CommentsOn October 25, 2017, protestors from the Catholic Worker and the LA Community action Network entered Los Angeles City Hall carrying covered toilets protesting lack of hygiene among homeless who have an outbreak of hepatitis A. The protestors tried to deliver the toilets to Mayor Garcetti.
The Los Angeles Times reported October 26 that the City Hall Security Desk stopped the toilets saying because they were porcelain “and no glass was allowed in the City Hall.” Skid Row residents wrote messages on the toilets and had previously brought the toilets to City Hall. Protestors also occupied 4th floor bathroom stalls where the City Hall council offices are located from 9:45 am-2:00 pm. protesting lack of toilets for the homeless.
Governor Brown has declared California’s hepatitis A outbreak an emergency on October 13. Fourteen people have the disease in Los Angeles and 71 in Santa Cruz. In San Diego 19 have died from hepatitis, over 490 have the disease, and 351 people have been hospitalized in the deadliest outbreak of the disease in 20 years. Most of the victims in these three cities have been homeless who lacked 24-hour public restrooms and hand washing facilities. Since hepatitis A can have a 15-to-50 day incubation period, people unaware they are infected can spread the disease through food or water contaminated by fecal matter or lack of hand washing. The LA Times said in “LA’s hepatitis A outbreak” that “the existence of even a handful of cases among people who live closely together, often share food and utensils, and cannot easily track their contacts is a blueprint for a potentially massive outbreak.”
In downtown Los Angeles Skid Row the city has only nine toilets for 1,800 people at night. 61,000 homeless are in the LA area with many living in tents along the Los Angeles River or under freeway underpasses have nowhere to wash their hands in the city and county. The demonstrators have asked for 164 toilets and wash stations for Skid Row to bring the area up to hygiene standards that the United Nations “sets for Syrian refugees.” Ruben Martin Garcia, who lived on Skid Row for 24 years, said, “We’re not asking for gold toilets with diamonds and emeralds. We’re just asking for some … toilets.”
City officials had promised to put up 10 more toilets in Skid Row by mid-September but by September 17th the toilets weren’t installed. The city then said by mid-October they would install a mobile “hygiene center” for Skid Row on a city-owned parking lot with toilets, washing stations, showers, and half a dozen stacked washers and dryers but didn’t.
Councilman Jose Huizar, whose district includes Skid Row, and Mayor Garcetti’s spokesman Alex Comisar both said they are working on getting new toilet facilities for Skid Row. The City Council has a discussion on the issue for October 27, 2017, on how to bring emergency portable toilets to the homeless. Councilmen Huizar, Mike Bonin, and Marqueece Harris-Dawson have agreed on a motion that in two weeks staff should report on portable toilets. Jed Poole, supervising coordinator at the Catholic Worker said, “The number [of people] on Skid Row … deserves human dignity and human rights. They deserve to not have to piss and shit on a sidewalk, and then have to be criminalized for it.”
LA City Council Mike Bonin secured funding to have public restrooms open 24-hours a day near Venice Beach, but the City hasn’t used the money yet. Bonin, who has worked for months on increasing restrooms for the homeless, asked the City Council to fund emergency portable toilets on Venice Beach and a mobile toilet-and-sink program like San Francisco’s. “The current situation is neither tolerable nor humane, and it is a risk to public health,” Bonin said
Hand washing or vaccinations are ways to stop the spread of the disease. LA’s Department of Public Health Los Angeles has started a vaccination program in homeless shelters, community clinics, service providers, and on the streets. Though persuading the homeless to get vaccinated is difficult.
The first week 1,200 people had been vaccinated, but that leaves 50,000 more people—drug users, the homeless, medical providers, jail inmates-- to vaccinate.
The hepatitis outbreak in California shows how lack of decent housing endangers public health. The first modern study of hookworm the National School of Tropical Medicine at Baylor College of Medicine in Houston showed hookworm, caused by lack of sewage treatment, is very common in Lowndes County, Alabama, which is 75% African-American and very poor. In Lowndes, the average income is $18,046 a year, and elementary waste disposal sanitation is “often non-existent.” 34% of the people in a new study tested positive for hookworm.
Scientists once thought that hookworm, a disease associated with dire poverty, was prevalent during in the 19th and the early 20th century among both blacks and whites in the South, but had died out by the 1980s. The hookworm parasite, after entering the body, can after months or years cause iron deficiency and anemia, weight loss, tiredness, and impaired mental function so that children do poorly in school and become impoverished adults. Civil rights protestors led by Martin Luther King in 1965 marched through Lowndes County from Selma to Montgomery, Alabama, for voting right for blacks, but voting rights have not improved the poor sanitation.
The Guardian describes how in Lowndes County children are “playing feet away from open pools of raw sewage; drinking water pumped beside cracked pipes of untreated waste …. “ The Baylor study found that 73% of the residents in the study have been exposed to “raw sewage washing back into their homes as a result of faulty septic tanks or waste pipes becoming overwhelmed in torrential rains.” Anthony Thigpen, a community activist, said his cousins who live in a trailer park with bad sewage pipes say they are disgusted by it but “there’s no public help for them here and if you’re earning $700 a month there’s no way you can afford your own private sanitation.” 80% of Lowndes County is not covered by any municipal system. Most blacks in Lowndes Country are much too poor to upgrade their septic tanks.
