San Diego has long faced criticism for a lack of public restrooms, especially downtown where leaders have designed a walkable community.

Now a public health crisis at least partly due to human waste in the streets has city officials scrambling to quickly add places to go to the bathroom. The county directed the city to swiftly add them to stem a hepatitis A outbreak that has left 16 dead.

The city placed four portable bathrooms near City Hall late last week, and have extended hours at 14 Balboa Park restrooms. They plan to add more downtown as soon as possible.

But the lack of bathrooms is not just a homeless issue. The rush comes two years after the city officially acknowledged criticism about the need for more downtown restrooms.

But the past few years, they’ve hit debacle after debacle even in far less urgent attempts to add them.

The problems have only grown along with San Diego’s downtown homeless population.

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Two restrooms that opened at an East Village public park last year have repeatedly been shuttered by restaurant workers ill-equipped to manage the constant chaos associated with them. They’ve dealt with fecal matter spread on walls, drug use, prostitution and many uncomfortable confrontations – challenges the city also reports at its other public restrooms.

Both infamous stalls known as the Portland Loos, added just two years ago, have been removed despite the city far exceeding its budget to install them in the first place. One disappeared from bustling Park Boulevard and Market Street on Sept. 7 as a construction project expanded, stunning some homeless San Diegans and nearby residents already rattled by the hepatitis outbreak.

City spokeswoman Katie Keach said there no immediate plans to deploy the loo elsewhere, as it requires water and sewer hookups and can’t be swiftly installed elsewhere.

Reese Jarrett, president of Civic San Diego, the downtown development agency overseeing the project, said the loo will return to Park and Market after construction is finished – in about three years.

Meanwhile, several homeless people living in East Village told Voice of San Diego they often avoid the 10 toilets the city’s paid Father Joe’s Villages more than $100,000 annually to open on its campus to replace another loo that was removed last year.

“They were always filthy,” said John Brady, who until recently lived on downtown streets and avoided the restrooms at Father Joe’s. “I’d rather use a bucket.”

When I visited late last month, the white tile floor was covered with a slippery film of water and speckled with black streaks of what appeared to be dirt.

Brady and others said the bathrooms are also often missing soap and toilet paper – common problems at other public restrooms.

That’s despite the nonprofit’s policy to restock supplies and clean the bathrooms at least every two hours.

San Diego leaders have repeatedly been told that more public restrooms are needed downtown.

A 2014 report by a task force assembled under ex-Mayor Bob Filner called on the city to develop a plan for adding public restrooms and replacing six that were being removed, and research whether it could cover bathroom maintenance costs with downtown parking revenues. The city attorney’s office repeatedly concluded the city can’t use that funding source for restrooms.

A year later, the San Diego County Grand Jury declared the city needed more public restrooms and that the city was taking too long to add them. At the time, the city hadn’t added any public restrooms other than Portland Loos in more than a decade.

Mayor Kevin Faulconer and the City Council formally agreed with both findings.

A City Council committee heard an update on the city’s response this March, around the time county public health officials decided a regional spike in hepatitis A cases was actually an outbreak.

David Graham, one of the city’s deputy chief operating officers, told the committee that challenges the city faced in adding more public restrooms in 2015 hadn’t changed.

The city’s downtown community plan now requires that any parks larger than a half block include public restrooms, Graham said, but funding them remained difficult. He noted three upcoming development projects, including where the East Village loo was recently removed, would have public restrooms once they were completed.

The city’s also added public restrooms at St. Vincent de Paul, Fault Line Park and Horton Plaza Park.

Adding more would require the city itself to set aside more cash for bathrooms, he said.

City Councilman Chris Ward, who represents downtown, told Graham he was dissatisfied with the city’s response.

“All the nefarious activity that’s happening on site is becoming a problem, and I think it’s generally because it’s one facility overburdened,” Ward said, referring to the Portland Loos that have both been removed. “You can’t just have one restroom there to be able to serve a need for people who are hopefully temporarily there on the streets, and we’re not providing adequate sanitary opportunities for those who are homeless in the East Village. We do create our own issue here.”

Ward and City Councilwoman Lorie Zapf both called on the city to try to better address its public restroom challenges.

In months since, a hepatitis A outbreak spread through microscopic traces of fecal matter – and thus thriving in part due to a lack of access to restrooms – has raged.

In an Aug. 31 directive to the city, county Chief Administrative Officer Helen Robbins-Meyer and Public Health Officer Wilma Wooten called for immediate increased access to public restrooms and wash stations citywide, but particularly in downtown San Diego, where “many homeless reside in unsanitary conditions,” they wrote.

The city and county have since placed 41 hand-washing stations downtown, and the city’s researching restroom options.

