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San Diego Scrambles to Address Long-Festering Lack of Restrooms

San Diego’s long had a dearth of public restrooms to accommodate downtown, and failed to add enough despite continued calls for more. Now that lacking response has amplified a deadly outbreak.

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.

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.”

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