Everybody Poops BRIDGING RURAL HOMELESSNESS & WELL-BEING Public toilets are a community issue: A toilet facilities knowledge brief When you have to go, you have to go. Having easily accessible public toilets can impact social inclusion, comfort, and safety for many people in our communities. This includes parents, older adults, pregnant people, people with health concerns, and people with disabilities. Unfortunately, there is a lack of publicly accessible toilets in communities across BC, reflecting the broader issue of inadequate public toilet facilities in Canada. The lack of public toilets disproportionately impacts people experiencing homelessness. Access to washrooms and hygiene facilities has been a long-standing challenge for people who are unhoused and those with accessibility concerns. 1 The inability to use a toilet is not just embarrassing and annoying; it is a social justice and public health issue. 2 3 4 Installing publicly accessible toilets is crucial for promoting health, hygiene, and inclusion for all community members. This issue has become a crisis in rural communities, where public toilet facilities are even more limited than in urban centres. In the rural West Kootenay region of BC, only the City of Nelson provides access to a permanent public toilet 24/hours per day (located on Baker Street). 5 While public access to toilets is a community-wide issue, people experiencing homelessness are particularly vulnerable and experience additional barriers. Reluctance is one of these barriers, stemming from the fear of experiencing harassment or discrimination due to the stigma of homelessness. There is an increased urgency to find solutions for inadequate public toilet facilities in our communities. Access to toilet facilities has declined over the last few years due in part to the toxic drug crisis and as a result of restrictions related to COVID-19. Exacerbating this issue are the growing pressures that social service agencies are experiencing, which is resulting in less access to toilet facilities that were previously available through service agencies. This knowledge brief highlights key aspects of accessible toilets and summarizes approaches and solutions from other communities. While this discussion is limited to toilet facilities, people without homes also face other hygiene issues relating to a lack of shower and laundry facilities. Why are public toilets an issue? STIGMA FACED BY PEOPLE EXPERIENCING HOMELESSNESS Stereotypes and assumptions made about unhoused people are significant barriers to accessing public toilets. Arguments against installing additional public toilets tend to stem from stereotypes and stigma. Social media, news media, and community messaging can all contribute to stigma, and preconceived notions about people’s appearances can be particularly harmful. The visible homeless population is increasing in the West Kootenays, and with it comes rising stigma and hostility. Tensions are inflamed when people are assumed to be using substances. When faced with discrimination and hostility from businesses and the general public, people experiencing homelessness have no other option than to urinate or defecate openly or in their clothes. 6 7 When people experiencing homelessness feel like they have no choice but to relieve themselves in public, it results in further isolation, loss of dignity, and reinforces negative stereotypes. Overcoming stigma starts with letting go of divisive judgements and biases and framing homelessness as a societal issue requiring a community-based solution. SUBSTANCE USE Concerns are mounting regarding substance use and overdose in public toilet facilities. These public locations often include private businesses and organizations, libraries, government buildings, and park spaces. Toilets are locations for substance use because they are private places where they can avoid stigma and fear of others knowing of one’s substance use. This is especially the case when people are not able to access supervised consumption or overdose prevention sites. 8 The absence of a coordinated municipal or provincial response to this concern has resulted in many places no longer allowing access to their facilities or are implementing measures to discourage substance use. Rather than increasing safety, this approach increases risks for people who use substances. 