Years before homeless people started dying and ending up in hospitals with hepatitis A, the city of San Diego was given a choice: Either open more public restrooms downtown so people can do their business in a toilet and wash their hands, or be liable for an outbreak that was surely brewing in the unsanitary conditions of homeless encampments.
San Diego made the wrong choice, saying in 2005 that it didn’t “have the resources to execute a project of this magnitude.” Now, 481 mostly homeless people have tested positive for hepatitis A and 17 of them have died, making this outbreak one of the largest in two decades.
“This hep A outbreak in other parts of the state helps give us a wake-up call that we need public facilities, but we need them to be safe and clean,” Sacramento Councilman Jeff Harris told The Sacramento Bee last week.
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Sacramento doesn’t want to be like San Diego – or Santa Cruz or Los Angeles, which have growing outbreaks of their own – and that’s understandable. But let’s not pretend this is a new problem.
Ever since the City Council closed or limited the hours of about a dozen public restrooms during the recession, homeless advocates have been pushing to reopen them as a matter of public health. But too often, the thinking in Sacramento and across California has been that if cities don’t provide restrooms, all of those unseemly homeless people will just go away.
Well, there is no “away.” There’s only hepatitis A.
It’s spread through the accidental ingestion of fecal matter from an infected person and it’s highly contagious, especially among homeless people who can’t wash their hands and often suffer from liver disease and other chronic ailments.
The best way to prevent hepatitis A is to get vaccinated. But the California Department of Public Health says it has only gotten requests for 1,000 vaccines, far less than the 3,600 or so homeless people living in Sacramento County.
I think about this every time I walk past the same pile of human feces. It can get dark and desolate on Q Street in the wee hours, and my guess is some homeless person, unable to find a toilet, just squatted there one night.
It’s not like this is unusual in midtown or downtown either. When I have friends visit from out of state, one of the first things I tell them is to watch where they step. Alleys smell like urine and vomit. I’ve seen feces smeared on the sidewalk and nestled in people’s lawns. The lower half of the American River is apparently teeming with E. coli, most likely from homeless campers dumping their bodily fluids in the river before bathing in the same water.
The response to this disgustingness from both the city and county has largely been to move homeless people around and clean up after them – and then complain about the gobs of money that’s spent on both exercises in futility.
Meanwhile, the only public restroom open to homeless people downtown is in the Central Library, which isn’t open at night. The city-run restroom that was in Cesar Chavez Plaza is now run by the trendy restaurant LaCosecha and it’s closed to the public over fears of vandalism.
It’s easy to blame homeless people for this. But come on. Everybody poops.
The City Council seems to recognize this – at least in theory. In the past two years, I’ve heard members discuss everything from building a Portland Loo to reopening restrooms in certain midtown parks.
Last year’s Pit Stop program, which temporarily put a portable restroom in the River District near Loaves & Fishes, was a success. It was expensive, though, costing $173,000 for six months, mostly because of the paid attendants who made sure the stalls stayed clean and didn’t become havens for drug use.
Harris says he’s working on a plan to revive the best aspects of the program, ideally for less money. Hopefully, it will become a reality this time, instead of just more talk.
But if it turns out the city is too late and there’s already a strain of hepatitis A infecting homeless people, then council members will have only themselves to blame for procrastinating and putting the public’s health at risk.
“The bottom line,” Harris said, “is I want to be able to walk from City Hall to Golden 1 Center and not smell feces and urine.”
Yes, that would be nice.