The week before the county directive, Assistant Chief Operating Officer Stacey LoMedico acknowledged the city voiced concerns when county officials pointed to the restroom need.

LoMedico said told VOSD on Aug. 25 that the city feared “illegal activities, unprotected sex and drug activities” common at public restrooms the city already has could inflame rather than weaken the hepatitis A outbreak. She said the city had particular worries about unattended restrooms and has even struggled with the City Hall restroom that has an attendant on site.

The city’s now preparing to accept bids for a new contract to operate the civic center restroom that may include increased security. At the time, LoMedico said she hoped that contract could set the stage for improved public restroom operations elsewhere in the city too.

LoMedico’s now leading the city’s efforts to set up many more public restrooms.

The city itself has concluded that the 19 permanent public restroom locations downtown aren’t sufficient to serve those living and spending time downtown.

But other than the county letter, I couldn’t find any government directives that it add more or maintain a certain number of restrooms – or clarity on whether the city is following urban planning best practices for restroom availability.

Building codes, local regulations and federal worker safety requirements direct businesses, governments and event planners on restroom necessities based on building occupancy, number of workers or event attendance. They don’t offer mandates or best practices for restrooms necessary to serve city dwellers and visitors, including those living on the streets.

It speaks to a somewhat surprising reality about restrooms: Everyone needs them but they’re often an after-thought in the planning and development process.

Clara Greed, a now-retired urban planning professor at the University of the West of England, spent the latter part of her career arguing that needed to change.

In a 2003 book, Greed detailed how a lack of access particularly hampers and discriminates against women, children and seniors who require more regular bathroom access. She also documented restroom design choices in those that do exist.

Greed argued that public toilets should be at the forefront of planning discussions rather than “hidden behind some bushes where they are likely to be vandalized.”

“While there has been a sexual revolution, there has not been a commensurate ‘defecation revolution,’” Greed wrote.

Greed and other advocates have also argued a greater upfront focus on design and safety – and an increased number of restrooms in the first place – could lessen safety issues associated with isolated restrooms. More restrooms that are better designed and flanked by security officers or attendants could lessen the burden on a particular restroom and the area surrounding it.

Homeless advocates and those living on the streets in San Diego and elsewhere have also long argued a lack of clean, safe 24-hour restrooms for that population robs them of basic dignity. They can be forced to wait for hours for an open restroom or to relieve themselves in buckets, cups or bushes when they can’t wait.

“Bodily functions don’t stop because you’re homeless,” said Anne Rios, executive director of San Diego homeless advocacy group Think Dignity, which pushed for the now-removed Portland Loos.

San Diego’s dramatic hepatitis A outbreak, now among the deadliest in decades, has given the broader community a greater stake in homeless San Diegans’ access to bathrooms, too.

Nearly a third who’ve been infected are not homeless or drug users, the two groups hit hardest by the virus.

Jenna Davis, a Stanford University engineering professor and public health expert who’s worked on sanitation issues in developing countries more often plagued with waste-related infections, said the outbreak underlines the importance of restrooms and sanitation for all.

“I think most of us in California and the United States have developed a level of expectation around having clean water and adequate sanitation that perhaps makes it hard for us to appreciate how very critical that infrastructure is,” Davis said. “Even if a small segment of the population lacks access, it can create environmental contamination that becomes a problem for a much larger group of people.”

    This article relates to: Government, Homelessness

    Written by Lisa Halverstadt

    Lisa writes about San Diego city and county governments. She welcomes story tips and questions. Contact her directly at or 619.325.0528.

    Joyce Steven
    Joyce Steven

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    Joyce Steven

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    Scott Hopkins
    Scott Hopkins subscriber

    I have long noticed there are no public restrooms at the Old Town Transit Center, a highly populated mix of city buses, the trolley, Amtrak and the Coaster. We have thousands of tourists pass through this location every day as well. How can we allow such a lack of services to continue? Yes, there are many homeless and transients in the area. Yes, there is a large public mental health facility nearby. Yes, restrooms here would have to be monitored or staffed, but isn't public decency worth that? Also, the Amtrak station downtown, a public transportation station, has signs stating the restrooms are only for ticketed passengers plus there are no public drinking fountains that are operational in this entire station.

    Nona Yerbsns
    Nona Yerbsns

    I was going to read the article, but got stuck when I read the confusing and meaningless "But the past few years, they’ve hit debacle after debacle even in far less urgent attempts to add them."  What was meant was, of course, obstacle after obstacle, as it is impossible to "hit" a debacle. Please have the editor (if there is one) fix this as it can be very problematic for folks to understand a situation when correct word choice is not used. 

    Mark Giffin
    Mark Giffin subscribermember

    Good management is proactive. Poor management is reactive.