9 TALKING ABOUT BODILY FUNCTIONS IS EMBARRASING During childhood, we depict bodily functions as embarrassing and public toilets as dirty or unsafe.7 This portrayal can lead to a negative relationship with these topics in adulthood. It is hard to talk about the need for toilets without discussing bodily functions. We often avoid stating the obvious: all humans have bodily functions requiring toilet or washroom facilities. Removing toilet access does not reduce community members’ need to urinate, defecate, change diapers, or empty ostomy bags. Without toilets, these bodily functions are happening in public spaces and can create public health issues, increase the spread of communicable diseases, and further ostracize vulnerable populations. It is not the unhoused population’s fault that they have to urinate and defecate unexpectedly. Nor is it realistic to ask people who are homeless to schedule their bodily functions for when they are at a shelter or a social service agency. T o ilet Fa cilities Kn o w ledg e Brief Ap ril 2 02 3 2 Who is responsible for addressing this issue? No public policy or funding structure identifies which level of government or who in our community is responsible for ensuring public toilet access. There are some bylaws related to establishments that serve food and alcohol having to provide toilet facilities. Still, they are also allowed to limit that access to paying customers, making the facilities inaccessible for many people experiencing homelessness and those living in poverty. Again, this is linked to stereotypes of what someone experiencing homelessness or using substances looks like because, anecdotally, it is commonplace for establishments to allow nonpaying customers who are dressed nicely or don’t “look homeless” to use their facilities. These bylaws may also pass the burden of providing toilet access to the public onto private businesses. Some municipalities have taken on this responsibility by including public toilets in their budget. 10 For example, the City of Nelson approved a one-time cost for a public toilet and used city staff for the installation. More commonly, public toilet installations in BC communities have been funded by applying for grants or accessing one-time funding from provincial or federal programs. Although this has recently expanded publicly accessible 24-hour toilets, it is not a long-term sustainable plan that embeds toilet access into municipal planning and funding. In many communities, it ends up being social service agencies and non-profit organizations that shoulder the burden of providing toilet access, specifically for people experiencing homelessness. This is an unsustainable long-term solution because the services these agencies offer tend to ebb and flow with funding cuts, staffing availability, and accessibility of their facilities. For example, in Nelson, the Salvation Army was a stop for people to use the toilet when they were there to get some food during morning and lunch drop-in times. With the recent closure of that drop-in service, people are losing access not just to breakfast and lunch, but to toilet and shower facilities. 11 Figure 1: Portland Loo in Downtown Nelson, 2017. Photo: City of Nelson. T o ilet Fa cilities Kn o w ledg e Brief Ap ril 2 02 3 3 What are some possible solutions? ADVOCACY Part of responding to this issue will be advocacy work to address stigma issues, garner community support and frame toilets as a social justice and community inclusion issue. Local anti-stigma campaigns locally focused on homelessness, substance use, and harm reduction have been successful. These campaigns have been run by community groups and agencies like the Trail Community Action Team, Trail Family and Individual Resource Centre (FAIR) Society, Castlegar & District Community Services Society, and the AIDS Network Kootenay Outreach and Support Society (ANKORS) and their Rural Empowered Drug User Network (REDUN) program. There are opportunities to build on this work and organizational knowledge to develop a public campaign to advocate for the urgent need for additional toilet facilities. In 2018, advocates in Winnipeg, MB, got creative and organized pop-up public toilets that also served as social enterprise for at-risk youth. 12 This situation was a unique partnership between an architecture firm and a business group. Together, they created an advertising campaign to bring attention to the need for public washrooms. They then created brightly coloured pop-up toilets that also housed a kiosk that employed at-risk youth to sell a variety of items and to monitor and clean the toilets. While these were not 24-hour toilets, they demonstrated the need, increased awareness, and gained public support for more permanent solutions. There were five key learnings from the Winnipeg project: 1. Partnerships: Partnerships were important. This case involved, among others, members of local businesses and community members, architectural and graphic designers, social enterprise advocates, outreach workers, municipal officials, and city councillors. 2. Community services: Using youth employees in oversight and maintenance, rather than having self-cleaning toilets, provided youth with not only experience and money, but an opportunity to contribute positively towards society. 