As the homeless figures rise, the need for more toilets, showers and laundry facilities is evident
During the last week of September, two portable toilets were placed in downtown Oregon City, providing access to public restrooms in downtown 24 hours a day, every day of the week for the first time in the city’s history.
Called “Arta Potties” after the community organization in Salem that works to install port-a-potties throughout Salem’s downtown core, the public toilets are painted over with scenes of Oregon City’s history. The Oregon City Police Department spearheaded the installation, citing the need for public bathrooms, especially among the city’s homeless population.
When people name the most important services to offer to homeless people, they often list shelter and food.
Another essential service, hygiene, is less commonly mentioned. But as homelessness in the Portland area increases – by 10 percent, according to this year’s biennial point-in-time count – and the region’s affordable-housing crisis shows little abatement, more efforts are being made to provide such services to homeless people.
A Portland State University study, released this spring, surveyed 550 homeless people and found that the majority of respondents “struggle to meet their basic hygiene and health needs because of a shortage of showers, bathrooms and washers and dryers.”
FURTHER READING: Lack of access to basic hygiene compounds difficulties of homelessness
Not showering or having access to a shower and other hygiene services is linked to methicillin-resistant Staphylococcus aureus (MRSA), fungal, strep and staph infections, and skin infections such as scabies and head and body lice.
Lack of cleanliness and hygiene could also be one of the main reasons homeless people are so stigmatized by the public.
“It’s immediately othering,” said David Bikman, chair of the steering committee of the Village Coalition, which supports and advocates for homeless villages in Portland. “Being clean is pretty important to your pride and sense of self worth.”
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In Portland, the availability of hygiene services is a bit patchy. The day center at Bud Clark Commons, which is operated by Transition Projects, allows for 100 showers and 48 loads of laundry each day.
JOIN, the outreach agency in outer southeast Portland, offers 40 showers a day each weekday and vouchers for a nearby laundry, but those showers and the rest of the agency’s day center has been closed for much of this year for mold remediation and repairs.
The Portland Loo, the stainless steel, European-style public bathrooms championed by former city commissioner Randy Leonard, was built as a way of providing bathroom services for homeless people.
When they appeared in downtown and the Pearl District, they caused a great deal of controversy and “not in my backyard” backlash. News of the loos has since waned, but six more have been built in Portland since the original four planned by Leonard’s office, said Evan Madden, sales and marketing director of Madden Fabrication, the company that builds the loos. The loos are also installed in new parks in Portland and are also replacing old brick-and-mortar bathrooms.
The lack of comprehensive hygiene services in the Portland area is evident. In the PSU survey, 40 percent of respondents reported medical issues, including staph infections, scabies, lice and open sores – all of which could be prevented with better hygiene.
The consequences of poor hygiene can go far beyond health. In the survey, one in five respondents said they were turned away from sleeping in a shelter due to poor hygiene. The same amount also said their poor hygiene meant being denied access to food pantries or other services.
Earlier this month, Islamic Social Services of Oregon hosted its annual “Day of Dignity” event, where various agencies provided free medical and dental care, hair cuts, and other services to homeless people. The organization distributed 550 hygiene kits containing toothbrushes, toothpaste, combs, soap, towels and deodorant.
When the Day of Dignity event started 10 years ago, Laila Hajoo, president of Islamic Social Services of Oregon, said that providing hygiene kits was a fundamental part of the service.
“If it were plentiful and easy to get, (people) wouldn’t be asking for it,” she said.
This year’s Day of Dignity event was the first time the Portland Menstrual Society, a Portland State University student group that advocates for access to female hygiene products, participated in the event. Within a few hours, the group handed out 200 kits, including enough sanitary pads and tampons to last a week, and 50 menstrual cups.
“Easily, just at our tent, we saw 300 people,” said Lynn Hager, the group’s founder.
One of those people, Hager said, was a homeless man who told the group that his 12-year old daughter, also homeless, had just started her period.
“When people think of the houseless community, they think about the need for food, shelter, clothes, warm blankets,” Jennee Martinez, a member of the group, said. But it’s also important to think about hygiene and menstrual supplies, she said. “It’s commonly overlooked.”
In July, the day center of the Clackamas Service Center closed because of a fire. It is the only homeless services agency of its kind within miles in southeast Portland. But despite the damage, volunteers and staff never stopped offering some its most important services.
Within days of the fire, agency staff set up tables in front of the center’s building, offering food and clothes from the clothing closet, distributing mail, and giving out hygiene items such as hand sanitizer and soap. The agency is also renting two portable sinks with hand sanitizer and two port-a-potties. A medical unit from Outside In, a homeless youth services agency, visits the center once a week, and Debra Mason, the center’s executive director said, “We needed a presence” so that the medical unit had patients to serve.