    Seems clear where the city fits into the quality of its management

    Greg Martin
    Greg Martin subscriber

    We have requirements to have parking, but not public restrooms.  What does that say about this city and its priorities?

    Bryan Borich
    Bryan Borich subscriber

    The restroom situation downtown is a disaster.

    When I was homeless downtown the only decent bathrooms were in the library (both old and new), the train station (which technically wasn't public) and by the Trolley stop across the street.

    The bathroom by City Hall was a nightmare and I expect hasn't changed, even with an attendant there.

    And while I haven't tried the new one in the new Horton Plaza, the smell alone would keep you out. In fact, the smell reminds me of what used to be coming from the underground bathrooms(? tunnel?) decades ago.

    And of course, if you're, a tourist, your s8*t out of luck, and I see them try to find one all the time.

    It's amazing hardly any of the Trolley stops have one either.

    [and having a few medical issues myself I need to stay within roughly an hour of a restroom if any trip is longer than that I might have a problem]

    Realistically I don't know of a decent solution, especially when some users abuse the restrooms available.

    Molly Cook
    Molly Cook

    Kevin Faulconer's legacy is going to be death and sh*t.  I hope he understands that.  I know there's a petition circulating to have San Diego officials charged with manslaughter in the deaths from Hep C as officials were in Flint for deaths from polluted water.  I fully support this petition. 

    While Faulconer and his cronies were blowing millions to keep a frigging football team in the city, people were getting sick and dying.  What kind of place is this?  San Diego has a "can't do" attitude that's truly appalling when it comes to humane behavior.  The people in charge of this fiasco need to be sued, booted out, replaced and relieved of their high-paying jobs.  What's happened in San Diego is becoming the shame of the nation and for good reason.  We're hitting the headlines in all the major news media and this one won't be forgotten any time soon. 

    Sixteen.  Remember that number.  That's the number of deaths it took for the city to even begin to take real action.  Sixteen. 

    Unacceptable, unbearable, unimaginable in 21st century America.

    Sharon Parks
    Sharon Parks

    ok, let's wait for the Hep B outbreak. Maybe then the city will bring in the semi's that they use for Quarkyard events.If the city can pay wannabe security guards to baby-sit the homeless during game season. then they could use them to "police" the toilets. What a scam, The city needs to get SUED!!!!! The longer they put off the need for toilets, the more death and disease will follow.These are third world conditions and the city is being.abusive and negligent to the citizens their sworn to protect.

    Mark Robak
    Mark Robak subscriber

    If you just step back and think about what is going on here, it is hard to fathom in a developed country.  Lack of restrooms, not only for the homeless but anyone else that would need to use one.  As well, The Trolley, owned and operated by the San Diego Metropolitan Transit System (MTS) also lack restrooms at their stations, including their main one near Petco Park where the MTS is headquartered.  So if you take The Trolley to the Padre game, you need to "hold it" before you get to the game.  And of course, there is The Trolley taking people all over the County, including people that might have Hepatitis A.  Some get off The Trolley at those other stations, where there are also no restrooms.  And if they are also homeless (which is common) they often times urinate and defecate in public.  Then the residents and business owners (including myself) have to clean-up, possibly putting themselves at risk.  

    I have repeatedly contacted the MTS about this as well Public Health Officer Wilma Wooten about the problemn and their silence has been deafening.  As the article correctly points out, restrooms cost money to be built and maintained and that is why it largely hasn't been done in the area. In the case of The Trolley, the taxpayers built and fund the system, which is not self supporting and requires ongoing taxpayer subsidies.  So the taxpayers are being asked to support an enormously expensive trolley system, but at the same time be asked to look the other way when it comes to the MTS providing a basic necessity like restrooms?  They should be ashamed of themselves for ignoring basic public sanitation that is common in other big transportation systems in the U.S. and throughout the developed world! 

    Bryan Borich
    Bryan Borich subscriber

    @Mark Robak  Actually, MTS does have bathrooms there sortof, they are in the government building housing MTS, and other offices.

    One of the few. Well, ok I know of only 4 stops that have one, 5 if I include the train station which technically isn't public.

    David Crossley
    David Crossley subscriber

    Where is that $5 million the Mayor wanted to use for the Soccer City special election that's not going to happen this year?

    Sharon Parks
    Sharon Parks

    @David Crossley  his wife took a over-niter to Newport Beach to go shopping , plus their trip to Canada plus their trip to China. plus all the other trips and shopping trips they have taken since he took over as mayor

    bgetzel subscriber

    Whether it is providing hand-washing stations, public restrooms or addressing the housing for the homeless, one thing is for certain - our Mayor has failed to respond aggressively. His passivity is an embarrassment! The guy needs a good shot of vitamin B12.