As part of the construction of Park & Market, UCSD was required to open a public restroom on the premises. (Photo credit Erik Jensen)

The County of San Diego announced in February that a person experiencing homelessness died from Hepatitis A and five more were sickened by the disease. While not enough cases to qualify as an outbreak, it still highlighted how little has been done since the major Hepatitis A outbreak from 2016 to 2018 to permanently improve sanitation infrastructure.

During the HepA outbreak and Shigella outbreak last year, port-a-potties and temporary hand-washing stations were added near encampments. However, those have been taken down without permanent facilities replacing them.

“I would not say it’s getting better,” said Terry McCleary, small business owner and member of Downtown Community Planning Council (DCPC).

In an audit of all the public restrooms in Downtown, SDSU researchers from the Project for Sanitation Justice reported in December that there are only two bathroom locations with both overnight and weekend access. Divided between the growing unsheltered population, that comes to one toilet for every 200 people experiencing homelessness.

“More than 44% of the unhoused people we spoke with told us that on a typical day they have to practice open defecation. So this is inequality. This is something that’s playing out on our city streets, and especially in Downtown on a daily basis, and I would emphasize also on a nightly basis,” said SDSU Associate Professor Megan Welsh Carroll who leads the Project for Sanitation Justice.

Alongside the community health risks posed by open defecation and lack of sanitation access, there are also individual health concerns for people without access to a bathroom regularly. Welsh Carroll recalled an elderly homeless interviewee who intentionally dehydrates himself and does not eat after 4 p.m. so that he will not need to use the restroom during the night – putting strain on his own aging body.

Dignity issue

Beyond just complaints about the city lacking a key piece of public infrastructure, there has been a recent change in language to note that it is a social justice issue that exacerbates inequality.

“It is a justice issue to me because not everyone has equal access to high quality basic sanitation,” Welsh Carroll said.

Office workers who drive in and out of the city center may not feel the lack of public restrooms as acutely as someone who depends on public transit or a delivery driver.

It also makes visiting Downtown less accessible for disabled people or families with young children. Since most businesses require people to be customers to use the premise’s bathroom, it can cost money to be allowed to use the facilities. For people experiencing homelessness, figuring out where to use a bathroom can be a daily piece of their survival.

“The access is so abysmally low right now, and it’s especially low for folks who are the most economically marginalized in our society,” said Welsh Carroll.

McCleary, the owner of MAKE Pizza + Salad in the East Village, referenced Howard Schultz’s editorial stating that Starbucks cannot be the bathroom for America. McCleary said neither can small businesses.

“It is something that all small businesses are dealing with on a daily basis…It’s not something we’re necessarily equipped to handle,” he said.

In addition to welcoming in those living and working in Downtown, it becomes too much volume for small businesses to accommodate when factoring in crowds that flood the area for Padres games and tourists.

McCleary, who also leads the sanitation, health and dignity subcommittee for DCPC, noted that feces on the street is not good for the quality of life for those living in Downtown and is not welcoming to tourists whose money the city depends upon.

“It’s a dignity issue as well not only for those that have to use the restroom and might be forced to do it on a street corner,” he said. “I don’t want to have to necessarily walk everywhere with my head down, making sure that I’m not stepping in something and, certainly if I do, I don’t feel great walking into a meeting or into my home.”

Volume is an issue at the public restrooms that are open as well. The Civic Center and other locations have lines not everyone can wait in. So many people using the same facility also makes maintaining high quality restrooms more difficult.

The lack of bathrooms is also a gendered issue, with women often worrying about the security features at certain restrooms and facing time constraints.

Of the 22 bathrooms SDSU researchers studied in their census of Downtown restrooms, only four had menstrual products. Two of those charged money for those products. This comes after both the city and county promised menstrual products would be free at the bathrooms they maintain.

Lack of public bathrooms can push women out of jobs in delivery services or other sectors which depend on them. It is also a safety issue for unsheltered women needing to find a dark alley or private area to relieve themselves at night that will not put them at greater risk.

“There is a lack of dignity and a perpetuation of stigma anytime someone has to practice open defecation when they would rather be using a restroom,” Welsh Carroll said. “When we interviewed folks about this, there was a deep level of shame and frankly sometimes anger about not having access to these basic resources.”

The San Diego Downtown Partnership, with its motto of keeping Downtown clean and safe, agrees that more restroom access is needed.

“Through both service request data and their observations walking our urban neighborhoods, our team sees firsthand that the need for additional publicly accessible restrooms exists,” the Partnership said in a statement.

In addition to inadequate quality and limited hours, Welsh Carroll noted many supposedly public bathrooms have barriers for entry. To use the bathroom at Frontline Park, visitors must find the correct person with a key to unlock the facility.

Solutions

Nearly everyone agrees that there are not enough quality, accessible public bathrooms in the city. Finding consensus on what to do about it is much more challenging.

Some suggest that all new major building projects must add a public restroom component, something Council member Stephen Whitburn has done previously.

“Council member Whitburn believes safe and clean public restrooms are beneficial, and he has successfully secured restrooms at the corner of Park Blvd. and Market St., and in the plans for the Campus at Horton, East Village Green Park, and Children’s Park,” his office said in a statement.

The Downtown Community Planning Council also supports constructing new bathrooms. The citizen group wrote a letter urging Mayor Todd Gloria to add public restrooms in the upcoming Tailgate Park development.

There is also a push for funding monitors at bathrooms to prevent the bathrooms from being vandalized and misused so they may remain operable.

“I do think it would lead to fewer nefarious activities happening in these restrooms if there were folks down there,” McCleary said.

Public-private partnerships could also be key in addressing the shortage of restrooms. A program in Germany currently utilized on a smaller scale in Coronado gives businesses grants to open their restrooms to the public. This would address the staffing issue to clean and monitor the bathrooms that McCleary said is a challenge many small businesses face.

Staffing monitors and opening new bathrooms are all costly— which is why some people have suggested a fee-based system where a few coins open the door. Paris and other European cities use this method which also cuts back on the volume of people using the public restrooms.

Welsh Carroll believes this would only increase inequality. She notes that tons of money has been wasted on temporary fixes, like bleaching the streets, adding port-a-potties and temporary handwashing stations that could be redirected towards improving current facilities and extending hours.

“Our team stands ready to support implementing additional restrooms — and the resources they need to stay accessible and safe — as a critical component of Downtown’s public infrastructure,” the Downtown Partnership said in a statement.

Welsh Carroll noted that so many agencies are responsible for different bathrooms that it is difficult to hold anyone accountable for improving the situation: some bathrooms are maintained by the parks department and some are not. In Downtown, public restrooms might be maintained by the city, county, or even Port Authority.

In addition to confusion over which agency is in charge of which Downtown bathroom, Welsh Carroll bemoaned that there is no clear person at the city or county in charge of sanitation infrastructure. She wants elected officials to appoint a restroom czar to oversee the facilities.

“Currently that does not exist and it seems to result in displaced responsibility,” she said.

The lack of a well-organized, wide effort to advocate for better public restrooms is also a concern.

“There are disparate efforts by many different organizations and groups, but there doesn’t seem to be necessarily one coalition that has come forth strong enough to be the leader in this and then put some pressures on the powers that be to make a difference and do it quickly,” McCleary said.