Mason said offering hygiene services is one of the center’s top priorities. And it is paying off in people’s health. Kelly Anderson, communications director with Outside In, saud more than 90 percent of the homeless people mobile medical staff were seeing had improved health outcomes – less scabies, lice and skin infections.
“That was an outcome we weren’t thinking about at all,” Mason said.
The Clackamas Service Center also uses a mobile shower cart, located on its property, that contains two shower stalls. The center began offering showers a year ago, and Mason hopes to start offering the service again to the center’s clientele in the coming weeks.
Fifteen minutes of hot water and a private shower makes a huge difference in clients’ lives, Mason said.
“Looking at the look on clients’ faces was amazing,” she said. “Saying it was a blessed out look is not overstating it. We knew it was going to make people feel good.”
Ronni Gilboa, the general manager of Seattle’s Urban Rest Stop, does not mince words when she speaks of the importance of hygiene to homeless people.
“We are keeping people alive, safe, clean and healthy,” she said.
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In 1999, the Low Income Housing Institute opened its first Urban Rest Stop in Seattle. Today, there are three such hygiene centers offering showers, laundry services and bathrooms.
Since opening, Urban Rest Stop has served over 100,000 people, general manager Ronni Gilboa estimates. Each year, the program serves between 5,500 and 6,500 people. Half of those people, Gilboa said, are clients who had never used Urban Rest Stop’s services before.
Each client is allowed a 15-minute shower in a stall also containing a toilet, a sink and a place to safely store possessions.
After each use, the stalls and bathrooms are cleaned with bleach and water, and the air is cleaned with an electrostatic purifier.
The cleaning measures are cheap and necessary, Gilboa said.
“We’re dealing with people who live outside,” she said. “Their immune systems are compromised. They’re under stress, not eating well, not sleeping well. God knows what kind of contaminants they’re picking up.”
Once someone has taken a shower and used Urban Rest Stop’s other services, Gilboa said, it’s hard to tell if they’re homeless.
“They’re not unlike anybody else in town with a backpack, and there are a lot of people who have backpacks and rain jackets in Seattle,” she said.
Urban Rest Stop does not operate any mobile shower units, but Gilboa said it is something the agency is thinking of adding. Mason said the Clackamas Service Center is considering adding a mobile shower unit to its services. But there are logistical challenges, such as limited water and time.
The Village Coalition, which works to build and support tiny-home villages, is working with a private philanthropist to build a solar-powered tiny house, on a trailer, that contains a shower and a washer and dryer. The coalition was instrumental in starting Portland’s newest homeless village, the new Kenton Women’s Village in the Kenton neighborhood.
Bikman said the hygiene trailer can be built for less than $8,000, and the first one will be used at Right 2 Dream Too, a homeless village in inner northeast Portland, in the coming weeks.
“Increasing access to hygiene is changing the public’s perception of what houseless people are capable of and how they should be cared for and empowered to care for themselves,” he said.
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One need look no further than San Diego, where there has been a deadly outbreak of Hepatitis A, especially among the homeless population, to understand the consequences of not providing hygiene services.
The outbreak of the potentially fatal disease, which attacks the liver, began in November 2016 and has resulted in the deaths of 17 people and the hospitalization of more than 400, the large majority of them homeless. The Centers for Disease Control and Prevention said earlier this year that the outbreak represented the most deaths of any outbreak in the United States in the past 20 years.
Hepatitis A is spread through water and food contaminated by human feces. It is easily preventable and “closely associated with unsafe water or food, inadequate sanitation and poor personal hygiene,” according to a World Health Organization fact sheet.
San Diego declared a public health emergency in September and has begun power-washing sidewalks with bleach and water, as well as opening public restrooms and hand washing stations. Police are also sweeping parts of downtown where nearly 1,000 homeless people have been camped.
Gilboa could hardly contain her “nausea and my anger” when she learned of the outbreak, not only because the outbreak was easily preventable but also because of the cost of hospitalizations and other responses. “You could have built a chain of Urban Rest Stops,” she said.
Whether an Urban Rest Stop-style hygiene center will be built in Portland remains to be seen. The main recommendation of the PSU survey is to build a hygiene center open seven days a week for at least 12 to 14 hours, providing showers, bathrooms, laundry facilities, and storage or locker space.
Lisa Hawash, the Portland State University professor who spearheaded the hygiene survey, said she is developing a business plan for a hygiene center in the Portland area.
“There is a sense of urgency with thoughtfulness,” she said.
“We have a civic responsibility to take care of people … to sustain people, (so they can) get into housing,” Gilboa said. “End of discussion.”