Catherine Flowers, founder of Alabama Center for Rural Enterprise (ACRE), a non-profit that uncovers the root causes of poverty in rural Alabama, says, “Our billionaire philanthropists like Bill Gates fund water treatment around the world, but they don’t fund it here in the US because no one acknowledges that this level of poverty exists in the richest nation of the world.” Scientists from Houston who did the first study want now to conduct a larger study, and estimate as many as 12 million people in the U.S. could have neglected tropical diseases in the South and the Midwest. Dr. Peter Hotez, dean of the National School of Tropical Medicine, told the Guardian that the study’s results were a “wake-up call to the nation.”
The New York Academy of Medicine (NYAM) in October, 2016, also had a study that reported that bad housing causes many health problems. Metro USA New York reported that the NYAM study cited how in East Harlem, a very poor neighborhood, residents since 2011 have lost 2,000 units of affordable housing and estimates predict they will lose 6,000 more units in the next 10 years. Lacking housing they could afford, residents have increased homelessness and their health suffers: they have “high rates of hypertension, diabetes, asthma, infant mortality, drug addiction, and mental issues.”
A lead author of the NYAM report Kimberly Libran said that the report’s findings could apply to other communities in New York City as well as other cities. Holly Slaton is one such tenant who reports that tenants in her building experienced months of loud, hazardous construction that left many sick: “My daughter and I suffered months of respiratory infections, where our doctor told us to wear a dust mask in our own home. A woman downstairs report having her eye swollen shut as a result from a sinus infection which we also believe was caused by the dust we were forced to breathe in our own homes.”
Brandon Kielbasa of Cooper Square Committee, which advocates for affordable housing, says that tenants in gentrifying neighborhoods face both unhealthy housing and intense psychological turmoil: “The physical act of converting affordable housing to luxury brings with it an unhealthy, unsafe, and often toxic environment for tenants.”
The connection between bad housing and bad health has been known for over a hundred fifty years. In the 19th century as huge populations in both Britain and the United States poured into the newly industrializing cities, communal wells provided water and few cities had facilities that removed sewage. The poor lived in cramped tenements where infectious disease spread: epidemics of cholera, small pox, tuberculosis, and typhoid fever occurred regularly. In England Dr. John Snow discovered in 1854 how a cholera epidemic was spread by polluted water. The Public Health Act in 1875 in England made local cities provide sewage disposal facilities and clean water for all. Also in many U.S. cities public health officials installed sewers and hygienic water systems and death rates fell drastically.
In Los Angeles KCET TV did a story “Addressing South L.A’s Slum Housing and Indoor Air Pollution” where Lizzeth Henao Rosales reported that South Los Angeles, which is largely black and Latino, has 69% renters in some of the oldest housing in the city.
Vilma Marroquin lived in a building in South Los Angeles owned by a notorious slumlord William Little. The building has “a severe pest infestation, including cockroaches and bedbugs, crumbling walls, and leaking plumbing.” The landlord’s use of toxic pesticides caused Marroquin’s two children to have severe health problems needing multiple visits to the emergency room: once her son “stopped breathing a day after her unit had been fumigated.”
Marroquin became a tenant leader in Strategic Action for a Just Economy’s campaign for healthy housing which advocates use of Integrated Pest Management (IPM) that requires “significant repairs to the crumbling infrastructure and a holistic view of the building as one unit.” Marroquin filed complaints with City of Los Angeles Housing and Community Investment Department as well as the Los Angeles County Department of Public Health. Her physician wrote letters for her two children demanding the landlord stop using toxic chemicals. Her landlord started using non-toxic pesticides and patched some holes in her apartment, but not for other apartments, so the building still has a severe pest infestation.
The World Health Organization by 2017 has said that adequate housing should protect against communicable diseases; protect against injury, poisoning and chronic diseases; and reduce psychological stress to a minimum. Currently some of the major health problems in the U .S. from poor housing are water seeping into a home and poor ventilation that increase moisture leading to pests—cockroaches, rats, and mice-- and to mold—two known triggers of allergies and asthma. High lead levels from housing with very old lead pipes results in learning disabilities, neurological problems, and even death. Aging and poorly built homes also increase risk for chronic respiratory infections. Poor cooling in homes during heat waves can lead to the elderly having heat exhaustion and death from heat stroke while poor heating during winter helps facilitate diseases. Inner city neighborhoods that are food deserts lacking grocery stores with healthy fruits and vegetables lead to higher rates of obesity and its diseases than in wealthier neighborhoods with grocery stores.
As the nation’s housing crises worsens with less affordable housing, then corresponding health problems will also increase among the homeless and among population forced to double or triple up—seven people living in a one-bedroom apartment, for example—increasing the spread of disease. The recent epidemic of hepatitis A in San Diego, Los Angeles and Santa Cruz as well as the National School of Tropical Medical at Baylor Medical School’s recent study of hookworm among the poor blacks in Lowndes County, Alabama, are indeed wake up calls to the nation.
(Julia Stein is a poet and an activist. She lives in Los Angeles.)
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