How public washroom access impacts people with digestive disease

Update: despite multiple tweets and emailing Shane/CBC directly, I never got a response.

Apparently my post about the accessibility of "car-free" and transit for people with chronic illness has now become part one of a series of posts on chronic illness and urban life. I caught something interesting on the CBC the other day. Shane Foxman did a small segment covering a protest held by the Raging Grannies calling for public washrooms in the transit system. You can watch the short video segment here. At the end, he asked for feedback, so here it is.

Public Theater
Photo by Susan Sermoneta

Dear Shane,

The thing that struck me most about the segment was how you seemed to think this issue was funny, or not so much funny, but a bit of a joke. Several of the people interviewed on the issue brushed it off, saying "just hold it" or "be more prepared" or some variation of that response. That indifference was the main sentiment of the bit was baffling, and something I could only chalk up to either complete ignorance, or less offensively, lazy reporting.

Fact of the matter is that the lack of public washrooms in Vancouver, and specifically in the transit hubs and skytrain stations, is an enormous barrier to a large variety of people. The elderly, people with bowel and bladder problems, and of course children, all have varying abilities to "just hold it". It's not a joke, it's not funny - it has a severe impact on peoples' lives.

Shocking numbers

Let's look just at bowel diseases, since that's the segment I can relate to most:

Any way you slice it, there are thousands upon thousands of people in Vancouver living with some kind of bowel disease or digestive disorder, and you can be pretty well guaranteed it affects their washroom access needs.

Significant impacts on quality of life

Crohn's and Colitis Canada outlines some of the basic effects of lack of washroom access for people with bowel disease:

Humiliation

It should come as no surprise that three-quarters of respondents have not only been embarrassed but at times humiliated when asking for permission to use bathroom facilities. It is no small thing to be in a panic over the urgent need to use a bathroom and then have to negotiate with someone for access to a toilet.

The concern about soiling oneself is not an overblown fear. Our survey told us that 44 per cent of respondents have experienced an accident because they have not been able to get to a toilet in time. 

No one should have to experience that kind of humiliation.

Lifestyle Changes

For someone who suffers from Crohn’s or colitis, the lack of toilet access significantly alters their freedom and mobility. In fact, more than three-quarters of respondents told us that they chose to stay home when they are experiencing a flare-up, in case they can’t find a bathroom.

As a result, activities are often curtailed when flare-ups occur. This includes restrictions on sports, vacations, socializing with friends, shopping and entertainment. Travel for work can also be affected. Nearly three-quarters of respondents restrict their travel during a flare-up; 69 percent avoid public transit and even shy away from driving in case an urgent need arises and no bathroom can be found... 

In a CBC story from a few years back on the impacts of IBD, the executive director of research at the Crohn's and Colitis Foundation of Canada, Dr. George Tolomiczenko emphasizes this:

[A]nd that's one of the biggest challenges that people living with IBD face. The disease often causes them to avoid many activities and situations because of the fear that they might not have easy and quick access to a washroom... 

That's right folks, shitting your pants isn't as funny as Margaret Cho makes it sound.

The impact of this can't be underestimated or minimized. This is a very real and very urgent situation for many people who may not even have a minute to reach a washroom when symptoms hit. In another CBC article from this spring about a phone app developed by Crohn's and Colitis Canada to help sufferers of digestive disease find publicly accessible washrooms, Crohn's disease sufferer Jennifer Wakeford talks about how much washroom access would help her:

[Lack of public access to washrooms] limits what you're willing to do, where you're willing to go, just because you don’t know if you have access to a washroom which is so important... A lot of people don't really understand. It's not like you have the ability to hold it. You need to go to the washroom right away. So, having the knowledge that you can go to a certain business and utilize the washroom is great.

Think this is an exaggeration and people with digestive disease don't shit themselves on public transit because they can't access a bathroom? Think again. This isn't a story that happened in Canada, but it's one that someone was willing to share about being on a bus and not making it to a washroom in time.

Personally...

Lack of access to washrooms is the #1 reason of two main reasons I rarely use transit anymore, as much as I'd really like to. (#2 is that despite being fairly mobile, my severe fatigue and low blood pressure make standing and walking for long time periods very difficult, and unfortunately the bus line that I live nearest is ridiculously unreliable, and I board at a stop with no seating.) If I knew there was going to be an easy to access washroom at every skytrain station, that would enable me to confidently travel on skytrain, and also have a safe zone near the stations.

Over the past year, as my digestive flares have been more severe than ever, I've found myself having to be even more careful about where I go - a flare necessitating washroom access can come out of nowhere, with mere seconds of warning. It severely restricts my ability to be out in the world, so I limit my outings as much as possible when I have any uncertainty about the stability of my digestive system (which is pretty much always). 

