cart of everything he owned.

“It’s 'Marti Gras' time,” said Hottenstein, shouting on her bi-weekly trek to a corner market for ice cream and deli sandwiches. Her skipping, she said, is deliberate “to show them you can have fun without being high.”

From a block away, a woman in a bright purple shirt ran over, the two pom-poms on her knit hat bouncing as she embraced Hottenstein.

“I love her,” said the brunette, who admitted to Hottenstein that she had relapsed recently. It was Hottenstein’s group that convinced her to get treatment.

Like many users who come from the suburbs, the 32-year-old said she didn’t get her first taste of opioids on the streets surrounding her. The Warrington native got addicted to painkillers in the “posh suburbs of Buckingham."

“Kids had so much money and nothing to do,” said the woman, who like many, turned to heroin when the number of pills she needed to get high got too pricey.

As she spooned cookies-and-cream ice cream into her mouth, she watched as Hottenstein encouraged the man she bought a bologna sandwich for to seek help.

“When you are down here and think there is no one else on your side, you see her doing things for perfect strangers, and it’s a beautiful thing,” she said.

The woman said she knew Hottenstein’s history and what brought How to Save a Life to the streets of Kensington.

Hottenstein created the foundation after her son Karl died of a drug overdose in October 2006. Karl was denied treatment at an in-patient facility. He died of an overdose six weeks later, a week after his mother's wedding.

She’s been working to get youth off the streets for 11 years.

Her success stories — those she has guided into long-term recovery — are fathers, mothers, sons, daughters who now are planning weddings, launching support groups, attending school, according to the volunteers who have witnessed her work.

“I do this for the love of my son, God and all the people who don’t feel loved,” Hottenstein said. “I know there is hope ... Look at me. I think connecting with people is a gift that God has given me through the death of my son and to meet people where they are without any expectation. I come here as I am, a broken mother, but knowing even though I’m broken and weak, I have a strong God that can plow through this whole thing and that’s how the love comes out. By me passing it on, it allows me to love and heal.”

The woman in the purple shirt was one of more than a thousand people she’s helped through her foundation and connections with treatment and rehabilitation centers across the region.

Though the woman relapsed, Hottenstein isn’t giving up hope.

Relapses are part of the disease, and Hottenstein — a licensed therapist and recovery specialist — knows there are different paths of recovery for different people.

As she drove away from the encampment just an hour after her “Marti Gras" skip to the store, Hottenstein caught a glimpse of the woman in the purple shirt. She was “nodding off” on the edge of a mattress after shooting heroin into her bruised arm.

Hottenstein hoped that on her next visit, the woman would find the strength to say, "I'm done."

“It breaks my heart every time I leave her."