Thirty-year-old Rasheed Clarke knows where all the bathrooms in downtown Toronto are. He has to, because when Clarke needs to go, he needs to go now.
“There have been times that I literally can’t hold it in,” he says. “I’ve had accidents because I haven’t been able to get to a bathroom on time.”
Clarke, a communications coordinator from Mississauga, was diagnosed with ulcerative colitis, a lifelong medical condition requiring urgent access to a washroom, in his second year at the University of Toronto. One out of every 150 Canadians suffers from this kind of inflammatory bowel disease (IBD), the principal types being colitis and Crohn’s. These conditions cause inflammation in the gastrointestinal tract and often require quick washroom access for those affected, as they experience frequent and urgent bowel movements that range from five to more than 20 times a day. Crohn’s and colitis are twice as common as multiple sclerosis and Parkinson’s disease.
But while 94,000 Ontarians suffer from IBDs, access to public washrooms across the province is extremely limited, according to Natasha Mistry, manager of public policy and stakeholder relations at Crohn's and Colitis Canada. Even though the incidence of IBD has steadily risen in children under the age of 10 since 2001, she believes it’s still not on the urban planning radar.
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“The U.S. has 14 states that have developed legislation enforcing open washrooms to those with medical conditions,” she says. “If you look across the ocean at Japan and cities like Paris, washroom access is part of the urban planning process. It’s part of the infrastructure they think about when they build new facilities. Here in Canada, we don’t think about creating washroom facilities. That mentality is not there.”
Even public transit in a major city such as Toronto lacks convenient washroom access. Of the 69 TTC stations, only 10 have washroom facilities. Mistry says this creates fear of using public transit for those who suffer from Crohn’s or colitis, which has implications for traffic as well as productivity.
“People say they would rather drive to work instead of taking public transportation because it avoids that humiliation they feel when they need to go urgently,” she says. “A lot of people who live with this condition become isolated and end up staying home. They don’t go out, they don’t engage in their community, they’re not productive citizens, because they can’t get access to washrooms when they leave their homes. If we’re encouraging people to be environmentally friendly and to cut down on traffic and gas emissions, we have to start thinking about these issues.”
According to Brad Ross, executive director of corporate communications at the TTC, retrofitting existing subway stations with public washrooms would be extraordinarily cost-prohibitive, not just from a build perspective, but also because of cleaning and maintenance costs that would be required on an annual basis. The TTC’s policy, he says, is to build public washrooms at terminal stations only.
“The TTC has many transit-related challenges with respect to its budget,” Ross explains. “Additional public washrooms beyond the existing policy is not something TTC staff is considering.”
But cities such as Toronto are still much better off than places such as the town of Guelph. With a population of over 125,000, Guelph still has not addressed an urgent need for after-hours public washrooms. Public fouling is still a problem in the downtown core, where large populations of students find themselves without nearby washroom options after bars and restaurants close. While ad hoc solutions such as rented toilets for special events and improved temporary signage are in place, there is no permanent solution on the horizon according to Ian Panabaker, corporate manager of downtown renewal at the City of Guelph.
“Full public washrooms that are 24 hours a day are a major operating public safety obligation,” he says. “It’s a perennial issue. When are we going to make the investments in permanent all day-all night washrooms? We haven’t made those commitments yet.”
One city where finding a nearby washroom should get easier is Ottawa. On Sept. 1, the city’s finance and economic development committee approved a proposal to create a mobile phone app to direct those in need to the nearest public toilet. If approved by city council, city staff will work with third-party developers to map the user’s location and the nearest open public toilet in a mobile application. The proposal was in response to pressure from the GottaGo Campaign, which lobbied for more restroom options available to people with medical conditions—and other types of people often in need of facilities, such as tourists, the elderly and pregnant women and parents with small children.
In Toronto, a similar app exists courtesy of a Crohn’s and Colitis Canada initiative called GoHere. GoHere has three components to help people find washrooms when and where they need them: a decal in the window of participating businesses, a washroom finder app for smartphones, and a washroom key card which serves as proof of a medical condition. Clarke thinks the decal would be an extremely useful feature, and he wishes more businesses would start using it.
“When I had more active colitis, five minutes was the maximum I’d be able to hold it,” he says. “Maybe 10 minutes and very, very uncomfortably. If we could walk by a store or restaurant with a decal and say ‘OK, this is safe place and a place that’ll understand my needs and I can go in there without feeling any embarrassment or guilt,’ I’d be very grateful. I’d probably go back there on a better day and browse just to see if there was something I could buy.”
As for the app, Clarke isn’t sure that it’s the most time-effective solution.
“Don’t get me wrong, it’s a great idea,” he says, “but sometimes you just need to be able to look around you, see a sign and go. When you really need to go, fiddling with your phone is the last thing on your mind.”
This article has been updated with additional attribution.