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Lack Of Access To Clean Water Is Putting Homeless People At Risk Even As Cities Reopen Amid COVID-19

Health officials say hand washing is key to avoiding the novel coronavirus, but millions of homeless people continue to have little or no access to hygiene stations.

A neglected hand-washing station in Oakland, Calif., on Tuesday, March 24, 2020.Getty Images

The sun was just beginning to rise over Peoria, Illinois, when construction workers showed up at their job site and began ordering people camping on the lot to get up and move. In the early morning chill, some of the campers—virtually all of them elderly and coping with chronic pain and mobility issues—struggled to get going. This was not the first time they had been displaced from their makeshift encampment, but it was a surprise to be ushered out so suddenly in the middle of the COVID-19 pandemic. It didn’t just mean the loss of a rare patch of relative shelter; it also meant that, once again, they would have no nearby access to toilet and hand-cleansing facilities.

When Chris Schaffner, program director at JOLT Harm Reduction, made his routine morning drive-by on May 19, he found the campers gathered across from the construction site, next to a set of portable toilets and a hand-sanitizing station that his organization had worked with the city to secure after the novel coronavirus caused public facilities and businesses to close. It was no accident that the toilets were directly across the street from the newly displaced encampment.

“I advocated for them specifically because they have limited mobility, so we wanted one close to where they were at for that very reason,” lamented Schaffner. 

There are four bathrooms and two hand-sanitizing stations total, at two downtown locations. They don’t use water, just alcohol-based sanitizing gel—JOLT tries to make up for that by bringing jugs of water and hand soap when the organization does harm reduction outreach at the encampments—but they give Peoria’s homeless population a measure of cleanliness and privacy. 

“When our government implemented shelter-in-place protocols throughout the state … people living on the streets had every bathroom they were able to use previously just taken away from them,” recalls Schaffner. Not only were they forced to relieve themselves outdoors, they also had no way to keep themselves clean or wash their hands—an essential component of basic hygiene now even more crucial in the context of a viral pandemic.

Across the nation, with many businesses and nonprofits still closed to foot traffic even as states loosen restrictions, people without homes are left with few options for staying clean.  

The Centers for Disease Control and Prevention (CDC) issued guidance on how to address some of the unique risks that come with being homeless during the pandemic, including lack of access to hygiene facilities. The agency recommends a “whole community” approach that utilizes collaboration between the full spectrum of providers, including law enforcement, health departments and other government agencies, and outreach teams and people experiencing homelessness themselves.

Some metropolitan areas have taken those recommendations to heart, like Seattle, which has the third largest homeless population in the United States. There, various city and county offices, such as Seattle Public Utilities and Public Health Seattle & King County, have teamed together to operate a variety of hygiene stations. These include two hygiene trailers equipped with showers, and strategically placed hand-washing stations that are operational near known encampments every day from 7 a.m. to 8 p.m. 

“There’s definitely a need for sanitary systems, [there’s] not enough sinks, and not enough bathrooms,” said Shilo Jama, executive director of the People’s Harm Reduction Alliance (PHRA), a drug user-led syringe distribution service headquartered in Seattle. “We have a hepatitis A outbreak that is pretty bad in the city, and that’s partly because of the [lack of] sanitary systems.” 

In addition to its regular services, PHRA has been operating a portable hand-washing station during its open hours. ROOTS Young Adult Shelter, in conjunction with the University of Washington, also installed a hand-washing station in the same alleyway where PHRA operates, near the university’s main campus. Jama described other community hygiene efforts, such as a local business owner producing and dispensing hand sanitizer, and free hepatitis A and hepatitis B vaccinations offered weekly by Public Health Seattle & King County at PHRA.

“My community … wouldn’t make it without everyone involved,” Jama said. “That includes the shop owners, that includes residents, that includes homeless community members, everyone.”

A smattering of cities across the U.S. report similar endeavors. Denver and San Francisco, for example, implemented public hand-washing facilities in collaboration with community organizations that serve high-risk populations. But many parts of the country lack a holistic, targeted response to address hygiene among people experiencing homelessness. 

“The homeless situation as far as showers are slim to none, the portable toilets around the city are slim to none. These are all essential things people need,” said Hiawatha Collins, harm reduction community mobilization coordinator at the Harm Reduction Coalition in New York. New York City has the highest number of homeless people in the country; although some shelters have remained open, many drop-in centers where people can take showers and rest have been forced to close.

Some communities have decided to stop waiting for government action. Devin Ceartas, a mutual aid organizer in Chapel Hill, North Carolina, teamed with other community members he knew from past mutual aid projects to build and distribute simple but functional makeshift hand-washing stations throughout Chapel Hill and the neighboring towns of Durham and Carrboro. Unlike Peoria’s city-funded efforts, these home-crafted units use soap and water, which volunteers refill once an alert is posted on a website that Ceartas built to track the units. Overall, he says the stations have been well-received, though a couple have gone missing. One was even called in to the police as a bomb scare, Ceartas recalled with a chuckle—but besides those few hiccups, the response has been overwhelmingly positive.

“If washing your hands is the most important thing to do right now and you don’t have a place with running water, that’s going to be an issue” Ceartas said. “Any time we see people on the streets, they are very thankful for [the hand-washing stations]. They all agree it’s a good idea.”

In Peoria, Schaffner says members of the displaced encampment have not yet found a suitable location to replace the site they lost, and that virtually no other options exist near the downtown area.

“The options are limited, and will push them farther from the public restrooms,” he said. “They will likely end up in a small encampment farther out, that will very rapidly become unsanitary, risking a hep A outbreak again, which is why we fought to get those toilets up to begin with.”