A BARE-BREASTED woman darts into the road in front of us, her torn trousers hanging below her naked bum.
Clearly intoxicated, or in the middle of a psychotic episode, she crosses the street in broad daylight and scuttles off into the rows of makeshift tents lining the rat-infested streets.
But even more disconcerting is that barely anyone even bats an eyelid.
Many are high on crystal meth - which can be bought for just $2 a hit - others are in the throws of mental illness or ravaged by addiction or other health problems.
Everyone has seen these kind of incidents too many times before.
This is Skid Row, Los Angeles.
Just a stone's throw from the city's central banking district, where billion dollar skyscrapers house some of the biggest banks in the world, a 10 block stretch of Downtown Los Angeles is home to around 5,000 homeless people.
Some live in missions and homeless shelters, others in run-down social housing - while about 3,000 live in tents and makeshift camps on the side of the roads.
And being homeless in LA has become deadlier than ever - with an October 2019 report revealing how the number of homeless deaths had doubled between 2008 and 2013, with the overall death rate up by a third.
'This is the Wild West'
Drug and alcohol overdose was the biggest cause of death at 27 per cent, followed by violence (24 per cent), heart disease (22 per cent), transport-related injuries (9 per cent), murder (six per cent) and suicide (about five per cent), according to the shocking report by Los Angeles County Department of Public Health.
Newer figures show that nationally - across the US - homelessness rose 2.7 percent from 2018 to 2019, according to the Department of Housing and Urban Development, a rise they say was driven "entirely" by the soaring rates in California.
"This is the Wild West," Armes, a homeless man who has lived in the Skid Row area for the past year, tells me.
"We have everything crazy going on here; drugs, alcohol, prostitution, fighting, violence.
"It's a society within a society, the homeless people sell drugs and alcohol to other homeless people.
"But there's no love for anybody, there'll be someone who is passed out drunk getting robbed and everyone will just stand there and say 'Ah look they're robbing Jimmy'."
"Even though they know Jimmy they won't do anything - they just say 'well he shouldn't have got intoxicated'.
"I had a friend who was a marijuana dealer. But she had a condition which gave her fits and every time she had a fit they would rob all her marijuana and her money.
"One time I was with her and she had a fit. I tried to stop people robbing her by shouting at them to call the police, call the police.
"But then not long after she told me it happened again.
"This place is just crazy. I grew up in the city in Philadelphia, but even I was shocked when I first came here."
Skid Row was created around 25 to 30 years ago when city officials thought it would be a good idea to put all the homeless services in one area.
It soon became overwhelmed, and with rent prices and cost of living in LA soaring, and the opioid epidemic in full swing, it has only got worse over the years.
'Horrible, disgusting conditions'
Homelessness in Los Angeles county is up 12 per cent in 2019 compared to 2018 - to around 60,000 people - and it doesn't appear to be slowing.
President Trump has been highly critical of LA's homeless problems, calling it a "disaster" which which was "destroying" the city.
He even took time out on Christmas Day to blast California governor Gavin Newsom over the issue, tweeting: "Governor Gavin N has done a really bad job on taking care of the homeless population in California. If he can't fix the problem the Federal Govt. will get involved!"
During a rallyin Ohio last year he said: "Nearly half of all the homeless people living in the streets in America happen to live in the state of California.
"What they are doing to our beautiful California is a disgrace to our country. It's a shame the world is looking at it.
"Look at Los Angeles with the tents and the horrible, horrible disgusting conditions."
But there are no easy solutions, explains Herb Smith, president of homeless charity the Los Angeles Mission.
The mission provides crisis care such as food, beds and showers as well as longer term programmes to help people with addiction problems as well as housing, education and employment programmes.
"The biggest challenges we're facing right now at the mission in finances," he says. "And people say 'Why is that?
"There's so much government money' but most of that money hasn't flowed down to us or to many of the social services agencies, so we're still dependent on private fundraising and that has been a challenge in this economy.
"Even thought we've got a booming economy in the current administration it hasn't always filtered down to the lowest income levels.
"Los Angeles has an extremely high cost of living - particularly housing costs and we see that every day.
"Even working individuals earning a $15 minimum wage - if you work the numbers on that they can really only afford a $1,000 rent or less but 66 per cent of the housing costs in LA are over $2,000.... that's a challenge."
'You have to sleep with one eye open'
Melvin used to live on the streets but now stays at the mission.
Even though he works full time at a local warehouse he can't afford a place to live.
"It's scary out there. You have to sleep with one eye open always - that's a must - because of violence, robbery, killings, all that," he said.
"LA is wild and people just don't have no love or respect for each other - everybody's out for themselves round here. That's how it is.
"What it is the rent is too high around here. That's why you got a lot of homeless people here.