I'm just one person, but like I said, there are thousands upon thousands in this city who are affected by conditions that lead them to require washroom access with little notice. There are so few public washrooms in Vancouver, and even if you're nearby to a business, they often refuse access, leaving people like me not only in severe physical pain and discomfort, but also with the prospect of having to run around seeking a washroom when ill, or suffer the unfortunate, and traumatic, consequences.

Some might argue that the bathrooms are too expensive to install or keep clean - but I have used public washrooms in other big cities, some which charge a small fee, and I can assure you: it's better than nothing. Some of them, particularly the pay ones (not that I completely agree with charging for access, as people who are poor also have bowel and bladder problems!), were actually very clean and felt quite safe. 

"Go Here"

This issue is so significant that Crohn's and Colitis Canada has developed a phone app (currently in re-development) and decal program called "Go Here" (previously called "Can't Wait") that helps connect people with bowel disease with publicly accessible washrooms. There's a great video segment about the program from CBC Calgary, I encourage you to watch.

I can't wait until the app is re-released, I'll certainly be using it.

So Shane, I ask you to take think a bit harder and have a little more empathy about this issue. Instead of using your position as a journalist to make a joke out of something significantly impacting a lot of people, maybe you'd consider giving their voice and cause some more serious air time?

Sincerely,

Ariane Khachatourians

Comments

I've been pretty lucky in that my allergies and various food intolerances have never led to a traumatic outcome while out and about. But I know friends for whom it has--completely unnecessarily. Every building they pass has a working toilet. Every. Single. One.

Accessible, available, free public toilets are a human right and should be regarded as such.

I couldn't agree more - toilet access should never be refused to someone in need. Though I think publicly provided washrooms are a very important part of this, so that businesses aren't burdened cost-wise, when making up for the complete lack of public facilities. 

Especially in countries where there ARE ample toilet facilities, nobody should have to go through the trauma and stress of publicly soiling themselves. Nobody should even have to worry about this to the point where they have to restrict their mobility, social lives, ability to work, ability to use public transit. All because of lack of access to a toilet!

This is an issue that is all too personal for me, and has been for years. While I don't necessarily understand the specifics of bathroom shortages in Vancouver or more specifically with regards to Vancouver transit, I have lived all over the country and experienced similar problems no matter what urban centre I'm in. The problem seems to be that there are alot of washrooms in public places, that are simply not allowed to be used by the public. While I understand the reasoning behind the rules that proprietors follow with regards to the use of their facilities, it does not take into account the people in the public who really do NEED the washroom.

I have many bad memories of times when I've had some kind of bowel attack while in a public place, and when asking to use the bathroom, they say "I'm sorry, we don't have a public washroom." And you KNOW they have a washroom for staff, and you understand their reasons for hesitation, so you're trying to say "Ummm its an emergency", hoping they see the desperation on your face, while you stand there in excruciating pain with cramping and dizziness and the very real possibility of soiling yourself. And the workers have NO concept. If you're lucky, they'll let you in. If you're not, you're stuck walking somewhere else, hoping to find a bathroom in reasonable time.

'Urgency' and 'emergency' are very different...people with bowel disease of any kind, even IBS, can be in sudden, excruciating pain, often accompanied by vasovagal syncope, headaches, sweating, anxiety, etc...and it is only relieved by using the washroom. While this is not a glamorous issue to discuss, it is as real of a problem as not being able to access a building due to mobility issues.

Exactly - it baffles me how people can be so cold to those who are legitimately in distress! And I'm glad you mention the vasovagal syncope. I have low blood pressure and often get really dizzy when I'm having a severe flare - nothing like being worried about BOTH pooping your pants and passing out...

I've often wondered if threats of what they'd have to clean up would help, but I've so far been too polite (embarassed?) to suggest such a thing...

What's amazing to me is if someone were nauseated and got sick to their stomach, the concern and empathy for that is (understandably) instant and genuine. "oh that poor person, must have the flu or food poisoning". However the overall attitude regarding bowel issues would be as was stated here, just hold it.

The complex and multi-staged efforts I make in anticipation of the possibility of issues is extensive, expensive, and difficult. I won't even eat at restaurants with men's rooms that have only one stall.

Couldn't agree more - the embarassment and judgement around bowel issues and needing to poop are incomprehensible to me! Like the book says, everyone poops!

My life is also horribly controlled by plans around bathroom access, it is really ridiculous to have to go to such lengths and miss out on so much, when there could be better access with so little effort on the behalf of businesses and local goverments...

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