Health
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NEW YORK — Four years after she left a city homeless shelter, Ayana James, a domestic violence survivor, still carries personal belongings — toothpaste, sanitary pads and a fresh change of clothing — in a bag along with a stack of resumes and some oranges. Memories of icy showers where sexual predators lurked prepared James to be ready to wash anywhere.
“You don’t want to be embarrassed, so you take a change of clothing,” said James, 36. “Bras, panties, deodorant — that’s what I got in there.”
As New York City grapples with historic levels of homelessness, staying clean is part of a daily struggle for thousands of women, including 3,262 single women, who live on the streets, where maintaining a sense of dignity is a time-consuming and potentially dangerous endeavor.
Debbian Fletcher-Blake, assistant executive director of Care for the Homeless, which provides medical care at 25 city clinics, said medical providers face an “overwhelming” tide of women seeking care. Homeless women, she said, face steeper medical challenges than their male counterparts. Minimal access to safe sanitary spaces, for example, puts women in risky situations.
“It’s survival of the fittest,” said Fletcher-Blake, a registered nurse. “A woman can't pee behind a tree like a male can. A woman gets her period. It’s hard for her to wash up. If she’s a heavier woman, she can develop skin infections or an abrasion under the breast.”
Cleaning oneself can also remind women of the appearance they once maintained before a life on the streets. At the Bowery Mission’s Women's Center in Harlem, which opened in June after a spike in levels of homeless women, residents are required to shower and make their beds daily. Re-establishing a hygiene routine is key to recovering a sense of self, said Cheryl Mitchell, the center’s director.
"Self-care and the ability to receive care in this setting helps to build a woman’s self-worth and value," she said.
For the homeless, even the basic tasks of taking showers and maintaining good hygiene can be daunting. For women, in particular, staying clean can be even more challenging. Al Jazeera spoke to two women about their hygiene practices.
A handful of other shelters provide showers where the homeless can wash and receive a fresh change of clothing. At Part of the Solution (POTS), a Bronx shelter, volunteers sorted jeans on a recent December morning in a basement distribution center. Mostly men’s gray winter coats hung in front of them, and a woman’s beige leather jacket stood out.
Program manager James Brannigan said a group of about five homeless women have become regulars at the facility. Until recently mostly men would sign up for a spot in one of the three showers on site. “I have seen the upswing of women coming in,” he said.
Some women Brannigan receives still wear wristbands from their admission to a nearby hospital. He said women check into the hospital to stay safe and wash when no other options remain on weekends. Outside POTS' shower hours of 8 to 10 a.m. Monday through Friday, homeless women in the area are forced to wash up elsewhere.
“A woman can get her period at any time,” said Fletcher-Blake. “She just wants to wash up and feel fresh at 4 p.m. and not just at 9 a.m.”
Faced with dangerous conditions — sexual assault and theft are common issues — at many shelters and restrictive operating hours for showers, women have become “extremely resourceful,” said Fletcher-Blake.
Some live in their cars, which they park close to hotels or gyms. Other women spend the little money they have to access showers via gym memberships. Others say they avoid drinking during dinner to avoid having to use the restroom at night.
But that practice comes with risks. Curtailing water consumption to avoid using restrooms is a common cause of urinary tract and bladder infections in women, according to a recent United Nations report. The study criticized “the degrading condition” women face accessing safe facilities during their menstrual cycles.
Maribel Guillet, a single mother of a special-needs son who has lived in a Bronx shelter for over two years, said she tries to wash at her uncle’s apartment during weekends. That way, her son can avoid using the shelter’s facilities. The freezing temperatures in the shelter have exacerbated her asthma, she said, which prompted her visit to Care for the Homeless on a recent winter morning.
“I try to not let him drink liquids at night so he doesn't have to be go to the bathroom at night,” said Guillet, 36. “I don't trust the people there. I don’t know who’s who.” Sometimes the shelter’s showers are too dirty to bathe her son there, she added. “I had to disinfect, so I’m always buying stuff to clean before he’s in the shower.”
For Guillet, who said her period typically lasts about 10 days, with heavy bleeding that requires changing her sanitary pad “every 20 minutes,” the shelter’s bathroom restrictions become particularly cumbersome. “Sometimes the lady's nice. Other ladies is not,” she said, referring to shelter supervisors. “Some of them won't work with you.”
Many shelters and homeless centers hand their female residents female hygiene products, along with toothpaste and shampoo. But social workers said that pads and tampons are often harder to source from public donors.
Rosanna Montilla, an associate at Care for the Homeless, said the organization is running out of tampons. Its latest donation drive in November yielded just one contribution of tampons, she said. Similar problems plague its sister branch in Orlando, Florida, where a University of Central Florida student recently launched a fundraising campaign to buy menstrual products for homeless women.
“It’s not one of the items that people automatically think of when they donate toiletries,” said Montilla. “When you get to specific items like female hygiene products, you have to specifically ask for it.”
It’s hardly the only need of homeless women, but the struggles to stay clean can be a confounding factor. A recent study of 328 mothers in the city’s shelter system that Fletcher-Blake helped direct, one-third of women screened positive for depression. Of those who participated in a follow-up study, only 12 reported receiving treatment for their condition in the last three months, despite some showing severe trauma and anxiety.
“As homelessness explodes,” said Fletcher-Blake, “more resources are necessary to take care of women who have experience with any type of trauma in their lives and on the streets.”
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