"I see people with drugs addictions, madness. It just takes them over. They
"This is not a place to be living. There's a police station right there and it don't matter to these people. Everything just happens right in front of the police station drugs, fighting everything."
Antwone Sandford is the manager of emergency services and outreach at the mission, and agrees to take us on a walk around of the area.
The streets are chaotic - and according to Antwone "very dangerous".
"You have to stick with me," he says. "People can suddenly snap, especially if they don't know you."
People wander around talking themselves, or stumbling around the streets like Zombies "tweaking" - jerking involuntarily and scratching at their faces - as they come down from crystal meth.
Others listen to loud music from old ghetto blasters selling single cigarettes - while other people openly deal drugs.
Senior citizens sit in filthy tents, belongings strewn all over the streets, staring into space. The air is thick with the smell of urine.
You can buy it for $2 around here. People will buy $20 worth and then cut it into smaller pieces
Pastor Antwone Sanford
One man asks me for five dollars but Antwone tells me not to give out money.
"What do you think he will spend that money on? He'll buy crystal meth," he said.
"You can buy it for $2 around here. People will buy $20 worth and then cut it into smaller pieces.
"The biggest problem in my experience around here is drug abuse and the main drug nowadays is crystal meth.
"When life is hard like this - and they can't take their strength from God or something else - they turn to drugs like crystal meth.
"And once you open up that door - that drug, that chemical will take over."
Other people walk around with open wounds or other visible health problems - and I ask what is done to help them.
"The medical services are here but they're just not taking advantage of them," Antwone explains.
"When you are out here on drugs you stop caring for yourself and you run yourself down.
"Sometimes they won't even eat. They'd rather get high than go get some water or rather get high than get some food.
"We do prayer walks at the mission where we go around giving out water and hygiene kits - we try to target all of Skid Row - and we tell them about our services and encourage them to come in.
'You get raped or your a** beat'
"I had one couple who took me up on my offer. The guy was HIV positive and he'd been off his medications for over a year and he began to get breakouts.
"I got him a bed and I helped him to get an appointment with a doctor so he could get back on his meds.
"When a person is in an addiction they will neglect their health.
"We have LA Mission, other missions, multiple health centres and it's all free, all they have to do is walk through those doors but that's the hardest thing for them sometimes. They need some encouragement."
We meet Joy, who is housed in a single occupancy housing unit - there are many of these units, run by charities and housing associations for homeless people, may of them in old hotels or apartments.
While she is off the street for now, the area is unclean and unsafe, and "no one stands a chance".
"I've had my a** beat three times walking out of here," she said.
'Roaches and rats everywhere'
"This is a mental institution.
"I have kids - they are grown - but I can't have them come down here.
"It's very, very dangerous.There's registered sex offenders all over in these tents.
"You can't come out here because you might get raped or your a** beat. You might get shot.
"And it's filthy - there are roaches everywhere and rats."
Skid Row is so shocking it has been described as worse than a refugee camp.
'Worse than a refugee camp'
Medieval diseases such as typhus, which was near eradicated in the developed world, have returned to Skid Row - with 167 cases confirmed in 2018.
There have also been outbreaks of hepatitis A, tuberculosis and staph. Some doctors even believe that the bubonic plague - known as the "Black Death" in the 14th century - may already be present in LA.
"You can make some analogies to refugee camps and numbers of bathrooms and public facilities - we have far fewer available than you would have in a refugee camp," Herb says.
He adds: "If you walk down the streets the visual impact is appalling. If you peel back the onion skin a little bit you'll find out that many of these individual have mental illness issues.
"Our system does not do a good job of helping get them off the street. We have this focus on individual rights and individual choice in this country which puts a risk individuals at the same time.
"It's difficult to navigate the mental health systems for family and friends to get the services that the individuals need so they end up frequently on the streets.
"We have addiction issues - drug and alcohol issues - that put people on the street.
"Again they've broken family relationships or work relationships or they've just chosen it's a better lifestyle to live on the streets and experience their addictions.
"Then we have individuals who for various reasons have been on the street for a very long time - we didn't address the situation well. Many of them for mental health or other reasons got out there and were so far gone they couldn't get back."
Herb is keen to point out that as shocking as Skid Row is, it's only a fraction of the wider problem of homelessness in LA, where more people are becoming homeless each month.
And he admits there are no easy solutions.
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"Homelessness is like soup, it's trying to dissect vegetable soup. And in order to do that you have to dissect the individual pieces.
"What is it that got a person into this mess and what can we do to get them out and that varies from person to person.
"We can clump some of them together and say it's housing for one and drugs for another or mental health for some, but it's breaking it down individual by individual, which is time-consuming and costly but at the end of the day the best long term results are found that way."