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Access to clean public bathrooms could be the key to flushing out Hepatitis A

A bathroom.
A bathroom.

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LA County declared an outbreak of Hepatitis A last week when two homeless people contracted the disease.

It's usually transmitted when a person comes into contact with objects or food contaminated by the feces of an infected person, and that might be more likely in a place like LA's Skid Row.

There are just nine public bathrooms serving the more-than 1,700 people who live there without a roof over their heads-- or indoor plumbing to call their own. 

Ricky Bluthenthal, a professor of preventive medicine at USC, found that not having bathrooms can lead to a laundry list of health problems among that population.

"Wound botulism is one. You can get sepsis. Abscesses. Skin and soft tissue infections," said Bluthenthal in an interview with Take Two host, A Martínez.

Homeless people mill around on a Skid Row sidewalk after packing up their tents for the day and before businesses open.
Homeless people mill around on a Skid Row sidewalk after packing up their tents for the day and before businesses open.
David McNew/Getty Images

But Bluthenthal also found that public restroom access is a slippery issue when it comes to serving homeless populations. People may use illicit drugs in the bathrooms, or even take the bathrooms over  altogether and prevent others from using them. And even if there are bathrooms for people to use, that doesn't always mean they're going to be clean. 

Bluthenthal has found that shelters will offer clean places to shower and go to the bathroom, but there aren't enough shelters for everybody to use all the time. Mobile hygiene units can also attend to the bathrooms, and reduce the risk of fecal contamination. 

"In the short term, figuring out ways for people to be safer and cleaner completely makes sense," said Bluthenthal. "And then, the other piece is, you know really engaging with the structural determinants of homelessness, and working on putting in place both the housing pieces and the social support pieces and the medical support that people need to come in from the outdoors in the long term. That would be valuable as well."

The key to all this? For Bluthenthal, there's no way forward if there's no political will. 

"If we engage with the [homeless] population, recognizing that there's diversity, they're going to be open to a variety of solutions. We can solve this before it gets any worse," said Bluthenthal. "But certainly, I don't want to see a situation where it gets worse and worse, and then there's some sort of crazy, most-likely-to-be draconian, response to it."

To hear the full interview and learn more about the relationship between public health and public restrooms, use the blue media player above.