Nearly 3.6 billion people globally do not have access to toilets, which results in poorly managed sanitation. In observance of World Toilet Day on 19 November 2021, we take a closer look at the impact of lack of access to toilets for people experiencing homelessness, especially in times of crises such as the Covid-19 pandemic. New research highlights the impact of Covid-19 on toilet access for people experiencing homelessness in Mexico City.
While the impacts of Covid-19 are wide-ranging, the closure of facilities providing affordable water and sanitation services has been overlooked, such as metro stations with toilet facilities or restaurant owners that let passers-by fill up a bottle of drinking water. For people experiencing homelessness, the lack of water and sanitation services due to Covid-19 restrictions created immediate threats to health, safety, and dignity. In addition, many lost their incomes and were unable to pay for these services. Together with the Mexican civil society organization El Caracol, SEI investigated the uneven impacts of Covid-19 on homeless people in Mexico City.
"Before the pandemic, I could drink water from the water fountains in the metro station, but they closed the facilities. Now I have to buy bottled water, which is expensive." – Anonymous interviewee
From February to April 2021, we documented the experiences and factors affecting access to water, sanitation and hygiene (WASH) services and the resulting coping strategies among people experiencing homelessness in Mexico City during the Covid-19 pandemic. The data collection was part of the health campaign that El Caracol had initiated at the beginning of the pandemic, which consisted of visiting different municipalities of the city to provide barrels of water and sanitary products to protect against Covid-19.
According to the last census carried out in Mexico City in 2018, there were 6754 people experiencing homelessness, of which 4354 were found in public spaces and 2400 in public and private shelters, where 87.27% were male and 12.73% female. Women tend to avoid sleeping on the streets because they are more likely to face sexual harassment, abuse and violence.
For many people experiencing homelessness, taking care of their water and sanitation needs represents an economic and safety issue. Many of them depend on businesses and public services to attend to their WASH needs. This exposes them more frequently to potential aggression and discrimination when attempting to access a sanitation facility.
"When I am in the toilet, they just throw water at me because they think I am dirty." – Anonymous interviewee
Some are denied access to facilities because of their physical appearance and others do not have enough money to pay the entrance fee every time they need to use the toilet or take care of their menstrual hygiene. This takes a higher toll on women with different water and sanitation needs, such as the need for more privacy to take care of their menstrual hygiene, as well as the needs of their children and elderly family members on many occasions. While these barriers have always existed for people experiencing homelessness, the Covid-19 pandemic exacerbated them.
When the Covid-19 pandemic was declared a national sanitary emergency in March 2020, businesses and public facilities in Mexico City closed, affecting access to water and sanitation facilities for people experiencing homelessness. From one day to another, they were left with no private spaces to urinate, defecate and take care of their menstrual needs.
Deprived of the limited access to sanitation facilities, many people experiencing homelessness had to move away from their usual areas and find new sanitation facilities, while others had to resort to coping mechanisms that on many occasions put their health and dignity at risk. For those that used new facilities, they reported that these were dirtier and more insecure and expensive. For those who decided to stay in their conventional areas, some of the coping mechanisms they implemented to avoid using poor sanitation facilities frequently included eating and drinking less to avoid going to the toilet often. This left many with no alternative but to practice open defecation.
Open defecation can have a large negative effect on human health and the environment. However, for those who defecate in the open, it can have severe safety and dignity implications and cause long-term negative effects on psychosocial well-being. Girls and women who are homeless or have experienced homelessness expressed feeling dirty, vulnerable and more exposed when forced to defecate and take care of their menstrual hygiene in the open. In the study, individuals who practiced open defecation during the pandemic reported having experienced physical violence and verbal abuse from the authorities. Open defecation is a violation of human dignity and therefore a human rights concern.
The reality is that practically no sanitation facility is public in Mexico City, in the sense that the government pays for it. Even though all restaurants are required by law to provide free access to toilets for both clients and non-clients, many restaurants in Mexico City either ask for a fee or have codes or locks to enter sanitation facilities. Similarly, public facilities such as toilets in parks or metro stations have established entrance fees that cannot be avoided. Daily expenditures on water and sanitation services have always represented an economic burden for people experiencing homelessness.
Covid-19 enlarged this burden, with many of the new facilities that were open increasing their prices and the income of the population experiencing homelessness negatively impacted due to the closure of businesses and the reduced number of people on the street. This meant that even if they were able to find an open sanitation facility, they would still need to find the economic means to pay the entry fee.
During the height of the pandemic, workers form El Caracol reported an increase of violence in reports of discrimination and violence against the homeless population.
"The police became more aggressive towards the population. It almost felt like the virus was a justification for such attitudes." – Anonymous interviewee
This could be linked to media reports suggesting that people experiencing homelessness were infectious and carriers of the virus. A report from COPRED states that certain members of the homeless population even had bleach thrown at them with the aim to disinfect them. As a consequence of this, some people experiencing homelessness reported being denied access to the few open sanitation facilities in the city.
"They think I have the virus, so they don't let me in." – Anonymous interviewee
Access to sanitation is a human right that governments must guarantee and cannot treat as charity or assistance. According to the human rights to water and sanitation, sanitation services must be available, accessible and affordable and must ensure the safety and privacy of the person using them. While the closure of public facilities and businesses is an indirect consequence of the pandemic, it highlighted the importance of the provision of public services that are available, reliable and affordable for everyone, even in times of crisis.
While many major cities do not have the proper infrastructure or incentive to provide access to sanitation facilities, governments still need to ensure that the human rights to water and sanitation are fulfilled for everyone. This means that public policies need to be guided by the normative content of human rights. In this sense, governments need to make sure that the needs of the most vulnerable populations are addressed in policymaking and planning processes. Suggestions to ensure the inclusion of the homeless population and other vulnerable groups in water and sanitation policy processes include participatory workshops to offer them a platform to raise their concerns and needs. Furthermore, the provision of information that allows them to locate the available WASH services in their area, the creation of token schemes that allow them to enter the facilities without spending a large amount of their income on it and the certification of toilets that are safe and accessible for anyone by the city could be great first steps towards ensuring the realization of the human right to sanitation.
Toilets should not be seen as a luxury. They are essential services that have a direct impact on the health and dignity of all individuals and providing access to them is essential for the realization of other human rights, in particular the right to life.
El Caracol is a civil society organization that contributes to the visibility and social inclusion of people experiencing homelessness in Mexico City through research, health campaigns and advocacy. It works through a care model based on well-being and good treatment that promotes a life off the streets.
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