3. Design: The intention was not to be discreet but to capture the public's imagination through bright, attention-grabbing toilets. 4. Messaging: Different methods were used to magnify the message, such as politicized art, media exposure, and strong public presence. 5. Public involvement: The pop-up toilets garnered positive publicity and media responses. The toilets were well used and the area surrounding the pop-up saw dramatic improvements in cleanliness and decreased vandalism. This evidence can be used to counter concerns about the safety of public toilets. MAKING EXISTING FACILITIES SAFER One solution to increase access to public toilets is to utilize existing toilet facilities in public spaces and buildings. First, concerns regarding substance use and overdose must be addressed. There are ways of making bathrooms safer for people who use substances. Implementing a safer bathroom policy/protocol promotes increased safety for all bathroom users, including staff. The University of Victoria’s Safer Bathroom Toolkit outlines principles, standards, and procedures for improving bathroom safety. 13 This excellent resource includes checklists, design ideas, and signage that businesses and organizations can use. There are also systems like Brave that alert staff to potential overdoses in their toiler facilities (currently in use at Nelson’s Stepping Stones shelter). 14 It detects a lack of movement and sends out an T o ilet Fa cilities Kn o w ledg e Brief Ap ril 2 02 3 4 alarm. It is important to note that these resources differ from traditional methods for discouraging substance use, such as blue lights, which make it harder to find veins for injections, as these methods can increase harm.8 9 EXPANDING PUBLIC ACCESS There is potential for a community-based toilet facilities solution not yet implemented widely in Canada – the Community Toilet Scheme. This policy provides public access to existing toilet infrastructure within private establishments. Found throughout the United Kingdom and Europe, this approach has been particularly successful in the City of London. Municipalities partner with private businesses that voluntarily participate and open their toilets to the public. Businesses must present adequate signage for their toilets outside their building to indicate to the public that their bathrooms are available. There must also be signage and mapping to indicate nearby Community Toilet Scheme toilets. In return, the businesses are compensated through tax breaks or a subsidy to cover the additional expenses for cleaning, maintenance, and supplies. Participating communities and government officials have praised Community Toilet Schemes as an inexpensive and fast way to increase toilet provision to the public. However, the main disadvantages are limited hours of availability and the societal barriers and stigma preventing people from freely using the facilities, despite being open to the public. 15 The toxic drug crisis is also presenting barriers to publicly accessible toilet facilities. Financial and practical support may be needed to address business owners' and operators' safety concerns regarding substance use and overdosing. Understanding how to implement this solution locally requires more research. INSTALLING 24-HOUR ACCESSIBLE TOILETS • • • Portable toilets – Known as porta-potties, these mobile toilets are used in several BC communities. They are currently in use in Castlegar as a short-term solution. 16 A local company, Trowlex Rental & Sales, reduced the cost of the Castlegar toilets by donating the units. Other municipalities have reported the rental prices as $4,500 for three months (not including maintenance fees). 17 This option can be costeffective, but the toilets may not be accessible for all persons and require additional maintenance for cleaning. Self-cleaning toilets – Widely used in Europe and the United Kingdom, some Canadian cities have trialled these automated toilets. Despite the perceived cost-savings in maintenance fees due to the automated cleaning, these units may not be suitable for Canadian climates. 18 19 Cities like Calgary, AB, removed these expensive units due to issues with upkeep and repair and seasonal concerns (e.g., frozen water lines). Portland Loo – This option has been the most popular choice for toilet solutions in BC, with installations in Esquimalt, Kamloops, Nanaimo, Nelson, Prince Rupert, Smithers, Vancouver, and Victoria. These singleoccupancy units are easily installed, solar powered, and have features including anti-graffiti panels, open grating at the top and bottom of the unit, and a coating for easy cleaning. This model was developed in Portland, OR, as a response to the lack of public toilets for people experiencing homelessness. Features were intentionally designed to address common concerns and issues in traditional public washrooms (e.g., vandalism, drug use, and prostitution). These units have been generally well-received by the public, are well-utilized by community members, and have shown to be a sustainable option for municipalities regarding ongoing maintenance. While the Portland Loo unit costs $150,000, installation costs vary depending on infrastructure needs. Most communities' average installation costs range between $200,000-$300,000, with a recent Vancouver project costing $649,000. 