After being chased out of spot after spot, Bobby Hilton sleeps and shoots heroin in a tent made of bedsheets and towels on a narrow, needle-strewn Kensington railroad bridge. When the Conrail train rumbles nearby, "it feels like an earthquake," Hilton said. He almost died up there the other day, overdosed and alone, facedown in the dirt.

In the dark underpass at Lehigh, a near-daily dance has developed. Police roust the swelling crowds that sleep and use there – and cleanup crews dump the dirty mattresses a few blocks away, hoping none of the people who use them will find them. Thursday's haul: 15 mattresses. The students at Visitation BVM Catholic School walk past, seeming not to notice what's been happening along their route.

The crisis has crept toward the steps of the Firm Hope Baptist Church on Auburn Street, where the Rev. Richard Harris has ministered for 30 years. His church sits on a relatively quiet street six blocks from Kensington Avenue. The people pushed off The Avenue shoot up in his playground.

This is what Kensington looks like now, a few months after the city cleared out its big set pieces of suffering at the heart of the opioid epidemic: The Gurney Street train gulch, where a heroin encampment had existed for decades. The McPherson Square library lawn, where young people from all over had set up camp. And the hulking ruins of Ascension of Our Lord parish, which became a haven after people were ushered out of the first two spots.

"Safe places" for people to use heroin that were deeply unsafe. Places where no person should take refuge – but in Kensington, they did.

And now they're gone. Rightfully so.

But when you take away these so-called safe places, you have to offer something better, or else people will just move into more perilous, and more public, spaces. But we can't offer something better yet. While the city works to usher more into recovery, it does so without the treatment capacity or harm-reduction services needed to meet the crisis head on.

So the problem spreads, as many feared. Kensington itself has become the set piece – at least, much of the neighborhood has.

There are Gurney Streets everywhere. For weeks, a tent city sprang up in vacant lots at Kensington and Somerset. Large domed tents. The city scattered the camp to smaller lots along The Avenue like the one where Taylor, from Harrisburg, and Mackenzie, from Delaware County, now sleep.

Taylor used to stay at the shuttered church.

"It was dirty and terrifying," she said. She said she feared she would be raped in the ruins.

The crowds living under the Emerald Street Bridge have grown so thick in recent months that the place's ironic moniker – Emerald City – doesn't sound so ironic anymore. On a recent afternoon, Casey O'Donnell, the president of Impact Services Corp., a neighborhood revitalization organization, was delivering food under the bridge when a man redirected him:

"That's not my kitchen," the man said. "That's my bedroom. Please put the food there."

Emerald City has its own dance. Every Friday, the cops give the residents some time to grab their belongings, then clear the space out. By nightfall, Emerald City is reborn.

Some people who once slept along The Avenue now sleep on the sidewalks of a Port Richmond strip mall, a mile east along Aramingo Avenue. So many people that Patryk Stepka, who delivers Tastykakes to the 7-Eleven, snaps photos. Because he wants to show his family back in Poland just how bad it has gotten here.

"It's sad," he said, of the young people on the sidewalk. "But they had to go somewhere."

Bobby Hilton had been sleeping in front of the 7-Eleven before he made his tent on the train bridge. Hilton is 33 and originally from Southern California. He moved to Frankford as a teenager. Not too long ago, he had an apartment and a job. His son will turn 8 soon. For now, the rats and raccoons keep him up at night – and the thundering trains. Fortunately, the day he overdosed, one of his neighbors on the tracks found him.

He has more and more neighbors now.

Laura Schram, who is 33 and from the Northeast, sleeps in a tent down the tracks with her boyfriend, Adrian. They count on two hands the places they have slept since summer: McPherson Square, a ramp on Aramingo, the church, four abandoned houses, the tent city on The Avenue, and now the bridge.

She overdosed one night recently in an abandoned house. Adrian was there to revive her. Afterward, she said, she felt as if her blood was cold.

Bobby and Laura said they hoped the city would open a safe injection site.

The city has always known that addressing the long-entrenched camps was just a first step, Managing Director Michael DiBerardinis told me Thursday. The city is working with neighborhood groups like Impact on a block-by-block neighborhood engagement and cleanup plan. They hope to implement it in weeks, not months.

But what about the people in the camps? In two weeks, the city will be sending a delegation – including the health commissioner and fire and police officials – to Vancouver and Seattle to tour safe injection sites. They will see exactly what I saw when I visited similar sites in Toronto last month: that they save lives and help neighborhoods and that we need one now as part of our solution.

Some say no. Like the councilwoman whose district encompasses parts of Kensington, Maria D. Quiñones-Sánchez. She attended a ceremony Friday at the Bellevue hotel honoring the McPherson Square librarians who learned this spring how to administer Narcan and tried their best to save lives in the face of overwhelming indifference. The situation on that lawn deteriorated for a year before media reports sparked outrage. The situation in Kensington spirals by the hour and clean-up crews hide mattresses, and more children step over more sunken forms on their way to school.

I was at the ceremony, too. Afterward, I asked the councilwoman, in the face of more people dying in her district from overdoses than anywhere in the city, what is her plan to save lives.

It's not that she didn't come prepared. Some of her plans are exactly what the city needs — like reforming Philadelphia's outdated and overwhelmed treatment system, and holding accountable treatment providers who rake in millions, but help far too few. Others, frankly, are alarming.

She wants police to round up people in addiction to force them to connect with outreach workers at a 24-hour staging center, which to me smacks of ham-handed War-on-Drugs policies, when a safe injection site would do the same thing without the police involvement.

"Police cannot arrest their way out of this," she said, "but they can help us round up these people involuntarily."


The focus, she said, needs to be on fixing a broken system. She said she would not spend money or "political equity" on injection sites, especially in a district already rich in recovery centers and other treatment services.

There, the councilwoman misses the point entirely.

A safe injection site is exactly what we need while fixing the system – it's the first step of many that are needed, and one that would bring some relief to her traumatized district.

"You need to check your biases," she counseled me, meaning my brother's death from a heroin overdose years ago, which I have written about.

Here, the councilwoman was right. Yes, it is personal for me. But by now, it should be personal for everyone in the city.