Hygiene Conditions Still Substandard: Or Hygiene Standards in San Francisco’s Shelters Still Too Low
It is a sad state of affairs when one of the city’s best shelters has failed to address poor hygiene in its facility. In a site visit conducted by the Shelter Monitoring Committee on November 26, 2006, Hamilton Family Shelter—a shelter which had been one of only six that met basic health and hygiene criteria—was found to have bathrooms in which, “the majority of shower curtains had or smelled strongly of mold.” Because of this, the Committee strongly recommended that these shower curtains be replaced.
In an interview I conducted on April 12, 2007, this recommendation had obviously not been taken into account: “I have noticed that in a couple of bathrooms the shower curtains have been really dirty,” said one of the residents at the shelter. “Some of them even have mold on them.”
This issue has not only been ignored when brought to light by the Shelter Monitoring Committee, but also when it has been an expressed concern of the residents living at the shelter. Hamilton Family Shelter conducts weekly meetings to allow shelter residents to express problems or to make suggestions regarding the shelter programs and facilities. However, with regard to the soiled shower curtains, these concerns seem to have been ignored.
“We’ve brought it up at the meeting a couple of times but I don’t know whether or not the shower curtains have been changed,” said the resident. She went on to admit that nothing had been done to correct the problem.
In addition to this, the Shelter Monitoring Committee reported that the bathrooms at this shelter had smelled like mold. The resident with whom we spoke also complained about the bathrooms not smelling completely clean.
“When I walk into a bathroom I like to smell that it’s clean,” she said. She tried to put her finger on exactly why the bathrooms didn’t smell clean, finally stating, “The cleaning solutions they use… there’s a different smell.”
However, maybe it was not the cleaning solutions that smelled, but the mold. According to the Center for Disease Control, “Molds produce a variety of volatile organic compounds, the most common being ethanol, which are responsible for the musty odors associated with fungal growth.”
Mold, especially in areas where it is likely to come into contact with skin or where it is likely to be disturbed, can cause adverse health effects. When mold is disturbed, it aerosolizes, meaning that the spores go into the air where they can be inhaled. According to the Center for Disease Control, “Inhalation is usually presumed to be the most important mechanism of exposure to viable (live) or nonviable (dead) fungi, fungal fragments or components, and other dampness-related microbial agents in indoor environments.”
On the floor for emergency shelter residents, up to 30 people will use one shower. This means that any mold on these shower curtains will be disturbed and can become airborn up to 30 times per day—every time someone goes in or out of the shower, rustling the curtain. Higher exposure means that these residents, who are experiencing the most trauma, are more likely to contract mold-related diseases.
Health problems related to exposure to mold usually occur on an individual basis. People with lowered immune systems or who are sensitive to allergens will usually develop allergic symptoms, such as runny or itchy nose, nasal congestion, sneezing, and a sore throat. In addition, mold exposure can cause lower respiratory symptoms such as coughing and wheezing. For children or adults with asthma, this irritation will worsen the illness, sometimes causing pneumatic-like symptoms.
Not only can inhalation of spores from mold cause allergic reactions, it can also cause people to develop influenza-like symptoms, which the Center for Disease Control calls “inhalation fevers.” Symptoms of this type of response to mold inhalation include fever, headache, extreme tiredness, cough, sore throat, runny nose, body aches, and even diarrhea and vomiting.
Exacerbating this mold problem, the resident also noted that there had been a problem with possible exposure to fecal matter from a backed up toilet. Apparently, it had clogged and was rimmed with fecal matter.
“The water was just backed up and it took some time to get it cleaned, or whatever they had to do, because it was like that for like four days,” she stated. “When you walked into the stall it was just like really black inside and the bowl was drained, but it was just, like, really black.”
Apart from the disgusting sight and smell of a clogged toilet, leaving feces to sit in a bathroom for four days causes massive health risks. Feces are known to spread multiple diseases upon contact, including meningitis, E-coli, giardiasis, and a host of other diseases sharing similar symptoms. The most common symptoms from viral and bacterial infections caused by accidental ingestion of feces (even in very trace amounts) are diarrhea, nausea, vomiting, and stomach cramps. The symptoms last anywhere from two days to two weeks, depending upon the infection, and can lead to severe dehydration. Although it may seem like a clogged toilet would not lead to this type of exposure, considering the fact that this is a family shelter, it would be unwise not to be concerned about children coming into contact with this fecal matter. Specifically looking at giardiasis, the Center for Disease Control notes that one cause of infection may come from, “accidentally swallowing Giardia picked up from surfaces (such as bathroom fixtures, changing tables, diaper pails, or toys) contaminated with feces from an infected person.” Also, with infections such as this, people are often carriers, not showing symptoms although they are infected.
The resident who was interviewed at Hamilton Family Shelter had actually begun experiencing these symptoms the week before I conducted the interview. Although she felt that she had contracted a communicable disease that, according to her, had affected most of the residents at the shelter, she also noted that she wasn’t sure how she had gotten sick. First, her seven-year-old son got sick. He would hardly eat and had stomach cramps and a fever. Her husband was next, but barely showed any symptoms.
The resident with whom I spoke was hit last, however, and suffered the worst. According to her, she vomited four times, felt fatigued, and had horrible diarrhea. “I was going to the bathroom all night long,” she said. “It was so bad I had to wrap a towel around my waist.” Luckily, she knew to drink liquids to keep her from getting extremely dehydrated, but the illness still lasted a week, almost three times longer than any illness she had experienced in the past, and kept her from getting the rest she needed.
This resident had previously been a victim of domestic abuse and still suffers from insomnia. On top of this, she had spent the past few months hopping from emergency beds to normal rooms at the shelter, filling out mountains of paperwork each time. This had caused her to not only lose sleep, but also to miss much needed visits to her psychologist to aid in easing her symptoms of PTSD. This was a woman who could not afford to get sick.
Whether this resident had contracted influenza-like symptoms from exposure to mold, one of the many infections related to contact with fecal matter, or simply a communicable disease that had spread like wildfire through the whole shelter, it is apparent that problems with health and hygiene intensified her symptoms. Leaving moldy shower curtains in a bathroom or waiting a few days to fix a clogged toilet may not seem like massive problems, but in a shelter where families with young children live in very close proximity to each other, these are huge problems. Many of these families have about sixty days to find permanent housing, and losing a week of that time has dramatic consequences. It is imperative to maintain a healthy living space so that families and their children can return to their normal lives as quickly as possible.
Katy