20 Maintenance costs depend on infrastructure and labour but are quoted between $30,000-$55,000 annually. The City of Nelson has indicated that the long-term operating and maintenance costs are lower than for a conventional public washroom building. 21 T o ilet Fa cilities Kn o w ledg e Brief Ap ril 2 02 3 5 References Macrae, E. (2020, September 18). Let them have toilets: COVID puts spotlight on lack of access to sanitation. Ricochet. https://ricochet.media/en/3289/let-them-have-toilets-covid-puts-spotlight-on-lack-of-accessto-sanitation 2 Dunham, J. (2016, September 16). Canadians suffering for lack of public washrooms: expert. CTV News. https://www.ctvnews.ca/canada/canadians-suffering-for-lack-of-public-washrooms-expert-1.3075299 3 Picard, A. (2015, July 7). An urgent matter: more public washrooms. The Globe and Mail. https://www.theglobeandmail.com/opinion/an-urgent-matter-more-public-washrooms/article25327995/ 4 Wilson, E. (2018). “Washrooms for customers only”: Space, dignity, and sh*tting in the city [Master’s dissertation, University of Guelph]. The Atrium. https://atrium.lib.uoguelph.ca/xmlui/handle/10214/14705 5 Nesteroff, G. (2017, May 23). Nelson to install Portland loo. My Nelson Now. https://www.mynelsonnow.com/26169/news/nelson-install-portland-loo/ 6 Gangdev, S. (2020, September 10). ‘It’s so frustrating’: Lack of public toilets leaves Downtown Eastside residents with few options. Global News. https://globalnews.ca/news/7327479/its-so-frustrating-lack-of-publictoilets-leaves-downtown-eastside-residents-with-few-options/ 7 Lowe, L. (2018). No place to go: How public toilets fail our private needs. Coach House Books. 8 Goodyear, T., & Gagnon, M. (2022, October 11). Drug overdoses in public bathrooms are common: new tools could prevent harm and improve response. The Conversation. https://theconversation.com/drugoverdoses-in-public-bathrooms-are-common-new-tools-could-prevent-harm-and-improve-response191406 9 Wytton, M. (2022, November 22). Saving lives one bathroom at a time. The Tyee. https://thetyee.ca/News/2022/11/22/Saving-Lives-Safer-Bathrooms/ 10 Grochowski, S. (2020, September 21). ‘It is a human right’: $1.1M committed for public washrooms in Downtown Eastside. Vancouver is Awesome. https://www.vancouverisawesome.com/local-news/million-publicwashrooms-dtes-vancouver-2729798 11 Nelson Star Staff. (2023, March 16). Nelson’s Salvation Army ending morning drop-in service. Nelson Star. https://www.nelsonstar.com/news/nelsons-salvation-army-ending-morning-drop-in-service/ 12 Bridgman, R. S. C., & Bridgman, W. (2018). Public toilets, accessibility, and human rights: A Winnipeg pop-up campaign. Plan Canada. http://dx.doi.org/10.25316/IR-15100 13 Canadian Institute for Substance Use Research. (n.d.). The Safer Bathroom Toolkit. University of Victoria. https://www.uvic.ca/research/centres/cisur/projects/active/projects/safer-bathrooms.php 14 Brave. (n.d.). Overdose detection for public bathrooms. https://www.brave.coop/overdose-detection-sensors 15 Bichard, J-A., & Knight, G. (2011). Publicly assessible toilets: An inclusive design guide. Royal College of Art. https://researchonline.rca.ac.uk/440/ 16 Kline, B. (2023, January 5). Three portable public toilets to be installed around Castlegar. Castlegar News. https://www.castlegarnews.com/news/three-portable-public-toilets-to-be-installed-around-castlegar/ 17 Depner, W. (2022, June 8). Standard and accessible portable toilets coming to Sidney’s Beacon Park. Victoria News. https://www.vicnews.com/news/standard-and-accessible-portable-toilets-coming-to-sidneysbeacon-park/ 18 Khairzada, Z. (2022, March 23). LA flushes deal that brought self-cleaning public restrooms to downtown. Spectrum News 1. https://spectrumnews1.com/ca/la-west/politics/2022/03/23/toilets-for-ad-space 19 Pike, H. (2022, September 16). Self-cleaning public toilets in East Village to be replaced. CBC News. https://www.cbc.ca/news/canada/calgary/east-village-calgary-cmlc-self-cleaning-toilets-1.6584480 20 DeRosa, K. (2021, March 23). Flush with cash: Vancouver’s $645,000 public toilet raises eyebrows. Vancouver Sun. https://vancouversun.com/news/local-news/vancouvers-645000-public-toilet-raises-eyebrows 21 City of Nelson. (2017). Top 10 questions about the Portland Loo in downtown Nelson. https://www.nelson.ca/archive/viewfile/item/144 1 T o ilet Fa cilities Kn o w ledg e Brief Ap ril 2 02 3 6