Let them have toilets: COVID puts spotlight on lack of access to sanitation

People who use wheelchairs and those experiencing homelessness among groups facing new barriers to basic hygiene
Emily Macrae
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On a weekday morning at Toronto’s Grange Park, damp clothes dry on improvised laundry lines outside half a dozen tents while city workers rake the playground and seniors assemble for tai chi on the lawn.

The encampment fluctuates in size from day to day but has steady access to multiple sources of running water. Later in the day children will run through a splash pad, friends will take selfies beside a silver fountain, cyclists will fill water bottles and people of all ages will shuffle in and out of a cluster of public washrooms.

Park washrooms are closed overnight, leaving residents of Toronto’s encampments with no safe place to meet basic needs for 12 hours each day. It’s a challenge that’s not unique to Canada’s largest city.

Despite the lack of toilets, sinks or showers, encampments continue to grow in communities across the country, surfacing long-standing sanitation issues at a time when public awareness of handwashing has never been higher.

Social distancing without a home

Though they may seem like a symptom of the COVID-19 pandemic, “encampments have always existed,” notes Dr. Claire Bodkin, a resident in family medicine and organizer with the Hamilton Social Medicine Response Team. She has been working to support encampments since the spring, seeing “more and more people wanting to avoid shelters because of their concerns about COVID-19.”

The pandemic has exposed congregate living situations as a high risk for infection. The City of Toronto has had to improve distancing measures at shelters following a legal challenge.

“Tents are arguably better social distancing than many shelters,” says Dr. Eva Purkey, an organizer supporting the Belle Park encampment with Mutual Aid Katarokwi-Kingston.

Different cities have taken different approaches to meeting the sanitation needs of encampment residents since the outset of the pandemic.

Toronto opened two shower facilities and increased access to public washrooms at four other sites.

Kingston initially supported sanitation at the Belle Park encampment by extending the hours of the park washrooms and providing additional porta-potties, wash stations, power and waste disposal. However, these services were cut off in mid-August, and the community was evicted on Sept. 1, forcing residents farther into the woods.

In contrast, a statement from the City of Hamilton confirms that six porta-potties that were removed from downtown locations on June 26 “were not provided for the encampments.” Instead, the city describes them as “a temporary measure during the early days of the pandemic shut down as no public restrooms were available.”

A loss of dignity

Access to public washrooms is not only an issue for people living in parks. Dr. Bodkin describes patients not experiencing homelessness who are nonetheless “not being able to make it to a washroom on time … because there’s so few public washrooms available.” The resulting loss of dignity and lack of cleanliness only compounds the stigma for those who don’t have reliable access to washrooms.

For people who use wheelchairs, planning everything from social gatherings to grocery shopping around access to washrooms long predates the pandemic. Laurence Parent conducted her doctoral research on the mobility experiences of Montrealers with disabilities. As a wheelchair user herself, she knows that “truly accessible washrooms are rare.”

While people experiencing homelessness lack access to showers and laundry facilities, people using wheelchairs and other mobility aids struggle with doors that are too narrow, sinks that are too high and entire buildings that are blocked off by steps. The lack of accessible and adequate sanitation prevents both groups from fully participating in public life.

Like people using shelters, people with disabilities are more at risk of COVID-19 because thousands are confined to long-term care centres in the absence of community supports. Even outside of institutional settings, experiences often intersect, since people who are precariously housed are also more likely to live with disabilities.

Dr. Parent’s research shows that “those who experience several types of discrimination — for example, racism and ableism — are more likely to face obstacles.” In Kingston, at least one resident of the Belle Park encampment used a wheelchair, making the porta-potties all but unusable. The alternatives are no safer: if you’re Indigenous, racism among healthcare providers means wearing a catheter can be a death sentence.

Sanitation is a right

The result is not simply that basic needs are unmet, but fundamental rights are trampled. In 2010 the United Nations recognized the right to sanitation, defined as “safe, hygienic, secure, and socially and culturally acceptable and that provides privacy and ensures dignity.”

That same year, Canada signed and ratified the United Nations Convention on the Rights of Persons with Disabilities. The convention’s commitment to living independently states, “Community services and facilities for the general population are available on an equal basis to persons with disabilities.” The same cannot be said of coffee shops with steps at the entrance or concert venues with basement bathrooms.

In Canada, recent federal disability legislation has been narrow in scope, and a patchwork of provincial approaches set standards for accessibility without allocating funding for retrofitting existing buildings or enforcing compliance. Quebec’s accessibility legislation was world-leading when introduced in 1978, but today’s political leaders have not prioritized necessary updates.

As for the human rights of people experiencing homelessness, tent cities have attracted international scrutiny with the UN releasing A National Protocol for Homeless Encampments in Canada. The document frames encampments as “human rights violations of those who are forced to rely on them for their homes.” At a minimum, it says, encampments must have access to hygiene and sanitation facilities. “Using existing facilities that remain open to the general public will not be appropriate.”

UN investigators, encampment allies and accessibility researchers all point to a common solution to the crisis of sanitation facing people experiencing homelessness and living with disabilities. The encampment protocol starts by recognizing residents as “experts in their own lives.”

Based on her experiences at Kingston’s Belle Park encampment, Dr. Purkey agrees. “People are amazingly resourceful and resilient and that is worthy of respect.”

Similarly, Dr. Parent celebrates “the brilliant strategies other disabled Montrealers have developed to navigate the city.”

Creating communities where everyone can live with dignity requires a commitment to listening to people with lived experience of trauma and discrimination, then redistributing resources to act on their observations. As Dr. Bodkin from the Hamilton Social Medicine Response Team says, addressing the tangled web of sanitation and stigma means “treating people as people and not as a problem to be solved.”

Emily Macrae is a writer and organizer combining policy analysis with lived experience to build accessible digital and urban environments.

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